Objective To explore the clinical curative effect of using different blocking methods to renal artery in laparoscopic nephron sparing surgery.Methods A total of 118 cases admitted in the Affiliated Heji Hospital of Changzhi Medical College who reserved the nephron routine after laparoscopic surgery of renal tumor surgery were selected.According to different methods of renal artery block,the patients were divided into the whole block group (61 cases) and selective blocking group (57 cases).The clinical curative effects of the two groups were compared.Results The differences of age,sex,suffering from kidney area and excising were not statistically significant between the two groups(all P ＞ 0.05).The blocking time,operation time and intraoperative blood loss,drainage at postoperative 1 day in the whole block group were (22.58 ± 4.62) min,(138.75 ± 21.76) min,(108.47 ± 75.39) mL and (137.36 ±18.34) mL,respectively,which in the selective block group were (28.61 ± 4.59) min,(103.26 ± 18.64) min,(132.58 ± 68.43) mL and (163.15 ± 15.87) mL,respectively,the differences were significant between the two groups (t =5.356,-8.247,7.463,10.358,all P ＜ 0.01).The postoperative hospital stay [(8.36 ± 2.19) d vs.(7.78 ±2.35)d] had no statistically significant difference between the two groups(P ＞0.05).There were no statistically significant differences in preoperative creatinine level and glomerular filtration rate between the two groups (all P ＞0.05).After operation,the creatinine and glomerular filtration rate in the whole block group were (106.38 ±32.76) μmol/L,(33.53 ± 6.14) ％ statistically,which in the selective block group were (95.26 ± 25.49) μmol/L,(38.27 ± 5.29)％ statistically,the differences were statistically significant between the two groups (t =-2.154,4.572,all P ＜ 0.05).Conclusion Renal artery block has shorter operation time,larger haemorrhage amount,increased postoperative creatinine,reduced glomerular filtration rate,for a small single kidney surgery,using selective renal artery block as far as possible,it has less intraoperative bleeding,and postoperative effect is better.

As a pilot program of teaching reform,some excellent undergraduates majoring in nursing were selected to take specialized courses in ICU in order to cultivate the intensive care specialized nurses.The teaching team of specialized courses in ICU was established to guarantee the teaching quality.The team was in charge of the ICU specialized curriculum building,textbooks selection and teaching content examination.The high leveled teaching team of specialized courses in ICU was organized by taking teaching and researching section as a unit to improve theoretical teaching level,using clinical department as training base to enhance practice skill and participating in special subject classes and in-service study to promote specialized quality.

OBJECTIVE:To establish a method for the contents determination of 9 components in Guizhi decoction,and com-pare the effects of traditional decoction method and the extracting machine decoction method on these contents in Guizhi decoction. METHODS:HPLC was performed on the column of Agilent Zorbax SB-C18 with mobile phaseof acetonitrile- 0.1% phosphoric ac-id(gradient elution)at a flow rate of 1.0 ml/min,the detection wavelength was 230 nm,254 nm and 280 nm,the column tempera-ture was 25℃,and the injection volume was 10μl. RESULTS:The linear range was 0.410 2-210.0μg/ml for gallic acid(r=0.999 9), 0.994 0-254.5μg/ml for albiflorin(r=0.999 9),1.636 0-1 675.0μg/ml for paeoniflorin(r=0.999 9),0.988 3-506.0μg/ml for liquiri-tin(r=0.999 6),0.987 3-31.59 μg/ml for coumarin(r=0.999 5),0.486 8-124.6 μg/ml for cinnamic acid(r=0.999 5),2.458 0-314.6μg/ml for cinnamaldehyde(r=0.999 5),0.034 3-1.096 μg/ml for 2-methoxy cinnamaldehyde(r=0.999 8),and 1.711 0-219.0 μg/ml for glycyrrdhizic acid (r=0.999 7);RSDs of precision,stability and reproducibility tests were lower than 5%,recoveries were 93.56%-103.19%(RSD=4.00%,n=9)、101.51%-107.32%(RSD=2.21%,n=9)、95.08%-103.76%(RSD=2.87%,n=9)、100.82%-105.73%(RSD=1.85%,n=9)、85.08%-89.12%(RSD=1.40%,n=9)、92.31%-99.12%(RSD=2.71%,n=9)、99.17%-102.32%(RSD=1.24%,n=9)、100.15%-103.98%(RSD=1.18%,n=9)、99.93%-102.61%(RSD=1.03%,n=9). The content of total effective components from the extracting machine decoction method was 4 565μg/g,that from the traditional decoc-tion method was 2 742 μg/g.CONCLUSIONS:The method is simple,stable and reproducible,and can be used for the simultaneous determination of 9 componentsin Guizhi decoction. The contents of gallic acid,albiflorin and 2-methoxy cinnamaldehyde are first re-ported. The total effective components from the extracting machine decoction method are higher than that from the traditional decoc-tion method.

