Objective To evaluate retrospectively the methods and outcomes of surgical treatment of patients with intrahepatic cholelithiasis and biliary stricture.Methods The data of the surgical therapy of 165 cases of cholelithiasis and biliary stricture admitted between January 1995 and January 2003 were analyzed.Group A included 85 cases managed by various types of hepatectomy or hepatic segmental resection(HSR).In group A,40 patients underwent simultaneous cholangiojejunostomy,in 10 patients the dilated bile duct on(resected) surface of liver and bile duct of hepatic hilum were separately anastomosed to the jejunum by double stoma anostomosis,T-tube drainage was done in 21 cases and U-tube drainage in 14 cases.Group B(patients)(n=80) were treated by operation without HSR,included 23 cases with choledochotomy and stone removal plus T-tube drainage,15 cases with choledochotomy and stone removal plus U-tube drainage,42(cases) with choledochotomy and stone removal plus biliary-enteric anastomosis;in group B,plastic operation of the hepatic duct stricture was proforemed in 46 cases.Results In Group A,no operative death occurred.The cases were followed up after operation from 2 to 7 years,and showed residual calculus rate was 4.71%,and symptoms recurrence rate 3.53%.No patient was operated again.In Group B,no operative death(occurred).The cases were followed up from 2 to 7 years after operation,and residual stones were found in 12 cases,a residual calculus rate of 15.00%.After operation,10 cases complained of upper abdominal pain and(fever),with a symptoms recurrence rate of 12.5%.The residual stones of 5 cases were removed by fiber biliary(endoscopy),while 3 cases of the other 6 cases received hepatectomy.Conclusions The combined(hepatic) resection and other operation is an ideal and effective surgical method to treat hepatolithiasis.

0.01). There was a significant difference in TIMP-1,-2 expressions between saccule injury group and control group (P

OBJECTIVE:To analyze the related factors that initiating the occurrence of adverse drug reactions (ADR). METHODS: The 184 ADR reports occurred from April, 1999 to July, 2004 were analyzed by a descriptive research method. RESULTS: Among the 184 cases, female cases outnumbered the male cases with the ratio at M∶F=1∶1.4, 122 cases were the elderly at the age of more than 60 which accounts for 66.30% of the total;there were 123 single medication cases and 61 combined medication cases;there were 23 severe cases, 128 moderate cases and 33 mild cases; 153 patients were symptomatically treated, 31 cased were not given special treatment;161 patients were fully recovered, 17 cases showed some improvement and 6 cases did have sequela;in the cause-effect relationship assessment, there were 3 certain cases, 153 probable cases and 28 possible cases; the anti-infective-led ADR accounted for 64.39%, then came the central nervous system drugs and Chinese traditional medicines at a percentage of 12.33% and 10.55% respectively;skin and its appendages impairment cases were the most with a percentage at 67.55%.CONCLUSION: To lessen or avoid the occurrence of ADR, monitoring of which and publicizing of ADR knowledge should be emphasized.

Objective To screen for nonresponding cases of superficial transitional cell carcinoma of the bladder at an early stage of intravesical bacillus Calmette Guetin(BCG) therapy. Methods IL 8 and urine pH were assayed both before intravesical BCG instillation and after the 1st and 6th instillation for 32 cases of superficial transitional cell bladder cancinoma following TURB or partial cystectomy.Urinary IL 8 was measumed by chemiluminescence enzyme immunomeric assay and urine pH by routine examination.The result was studied with reference to the clinical outcome of the patients. Results All the patients have been followed up for 6～25 months with tumor recurrence in 5.Urinary IL 8 in these 5 dropped to 161.3?64.5 ng/L after the 1st instillation whereas it was 579.4?77.8 ng/L in the others ( P

