Objective To investigate the clinical effect of fissure for ligamentum teres hepatic (LTH) approach in hepatectomy.Methods The method of cross-sectional study was adopted.The clinical data of the 85 patients undergoing hepatectomy through fissure for LTH approach who were admitted to the West China Hospital of Sichuan University from February 2009 to December 2013 were collected.Among all the 85 cases, there were 61 of hepatocellular carcinoma, 12 of intrahepatic bile duct stones, 6 of bile duct cellular carcinoma and 6 of metastatic hepatic carcinoma.The operations involved dissecting fissure for LTH, dealing with portal vein, hepatic artery and bile duct inside the fissure, lowering the hepatic portal, mutilating hepatic parenchyma, and undergoing the hepatic left lateral lobectomy, left hemihepatectomy, mesohepatectomy, hepatic left and/or right trisegmentectomy.Operation method, operation time, volume of intraoperative blood loss, intraoperative blood transfusion, postoperative drainage-tube removal time and complications were recorded.The follow-up including recurrence and metastasis of tumor and survival of patients was conducted by outpatient examination and telephone interview up to August 2015.Measurement data with normal distribution were presented as (x) ± s.Measurement data with skewed distribution were presented as M (range).The survival rate was caculated by Kaplan-Meier method.Results The 85 cases of hepatectomy were successfully completed through fissure for LTH approach, including 19 cases of hepatic left lateral lobectomy (9 with hepatocellular carcinoma, 6 with intrahepatic bile duct stones, 1 with bile duct cellular carcinoma, 3 with metastatic hepatic carcinoma), 20 cases of left hemihepatectomy (8 with hepatocellular carcinoma, 5 with intrahepatic bile duet stones, 4 with bile duct cellular carcinoma, 3 with metastatic hepatic carcinoma), 5 cases of left hemihepatectomy + caudate lobectomy (3 with hepatocellular carcinoma, 1 with intrahepatic bile duct stones, 1 with bile duct cellular carcinoma), 14 cases of meso-hepatectomy (14 with hepatocellular carcinoma) and 27 cases of hepatic left and/or right trisegmentectomy due to hepatocellular carcinoma (15 of hepatic left trisegmentectomy and 12 of hepatic right trisegmentectomy).No perioperative death occurred.The median operation time was 280 minutes (range, 95-430 minutes).The median volume of intraoperative blood loss was 450 mL (range, 200-3 200 mL).There were 18 cases of intraoperative blood infusion.The postoperative peritoneal drainage-tube removal time was 3 days (range, 2-5 days).Eleven patients with postoperative complications recovered after symptomatic conservative treatment, including 6 with lung infection, 4 with peritoneal effusion and 1 with abdominal infection.There was no case of intra-abdominal bleeding, bile leakage or hepatic failure.No patient died within 1 month after operation.Seventy-nine patients were followed up for a median time of 38 months (range, 18-53 months) with a follow-up rate of 92.9％ (79/85).The 1-year overall survival rate and l-year disease-free survival rate were 79.0％ and 65.0％, and the 3-year overall survival rate and 3-year disease-free survival rate were 56.0％ and 34.0％, respectively.Conclusion Hepatectomy through fissure for LTH approach is safe, effective and easily operable, with a good short-term outcome.

Objective To investigate the value of treadmill exercise test and dipyridamole electrocardiography stress test (DP T) in diagnosis of coronary heart diseases (CHD), with an attemp of developing a safe, effective and simple diagnostic method for patients intolerable to the exercise. Methods Fifty two male patients aged from 41 to 75 years, averaged 58.44?8.79 years and with suspected or confirmed CHD were recruited to perform the treadmill exercise test, DP T and coronary angiography, respectively, within one month. Results The sensitivity and specificity of the treadmill exercise test for diagnosing CHD were 100% and 78.95%, respectively, while those of DP T for diagnosing CHD were 79.31% and 65.22%, respectively.As corresponded to the number of sites of coronary artery lesions,the numbers of cases with positive results revealed were 0, 2, 10 and 17 by the treadmill exercise tests and 0, 6, 11 and 15 by DP T, respectively.Based on the criteria of DP T, the sensitivity and specificity symptom, the changes in electrocardiography (ECG) and the combination of the two, for diagnosing CHD were 72.41%, 65.22%; 65.52%, 82.61%;and 79.31%, 65.22%, respectively. Conclusion The sensitivity and specificity of the treadmill exercise test and the DP T in the diagnosis of CHD were similar. More positive cases were revealed in above mentioned tests as the sites and degree of coronary artery lesion increased. DP T was particularly suitable for helping diagnose CHD in patients intolerable to exercise.