Objective The objective of this study was to determine the lesion range between gastric cancer lesions and normal gastric wall,improve the early diagnosis of gastric cancer rate,distinguish between me-tastatic lymph nodes and non-metastatic lymph nodes,and accurate N staging by dual-source CT double-en-ergy enhanced scan parameters.Methods The dual energy enhanced scan of patients with preoperative gastric cancer was performed by Siemens Somatom Definition Flash dual-source CT.The collected data were analyzed by Syngo.Via software and reconstructed three-dimensionally to obtain the absolute iodine of gastric cancer,nor-mal gastric wall,metastatic lymph node and non-metastatic lymph node value,standardized iodine value and vir-tual single energy spectrum curve of the slope to combine with postoperative pathological results.The use of statis-tical methods was to determine the difference between the post-and preoperation.Results The absolute iodine values(IC)were(3.329±0.812)g/L in the gastric cancer lesion and(64.006±17.450)% for the standard io-dine values(NIC).The slope of the virtual single energy spectrum curve was-2.916±1.3227,IC(1.563±0.708)g/L in the normal gastric wall.The NIC were(37.122±16.267)%and-1.621±1.4028 for the slope of the virtual single energy spectrum curve.They were significantly statistical difference(P<0.05).The IC of meta-static lymph nodes were(2.968±0.547)g/L,(63.597±14.633)% for the NIC and(-2.532±0.753)for the slope of the virtual single energy spectrum curve.The IC of non-metastatic lymph nodes were(1.465±0.408)g/L,(35.240±14.357)%for the NIC and(-1.378±0.726)for the slope of the virtual single energy spectrum curve.They also had significantly statistical difference(P<0.05).Conclusion Dual-source CT dual-energy scan combined with three-dimensional reconstruction technique can help to determine the lesion range,improve the diagnostic rate of early gastric cancer,distinguish between metastatic and non-metastatic lymph nodes,and improve the accuracy of N staging.

