Objective To explore the clinical features and surgical management of aged patients with acute cholecystitis,and try to command the opportunity and procedure of laparoseopic cholecystectomy(LC)better.Meth- ods Clinical data of 52 aged cases with acute cholecystits undergone LC were analyzed retrospectively.Results All of the patients(within 48h of the acute attack)were successfully recovered without serious operative complications. Conclusion Aged acute cholecystitis progressed rapidly and its operative difficulty and risk were higher;only if more attention was paid to perioperative managements and operative time and technical skill were mastered,early LC for the patients was safe and feasible.Therefore.it should be recommended in the great majority of cases except the des- perate patients whose general condition was too poor to operate.

AIMTo investigate the alleviating effect of N-acetylcysteine (NAC) on lung injury induced by lipopolysaccharides (LPS) and its mechanism.

METHODSThe effects of NAC on changes of the pulmonary arterial reactivity and the ultrastructure of pulmonary arterial endothelium induced by LPS were observed with the isolated artery ring technique and scanning electron microscope (SEM). Malondialdehyde (MDA), nitric oxide (NO) contents and superoxide dismutase (SOD) activity of pulmonary artery tissues were detected.

RESULTSThe exposure of pulmonary artery to LPS (4 microg/ml, 7 h) led to reduction of endothelium-dependent relaxation response to acetylcholine (ACh), which was reversed by the concomitant exposure to NAC (0.5 mmol/L, 7 h), whereas NAC itself had no effect on the response. Significant structural injury were observed under SEM in LPS group and alleviated the changes in LPS + NAC group. The MDA, NO contents increased but SOD activity decreased in LPS group, which were reversed by the concomitant exposure to NAC.

CONCLUSIONNAC protects pulmonary artery endothelium and enhances endothelium-dependent relaxation response of pulmonary artery by antioxidation effect, which may be one of the mechanisms of its reversing pulmonary artery hypertension and following lung injury induced by LPS.

Acetylcysteine ; pharmacology ; Animals ; Endothelium ; metabolism ; pathology ; ultrastructure ; Lipopolysaccharides ; adverse effects ; Malondialdehyde ; metabolism ; Microscopy, Electron, Scanning ; Nitric Oxide ; metabolism ; Pulmonary Artery ; metabolism ; pathology ; ultrastructure ; Rabbits ; Superoxide Dismutase ; metabolism

Floaters are entopic phenomenon created by vitreous opacities. Some researchers term it as “symptomatic vitreous turbidity”, which usually refers to primary type in clinic. With the increasing prevalence and aging of myopia worldwide, vitreous floaters are becoming increasingly prevalent in clinics but receiving less attention. Floaters can impair patients' vision and quality of life due to their discomfort and disorientation. A few patients become intolerable and express a strong desire for treatment. YAG laser vitreolysis for floaters has garnered considerable attention in recent years. Although some doctors still have concerns about its efficacy and safety, a handful of studies have found some beneficial effects in recent years. The author has gained expertise in clinical practice in recent years. In this review, we talk about what causes floaters and how to classify them. We also talk about the clinical indications, how YAG laser ablation works, and whether or not it is safe.

To explore the underlying mechanism(s) of pulmonary arterial hypertension in endotoxic shock, the roles of N-acetylcysteine (NAC), nitric oxide (NO) and carbon monoxide (CO) were investigated. Pulmonary arterial rings (3-mm width) were prepared from 24 rabbits. Lipopolysaccharide (LPS), after 7-hour incubation, decreased the endothelium-dependent relaxation response of the arterial ring (pre-contracted with phenylephrine) to acetylcholine (1 mumol/L), but did not affect the endothelium-independent relaxation response to sodium nitroprusside. The LPS effects were reduced by a concomitant incubation with the free radical scavenger (NAC), NO donor (L-arginine), and CO donor (hemin), respectively. On the other hand, the LPS effects were enhanced by applying heme oxygenase-1 (HO-1) inhibitor (zinc protoporphyrin) to block CO production. The response to acetylcholine changed from relaxation to contraction, however, the contractile response to phenylephrine increased significantly after pre-incubation with nitric oxide synthase (NOS) inhibitor (L-NAME) to block NO production, confirming the importance of CO and NO. These results show that LPS impairs endothelium-dependent relaxation of the pulmonary artery, which can be greatly reduced by the antioxidant, or by supplying with NO and CO. Thus, multiple factors are involved in this model of endotoxin-induced pulmonary hypertension.
Acetylcysteine ; metabolism ; Animals ; Carbon Monoxide ; metabolism ; Hypertension, Pulmonary ; etiology ; physiopathology ; Lipopolysaccharides ; toxicity ; Male ; Nitric Oxide ; metabolism ; Pulmonary Artery ; drug effects ; physiopathology ; Rabbits ; Shock, Septic ; complications

