BACKGROUND:In the past, the surgical treatment of patients with hemophilia B was difficult, the bleeding was difficult to estimate, and the wound healing was difficult. In the perioperative period, the control of coagulation factor IX activity in a safe range can ensure the safety of the operation, resulting in wel wound healing, good recovery, and no significant complications appeared in the long term. OBJECTIVE:To study essentials of perioperative diagnosis and treatment in omarthritis patients with hemophilia B undergoing humeral head replacement, and to analyze the importance on prognosis and rehabilitation. METHODS:The significance of surgical treatment for hemophilia B patients with arthritis, the prevention and treatment of perioperative complications were summarized through literature review. Humeral head replacement was conducted in a patient with hemophilia omarthritis by monitoring coagulation factor activity and infusing human prothrombin complex and frozen plasma. RESULTS AND CONCLUSION:(1) According to the monitoring, patients, whose coagulation factor IX activity increased from 7%to 50%, underwent humeral head replacement. (2) Within three days after replacement, coagulation factor IX activity was control ed>30%, 3 days-2 weeks>20%. No obvious complication was found after surgery. (3) These results suggested that hemophilia B arthritis was commonly treated by surgical treatment, which plays an important role in assessing patient’s condition and treatment. During perioperative period, replacement therapy of human prothrombin complex and control of coagulation factor activity in a appropriate range can effectively prevent postoperative complications.

Objective To explore the extraction process of Yinxing Huonao capusle.Methods Central composite design-response surface method was used to optimize the extraction process with quantity of water and boiling time as main factors and with syringin transfer rate,emodin transfer rate and solids retention rate as evaluation index.Results The conditions of the optimized extraction process were as follows:10-fold water,extracting time of 160 min,extracting 2 times.Conclusion It is feasible that central composite design-response surface method is used to optimize the extraction process of Yinxing Huonao capusle,and the optimized extraction process is simple and reliable.

Objective To explore the selection of reasonable interventional treatment to portal hypertension under different conditions.Methods The data of 76 patients with portal hypertension and interventional treatment from 1997 to 2002 were retrospectively analyzed. 26 patients were treated with transjugular intrahepatic porto-systemic stent shunt (TIPSS). Of these 26 patients, 11 patients suffered from hemorrhage after surgery treatment by devascularization, 6 patients with hemorrhage after stomach mirror treatment, and 9 patients with ineffective medicine treatment. 50 patients were treated with percutaneous transhepatic variceal embolization (PTVE) combined with partial splenic embolization (PSE), and they all showed inefficacy by medicine treatment. Free portal pressure (FPP) in pre- and post-treatment was measured in all 76 cases. The hepatic volume was measured by spiral-CT before and one year after the treatment.Results In TIPSS group, FPP was reduced from (3.85?0.42) kPa to (3.09?0.44) kPa (( t= 3.682, P

Objective To discuss the role of IL-8 and NF-?B in the airway inflammation of COPD in stable stage.Methods From Mar.2003 to Sep.2005,select 26 COPD patients in stable stage,determine the concentration of IL-8 in the serum of induced sputum,separate the macropolycyte and determine the degree of active expression of NF-?B,the concentration of SOD,MDA and IL-8 in peripheral blood.Lung function(the percent of FEV_1/FEV_1 prospectived value,FEV_1/FVC)of all patients were investigated.Results The concentration of IL-8 in the serum of induced sputum of COPD patients was higher than the normal group obviously(P

OBJECTIVE:To establish the quality standard of Compound duzheng tablets. METHODS:TLC method was used for qualitative identification of Vitis davidii,Aralia chinensis,Acanthopanax senticosus and Panax notoginseng in the preparation. The contents of syringoside,oleanolic acid,ginsenoside Rg1,ginsenoside Rb1 and notoginsenoside R1 were determined by HPLC. The determination was performed on Inertsil ODS-SP C18 column with mobile phase consisted of acetonitrile-water(gradient elu-tion)at the flow rate of 1.0 mL/min. The detection wavelength was set at 215 nm,and the column temperature was 25 ℃. The sam-ple size was 10 μL. RESULTS:TLC spots of V. davidii,A. chinensis,A. senticosus and P. notoginseng were clear and well-separat-ed without interference from negative control. The linear ranges of syringoside,oleanolic acid,ginsenoside Rg1,ginsenoside Rb1 and notoginsenoside R1 were 0.056-0.337 μg(r=0.9998),0.022-0.130 μg(r=0.9999),0.030-0.182 μg(r=0.9995),0.010-0.061 μg(r=0.9998),0.038-0.226 μg(r=0.9999),respectively. RSDs of precision,stability and reproducibility tests were all lower than 3.0%. The recoveries were 100.55%-103.80%(RSD=2.0%,n=9),100.00%-104.56%(RSD=3.0%,n=9),97.06%-102.94%(RSD=2.1%,n=9)、97.06%-102.94%(RSD=2.0%,n=9),96.67%-100.00%(RSD=1.5%,n=9). CONCLUSIONS:Established standard can be used for the quality control of Compound duzheng tablets.

