0.05) The correlation coefficients were 0 52-0 96 (2) The correlation coefficients of left ventricular mass(EDM and ESM) among three methods were lower than those of left ventricular volume ,and there was statistically significant difference in ESM between MRI and echocardiography( P

ObjectiveTo evaluate the intraoperative combined application of fibercholedochoscopy and B-type ultrasound for the treatment of intrahepatic biliary duct stones. Methods In our department 65 cases of intrahepatic biliary duct stones treated by fibercholedochoscopy and followed up for ten years were used as control. Results were compared with that of 78 cases undergoing combined management.ResultsFollow-up at first 5 years showed that patients treated with fiberbiliascopy had a much lower stone recurrent rate than that without, though difference became less significant within second 5 years. Intraoperative combined application of fibercholedochoscopy and B-ultrasound futher decreases the stone recurrence rate. ConclusionsCombining fibercholedochoscopy with B-type ultrasound intraoperatively enables the operator to locate intrahepatic biliary duct stones, reduces retained stone rate and stone recurrence.

Objective To evaluate the effect of colquhounia root tablet on the expression of tight junction proteins claudin-5 and ZO-1 in the renal tissues of rats with acute lung injury (ALI).Methods Twenty-four healthy male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),ALI group;and colquhounia root tablet group (group H).Oleic acid 0.04 ml/kg was injected into the trail vein to establish the model of ALI.In group H,colquhounia root tablet 600 mg · kg-1 · d-1 was instilled into the stomach of each rat for 10 consecutive days,and oleic acid was injected at 1 h after instillation on 10th day.Blood samples were collected from the abdominal aorta at 6 h after injection of oleic acid for determination of plasma creatine (Cr) and blood urine nitrogen (BUN) concentrations.The animals were then sacrificed.The lungs were removed for determination of wet/dry lung weight ratio (W/D ratio),and for examination of the pathological changes.The kidneys were removed for determination of the expression of claudin-5 and ZO-1 (by immunohischemistry assay and Western blot) and for examination of the pathological changes.The damage to the renal tubules was scored.Results Compared with group C,W/D ratio,plasma Cr and BUN concentrations,and renal tubular damage score were significantly increased,and the expression of claudin-5 and ZO-1 was down-regulated in group ALI (P＜0.01).Compared with group ALI,W/D ratio,plasma Cr and BUN concentrations,and renal tubular damage score were significantly decreased,and the expression of claudin-5 and ZO-1 was up-regulated in group H (P＜0.01).The pathological changes of lungs and kidneys were significantly attenuated in group H as compared with group ALI.Conclusion Colquhounia root tablet can attenuate kidney injury through up-regulating the expression of tight junction proteins claudin-5 and ZO-1 in the renal tissues of rats with ALI.

Objective To study the hemodynamic changes of rabbit VX2 liver tumors before and after ethanol injection by perfusion imaging of MSCT and investigate the correlation between perfusion parameters and microvessel density (MVD). Methods All of 15 Japanese long-ear white rabbits were divided into control group and experiment group. All rabbits were inoculated with VX2 liver tumor. Perfusion imaging of MSCT scans were conducted in 5 rabbits in the control group on the 14 th day after VX2 tumor inoculation, and the borders of the tumors were stained with immunohistochemical stains, and MVD was measured by anti-CD34. Perfusion imaging of MSCT scans were conducted in all 10 rabbits in the experiment group on the 14 th day after VX2 tumor inoculation. Then absolute alcohol was injected into the tumors by laparotomy. CT scans were conducted 3 and 30 days after absolute alcohol injection, and the borders of the tumors were stained immunohistochemically, and MVD was measured by anti-CD34. The differences of perfusion parameters such as hepatic blood ( BF), hepatic blood volume (BV), mean transit time ( MTT),permeability of capillary vessel surface (PS), and hepatic arterial fraction (HAF), hepatic arterial perfusion (HAP) were compared to evaluate the liver hemodynamic changes. Statistical repeated measurement t test, correlation analysis were performed. Results BF of border of the tumor between pretreatment, 3 days after ethanol injection and 30 days after ethanol injection were ( 280. 62 ± 59. 87 ),(322.03 ± 86. 94 ), ( 177.05 ± 75.96) ml · min -1; HAF were 0. 59 ± 0. 08, 0. 89 ± 0. 12, 0. 23 ± 0. 07;HAP were ( 189. 26 ± 25.46), ( 251.57 ± 31.78 ), (40. 90 ± 5.17 ) ml · min - 1 · ml - 1. HAP increased significantly after ethanol injection 3 days ( P ＜ 0. 05 ); BF, HAF, HAP decreased significantly 30 days after ethanol injection compared with 3 days after ethanol injection ( P ＜ 0. 05 ); BF, HAF, HAP decreased significantly 30 days after ethanol injection compared with pre-treatment ( P ＜ 0. 05 ). It showed positive correlation between BF, PS, HAF, HAP and MVD (r=0. 916, 0. 726, 0. 870, 0. 889; P ＜0. 05). MVD decreased significantly compared with the control group (43.9 ± 4. 0)/HP 30 days after ethanol injection (21.8±3.5)/HP (t = 12.271, P ＜0.05). Conclusion Perfusion imaging of MSCT can detect the hemodynamic changes in rabbit VX2 liver tumors, and also in tumors before and after ethanol injection. CT perfusion can take the place of MVD to evaluate the tumor angiogenesis.

