OBJECTIVE:To optimize the soxhlet extraction technology of Atractylodis macrocephalae,and to provide evi-dence for research and preparation of its formula granules. METHODS:Using the contents of atractylenolide Ⅰ,Ⅱ,Ⅲ as index, based on single factor test,the Soxhlet extraction technology of A. macrocephalae formula granules was optimized and verified by L9(34)orthogonal test with extraction time,solid-liquid ratio,extraction times as factors,and then compared with other technolo-gies (normal temperature extraction method,ultrasonic extraction method,reflux extraction method). RESULTS:The optimal ex-traction technology was as follows as 6-fold ethanol,extracting for 3 times,lasting for 8 h. Results of validation test showed that the extraction amounts of atractylenolide were 0.769,0.752,0.781 mg/g (RSD=1.99%,n=3) for 3 times,which were higher than the extraction amounts of other 3 methods(0.683,0.489,0.693 mg/g). CONCLUSIONS:The optimized extraction technolo-gy possesses high extraction rates of atractylenolide Ⅰ,Ⅱ,Ⅲ,and can be used for the extraction of internal ether from A. macro-cephalae formula granules.

Objective To explore the application value of fiberoptic bronchoscopy in the diagnosis and treatment for refractoriness pneumonia in children.Methods Sixty-two cases of refractoriness pneumonia who had not been cured with normal anti-infective therapy for 2 weeks in Guiyang Children′s Hospital from Jun.2005 to Jun.2009 were selected.Fiberopic bronchoscopy Olympus BF-3C30 or BF-P40 examination was applied after routine local infiltration anesthesia to diagnose and local treat refractoriness pneumonia in 62 children.Results There were 27 cases(43%) of simple inflammation,20 cases(32%) of foreign bodies with concurrent infection,7 cases(11%) of dndobronchial tuberculosis,4 cases(6%) of dysplasia with concurrent infection,2 cases(3%) of bronchiectasis,and 2 cases(3%) of pulmonary hemosiderosis,among them,dysplasia were diagnosed on children under 1 year old,foreign bodies with infection on 1-3 years old,and tuberculosis and bronchiectasis on school age.Eleven cases(40%) of simple inflammation were identified various pathogen by bronchoalveolar la-vage fluid culture,mycoplasma PCR test and bronchial brushing and microscopic examination.Forty-seven cases of bronchi obstruction and stenosis caused by inflammation were irrigated and treated by drug and achieved satisfactory,among them,15 cases(79%) of pulmonary atelectasis were recovered with the treatment of fiberoptic bronchoscopy within 2 weeks,14 cases(70%) of foreign bodies were succeed in taking choked thing from bronchus with fiberoptic bronchoscopy.Conclusion The fiberoptic bronchoscopy play an important role in the etiological diagnosis and therapy of refractoriness pneumonia in children.

Adult ; Cardiovascular Diseases ; physiopathology ; Cardiovascular Physiological Phenomena ; Case-Control Studies ; Female ; Heart ; physiopathology ; Humans ; Pregnancy ; Sports ; Stress, Psychological ; physiopathology

Adolescent ; Adult ; Ear, Middle ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Mastoid ; diagnostic imaging ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo evaluate the overall effect of transsphenoidal microsurgery for pituitary adenomas in recent 5 years and to discuss the surgical technique, application of new technology and postoperative follow-up results.

METHODSThe clinical presentation, image characteristics, endocrinal findings, pathological types, tumor removal percentage, postoperative complication and follow-up of 1 462 patients with pituitary adenomas who underwent the transsphenoidal microsurgery from 1997 to 2002 were analysed retrospectively.

RESULTSTotal rate of tumor removal for the patients achieved 97.0% in the patients with Hardy I adenomas, 95.2% with Hardy II, 90.5% with Hardy III, and 47.4% with Hardy IV respectively. A significant postoperative improvement both in clinical symptoms and endocrinal parameters was achieved. The tumor recurrence rate was 0.3%.

CONCLUSIONSWith the improvement of microsurgical technique and application of novel technology, the indication of transsphenoidal microsurgery for pituitary adenomas was increasingly extended. Endoscope and(/or) neuronavigation-assisted microsurgery via transsphenoidal approach should be of the first choice for the treatment of pituitary adenomas. The routine postoperative radiotherapy is not required for patients with total tumor removal.

Adenoma ; surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Neurosurgical Procedures ; methods ; Pituitary Neoplasms ; surgery ; Retrospective Studies ; Sphenoid Sinus ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the efficacy and safety of fast-track surgery(FTS) in patients with colorectal cancer.

METHODSOne hundred and sixteen patients with colorectal cancer underwent colorectal operation between June 2006 and May 2008. FTS procedures were used in these patients during the study period. Data were retrospectively analyzed pertaining to post-operative hospital stay and operative complications.

RESULTSThe median postoperative hospital stay was (5.6+/-5.4)(range 1-54) d. Fourteen patients(12.1%) had postoperative complications, in which the rate of anastomotic leakage and wound infection was 1.7% and 2.6% respectively. 30-day readmission rate was 1.7%, and the 30-day mortality was 0.9%.

CONCLUSIONFast-track surgery is feasible in an unselected patient population undergoing elective colorectal cancer resection without compromising surgical outcomes.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; rehabilitation ; surgery ; Digestive System Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Postoperative Care ; methods ; Retrospective Studies

OBJECTIVETo assess the efficacy and safety of damage control surgery with abdominal packing in non-trauma patients with severe abdominal hemorrhage.

