Splenic arteriovenous fistula is a rare disease and is also easy to be misdiagnosed.Clinical manifestations of the splenic arteriovenous fistula include portal hypertension,esophageal gastric varices,gastro-intestinal bleeding,diarrhea,abdominal pain,ascites,dyspnoea and heart failure.One patient with splenic arteriovenous fistula after splenectomy was treated at the First Affiliated Hospital of Soochow University from April to May in 2014.The patient was cured successfully by percutaneous transarterial embolization and celiac arteriography with the aid of interventional radiology.Hepatic and renal functions of the patient got a normal condition combined with a missing of the ascites and portal hypertension by abdominal enhanced computed tomography at postoperative month 2.

Objective To explore ways to decrease peripheral vascular complications during parenteral nutrition through peripheral veins. Methods According to the support sequences of giving peripheral parenteral nutrition, ninty perioperative cases were randomly divided into low(20. 3 kPa·h-1 ),medium(27. 1 kPa·h-1 ) and high(33. 9 kPa·h-1 ) osmotic pressure rates(n=30 in each group). The infusion pump was used to control the rate of infusion. The total parenteral nutrient was infused through BD24G venous indwelling needles. The pain ratings at injection sites were evaluated after parenteral nutrition everyday,the incidences of phlebitis were observed three days later after removing the indwelling needles. ResultsUnder the low osmotic pressure,the pain was mild,while for the medium osmotic pressure,the pain became more obvious. The pain was aggravated obviously under high osmotic pressure. There were only two cases of over grade-II phlebitis under low osmotic pressure rate,9 cases under medium osmotic pressure rate and 14 cases under high osmotic pressure rate, in which a grade-Ⅲ phlebitis developed. Conclusion Decreasing the osmotic pressure rate through peripheral venous is an effective method to avoid or reduce the incidences of peripheral vascular complications with the peripheral parenteral nutrition support.

Administration, Oral ; Adult ; Biomarkers ; analysis ; Budd-Chiari Syndrome ; chemically induced ; diagnosis ; pathology ; Cyproterone Acetate ; adverse effects ; therapeutic use ; Diagnosis, Differential ; Ethinyl Estradiol ; adverse effects ; therapeutic use ; Female ; Humans ; Liver ; diagnostic imaging ; pathology ; Menstruation Disturbances ; drug therapy ; Radiography

ObjectiveTo investigate the effect of acupuncture on motor function and serum expressions of TNF-aand IL-6 contents in cerebral hemorrhage rats.MethodSeventy-two male Wistar rats were randomized into sham operation, model and acupuncture groups. A rat model of cerebral hemorrhage was made by intracerebral injection of autoblood. Baihui-to-Qubin acupuncture was performed after successful model making. The TNF-aand IL-6 contents of rat serum were measured by enzyme linked immunosorbent assay at three time points: one, three and seven days.ResultBaihui-to-Qubin acupuncture markedly increased the neurological function score and reduced neurologic deficits in cerebral hemorrhage rats. At the same time point, serum TNF-aand IL-6 contents were significantly lower in the acupuncture group of rats thanin the model and acupuncture group; there were statistically significant differences (P<0.01).ConclusionBaihui-to-Qubin acupuncture can reduce neurologic deficits in cerebral hemorrhage rats. It may be related to decreases in serum TNF-aand IL-6 contents after acupuncture.

ObjectiveTo investigate the effects of mefformin on the levels of serum retinol-binding protein 4 (RBP-4),high sensitive C reactive protein (hs-CRP) and tumor necrosis factorα (TNF-α) in patients with impaired glucose tolerance(IGT) and metabolic syndrome(MS). MethodsSixty patients with IGT and MS were divided into mefformin treatment group (30 cases) and life-style intervention group (30 cases) by random digits table. Body mass index (BMI),the levels of HbAic, HOMA-IR, blood fat, RBP-4,hs-CRP, TNF- α were measured both before and 16 weeks after treatment in the two groups and compared.ResultsThe levels of HbA1c, HOMA-IR, RBP-4, hs-CRP and TNF- α were significantly lower in mefformin treatment group than those in life-style intervention group [(5.09 + 0.26 )％ vs. (5.69 ± 0.49 )％, 2.95 ± 0.63vs. 3.49 ± 0.78, ( 18.69 ± 6.50) mg/L vs.(26.20 ± 6.97) mg/L, (2.37 ± 0.53) mg/L vs.(2.99 ± 0.57) mg/L,(9.49 ± 2.37) μ g/L vs. ( 14.33 ± 2.62) μ g/L] (P ＜ 0.01 ). The results of multiple linear regression showed that correlations were found between the changes of RBP-4 and BMI,HOMA-IR,hs-CRP,TNF-α(β =0.284,0.506,0.274,0.230,P ＜0.01 ),and HOMA-IR was the most important limiting factor. Conclusions Mefformin can improve insulin sensitivity of the patients with IGT and MS, and depress the levels of RBP-4,hs-CRP and TNF- α. Meanwhile mefformin has anti-inflammatory effect.

