Objective To establish a RP-HPLC method for the determination of drug release in vitro of atractylenolide Ⅰ liposomes. Methods The release behavior of the drug from liposomes was studied by the third method for dissolution. ZORBAX C18 column (4.6 mm × 250 mm, 5 μm) was used with a mobile phase of Methanol-Acetonitrile-0.2% from liposomes in vitro fitted the log-normal distribution equation and had a property of sustained release. Conclusion The method is simple, fast and selective. It is suitable for the determination of release profile in vitro of atractylenolide Ⅰ liposomes.

OBJECTIVETo evaluate the colorectal cancer incidence among compliers and non-compliers in the population of colorectal cancer screening area, and to provide scientific basis for health economic evaluation of cancer screening.

METHODSBy screening different years build queue, to retrospectively compare the data of colorectal cancer screening from January 1, 2008 to December 31, 2013 and the data of cancer registration, and to analyze the colorectal cancer incidence rates among screening compliers and non-compliers, and to compare the average intervals between the end of screening and clinical cancer diagnosis using SPSS 19 statistical software. Mantel-Haenszel test was performed with a statistical significance level of α = 0.05.

RESULTSThe non-compliance rate was 38.24% among males and 28.49% among females (P < 0.001). The non-compliance rate was highest in the 40-44 and 70-74 years age groups and lowest in the 50-59 years age group. The compliers of the screening were followed up for 476,049 person-years, and there were 51 cases of colorectal cancer, with an incidence rate of 10.71/100,000. The non-compliers of the screening were followed up for 259 183 person-years, and there were 66 cases of colorectal cancer, with an incidence rate of 25.46/100,000, which was 1.38 times higher than that of the compliance group (χ2 = 21.699, P < 0.001). The incidence rate of colorectal cancer among subjects who were positive in initial screening but refused to receive an electronic colonoscopy was as high as 164.40/100,000, and the average delay time was 20.8 ± 16.8 months.

CONCLUSIONSThe colorectal cancer screening adherence among women is better than among men, and that of 50-54 years and 55-59 years age groups is better than in other age groups. The subsequent incidence rate of colorectal cancer in the non-compliance group is significantly higher than that of the compliance population.

Adult ; Age Factors ; Aged ; China ; epidemiology ; Cohort Studies ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; epidemiology ; Early Detection of Cancer ; Female ; Humans ; Incidence ; Male ; Mass Screening ; statistics & numerical data ; Middle Aged ; Patient Compliance ; statistics & numerical data ; Retrospective Studies ; Sex Factors

Objective To investigate the effect of via-anal ileus tube used as a drainage in left-sided acute malignant colonic obstruction.Methods Forty-seven cases of left-sided acute malignant colonic obstruction were divided into control group (25 cases) and tube group (22 cases).The patients in control group received intraoperative colonic lavage for one-stage surgery.The patients in tube group received via-anal ileus tube for decompression before the surgery.Compared the difference of bowel movement recovery time,exhaust time,fasting time,postoperative hospitalization time,hospitalization costs and complication rate between two groups.Results The technically successful rate in tube group was 90.9％ (20/22),and one-stage surgery were performed.No anastomotic leakage or postoperative stenosis occunred after operation.There were 23 cases in control group who performed coloclysis in operation and one-stage surgery.The bowel movement recovery time,exhaust time,fasting time,postoperative hospitalization time and hospitalization costs in tube group were significantly lower than those in control group [(12.78 ± 2.07) h vs.(18.01 ±3.42) h,(78.76 ± 11.43) h vs.(96.38 ±13.09) h,(3.18 ±1.76) d vs.(5.51 ±2.95) d,(10.23 ± 2.33) d vs.(15.86 ± 6.74) d,(25 437.43 ± 2 343.67) Yuan vs.(31 051.32 ± 2 542.73) Yuan](P ＜ 0.01 or ＜ 0.05).After operation,there were 2 cases of stomas fistula and 2 cases of peritoneal cavity infection in control group,and none of them in tube group,the complication rate in control group was significantly higher than that in tube group [17.4％ (4/23) vs.0,P ＜ 0.05].Conclusions The via-anal ileus tube used as a drainage in left-sided acute malignant colonic obstruction is effective and safe,and can improve the rate of one-stage anastomoses,decrease the complication rate,promote the promote.It has important clinical value.