Objective To prepare a new type of chitosans nanoparticles(PEG/CS-EPI NPs),which contains epirubicin and modified by PEG.Furthermore,to investigate the anticancer activity of the NPs in vitro and in vivo.Methods The ionic gelation technique was employed to prepare the PEG/CS-EPI NPs and CS-EPI NPs.The particle size and shape were illustrated respectively by laser scattering and transmission electron microscopy.The proliferation of nasopharyngeal carcinoma cells was detected by MTT assay;The mouse model of implantation murine sarcoma cells(S-180) was applied to evaluate the anticancer effectiveness of PEG/CS-EPI NPs and CS-EPI NPs in vivo.Results The PEG modified CS NPs were discrete and uniform spheres with average diameter of 322.1 nm.The rate of drug loading and encapsulation is 13% and 74% respectively.The results of the anticancer tests showed a sustained cytotoxicity of loading drug NPs on nasopharyngeal carcinoma cells in vitro and the stealth nanoparticles was more powerful than ordinary nanoparticles on the inhibitory potency in vivo.Conclusion Stealth chitosan nanoparticles as compared with ordinary chitosan nanoparticles seems to be a potential candidate of chemotherapy drug carriers.

OBJECTIVE:To prepare Baicalin monolithic osmotic pump tablets and investigate its in vitro drug release behavior. METHODS:Using accumulative release rate as evaluation index,baicalin solid dispersion was prepared to improve solubility,sin-gle factor test and orthogonal test were used to optimize preparation technology(the amount of penetrating agent and pore-forming agent,weight gaining of coating film) of monolithic osmotic pump tablets using baicalin solid dispersion as intermediate. Release rate and mechanism of samples prepared by optimized technology were investigated in 3 kinds of release medium (water,0.1 mol/L HCl,simulated gastric fluid). RESULTS:The optimal preparation technology was that penetrating agent sodium chloride was 30 mg;pore-forming agent polyethylene glycol 400 was 20% amount of excipient cellulose acetate;weight gaining of coating film was 2%. RSD of 12 h accumulative release rate was 1.06%(n=3)for 3 batches of Baicalin monolithic osmotic pump tablets pre-pared by optimized technology. 12 h accumulative release rate of them in 3 kinds of medium were similar to each other,being all more than 80%. Release equation was in line with zero-order drug release model (r=0.9985). CONCLUSIONS:Prepared Ba-icalin monolithic osmotic pump tablets after optimization can release drug at controlled rate.

Objective To investigate the influencing factors of successfully switching to sequential ventilation in patients with prolonged weaning due to acute respiratory failure (ARF) after thoracolaparotomy based on the initial rapid shallow breathing index (RSBI) at 60 min after spontaneous breathing trial (SBT), namely, the f/VT optimal value range of 80-120 times/ (min · L), thus providing the basis for determining the ideal timing of weaning in clinical practice.Methods A prospective observational study of sequential ventilation [RSBI during the initial SBT (60 min), 80-120 breaths/ (min · L)] was carried out in 42 patients on mechanical ventilation (≥ 48 h) due to post-thoracolaparotomy ARF in the ICUs.According to the duration of the mechanical ventilation, the patients were divided into 2 groups : successfully prolonged weaning group (≥ 7 days, n =24) and refractory weaning group (＜ 7 days, n =18).The patients with cardiac failure, aged less 18 or over 80, with hepatic dysfunction, or those needing gastrointestinal decompression after esophageal surgery or upper abdomen surgery were excluded.The demographics, APACHE Ⅱ scores and duration of mechanical ventilation of both groups were recorded, and the respiratory work and oxygen metabolism variables before the switch to sequential ventilation (within 24 hours after admission to ICU) and at the time of switching (24 hours in the ICU after admission) were recorded, respectively: clinical puhnonary infection score (CPIS), assessment of cough severity, pH, PaO2, PaCO2 and PaO2/FiO2;hemodynamic and microcirculation-related variables: HR, MAP, fluid balance, BNP and Lac;endocrine and metabolism variables : Hb, ALB and random serum cortisol (COR).The clinical features and the changes of the above-mentioned variables before and at the time of switching were compared between both groups.The independent sample t test was used for the single factor comparison and Mann-Whitney U test was applied to the non-normal distributions.The Fisher exact probability test was used for the single factor comparison of ranked data such as categorical variables.Results There were no significant differences in age, gender and severity of disease between two groups (P ＞ 0.05);the successfully prolonged weaning group had longer duration of invasive mechanical ventilation and ICU stay compared with the refractory weaning group (P ＜ 0.05).There were significant differences in cough severity, PaCO2, pH, HR and fluid balance between two groups before switching (P ＜ 0.05).Compared with those before switching, in the refractory weaning group there were marked decrease in Lac (P ＜ 0.05), obvious increase in cough severity, pH, Hb and ALB (P ＜ 0.05), but there was no significant difference in COR (P ＞ 0.05);while in the successfully delayed weaning group, there were significant decrease in CPIS, PaCO2, HR, MAP, BNP, fluid balance and Lac (P ＜ 0.05), and cough severity, pH, ALB and COR showed an upward trend (P ＜ 0.05).Conclusions The key of successful sequential ventilation is within the values of RSBI ranging from 80 to 120 times/ (min · L) during the initial SBT (60 min) selected as the switching point in patients with prolonged weaning after thoracolaparotomy.The major influencing factors for determining the ideal timing of switching include the matching status between respiratory endurance and respiratory work, the balance between myocardial strength and both cardiac preload and afterload, the severe disease associated with adrenal insufficiency, and malnutrition.