This study, using cultured bovine pulmonary artery endothelial cells (BPAECs), was undertaken to investigate the roles of endogenous ONOO(-) in LPS-caused injury in endothelial cells. The fluorescent intensity of nitrotyrosine (NT), a specific marker of ONOO(-) generation, in BPAECs represented the content of endogenous ONOO(-) generation. The fluorescent intensity of NT and the number of NT positive cells were detected with flow cytometry (FCM), and the percentage of NT positive cells was calculated. The results are as follows. (1) LPS (1, 5 and 10 microg/ml) caused a marked increase in fluorescent intensity of NT in a dose-dependent manner, which was significantly increased compared to the vehicle group (P<0.01).The number and percentage of NT positive cells were markedly increased (both P<0.05 vs vehicle group). Aminoguanidine (AG), a selective inhibitor of inducible nitric oxide synthase (iNOS), inhibited LPS-induced increase in fluorescent intensity of NT in BPAECs. However, the number and percentage of NT positive cells had a tendency to reduce. (2) LPS brought about an enhancement in MDA content and the activity of LDH in cultured supernatant. AG reversed the enhancement in MDA content induced by LPS (P<0.01). In contrast, AG had a marginal effect on the activity of LDH. (3) LPS induced an increase in apoptotic rate in BPAECs in a dose-dependent manner. The number of apoptotic cells markedly increased as well. Some BPAECs stained with fluorescent probe ethidium bromide showed morphological features of apoptosis with chromatin condensation and nuclear fragmentation. AG reduced the apoptotic rate and the number of apoptotic cells, both of which were still higher than those of vehicle group (P<0.05). LPS led to inhibition of mitochondrial respiration and membrane potential in an accumulation manner. In conclusion, LPS caused injury to cultured BPAECs and increased the production of ONOO(-).The cytotoxicity of LPS may be mediated by the endogenous ONOO(-).
Animals ; Cattle ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; pathology ; Lipopolysaccharides ; toxicity ; Lung Injury ; physiopathology ; Peroxynitrous Acid ; biosynthesis ; physiology ; Pulmonary Artery ; cytology ; pathology

Pudilan Xiaoyan Oral Liquid has effects in clearing away heat and detoxifying,and is used to treat pharynx and throat swelling caused by the syndrome of excessive heat and toxin accumulation. Its efficacy is to relieve swelling and pain( redness,swelling and hot pain). It is included in the Chinese Pharmacopoeia of 2015 Edition,and has been listed in provincial health insurance directories of Shaanxi,Jiangsu,Liaoning,Hunan,Tianjin,Xinjiang and Hebei. It has been recommended by health departments of Beijing,Chongqing and other provinces as a preferred drug for the prevention and treatment of H1 N1 and HFMD,and listed in the diagnosis and Treatment Guide of HFMD by the Ministry of Health,the Clinical Application Guide of Chinese Patent Medicine edited by the Lung Department Disease Branch of China Association of Chinese Medicine,and the Clinical Practice Guide of Single Administration/Combined Administration of Antibiotics in Treatment of Common Infectious Diseases by China Association of Chinese Medicine. To further improve the clinician's understanding of drugs and better guide the rational clinical application,we invited front-line clinical experts from respiratory department,infectious department and dermatology of traditional Chinese and Western medicine to develop and compile the expert consensus. The consensus fully considered the clinical evidence and the expert clinical experience to give recommendations for clinical problems with evidence support and consensus suggestions for clinical problems without evidence support by the nominal group method.This consensus is based on clinical research evidence and expert experience in a simple and clear format,which provides a preliminary reference for the clinical use of the drug.
China ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Medicine, Chinese Traditional ; Nonprescription Drugs