OBJECTIVE:To prepare diclofenac sodium liposomes and establish a method for their quality control.METHODS:The diclofenac sodium liposomes were prepared by pH gradient method;the particle shape and size were measured by transmission electrical miscroscope;the concentration and encapsulation efficiency of diclofenac sodium in the liposomes were determined by HPLC.RESULTS:The prepared lipisomes were uniformly distributed with particle size of 150～175 nm.The linear range of diclofenac sodium was 0.01～1 mg?mL-1(r=0.999 0,n=6)at an average recovery of 100.05%(RSD=1.21%,n=6).The encapsulation efficiency ranged from 52.4% to 85.8%.CONCLUSION:High encapsulation efficiency of diclofenac sodium liposomes can be obtained from the established method.

Objective To evaluate the feasibility and advantages of gasless endoscopic thyroidectomy via the infraclavicular approach.Methods A single 2-to 4-cm infraclavicular incision was made at the ipsilateral side under local anesthesia.The subplastysmal plane was dissected up to the anterior neck to build a gasless space by mechanical method.Afterwards,by using ultrasonic scalpel,thyroidectomy was performed.Results The procedure was completed in 34 cases with a mean operation time of(120?30) min and mean blood loss of(20?12) ml.After the surgery,3 patients developed subcutaneous fluid and 1 patient had incisional infection,all of the 4 patients were cured by conservative therapy.The 34 cases were followed up for 1 to 30 months with a mean of 18.5 months,during the period,none of them had recurrence.Conclusions Gasless endoscopic thyroidectomy via the infraclavicular approach is a simple and safe method with good cosmetic outcomes.

ObjectiveTo evaluate the treatment strategy for patients with abdominal aortic aneurysm (AAA) and concomitant digestive system diseases (DSD) necessitating a surgery.Method From Mar. 1999 to Oct. 2001, clinical result of 6 cases suffering from concomitant AAA and DSD was reviewed. The AAA ranged from 4 8 to 11?cm in diameter. Cholecystectomy (for acute cholecystitis) and sigmoidectomy (for colonic cancer) were performed synchronously with AAA repair in 2 cases and 1 case respectively. Right semicolonectomy, radical subtotal gastectomy and esophagogastrectomy (all for carcinoma) were performed heterochronously with AAA endovascular exclusive grafting in one each patient, ResultGastric paresis developed postoperatively and recovered spontaneously in one patient. Esophagogastroanastomosis leakage caused a death in 1 patient. With follow up of 6～42 months the remaining 5 patients were alive, with no graft infection, nor cancer recurrence. ConclusionThe concurrent presentation of AAA and digestive tract diseases necessitating surgical intervention could be successfully managed synchronously or heterochronously.Endovascular exclusive graft of AAA is an effective therapy in patiens suffering from concomitant AAA and DSD.

BACKGROUND:Dihydroartmisinin can promote apoptosis of glioma cels GL261, but its effect on glioma stem cels is stil unknown. OBJECTIVE:To investigate the preliminary mechanism that dihydroartemisinin inhibits migration and invasion of glioma stem cels. METHODS: Glioma stem cels were isolated from mouse malignant glioma cel lines GL261. Immunofluorescence analysis was conducted to identify the characteristics of glioma stem cels. Migration and invasion abilities of glioma stem cels were analyzed by Transwel assay. The mRNA expressions of Tol-like receptor 2, matrix metaloproteinase-2 and matrix metaloproteinase-9 were examined by real-time fluorescence quantitative PCR. RESULTS AND CONCLUSION:The characteristics of glioma stem cels were identified by CD133 and Nestin staining. The migration and invasion of glioma stem cels were attenuated by dihydroartemisinin dose-dependently. Moreover, the mRNA expression of Tol-like receptor 2, matrix metaloproteinase-2 and matrix metaloproteinase-9 was also decreased by dihydroartemisinin in a dose dependent manner. These results suggest that dihydroartemisinin inhibits the migration and invasion of glioma stem cels probably through attenuation of Tol-like receptor signaling pathway.

Objective To conduct the statistical analysis on the free carnitine and acylcarnitines levels in 0?6 years old children by detecting the contents of free carnitine and acylcarnitines in dry blood spot to provide the biological reference range for the diagnosis of fatty acid metabolic disorder and organic acidemia.Methods The levels of acylcarnitines of peripheral blood dry blood spot in 263 normal children were detected by using the isotopic dilution non-derived tandem mass spectrometry.All children were divided into male and female groups according to different genders and divided into the groups according to the age,1-28 d(gestational weeks ≥37 weeks),1-12 months old,13 months-3 years old and 4-6 years old.Results The detection results after normality test found that the levels of free carnitine and acylcarnitines in children showed a normality distribution.The free carnitine and various acylcarnitines levels had no statistical difference between male children and female children (t=0.5,P=0.619).The C4,C5,C6,C10,C12 and C18 had equal variance among various age groups(P>0.05) and could conducted the one way variance analysis;C0,C2,C3,C5,OH,C6,C8,C14,C16 and C18 had the variance heterogeneity among different age groups(P<0.05) and could conduct the rank-sum test(P<0.05).The C0,C2,C3,C5,OH,C6,C8,C10,C12,C14,C16 and C18 had statistical differences among different age groups,the reference value ranges were calculated according to different ages.The difference in C4 and C5 had no statistical significance and the reference value range could be calculated by the merged group.Conclusion It is a very important for the diagnosis and treatment of fatty acid metabolic disorder and organic acidemia to establish the reference value ranges of dry blood spot free carnitine and acylcarnitines in children according to different ages.

