To investigate the effects of a formula of components from Shengmai Powder, a compound traditional Chinese herbal medicine, on glucocorticoid receptor (GR) in rats after thermal injury.

Objective To observe the effect of mouse nerve growth factor (mNGF) on cognitive function and activities of daily living (ADL) in patients with delayed encephalopathy after acute carbon monoxide poisoning. Methods 35 patients with delayed encephalopathy after acute carbon monoxide poisoning were randomly divided into treatment group (n=18) and control group (n=18). Both groups accepted hyperbaric oxygen and medication, while the treatment group was injected with mNGF 20 mg a day in addition for 12 weeks. They were assessed with Loewenstein Occupational Therapy Cognitive Asessment (LOTCA) and modified Barthel Index (MBI) before and after treatment. Results The scores of LOTCA and MBI improved more in the treatment group than in the control group after treatment (P<0.05). Conclusion mNGF can obviously improve cognitive function and ADL for patients with delayed encephalopathy after acute carbon monoxide poisoning.

Objective To investigate the association between peripheral white blood cell count including its subtypes and cardiovascular disease (CVD) incidence and one-year all-cause mortality in maintenance hemodialysis (MHD) patients.Methods A total of 371 MHD patients at Zhongshan Hospital,Fudan University between March 2009 and February,2011 were enrolled.Demographic,hematological,nutritional and inflammatory markers were obtained.All patients were followed for one year to investigate the risks for CVD event and mortality.Spearman correlation and linear regression were used to assess the relationship between white blood cell count and other laboratory parameters.Difference in categorical factors between two groups were determined with Chi-square test,Difference in continuous values between two groups were assessed with t test.Kaplan-Meier analysis and Cox proportional hazards model were applied to assess one-year mortality predictors.Results Patients with CVD event had lower lymphocyte count level (1.17±0.38 vs 1.34±0.51,P＜ 0.05) and higher monocyte count level (0.44 ± 0.15 vs 0.37 ± 0.15,P＜0.01) than those without CVD event.Cox proportional hazard regression showed that an increased lymphocyte count was associated with reduced mortality risk,95％CI:0.136-0.719,P ＜ 0.01) and that an increased monocyte count was associated with increased mortality risk,95％ CI:2.657-74.396,P＜0.01) after adjustment for hsCRP.Conclusion Decreased lymphocyte level and increased monocyte level are significantly related to CVD event and are independent predictors of increased one-year all-cause mortality risk in MHD patients.

ObjectiveTo evaluate the various methods of choledochoplasty in the repair of major bile duct defects in Mirizzi syndrome.MethodsThis is a retrospective study on 3 patient with Mirizzi syndrome with a large bile duct defect.These defects were repaired by using a vascular gastric pedicle patch in our department from July 2008 to November 2011.The authors searched the domestic medical literature on surgical repair for Mirizzi syndrome in the past ten years.The patients were treated by various surgical methods,and they were analyzed according to the Csendes Classification.ResultsThere were no surgical complications in our three patients.There was one patient with a Csendes type Ⅲ,while the remaining 2 patients were with Csendes type Ⅳ.At a median follow- up of 2.5 years,no patient developed signs of chronic cholangitis.In the medical literature,there were 93 patients who were with Csendes type Ⅰ ; and 58 patients were treated by cholecystectomy only,while 35 patients were treated by partial cholecystectomy plus mucosal ablation.Of the 40 patients with type Ⅱ,29 patients were treated by direct fistula repair,9 patients by pedicle gallbladder flap and 2 patients by pedicle round ligament.Of the 20 patients with type Ⅲ,9 patients were treated by pedicle gallbladder flap.1 patient by pedicle round ligament,3 patients by pedicle gastric flap and 7 patients by Rouxen- Y hepaticojejunostomy.For the 5 patients with type Ⅳ,they were treated by Roux-en- Y hepaticojejunostomy.Of these 159 patients,postoperative complications included biliary fistula (n=1 ),upper gastrointestinal bleeding (n=1),and biliary stricture (n=1).All the remaining patients were cured.ConclusionIn patients with Mirizzi Syndrome,the choice of treatment depends on the size of the fistula.For patient with a major tissue defect in the common hepatic duct,a pedicle vascular gastric flap is a good treatment.

Objective To evaluate the feasibility of and indications for laparoscopic left lateral hepatectomy. Methods The candidates for laparoscopic left lateral lobectomy were 7 cases with liver lesions including 2 cases of primary liver cancer,5 cases of liver hemangioma. Results These patients underwent laparoscopic hepatectomy uneventfully. The operation time averaged at 210 min. The blood loss in operation averaged at 700 ml. The postoperative hospital stay averaged at 5.7 days. No complications occurred. Conclusion Based on these preliminary results, we conclude that laparoscopic anatomical left lateral lobectomy can be carried out safely and effectively by a surgeon with the sufficient expertise of laparoscopy and hepatobiliary surgery.

Objective To investigate and cure major complications after percutaneous transhepastic biliary drainage(PTBD).Methods The clinical data of 13 major complications after PTBD were retrospectively analyzed,5 complications were acute and the other 8 complications were delayed.Two cases were dealed with intervention.and operations were performed for the other 11 patients immediately.Results Among the 7 patients who received one-stage operation,3 patients were accompanied with acute kidney failure,and 2 patients were died.Two patients who received the second-stage operation recovered snccessfully.Two patients who surrendered were surrived 3 and 8 months respectively.Conclusions It is difficult to deal with the major complications after PTBD,and the main cause of postoperative death is acute kidney failure.It will be helpful to deal with the primary disease on the second-stage.

