Objective To investigate the causes of success or failure of natural orifice translumenal endoscopic surgery(NOTES)in animals.Methods Data were collected from animal studies of NOTES carried out between August 2007 and September 2009.The studies were divided into acute phase and survival phase.In the studies,simple NOTES and laparoscopic-assisted NOTES were performed on female miniswines or adult mongrel dogs.Diagnostic abdominal exploration,liver biopsy,cholecystectomy,tubal ligation,oophorectomy,gastrojejunal anastomosis,and splenectomy were made in the animals.The intra-and post-operative complications and technical difficulties were recorded during the procedures.Results Totally 37 miniswines and 16 mongrel dogs were enrolled in the studies of NOTES procedures(91 procedures),including 22 acute experiments and 31 survival experiments.Simple NOTES was conducted through the transgastric route in 25 cases,transcolonic route in 8 cases,and combinations of transgastric and transcolonic routes in 16 cases,and combinations of transgastric and transvaginal routes in 6.In Laparoscopic-assisted cases,36 animals were treated via the transgastric route by traditional(26 cases)or single-port transumbilical laparoscopy(10 cases).Diagnostic exploration was carried out in 33 cases,liver biopsy was done in 11 cases,tubal ligation was made in 11,and oophorectomy was performed on 6;the procedures were all completed in these cases showing a success rate of 100%.Cholecystectomy was completed in 27 cases with a success rate of 44.4%(12/27).One case of splenectomy,and two cases of gastrojejunal anastomosis failed.The totally complication rate in the studies were 39.6%(21/53).The complications included perforation(8 cases),organ injury(5 cases),bleeding(4 cases),infection(3 cases)and pneumoperitoneum with hypertonia(1 case).Conclusions NOTES is feasible,safe and effective in diagnostic abdominal exploration and simple abdominal surgeries,but does not suit difficult abdominal surgeries.By using laparoscopy,the technique may be further developed and used in the future.

Objective To study the function and diurnal variation of hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-thyroid(HPT) axis,and the relationship with clinical characteristics of di-urnal rhythm in depressed patients. Methods Forty-nine depressed patients met diagnostic DSM-Ⅳ criteria and thirty-eight normal controls were collected. The plasma levels of cortisol (CORT), adrenocorticotropic hormone (ACTH), T3, T4, thyroid-stimulating hormone (TSH) at 7 am and 7 pm were measured by radioimmunoassay, then the results concemed were compared among the depressed groups with and without diurnal variation and control group by multivariate analysis of variance. Results The plasma level of morning CORT, morning and evening TSH ((365.94±120.78) nmol/L; (6.24±2.47)μIU/ml; (6.68±2.42)μIU/ml; respectively) were respective-ly higher than those of control group((284.91±83.39) nmol/L; (3.82±1.75)μIU/ml;(4.01±1.69)μIU/ ml, P<0.05). The plasma levels of morning and evening T4 were significantly lower than those of control group(P <0.05). The CORT morning-evening difference variable distinguished between depressed and control group (P< 0.001),but no significant differences could be found between the depressed groups with and without diurnal varia-tion. There were no significant differences in the CORT, T3, T4, TSH morning-evening difference variable between various clinical subtypes of depressed patient (unipolar/bipolar; psychotic/nonpsychotic). Conclusion Abnormal CORT morning-evening difference variable was observed in the depressed patients compared with normal controls,and may be used as a special trait mark of depressed group.

ObjectiveTo study the effect of facilitation antagonism acu-therapy in early rehabilitation of patients with cerebral thrombosis.Methods60 patients with cerebral thrombosis were divided randomly into two groups, Group A received facilitation antagonism acu-therapy, Group B received traditional acu-therapy. Fugl-meyer(FMA), MBI, etc were applied to assess effect before and after treatment.ResultsBoth groups had a great improvement after treatment(P<0.01).The effect in Group A was better than that in Group B compared in two groups (P<0.01 or P<0.05).ConclusionThere is effective in early rehabilitation of patients with cerebral thrombosis using facilitation antagonism acu-therapy.It is better than traditional acu-therapy.

