Objective To observe the therapeutic effects of comprehensive rehabilitation treatment in patients with chronic renal failure (CRF). Methods Fifty patients with CRF were randomly and equally divided into a rehabilitation group and a control group. Those in the rehabilitation group were intervened with comprehensive rehabilitation protocol including regular counseling, health education and adequate aerobic exercise in addition to routine medications, while those in the control group with the routine medications only. The therapeutic effects were evaluated by means of Symptom Check List- 90(SCL- 90) and the questionnaire about quality of life (QOL) for patients with CRF, as well as such biochemical parameters as SCr, BUN, Ccr, DBP and SBP before and after treatment. Results Compared with those in the control group, the physiological capability and other relevant parameters of QOL in the rehabilitation group were significantly improved after one year of comprehensive rehabilitation, while SBP and DBP significantly decreased. There was no statistically significant changes of the concentrations of Scr, Bun, and Ccr. Conclusion Comprehensive rehabilitation intervention is superior to routine drug therapy in terms of improving the physiological capability, decreasing the BP and improving the QOL of the CRF patients.

Objective To investigate the clinical outcomes of alprostadil in prevention of portal vein thrombosis after splenectomy and devascularization.Methods 113 patients with PHT who were treated with prophylactic alprostadil after splenectomy and devascularization procedures from May 2009 to Apr 2013 were included into the treatment group.112 conservative patients with PHT who were treated with traditional prophylactic anticoagulants after the same operations before May 2009 were included as the control group.The postoperative complication rates,mortality,postoperative drainage volume from the abdominal cavity,blood platelet counts,prothrombin time,liver function,Child-Pugh's scores and portal vein thrombosis rates between the two groups were compared.Results When compared with the control group,the postoperative complication rate and mortality in the alprostadil group were not increased,while the postoperative drainage volume from the abdominal cavity was significantly reduced.The increase in blood platelet counts and prothrombin time were similar in the 2 groups.Furthermore,the extent of hepatic dysfunction on the 3rd and 7th after operation was significantly decreased.On short term follow-up,color droppler ultrasonography showed the portal vein thrombosis rate of the treatment group was significantly lower than the control group,with less extensive degree of thrombosis in the treatment group.Conclusion Alprostadil is a safe and effective anticoagulant which provided better prevention of portal vein thrombosis after splenectomy combined with devascularization.

Objective To explore the optimal techniques in separation of phenols from Melastoma dodecandrum with macroporous resins.Methods Static and dynamic adsorption-desorption methods were adopted,and the concentration of phenols was measured by UV spectrophotometer to evaluate the separa-ting efficiency.Results The HPD 100 macroporous resin was found with the best separating efficiency,by which the content of phenols could reach more than 50 percent in the extraction.The optimum technique condition was 0.2 g/mL concentration of crude drug,pH value was 2.7—4.5,adsorption in 3 BV/h,delution by 5 BV,60% alcohol in 3 BV/h.Conclusion This method is simple and feasible with good efficiency of separation,which could also meet the industrial requirements.

Pancreatic sinistral portal hypertension is a localized kind of portal hypertension that usually occurs as a result of the splenic vein obstruction caused by pancreatic diseases.Furthermore,it is also an important cause of upper gastrointestinal hemorrhage.Management in clinical practice should be directed at the sinistral portal hypertension and primary pancreatic diseases.

Objective:To establish an HPLC method to determine the content of chloramphenicol, salicylic acid and the related substances in compound chloramphenicol alcoholic solutions. Methods:The analytical column was Agilent Eclipse XDB-C18 (150 mm × 4. 6 mm,5 μm), 0. 8% acetic acid solution- acetonitrile(60∶40) was used as the mobile phase with the flow rate of 1. 0 ml· min-1 , the detection wavelength was 290nm for chloramphenicol and salicylic acid, and 272nm for the related substances, the column temperature was 25℃,and the injection volume was 10 μl. Results: Chloramphenicol and salicylic acid were completely separated from the related substances. The linear relationship of chloramphenicol ranged from 14. 88 to 297. 60μg·ml-1(r=0. 999 9), and the average recovery was 101. 18% with RSD of 0. 82%(n=9). The linear relationship of salicylic acid ranged from 9. 72 to 194. 40μg· ml-1(r=1. 000 0), and the average recovery was 99. 78% with RSD of 0. 27%(n=9). Conclusion:The method is good in resolu-tion, reproducibility and sensitivity. It is suitable for the determination of the two components and related substances in compound chloramphenicol alcoholic solutions.