Objective To assess the significance and the relationship of BODE index score and inflammation factors in stable chronic obstructive pulmonary disease(COPD).Methods Sixty COPD patients in their stable condition were evaluated for BODE index score and the level of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8) and C reactive protein (CRP) were determined.Results BODE index score in COPD patients was positively correlated with serum concentrations of TNF-α,IL-8 (r =0.455,P ＜ 0.01 ; r =0.303,P ＜0.05),but not with CRP (r =0.111,P =0.398).IL-8 and TNF-α were both significantly negatively correlated to body mass index(BMI),force exhale volume of the first second (FEV1) and 6 minute walking distance (6MWD) (r=-0.417,P ＜0.01;r=-0.538,P＜0.01;r =-0.419,P＜0.01 for IL-8;and r=-0.262,P＜0.05;r=-0.348,P＜0.01;r=-0.334,P＜0.01 for TNF-α).Conclusion The BODE index,as a simple multidimensional grading system for COPD,is closely related to system inflammation,which indicates that system inflammation may contribute to the systemic development of COPD.

Objective To report the experience in the use of laparoscopic extravascular stent for the treatment of the nutcracker syndrome. Methods Five patients (4 men and 1 woman) aged 20 to 35 years (mean 25) underwent laparoscopic extravascular stent of the left renal vein (LRV) for treatment of nutcracker syndrome associated with severe recurrent gross hematuria and left gonadal vein varices. All patients met the criteria for establishing the diagnosis of nutcracker syndrome. Ultrasonography, computed tomography, and magnetic resonance imaging revealed visible entrapment of the LRV between the superior mesenteric artery and aorta. Bleeding from the left ureteral orifice was detected by cystoscopy in 3 cases. An externally reinforced graft was selected to form an external stent around the LRV to relieve the compression. Results The mean operation time was 67 min (65-70min). No complications occurred during surgery. The postoperative follow-up was 9 to 39 months (mean 28). Total relief was achieved in 4 men without a relapse of symptoms and abnormalities were not found in urine tests. There was partial relief for the female patient due to microscopic hematuria after the operation. In all the 5 cases, Color Doppler ultrasonography showed that the blood outflow was smooth, the inner diameter and flow velocity of the aortomesenteric portion of the LRV were both decreased, and the gonadal vein varices had diminished in diameter. Conclusions The laparoscopic extravgscular stent of the renal vein could be a feasible approach for re-establishing free renal venous outflow in patients with nutcracker syndrome. This slightly invasive treatment could eliminate the symptoms of the condition.

Objective To investigate the role of NF-κB activation in the inflammatory mechanism of chronic obstructive pulmonary disease (COPD).Methods Monocyte were collected from patients with COPD and were cultured,and stimulated with lipopolysaccharide (LPS) ; NF-κB p65 activation was measured by immunohistochemistry; SOD ,MDA and IL-8 and lung function were determined synchronously.Results The NF-κB p65 was induced by LPS in monocyte in all subjects, but it was most markedly done in COPD patients with exacerbateions; There was positive correlation between the NF-κB p65 activation of monocytes and levels of IL-8 and MDA in circulation, but it was negative correlation to SOD.Conclusion NF-κB plays a vital role in regulating product of IL-8 in monocyte in COPD.