Objective To evaluate the efficacy and safety of continuous suture by QuillTM SRS self-retaining suture for closing choledoch incision. Methods From January 2015 to October 2015, 66 patients with gall bladder calculi combined with common bile duct stones who received laparoscopic gallbladder excision, common bile duct explo-ration, laparoscopy choledochotomy, suture choledoch immediately were randomly divided into two groups, experi-mental group using QuillTM SRS self-retaining suture for closing choledoch incision and control group using tradi-tional absorbable suture for closing choledoch incision. Then observe the operation time, the risk of bile leakage oc-curred in the operation and the risk of bile leakage after operation. Results All patients successfully completed in laparoscopic surgery without laparotomy. Operation time, the risk of bile leakage occurred during operation in exper-imental group has statistically significant difference compared with control group ( < 0.05). The operation time and incidence of intraoperative bile leakage of the experimental group was less and lower than control group, while the risk of bile leakage after operation show no statistically difference ( >0.05). Conclusion Compared with interrupted suture by normal sutures, continuous suture by QuillTM SRS self-retaining suture for closing choledoch incision has the characteristics of shorter operation time and lower incidence of intraoperative and postoperative bile leakage. It is worthy of promoting.

Objective: To study the roles of N methyl D aspartate acid (NMDA) receptors of glutamate in mediating the arterial baroreceptor reflex (ABR)in rostral ventrolateral medulla (RVLM) in rats. Methods: The blood pressure, heart rates and ABR were observed after the bilateral microinjection of 0.1 ?l 50 mmol/L ketamine into RVLM of ureth anesthetized rats. Results: Bilateral microinjection of ketamine into RVLM induced decrease of the blood pressure and heart rate ( P

Objective To investigate the CT features of pulmonary sarcoidosis.Methods Ninety patients with histologically proved pulmonary sarcoidosis were retrospectively studied by using CT scans and clinical recording.Results The main CT findings of pulmonary sarcoidosis were nodules which were seen in 69 cases(76.7%),and the nodules mostly distributed around the bronchovascular bundle(n=37, 41.1%).Other abnormalities included consolidation(n=31,34.4%),ground-grass(n=39,43.3 %), thickening of bronchovascular bundle(n=30,33.3%),interlobular septal lines(n=58,64.4%), fibrosis(n=17,18.9%)including bronchial distortion(n=8,8.9%),linear shadow(n=5,5.6%), and honeycombing shadow(n=4,4.4%),air-trapping(n=3,5.3%),bronchial straitness(n=8, 8.9%),pleural thickening(n=42,46.7%),and hilar and mediastinal adenopathy(n=76,84.4%). Two or more abnormal findings co-existed in 83 cases.The pulmonary lesions co-existed with hilar and mediastinal adenopathy in 76 cases.The nodules(n=25),consolidation(n=9),ground-grass(n=11), thickening of bronehovascular bundle(n=10)were improved after therapy.Ten cases of the interlobular septal(10/22),0 of bronchial distortion(0/4),1 case of diffuse linear(1/3),and 0 case of honeycombing(0/2)were improved.Conclusion CT manifestations of pulmonary sarcoidosis are varied, but has some specific radiographic features.A correct diagnosis can be made.combined with hilar and mediastinal adenopathy.

