Objective To investigate the safety and therapeutic effect of intra-carotid infusion with cold sa line in rats with acute focal cerebral ischemia-reperfusion injury.Methods 60 rats were randomly divided into six groups:sham operated group,normal infusion group,stroke group,local hypothermic group,local normothermic group,and systemic infusion group.Brain infarct volume and cerebral water content were analyzed 48 h after ischemia.Neurological deficits were assessed using the mNSS 24 h and 48 h after infarction.Results In the local hypothermic group,brain temperature was reduced to 33 to 34 ℃ within 5 to 10 minutes,and this significantly low temperature maintained to nearly 60 minutes after infusion continued.Physiological variables were not significantly different among each time point (P ＞ 0.05).No significant morphological abnormality was found in brain sections stained with TTC and HE.Animals receiving local cold infusion significantly decreased infarct volume and brain water content compared to stroke group (P ＜ 0.05).Both 24 h and 48 h mNSS in local hypothermic group was significantly lower than those in other groups (P ＜ 0.05).Conclusions Intra-carotid infusion with cold saline can quickly and effectively reduce brain temperature and is a relatively safe cooling method.Local hypothermia significantly reduced brain infarct volume,decreased brain water content and improved neurological functional outcomes after brain ischemia.

Objective:To evaluate the short-term effect of robotic pancreaticoduodenectomy (RPD) and laparoscopic pancreaticoduodenectomy (LPD) in the treatment of ampullary and periampullary tumor systematically.Methods:A systematic search of the PubMed, Embase and Cochrane library database using the key words "pancreaticoduodenectomy, duodenopanreatectpmy, whipple, laparoscopic, robotic, Da Vinci" . A systematic search of the Sinomed, Wangfang, VIP and CNKI databases including the key words "胰十二指肠切除" , "腹腔镜" , "机器人" , "达芬奇" . To investigate the differences of the conversion rate of laparotomy, incidence of postoperative complications, and the postoperative hospital stay between the RPD group and the LPD group. The software RevMan5.3 was used in this meta-analysis.Results:A total of 4 retrospective cohort studies and 1 001 patients were included in this meta-analysis, including 451 patients in the RPD group and 550 patients in the LPD group. The results of the meta-analysis showed that there were significant differences between RPD group and LPD group for the conversion rate laparotomy ( OR=0.35, 95% CI: 0.24-0.50, P<0.05). There were no significant differences between RPD group and LPD group for the incidence rate of overall complication( OR=1.23, 95% CI: 0.95-1.58, P>0.05), hemorrhage ( OR=0.71, 95% CI: 0.50-1.00, P>0.05), pancreatic fistula ( OR=1.09, 95% CI: 0.80-1.49, P>0.05), delayed gastric empty ( OR=0.81, 95%CI: 0.57-1.14, P>0.05) and hospital stay after surgery ( WMD=-2.87, 95% CI: -1.44-1.70, P>0.05). Conclusions:RPD is as safe as LPD, with the same complication rate. Therefor it is worthy for further application in medical institutions with relevant conditions.

Objective To optimize the solid-phase synthesis process of phosphorodiamidate morpholino oligonucleotide(PMO)and determine the optimal reaction conditions.Methods The PMO tetramer PMO-TTTT was synthesized according to the reported reaction conditions,followed by purification through a semi-preparative high-performance liquid chromatography(HPLC)process.PMO-TTTT was structurally verified using nuclear magnetic resonance(NMR)and high-resolution mass spectrometry.With purified PMO-TTTT as a reference,a calibration curve was established,which subsequently guided the optimization of the reaction conditions for the solid-phase coupling reaction process,including the organic base,additives,duration of reaction and temperature.Under the optimized reaction condition,the anti-influenza A virus PMO sequence,PMO-flu,was synthesized and purified using a nucleic acid purification device.Results The optimal parameters for PMO solid-phase synthesis were determined.The organic base was N-ethylmorpholine,the additive was lithium iodide,the best temperature was 30 ℃,and the duration was 90 minutes.Conclusion The PMO solid-phase synthesis process has been established.LiI has been screened as a potent coupling reaction additive which could significantly boosts the efficiency of PMO solid-phase synthesis.

