Objective　To study the value of B type ultrasonography guiding percutaneous radiofrequency ablation (PRFA) for hepatic cancer (HC). Methods　70 patients with primary or metastatic hepatic malignancies were treated by PRFA under ultrasound guidance through LeVeen multipolar array needle electrode and RF 2000. All patients were followed up by turnor marker, B type sounography and MRI monthly. Results　PRFA were performed in 53 patients with hepatocellular carcinoma (HCC) and 17 cases with metastatic liver cancer. Liver function classfication was 53 cases in Child class A, 15 in class B and 2 in class C. In 21 patients with non-operated small HCC (≤5 cm), 12 of 17 patients with AFP positive were decreased to normal (70.6%) and decreased markedly in 4 (23.5%), and MRI showed the treated tumors were completely necrosis in 16 patients (76.2%). The 3, 6 month survival rates were 90.5%, 100% respectively in small HC groups, and 66.7% to 72.7% and 27.6% to 72.7% in large HC groups.Conclusions　PRFA as a local thermal therapy is becoming a kind of new palliative treatment for hepatic malignancies, which not only is safe, minimally invasive, and effective for small ones; but also can be used with combination of TACE for larger ones.

Objective To explore the clinical value of tissue synchronization imaging(TSI) in assessment of the characteristics of myocardium asynchrony in patients with ischemic cardiomyopathy(ICM). Methods Thirty-eight patients with ICM were divided into two groups: 26 patients without left bundle branch block(LBBB) in group A, and 12 patients with LBBB in group B. The control group consisted of 26 normal healthy subjects. According to 2D color,the characteristics of myocardium motion in each group were compared by TSI. The time for reaching systolic velocity peak(Ts) and early diastole velicity peak(Te) were measured separately in 12 segments. Standard deviations of Ts(Ts-SD) and Te(Te-SD) as well as difference of Ts(Ts max-min) and Te(Te max-min) of all 12 segments were calculated. The myocardium synchronization were assessed in each group. Results ①91.8% segments in the control group showed normal, with only 8.2% segments were slightly prolonged. TSI of all the ICM patients showed an obvious uneven chroma distribution from green to yellow and then to red. There were far more yellow or red segments than in the control group. ②Ts-SD.Ts max-min of LV 12 segments were significantly prolonged in all ICM groups compared with that in the control group ( P <0. 05). Systolic asynchrony was more obvious in group B than in group A. ③Te-SD,Te max-min of LV 12 segments were significantly prolonged in ICM groups than in the control group ( P < 0. 05). Diastolic asynchrony was more obvious in group B than in group A( P < 0. 05). ④Compared with that in the control group, postsystolic shortening(PSS) was common in patients with ICM. 32. 4% segments of group A were detected PSS.and 56. 0% segments of group B were detected PSS. Conclusions Left ventricular systolic and diastolic mechanical asynchrony is obvious in patients with ICM and PSS is common among them. Systolic and diastolic mechanical asynchrony is more severe in ICM patients with LBBB. TSI is the optimal means to evaluate the characteristics of asynchronous myocardial contraction.

Objective: To study the influence of preoperative transcatheter arterial chemoembolization (TACE) by selection on survival rate of resectable hepatocellular carcinoma (HCC) patients. Methods: Jan. 1996 to Jan. 1997, TACE was performed before surgery in 62 of 126 patients undergoing resection and the other 64 patients without TACE from. Results were retrospectively analyzed with regard to the changes of pathological examination after operation, recurrence rate and survival rate 1, 2, 3 years after operation. Results: Pathological examination showed that there were 13 total necrosis in TACE group, but no one in contrast group. There were no significant difference of recurrence rate 1, 3 years after operation between 2 groups. Recurrence rate 2 years after operation was 29.8% in TACE group, but 58.3% in contrast group. There were significant difference of recurrence rate 2 years after operation between 2 groups (P<0.05). Survival rate 3 years after operation was 54.4% in TACE group, but 33.3% in contrast group. Survival rate of TACE group was higher than that of contrast group (P<0.05). There were not significant difference of recurrence rate 1, 2 years after operation between 2 groups. Conclusion: Proper preoperative TACE for resectable HCC can improve the outcome of the operation to some extent.