Objective To compare the different effects of 1% diatrizoate meglumine,2.5% mannitol and water as oral contrasts in PET/CT scan in gastrointestinal tract delineation and 18F-fluorodeoxyglucose (FDG) uptake. Methods Sixty-one patients referred for PET/CT scan without gastrointestinal diseases were divided into three groups randomly ( random number method). One liter of 1% diatrizoate meglumine,2.5% mannitol,or water was orally taken by groups 1 (25 cases),2 (20 cases) and 3 ( 16 cases),respectively before scan. The scan was performed with GE Discovery LS PET/CT scanner in two-dimensional (2D) mode 50 min after 18F-FDG (5.55 MBq/kg) injection. Patients with abdominal lesions were excluded from this study. The degree of gastrointestinal filling and 18F-FDG uptake was evaluated by 3 nuclear medicine physicians using visual analysis according to a 4-grade classification method:none,mild,moderate,and high. Statistically analysis was performed by Kruskal-Wallis,Mann-Whitney and paired t tests.Results Both the differences of serum glucose and insulin levels were not significant before and after contrast taken in group 2. Group 2 had better gastrointestinal filling than that of group 1 and also better than group 3 except in rectum. The stomach,jejunum,ascending,and transverse colon were better filled in group 1 than in group 3. The degree of 18F-FDG uptake of group 3 was significantly higher than that of group 2 in stomach,jejunum and ileum (z= -3. 192,-3.290,-3.290,all P＜0.05),and was also significantly higher than that of group 1 (z = - 3. 603,P ＜ 0.05) in jejunum. The degree of 18 F-FDG uptake of group 3 was significantly lower than that of group 1 in ascending colon (z = - 2. 706,P ＜ 0. 05 ) and was significantly lower than that of group 1 and 2 in transverse and descending colon (z= - 3. 503,- 2.403,- 4.225,-4. 027,all P ＜0.05),and was also significantly lower than that of group 2 in rectum (z = -4. 128,P ＜0. 01 ). The maximum CT values in stomach,jejunum,ileum and ascending colon in group 1 were ( 132 ±23),(191 ±31),(313 ±47) and (374±53) HU,respectively,whose difference was significant (t = -7.088--1.781,all P ＜0. 01 ). Conclusion Oral iso-osmotic mannitol intake has better gastrointestinal filling and less physiological 18F-FDG uptake compared to diatrizoate meglumine and water.

This article is aimed to provide a method for the simultaneous analysis of five heavy metals, including Cu, As, Pb, Cd, and Hg, in Chuanxiong Rhizoma and Gastrodiae Rhizoma through ICP-MS. Five heavy metals were determined by an inductively coupled plasma-mass spectrometry method after microwave-assisted digestion. The linear correlation coefficients were all better than 0.999. The lowest limits of quantification for all target elements were 0.003 0.134 ug·L-1, while the recovery values ranged from 80.04% 118.34%. This method was accurate, convenient, rapid, and highly sensitive, and can be applied to determine five heavy metals, including Cu, As, Pb, Cd, and Hg in Chuanxiong Rhizoma and Gastrodiae Rhizoma.

This study was aimed to establish a quality evaluation method, quantitative analysis of multi-components with a single-marker (QAMS) to determine the contents of five saponins in Yao-Bi-Tong (YBT) capsules. Ginseno-side Rg1 was used as the internal standard; the relative correction factor (RCF) of notoginsenoside R1, ginsenoside Re, ginsenoside Rb1 and ginsenoside Rd were calculated and evaluated. The contents of 5 saponins were determined by the external standard method and QAMS, respectively. Rationality, feasibility and repeatability of the QAMS method were verified by comparing the results obtained from two different methods. The results showed that RCFs of notoginsenoside R1, ginsenoside Re and ginsenoside Rb1 to ginsenoside Rg1 against YBT capsules were 0.999, 1.228, 0.990 and 1.094, respectively, indicating good reproducibility. These results of two methods had no significant dif-ference. It was concluded that the QAMS method can be accurately, rapidly and reasonably used as a new quality assessment model for ginsenosides in YBT capsules.

This study was aimed to analyze differences of chemical compounds of Ginseng and Radix Puerariae be-fore and after compatibility using HPLC. Hypersil ODS column (4.6 mm × 250 mm, 5μm) was adopted. The mobile phase was acetonitrile-water for gradient elution. The detection wavelength was set at 203 nm. The column tem-perature was 25℃. The flow rate was 1 mL/min. The results showed that through the study of all main peaks in the finger print spectra, there was no obvious influence on extract before and after compatibility of Ginseng and Radix Puerariae. It was concluded that there were no obvious chemical changes of Ginseng and Radix Puerariae before and after compatibility. The synergistic mechanism of compatibility might mainly come from the interaction between the pharmacological actions and the absorption or the metabolism of effective constituents of the medicinal plants.