Drugs, Chinese Herbal ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional

Objective To evaluate the effect of surgical treatment for primary hepatocellular carcinoma(HCC) with bile duct thrombi(BDT).Methods Eleven cases were diagnosed as HCC with BDT by B ultrasound,CT,MRCP or ERCP.Hepatectomy and choledochotomy were performed,resecting the primary tumor and cleaning the BDT completely,followed with TACE.Results No patients died during operation.The survival time of 9 patients who received hepatectomy and BDT clearance ranged from 3 to 38(average 18.5) months,and that of the other two patients received TACE and BDT clearance survived 6 and 11 months respectively.Conclusion Accurate diagnosis and radical hepatectomy with complete BDT clearance are effective treatment for HCC with BDT.

Child ; Endoscopy ; Humans ; Male ; Paraganglioma ; surgery ; Urinary Bladder Neoplasms ; surgery

Objective:To investigate the levels of periphreal blood free carnitine and amino acids in healthy pregnant women in the third trimester and their association with maternal, fetal, and neonatal cardiac function and structure.Methods:This prospective descriptive study included healthy singleton pregnancies who underwent routine obstetric examination and delivered in two district maternal and child health hospitals (one in the urban and one in the suburb an area) in Beijing from June 2017 to February 2018. All recruiters had serology Down's syndrome screening test at (18±1) gestational weeks. Besides measurement of amino acids and free carnitine levels in whole blood and urine samples by liquid chromatography-tandem mass spectrometry, all cases underwent maternal and fetal echocardiography at (35±1) weeks of gestation. And neonatal echocardiography was performed after delivery to assess the heart function and structure. Antenatal factors were also collected, including maternal education background, age at first marriage and conception, gravidity, and folic acid supplement in early pregnancy. Statistical analysis was performed using t-test, ANOVA, Chi-square test, Pearson correlation coefficient, and Kappa test. Results:A total of 493 mother-neonate dyads were enrolled in this study. Blood free carnitine levels in the healthy pregnant women in the third trimester ranged from 5.09 to 59.17 μmol/L (reference value: 10.00-50.00 μmol/L) with an average value of (13.03±3.87) μmol/L. None was found with structural abnormalities by cardiac ultrasound, showing an average left ventricular end diastolic diameter (LVEDD) and end systolic diameter (LVESD) of (45.70±3.08) mm and (29.17±3.12) mm, respectively, and left ventricular ejection fraction (LVEF) of all cases were over 55%. No cardiac malformation was detected by the third-trimester fetal echocardiography. The average birth weight of the 493 newborns was (3 340±313) g. Those whose birth weight <2 500 g and >4 000 g were accounted for 1.0% (5 cases) and 3.0% (15 cases) with the average maternal blood free carnitine level of (13.25±2.17) μmol/L (10.46-19.21 μmol/L) and (12.64±2.50) μmol/L (8.78-17.73 μmol/L) ( t=0.42, P>0.05). The average LVEDD and LVESD of the 493 newborns were (17.21±1.27) mm and (11.03±1.30) mm, respectively. For the 64 newborns (13.0%) whose LVEF<60%, the maternal blood free carnitine level was (12.93±2.78) μmol/L (7.34-22.13 μmol/L), showing no statistical difference ( t=-0.29, P>0.05) with those 59 neonates (12.0%) whose LVEF over 75% and maternal carnitine level of (13.09±3.24) μmol/L (8.66-27.49 μmol/L). All cases were divided into four groups based on the quartiles of maternal blood free carnitine level and no significant difference in maternal or neonatal LVEDD or LVEF was observed among these groups (all P>0.05). Conclusions:Blood free carnitine concentration in healthy pregnant women in the third trimester is at the lower limit of normal range, and no significant effect on maternal cardiac function and fetal cardiac structure is seen. However, the effect of low maternal carnitine level in the third trimester on children's myocardial function and whether carnitine should be supplemented in the third trimester are worthy of further investigation with larger sample size.

OBJECTIVETo establish osteoblast apoptosis model induced by gingipains, and to examine the expression of pro-apoptotic protein Bcl-2 interacting mediator (Bim), Bcl-2 associated X protein (Bax) and Bcl-2 antagonist/killer (Bak).