Objective To compare the measured resting energy expenditure (MREE) in patients with sepsis calculated using respiratory indirect calorimetry and Harris-Benedict (HB) coefficient method,and to investigate the influence of different energy target on the prognosis of patients with sepsis.Methods This was a prospective comparative study.60 patients with sepsis who were suitable for nutrition support and respiratory indirect calorimetry in the Intensive Care Unit (ICU) of the General Hospital of Ningxia Medical University from January to October 2015 were selected.(1) MREE was measured simultaneously with respiratory indirect calorimetry and HB coefficient (Harris-Benedict equation × stress coefficient) in the 60 patients on the 0,3rd,7th,and 14th days of nutrition support.The MREE calculated with the two methods were compared to detect difference.(2) The septic patients were randomly divided into two groups according to the random number table:respiratory indirect calorimetry group (n =30),in which the nutrition support was given according to the MREE measured using respiratory indirect calorimetry as the energy target;HB coefficient method group (n =30),in which the nutrition support energy target was the MREE measured using HB coefficient method.The clinical data of the patients in both groups were recorded and compared,which included the baseline characteristics,nutrition-related complications,and prognostic indicators.Results (1) Within 2 weeks during nutrition support,the dynamic MREE in the respiratory indirect calorimetry group was significantly higher than that in the HB coefficient method group (P ＜0.05).There was no significant difference in MREE on the 0,3rd,7th,and 14th days of nutrition support measured by respiratory indirect calorimetry (P ＞ 0.05).(2) There were no significant differences between the two groups in incidence of liver function damage and abnormal blood glucose within 2 weeks of nutrition support (both P ＞ 0.05).Compared with the HB coefficient method group,the length of ICU stay and 28-day mortality were significantly lower in the respiratory indirect calorimetry group [193.5 (172.2,289.7) h vs.247.5 (194.7,393.2),Z=-2.061,P=0.039;3.3％ vs.23.3％,x2 =5.129,P=0.023],but there was no significant difference between the two groups in mechanical ventilation time (P ＞ 0.05).Conclusions The MREE of septic patients may be considerably high and with little fluctuation in a short period.Respiratory indirect calorimetry may be more suitable to guide the energy intake target in septic patients.

BACKGROUND: The surgical resection rate of pdmary hepatic carcinoma is low, thus, the local treatment arose more attention. Microwave coagulation therapy can inactivate rather than kill the hepatic carcinoma ceils. Slow-release chemotherapy has been used in treating primary hepatic carcinoma because it can form local high concentrations and last for a long time. OBJECTIVE: To observe the therapeutic effect of epirubicin-loaded chitosan microspheres combined with microwave coagulation on treating hepatocellular carcinoma in mica. METHODS: Epirubicin-loaded chitosan microspheres were prepared by using emulsion-chemical cross linking technique. The surface morphology and particles size of chitosan microspheres were observed by scanning electron microscope. Ultraviolet speotrophotometer was used to analyze the entrapment efficiency, entrapment efficiency and cumulative release rates of epirubicin-loaded chitosan microspheres. Totally 24 mice with transplanted subcutaneous H22 HCC were divided into 4 groups, which were respectively treated by microwave coagulation therapy, intratumoral injected with physiological saline after microwave coagulation therapy, intratumoral injected with epirubicin after microwave coagulation therapy, intratumoral injected with epirubicin-ioaded chitosan microspheres after microwave coagulation therapy. The tumor inhibitory rate was calculated. RESULTS AND CONCLUSION: The average diameter of chitosan microsphere was 105 μm, with uniformed particle diameter. The ratio of drug loading was 11% and the entrapment was 80%. The in vitro drug cumulative release rate was 84% after 2 weeks. The tumor inhibitory rates of the microwave coagulation combined with physiological saline, epirubicin, and drug carried microspheres groups were 8%, 20%, and 47%. It suggested that chitosan microsphere is a safe and effective slow-release dosage form, which exhibits strong anti-tumor effect when combined with microwave treatment.

dneys, renal hilars and adjacent blood vessels. Conclusions Most of the adrenal lymphoma manifested as large soft tissue masses with shght contrast enhancement. The larger lesions were likely to invade the ipsilateral kidney and adjacent blood vessels.