Objective To investigate the clinical efficacy of ultrasound-guided double-tract percutaneous cholecystostomy combined with choledochoscopic gallbladder-preserving cholecystolithotomy for the elderly patients with acute calculous cholecystitis.Methods The clinical data of 35 elderly patients with cholecystolithiasis who were admitted to the General Hospital of Chengdu Military Command from January 2012 to December 2013 were retrospectively analyzed.All the 35 patients received ultrasound-guided double-tract percutaneous drainage,and then received choledochoscopic gallbladder-preserving cholecystolithotomy.The long-term oral use of anti-inflammatory and cholagogue medications after operation reduced recurrence of cholecystolithiasis.All the patients were followed up by telephone interview and outpatient examination till June 30,2014.Results All the 35 patients undergoing successfully the ultrasound-guided double-tract percutaneous cholecystostomy.Of the 35 patients,1 patient with the puncture bleeding was cured successfully by symptomatic treatment,1 patient was treated by cholecystectomy due to the unformed sinus tract under costal margin,and other 34 patients underwent successfully cholecystolithotomy.The follow-up was carried out for 4 to 24 months and 1 patient was diagnosed as with recurrence of cholecystolithiasic.Conclusion Ultrasound-guided double-tract percutaneous cholecystostomy combined with choledochoscopic gallbladder-preserving cholecystolithotomy for elderly patients with acute calculous cholecystitis is safe and feasible,with an advantage of promotional value.

Objective To establish a platinum resistance nude mice model of epithelial ovarian cancer (EOC) and investigate its resistance to cisplatin (DDP) biological characteristics, so as to provide evidences for exploring chemoresistence mechanisms and screening for reversal targets in vivo micro-environment. Methods The resistance model was produced by repeating a crossover subcutaneous injection of human ovarian cancer SKOV3 cells labelled green fluorescent protein(GFP) and transplatation of tumor fragment into nude mice. Two kinds of cancer cell lines of SKOV3/DDPⅠand SKOV3/DDPⅡwere induced with acquired resistence to DDP. The chemosensitivities of EOC cells to DDP were tested and half maximal inhibitory concentration(IC50) was measured by methyl thiazolyl tetrazolium (MTT) and flow cytometry (FCS). Dynamic analysis among the concentration of DDP treatment and cell apoptosis, cell cycle phase distribution and intracellular DDP concentration. The expression of PTEN, STAT5, XIAP, BRCA1 and MDR1 were examined by real time quantitative reverser transcription PCR (qRT-PCR) in vivo. Results IC50 value of cisplatin for SKOV3/DDPⅡ were 2.83 ± 0.12 and 3.82 ± 0.19 folds than those for SKOV3/GFP by MTT and flow cytometry, separately. SKOV3/DDPⅠwere 2.20±0.16 and 3.40±0.20 folds. The apoptosis rate of SKOV3/DDPⅡ and SKOV3/DDPⅠ were decreased significantly at 29.7 and 39.6μmol/L DDP when treatment for 36 hours,which were lower than that of SKOV3/GFP cells [(57.0±1.4)%vs (37.6 ± 4.36)%vs (83.1 ± 2.71)%,P=0.024;(74.4 ± 2.3)%vs (50.5 ± 3.4)%vs (87.4 ± 4.0)%,P=0.001]. SKOV3/DDPⅠ and SKOV3/DDPⅡ was positively related with cisplatin processing time. Intracellular DDP accumulation of SKOV3/DDPⅡand SKOV3/DDPⅠwere lower than SKOV3-GFP in dynamic processes(P<0.05). Besides intracellular DDP accumulation of SKOV3/DDPⅡ also lower than SKOV3/DDPⅠin dynamic processes (P<0.05). Transplanted tumor of SKOV3/GFP appeared organelle degradation and nuclear membrane imcompleted after five times DDP injection with concentration of 4 mg/kg. SKOV3/DDPⅡand SKOV3/DDPⅠdid not generate these phenomenon untill eighth DDP injections with concentration of 4 mg/kg. STAT5 and BRCA1 of SKOV3/DDPⅡwere increased with DDP treatment at concentration of 4 mg/kg. Expression of XIAP from SKOV3/DDPⅡwas positive correlated with injection times. STAT5,XIAP and BRCA1 of SKOV3/DDPⅡwere up-regulated 3.86,28.1 and 14.6 folds than those in SKOV3/GFP cells after eighth DDP treatment, separately. While PTEN of SKOV3/DDP Ⅱ was decreased 3.77 folds. Conclusions We have successfully established platinum-resistent EOC mice model,which provides a new platform for further study on chemoresistant reversal and individualized clinical treatment. The results shown that potential mechanisms of SKOV3/DDPⅡDDP-resistance included over-expressed BRCA1 gene may be promote DNA damage repair, elevate XIAP gene to decrease cell apoptosis,up-regulated STAT5 gene and decrease PTEN gene to stimulate proliferation.