OBJECTIVE:To optimize the extraction technics of liver-strengthening cholagogue oral preparation.METHODS:The effects of the four factors-the quantity of the added water,the decoction time,the decoction times and the alcohol precipitation concentration on the extraction results were determined with content of total flavonoids taken as index.RESULTS:The best extracting condition was the following,the amount of the added water was 10 times that of the medicinal materials,the decoction duration was 60min,the alcohol precipitation concentration was 50%and the decoction was carried out twice.CONCLUSION:The preparation under this technics is of high clarity and stable contents.

In the interactive image-guided thermotherapy, we need the real time image and location of the target tumor. But the current mono-modal imaging technique can not do it. We present a method to register a preoperative 3D MRI volume to a set of intra-operative ultrasound images for the target localization of the liver tumor in the thermotherapy. The registration method is a genetic algorithm based on the features such as liver surface vessels and liver surface.
Humans ; Hyperthermia, Induced ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Liver Neoplasms ; diagnostic imaging ; therapy ; Magnetic Resonance Imaging ; Ultrasonic Therapy ; methods ; Ultrasonography, Interventional

The cluster sampling method was used and a retrospective survey on mortality trends of cerebrovascular diseases from 1989 to 2008 was conducted among residents from Erqi District in Zhengzhou city and Xigong District in Luoyang city. The average mortality rate of cerebrovascular diseases in these two districts was 69. 5/100 000 in 1989 to 2008. The standardized mortality rate for men was 118. 67/100 000 in 1989 to 1993, and dropped to 44. 23/100 000 in 2004 to 2008. The standardized mortality rate for women was 68.21/100 000 in 1989 to 1993, and dropped to 30. 2/100 000 in 2004 to 2008. The declining trends of cerebrovascular disease mortality rates might be related to early diagnosis and early treatment of the disease, and the extensive health education and prevention programs.

Objective To evaluate the clinical efficacy of acupuncture on sphenopalatine ganglion in the treatment of severe perennial allergic rhinitis (PAR) in a randomized controlled clinical trials. Methods A total of 81 patients with severe perennial allergic rhinitis were randomly divided into three groups: 27 in the observation group, 27 in the drug control group and 27 in the acupuncture control group. The patients in the observation group were treated with acupuncture on sphenopalatine ganglion; and the patients in the drug control group took Desloratadine; and the patient in the acupuncture control group were treated with acupuncture on Yintang (GV 29) and Yingxiang (LI 20). All the groups were treated for 4 weeks. The TNNS and VAS score system were tested before and after the treatment, and the nasal exhalation of nitric oxide (eNO) concentration level wa detected at baseline and each week's during treatments. Results After the treatment,the effective rate [80.8%(21/26)vs.64.0%(16/25),65.4%(17/26),x2=13.811]of the observation group was significantly higher than either the drug control group or the acupuncture control group (P<0.01). Compared to the score of the three group before treatment, the TNNS score was significantly lower (P<0.01) after the treatment. Compared with the drug control group, the level of eNO in nasal exhalation air (265.377 ± 36.475 ppb vs. 281.769 ±45.823 ppb vs. 295.231 ± 24.595 ppb, F=4.247) of the observation group and the acupuncture control group were significantly higher (P<0.05). Conclusions Acupuncture on the sphenopalatine ganglion can not reduce the eNO concentration level of nasal exhaled air in patients with perennial allergic rhinitis, but it can improve the symptoms of rhinitis. The clinical effect of acupuncture on the sphenopalatine ganglion was better than the desloratadine and acupuncture on GV 29 and LI 20.

Objective To analyze the clinical features of neuropsychiatric systemic lupus erythematosus (NPSLE) with convulsion or coma as the main manifestation to facilitate the improvement of such patients' diagnosis. Methods Ninety-two patients with NPSLE confirmed in Peking Union Medical Hospital from January 2013 to December 2016 were collected, 27 NPSLE patients with convulsion or coma were in the study group, and the remaining 65 cases were in the control group. The following items in the two groups were compared in order to discover the differences in characteristics between the two groups: including sex, age, the first NPSLE episode or not, history of systemic lupus erythematosus (SLE), kidney, blood, heart, lung, skin mucous membrane, gastrointestinal involvement and co-infection, cerebrospinal fluid (CSF) pressure, cerebrospinal fluid cell count, cerebrospinal fluid/serum protein ratio, cerebrospinal fluid/serum glucose ratio, cerebrospinal fluid/serum chlorine ratio, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complement 3 (C3), complement 4 (C4), magnetic resonance imaging (MRI) results, double strand deoxyribonucleic acid (ds-DNA) antibody, treatment status and hospitalization days. Results The number of CSF cells in the study group was significantly lower than that in the control group (×106/L: 91.84±25.37 vs. 279.52±101.12, P < 0.01). The skin mucosa involvement rate in the study group was significantly higher than that in the control group [14.81% (4/27) vs. 1.54% (1/65), P < 0.05]. Cerebrospinal fluid/serum protein ratio was higher in the study group than that in the control group (0.12±0.02 vs. 0.04±0.01, P < 0.05); the cerebrospinal fluid/serum glucose ratio was significantly lower than that in the control group (0.55±0.17 vs. 0.70±0.20, P < 0.01). The positive rate of MRI in the study group was higher than that in the control group [81.48% (22/27) vs. 55.38% (36/65), P < 0.05]; there were no significant differences between the two groups in other indexes (all P > 0.05). Conclusion Few cerebrospinal fluid cells increased involvement of skin mucosa, increased cerebrospinal fluid/serum protein ratio, decreased cerebrospinal fluid glucose/serum glucose ratio and increased MRI positive results were the clinical features of NPSLE patients with convulsion or coma as the clinical manifestation, early detection of this type of patients and early intervention can be beneficial to improve the prognosis.

