Objective　To study anticipated value of the retention rate of indocyanine green at 15 minutes after injection (ICGR15) and oral glucose tolerance test (OGTT) on hepatic function reserve in patients with primary hepatic cancer (PHC). Methods　58 patients with PHC were divided into 3 groups according to the recovery after operation for PHC. Of them, 29 cases showed good recovery (group A), 18 mild liver dysfunction (group B) and 11 severe liver dysfunction (group C) respectively. ICGR 15, OGTT, routine liver function tests were performed in all 　patients preoperatively. Results　　ICGR15 in group C(24.17%±6.59%) obviously increased than that in group A(11.42%±3.91%,P<0.01) and in group B(16.28±6.07%, P<0.01). 　Blood glucose lever of 120 min after glucose loading test in group C (9.91 mmol/L±3.09 mmol/L)was significantly higher than that in group A(5.42 mmol/L±0.83 mmol/L, (P<0.01)and group B(6.68±1.61, P<0.01). 　The accuracy (81.0%,86.2%), positive (90.6%, 93.5%) 　and negative prediction value (72.5%, 74.4%) of OGTT and ICGR 15 were respectively significent greater than those of Pugh's scoring (P<0.01).Conclusions　ICGR15 and OGTT are worthwhile indicators to assess hepatic function reserve for patients with PHC. Combination of both ICGR15 and OGTT has higher predictive value on hepatic function reserve.

A new dynamic in vitro intestinal absorption model for screening and evaluating lipid formulations was established by means of the characteristics of the intestinal digestion and absorption of the lipid formulations. This model was composed of two systems, including intestinal digestion and the intestinal tissue culture, which drew the evaluation method of intestinal absorption into the in vitro lipolysis model. The influence of several important model parameters such as Ca2+, D-glucose, K+ on the two systems of this model has been investigated. The results showed that increasing of Ca2+ concentration could be significantly conductive to intestinal digestion. The increasing of D-glucose concentration could stepped significantly down the decay of the intestinal activity. K+ was able to maintain intestinal activity, but the influence of different concentration levels on the decay of the intestinal activity was of no significant difference. Thus the model parameters were set up as follows: Ca2+ for 10 mmol x L(-1), D-glucose for 15 mmol x L(-1) and K+ for 5.5 mmol x L(-1). Type I lipid formulation was evaluated with this model, and there was a significant correlation between the absorption curve in vitro and absorption curve in vivo of rats (r = 0.995 6, P < 0.01). These results demonstrated that this model can be an attractive and great potential method for the screening, evaluating and predicting of the lipid formulations.

This paper report the development of a new dosage form - self-microemulsifying mouth dissolving films, which can improve the oral bioavailability of water insoluble drugs and have good compliance. A three factor, three-level Box-Behnken design was used for optimizing formulation, investigated the effect of amounts of microcrystalline cellulose, low-substituted hydroxypropyl cellulose and hypromellose on the weight, disintegration time, cumulative release of indomethacin after 2 min, microemulsified particle size and stretchability. Optimized self-microemulsifying mouth dissolving films could fast disintegrate in (17.09 +/- 0.72) s; obtain microemulsified particle size at (28.81 +/- 3.26) nm; and release in vitro at 2 min to (66.18 +/- 1.94)%. Self-microemulsifying mouth dissolving films with broad application prospects have good compliance, strong tensile and can be released rapidly in the mouth through fast self-microemulsifying.

Solid carriers had important effects on the properties of solid self-microemulsifying drug delivery systems (S-SMEDDS). In order to make the basis for further development of S-SMEDDS, the influences of silica on the absorption of S-SMEDDS were investigated. An in vitro lipolysis model was used to evaluate the influence of silica on self-microemulsifying drug delivery system digestion from intestinal tract. S-SMEDDS containing silica were prepared by extrusion/spheronization. The drug release and absorption were investigated. The results showed that lipolysis rate and drug concentration in aqueous phase after intestinal lipolysis both increased by adding silica, which was benefit to drug absorption. And silica was not benefit to absorption for slowing drug release. Consistently, there was no significant influence of silica on intestinal absorption. This study implied that the influences of silica on lipolysis rate and drug release were both amount dependent and it is suggested that silica could be used as the solid carrier but the proportion needs to be optimized.

The distribution fate and solubilization behavior of indomethacin through the intestinal tract were investigated with in vitro lipolysis model, by comparing the Capmul MCM and Labrafil M 1944 CS type I lipid formulations. The results showed that the more favorable solubilization was in the aqueous digestion phase from each lipid formulations for indomethacin. The lipolysis rate and extent were decided with chemical constitution of the lipid excipients, which meant that less indomethacin was transferred from the long chain polar oil lipid solution into the aqueous digestion phase. Increasing the concentration of indomethacin in the lipid formualitons from a solution to a suspension led to a linear increase in the concentration of indomethacin attained in the aqueous digestion phase from lipid formulations. This study also implied that adverse effects of the lipolysis rate and extent on drug absorption were could be taken into consideration when screening lipid formulations. Lipid suspensions likely had better enhancement of drug absorption. Last, this study demonstrated that a potential basis for optimizing and assessing type I lipid formulations and also researching in vivo-in vitro correlations of lipid formulations were provided by an in vitro lipolysis model.

