Objective To evaluate the therapeutic effect,prognostic factors and the methods to improve long term survival of liver resection for hepatic metastases of colorectal cancer.Methods 52 patients operated on for hepatic metastases from colorectal cancer were followed up,and the clinical and pathologic data of 11 (cases),who survived more than 5 years,were compared with 41 survivors of less than 5 years after hepatic (resection).Results The 1-,3-and 5-year survival rate was 75.0%,30.8%,and 21.2%,(respectively).The important factors affecting prognosis were pathologic type of the primary cancer,(number) of (hepatic) metastasis,selection of the methods and timing of surgery,and postoperative treatment(P

Six cases of suicidal sedative-soporific drug poisoning is reported.The main clinical features were coma,respiratory depression,hypotension,disappearance of reflexes and peripherel circulatory failure.Thepathological fingdings were as follows:pulmonary congestion and edema;fatty degeneration of the liver;degeneration of the epithalial cells of the proximal convoluted tubules and cerebral edema.The severityof the pathological changes depend upon the duration between the drug administration and the time of deathThe longer the course,the more prominent the changes.The fatality rate related with the dose of drugadministration,the underlying deseases and the complications.

The paper is to report the study of the effect of Shenfu injection on the enzyme activity of liver CYP450 and its mRNA level of rat liver. Microsome of rat liver was prepared after intravenous administration of Shenfu injection for 7 days. The enzyme activity was quantified by Cocktail method. Meanwhile, the mRNA expression of CYP1A2, CYP2B1/2, CYP2C11 and CYP3A1 in the liver was detected by RT-PCR. Shenfu injection obviously induced the enzyme activities of CYP2B and CYP2C. Meantime Shenfu injection decreased the enzyme activities of CYP1A2 and CYP3A. The mRNA levels of CYP2B and CYP2C were also induced in rats treated with Shenfu injection. But it obviously inhibited the mRNA level of CYP1A2 and CYP3A. Since the enzyme activity and mRNA level were obviously changed after administration, the potential effect of drug-drug interaction should be concerned.

China has a heavy burden of hepatocellular carcinoma, which is a serious threat to people′s life and health. However, the available drugs for advanced hepatocellular carcinoma in the past are limited and the efficacy is not satisfactory. In recent years, immunotherapy has a significant effects in some tumors. The authors introduce the efficacy of restart immunotherapy on an advanced hepatocellular carcinoma patient undergoing interruption of treatment due to corona virus disease 2019, in order to provide references for the diagnosis and treatment of this kind of patients.

Objective:To compare the efficacies of robot-assisted unilateral and manual unilateral/bilateral puncture kyphoplasty (PKP) for the treatment of osteoporotic thoracolumbar fracture (OTLF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 64 OTLF patients admitted to First Affiliated Hospital of Kunming Medical University from April 2021 to May 2022. The patients included 28 males and 36 females, aged 57-88 years [(74.5±5.6)years]. Fracture segments were 12 patients from T 1-T 9, 32 from T 10-L 2, and 20 from L 3-L 5. All the patients were treated with PKP. Among them, 25 patients underwent manual unilateral puncture (manual unilateral group), 18 patients underwent manual bilateral puncture (manual bilateral group), and 21 patients underwent robot-assisted unilateral puncture (robot-assisted unilateral group). The operation time, channel establishment time, intraoperative blood loss, intraoperative fluoroscopy times, bone cement injection volume, and bone cement spatial distribution score were compared among the three groups. The visual analogue score (VAS), Oswestry disability index (ODI) and Cobb angle of kyphosis were compared among the three groups before operation, at 3 days and 3 months after operation, and at the last follow-up. The incidence of complications was compared. Results:All the patients were followed up for 6-10 months [(7.0±0.9)months]. The operation time of the manual unilateral group was (30.2±6.1)minutes, which was shorter than (37.9±8.9)minutes of the robot-assisted unilateral group and (49.0±10.2)minutes of the manual bilateral group; the operation time of the robot-assisted unilateral group was markedly shorter than that of the manual bilateral group (all P<0.05). The channel establishment time of the robot-assisted unilateral group was (4.7±1.4)minutes, which was markedly shorter than (10.4±4.4)minutes of the manual unilateral group and (21.7±6.2)minutes of the manual bilateral group (all P<0.05). The intraoperative blood loss of the robot-assisted unilateral group was (23.8±7.2)ml, which was less than (34.3±7.7)ml of the manual unilateral group and (55.9±18.7)ml of the manual bilateral group (all P<0.05). The number of intraoperative fluoroscopy of the robot-assisted unilateral group was (12.1±2.5)times, which was markedly less than (21.2±5.9)times of the manual unilateral group and (39.6±9.5)times of the manual bilateral group (all P<0.05). The channel establishment time, intraoperative blood loss and intraoperative fluoroscopy times of the manual unilateral group were markedly shorter or less than those of the manual bilateral group (all P<0.05). The bone cement injection volume and bone cement distribution score of the robot-assisted unilateral group were (4.7±1.3)ml and (7.9±1.2)points, which were not statistically different from (5.7±1.3)ml and (8.7±1.1)points of the manual bilateral group (all P>0.05), but were markedly higher than (3.0±1.3)ml and (5.1±1.8)points of the manual unilateral group (all P<0.05). There were no significant differences in VAS, ODI and Cobb angle among the three groups at 3 days, 3 months after operation and at the last follow-up (all P>0.05), but which were all lower than those before surgery (all P<0.05). There were no significant differences in VAS, ODI and Cobb angle among three groups before operation, at 3 days, 3 months after surgery and at the last follow-up (all P>0.05). The complication rate was 4.8% (1/21) of the robot-assisted unilateral group, 32.0% (8/25) of the manual unilateral group, and 33.3% (6/18) of the manual bilateral group, with no significant difference between the manual unilateral group and the manual bilateral group ( P>0.05), but both of which was markedly higher than that of the robot-assisted unilateral group ( P<0.05). Conclusion:Robot-assisted unilateral puncture and manual unilateral/bilateral puncture PKP can both achieve satisfactory results for the treatment of OTLF, but robot-assisted unilateral puncture has shorter channel establishment time, less intraoperative blood loss and intraoperative fluoroscopy times, and lower complication rate.

