Objective Toinvestigatetherelationshipbetweendifferenttypesofinternalwatershed infarctionandtandemstenosesofinternalcarotidartery(ICA).Methods Atotalof55patientswith internal watershed infarction confirmed by head MRI and diffusion-weighted imaging (DWI )examination were enrolled. They all underwent the extracranial internal carotid artery (ICA ) ultrasonography and intracranial cerebral artery MR angiography (MRA)examinations. According to the findings of imaging,the 55 patients with internal watershed infarction were divided into a simple internal watershed infarction (IWSI)group and an internal watershed infarction accompanied with ipsilateral cortical watershed infarction (C-IWSI)group. The relationship between the two types of internal watershed infarction and tandem stenoses of ICA was analyzed. Results (1 ) Of the 55 patients with internal watershed infarction,24 cases (43. 6%)were in the internal watershed infarction group and 31 cases (56. 4%)were in the C-IWSI group. The ipsilateral vascular stenosis were ICA 20 cases (36. 4%,including extracranial segment 11 cases and intracranial segment 17 cases),middle cerebral artery (MCA)44 cases (80. 0%), and tandem stenoses of ICA 15 cases (27. 3%). (2)Ipsilateral tandem stenoses of ICA:2 cases were in the IWSI group (intracranial ICA+MCA 2 cases);13 cases were in the C-IWSI group (extracranial ICA+intracranial ICA +MCA 4 cases,extracranial ICA + intracranial ICA 1 case,extracranial ICA + MCA 2 cases,and intracranial ICA+MCA 6 cases). (3)Compared with the IWSI group,the incidences of ipsilateral ICA stenosis and tandem stenoses of ICA in patients of the C-IWSI group were higher (54. 8%[n=17]vs. 12. 5%[n=3],41. 9%[n=13]vs. 8. 3%[n =2]),and there were significant differences(P =0. 001, 0.006]). The incidences of extracranial and intercranial ICA stenosis were higher than those of the IWSI group (35. 5%[n=11]vs. 0,45. 2%[n=14]vs. 12. 5%[n=3]),and there were significant differences (P=0.003,0.009).Conclusion Inthedifferenttypesofinternalwatershedinfarction,theincidenceof tandem stenoses of ICA is different. The IWSI patients with ipsilateral cortical watershed infarction often accompany by tandem stenoses of ICA.

Photothermal therapy (PTT) has attracted significant attention due to minimal side effects and high treatment specificity. However, it often requires very high temperature to achieve complete tumor ablation under a single PTT. Such high temperature brings obvious thermal damage and inflammatory response to the body, affecting the therapeutic effect. In recent years, nitric oxide (NO) has been used to significantly inhibit tumor growth and enhance the sensitivity of tumor cells of temperature and drugs, thus enhancing the therapeutic effect. However, compounds as NO donors often have some disadvantages such as poor biocompatibility and untargeted delivery, etc., therefore, this medical application based on NO therapy is limited. In conclusion, the organic combination of NO donors and photothermal agents (PTAs) is expected to overcome the shortcomings of single therapy and achieve the antitumor effect of "1 + 1 > 2". In view of the rapid development of NO combining with PTT in tumor therapy, this review firstly introduces the antitumor mechanisms of different types of NO donors. Then the treatment strategy based on NO combined with PTT is discussed. Finally, the prospects and challenges of this combination therapy strategy in the clinical treatment of cancer are discussed.

OBJECTIVETo investigate the result of hip arthroplasty for failed internal fixation of femoral neck fractures.

METHODSFrom June 2007 to January 2014, 29 cases who underwent hip arthroplasty for failed of internal fixation of femoral neck fractures were reviewed. There were 12 males and 17 females. The mean age was 60.3 years (ranged 43 to 83 years) at the time of the fracture. Left hip was in 16 cases, right hip was in 13 cases. The average interval from fracture to arthroplasty was 23.3 months (ranged, 3 to 48 months).

RESULTSAll of 29 cases were performed total hip arthroplasty. There were 20 cases of cementless cup,7 cases of cementless cup with bone graft, 2 cases of cemented cup with bone graft; 13 cases of cementless stem, 16 cases of cemented stem. There were no complications occurred such as intraoperative fracture of the greater trochanter. The average operative time was (115 ± 38) minutes,the mean intraoperative blood loss was (420 ± 175) ml, the average postoperative drainage volume (240 ± 119) ml, intraoperative blood transfusion was (200 ± 220) ml, intraoperative fluid volume was (2,200 ± 400) ml, the average postoperative blood transfusion was (300 ± 200) ml. There was 1 case get postoperative dislocation. All patients were followed up for 14.7 months in average (ranged, 5 to 24 months). There was no revision for mechanical failure. Harris Hip Score significantly was improved from 51.1 ± 7.5 before the conversion to 88.5 ± 6.4 points at the final follow-up.