Purpose　The aim is to investigate the hemostatic and protective effect of fibrin sealant(FS) on liver trauma in rats.Methods　On the surface of cracked wound(type Ⅰ) and resected wound(type Ⅱ)，spraying of FS or thrombin or direct suturation, was used receptively. Natural hemostasis was used as control.During postoperation the hemostatic time and the state of wound healing on 1st, 4th, 7th,14th, 50th day were observed.Results　Compared with the natural hemostasis,the hemostatical time of the FS group was shorter 86.0%(P＜0.01)in liver trauma type Ⅰ and 79.0%(P＜0.01)in liver trauma type Ⅱ.Compared with the thrombin group,the hemostatical time of the FS group was shorten 45.0%(P＜0.01)in liver trauma type Ⅰ and 84.0%(P＜0.05) in liver trauma type Ⅱ.The wound surface of FS group was healed faster than that of other groups.Conclusion　FS was an effective hemostatic and healing-promoter on liver trauma of rats.

To study the effect of steaming and baking process on contents of alkaloids in Aconite Lateralis Radix (Fuzi), 13 alkaloids were analyzed by UPLC-MS/MS equipped with ESI ion source in MRM mode. In steaming process, the contents of diester-diterpenoid alkaloids decreased rapidly, the contents of monoester-diterpenoid alkaloids firstly increased, reached the peak at 40 min, and then deceased gradually. The contents of aconine alkaloids (mesaconine, aconine and hypaconine) increased all the time during processing, while the contents of fuziline, songorine, karacoline, salsolionl were stable or slightly decreased. In baking process, dynamic variations of alkaloids were different from that in the steaming process. Diester-diterpenoid alkaloids were degraded slightly slower than in steaming process. Monoester-diterpenoid alkaloids, aconine alkaloids and the total alkaloids had been destroyed at different degrees, their contents were significantly lower than the ones in steaming Fuzi at the same processing time. This experiment revealed the dynamic variations of alkaloids in the course of steaming and baking. Two processing methods which can both effectively remove the toxic ingredients and retain the active ingredients are simple and controllable, and are valuable for popularization and application.
Aconitine ; analogs & derivatives ; isolation & purification ; Aconitum ; chemistry ; Alkaloids ; isolation & purification ; Chromatography, High Pressure Liquid ; Drug Stability ; Drugs, Chinese Herbal ; isolation & purification ; Hot Temperature ; Plant Extracts ; isolation & purification ; Steam ; Tandem Mass Spectrometry ; Time Factors

OBJECTIVETo observe the clinical efficacy of Shen No. 9 Recipe (SR) combined with Qingre Moshen Granule (QMG) in treatment of idiopathic membranous nephropathy (IMN) patients with no efficacy after treated by hormone or immunosuppressive agent, and further to explore the possible mechanism of this method in treatment of IMN by detecting the cellular immune function and cytokine interleukin-2 (IL-2).

METHODSForty-four IMN patients with no efficacy after treated by multiple Western drugs were recruited from October 2007 to October 2009. They took SR (one dosage daily, oral administration in two portions) and QMG (each package each time, thrice daily) for 24 weeks. The 24-h urine protein, glomerular filtration rate (GFR), plasma albumin (Alb), serum creatinine (SCr), urea nitrogen (BUN), triglyceride (TG), serum total cholesterol (TC), levels of cellular immune function (CD4+, CD8+, CD4+/CD8+ ratio), and IL-2 were detected before and after treatment. The changes of Chinese medicine syndrome and adverse reactions were observed and recorded.

