Objective To evaluate the rewarming and?anesthetic recovery regularity in different body mass index(BMI) patients with primary liver cancer by the same rewarming measures. Methods The data of 67 primary liver cancer patients with hypothermia after surgery were analyzed retrospectively and divided into three groups (low BMI group:BMI<18.50 kg/m2,normal BMI group: BMI 18.50-22.99 kg/m2, and high BMI group: BMI≥23.00 kg/m2) according to the standard of Asian BMI. Rewarming time and speed, spontaneous breathing recovery time,waking time and shivers in the three groups were observed and compared. Results Rewarming time, spontaneous breathing recovery time,waking time were (114.75± 21.91), (62.60±23.47), (94.65±20.54) min in low BMI group, (93.46±30.39), (41.19±21.47), (66.11±24.78) min in normal BMI group and (61.43±16.37), (25.81±8.90), (50.57±10.41) min in high BMI group,there were significant differences among three groups (F=25.300, 18.962, 25.647, all P<0.05). Rewarming speed was (0.85±0.13) ℃/h in high BMI group, (0.44±0.10) ℃/h in normal BMI group, (0.47±0.16) ℃/h in low BMI group,there were significant differences among three groups(F=65.810, P<0.05). Conclusions Rewarming for a long time in the primary liver cancer patients with low BMI and hypothermia after surgery by the same measures.More attentions should be paid to management of low BMI patients in the rewarming process, and aggressive measures should be taken to restore body temperature to normal.

Objective To study the indications,feasibility and efficacy of rigid choledochoscopy via biliary fistula tracts to remove bile duct stones.Methods A retrospective analysis was performed on the clinical data of 86 patients with bile duct stones treated with rigid choledochoscopy via biliary fistula tracts at our hospital between November 2011 and July 2016.Patients with bile duct stones were divided into the percutaneous transhepatic cholangio drainage (PTCD) group and the T tube tract group.There were 40 patients who underwent lithotomy using rigid choledochoscopy via the PTCD tract and 46 patients who underwent choledocholithotomy using rigid choledochoscopy via the T-tube tract.A comparison was conducted to compare the duration of the procedures,the amount of perioperative bleeding,the postoperative complication rates and residual stone rates between the two groups.Results In the PTCD group,the average operation time was (77.0 ± 36.5) min,the amount of perioperative bleeding was (26.5 ± 54.1) ml,and the postoperative complication rate was 37.5 ％ (15/40).Complete lithotomy in one-stage was successful in 33 patients,and in two-stages in 1 patient.The residual stone rate was 15.0％ (6/40).In the T tube tract group,the average operation time was (82.5 ± 44.1) min,the amount of perioperative bleeding was (14.8 ± 21.0) ml,and the postoperative complication rate was 32.6％ (15/46).Complete lithotomy in one-stage was successful in 34 patients,and two-stages in 2 patients.The residual stone rate was 21.7％ (10/46).There were no significant differences in the residual stone rates,complication rates and operation time between the two groups (P ＞ 0.05).The amount of operative bleeding was significantly better in the T tube tract group than the PTCD group,(P ＜ 0.05).Conclusions There was no significant differences in the clinical efficacy in the treatment of bile duct stones using choledochoscopy either via the PTCD tract or the T tube tract group.Both approaches can be used for bile duct stones.

AIM: To determine the topographic and spactial changes of endothelin-1 (ET-1) mRNA in cords after spinal cord injury(SCI). METHODS: A SCI model of the rat was made by modified Allen's weight drop method(50g-cm). ET-1 mRNA in the spinal cords before and after injury was examined by in situ hybridization and the content of ET-1 mRNA was determined by semi-quantitative image pattern analysis. RESULIS: Compared with control, the ET-1 mRNA positive neurons, glial cells and endothelial cells increased and the positive signal enhanced in the adjacent cord of the contused region. There was also a significant increase in positive unit of ET-1 mRNA staining in injured spinal cord except 48 h-group. The quantity of neuron expressing ET-1 mRNA decreased gradually in contused region after SCI, while the quantity of glial cell expressing ET-1 mRNA increased. CONCLUSION: Expression of ET-1 mRNA upregulates in spinal cord after SCI. It suggests a pathophysiological role for ET-1 in SCI. Neuron is the main contributor to the increase for ET-1 in injured spinal cord.

Objective To optimize the concentrate process ofDanshen injection.Methods The concentration changes of Salvianic acid A sodium, Protocatechuic aldehyde and Salvianolic acid B were selected as indexes to compare mospheric concentrate, vacuum concentrate, nanofiltration concentrate and nanofiltration-vacuum coupling concentrate methods with HPLC. Results Phenolic acid composition changed when atmospheric and vacuum concentrate method were used. Retention rate of three phenolic acids were over 93% after nanofiltration concentration, but the concentration efficiency was limited by solution viscosity. Nanofiltration-vacuum coupling concentrate methods could solve the above problems, meanwhile, retention rate of three phenolic acids were over 91%.Conclusions Nanofiltration technology takes advantage in medicine extraction concentrate with heat sensitive ingredients, and its application prospect in traditional Chinese medicine pharmaceutical industry would be broad.