Objective To investigate the value of endoscopic papillosphincterotomy (EST) in the management of common bile duct stone and constrictive papillitis. MethodsFrom July 1987 to May 2001 746 cases treated with EST were analyzed retrospectively. ResultsThe rates of success in constrictive papillitis and functional disturbance of Oddi′s sphincter were 94.8% and 94.1% respectively. Forty patients (88.9%) with chronic obstructive pancreatitis caused by constrictive papillitis were alleviated and common bile duct stone were removed in 538(94.1%) out of 572 patients after EST. The incidence of complications (severe pancreatitis and hemorrhage) after EST was 2.2% and the mortality was nil. ConclusionEndoscopy is effective and minimally invasive treatment for common bile duct stone and constrictive papillitis.

Objective To assess the feasibility of hepatolithiasis treatment using laparoscopic liver resections. Methods A prospective study of laparoscopic liver resections was undertaken in selected patients with left intrahepatic stone, and these patients were operated by laparoscopic left lobectomy. Results Two cases were operated successfully. Mean blood loss was 400～600 ml. Conclusion Laparoscopic resections are feasible in selected patients with left intrahepatic stone and bring up a new method for hepatolithiasis.

10.3969/j.issn.2095-4344.2013.25.023

Objective To summarize the extra-bone joint characteristics of 18F-FDG PET/CT images in patients with adult-onset Still's disease. Methods Twelve patients with adult-onset Still's disease as confirmed by clinical and laboratory tests were enrolled in this study. The characteristics of 18F-FDG PET/CT images were retrospectively analyzed. Results Among the 12 patients, no patients were found with solid malignant tumors. Various degrees of high uptake were found in liver, spleen, bone marrow or lymph node. The hepatic SUV was 2.74 ± 0.89, the spleen SUV was 3.68 ± 1.24, and the SUV of thoracic spine was 4.36 ± 1.35. For the lumbar vertebral, the value of SUV was 4.26 ± 1.25. Lymph node high uptakes were found in 8 patients at different sites , including retroperitoneal , pelvic cavity and pelvic wall , inguinal bilateral neck , hepatic portal , axillary lymph nodes. The value of SUV was 3.76 ± 1.41. Conclusions 18F-FDG of AOSD has certain characteristics, such as diffusely uptake of liver, spleen, bone marrow, or lymph node, with or without pleural effusion.

BACKGROUND: Compared to other preparation method, chemical extraction can almost removed all cellular components,reduce the possibility of immunological rejection, and remain the integrality of nerve graft. However, there are still problems need to be explored.OBJECTIVE: To investigate the optimal condition of acellular nerve graft using Trito X-100 and sodium deoxycholate as extracting agent.DESIGN, TIME AND SETTING: Randomized grouping, controlled cytology observation. The experiment was performed at the Department of Stomatology, Affiliated Hospital of Binzhou Medical University, from February to June 2009.MATERIALS: Fifteen New Zealand white rabbits, aged 3-4 months, weighing 2.5-3.0 kg. Triton X-100 and sodium deoxycholate were provided by Sigma Company, USA.METHODS: The bilateral facial nerve were obtained from rabbits, and removed the adipose tissue and epineurium of the nerve surface under the surgery microscope, then divided these nerves into 66 segments, with each length of 10 mm. The 66 neurons were randomly divided into 11 groups, with 6 neurons in each group. Except the control group, all neurons were placed into Petri dish for 12 hours bathing using distilled water at room temperature, then 5 groups of which were cultured with Triton X-100 for 12,24, 36, 48, and 60 hours, oscillation at room temperature; the remained 5 groups were cultured with 3% Triton X-100 for 12 hours,followed by 4% sodium deoxycholate for 12 hours, repeated for 1-5 cycles.MAIN OUTCOME MEASURES: Haematoxylin-eosin staining; degrees of decellularization and integrality of fiber pipe.RESULTS: Only use Triton X-100 to deal with the nerve of New Zealand white rabbits, even if 60 hours, could not to remove all the cellular components, and the basement membrane of Schwann cells were greatly destroyed. After 2 cycles treatment of Trito X-100 combined with sodium deoxycholate, cellular components and myelin sheath of nerve fibers and axons were removed effectively, and basement membrane of Schwann cell was remained, with epineurium and perineurium could be seen.CONCLUSION: Oscillation accompanied by 2 cycles treatment of Trito X-100 and sodium deoxycholate can obtain acellular nerve graft by removing cellular components completely, and reserving integrated basement membrane of Schwann cells.