RESULTSAfter treatment the complete remission rate, the basic remission rate, and the total effective rate was 4.5%, 68.2%, 84.1%, respectively. The total markedly-effective rate of Chinese medicine syndrome was 90.9%. The Chinese medicine syndrome was significantly lower than before treatment (P < 0.01). The 24-h urine protein obviously decreased (P < 0.01), Alb obviously increased (P < 0.01), levels of TC and TG obviously decreased (P < 0.01, P < 0.05). There was no obvious change in levels of SCr and BUN (P > 0.05). The GFR significantly increased (P < 0.05). CD4+ and the ratio of CD4+/CD8+ were obviously elevated (P < 0.01) and the CD8+ obviously decreased (P < 0.01). The expression level of IL-2 obviously increased, but it still was lower than the normal value, showing statistical difference (P < 0.01).

CONCLUSIONSSR + QMG showed definite efficacy in treatment of IMN patients with no efficacy after treated by multiple Western drugs. It could improve the level of cellular immunity and improve abnormal expression levels of IL-2.

Adult ; CD4-CD8 Ratio ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Glomerulonephritis, Membranous ; drug therapy ; immunology ; Hormones ; therapeutic use ; Humans ; Immunity, Cellular ; Immunosuppressive Agents ; therapeutic use ; Interleukin-2 ; immunology ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome

In order to clarify material basis of effective parts of liangxue tongyu prescription, blood-heat and blood-stasis rat model induced by dry yeast was established. The changes of rectal temperature, blood viscosity and plasma viscosity were used to evaluate the cooling-blood and activating-blood effects of liangxue tongyu prescription and its parts. Compared with the model group, the extract from liangxue tongyu prescription, its volatile oil and n-butanol part could significantly reduce rectal temperature (P<0.01), and also reduce blood viscosity and plasma viscosity to various degrees (P<0.01 or P<0.05). So volatile oil and n-butanol part were primarily identified as effective parts of liangxue tongyu prescription. By using GC-MS with normalization method of area to analyze volatile oil of liangxue tongyu prescription, 70 compounds were identified, accounting for about 92.54%, mainly as β-asarone, paeonol, α-asarone and shyobunone. 42 compounds such as peony glycosides, tannins, and iridoid glycosides were identified by HPLC-MS techniques and standard comparison. The study determined the effective parts of liangxue tongyu prescription and clarified the chemical composition providing the foundation for further studies on material basis of liangxue tongyu prescription.
Acetophenones ; chemistry ; Animals ; Anisoles ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Gas Chromatography-Mass Spectrometry ; Oils, Volatile ; chemistry ; Rats ; Tannins ; chemistry

OBJECTIVETo study whether acupressure could relieve urinary retention after radical hysterectomy in cervical cancer patients.

METHODSA randomized controlled prospective double-blinded trial was carried out in 107 urinary retention patients undergoing grade III radical hysterectomy. They were assigned to Group A (positive acupoints, 40 cases), Group B (negative acupoints, 32 cases) , and Group C (with no acupoints, 35 cases). All patients received protective 115 000 potassium permanganate sitz bath, 15 - 20 min each time, 3 times per day. Patients in Group A received acupressure at positive points [liniao point and Qihai (RN6)] combined points by syndrome typing [Guanyuan (RN4) , Zhongji (RN3) , Shenshu (BL23) , Zusanli (ST36), Sanyinjiao (SP6), and Taixi (K13)]. Patients in Group B received negative acupressure at sham-acupoints (for adjusting gastrointestinal functions). Patients in Group C only received conventional sitz bath. All medication was performed 3 times per day, 7 days as one therapeutic course, 21 days in total. The residual urine volume was detected. The recovery time for bladder function was recorded. The average residual urine volume was also recorded at day 7, 14, and 21.

RESULTSCompared with Group B and C, the time for ureter retention was shortened for mild and severe CKD patients in Group A (P <0. 01). The residual urine volume was also lessened for mild and severe CKD patients in Group A at day 7, 14, and 21 (P <0.01).

CONCLUSIONCervical cancer patients could relieve urinary retention by self-acupressure after radical hysterectomy.