The experiment was conducted between February 2004 and May 2006 at The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang province, China. Forty hybrid pigs were used in the experiment, 20 were used as donors and the other 20 were used as recipients. Donor operation: Abdominal aorta was lavaged in situ with 500 mL 4℃ heparinized saline (lavage pressure 7.8-9.8 kPa), intestinal canal cut from donor was conserved in 4℃ physiological saline.Recipient operation: Orthotopic small intestine transplantation and heterotopic small intestine transplantation were conducted according to exploring results, and abdominal cavity was washed with 40-45℃ physiological saline until the flush out liquid became warm.Periprocedural management: Preoperative discussion and postoperative discussion were done, and body temperature of pigs was monitoring and controlled. Early-stage feeding was used, 4 pigs could drink water freely after transplantation and took food normally at the second day, while other 16 pigs began to drink water 2 days after transplantation. Evaluation after the operation: No experimental animal had anastomotic leakage after taking food. Sixteen pigs survived over 7 days, average 9 days, the longest over 14 days. The success rate of the small intestine transplantation is 80% (16/20). Failure reasons: One with phlebothrombesis, one with blood loss and two with unknown reasons. Results showed that experience of periprocedural management had got relatively satisfactory effects through a great quantity of small intestine transplantation practices.

OBJECTIVETo compare the neuroprotective effects of intracarotid cold saline infusion (ICSI), ice cap and systemic cooling in rats with early cerebral ischemia.

METHODSSD rats were randomly divided into model group, ice cap group, systemic cooling group and ICSI group (n=13). Cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) for 2 h. In the 3 hypothermic groups, the target temperature of 33-34 degrees celsius; was achieved and maintained for 20 min. In each group, the neurological scores were recorded at 48 h after the reperfusion, and the brains were removed for measuring the infarct size using 2,3,5-triphenyltetrazolium chloride staining. The brain water contents and serum levels of neuron-specific enolase (NSE), S100β and matrix metalloproteinase 9 (MMP9) were also measured.

RESULTSCompared with the model group, the ice cap, systemic cooling and ICSI groups all showed significantly reduced infarct size by 27.4% (P<0.05), 47.6% (P<0.01) and 61.6% (P<0.01), respectively. The systemic cooling and ICSI groups, but not the ice cap group, had significantly lower brain water contents than the model group (P<0.05). Among the 3 hypothermic methods, only ICSI significantly improved the neurological scores (P<0.05) and reduced serum NSE and S100β levels (P<0.05).

CONCLUSIONOf the 3 hypothermic groups, ICSI has the best neuroprotective effects, and systemic cooling produces better effect than ice cap in rats with ischemic stroke.

Animals ; Brain Ischemia ; therapy ; Cryotherapy ; methods ; Hypothermia, Induced ; methods ; Infusions, Intra-Arterial ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; prevention & control ; Sodium Chloride ; administration & dosage

OBJECTIVE:To investigate drug combination in outpatient prescriptions of hypertension patients in our hospital, provide reference for rational drug use in clinic. METHODS:The outpatient prescriptions of patients diagnosed as hypertension dur-ing Jan. 1st to Feb. 1st in 2015 were collected from the hospital. The prescriptions of two or more than two drugs were screened, and the prescriptions of drug combination containing CYP enzyme substrate,inhibitor or inducer were recorded. Guided by metabol-ic enzymology theory,the potential metabolic drug interactions in prescriptions were evaluated on the basis of relevant literature and data reports. RESULTS:Totally 1042 prescriptions were consulted. The prescriptions of the combined medication were 551, and the potential metabolic drug-drug interactions were detected at 249 prescriptions,accounting for 45.2％. Main CYP enzyme sub-types were CYP3A4,CYP2C9,CYP2C19 and CYP2D6. Totally 214 prescriptions were correlated with CYP3A4,accounting for 85.9％ of drug interaction prescriptions;CYP3A4 substrate combined with substrate in 199 prescriptions,with inhibitor in 27 pre-scriptions,and with inducer in 11 prescriptions. Totally 27 prescriptions were correlated with CYP2C9,accounting for 10.8％ of drug interaction prescriptions;CYP2C9 substrate combined with substrate in 8 prescriptions,and with inhibitor in 20 prescriptions. Totally 27 prescriptions were correlated with CYP2D6,accounting for 10.8％ of drug interaction prescriptions;CYP2D6 substrate combined with substrate in 15 prescriptions,and with inhibitor in 12 prescriptions. Totally 4 prescriptions were correlated with CYP2C19,accounting for 1.6％ of drug interaction prescriptions;CYP2C9 substrate combined with inhibitor in 2 prescriptions, and with inducer in 2 prescriptions. CONCLUSIONS:Many metabolic drug-drug interactions are detected in the outpatient prescrip-tions of hypertension patients in our hospital. In order to improve the rationality and safety of the prescription,clinicians and phar-macists should pay attention to the drug combinations with drug-drug interactions which have been reported in the existing litera-ture,and choose similar drugs without or with little interactions.