Objective To optimize the prescription and preparation technclogy of ligustilide liposomes. Methods Ligustilide liposomes were prepared by ethanol injection method. The encapsulation efficiency was taken as inspection target and the preparation of liposomes was optimized by orthogonal design. HPLC was used to measure the encapsulation efficiency. Results The best prescription was ligustilide-lecithin (1:10),lecithin-cholesterol (2:1),the water phosphate buffer solution (pH 7.5),the hydration temperature was 35 ℃. Conclusion The optimized formulation of ligustilide is reasonable in prescription and practicable in technology.

Objective To evaluate the protective effect on the pulmonary micmvascolar permeability and thereby to ameliorate the lungs injury attributed to cardiopuimonary bypass(CPB).Method Twenty-four adult hybrid health dogs were randomly divided into three groups(8 in each group):group C(normal saline given after CPB),group N1(NAC given intravenously just before CPB)and group N2(NAC given just after CPB).The changes of respiratory index(RI)and malondialdehyde(MDA)content in lung tissue were observed.Samples were taken three times,before CPB(T0),30 min after CPB surned off(T1)and 60 min after CPB sumed off(T2).The leucocyte count and slbumin content in bronchoalveolar lavage fluid(BAlF),the pulmonary micmvascular permeability index(PMPI),and the histological changes of lung under light microscope and electromicroscope in 3 groups were examined.Results No significant differences were found in the levels of Ri and MDA content of lung tissue between groups before CPB.However,they gradually reduced after CPB(P<0.05)in the three groups,but they still were significantly lower in group N1 and group N2 compared with those in group C at,T1 and T2(P<0.05)and those in group N1 were significantly lowere than those in group N2 at T1 and T2(P<0.05).MDA gradually increased after CPB in three groups(P<0.05),but it was still significantly lower in group N1 and group N2 than that in group C at T1 and T2(P<0.05).The leucocyte count and albumin content in BALF were significantly lower in group N1 and group N2 in comparison with those in group C(P<0.05)and they were significantly lower in group N1 compared with those in group N2(P<0.05).The PMPI were significantly lower in group N1 and sroup N2 compared with those in group C(P<0.05)and they were significantly lower in group N1 compared with those in group N2(P<0.05).By using electromicroscope,the apparent inflammatory change of lung with endothelium cellular swelling,inter-endothelial cells spaces widened,and the indistinctness,deformation or decurtation of microfilarnent were observed.And the dissolution of laminated body,swollen mitochondria and plasmolysis were found in alveolar epithelial cell Ⅱ in group C.However,these changes were markedly alleviated in group N2 and group N1.Conclusions The results clearly demonstrate that NAC could protectie effect on the CPB injured lung and reduce the pulmonary microvascalar permeability,and the protetive effect is better in group N1 than that in group N2.

Objective To evaluate the clinical effect of a novel computer-assisted navigation technique for intraoperative correction of femoral rotation deformity in diaphyseal fractures.Methods From November 2015 to November 2016,a navigation system (BrainLAB,Germany) was used in antegrade intramedullary nailing for 13 patients with femoral shaft fracture to intraoperatively restore the normal length and rotation of the fractured femur.They were 11 men and 2 women,with an average age of 38.2 years.The iujury affected the left side in 5 cases and the right side in 8.According to the Winquist Classification,there were 6 cases of type Ⅰ,3 ones of type Ⅱ,3 ones of type m,and one of type Ⅳ.This navigation system allowed the surgeons to detect and set the femoral anteversion (FAV) and length of the injured leg at the desired angle and length of the healthy contralateral femur,precisely matching the contralateral limb and restoring the normal length and rotation of the fractured femur.All the patients underwent postoperative CT scan of bilateral femora for measurement of the lengths and rotations which were conpared with the intraoperative values obtained with the navigation system.Results Additional operative time required for computerized navigation averaged 42.8 min (from 35 to 55 min).The mean length difference between the treated and untreated femora was 4.2 nnn (from 2 to 9 mm).The FAVs obtained from intraoperative navigation and postoperative CT scan were 34.0° ± 8.4° and 33.5° ± 8.3° in the healthy side and 31.2° ± 8.5° and 32.8° ± 9.0° in the injured side,showing no significant differences either between the 2 sides or between intraoperation and postoperation (P ＞ 0.05).The mean rotational difference between the 2 extremities were 4.8° ± 1.6° for the navigation and 3.8° ± 1.9° for the CT scan,showing an insignificant difference (P ＞ 0.05).All the incisions healed well with no intraoperative or postoperative complications.Conclusions This novel navigation technique may serve as a reliable tool to accurately correct the rotational malalignment of femoral shaft fractures intraoperatively,but care should be taken in every step of the navigation procedure to reduce complications.