ObjectiveTo explore the possible mechanism of Bushen Huoxue Formula （补肾活血方， BHF） in the treatment of Parkinson's disease （PD） from the the perspective of intestinal flora. MethodsSeventy-two male C57/BL6J mice were randomly divided into blank group， model group， Madopar group and low-， medium- and high-dose BHF groups， with 12 mice in each group. The mice in the blank group were intraperitoneally injected with 10 ml/kg of normal saline， and those in the other groups were intraperitoneally injected with 30 mg/kg of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine （MPTP） at a concentration of 3 mg/ml to induce PD mice model， both once a day for 7 consecutive days. After successful modeling， the low-， medium-， and high-dose BHF groups were given 7.5， 15， and 30 g/（kg·d） of BHF by gavage， respectively， while the Madopar group was given 112.5 mg/（kg ·d） of Domedopar tablets by gavage， and the blank group and the model group were given 15 ml/（kg·d） of distilled water， all once a day for 14 consecutive days. The rod climbing test， rotating rod test， grip strength test and weight-bearing swimming test were used to evaluate the behavioral indicators of mice. Western blotting was used to measure the protein expression levels of Toll-like receptor （TLR）/nuclear factor kappa B （NF-κB） pathway inflammatory factors in the mouse ileum， including Toll-like receptor 2 （TLR2）， Toll-like receptor 4 （TLR4）， NF-κB， tumor necrosis factor α （TNF-α）， interleukin 6 （IL-6）， and interleukin 17 （IL- 17）. 16S rRNA high-throughput sequencing was used to analyze changes in mouse intestinal flora. ResultsCompared to those in the blank group， the mice in the model group had longer bottoming time when climbing the pole， reduced grip strength， shortened rotary pole duration and swimming duration， and increased protein expression levels of TLR2， TLR4， NF-κB， TNF-α， and IL-6 in the ileal tissue （P＜0.01）. Compared to the model group， the Madopar group and the low-， medium- and high-dose BHF groups had shortened bottoming time of the climbing pole and increased grip strength； the Madopar group and the high-dose BHF group had prolonged rotary pole duration， and reduced protein expressions of TLR2， TLR4， NF-κB， TNF-α， IL-6， and IL-17 levels； and only the high-dose BHF group had prolonged swimming duration （P＜0.05 or P＜0.01）. Compared to those in the low-dose BHF group， the bottoming time of the climbing pole were shorter in the moderate- and high-dose groups （P＜0.05 or P＜0.01）， and the grip strength increased while the protein expression levels of TLR2， TLR4 and IL-17 decreased in the high-dose group （P＜0.05 or P＜0.01）. The intestinal flora results showed significant differences between the blank group and the model group in the Dominance index， Pielou_e index， Shannon index， and Simpson index （P＜0.05 or P＜0.01）. Compared to those of the model group， the Shannon index， Chao1 index， and Observed_otus index of the Madopar group， as well as the Chao1 index， Observed_otus index， Dominance index， Pielou_e index， Shannon index， and Simpson index of the high-dose BHF group all showed significantly statistical differences （P＜0.05 or P＜0.01）. At the phylum level， the relative abundance categories of bacterial phyla with statistically significant differences in each group included Proteobacteria， Bacteroidetes， and Firmicutes （P＜0.05 or P＜0.01）. At the genus level， the relative abundance categories of bacterial genera with statistically significant diffe-rences among each group included Muribaculaceae， Akkermansia， and Helicobacter pylori （P＜0.05 or P＜0.01）. ConclusionThe possible mechanism of BHF in treating PD may be to reconstruct the disordered intestinal flora structure and improve the inflammatory response.