METHODSGingipain and gingipain acticity were extracted and measured. Mouse osteoblast cell line MC3T3-E1 cells were cultured in the presence of 0.453, 0.906, 1.812 U/L gingipains for 0, 16, 24 and 48 h. Apoptosis was examined by 4',6-diamidino-2-phenylindole (DAPI) staining or annexin V/propidine iodide (PI) staining.Protein expression of Bim, Bax and Bak was determined by Western blotting after osteoblasts were cultured with 1.812 U/L gingipain for 0, 4, 8, 16, 24 and 48 h. Osteoblasts were cultured with 1.812 U/L gingipain which had been inhibited with N-alpha-tosyl L-lysyl-chlorom ethylketone (TLCK). Western blotting was used to detect Bim expression and DAPI staining to measure apoptosis.

RESULTSArginine-specific proteinases (Rgp) activity was (18.11 ± 2.11) U/L and specific proteinases (Kgp) was (1.02 ± 0.25) U/L. Percentage of osteoblast apoptosis induced by 1.812 U/L gingipain rose to (6.31 ± 0.37)% after 16 h, and reached (11.20 ± 0.35)% at 24 h and (10.80 ± 0.46)% after 48 h with DAPI staining. Annexin V/PI staining supported the result from DAPI staining.Bim protein level increased during osteoblast apoptosis, the relative fold rose to (0.31 ± 0.03) after 4 h (about 2 fold compared to control), peaking at 24 h (0.57 ± 0.05, 3-4 fold compared to control). Proteinase inhibitor TLCK effectively blocked the activity of gingipain and inhibited up-regulation of Bim induced by gingipains from (0.58 ± 0.04) to (0.14 ± 0.03). The percentage of osteoblast apoptosis decreased from (11.20 ± 0.35)% to (4.31 ± 0.38)% in the presence of TLCK. Expression of Bax remained unchanged when cells were cultured with or without gingipains. Bak was under the detectable level in MC3T3-E1.

CONCLUSIONS1.812 U/L gingipains induced osteoblast apoptosis. Protein expression of Bim was up-regulated during cell apoptosis and was down-regulated when gingipain inhibited with TLCK, suggesting that Bim was involved in osteoblast apoptosis induced by gingipain. Inhibition of Bim protein expression protected osteoblast from apoptosis.

Adhesins, Bacterial ; pharmacology ; Animals ; Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; metabolism ; Bcl-2-Like Protein 11 ; Cell Line ; Cysteine Endopeptidases ; pharmacology ; Humans ; MCF-7 Cells ; Membrane Proteins ; metabolism ; Mice ; Osteoblasts ; cytology ; metabolism ; Proto-Oncogene Proteins ; metabolism ; Tosyllysine Chloromethyl Ketone ; pharmacology ; bcl-2 Homologous Antagonist-Killer Protein ; metabolism ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo systematically evaluate the efficacy and safety of kidney-tonifying traditional Chinese medicine in the treatment of male infertility.

METHODSBased on the principles and methods of Cochrane systematic reviews, we searched CNKI, VIP, and Wanfang databases from inception to December 2012 for randomized controlled clinical trials addressing the treatment of male infertility with kidney-tonifying traditional Chinese medicine. According to the inclusion and exclusion criteria and retrieval strategies, we extracted the data, evaluated the quality of the included literature, and conducted meta-analysis using the RevMan 5. 2 software.

RESULTSTwenty trials involving 2,272 patients were included, and the sample size of each study was from 60 to 270 cases. All the studies were graded as of poor quality, with Jadad scores of no more than 3 points. The results of meta-analysis showed that the total effectiveness rate of traditional Chinese medicine versus Western medicine on male infertility was RR = 1.71, 95% CI 1.19-2.47, and that of Chinese-Western combined therapy versus Western medicine was RR = 1.15, 95% CI 1.01-1.30. Both traditional Chinese medicine and Chinese-Western combined therapy showed a significantly better total effectiveness than Western medicine alone in improving the pregnancy rate without serious adverse reactions.

CONCLUSIONDue to the poor methodological quality and high heterogeneity of the included studies, the evidence for the efficacy and safety of kidney-tonifying traditional Chinese drugs in the treatment of male infertility is of but limited value, and further validation is needed by more high-quality studies.

Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infertility, Male ; drug therapy ; Kidney ; Male ; Medicine, Chinese Traditional ; Pregnancy ; Randomized Controlled Trials as Topic

Objective To screen the arsenic content situation of drinking water in lower reaches of Yellow River and survey the amount of threatened people drinking high arsenic water and the condition of endemic arsenism.Methods Four counties of Yuncheng,Jiaxiang,Dongchangfu and Boxing were selected to colleft the water samples by CroOSS-sectional survey method.The water arsenic content wag determined by semi-quantitative rapid kit.All water samples having arsenic were re-determined by atomic fluorescence spectrometry.And the nurober of threatened people who drinking high arsenic water were investigated.Results In 4765 water wells screened,303 water samples had contained arsenic,arsenic content of 35 samples Was≥0.030 mg/L,12 samples were exceeding the international standard (arsenic content≥0.050 ms/L),they distributed in 3 counties of Dongchangfu,Yuncheng and Jiaxiang.The residents drinking water wells of arsenic content≥0.030 mg/L were surveyed by epidemiological investigation.And in the 28 villages 13 032 residents and 11 Bu8picious patient8 wlere checked out.Conclusion The wells with excesive water arsenic content are existing in the lower reaches of Yellow River and people suspicious of endemic arsenism need to be further identified.

Objective To observe the electrocardiogram changes of threatened crowds in Keshan disease (KSD) endemic area in Shandong province. Methods In 2008,inhabitants from 21 villages of Zoucheng,Sishui,Tengzhou, Yishui, Pingyi, Wulian, Juxian and Qingzhou regions were selected as subjects undergoing electrocardiogram. No less than 100 people were chosen from each village and the examination rate was not lower than 85%. Results Among the 3378 inhabitants investigated,460 cases showed abnormal electrocardiogram and the total incidence of abnormal electrocardiogram was 13.62% (460/3378). The relatively high incidence was T-wave changes,QRS low voltage and ST-T changes,the detection rate being respectively 2.69% (91/3378), 1.92% (65/3378) and 1.72% (41/3378). The highest incidence of abnormal electrocardiogram (26.76%,55/213),the intermediate(21.50%,43/200) and the lowest(5.50%,12/218) was respectively found in Pingyi,Qingzhou and Sishui. Conclusions The threatened crowds in KSD endemic area in Shandong province are still in a state of high abnormal electrocardiogram detection,and electrocardiogram is of great value in the evaluation of KSD patients.

Objective To discuss and analyze the diagnosis,management and surgical techniques for cranioplasty of skull vault defects and skull base reconstruction in order to raise the therapeutic effect. Methods The clinical data of 169 cases of skull vault and skull base defects treated with cranioplasty of skull vault defect and skull base reconstruction were retrospectively analyzed.Results Overlay tech- nique or inlay technique with imported titanium alloy mesh was used in 160 cases,and homologous bone was used in 9 cases.The surgical time ranged from 3 months to 8 years after injury.Eight cases presented with complications such as hematoma,subcutaneous effusion,infection and epilepsy postoperatively,but no operative death occurred.Conclusion For patients with skull vault defect with the diameter≥3 cm the best operative time is 3 months after injury,and for patients with intracranial and extracranial communica- ting tumors,skull base reconstruction can be performed when tumors are removed.Much attention should be paid to perioperative management and surgical skills.

Objective:To investigate the effects of estradiol on ~(60)Co?-ray induced apoptosis of bone marrow hematopoietic cells of mice,and to discuss the related anti-irradiation mechanism.Methods:KM mice were randomly divided into 3 groups(15 mice/each group):control group(without radiation),pure radiation group and estradiol+radiation group(ER group).The pure radiation group was irradiated by 4.0 Gy?-ray at a dose rate of 1.15Gy/min;the ER group was administered with 0.1 mg estradiol(IM)at 10 days before 4.0 Gy?-ray radiation;and the control group received no special treatment.The apoptotic DNA segments of bone marrow hematopoietic cells were analyzed by DNA agarose gel electrophoresis;flow cytometry was used to examine the apoptosis rate of cells and expression of Fas and Bcl-2 at 4 h,8 h,and 12 h after irradiation.Results:Eight hours after radiation,the apoptotic DNA segments were obviously increased and apoptotic DNA ladder appeared,which was not seen in the other 2 groups.The apoptosis rate of bone marrow hematopoietic cells in ER group was significantly lower than that in the pure radiation group at 4,8,and 12 h after irradiation(P