Objective To evaluate surgical indications and method for regional pancreatoduodenectomy combined with blood vessel reconstruction. Methods Forty-four patients underwent pancreatoduodenectomy combined with superior mesenteric vein and portal vein(smv-pv) resection and reconstruction between April 1994 and March 2001.Among them superior mesenteric artery (SMA) and hepatic artery (HA) were reconstructed in 4 and 2 cases, respectively. Partial resection of the anterior wall of the inferior vena cava was performed in one case for tumor invasion. Results The overall mortality was 7.1%,with no complications. The resected endothelium or margins of the blood vessel and pancreas were microscopically tumor free in all cases. Histological specimen examinations demonstrated adenocarcinoma of pancreas head in 43 cases, neuroendocrine adenocarcinoma was diagnosed in one case. Patients were followed-up from 3～87 months with 2 cases lost after PV/SMV for pancreatoduodectomy. Six patients have survived more than 5 yearsand 21 cases more than 3 years. Conclusion Regional pancreatoduodenectomy combined with reconstructionof blood vessel could increase tumor resection rate in properly selected patients and could be performed safely without increased morbidity and mortality.

Objective To study the surgical manipulation of major blood vessels invaded by retroperitoneal tumors in order to raise the resection rate. Method Clinical data were analyzed on 56 patients undergoing resection of retroperitoneal tumors along with reconstruction of major blood vessels in our hospitals from July 1994 to June 2002. Results There was no surgical mortality, and 51 patients were followed-up from 6 months to 8 years and 1 month (average of 4.8 years). Grafts were patent in 49 cases, thromboembolism developed in 2 cases. Forty-seven cases have survived more than 1 year, 38 cases more than 3 years, and 16 cases more than 5 years. Conclusion Combined resection of retroperitoneal neoplasm and reconstruction of major blood vessels is safe, effective and practical.

BACKGROUND: Zinc, an inorganic antibacterial material, has a suitable degradation rate and good antibacterial property. Adding alloying elements can improve the mechanical properties and biocompatibility of the material, which is the development direction of novel medical biodegradable metal materials. There is still lack a comparable research on the antibacterial properties among zinc-based materials. OBJECTIVE: To investigate the antibacterial properties of pure zine and zinc-based alloys in vivo. METHODS: Eighty Sprague-Dawley rats, SPF grade, were randomized into two groups (n=40/group) , and all rats were injected with Staphylococcus aureus or Escherichia coli solution to prepare infection models. Different materials (Zn, ZnAl, ZnSr, Zn3 Mg, Zn3 Ag, Zn3 Ca and Zn4 Cu; five rats for each material) were implanted into the medullary cavity of femur. The control group without any material was set. At 1, 4, 7 and 14 days after implantation, the changes of body temperature, white blood cell count, serum tumor necrosis factor α and serum zinc content in rats were detected. The secretions and tissues of the surgical site were collected to identify the bacterial species. RESULTS AND CONCLUSION: (1) The body temperature in all the rats was increased to different extents after bacterial infection, but the temperature of the rats implanted with zinc and zinc alloys was always lower than that in the control group at 7 and 14 days (P < 0.05) . The temperature in the Zn3 Ag group was significantly lower than that in the other groups at 7 and 14 days (P < 0.05) . (2) The white blood cell count and tumor necrosis factor α level in the zinc and zinc alloys groups were significantly lower than those in the control group at 7 and 14 days after implantation (P < 0.05) . The white blood cell count and tumor necrosis factor α level in the Zn3 Ag group were significantly lower than those in the other groups (P < 0.05) . (3) The serum zinc content in all groups has no significant difference (P> 0.05) . (4) The bacterial culture results showed S.aureus (+) in the Staphylococcus aureus infection group and E.coli (+) in the Escherichia coli infection group. (5) To conclude, degradable zinc-based alloys exert marked antibacterial effects, and Zn3 Ag alloys have the best antibacterial activity.

Objective: To investigate the safety and efficacy of fluorouracil-based two-drug combination chemotherapy with apatinib, as a conversion therapy, in patients with unresectable gastric cancer (GC). Methods: A retrospective analysis of 33 patients with unresectable stage IV GC receiving conversion therapy at Tianjin Medical University Cancer Institute and Hospital between March 2017 and June 2018, was performed. Patients with peritoneal or ovarian metastasis received S1/paclitaxel (PTX)/apatinib (S1: 60 mg, bid, days 1-14; PTX: 50 mg/m2 iv, days 1 and 8; PTX: 20 mg/m2 ip, days 1 and 8; q3w; apatinib 500 mg po, qd). Patients with other non-curable factors were administered a regimen of SOX plus apatinib (oxaliplatin 130 mg/m2, S1: 60 mg, bid, days 1-14; apatinib 500 mg po, qd). Apatinib should be withdrawn from the last cycle before surgery. Surgery should be performed after MDT. Results: After at least three cycles chemotherapy, 21 patients achieved partial response (PRand 8 patients had progressive disease (PD), resulting in an objective response rate of 75.7%. Surgery was performed on 22 patients with PR, and 21 patients (63.6%) achieved R0 resection; the number of excised lymph nodes was 57.0±15.6, intraoperative hemorrhage was (164±46) mL, the operation time was (212.0±44.8) min, and the postoperative hospital stay was (13.0±2.7) days. Patients who had surgery had a median progression free survival (mPFS) of 10.5 months and an median overall survival (mOSof 16.5 months; for patients who did not undergo surgery, the median progression free survival (mPFSwas 2.5 months and mOS was 5.5 months. Conclusions: As a conversion therapy, fluorouracil-based two drug-combination chemotherapy with apatinib provided a high R0 resection rate for unresectable stage GC, with an acceptable safety profile. Keywords: apatinib, gastric cancer (GC), conversion therapy, safety, efficacy

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.