Objective To review the study on the risk factors and prognosis of laparoscopic cholecystectomy remedied by laparotomy. Methods Five hundred cases of laparoscopic cholecystectomy patients in our hospital were collected as a research object ,using univariate analysis and multivariate logistic regression analysis to screen and analyze laparotomy during laparoscopic cholecystectomy ,and its prognosis. Results 500 cases of cholecys-tectomy patients were converted to laparotomy in a ratio of 4.2%. The independent risk factors contained BMI index,patients with history of abdominal surgery,patients with cholecystitis episodes,doctors clinical experience , patients with gallbladder wall thickness during laparoscopic cholecystectomy. Twenty-one patients undergone laparotomy during laparoscopic cholecystectomy without severe complications. Conclusion Before laparoscopic cholecystectomy,physicians should analyze the following factors comprehensively in obesity,abdominal surgery, recurrent cholecystitis,gallbladder wall thickness,in order to determine the operating method and reduce the the rate from laparoscopic cholecystectomy to laparotomy.

Aged ; Aged, 80 and over ; Anthracosis ; blood ; Erythrocyte Indices ; Erythrocytes ; Hemoglobinometry ; Humans ; Middle Aged

OBJECTIVETo investigate the chemical constituents of dried whole plants of Artemisia annua.

METHODThe chemical constituents were isolated by repeated silica gel chromatography, medium pressure column chromatography, and semi-preparative HPLC, and their structures were elucidated by spectroscopic analyses and comparison of NMR data with those reported in literature.

RESULT15 compounds were isolated and identified to be 5-O-[(E)-Caffeoyl] quinic acid(l), 1,3-di-O-caffeoylquinic acid(2), 4 5-di-O-caffeoylquinic acid(3), 3, 5-di-O-caffeoylquinic acid (4), 3, 4-di-O-caffeoylquinic acid (5), methyl-3,4-di-O-caffeoylquinic acid(6), methyl-3,5-di-O-caffeoylquinic acid(7), 3,6'-O-diferuloylsucrose(8), 5'-β-D-glucopyranosyloxyjasmonic acid(9), Scopoletin(10), scoparone (11), 4-O-β-D-glucopyranosyl-2-hydroxyl-6-methoxyacetophenone (12), chrysosplenol D (13), casticin (14), chrysosplenetin(15).

CONCLUSIONCompounds 2, 6, 8 and 9 are obtained from the Artemisia genus for the first time. Compounds 7 and 15 are obtained from this plant for the first time.

Artemisia annua ; chemistry ; Chromatography, Gel ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Flavonoids ; chemistry ; isolation & purification ; Medicine, Chinese Traditional ; Plants, Medicinal ; Quinic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Silica Gel

Objective To explore a better method for treatment atrophic rhinitis.Methods 56 patients with atrophic rhinitis(96 lateral)were treated by nasal submucou pediculated bone-suberiosteal muscle flap extracted from anterior wall of sinus maxillaries.Results All patients were followed 2 to 10 years,total effective rate was 100 %, with 49 cases(87.5 %)showing prominent effect.Conclusion The grafted flap cannot be assimilated,felled off and necrosis,because the flap has rich blood supply.This methods has obvious short-term effective and stable long-term effective.No complications were found.

OBJECTIVETo summarize the experience of diagnosis and surgical treatment for pulmonary and pleural aspergillosis.

METHODSThe clinical data of cases with pulmonary and pleural aspergillosis were analyzed retrospectively between September 1972 and June 2003. There were 53 cases with pulmonary aspergillosis and 3 cases with pleural aspergillosis. Aspergillus was found preoperatively in 8 patients by sputum culture (5 cases) or needle biopsy of the lung (2 cases) or fibro-bronchoscopic biopsy (1 case). All patients were treated with surgical procedures following X-ray film or CT scan.

RESULTSOf 53 cases with pulmonary aspergillosis, 42 lobectomies, 3 segment-Pneumonectomies, and 8 wedge resections were performed. Of three cases with pleural aspergillosis following eliminating their diseased foci in residual pleural space, two underwent thoracoplasty, one underwent postoperative closed chest drainage for one and an half month with fluconazole injected into residual pleural space repeatedly for 1 month (200 mg/100 ml, 1 time per 2 or 3 days). No operative death and major postoperative complications occurred. None of the patients had recurrent symptoms at follow-up.

CONCLUSIONWe recommend aggressive surgical resection for pulmonary and pleural aspergillosis, and the surgical result is excellent.

Adult ; Aged ; Aspergillosis ; diagnosis ; surgery ; Female ; Humans ; Lung Diseases, Fungal ; diagnosis ; surgery ; Male ; Middle Aged ; Pleurisy ; diagnosis ; surgery ; Pneumonectomy ; methods ; Retrospective Studies ; Thoracoplasty ; Treatment Outcome

AIMTo investigate the effects of blockers of the three kinds of potassium channels: voltage-dependent K+ channel(KV), calcium-activated K+ channel(KCa) and ATP-sensitive K+ channel(KATP), on the proliferation of rat bronchial smooth muscle cells (BSMCs).