To understand the kinds and the characteristics of combination of traditional Chinese medicines and western medicines using on adults with type 1 diabetes in general hospitals,This research brings into 4 602 hospitalized adult patients with type 1 diabetes from hospital information system (HIS) of 13 third class A hospitals. These research objects were hospitalized in December 2003-July 2011. The research analyzes the operating frequency and associated usage of western medicines and traditional Chinese medicines by the method of frequency statistics and association rules. Through the analysis, the research says that in the clinical treatment of adult patients with type 1 diabetes, the western medicine used most frequently is insulin, a total of 1 539 cases, accounted for 8.47%; the traditional Chinese medicine used most frequently is oral agents of pseudo-ginseng, a total of 183 cases, accounting for 6.25%; the combinations of Chinese and western medicines commonly used include Huoxue Huayu Tongmai Shuluo decoction + vasodilator, support degree is 45.93%, followed by Huoxue Huayu Tongmai Shuluo decoction + vasodilator + hypoglycemic drugs, support degree is 45.50%; Huoxue Huayu Tongmai Shuluo decoction + vasodilator + nutritional agent, support degree is 36.29%.
Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus, Type 1 ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Electronic Health Records ; Female ; Humans ; Hypoglycemic Agents ; therapeutic use ; Insulin ; therapeutic use ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Panax

Objective To investigate the ultrasound imaging findings of anatomical relationship between femoral artery and vein in children of different ages.Methods Sixty-five children aged 4 months-7 years were enrolled in this study.The children were divided into 3 age groups: group Ⅰ＜ 1 yr;group Ⅱ 1-3 yr and group Ⅲ＞ 3,≤ 7 yr.A protable ultrasound machine was used.The probe was placed at the level of inguinal ligament and 2 and 4 cm below inguinal ligament.The children were placed in supine position.The legs were placed in 2 positions:(1)extended and in standard anatomical position and(2)flexed and 45° abducted and 45° laterally rotated.Results The examination showed that at the level of inguinal ligament,the femoral vein lay behind and lateral to femoral artery in 91% of children.At the level of 4 cm below inguinal ligament,the femoral vein lay posterior and lateral to the femoral artery in all children.When the leg was placed in abducted and laterally rotated,the depth of femoral vein was reduced and the vein was less overlapped by artery in all children,especially in preschool children.Conclusion At the level of 4 cm below inguinal ligament,the femoral vein lies posterior and lateral to the femoral artery in children.When the leg is placed in abducted and laterally rotated,the depth of femoral vein is reduced and the vein is less overlapped by artery.It is indicated that femoral vein puncture should be performed at the level of 4 cm below inguinal ligament with the leg flexed and abducted in all children,especially in preschool children.