METHODSA retrospective review of consecutive non-trauma patients who underwent abdominal packing to control severe abdominal hemorrhage between February 2002 and February 2007 were performed. The demographics, physiological parameters, surgical indications and procedures, mortality, morbidity and volumes of resuscitation were retrieved. The observed mortality was compared to those calculated from the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) and Portsmouth Predictor Equation (P-POSSUM) scores.

RESULTSA total of 26 non-trauma patients were included in this study, with a mean age of (42.6 +/- 15.8) years (range, 18 - 72 years). The most common etiologies associated with the severe hemorrhage was necrotizing pancreatitis (11 cases), intestinal fistula (5 cases) and tumor (4 cases). Of the patients, 24 cases (92.4%) achieved hemostasis by simple packing, 1 achieved hemostasis by using packing and angiographic embolization, and the other one failed and died. The mean intra-operative blood loss during the initial procedure was 1253.8 ml. The physiological parameters which improved significantly after rewarming and resuscitation in ICU phase included: body temperature, systolic blood pressure, heart rate, arterial pH, base excess, hemoglobin, hematocrit, prothrombin time, and international normalized ratio. The mean duration of packing was 4.3 days. The mean length of SICU stay and hospital stay was 40.5 and 67.4 days, respectively. Mortality rate predicted by POSSUM and P-POSSUM was 77.7% and 63.4%, respectively. Seven patients (26.9%) died after operation, brought an observed mortality rate significantly lower than predicted (P = 0.001 and 0.025, respectively). The most common complications included pneumonia (57.7%), bacteremia (50.0%), and re-bleeding (26.9%).

CONCLUSIONSDamage control laparotomy with packing is an effective procedure in the management of severe non-trauma abdominal hemorrhage, it can prevent the aggravation of "lethal triad" characterized by hypothermia, coagulopathy and acidosis. Appropriate application of the technique in strictly selected patients can result in a lower mortality rate.

Adolescent ; Adult ; Aged ; Bandages ; Female ; Hemoperitoneum ; therapy ; Hemostatic Techniques ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the safety and feasibility of robotic-assisted laparoscopic colectomy for colonic cancer.

METHODSThe clinical outcomes of 13 patients with colon cancer undergoing robotic-assisted laparoscopic colectomy from May 2010 to November 2010 were retrospectively evaluated.

RESULTSAll the operations were performed successfully, including 5 right colectomies, 3 left colectomies, and 5 sigmoidectomies. The operative time was (171.5±31.8) minutes. The estimated blood loss was (54.6±21.8) ml. Time to the return of bowel function was (60.9±15.8) hours and postoperative hospital stay was (6.4±3.6) days. There was one patient developed fat liquefaction at the incision. No bleeding, anastomotic fistula, anastomotic stenosis, or other complications were found.

CONCLUSIONRobotic-assisted laparoscopic colectomy is safe and feasible for colon cancer resection.

Adult ; Aged ; Colonic Neoplasms ; surgery ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Robotics ; Treatment Outcome

Small intestinal obstruction is a common complication of primary gastrointestinal cancer or metastatic cancers.Patients with this condition are often poor candidates for surgical bypasses,and placement of self-expanding metal stent (SEMS) can be technically challenging.In this study,we examined the feasibility of combined application of single-balloon enteroscope (SBE) and colonoscope for SEMS placement in patients with malignant small intestinal obstruction.Thirty-four patients were enrolled in this study,among which 22 patients received SEMS placement by using SBE and colonoscope,while the other 12 patients received conservative medical treatment.The patients were followed up for one year.Stent placernent was technically feasible in 95.5％ (21/22).Clinical improvement was achieved in 86.4％ (19/22).For the 19 clinical success cases,the average time of benefits from a gastric outlet obstruction scoring system (GOOSS) increase ≥1 was 111.9±89.5 days.For the 12 patients receiving conservative medical treatment,no significant improvement in GOOSS score was observed.Moreover,a significant increase of Short-Form-36 health survey score was observed in the 19 patients at time of 30 days after stent placement.By Kaplan-Meier analysis,a significant survival improvement was observed in patients with successful SEMS placement,compared with patients receiving conservative medical treatment.Taken together,combined use of SBE and colonoscope makes endoscopic stent placement feasible in patients with malignant small intestinal obstruction,and patients can benefit from it in terms of prolonged survival and improved quality of life.

OBJECTIVETo illuminate the preliminary genotype and allele frequency distribution of D6S477 and the other four short tandem repeat(STR) loci in Chinese Han population in Qingdao area and to probe the possibility of their genetic application.

METHODSTwo hundred ACD-blood specimens were collected from the unrelated individuals in Qingdao. The DNA samples were extracted with Chelex method and were amplified by polymerase chain reaction technique. The PCR products were analyzed by polyacrylamide gel electrophoresis and displayed using silver staining.

RESULTSThe authors obtained the allele frequency distribution and preliminary genotype of D6S477, D9S1118, D18S865, D19S400 and D20S161 STR loci. No deviation from Hardy-Weinberg equilibrium was observed in the five loci.

CONCLUSIONAll the five loci have higher chance of exclusion and discriminating power, and they will be useful markers for researches in genetics.

Asian Continental Ancestry Group ; genetics ; China ; Gene Frequency ; Genotype ; Humans ; Linkage Disequilibrium ; Microsatellite Repeats ; genetics ; Polymerase Chain Reaction ; Polymorphism, Genetic