Objective To assess the feasibility and safety between ALPPS and two-stage hepatectomy (TSH).Methods An electronic search was performed of the MEDLINE,EMBASE using subject heading to identify nearly three-years articles published that related to this topic.Pooled odds ratio was calculated for binary data and mean differences for continuous outcomes,using fixed-effects and random-effects models for meta-analysis.Results Four studies involving a total of 312 patients were used in the analysis.We found that ALPPS produced a higher increase rate of FLR than TSH (MD =24.78;95％CI:0.63 to 48.94;P =0.04).Comparing with TSH,ALPPS produced a shorter FLR growth time (MD =-26.55;95％ CI:-37.13 to -15.97,P ＜ 0.05).There was no statistical significance in overall mortality (OR =2.43;95 ％ CI:0.94 to 6.31;P =0.07),while ALPPS produced a more severe complication rate (≥ Ⅲ b) than TSH (OR =2.47;95 ％ CI:1.14 to 5.36;P =0.02).Conclusions It was better to make the FLR increasing to safe resection for ALPPS than TSH in a short period of time.There was no statistical significance in overall complication and mortality between ALPPS and TSH,but ALPPS produced more severe complication rate (≥ Ⅲb) than TSH.

Objective To explore the effects and mechanisms of urokinase-type plasminogen activator (uPA) on high glucose-induced rat mesangial cells proliferation and phenotype transformation. Methods Rat mesangial cells were cultured and incubated in media containing either 5 mmol/L D-glucose or 30 mmol/L D-glucose with or without addition of wortmannin, or uPA (105 U/L) for different time periods. At the end of the incubation period, mesangial cells proliferation was assessed by MTT assay and flow cytometric analysis. Cyclin-dependent kinase 2 (CDK2) and p27kip1 expression and activation of Akt were evaluated by Western blotting and Akt kinase assay respectively. Furthermore, the expression and distribution of α-SMA were detected with laser confocal microscopy. Results MTT assay and flow cytometric analysis demonstrated that high glucose induced mesangial cells proliferation (P＜0.05) and an incresed proportion of cells in G2/M+S stage after 24 h incubation (P＜0.01), which were attenuated by uPA or wortmannin (P＜0.01). High glucose induced the enhance of Akt activity after 3 h (P＜0.05), and the effect was inhibited by wortmannin or uPA (P＜0.01). High glucose did not alter CDK2 expression (P＞0.05),but significantly inhibited p27kip1 expression (P＜0.05), which was attenuated by wortmannin or uPA (P＜0.01). High glucose induced the up-regulation of α-SMA expression and perinucleus location in mesangial cells after 24 h (P＜0.01), which were alleviated by wortmannin or uPA (P＜0.01). Conclusion uPA up-regulates p27kip1 expression and counteracts high glucose-induced mesangial cells proliferation and phenotype transformation via blocking PI3K-Akt signaling pathway.

Objective To evaluate the effect of transitional care on the quality of life in patients with maintenance hemodialysis (MHD).Methods 101 MHD patients with symptoms of kidney ＜ 80 points were assigned into the interventional group (47 of 51 cases completed the study) and the control group (45 of 50 cases completed the study) by random number table method.The patients in the interventional group received transitional care for 6 months,while control group received routine care.The effects on function index,satisfaction index and clinical index were evaluated at the 3rd month and 6th month after intervention.Results 6 months after intervention,the scores of physical composite,mental composite,burden of kidney disease,symptoms/problems list,effects of kidney disease in the interventional group were 51.78±5.91,55.32±5.36,29.79±17.64,79.39±6.73,68.02±11.38,while the scores of the control group were 38.22±9.46,42.03±8.32,19.58±17.25,69.49±10.10,52.09±16.78,and the difference between the two groups was statistically significant (t=5.308-9.063,Z=-3.07,P ＜ 0.01).The scores of self-management behavior,health locus of control in the interventional group were 71.30-±5.42,25.74±2.42,while the scores of the control group were 65.0±8.74,22.47±3.97 (t=4.132,4.759,P ＜ 0.01).The nursing satisfaction in the interventional group scored 91.06±7.29,which was significantly higher than the control group scored 86.22±10.72 (Z=-2.45,P＜ 0.05).The level of serum phosphorus (PO4),Ca × PO4 products,parathormone (PTH) in the interventional group were (1.76±0.35) mmol/L,(51.02±10.04) mg2/dl2,464.56 ng/L,which were significanlty lower than (2.01±0.54) mmol/L,(57.41±17.38) mg2/dl2,625.78 ng/L in the control group (t=-2.691,-2.167,-2.000 in tum,P ＜ 0.01 or 0.05).Conclusions Transitional care achieves good effectiveness on the quality of life in patients with MHD.