Objective To investigate the mRNA expression of β‐catenin and PTEN in hepatocellular carcinoma exposed to hepa‐titis B virus(HBV) and aflatoxin B1(AFB1) .Methods 108 HCCs came from different districts of Guangxi province were labeled as four categories based on their biomarkers of HBV and AFB1 exposure .Group A :HBV(+ )/AFB1(+ ) ,48 cases ,group B :HBV (+ )/AFB1(-) ,27 cases ,group C :HBV(-)/AFB1(+ ) ,19 cases ,group D :HBV(-)/AFB1(-) ,14 cases .And normal hepatic tissue from 20 cases of hepatic hemangioma ,liver resection and liver transplant donor were chosen as normal control group .And the mRNA expression of β‐catenin and PTEN were detected by RT‐PCR .Results The mean expression level of β‐catenin gene mRNA in group A ,B ,C ,D and control group were(1 .13 ± 0 .14) ,(1 .06 ± 0 .12) ,(1 .16 ± 0 .18) ,(1 .01 ± 0 .13) and(0 .085 ± 0 .13) respec‐tively .There were significant differences between group A and C ,A and D .And there were significant differences between these four groups and control group(all P<0 .05) .The mean expression level of PTEN gene mRNA in four subgroup A ,B ,C ,D and con‐trol group were(0 .54 ± 0 .13) ,(0 .59 ± 0 .16) ,(0 .97 ± 0 .16) ,(0 .92 ± 0 .13) and(1 .10 ± 0 .16) respectively .There were significant differences between group A and D ,C and D .And there were significant differences between group A and C (P=0 .002) ,A and D(P=0 .032) ,B and C(P<0 .001) and B and D(P=0 .011) .And there were significant differences between subgroup A ,B and D and control group(all P<0 .05) .Conclusion The over expression β‐catenin of HCC cases may be associated with the exposure to AFB1 while the loss of gene PTEN may relate to the exposure to HBV .

Oxygen is a mandatory for all aerobic organisms. Oxygen-containing free radicals are produced when oxygen is not completely reduced to water in energy-producing oxidation reaction.The radicals may also transform into other reactive compounds through electron transfer and all the compounds with similar functions are referred as reactive oxygen species(ROS).Increased ROS is known to cause damage to proteins,DNA and lipids.Much evidence showed that changes in partial oxygen pressure,hormone,cytokine and chemical stimulation could increase ROS,and ROS,acting as signaling molecules,mediates cell functions.Hypoxia-inducing factor(HIF),a key transcriptional factor for most hypoxia-inducible genes,is a heterodimer consisting of 2 subunits.Recent study found that ROS plays an important role in HIF activity regulation under hypoxic and non-hypoxic conditions.This paper reviews the production of ROS and its role in the regulation of HIF activity.

Objective To study the clinical value of color Doppler ultrasound in carotid endarterectomy ( CEA) .Methods Forty-five patients with CEA were examined and analyzed by TCD and CDFI.The position, range,character,diameter,stenosis rate were measured by CDFI and collateral flow by TCD before CEA.The intraop-erative CDFI was applied to confirm the flow and the flaps in carotid artery.TCD monitoring of middle cerebral blood flow in CEA to assess whether use shunt technique and cerebral hyper-perfusion.CDFI was applied to assess patency and intimal hyperplasia of carotid artery.Results Seventeen low echo plaques,twelve high echo plaques and sixteen hypoechogenicity echo plaques in forty-five patients with internal carotid stenosis were found by color Doppler ultra-sound.Blood flow volume increased significantly in the ispilateal internal carotid arteries and middle cerebral arteris after operation.Carotid artery restenosis was not found by color Doppler ultrasound after CEA.Conclusion Applica-tion of color Doppler in CEA is valuable in the diagnosis of internal carotid stenosis,intraoperative monitoring and in the evaluation of effect.