ObjectiveTo evaluate the safety and feasibility of the tracheal stent implantation for treatment of malignant tracheal stenosis under general anaesthesia. Methods Eighteen patients with malignant tracheal stenosis underwent preoperative 64-slice spiral CT scan and airway reconstruction. The stenotic sites were located in main tracheal trunk(5 patients),in right main bronchus( 1 patient),in trachea and left main bronchus (4 patients),in trachea and right main bronchus (3 patients),in main tracheal trunk and bilateral main bronchus(5 patients).The degree of stenosis was rated 51％ to 70％ in 7 cases,71％ to 90％ in 11 cases.All patients,17 patients of ASA grade 1V and 1 patient of grade Ⅲ,presented with severe dyspnea. Under general anaesthesia,implantation of metallic stent was performed through the sputum aspiration hole of the connecting tubing with DSA guidance.The NBP,ECG,RR,SaO2 of the patients were recorded and compared with t test during the entire procedure. At the end of the procedure,relief of dyspnea,complications related to anesthesia and operation were recorded. Results The success rate of stent placement was 18/18,and dyspnea was significantly relived in all patients. Slightly bloody sputum occurred in 7 cases.The stent was obstructed by sputum in 1case,and the patient was treated with medication.There were no severe complications.The operative course were rated 11 to 9 in 17 cases,and 6 to 8 in 1 case.All 18 patients were cooperative during the procedure.Sixteen patients rated the procedure as very comfortable and 2 rated the procedure as comfortable.Respiratory rate (RR) and heart rate (HR) decreased in all patients after the operation [ ( 37.1 ± 2.8 )/min and ( 106.5 ± 14.2 ) bpm before the operation respectively,( 18.6 ± 1.4)/min and ( 73.2 ± 7.6) bpm after the operation respectively ],t =17.81 and 3.80,P ＜ 0.01.Pulse oxygen saturation ( SaO2 ) during the operation [ ( 91.2 ± 1.8 ) ％ ]increased [ (76.3 ± 8.6 )％ before the operation ] and increased further after the operation [ (94.5 ±4.3 ) ％ ],t =2.06 and 2.26,P ＜ 0.01.Blood pressure (BP) showed no changes throughout the operation (P ＞ 0.05 ).The conprehensive assessment of operation were favorable in all patients. Conclusion With careful preoperative evaluation and planning, tracheal stent implantation under general anaesthesia in patients with malignant tracheal stenosis is feasible and safe.

Objective To study the techniques of the treatment for epidermoid with endoscope-as- sisted microneurosurgery.Methods The suboccipital,infratemporal transtentorial approach and endoscope- assisted microneurosurgery were used.Results Total resection was achieved in 10 cases,and subtotal resec- tion was made only in 2, and had no complications of all.Conclusion Endoscope-assisted microneuro- surgery can increase the total-resection rate for tumors,and reduce complications.

Objective To observe the effect of using Ambroxol hydrochloride(AM)to wash respiratory way to treat neonatal respiratory distress syndrome(NRDS) in ventilator,to explore dynamic changes of respiratory mechanics after using AM to wash respiratory way.Methods Thirty premature infants were chosen according with diagnosis criterion,which were randomly divided into 2 groups: NS group(n=15);AM group(n=15).Both NS and AM groups were treated with Babylog 8 000 ventilator,and routine treating and nursing,NS group was given for washing respiratory way in NS group,whereas AM was done in AM group.Pulmonary compliance(C),time constant(Tc),respiratory resis-tance(R),C20/C and minute volume(MV)were observed in both groups.Blood gas was routinely checked after 1 h ventilation treatment,and X ray was shot after 24 h.Results Pulmonary C significantly increased in weaning than that of beginning ventilation(P0.05),MV significantly increased in group AM than NS,respectively[(0.56?0.12) L/min and(0.35?0.11) L/min(P0.05).But ventilator-treating-time was markedly shorter in group AM than NS,respectively(60.52?6.23) h and(98.21?5.82) h(P

OBJECTIVETo explore efficacy enhancing and detoxification roles of Jiedu Quyu Zishen Recipe (JQZR) in treating systemic lupus erythematosus (SLE) by studying its effect on Toll like receptor 9 (TLR9) signal pathway of murine macrophage cells after JQZR stimulated CpG oligodeoxynucletide (CpG ODN).

METHODSMurine macrophage cells in vitro cultured were randomly divided into 4 groups, i.e., the blank serum group, the CpG ODN stimulus group, the CpG ODN + dexamethasone group, the CpG ODN + medicated serum group. Murine macrophage cells were collected after 24-h intervention. The expression of TLR9, myeloid differentiation factor 88 (MyD88), NF-KB, IFN-α mRNA were analyzed by RT-PCR. The expression of TLR9 and NF-κB protein were analyzed by Western blot. Changes of the NF-KB transcriptional activity were assayed by Dual-Luciferase reporter assay system.