Objective To determine the optimum dose of oxycodone for anesthesia when combined with propofol in the patients undergoing induced abortion.Methods Three hundred patients, aged 18-40 yr, weighing 40-70 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective induced abortion, were randomly divided into 6 groups (n =50 each) using a random number table: fentanyl group (group F) and different doses of oxycodone groups (Q1-5 groups).In group F, fentanyl 1 μg/kg was intravenously injected.In Q1-5 groups, oxycodone hydrochloride 20, 40, 60, 100 and 150 μg/kg were intravenously injected, respectively.Propofol 2.5 mg/kg was intravenously injected 1 min later in all the patients, and the operation was started when the eyelash reflex disappeared.The occurrence of hypotension, bradycardia, body movement and respiratory depression during operation, and nausea and vomiting within 4 h after operation were recorded.The uterine contraction pain was assessed with numerical rating scale (NRS) at 30 min, 1 h and 4 h after operation.Patient's satisfaction was evaluated at 1 and 4 h after operation.Results With the prolongation of time, NRS score was gradually increased, and the degree of patient's satisfaction was gradually decreased in group F (P＜0.05).With the prolongation of time,NRS score was gradually decreased, and the degree of patient's satisfaction was gradually increased in Q1-2 groups (P＜0.05).There was no significant difference in NRS score and degree of patient's satisfaction between Q3-5 groups (P＞0.05).Compared with group F, NRS score was significantly decreased, and the degree of patient's satisfaction was increased at 4 h after operation in Q1-5 groups (P＜0.05).Compared with Q1-2 groups, NRS score was significantly decreased at 30 min and 4 h after operation, and the degree of patient's satisfaction was increased at 4 h after operation in Q3-5 groups (P＜0.05).Among the Q1-5 groups,the incidence of respiratory depression, body movement, and nausea and vomiting was the lowest in group Q4 (P＜0.05).Conclusion When combined with propofol, the optimum dose of oxycodone for anesthesia is 100 μg/kg in the patients undergoing induced abortion.

Objective To investigate the surgical management of Crohn's disease complicated with duodenal fistula.Methods The clinical data of 1 012 patients with Crohn's disease who were admitted to the Nanjing General Hospital of Nanjing Military Connnand from January 2002 to January 2014 were retrospectively analyzed.Of the 1 012 patients,22 were complicated with duodenal fistula,including 12 with ileocolonic anastomosis-duodenal fistula,7 with colo-duodenal fistula,2 with sigmoido-duodenal fistula and 1 with duodeno-enteric fistula.All patients received duodenal fistula repair + resection of diseased intestine.Patients were followed up via out-patient examination,phone call and email till May 2014.The condition of patients before and after enteral nutrition support was compared using the t test.Non-normal data were analyzed using the Mann-Whitney u test.Results Two patients with abdominal infection and 1 with gastrointestinal bleeding received emergent operation,and the other 19 patients received enteral nutrition support prior to operation.Three patients received emergent colostomy.Two patients had fistula at the duodenal anastomosis,and 1 patient was cured by enteral nutrition support + drainage for 12 days and the other 1 received reoperation.The energies provided by enteral nutrition and enteral + parenteral nutrition were (25.3 ± 2.1) cal/g and (28.5 ± 3.2) cal/g,respectively,and the time for nutrition support was (31 ± 5)days.The level of C-reaction protein and Crohn's disease activity index were decreased from 25 mg/L and 207 ± 111 before treatment to 2 mg/L and 117 ± 71 after treatment,with significant difference (u =53.000,t =0.942,P ＜ 0.05).The levels of body mass index,albumin and blood sedimentation rate were (17.0 ± 2.1) kg/m2,(35 ± 5) g/L and 26 mm/h before treatment,and (17.9 ± 2.8) kg/m2,(38 ± 5) g/L and 23 mm/h after treatment,with no significant differences (t =0.482,1.170,u =67.500,P ＞ 0.05).One patient was cured by enternal nutrition.Five patients received intestinal stoma and the other 13 patients received intestinal anastomosis.Twenty-two patients were followed up with the median time of 13.4 months (range,4.0-37.0 months).One patient had recurrence of ileocolonic anastomosis-duodenal fistula and received reoperation,and complications were not observed in the other 21 patients.Conclusions Selective operation is recommended for patients with Crohn's disease complicated with duodenal fistula.Enteral nutrition support is the first choice during the interoperative management.Resection of diseased intestine combined with repair of duodenal fistula after alleviation of Crohn's disease and malnutrition could achieve satisfactorv effect.