Objective To explore the diagnostic value of ultrasound-guided aspiration biopsy in patients with unexplained refractory ascites.Methods The data of 25 cases of unexplained refractory ascites were retrospectively analyzed.For all the cases the diagnosis was based on the examination of contrast enhanced CT or ultrasound.Ultrasound-guided aspiration biopsy of locally thickened peritoneum or ti- ny masses in ascites was performed.Reults Ultrosonographic image of all cases was as follows.10 cases,with locally thickened peritone- um,were isoechoic or hypoechioc.In 2 of 10 cases contrast enhanced ultrasound examination was done,and the images were characterized by an obvious enhancement in arterial phase and quick wash-out in veinous phase.In 7 cases there was irregularly thickened peritoneum, accompanied by adhesion and caking of the omentum.Cystic formation in ascites or in peritoneum was found in 5 cases.Solid mass in asci- tes was found in 2 cases,and splenomegaly and enlarged pancreas were found in 1 case.Ultrasound-gnided aspiration biopsy was perfomed in all the patients.Among them 4 patients were operated on later.Histopathologic examination showed malignency in 20 patients.Among them,malignant peritoneal mesothelioma accoumted for 6 cases,pancreatic cystoadenoma in 2,mestastic adenocarcinoma in 9,malignant schwannoma in 1,lymphoma in 1,and histiocytoma in 1 patient.In the other 5 cases the lesion was benign,and it was verified by follow- up for about 6 months.Among them there were 3 cases of tuberculosis,1 case of inflammatory disease and 1 case of retroperitonesl fibro- sis.Conclusion Ultrasound-guided aspiration biopsy is valuable in the diagnosis of locally thickened peritoneum and tiny mass in ascitic fluid,and is valuable for diagnosis of unexplained refractory ascites.

Background and purpose:Oxaliplatin is a new cytotoxic platinum compound widely used in antineoplastic treatments.Peripheral neuropathy characterized by allodynia remains the most common way to limit the usage of oxaliplatin.Oxaliplatin-associated neuropathic pain is often resistant to standard analgesics.The effects of antidepressant agents such as desipramine and fluoxetine on chemotherapy-induced neuropathic pain were investigated so as to provide experimental evidence for clinical treatment.Methods:A single injection of oxaliplatin(30 mg/kg)intraperitoneal was injected into a test subject,a mouse that had chronic neuropathic pain.Using the von Frey filament as a touch stimulator,the mechanical withdrawal threshold(MWT)was measured when observing allodynia.The MWT was measured before and 1 h after the administration of desipramin and fluoxetine.Results:Desipramine and fluoxetine both have the potential to increase the MWT in mice with oxaliplatin-induced neuropathic pain.Pretreatment with antagonists such as an opioid receptor like naloxone could deepen their effects.Furthermore,when desipramine is combined with an opioid analgesic as buprenorphine,it causes an augmentation in the MWT.Conclusion:Antidepressants desipramine and fluoxetine antagonize oxaliplatin-induced neuropathic pain by inhibiting allodynia.Furthermore,the tricyclic antidepressing agent desipramine could enhance the effects of buprenorphine in subjects with oxaliplatin-induced pain,suggesting a synergistic effect for opioid analgesic.