CONCLUSIONThe effect of the hip replacement for patients with failed internal fixation of femoral neck fractures was confirmed. This method can shorten the time on the bed and reduce the complications. It benefits the patients earlier functional recovery, but it must control operation indication. The long term efficacy is necessary to further observation.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Failure

OBJECTIVETo explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension (PAH) in patients of chronic obstructive pulmonary disease (COPD) associated with chronic cor pulmonale (CCP) during exacerbation.

METHODSSeventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group. The control group received standard treatment with antibiotics, antiasthmatic and expectorant medications, and oxygenation; and the ligustrazine treatment group received ligustrazine treatment (80 mg/d; i.v.; for 2 weeks) in addition to the standard treatment. Before and at the end of 2 week treatment, the clinic responses of the two regimens were evaluated, plasma levels of endothelin-1 (ET-1) and nitric oxide (NO) were determined; arterial oxygen partial pressure (PaO2, mean pulmonary arterial pressure (mPAP), outflow tract of right ventricle (RVOT), and internal diameter of right ventricle (RV) were measured.

RESULTSGood clinic benefits were achieved in both the standard and ligustrazine regimens, plasma level of ET-1, values of mPAP, RV and RVOT decreased significantly, plasma level of NO and PaO2 values decreased (all P < 0.01 vs pre-treatment to all parameters). Compared with the control group, ligustrazine greatly enhanced the clinic efficacy from 77.1% to 97.1% (P < 0.05), and also resulted in more significant changes of all these parameters (P < 0.01 vs control group for all parameters). For both groups, the levels of plasma ET-1 were positively correlated with values of mPAP, RVOT, and RV (r = 0.710, 0.853, and 0.766, respectively, all P = 0.000), and negatively correlated with plasma NO and PaO2 (r = - 0.823, and - 0.752, respectively, all P = 0.000).

CONCLUSIONLigustrazine is effective in treating pulmonary artery hypertension during acute exacerbation of COPD and CCP in patients from the plateau area. The observed changes in the plasma levels of NO and ET-1 in response to ligustrazine treatment suggest that ligustrazine may act through the selective effect on pulmonary blood vessels to enhance the synthesis and release of NO and suppress those of ET-1 from lung vascular endothelial cells, thus reducing pulmonary artery pressure and decreasing pulmonary arterial hypertension.

Altitude ; Blood Gas Analysis ; Chronic Disease ; Endothelin-1 ; blood ; Humans ; Hypertension, Pulmonary ; drug therapy ; Nitric Oxide ; blood ; Pulmonary Artery ; physiopathology ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Pyrazines ; therapeutic use ; Respiration

Objective To investigate the safety of cleaning and disinfection of duodenoscope used in endoscopic retrograde cholangiopancreatography (ERCP).Methods The duodenoscopes,which were used in Endoscopy Center of Digestive Disease Hospital,Heilongjiang Provincial Hospital from May 4 to May 31 2016,were cleaned manually and disinfected with sterilization powder.The samples from elevator and elevator channel were collected for bacterial culture to evaluate the safety of clinical application of duodenoscope.Results Among 60 high level disinfections,one was excluded because disinfectant concentration wasn't effective.Among 59 elevator samples no positive cultures were detected,while among 59 channel samples,4(6.8％) cultures were positive and all from the same duodenoscope,including 3 cases of Klebsiella pneumonia and 1 case of Pseudomonas aeruginosa.Conclusion Sterilization powder is effective for disinfection of duodenoscope used for ERCP.Residual organic material can't be excluded from elevator sample even if it is negative for culture.Duodenoscope with high level disinfection still has the risk of transmitted infection,and should be monitored regularly by culture and reprocessed in time.

Objective To observe the changes of immunological parameters and the effects of intravenous immunoglobulin (IVIG) in children with idiopathic thrombocytopenic purpura (ITP),schonlein-Henoch purpura(HSP) and mucocutaneoas lymph node syn-drome(kawasaki disease, KD).Methods T cell subsets and serum immunoglobulins and complements were measured with the flow cytometry and enhanced trubidimetric immunoassay. Routine therapy combined with IVIG. Results CD3+ CD4+ T cells were de-creased in children with ITP accompanied by increased serum IgG;Serum IgA and CD3+ T cells were increased in children with HSP; CD3+ CD8+ T cells were decreased in children with KD. Clinical features were markedly improved after treatment with IVIG. It was noted that the incidence of damage to coronary artery decreased after the use of IVIG. Conclusions T cell subsets, serum immunoglobulins should undergo the clinical routine examinations in ITP,HSP and KD. Early administration of IVIG might be important to improve disease prognosis and shorten its course of treatment in children with three kinds of immunology related diseases.