Objective To explore the risk factors of pulmonary artery hypertension (PAH) and the its relationship with T cell subsets to provide a foundation for the prevention and treatment of PAH.Methods 154 maintained hemodialysis (MHD) patients in our dialysis center were recruited according to the criterion and divided into two groups subsequently:PAH group (pulmonary artery systolic pressure,PASP ＞ 35 mmHg) and non-PAH group (PASP≤35 mmHg).The related clinical,biochemical and ultrasonic cardiogram data were collected and peripheral blood was acquired to detect the expressions of the surface antigen CD3,CD4,CD8 and CD69 with flow cytometry.Logistic regression analysis was used to find out the relationship between PAH and T cell subsets.Results There was no significant difference between 56 cases of PAH and 98 cases of non-PAH as regards gender,age,mean systolic and diastolic pressure,dialysis durations,morbidities of hypertension and diabetes,smoking rate,and left ventricular diameter.Compared with the non-PAH group,the PAH group demonstrated a lower percent of CD8 T cells and CD8 CD69 T cells,but a much higher left atrial diameter (LAD),Interventricular septum thickness,left ventricular posterior wall thickness,and NT-proBNP.The percentage of T cells,CD4 T cells and CD4 CD69 T cells showed no difference between the two groups.Multivariate analysis confirmed that PAH was negatively independently associated with the percentage of CD8 T cells and CD8CD69 T cells.Conclusions The decreased percentage of CD8 T cells and CD8CD69 T cells in the peripheral blood is a risk factor of PAH in maintained hemodialysis patients,and CD8 T cells may play an important role in the genesis of PAH.

Objective To analyze the efficacy of Xiyanping inhalation combined with acyclovir in treatment of children with herpangina and its influence on inflammatory factors.Methods A total of 90 children with herpangina were randomly divided into observation group and control group.The observation group was treated with Xiyanping inhalation combined with acyclovir,while control group was given intravenous dripping of Xiyanping and acyclovir.The effect,clinical signs disappeared time,hospitalization time,the change of inflammatory factors and adverse reactions before and after treatment were compared.Results The total effective rate of the observation group was significantly higher than the control group (P ＜ 0.05).The disappearance time of the fever,herpes,salivation clinical signs and hospitalization time in the observation group were significantly shorter than the control group (P ＜ 0.05).After treatment,there were significant differences in inflammatory cytokines such as IL-6,TNF-α,IL-2 and IL-10 between two groups (P ＜0.05).There was no significant difference between the two groups in incidence rate of adverse reactions (P ＞ 0.05).Conclusion Xiyanping inhalation combined with acyclovir is effective in treatment of children with herpangina.

Objective To analyze the efficacy of Xiyanping inhalation combined with acyclovir in treatment of children with herpangina and its influence on inflammatory factors.Methods A total of 90 children with herpangina were randomly divided into observation group and control group.The observation group was treated with Xiyanping inhalation combined with acyclovir,while control group was given intravenous dripping of Xiyanping and acyclovir.The effect,clinical signs disappeared time,hospitalization time,the change of inflammatory factors and adverse reactions before and after treatment were compared.Results The total effective rate of the observation group was significantly higher than the control group (P ＜ 0.05).The disappearance time of the fever,herpes,salivation clinical signs and hospitalization time in the observation group were significantly shorter than the control group (P ＜ 0.05).After treatment,there were significant differences in inflammatory cytokines such as IL-6,TNF-α,IL-2 and IL-10 between two groups (P ＜0.05).There was no significant difference between the two groups in incidence rate of adverse reactions (P ＞ 0.05).Conclusion Xiyanping inhalation combined with acyclovir is effective in treatment of children with herpangina.

Objective:To evaluate the mid-term results of fenestrated/branched endovascular aortic repair (f/b EVAR) for the treatment of thoracoabdominal aortic aneurysms. M ethods The clinical data of 105 thoracoabdominal aortic aneurysm patients treated with f/b EVAR at the Department of Vascular Surgery of Nanjing Drum Tower Hospital from 2018 to 2019 were retrospectively analyzed. Results:There were 43 cases of thoracoabdominal aortic aneurysm and 62 cases of thoracoabdominal aortic aissection.A total of 336 branch arteries were reconstructed,and technical success rate was 94.3%. 100 cases (95.2%) were followed-up, 6 cases (5.7%) received reoperation interventions, and 11 cases (10.5%) died. During the follow-up period, 69 cases had complete imaging data. Based on the recent CT date of the thoracoabdominal aorta, 58 patients hael positive aortic remodeling and 11 patients hael negative and indeterminate remodeling; there were 31 cases (29.5%) of endoleaks, including 7 cases (6.7%) of type Ⅰb endoleaks, 8 cases (7.6%) of type Ⅱ, 1 case (0.95%) of type Ⅲa, 13 cases (12.4%) of type Ⅲc endoleaks and 2 cases (1.9%) of type Ⅳ. Conclusions:The mid-term follow-up results were satisfactory for TAAA treated with f/b EVAR. Internal leakage remains key point for f/b EVAR.