Objective:To establish an HPLC method for determining the content of aspirin and sodium salicylat in A-Liu spirits and study the stability of the two components under different storage conditions. Methods:The analytical column was Agilent Eclipse XDB-C18(150 mm ×4.6 mm, 5 μm) ,0.01 mol·L-1 potassium dihydrogen phosphate (adjusting pH to 2.3 with potassium acid) -acetonitrile-methanol(55∶15∶30) was used as the mobile phase at the flow rate of 1. 0ml·min-1 , the detection wavelength was 280 nm and the column temperature was 30℃. The contents of aspirin and sodium salicylat were regularly determined under such storage conditions as ambient temperature, constant temperature and humidity(30℃ ± 2℃,65% ± 5%) and refrigeration (4℃ ± 2℃). Re-sults:The average recovery and RSD were 100. 06% and 0. 80%(n=9) for aspirin, and 100. 53% and 0. 82%(n=9) for sodium salicylat. Aspirin and sodium salicylat showed good linear relationship within the range of 31.0-310.0 μg·ml-1(r=0.999 9)and 30. 5-305. 0 μg·ml-1(r=0. 999 5), respectively. Under the three storage conditions, the content of aspirin was decreased, while that of sodium salicylat was increased, suggesting the temperature could significantly affect the hydrolysis rate and content of aspirin Conclusion:The method is promising with good resolution, reproducibility and sensitivity. It is recommended that the method be used to determine the content of aspirin and sodium salicylat in A-Liu spirits, and aspirin isn't stable under different storage conditions.

Objective To investigate the clinical features,diagnosis and prognosis of solid pseudopapillary tumor of the pancreas(SPTP). Method The clinical data of SPTP cases that underwent surgical resection with a definitive histological diagnosis in Zhong Shan Hospital from 1999 to 2007 were retrospectively analyzed.Result There were 42 SPTP cases undergoing surgery in this period,including 37 females and 5 males:mean age was 37.6 years.Tumors located in the pancreatic head in 18 cases and in the body or tail in 24 cases.The most common symptom was abdominal discomfort(n=20),palpable mass (n=8).Preoperative diagnostic accuracy of MRI and CT were 93%and 31.8%,respectively.Ten cases underwent pancreaticoduodenectomy,20 cases received distal pancreatectomy,3 cases did spleen-preserving distal pancreatectomy.Tumors were simply enucleated in 8 cases.Average diameter of the tumors was 6.1 cm,34 lesions were solid,6 were solid-cystic,2 were cystic.The overall perioperative morbidity was 38.1%,10 cases developed postoperative pancreatic fistula.The mean follow-up time was 38.6 months.Except three cases that were lost to follow-up,all the other cases were alive.Four cases(2 cases had had tumor enucleation,2 had had distal pancreatectomy)developed hepatic metastases on 70、110、41、3 months after first surgery,respectively.A transarterial chemoembolization was employed in three cases,while right hemihepatectomy was performed in one case. Conclusion SPTP is an indolent tumor with low-grade biological aggressiveness.Patients had a favorable outcome after surgical treatment,but enucleation should be avoided.Patients with liver metastasis may benefit from chemoembolization and liver resection.

Objective To promote the diagnostic accuracy of intrapancreatic accessory spleen (IPAS).Methods The clinical data of 10 cases of IPAS admitted in Fudan University Zhongshan Hospital from Apr 2005 to Dec 2013 were retrospectively analyzed.Results There were ten cases of IPAS confirmed pathologically.Only 1 of the ten cases was diagnosed correctly and definitely with IPAS preoperatively.The other 9 cases were misdiagnosed with benign or malignant pancreatic tumors,including nonfunctional neuroendocrine neoplasms in 5 cases,pancreatic neuroendocrine cancers in 3 and pancreatic intraductal adenocarcinoma in one.All the nine misdiagnosed patients has no specific symptoms or laboratory indexes.All the IPASs located in the tail of the pancreas with the mean diameter (1.3 ±0.2) cm(0.8-2.5 cm).7 cases of IPAS show strikingly similar dynamic enhancement to the spleen on the CT scans and/or MRI.Accessory spleen around the splenic hilum was found in five cases.Conclusions Morphological study plays an important role in the diagnosis and IPAS carries parallel dynamic enhancement to the spleen on CT scans and/or MRI.IPAS should be considered as a differential diagnosis while the lesion is no more than 2.5 cm in diameter and when other accessory spleens were shown around the splenic hilum.