METHODSThe effects of three kinds of potassium channel blockers on the proliferation of BSMCs were detected by MTT method, immunocytochemistry staining and flow-cytometry. Their effects on the dynamic changes of Ca2+ concentration in BSMCs were investigated by the fluorophotometry of Fura-2/AM.

RESULTSThe KV blocker 4-aminopyridine (4-AP) was shown to significantly increase the expression of proliferating cell nucleus antigen in cultured rat BSMCs (P < 0.01), but the KCa blocker tetraethylammonium (TEA) and KATP blocker glibenclamide(Glib) did not show such effect (P > 0.05). 4-AP was found to significantly increase the optical density value of the cultured BSMCs (P < 0.01) by MTT method and the numbers of S + G2M BSMCs(P < 0.05) by flow-cytometry. TEA and Glib did not show such effects. 4-AP significantly increased the Ca2+ concentration in cultured BSMCs(P < 0.01). TEA and Glib did not show such effects.

CONCLUSIONThis result suggests that inhibition of KV activity can increase intracellular Ca2+ and proliferation of rat BSMCs, but inhibition of KCa and KATP showed no effect.

4-Aminopyridine ; pharmacology ; Animals ; Bronchi ; cytology ; Calcium ; metabolism ; Cell Division ; drug effects ; Cells, Cultured ; Glyburide ; pharmacology ; Muscle, Smooth ; drug effects ; metabolism ; Potassium Channel Blockers ; pharmacology ; Potassium Channels, Calcium-Activated ; antagonists & inhibitors ; Potassium Channels, Voltage-Gated ; antagonists & inhibitors ; Proliferating Cell Nuclear Antigen ; metabolism ; Rats ; Rats, Sprague-Dawley ; Tetraethylammonium ; pharmacology

Objective To establish the feasibility of performing an endoscopic anterior approach for upper cervical spine in a clinical setting.Methods Application of this method on 13 Chinese cadavers was conducted to verify the practicability of this technique.Anatomic data were obtained by measuring the anterior cervical specimens,and anatomic observation was conducted in the neighboring structure through below the su- perior thyroid artery.Results The superior thyroid vascular-nerve plexus was neighbor to the puncture can- nula.But there has a quite large distance between the hypoglossal,the glossopharyngeal,the lingual artery, the external branch of the superior laryngeal nerve and the puncture cannula.There has enough space between the posterior wall of the pharynx and the prevertebral fascia to put the MDE canuula.Conclusion This ca- daver and clinical study demonstrates that an endoscopic anterior approach to the upper cervical spine is safe and feasible,and can be a valid alternative to the conventional transoral approach.

BACKGROUNDAirway smooth muscle (ASM) is suspected to be a determining factor in the structural change of asthma. However, the role of protein kinase C alpha (PKCalpha) and cyclin D1 involved in the dysfunction of ASM leading to asthmatic symptoms is not clear. In this study, the central role of PKCalpha and cyclin D1 in ASM proliferation in asthmatic rats was explored.

METHODSThirty-six pathogen-free male Brown Norway (BN) rats were randomly divided into 2 groups: control groups (group N1, N2 and N3) and asthmatic groups (group A1, A2, and A3). Groups A1, A2 and A3 were challenged with ovalbumin (OA) for 2 weeks, 4 weeks and 8 weeks respectively. Control animals were exposed to an aerosolized sterile phosphate buffered saline (PBS). The ASM mass and nucleus numbers were studied to estimate the degree of airway remodeling by the hematoxylin-eosin staining method. PKCalpha and cyclin D1 expression in the ASM cells was detected by reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry. The relation between PKCalpha and cyclin D1 was assessed by linear regression analysis. PKC agonist phorbol 12-myristate 13-acetate (PMA), PKC inhibitor Ro31-8220 and an antisense oligonucleotide against cyclin D1 (ASOND) were used to treat ASM cells (ASMCs) obtained from the 2 weeks asthmatic rats. The cyclin D1 protein expression level was detected by Western blotting.

RESULTSCompared with the control group, the PKCalpha and cyclin D1 mRNA levels were increased in the asthmatic group. Similar to RT-PCR results, immunohistochemistry analysis for PKCalpha and cyclin D1 expression revealed an increased production in ASMCs after allergen treatment for 2, 4 and 8 weeks compared with the respective control groups. No difference in expression of PKCalpha and cyclin D1 in ASM were found in the 2, 4 or 8 weeks asthmatic rats. There were significant positive correlations between PKCalpha and cyclin D1 expression, both transcriptionally (r = 0.944, P < 0.01) and translationally (r = 0.826, P < 0.01), in ASM. The content of cyclin D1 in asthmatic ASMCs increased after being stimulated by PMA, and decreased when induced by Ro31-8220. ASOND targeting for cyclin D1 lowered the expression of cyclin D1 induced by PMA.