The property of Zanthoxyli Pericarpium is warm and the taste is spicy, which can be used as food as well as medicine. Its alkaloids have a wide range of pharmacological activity and have good prospects for development in medicine and food. The resources of Zanthoxyli Pericarpium in China are abundant, and the intensive research on its active ingredients can promote the transformation and upgrading of industrial economy. This article reviewed the research status of extraction, content determination and physiological activity of alkaloids from Zanthoxyli Pericarpium, in order to provide references for efficient use of Zanthoxyli Pericarpium.

The present study is aimed to investigate the in vitro metabolic interconversion between baicalin (BG) and baicalein (B) in rat liver, kidney, intestine and bladder. BG and B were separately incubated with rat hepatic, renal, and intestinal microsomes, as well as bladder homogenates, for 30 min. The metabolites were identified and quantified by HPLC and metabolic kinetic parameters were obtained by fitting the data to the Michaelis-Menten equation. In hepatic microsomes, renal microsomes and bladder homogenates, but not in intestinal microsomes, BG was transformed into B, the hydrolysis metabolite of BG, with K(m) values being (44.65 +/- 6.01), (92.73 +/- 11.41), (74.60 +/- 3.68) micromol x L(-1), respectively, and V(max) values being (12.32 +/- 0.56), (3.30 +/- 0.18), (5.93 +/- 0.12) micromol x min(-1) x g(-1) (protein), respectively. In incubations with hepatic, renal, and intestinal microsomes and bladder homogenates, B was also transformed into BG, the glucuronidation metabolite of B, with K(m) values being (67.46 +/- 10.49), (226.7 +/- 71.59), (177.3 +/- 35.85), and (18.33 +/- 2.53) micromol x L(-1), respectively, and V(max) values being (14.74 +/- 0.97), (5.91 +/- 1.03), (38.14 +/- 3.60), and (1.22 +/- 0.05) micromol x min(-1) x g(-1) (protein), respectively. The results showed that the activity of UDP-glucuronosyltranferase (UGT) in intestinal microsomes was the highest among the four organs, and the activities of UGT were higher than that of glucuronidase (GUS) in hepatic, renal and intestinal microsomes, but the activity of GUS was higher than that of UGT in bladder homogenates.
Animals ; Anti-Infective Agents ; pharmacokinetics ; Antioxidants ; pharmacokinetics ; Biotransformation ; Flavanones ; pharmacokinetics ; Flavonoids ; pharmacokinetics ; Glucuronidase ; metabolism ; Glucuronosyltransferase ; metabolism ; Hydrolysis ; Intestines ; enzymology ; metabolism ; Kidney ; enzymology ; metabolism ; Liver ; enzymology ; metabolism ; Male ; Microsomes ; enzymology ; metabolism ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; enzymology ; metabolism

OBJECTIVETo study the effect of laryngotracheal reconstruction (LTR) in children with subglottic stenosis (SGS), and to discuss the indications and the risks of intraoperative and postoperative treatment of LTR.

METHODSFrom September 2008 to February 2010, 5 children (4 girls and 1 boy, aged 4 to 6 years) were treated by LTR. Among the 5 children, there were 2 congenital SGS and 3 acquired SGS. One had mild grade III SGS, 3 had severe grade III SGS, and one had grade IV SGS. One child with mild III SGS was treated by single-stage LTR, and the rest four children were treated by double-stage LTR. The surgical technique consisted of cricoid lamina midline vertical incision, rib cartilage graft interposition and endotracheal tube (ETT) stenting for 2 to 3 weeks.

RESULTSFour children with grade III SGS were de-cannulated 3 months after operation, and the child with grade IV SGS got de-cannulated 6 months after operation. Of all children, rib cartilage graft grower well, and the size of subglottis were amplified by grade III SGS to grade I SGS, and grade IV SGS to grade II SGS. All children obtained stable airway. One child with grade IV SGS who had hoarseness got effective phonation during follow-up 2 years after operation.

CONCLUSIONSLTR is a safe and effective treatment for pediatric subglottic stenosis. The important factors of successful operation are correct assessment and evaluation of the severity and overall medical status and selection of suitable surgical techniques.

Child ; Child, Preschool ; Female ; Humans ; Laryngostenosis ; surgery ; Larynx ; surgery ; Male ; Reconstructive Surgical Procedures ; methods ; Trachea ; surgery ; Treatment Outcome

As medicine and food plants, the market demand of Zamthoxyli Pericarpium is extensive, and the sanshool in Zamthoxyli Pericarpium is getting attention gradually. However, because of the low content and not establishing rating evaluation method for sanshool and lack of standards, the research on substance basis and physiological activity is necessary. This article reviewed the extraction, separation, purification and biological activities of sanshoolin Zamthoxyli Pericarpium in recent years to provide development and utilization of Zamthoxyli Pericarpium.