Background: Nonlinguistic cognitive impairment has become an important issue for aphasic patients, but currently there are few neuropsychological cognitive assessment tests for it. To get more information on cognitive impairment of aphasic patients, this study aimed to develop a new cognitive assessment test battery for aphasic patients, the Non?language?based Cognitive Assessment (NLCA), and evaluate its utility in Chinese?speaking patients with aphasia. Methods: The NLCA consists of five nonverbal tests, which could assess five nonlinguistic cognitive domains such as visuospatial functions, attention test, memory, reasoning, and executive functions of aphasic patients. All tests are modified from the nonverbal items of the current existed tests with some changes to the characteristics of Chinese culture. The NLCA was tested in 157 participants (including 57 aphasic patients, 50 mild cognitive impairment (MCI) patients, and 50 normal controls), and was compared with other well?established relative neuropsychological tests on the reliability, validity, and utility. Results: The NLCA was fully applicable in the MCI patients and the normal controls, almost working in the aphasic patients (57/62 patients, 91.9%). The NLCA scores were 66.70 ± 6.30, 48.67 ± 15.04, and 77.58 ± 2.56 for the MCI group, the aphasic group, and the control group, respectively , and a significant difference was found among three groups (F = 118.446, P < 0.001). The Cronbach's alpha of the NLCA as an index of internal consistency was 0.805, and the test?retest and interrater reliability was adequate (r=0.977 and r= 0.970, respectively). The correlations of the cognitive subtests and their validation instruments were between 0.540 and 0.670 (all P < 0.05). Spearman's correlation analysis indicated that the coefficient of internal consistency of each subtest itself was higher than other subtests.When choosing the Montreal Cognitive Assessment score of <26 as the diagnostic criteria of cognitive impairment, the area under the curve for all participants in the control and MCI groups was 0.942 (95% confidence interval: 0.895–0.989), and an optimal cutoff point of 75.00 seemed to provide the best balance between sensitivity and specificity. Age (r = ?0.406, P < 0.001) was the main influence factor for the NLCA. Conclusions: The NLCA could efficiently differentiate the cognitive impairment patients from the normal controls and is a reliable and valid cognitive assessment test battery to specially find nonlinguistic cognitive function for aphasic patients.

Critical Care ; Critical Illness ; Emergencies ; Female ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male ; Retrospective Studies ; Transportation of Patients

OBJECTIVETo study the blood pressure (BP) changes in the liver transplant recipients.

METHODSA total of 206 patients without preoperation hypertension received liver transplantation in our hospital from February 2001 to July 2005. The BP level and serum immunosuppressant concentration at preoperation and various time points post operation were determined.

RESULTSCompared with the preoperation, the average systolic and diastolic pressure was significantly increased at the 2 week, 1, 2, 4 and 6 months post operation. The mobility of hypertension increased significantly after liver transplantation, with the highest mobility (46.49%) at the 1st month post operation. There was no linear correlation between the immunosuppressant (FK506) concentration and the BP level at any time point.

CONCLUSIONThere was a high hypertension incidence after liver transplantation. Although the use of immunosuppressive drugs accompanied with the BP increase, there was no linear correlation between the immunosuppressant concentration and the BP level post operation.

Blood Pressure ; Female ; Follow-Up Studies ; Humans ; Hypertension ; etiology ; Immunosuppressive Agents ; adverse effects ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Postoperative Complications ; physiopathology ; Retrospective Studies