Objective To evaluate laparoscopic surgery for Mirizzi syndrome.Methods A retrospective study was carried out on 14 patients undergoing laparoscopic operation for Mirizzi syndrome from Feb.2013 to Nov.2018.There were 4 patients of type Ⅰ,8 patients of type Ⅱ,2 patients of type Ⅲ according to Csendes classification.Results Laparoscopic procedures were successfully completed in all patients.All 4 cases of type Ⅰ received laparoscopic cholecystectomy.4 patients of type Ⅱ were given laparoscopic cholecystectomy combined with primary suture of common bile duct;the other 4 patients of type Ⅱ underwent laparoscopic cholecystectomy plus T tube drainage.2 patients of type Ⅲ were treated with laparoscopic partial-cholecystectomy combined with repair of the duct defect and T tube drainage.All the patients recovered uneventfully.The postoperative hospitalization time was 4 to 7 d,with an average of 5.5 d.There were no major postoperative complications.14 patients were followed up for 1-8 months,and there was no biliary stricture and no stone recurrences.Conclusion For cases of type Ⅰ,type Ⅱ and type Ⅲ,laparoscopic surgery is a safe treatment.

Objective To study the effectiveness and safety of prophylactic anticoagulation in the prevention of portal venous thrombosis (PVST) in patients after laparoscopic splenectomy.Methods A systematic search of the PubMed,Embase,Cochrane Library,Sinomed,Wangfang,Weipu and CNKI databases was performed to identify studies which compared outcomes in patients with or without prophylactic anticoagulation after laparoscopic splenectomy.The quality of the included studies was assessed using the Cochrane collaboration tool and the Newcastle-Ottawa Scale.Heterogeneity was evaluated using the x2 and I2 tests.The primary outcome was the incidence of postoperative PVST.Results Five studies were included into this review,which involved 206 and 168 patients with or without prophylactic anticoagulation,respectively.The incidence of PVST was significantly reduced with prophylactic anticoagulation with an odds ratio (OR) of 0.32 [95％ confidence interval (CI),0.13 ～0.79,P＜0.05].Conclusion Prophylactic anticoagulation resulted in a significant reduced incidence of PVST after laparoscopic splenectomy.

0bjective: To establish a three-dimensional finite element model of mandible and study the transverse displacement of proximal segment after Bilateral Sagittal Split Ramus Osteotomy (BSSRO) with different retrogression amounts during mastication. Methods: DICOM data of a skull model were processed with MIMICS and ANSYS software, reconstructing the 3D model including the teeth and temporomandibular joint in order to simulate BSSRO and evaluate the transverse displacement of proximal segment with different retrogression amounts during mastication. Results: The mean of proximal segment width change were 2.955 mm and 3.490 mm, when retrogression amounts of distal segmentwere 3 mm and 8 mm, respectively.No significant difference between the two groups were found (P=0.131). Meanwhile the displacement color scale of the 3D finite element models showed that the apparent transverse displacement distribution of the proximal segment was measured around the gonial area, decreased from the exterior to the interior. Conclusions The mandibular angle width was significantly expanded right after BSSRO. The masticatory muscle system and single cortical fixation system played an important role in expanding the width of proximal segment. However there was no correlation between the widening effect and retrogression amounts of distal segment of mandible.

In recent years,public health events caused by severe infectious diseases had a profound impact on human health,economic and social development.Drug stockpiling for infectious disease prevention and treatment is of great significance in improving the ability to respond to public health events.However,the drug stockpiling system of China for infectious disease prevention and treatment still needs to be improved.Based on the investigation and comparison of the current status of drug stockpiling for infectious disease prevention and treatment between China and the United States,this article proposes some suggestions according to China's specific circumstances for reference.