CONCLUSIONSIncreased expression of PKCalpha and cyclin D1 in ASM along with smooth muscle structure changes might implicate PKCalpha and cyclin D1 participation in the proliferation of ASM and contribute to the pathogenesis of asthma after repeated allergen exposure in rats. The results suggested that cyclin D1 might be downstream of PKC signal transduction pathway.

Animals ; Asthma ; pathology ; Cell Proliferation ; Cyclin D1 ; genetics ; physiology ; Lung ; pathology ; Male ; Myocytes, Smooth Muscle ; pathology ; Protein Kinase C-alpha ; genetics ; physiology ; RNA, Messenger ; analysis ; Rats ; Rats, Inbred BN

OBJECTIVESTo report a new index (the SC-line) and a new classification for predicting of postoperative spinal cord decompression after cervical laminoplasty.

METHODSFrom March 2008 to August 2009, MRI images of 25 patients treated with cervical laminoplasty were retrospectively studied. Using T2-weighted images of the cervical spine, point A was anterior point of the spinal cord at inferior endplate level of cranial compressed vertebra. Point B was anterior point of the spinal cord at superior endplate level of caudal compressed vertebra. The SC-line was defined as a line that connects A and B. Posterior surface of compressor at compression level did not exceed the line in Type I, connected the line in Type II, and exceeded it in Type III. Twenty-five patients who underwent cervical laminoplasty were classified into 3 groups according to the SC-line classification. The posterior shift of the spinal cord after the posterior decompression procedure was evaluated by using a modified gradation of degree of anterior spinal cord compression by MRI finding. The relationship between the degree of anterior spinal cord compression after surgery and the SC-line types were analyzed.

RESULTSPreoperative cervical SC-line classification showed high correlations to the degree of spinal cord decompression. There were 3.82 ± 0.39 points in Type I before surgery, 3.90 ± 0.32 points in Type II, and 4.00 ± 0.00 points in Type III, respectively. After surgery, there were 1.15 ± 0.50 points in Type I, 2.70 ± 0.48 points in Type II, and 3.50 ± 0.55 points in Type III, respectively. Significant differences were found between each Type (F = 42.49, P < 0.01; Type I vs. Type II: P < 0.01; Type I vs. Type III: P < 0.01; Type II vs. Type III: P = 0.038).

CONCLUSIONSC-line can be used to predict the degree of postoperative spinal cord decompression following cervical laminoplasty.

Adult ; Aged ; Cervical Vertebrae ; pathology ; surgery ; Decompression, Surgical ; Female ; Humans ; Laminectomy ; methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Compression ; pathology ; surgery ; Treatment Outcome

OBJECTIVETo investigate intake of water in different periods of a day of primary and middle school students in Beijing, Shanghai, Guangzhou and Chengdu of China.

METHODSA total of 5914 primary and middle school students from Beijing, Shanghai, Guangzhou and Chengdu were recruited using multiple-stage random sampling method from September to October 2011. Among them, 5868 students completed the survey. The information of amounts and types of drinking in 8 time periods, morning, afternoon, night as well as in meal and non-meal time in 24 hours of a day was recorded by subjects for seven consecutive days using a quantitative measurement. This information was analyzed by different periods.

RESULTSThe amount of drinking water among 8 periods of a day was (99 ± 101), (130 ± 106), (191 ± 155), (96 ± 107), (246 ± 172), (90 ± 101), (188 ± 135) and (50 ± 81) ml, respectively for before breakfast, during breakfast, after breakfast, during lunch, after lunch, during dinner, after dinner, and midnight (F = 1679.77, P < 0.01). Based on three periods of a day, the amount of drinking water in the morning (420 ± 242) ml was the statistically significantly most, followed by afternoon (341 ± 199) ml, and the least in the evening (327 ± 195) ml (F = 325.23, P < 0.01). The distribution trend of plain water in three periods was the same as total drinking water, with (270 ± 209), (250 ± 179) and (224 ± 177) ml, respectively (F = 84.89, P < 0.01) ; but beverage consumption was the most in the morning(151 ± 133) ml, then in the evening (103 ± 122) ml, and the least in the afternoon (91 ± 199) ml (F = 373.56, P < 0.01). The daily plain water consumption in meal time was (316 ± 247) ml, while it in non-meal time was (773 ± 445) ml with statistically significant difference (Z = 65.2, P < 0.01). There was no significant difference in meal time between plain water (165 ± 194) ml and beverage (151 ± 152) ml (Z = 0.59, P = 0.56) whilst plain water (579 ± 408) ml in non-meal time was significantly higher than beverages (194 ± 204) ml (Z = 64.5, P < 0.01).

CONCLUSIONThe amount of drinking water of primary and middle school students in different periods of a day was different in four cities of China.

Adolescent ; Beverages ; Child ; China ; Diet Surveys ; Drinking Behavior ; Drinking Water ; Female ; Humans ; Male ; Students ; Surveys and Questionnaires ; Time Factors ; Urban Population