Acupressure ; Acupuncture Points ; Female ; Humans ; Hysterectomy ; Prospective Studies ; Urinary Bladder ; Urinary Retention ; therapy ; Uterine Cervical Neoplasms ; therapy

Nitric oxide synthases (NOSs) play complex roles in the regulation of cardiac excitation contraction coupling under basal and stressed conditions. Herein, using the recording approach for intracellular calcium transient and synchronous myocyte contraction, the potential mechanism for NOSs-mediated cardiomyocyte contraction was explored. We found that selective inhibition of neuronal NOS (nNOS) with 100 µmol/L spermidine markedly enhanced the cardiomyocyte twitch [control: (10.5 ± 0.21)%; nNOS inhibition: (12.4 ± 0.18)%] and calcium transient [control: (0.27 ± 0.03)%; nNOS inhibition: (0.42 ± 0.01)%], but slowed the relengthening of twitch [control: (25.2 ± 1.3) ms; nNOS inhibition: (53 ± 2.8) ms] and the calcium transient decay [control: (129 ± 4.3) ms; nNOS inhibition: (176 ± 7.1) ms], which was similar to that by dynamin inhibition with 30 µmol/L dynasore. The nNOS inhibition- or dynasore-mediated effects could be rescued by an NO donor, S-Nitroso-N-acetylpenicillamine (SNAP). Our data suggest that the selective nNOS-mediated regulation of cardiac contractile activity may partly involve the dynamin-mediated endocytic mechanism.
Animals ; Biological Transport ; Calcium Signaling ; Dynamins ; antagonists & inhibitors ; physiology ; Endocytosis ; physiology ; Female ; Hydrazones ; pharmacology ; Male ; Myocardial Contraction ; physiology ; Nitric Oxide Synthase Type I ; physiology ; Rats ; Rats, Sprague-Dawley ; Spermidine ; pharmacology ; Transport Vesicles ; physiology

Objective To investigate the median effective dose (ED50) of cisatracurium priming accelerating the onset of neuromuscular block in patients of different genders. Methods Ninety ASA Ⅰ or Ⅱ patients aged 18-55 yr undergoing elective abdominal operation under general anesthesia were divided into 2 groups ( n = 45 each): male group (group M) and female group (group F). Neuromuscular block was monitored with accelerograph F (TOF-Watch SX). A single twitch stimulation of ulnar nerve was used to monitor neuromuscular function.Anesthesia was induced with midazolam 0.04 mg/kg and fentanyl 1 μg/kg. Accelerograph F was opened after the patients lost consciousness. The priming dose of cisatracurium was injected intravenously, then fentanyl 5 μg/kg and propofol 2 mg/kg were injected intravenously 3 min later and the left dose of cisatracurium for intubation was injected intravenously 4 min later. Tracheal intubation was performed when the ratio of the single twitch stimulation value to control value (T/Tc). decreased to 10%. Anesthesia was maintained with iv infusion of propofol and remifentanil and inhalation of isoflurane. The priming dose of cisatracurium was determined by up-and-down sequential trial. The initial priming dose was set at 5 μg/kg. The ratio of two successive doses was 1.2. T/Tc, time to 90% block, onset time, maximal neuromuscular block and clinical duration were recorded 4 min after the administration of the priming dose. The ED50 and 95% confidence interval (CI) of cisatracurium priming required to accelerate the onset were caculated. Results Time to 90% block was significantly longer-in group M than in group F (P ＜0.05). No significant difference was found in the other parameters among the groups. The ED50 and 95% CI of cisatracurium priming required to accelerate the onset were 21.36 μg/kg (95% CI 20.52-22.23 μg/kg)in group M and 14.53 μg/kg (95% CI 13.77-15.33 μg/kg) in group F. The ED50 was significantly higher in group M than in group F ( P ＜ 0.05). Conclusion The ED50 of cisatracurium priming accelerating thd onset is 21.36 and 14.53 μg/kg in male and female respectively and it is significantly higher in male than in female.