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.

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

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

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.

OBJECTIVESTo study incidence and radiological features of intravertebral cleft (IVC) in patients with chronic pain due to osteoporotic vertebral compression fractures (OVCFs), and analyze influence of IVC for surgery of percutaneous kyphoplasty (PKP).

METHODSSeventy-six patients with osteoporotic vertebral compression fractures and pain duration more than one month were underwent procedures of PKP between August 2005 and August 2010. The incidence and radiological features of IVC were analyzed. Sixty-one patients with single-level OVCFs were divided into two groups with and without IVC. Preoperative and postoperative kyphotic angle and relative anterior vertebral height were recorded, as well as visual analogue scales (VAS) and Oswestry disability index (ODI). Cement patterns of opacification and leakage were also recorded.

RESULTSThirty two patients with 39 vertebrates were found with IVC sign. The diagnostic sensitivity of X ray, CT and MRI for IVC was respectively 33.3%, 85.7% and 84.6%. Two groups with IVC and without IVC both had apparent correction of kyphotic angle and reduction of anterior height at 3 days after surgery and last follow-up (F = 21.82 - 72.18, P < 0.01). There was no statistical significance between two groups (P > 0.05). In addition, both groups had significant improvement as regard to VAS and ODI (F = 131.06 - 364.12, P < 0.01). Solid pattern accounted for 72.0% of all cemented vertebrates in the group with IVC and 19.4% in the group without IVC. Four cement leakage were found in the group with IVC and another four in the group without IVC.

CONCLUSIONSThere is a high incidence of IVC in patients with chronic pain due to osteoporotic vertebral compression fractures. CT and MRI are sensitive for detection of IVC. The procedure of PKP is effective for both groups with and without IVC. IVC produces an apparent influence on cement opacification and leakage location during the procedure of PKP.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; methods ; Male ; Middle Aged ; Osteoporosis ; complications ; Retrospective Studies ; Spinal Fractures ; etiology ; surgery ; Treatment Outcome

OBJECTIVETo study the therapeutic method and effect of minimally invasive surgery for the thoracolumbar fractures.

METHODSA retrospective review of the minimally invasive surgically treatment thoracolumbar fractures from February 2005 to June 2010 was performed. There were 183 cases, 126 males and 57 females, aged 18 to 68 years, average 38.9 years. The involved levels of fractures were T(11) in 22, T(12) in 61, L(1) in 71, L(2) in 29. According to Gertzbein classification, 145 cases were type A fractures, 34 cases were type B fractures, 4 cases were type C fractures; According to Load-sharing score, 51 cases were 4 scores, 56 cases were 5 scores, 17 cases were 6 scores, 12 cases were 7 scores, 24 cases were 8 scores, 23 cases were 9 scores. Different surgical methods were selected according to the minimally invasive surgical strategy, 22 patients were treated with the minimally invasive percutaneous pedicle screws osteosynthesis (MIPPSO group), 102 patients were treated with the small-incision pedicle screws osteosynthesis (SISPSO group), 31 patients were treated with the small incision anterior thoracolumbar surgery (SIATS group) assisted by thoracoscope or headlight, and 28 patients were treated with the 270° decompression and reconstruction surgery (270° DRS group) via a posterior small incision. Preoperative and postoperative neurological status, the correction and loss of Cobb's angle, the decompression scope of spinal canal, the location and union of bone graft were followed up and reviewed.

RESULTSAll of 183 cases had successful surgery and were followed up. In the MIPPSO group, operative time was 52 - 100 min, blood loss was 35 - 55 ml. In the the SISPSO group, operative time was 48-68 min, the blood loss was 45 - 65 ml the correction of Cobb's angle in the two groups was 8° - 19°. In the SIATS group, operative time was 140 - 220 min, the blood loss was 160 - 1500 ml the correction of Cobb's angle was 15° - 25°, 1 case had pleural effusion, 1 had lateral femoral cutaneous nerve damage, the complications disappeared after treatment. In the 270° DRS group the operative time was 160-280 min, the blood loss was 700 - 4700 ml, the correction of Cobb's angle was 15° - 28°. The spinal canal mass was removed, the spinal canal was enlarged and completely decompressed. Neurological status improved in all of the preoperative incomplete paraplegia patients except 1 case whose neurological symptoms aggravated.

CONCLUSIONIt is satisfactory that the minimally invasive surgical strategy was rational used in the treatment of thoracolumbar fractures.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Young Adult

To investigate the regulatory effect of extracellular signal-regulated kinase (ERK) signaling pathway on airway smooth muscle cell (ASMC) proliferation in chronic asthmatic rats, the rat model of chronic asthma was established, and ERK agonist epidermal growth factor (EGF) and inhibitor PD98059 were used in the cell culture. ASMC proliferation was examined by flow cytometry analysis, methyl thiazolyl tetrazolium (MTT) colorimetric assay, [(3)H]-thymidine (TdR) incorporation and proliferating cell nuclear antigen (PCNA) immunocytochemical staining. The expressions of ERK mRNA, ERK protein, phosphorylated ERK1/2 (p-ERK1/2) protein were observed by RT-PCR and Western blot. The results showed that in chronic asthmatic group, compared with that in the control group, the percentage of cells at G(0)/G(1) phase was significantly decreased and the percentage of cells at S+G(2)/M phase was significantly increased. Absorbance (A(490)), DNA synthesis and the expression of PCNA protein in ASMCs in chronic asthmatic group were significantly increased. The expressions of ERK mRNA, ERK1/2 protein, p-ERK1/2 protein and the activation ratio of ERK in ASMCs in chronic asthmatic group were significantly increased compared with those in the control group. After treatment with PD98059, the percentage of cells at S+G(2)/M phase, A(490), DNA synthesis and the expression of PCNA protein in ASMCs in chronic asthmatic group were significantly decreased; the expressions of ERK mRNA, ERK1/2 protein, p-ERK1/2 protein and the activation ratio of ERK in ASMCs in chronic asthmatic group were significantly decreased compared with those in the control group. After treatment with EGF, the percentage of cells at S+G(2)/M phase, A(490), DNA synthesis and the expression of PCNA protein in ASMCs in chronic asthmatic group were significantly increased compared with those before treatment; and PD98059 markedly inhibited the effect of EGF. These results suggest that the endogenous proliferation activity of ASMCs in chronic asthmatic rats significantly increases compared with that in the control rats, and ERK1/2 participates in this process. The ERK signaling pathway might play an important role in regulating ASMC proliferation, leading to asthmatic airway remodeling.
Animals ; Asthma ; enzymology ; pathology ; Bronchi ; pathology ; Cell Proliferation ; Cells, Cultured ; Chronic Disease ; Colorimetry ; Enzyme Activation ; Extracellular Signal-Regulated MAP Kinases ; analysis ; genetics ; physiology ; Flow Cytometry ; Myocytes, Smooth Muscle ; pathology ; Rats