Objective To compare clinical outcome of microvascular decompression (MVD) and percutaneous balloon compression (PBC) by using a prospective cohort study in order to provide a reliable evidence for the clinical decision-making. Methods Patients with trigeminal neuralgia hospitalized at Hangzhou First People′s Hospital in 2010 were chosen as database for cohort study. The patients were divided into MVD group (30 cases) and PBC group (30 cases). The clinical efficacy was followed by independent observers for 36 months after surgery. Chi-square test for hierarchical data, t test for quantitative data, and Kaplan-Meier plot for clinical outcomes were applied in the research. The endpoint was follow-up accomplishment or severe occurrence. Results Sixty patients were included in the research till the endpoint. The general records before surgery were almost the same with the literature records. By comparing painless period, mild and severe relapse, MVD group was superior to PBC group (P < 0.05). As for the painless survival period, MVD group was 96.7% of pain free after 1 year, 93.3% after 3 years, while PBC group was 90.0% after 1 year and 83.3% after 3 years. Regarding 3 years of follow-up, the relapse seemed occurred after 1 year in both groups. Conclusions As a curative and nondestructive procedure , MVD is more effective and has longer lasting pain free period , which should be considered as the first choice of treatment for trigeminal neuralgia in healthy people.

AIM:To investigate the effects of silymarin on lipopolysaccharide(LPS)-induced acute lung injury in rats and its possible molecular mechanisms.METHODS: Fifty-eight male SD rats,weighting 230-250 g,were divided into four groups randomly: normal control(n=12);acute lung injury group(n=15),receiving intravenous LPS(O55∶B5,5 mg/kg);silymarin alone group(50 mg/kg,n=15);intervention group(n=16,receiving silymarin 50 mg/kg and LPS 5 mg/kg).The specimens were collected 6 hours later.The following changes,including blood gas analysis,the lung wet/dry weight ratio,the pulmonary vascular permeability,histological manifestations,lung tissue myeloperoxidase activity,the levels of TNF-?,IL-1?,MCP-1 and SOD,GSH-Px as well as malonaldehyde and conjugated diene in plasma and lung tissue,were observed.RESULTS: Compared with control group,the lungs of the rats in LPS treatment group showed significant hyperemia and spotted hemorrhage.The inflammatory granulocyte infiltrating,diffused alveolar septum thickening and spotted hemorrhage were observed in pathological examinations.The lung wet/dry weight ratio and Evans blue content(per gram) increased significantly after LPS treatment.The myeloperoxidase activity in plasma and lung tissue,the levels of TNF-?,IL-1?,MCP-1 and SOD,GSH-Px as well as malonaldehyde and conjugated diene were increased significantly in LPS treatment group.However,in intervention groups,all the above-mentioned measurements were reversed significantly by silymarin treatment compared with LPS treatment group.CONCLUSION: Silymarin may decrease inflammatory reaction and oxidative stress,and further decrease lung damage induced by LPS in rats,all indicating protection of silymarin against acute lung injury.