The research aimed to investigate the therapeutic effects and mechanisms of Opuntia dillenii Haw polysaccharide (OPS) on atherosclerosis of rats. First atherosclerotic rat models were established by high-fat and high-calcium diet. Thirty days later, the rats were treated with low dosage of OPS (0.2 g x kg(-1) x d(-1)) or high dosage of OPS (0.4 g x kg(-1) x d(-1)) by intraperitoneal injection for 60 days continuously. At the end of treatment, thoracic aorta rings were prepared and vasorelaxation of rat thoracic aorta in different experiment groups were determined by using 620M multi wire myograph system in vitro. Blood and livers of rats were collected. Then plasma levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein (LDL) of rats were separately determined using whole automatic biochemical analyzer; protein level of hepatic apolipoprotein B (ApoB) and that of hepatic diglyceride acyltransferase (Dgat1) were measured by Western Blot technique. Results showed that the ability of rat thoracic aorta to relax decreased markedly in the model group compared with that in the normal group, and significant differences existed in vasorelaxation ratios induced by different concentrations of carbamylcholine chloride (Carb) between these two groups (P < 0.01). After OPS treatment, the ability of rat thoracic aorta to relax improved markedly, the vasorelaxation ratios induced by Carb at 5 and 10 μmol x L(-1) were respectively 0.34 ± 0.08 and 0.62 ± 0.15 in the group treated with low dosage of OPS, while the ratios induced by Carb at 1 and 5 μmol x L(-1) were respectively 0.54 ± 0.08 and 0.98 ± 0.02 in the group treated with high dosage of OPS, which were all significantly different with those in the model group (P < 0.01). Plasma contents of TC, TG and LDL reduced significantly by the treatments both with low and high dosages of OPS compared with those in the model group (P < 0.01). Protein level of hepatic ApoB and that of hepatic Dgat1 decreased significantly after the treatment with high dosage of OPS compared with those in the model group (P < 0.01). These results indicate that OPS can markedly improve the vasorelaxation of thoracic aorta of atherosclerotic rats and has significant anti-atherosclerotic effect; inhibiting the expression of ApoB and Dgat1 and thus decreasing the amounts of TC, LDL and TG serving as one of the molecular mechanisms of its antiatherosclerosis effect.
Animals ; Aorta, Thoracic ; drug effects ; Atherosclerosis ; drug therapy ; Cholesterol ; blood ; Lipoproteins, LDL ; blood ; Opuntia ; chemistry ; Phytotherapy ; Rats ; Triglycerides ; blood

To study the pharmacokinetics characteristic of loganin, ferulic acid and stilbene glucoside in rat plasma after oral administration of Bushen Tongluo formula. The plasma samples were treated by using liquid-liquid extraction technique, the concentrations were determined by HPLC-UV. Johnson spherigel C18 column (4.6 mm x 250 mm, 5 μm) was adopted and eluted with the of mobile phase of methanol-water containing 0.01% glacial acetic acid in a gradient mode, with the flow rate at 1.0 mL x min(-1), column temperature at 30 degrees C and injection volume of 10 μL. According to the findings, loganin was determined at 235 nm, ferulic acid and stilbene glucoside were determined at 320 nm, with the sample size of 10 μL. The pharmacokinetic parameters of loganin, ferulic acid and stilbene glucoside were calculated by DAS 2. 0 software as follows: C(max) was (0.369 ± 0.042), (0.387 ± 0.071), (0.233 ± 0.044) mg x L(-1); t(max) was (0.226 ± 0.022), (0.282 ± 0.031), (0.233 ± 0.044) h; t(½β) was (6.89 ± 0.20), (10.73 ± 0.11), (6.93 ± 0.09) h; AUC(0-∞) was (1.91 ± 0.36), (3.22 ± 0.52), (1.52 ± 0.33) mg x h x L(-1); AUCO(0-t) was (1.62 ± 0.33), (2.58 ± 0.43), (1.30 ± 0.30) mg x h x L(-1); CL was (20.2 ± 4.0), (1.39 ± 0.23), (31.7 ± 6.9) L x h(-1) x kg(-1), respectively. The results showed that after the oral administration with Bushen Tongluo formula, loganin, ferulic acid and stilbene glucoside showed concentration-time curves in conformity with the two compartment model, with a rapid absorption, loganin and stilbene glucoside was excreted at a moderate speed, and ferulic acid was excreted slowly (but with the highest bioavailability). Bushen Tongluo formula can main maintain plasma concentration with three administrations everyday and so is suitable to be made into common oral preparation.
Administration, Oral ; Animals ; Biological Availability ; Coumaric Acids ; administration & dosage ; blood ; pharmacokinetics ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; pharmacokinetics ; Glucosides ; administration & dosage ; blood ; pharmacokinetics ; Iridoids ; administration & dosage ; blood ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley ; Stilbenes ; administration & dosage ; blood ; pharmacokinetics