Primary rat hepatocytes were cultured using different in vitro models and the enzyme leakage, albumin secretion, and cytochrome P450 1A (CYP 1A) activity were observed. The results showed that the level of LDH was decreased over time in culture. However, on day 5, LDH showed a significant increase in monolayer culture (MC) while after day 8 no LDH was detectable in sandwich culture (SC). The levels of AST and ALT did not change significantly over the investigated time. The CYP 1A activity was gradually decreased in a time-dependent manner in MC and SC. The decline of CYP 1A was faster in MC than in SC. This effect was partially reversed by using cytochrome P450 (CYP450) inducer such as Omeprazol and 3-methylcholanthrene (3-MC) and the CYP 1A induction was always higher in MC than in SC. In bioreactor basic CYP 1A activity was preserved over 2 weeks and the highest albumin production was observed in bioreactor followed by SC and MC. Taken together, it was indicated each investigated model had its advantages and disadvantages. It was also underlined that various in vitro models may address different questions.
Albumins/*secretion ; Bioreactors ; Cell Culture Techniques/*methods ; Cell Separation ; Cytochrome P-450 CYP1A1/metabolism ; Hepatocytes/*cytology ; Hepatocytes/metabolism ; L-Lactate Dehydrogenase/metabolism ; Mitochondria, Liver/enzymology ; Mitochondrial Proteins/metabolism ; Rats, Sprague-Dawley ; Time Factors

Background Clinical effectiveness of intavitreal injection of glucocorticosteroid for macular edema has been verified,especially triamcinolone acetonide(TA).However,the efficacy and safety of combination of TA with macular laser grid photocoagulation for macular edema is concerned. Objective This clinical trial was to evaluate the efficacy and safety of intravitreal injection of TA combined with macular laser grid photocoagulation in the treatment of macular edema. Methods A case-cohort study was designed.One hundred and twenty eyes of 120 patients with macular edema from diabetes or retinal vein occlusion were included in this study.The patients were randomized into trial group and control group,with the matched age,course,visual acuity,intraocular pressure (IOP).The patients of the trial group received intravitreal injection of TA combined with macular laser grid photocoagulation,and those of the control group were managed with macular laser grid photocoagulation only.Best corrected visual acuity ( BCVA),optical coherence tomography(OCT),fundus fluorescein angiography(FFA) and IOP were examined before TA injection and 1 week,1 month,3 months,6 months after treatment and compared among different time points between two groups.Written informed consent was obtained from each patient prior to entering this trial. Results Compared with TA injection before,the BCVA was significantly elevated in the trial group 1 week,1 month,3 months and 6 months after TA injection( all P=0.000),however,no obvious improvement of visual acuity was found in the control group before and after treatment at any time point (P＞0.05 ).At various time points,the visual acuity was significantly improved in the trial group than the control group (P =0.037,0.000,0.002,0.046 ).Macular thickness was significantly decreased at various time points after TA injection in comparison with before TA injection in the trial group(all P=0.000),but no significant change in macular thickness in the control group between before and after treatment at any time point( P＞0.05 ).Macular thickness was lower in the trial group compared with the control group at various time points after treatment ( P＜0.05 ).Recurrence of macular edema was seen in 7 eyes ( 1 1.67％ ) 4-6 months,and the IOP raise( ＞21 mmHg)was found in 11 eyes( 14.1％ )after TA injection in the trial group.Conclusions Intravitreal injection of TA combined with macular laser grid photocoagulation can be an effective method in the treatment of macular edema.However,recurrence of macular edema or increase of IOP may occur in a few patients within 6 months after TA injection.A long-term follow-up should be performed for the evaluation of efficacy and safety after intravitreous injection of TA.

Objective To evaluate the clinical significance of a modified T-staging system for hilar cholangiocarcinoma(HCC).Methods From 1999 through 2007,98 HCC patients were stratified by the Tstaging system.Statistical differences were evaluated for resectability,radical resectability,concomitant partial hepatectomy,partial portal vein resection,histological differentiation,lymph node characteristic and survival rate.Results There were 43 HCC patients graded at T1,37 at T2 and 18 at T3 respectively.The resectability rates were 65%,40% and 11%,and radical resection was achieved in 46%,21% and 0% respectively.Resectabilities decreased with increasing T stage(χ~2=15,P<0.01;χ~2=14,P<0.01,separately).In patients with T1 and T2 tumors who underwent resection,the concomitant partial hepatectomy accounted for 60% and 73%(χ~2=0.6,P>0.05),partial portal vein resection for 3% and 33%(χ~2=4,P<0.05),poor differentiated types for 71% and 40%(χ~2=4,P<0.05),and lymph node metastasis for 50% and 40%(χ~2=0.4,P>0.05),respectively.The 1-,3-and 5-year survival rates in patients with T1 lesions were 58%,30%and 18%,in 12 patients it was 43%,11%and 0.The 1-and 2-year survival rate in T3 patients was 12%and 0.Patients witll T1 or T2 stage tumors had a significantly longer survival than those with T3(P<0.05)(Log rank χ~2=14,Breslow χ~2=12,P<0.01;Log rank χ~2=6,Breslow χ~2=4,P<0.05,individually),and the difference in survival between T1 and T2 was not significant(Log rank χ~2=2,Breslow χ~2=1,P>0.05).Conclusions The T-staging system is appropriate for preoperative evaluation in HCC patients.However,its correlation with tumor histological differentiation and lymphatic characteristics needs to be elucidated.