Objective:To explore the effects of the γ-aminobutyric acid(GABA) neurons and melanin-concentrating hormone (MCH) neurons of the nucleus accumbens (NAc)-lateral hypothalamic area (LHA) neural pathway on the rewarding feeding(palatable food sweat condensed milk) in the obesity rats.Methods:Total 142 male Wistar rats of SPF grade were divided into normal diet (ND) group ( n=68) and high-fat diet induced obesity (DIO) group ( n=74) according to the principle of body mass matching. The rats in the two groups were given normal diet and high-fat diet for 8 weeks. Eight weeks later, 6 DIO rats were randomly selected to observe the nerve projection from GABA neurons in NAc to MCH neurons in LHA by fluorogold retrograde tracing combined fluorescence immunohistochemistry. And the expressions of c-Fos and MCH in LHA after ingestion of sweet condensed milk(rewarding feeding) were observed by fluorescence immunohistochemistry (6 rats in each group). GABA receptor agonist Musimol or GABA receptor antagonist Bicuculine was microinjected into the nucleus of LHA to observe the effect of GABA on rewarding food intake in ND and DIO rats ( n=8 in each group), and the changes of rewarding food intake after blocking MCH signal ( n=8 in each group). SPSS 17.0 was used for statistical analysis, two-way ANOVA and post hoc Bonferroni test were used for comparison among multiple groups, and t-test was used for comparison between two groups. Results:After 8 weeks of high-fat diet modeling, the intake of delicious food in DIO rats was significantly higher than that in ND rats((12.52±2.29) mL, (7.45±1.23) mL, t=4.778, P<0.01) after satiety.The results of fluorogold retrograde tracing combined with fluorescence immunohistochemistry showed that GABA neurons in NAc projected nerve fibers to neurons in LHA, and GABA A receptors in some neurons in LHA coexisted with MCH.The results of NAc-LHA pathway on delicious food intake showed that the interaction between rat group and drug intervention was significant( F=9.869, P<0.01). Simple effect analysis showed that the intake of delicious food after microinjection of Musimol into LHA nucleus of ND rats was significantly lower than that of microinjection normal saline ((4.25±1.38) mL, (7.29±1.49) mL, P<0.01), while the intake of delicious food after injection of Bicuculine was significantly higher than that of microinjection normal saline((10.72±2.11) mL, (7.29±1.49) mL, P<0.05). The intake of delicious food after microinjection of Musimol into LHA nucleus in DIO group was significantly lower than that of microinjection normal saline((3.51±1.77)mL, (13.68±2.95) mL, P<0.01), but there was no significant difference between microinjection Bicuculine and microinjection normal saline ((14.83±3.44) mL, (13.68±2.95) mL, P>0.05). The results of blocking MCH signal on delicious food intake showed that the interaction effect between SNAP-94847 and Bicuculine intervention was not significant ( F=1.468, P>0.05). The main effect of SNAP-94847 intervention was significant ( F=15.880, P<0.01)and the main effect of Bicuculine intervention was significant ( F=6.930, P<0.05). After intracerebroventricular injection of MCH receptor blocker SNAP-94847, the delicious food intake of ND rats was significantly less than that of injection normal saline((4.78±1.72) mL, (7.63±2.77) mL, P<0.05), and it was not affected by pre injection of Bicuculine in LHA ((6.24±2.18) mL, (4.78±1.72) mL, P>0.05). In the DIO rats, the interaction effect between SNAP-94847 and Bicuculine intervention was not significant( F=0.006, P>0.05). The main effect of SNAP-94847 intervention was significant ( F=18.46, P<0.01) and the main effect of Bicuculine intervention was not significant ( F=2.059, P>0.05). After intracerebroventricular injection of MCH receptor blocker SNAP-94847, the delicious food intake of DIO rats was significantly lower than that of injection normal saline((6.89±2.11) mL, (12.19±4.36) mL, P<0.05), and it was not affected by pre injection of Bicuculine in LHA ((8.72±2.26) mL, (6.89±2.11) mL, P>0.05). Conclusion:GABAergic signal in NAc can regulate the expression of MCH in neurons of LHA. In the DIO rats, the sensitivity of MCH neurons in LHA to satiety signal decreases and the hedonic feeding increases.

Background: Peste des petits ruminants (PPR), caused by the PPR virus (PPRV), is an acute and fatal contagious disease that mainly infects goats, sheep, and other artiodactyls.Peripheral blood mononuclear cells (PBMCs) are considered the primary innate immune cells. Objectives: PBMCs derived from goats were infected with PPRV and analyzed to detect the relationship between PPRV replication and apoptosis or the inflammatory response. Methods: Quantitative real-time polymerase chain reaction was used to identify PPRV replication and cytokines expression. Flow cytometry was conducted to detect apoptosis and the differentiation of CD4+ and CD8+T cells after PPRV infection. Results: PPRV stimulated the differentiation of CD4+ and CD8+ T cells. In addition, PPRV induced apoptosis in goat PBMCs. Furthermore, apoptosis and the inflammatory response induced by PPRV could be suppressed by Z-VAD-FMK and Z-YVAD-FMK, respectively.Moreover, the virus titer of PPRV was attenuated by inhibiting caspase-1-dependent apoptosis and inflammation. Conclusions This study showed that apoptosis and the inflammatory response play an essential role in PPR viral replication in vitro, providing a new mechanism related to the cell host response.