Objective To study the effect and mechanism of increase in radio sensitivity of kidney cancer cells(GRC-1) induced by ?-elemenen in vitro. Methods GRC-1 cells were divided into 3 groups, blank group (added with 2 mL culture medium), emulsion group (added with 2 mL blank emulsion culture medium) and drug group (added with 2 mL 50 mg?L -1 ?-elemenen culture medium). After been cultivated for 24 hours, the cells were irradiated using 6MeV X-linear accelerator in different doses at the rate of 400cGy per minute. Number of cell clones was counted, and radiation-survival curve of GRC-1 cells was drawn. Flow cytometry (FCM) was used to measure cell cycle and apoptosis. Cells of climbing flake were dyed by immunocytochemical method, the gene expression of bcl-2 and PCNA was measured by imaging system. Results The cell cycle showed that the G 2M blocking caused by 50 mg?L -1 ?-elemenen was enhanced with time increase. It reached peak at 24 hours. FCM showed that the level of apoptosis increased with increase in drug dose and action time. The gene expression of bcl-2 was decreased by 20% in drug group than that in blank group, but there was no expression of PCNA in the two groups. Conclusion The radiosensitivity of GRC-1 cells can be enhanced by ?-elemenen. The mechanism of effect may be associated with the cell cycle blocking, inducing cell apoptosis and down-regulating expression of bcl-2 gene.

Objective: To evaluate the role of the MAPK subtypes (p38MAPK, ERK and JNK) in ANG Ⅱ induced apoptosis of cultured human podocytes. Methods: The cultured podocytes were incubated in media containing either vehicle, SB202190(5 ?mol/L, an inhibitor of p38MAPK), PD98059 (1 ?mol/L, an inhibitor of ERK), SP600125 (5 ?mol/L, an inhibitor of JNK), ANG Ⅱ (10 -8 mol/L) with or without SB202190、PD98059 and SP600125 for 18 hours; the cells were assayed for apoptosis by morphologic staining with H 33342 and propidium iodide and DNA fragmentation assays; the cell proteins were probed for phosphorylated MAPKs to determine the activation of specific MAPK subtypes. Results: ANG Ⅱ promoted podocyte apoptosis in a time and dose dependent manner; ANG Ⅱ stimulated p38MAPK, but inhibited JNK; SB202190 inhibited both ANG Ⅱ induced podocyte apoptosis and p38MAPK phosphorylation; Inhibition of ERK by PD98059 had no effect on ANG Ⅱ induced cell apoptosis. Conclusion: ANG Ⅱ induced apoptosis through stimulation of p38MAPK and inhibition of JNK in human podocytes.

Objective To establish a method for the preparation of long-circulating liposomes (LCL) containing etoposide and to observe its stability in rats plasma.Methods The etoposide-containing liposome was prepared by ethanol injection method. Polyethylene glycol-distearoyl phosphatidylethanolamine (PEG2000-DSPE) was used to modify the membrane of the liposome. Reversed-phase high pressure liquid chromatography (RP-HPLC) was used to detect the concentration of the liposome,and dynamic release method was used to study its stability in mice plasma.Results The mean size of the LCL containing etoposide was (180?26) nm,and the mean concentration of etoposide was (4.78?0.22) mg/mL,with the entrapment efficiency being (88.71?8.2)%. The leakage ratio of the conventional liposome containing etoposide and LCL containing etoposide in mice plasma were (80.14?1.59)% and (46.72?2.61)%,respectively.Conclusion LCL containing etoposide with high entrapment efficiency and low leakage rate can be obtained by using ethanol injection method. Additionally,modification by PEG2000-DSPE could raise the stability of the liposome.