Conversion therapy has become the core in the treatment of borderline resectable or unresectable liver cancer, which provides resectable opportunities for more advanced liver cancer patients. In accordance with the first-choice treatment regimen recommended by the guidelines, the authors reported a successful case of Atezolizumab and Bevacizumab (T+A regimen) conversion therapy. The patient with initially borderline resectable advanced liver cancer was performed liver segment resection sucessfully after conversion therapy, and non-tumor recurrence was observed at postoperative 9 months. Postoperative pathological examination showed combined hepatocellular-cholangiocarcinoma, which also indicated the important value of T+A regimen in the conversion therapy of combined hepatocellular-cholangiocarcinoma.

OBJECTIVETo explore the effect of continuous negative pressure drainage with intermittent irrigation on surgical site infection (SSI) after laparoscopic extralevator abdominoperineal excison (ELAPE).

METHODSClinical data of 28 rectal cancer patients who underwent continuous negative pressure drainage with intermittent irrigation following laparoscopic ELAPE (negative irrigation group) at our department from March 2016 to August 2017 were analyzed retrospectively. At the same time, 32 rectal cancer patients who underwent laparoscopic ELAPE and simple presacral drainage from January 2014 to February 2016 were included as controls (simple drainage group). Self-made double cannula: one silicon rubber drainage tube was used; 3 side holes were cut at the front end with 1-2 cm interval; tube was ranked intermittently and oppositely; a small hole was cut in the middle of rear; the infusion tube was placed through the small hole to the front side of the drainage tube (to rinse when the drainage was turbid). The placement and use of self-made double cannula: it was placed in the presacral space and was drawn from the medial to the sciatic tubercle, then was connected to drainage bag for 24 hours; when no blood was observed, the drainage tube was connected to negative pressure drainage ball, keeping negative pressure status. The development of SSI within 30 days postoperatively and other perioperative parameters were compared between the two groups.

RESULTSThere were no statistically significant differences in baseline data between two groups (all P>0.05). Incidence of SSI in negative irrigation group was significantly lower than that in simple drainage group [14.3% (4/28) vs. 43.8% (14/32), χ=6.173, P=0.013]. Additionally, a shorter postoperative hospital stay was observed in negative irrigation group [(9.8±1.5) days vs. (11.4±2.6) days, t=2.918, P=0.005]. Besides, other perioperative parameters, including operative time, intraoperative blood loss, time to removal of drainage tube, etc were not significantly different between two groups (all P>0.05). After adjusting to confounders, multivariate analysis showed that negative pressure drainage was an independent protective factor for SSI following laparoscopic ELAPE (OR=0.214, 95%CI:0.060-0.762, P=0.002).

CONCLUSIONContinuous negative pressure drainage with intermittent irrigation can effectively decrease the incidence of SSI following laparoscopic ELAPE, and is safe and simple.

Drainage ; methods ; Humans ; Laparoscopy ; Perineum ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Surgical Wound Infection ; therapy ; Treatment Outcome

Objective: In this study, black tea and Citrus maxima (BT-CM), yellow tea and C. maxima (YT-CM), green tea and C. maxima (GT-CM) as subjects, the active ingredient content and antioxidant activity of three tea and C. maxima (T-CM) were analyzed. The effects of three T-CMs on apoptosis of liver cells in vitro and its mechanism were further explored. Methods: National standard method and HPLC were used for active ingredient analysis. MTT, cell flow cytometry and Western blot were used to analyze the effects of three T-CMs on cell proliferation, apoptosis, and its underlying molecular mechanism. Results: The content of tea polyphenols, free amino acids, ratio of polyphenols and amino acids, ester catechins, non-ester catechins and caffeine in YT-CM and GT-CM was significantly higher than that of BT-CM. The in vitro antioxidant capacity of YT-CM and GT-CM was also significantly stronger than that of BT-CM. Three T-CMs had the effects of inhibiting proliferation, arresting cell cycle and inducing apoptosis in HepG2 and Bel7402 cells, especially YT-CM and GT-CM. Western blot analysis showed three T-CMs activated PI3K/AKT/mTOR signaling pathway and regulated the expression levels of apoptosis-related proteins Bax, Bcl-2 and Caspase-3/9. YT-CM and GT-CM had better ability to change the signal pathway than BT-CM. Conclusion: In short, T-CMs, which combined different degrees of fermentation tea with C. maxima, were rich in nutrients and biologically active substances. T-CMs, especially YT-CM and GT-CM, are healthy drinks that help to prevent and treat liver cancer.