Objective:To evaluate the effect of ultrasound and CT three-dimensional reconstruction in open reduction and internal fixation of fractured ribs.Methods:A retrospective case-control study was conducted to analyze the clinical data of 112 patients with chest trauma and rib fractures admitted to Yan′an People′s Hospital from January 2021 to September 2023. According to the different preoperative positioning methods used, the reconstruction group was divided into a reconstruction group ( n=61) and a combined group ( n=51). The reconstruction group positioned the surgical incision position based on conventional CT three-dimensional reconstruction, while the combined group positioned the rib fracture end based on CT three-dimensional reconstruction combined with ultrasound. Record clinical data of two groups of patients and compare their preoperative positioning accuracy, average incision length, exposure time of fracture ends, fracture healing time, incision infection rate, surgical related indicators, visual analogue pain score (VAS) at one month after surgery, and surgical incision healing levels. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for inter group comparison; Comparison of count data between groups using chi-square test; The comparison of grade data were conducted using Mann-Whitney U test. Results:The preoperative localization accuracy, postoperative VAS at one month, and surgical incision healing grade A of the combined group patients were 94.4%, (2.26±0.48) points, 96.1%, respectively, the reconstruction group were 84.1%, (4.52±1.34) points, 72.1%, the combined group was better than the reconstructed group, the difference between the two groups was statistically significant ( P<0.05); The average incision length, fracture exposure time, fracture healing time, surgical time, and thoracic tube retention time of the combined group were (7.32±2.44) cm, (18.06±4.78) min, (48.16±4.58) d, (55.46±7.48) min, and (3.57±1.28) min, respectively. The reconstruction group were (10.16±2.86) cm, (29.45±5.65) min, (55.36±4.45) d, (64.36±7.52) min, and (7.49±1.52) min, respectively, the difference between the two groups was statistically significant ( P<0.05). Conclusion:Application of ultrasound combined with CT three-dimensional reconstruction in open reduction and internal fixation of fractured ribs can increase the preoperative positioning accuracy, which can guide the surgical incision, thus alleviating postoperative pain, facilitating postoperative healing, minimizing surgical trauma, and improving the patient′s prognosis.

OBJECTIVETo compare the chemical differences in 4 commercial specifications of Scutellaria Radix, research the affection of decayed central xylem part on the crude drug's chemical composition and provide scientific data for production, processing, sale and clinical applications of Scutellariae Radix.

METHODMacroscopical identification method was used for observation of different specifications of Scutellariae Radix, including Qinwang, Tiaoqin both in 1st class and 2nd class and inferior samples. HPLC fingerprint method was used to analyze chemically the decayed central xylem part and non-decayed part as well as complete sample, and the results were described by the relative peak area.

RESULTThe morphological characteristics of 4 specifications are greatly different from one another mainly in root diameters, root lengths and the proportions of decayed central xylem part in the root, and so the authors classified Qinwang and Tiaoqin in 1st class as Kuqin for all samples of them which have decayed central xylem; and classified Tiaoqin in 2nd class and the inferior samples as Ziqin, for having little decayed central xylem. The 4 specifications collected from the same producing area have similar HPLC fingerprint profile to one another, while they are different in relative peak area. The peak area ratios of aglycone to their glucuronide (baicalein/baicalin, wogonin/wogonoside, oroxylin A/oroxylin A-7-O-glucuronide) from Kuqin were significantly higher than those of Ziqin. The total area of the peaks in HPLC fingerprint chromatographs of decayed central xylem part were quite lower than that of non-decayed part, whereas peak areas of the characteristic peaks and the 3 peak area ratios of decayed central xylem were significantly higher than those of non-decayed part which could be used as characteristic parameters to distinguish Kuqin and Ziqin.

CONCLUSIONFour commercial specifications of Scutellariae Radix can be classified as Kuqin and Ziqin respectively according to morphological characteristics and the proportions of decayed central xylem part in the root. The chemical characteristics of Kuqin and Ziqin are different from each other, so it's worth clarifying the similarities and differences of Kuqin and Ziqin in future. The result in this research can be used as references for identification and quality control of Scutellariae Radix specifications, and investigation on effective components of Kuqin and Ziqin.

Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; standards ; Quality Control ; Scutellaria baicalensis ; chemistry

OBJECTIVETo develop a method for the determination of harpagide and harpagoside in Scrophulariae Radix (Xuanshen) by HPLC-UV under double wavelength, and to study the changes of these two constituents during processing, and to set the limitation of harpagide and harpagoside contents in crude drug and sliced pieces of Xuanshen.

METHODThe analyses were performed on an Agilent Technologies ZORBAX SB-C18 (4.6 mm x 250 mm, 5 microm) eluted with acetonitrile-water (containing 0.03% phosphoric acid) in gradient model. The flow rate was 1.0 mL x min(-1) . The column temperature was 25 degrees C. The UV detector wavelength was set at 210 nm before 13 min and then changed to 280 nm.

RESULTHarpagide and harpagoside were separated well. The linear calibration curves were obtained over of 0.0549 - 1.46 microg for harpagide (r = 0.9999, n =7) ,0.0225 - 0.900 microg for harpagoside (r = 0.9998, n = 9). The recoveries ( +/- RSD)% were 98.1 (+/- 2.4)% for harpagide and 98.8 (+/- 4.3)% for harpagoside. The contents of harpagide were 0. 277% - 0.620%, harpagoside were 0.078% - 0.362% in Xuanshen, and harpagide were 0.276% - 1.059%, harpagoside were 0. 059% - 0.183% in sliced Xuanshen, respectively. After the processing of Scrophulariae Radix, the content of harpagide increases 13.7% - 96.0%, while harpagoside decreases 11.0%-73.9%.

CONCLUSIONThis method is simple, accurate, and can be used for the quality control of Scrophulariae Radix. We propose that the total content of harpagide and harpagoside in either crude drug or sliced pieces of Scrophulariae Radix should not be less than 0.45%.

Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Glycosides ; analysis ; isolation & purification ; Iridoid Glycosides ; Magnoliopsida ; chemistry ; Plant Roots ; chemistry ; Pyrans ; analysis ; isolation & purification ; Spectrophotometry, Ultraviolet ; methods

Objective To investigate the incidence and risk factors of deep venous thrombosis (DVT) of lower extremity in patients with pelvic or acetabular fracture.Methods From August 2015 to December 2016,110 patients with pelvic or acetabular fracture were treated in our hospital.They were 76 males and 34 females with a mean age of 44.2 years (range,from 16 to 76 years).There were 48 pelvic fractures,including 12 anterior and posterior compression,16 lateral compression and 20 vertical shear ones by the Young-Burgess classification;there were 62 acetabular fractures,including 26 simple and 36 complex ones by the Letournel-Judet classification.The incidence of lower extremity DVT was detected preoperatively and postoperatively using ultrasound detection.The factors associated with the incidence of DVT were analyzed statistically.The risk factors were screened by single factor logistic regression analysis;the major independe risk factors were determined by multi-factor logistic regression analysis.P ＜ 0.05 was considered as statistically significant.Results DVT occurred in 32 patients (29.09％),including 21 cases (19.09％) of proximal thrombosis and 3 cases of combined pulmonary embolism.The incidence of DVT in patients with acetabular fracture was significantly higher than in those with pelvic fracture (P ＜ 0.05);the incidence of proximal DVT in patients with complex acetabular fracture was significantly higher than in those with simple acetabular fracture (P ＜ 0.05).Multivariate analysis showed that age of ＞ 60 years,combined injuries and interval of ＞ 2 weeks from injury to surgery were independent risk factors for incidence of DVT (P ＜ 0.05).Conclusions The risk of lower extremity DVT is high in patients with pelvic or acetabular fracture in spite of active prophylaxis,especially the risk of proximal thrombosis.Age of ＞ 60 years,combined injuries and interval of ＞ 2 weeks from injury to surgery may be the independent risk factors for incidence of DVT.