Objective To study the damaging effect of tumor necrosis factor-alpha (TNF-?) and Interleukin-1?(IL-1?) on brain of rats in acute pancreatitis(AP). Mothods AP pancreatitis model in rats was induced by retrograde injection of 5% sodium taurocholate into the pancreatobiliary duct(1ml/kg body weight), then pretreated with normal saline (NS) or TNF-??IL-1?, TNF-? plus IL-1? respectively. Animals were killed at 5 h after drugs administration. The changes of brain water contents, leukocyte accumulation and adhesion were measured, and pathological studies of pancreas and brain were also performed. Results In groups with inflammatory cytokines pretreated, brain water contents, leukocyte accumulation and adhesion increased more significantly than those in control group and in NS pretreated group(P0.05). Conclusions Inflammatory cytokines such as TNF-? and IL-1? play important roles in the formation and acceleration of the brain damage in acute pancreatitis.

Objective To compare the efficacy and survival of patients with malignant obstructive jaundice using either endoscopic self-expandable metallic stents or surgery,and to evaluate the compounding factors influencing prognosis.Methods 56 patients with malignant obstructive jaundice treated with endoscopic self-expandable metallic stents (the endoscopic group) were compared with 90 patients who received surgery (the surgery group) during the same study period.Clinical data and survival of the 2 groups of patients were retrospectively analyzed.Results The success rate was 100％ in the endoscopic group.The serum bilirubin,alkaline phosphatase (ALP) and γ-glutamyl transferase (γ-GT) decreased significantly by using either therapeutic endoscopy or surgery (P＜0.01).There was no significant difference between the two groups in the reduction of serum total bilirubin.The mean survival of the endoscopic and surgery groups were 340 d and 795 d respectively.The accumulative survivals of the endoscopic group at 3,6 and 12 months as evaluated by the Kaplan-Meier method were 82.6 ％,61.1％ and 46.6 ％,respectively,and for the surgery group were 97.0％,90.9 ％ and 65.4％ respectively. There was a significant difference in survival between the two groups (P＜0.01).Survival after therapeutic endoscopy was similar to surgery for patients with metastasis and hilar biliary obstruction.Conclusions Self-expandable metallic stents gave similar palliation in the relief of jaundice in patients with malignant biliary obstruction.The stents had no effect on the primary tumor.Therapeutic endoscopy with self-expandable metallic stents is a safe and effective method for the relief of jaundice in patients with obstructive jaundice caused by non-resectable malignant tumors.

ObjectiveTo identify the pathogens causing complicated skin and soft tissue infection and their susceptibility to antibiotics.MethodsThe clinical data on and aetiological examination findings in 99 cases of complicated skin and soft tissue infection were retrospectively analyzed.ResultsTotally,99 bacterial strains were isolated,including 51 Gram-positive bacteria(29 community-associated,22 hospital-acquired)and 48 Gram-negative bacteria ( 13 community-associated,35 hospital-acquired).Of the Gram-positive bacteria,staphylococci were the most common bacteria,which showed a high resistance rate to erythromycin (95.45％),penicillin G(72.73％),clindamycin,oxacillin and levofloxacin,but a high sensitivity to teicoplanin,vancomycin,linezolid,fusidic acid and moxifloxacin.Besides,the community-associated staphylococci possessed a higher sensitivity to trimethoprim + sulfamethoxazole,tetracycline and ciprofloxacin than the hospital-acquired staphylococci did(all P ＜ 0.05).Notably,11 of the 99 isolates were identified as methicillin-resistant staphylococcus aureus(MRSA).The four predominant Gram-negative bacteria were Pseudomonas aeruginosa,Klebsiella pneumonia,Escherichia coliand Acinetobacter baumannii.These Gram-negative bacteria,especially the hospital-acquired Gram-negative bacteria,exhibited high resistance to levofloxacin,trimethoprim + sulfamethox azole and gentamicin but favorable sensitivity to carbapenems,tobramycin,piperacillin and tazobactam.ConclusionsComplicated skin and soft tissue infection is caused by various species of bacteria with high resistance to common antibiotics.Therefore,the results of drug sensitive tests should serve as the basis for proper use of antibiotics in the treatment of complicated skin and soft tissue infection.

Angina Pectoris ; drug therapy ; Animals ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; Technology, Pharmaceutical