RESULTSmRNA expressions of TLR9, MyD88, NF-κB, and IFN-α, protein expressions of TLR9 and NF-κB, and NF-κB transcriptional activities were enhanced, showing statistical difference when compared with those of the blank serum group (P <0. 05, P <0. 01). Compared with the CpG ODN stimulus group, mRNA expressions of MyD88, NF-κB, and IFN-α, the protein expression of NF-κB and the NF-κB transcriptional activities decreased in the CpG ODN + dexamethasone group with statistical difference (P <0. 01). Compared with the CpG ODN stimulus group, mRNA expressions of TLR9, MyD88, NF-κB, and IFN-α, protein expressions of TLR9 and NF-κB, and NF-κB transcriptional activities were decreased in CpG ODN+ medicated serum group with statistical difference (P <0. 01).

CONCLUSIONEfficacy enhancing and detoxification roles of JQZR in treatment of SLE might be realized through regulating TLR9 signal pathways.

Animals ; Cell Line ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Macrophages ; metabolism ; Mice ; Myeloid Differentiation Factor 88 ; NF-kappa B ; RNA, Messenger ; Signal Transduction ; Toll-Like Receptor 9 ; metabolism

Objective To investigate the clinical features,the radiological characteristics,and the pathological changes of cerebral sparganosis.Methods We retrospectively collectted and summarized the clinical data of 42 patients with cerebral sparganosis from the Iinstitute of Anti-parasitic Diseases of Jiangxi Province and the First Affiliated Hospital of Nanchang University during January 2000 to January 2014.The follow-up period of the 42 patients ranged from 4 to 96 months.Results Forty-two cases (30 males and 12 females) with cerebral sparganosis were enrolled in the study.Among the 42 patients,34 cases suffered from seizures,16 cases experienced headaches,and 14 cases had limb weakness.The brain CT scan showed the small and punctuate calcifications scattering around the lesions in 18 cases.The features of enhanced MRI included aggregating ring-like enhancement in 38 cases,tunnel lesions in 14 cases,and lesion migration in 13 cases.Twenty-four of the 42 patients were performed surgery.The brain tissues revealed multiple inflammatory tunnels,in which live or degenerated larvae were identified in 20 cases,but only eosinophilia tunnels were observed in the other 4 cases.The serum and cerebro-spiral fluid specimens from 18 patients without surgery were positive to spirometra mansoni antigen.Their cerebral lesions disappeared and got a favorable prognosis after administration of praziquantel in long term follow-ups.Conclusions There is a high incidence of cerebral sparganosis in Poyang lake basin.The clinical features of cerebral sparganosis mainly include seizure,headache and hemiparesis.The enhanced lesions show knot or tunnel signs on multi-planar MRI which are associated with the multiple inflammatory tunnels of larvae migration.A longterm administration of high dose opraziquantel can also get a good treatment prognosis without the classical surgical therapy for cerebral sparganosis.

AIM:To observe the inhibition effect of endostatin ( endostar ) on mice choroidal neovascularization model ( CNV) and compare with the Avastin.
METHODS: Using 532nm laser photocoagulation to establish a mouse model of CNV. We observed the formation of CNV by histopathological examination after 2wk later. Forty successful models of mice were randomly divided into control group (group 1, 10 rats), normal saline group ( group 2, 10 rats ), endostatin group (group 3, 10 rats) and avastin group (group 4, 10 rats) . The drugs were injected into the mice' vitreous after photocoagulation 2wk later. Then 1wk later, we took the mice eyeballs to perform the HE and immunohistochemical staining to observe. The statistical analysis of ANOVA was done by SPSS 16. 0 and the LSD-t test was used for multiple samples, taking P<0. 05 as the test standards.
RESULTS: Two weeks later, HE histopathological examination was done , light microscope showed large amount of new vessels' formation, the positive rate for CNV was 72. 8%. The blank control group compared with the normal saline group P>0. 05, had no inhibitory effect on CNV;endostatin treated group compared with control group, P<0. 05, had a certain inhibitory effect; avastin group compared with the control group, P<0. 05, had an inhibitory effect on CNV; the LSD-t was performed on Avastin group and endostatin group, P<0. 05, which were statistically significant. We thought that the two drugs have different inhibitory effect on mice' CNV, because xAvastin=26. 90 ,xendostatin=29. 13,xAvastin CONCLUSION: Laser-induced CNV animal models of colored mice C57BL/6J is of short time and high rate establishment and it is an ideal model for CNV study. Endostar has certain inhibitory effect on CNV, and it is likely to become one of the important drugs for CNV-related diseases in the future.