Objective:To evaluate the value of pretreatment 18F-fluorodeoxyglucose (FDG) PET/CT-based heterogeneity for early prediction of targeted therapy outcome in patients with human epidermal growth factor receptor 2 (HER2) positive metastatic breast cancer. Methods:From May 2012 to April 2018, 29 patients (all females, median age: 52 (32-69) years) who had HER2 positive metastatic breast cancer and underwent pretreatment 18F-FDG PET/CT in Fudan University Shanghai Cancer Center were retrospectively enrolled. All patients received trastuzumab as first-line treatment and were followed up for 6-87 (median time: 35) months. The relations between clinicopathologic parameters or PET/CT-based parameters and progression-free survival (PFS)/overall survival (OS) were analyzed with Cox univariate analysis. The parameters with P≤0.01 were further analyzed with Cox multivariate analysis. Optimal cut-off values were determined by time-dependent receiver operating characteristic (ROC) curve analysis. The survival analyses were estimated by Kaplan-Meier method and log-rank test. Results:The median OS of the 29 patients was 30 (6-83) months, and the median PFS was 10 (2-29) months. The PET/CT-based heterogeneity index(HI), including the maximum standardized uptake value (SUV max) ratio (SUV max-R; hazard ratio ( HR)=8.6, 95% CI: 2.7-27.8, P<0.001), the mean standardized uptake value (SUV mean)-2.5 (the cut-off value of standardized uptake value (SUV)=2.5) ratio (SUV mean-2.5-R; HR=2.6, 95% CI: 1.2-5.9, P=0.020), the metabolic tumor volume(MTV)-2.5 ratio(MTV-2.5-R; HR=2.4, 95% CI: 1.1-5.2, P=0.030), and the total lesion glycolysis(TLG)-2.5 ratio(TLG-2.5-R; HR=3.2, 95% CI: 1.4-7.4, P=0.008) of the lesion with the highest SUV max to that with the lowest SUV max, were significantly associated with PFS. None of the parameters was significantly associated with OS (all P>0.05). Multivariate analysis showed that the SUV max-R was the only independent predictor for PFS ( HR=6.8, 95% CI: 1.8-26.1, P<0.01). Area under the ROC curve for SUV max-R was 0.747. With a cut-off value of 1.8, SUV max-R could effectively distinguish the benefit from non-benefit population treated with trastuzumab (15.0 vs 7.0 months; χ2=18.68, P<0.01). Conclusion:Pretreatment 18F-FDG PET/CT-based HI has potential value for early prediction of first-line trastuzumab treatment outcome in patients with HER2 positive metastatic breast cancer.

Objective To observe the rates of local complications (bleeding/swelling) after trans-radial coronary intervention (TRI),to investigate possible impact factors,in order to provide guidance for the prevention of these adverse events.Methods A total of 198 cases who performed TRI at the department of interventional cardiology of the First Affiliated Hospital of Sun Yat-sen University from August to December,2011 were included in the present study.Data with regards to local complications were collected peri-operatively,by means of direct inquiry,point-of-care observation and measurements,and laboratory testing.Patients who developed complications and patients who did not were compared in terms of compressor position,loosening protocol and so on.Variables with statistical significance in univariate analysis were further included in Cox regression.SPSS 18.0 software was applied for all statistical analysis.Results The relative risks (RR) of the following two variables,namely whether or not the midpoint of compressor was on the midline of forearm,and the vertical distance from the horizontal plate of the compressor to the puncture site,were 2.602 and 1.403,respectively.Conclusions The midpoint of compressor on the midline of forearm,and the vertical distance from the horizontal plate of the compressor to the puncture site were major risk factors of local complications after TRI.

Simvastatin, a semisynthetic derivertive of lovastatin, is an important drug for the treatment of hypercholesteromia, and is traditionally prepared by direct alkylation of lovastatin. Chemical reaction conditons are very rigid, and the final product is difficult to purify, also the pressure of labor protection and environment protection is very high. Recently, with the devolpement in the research of lovastatin biosynthesis, more and more attention has been paid to simvastatin biosynthesis. This paper compared the chemical and biological routes in simvastatin production. Simvastatin could be produced by direct fermentation with combinational biosynthesis method, and could also be synthesized from monacolin J with acyltransferase LovD.
Acyltransferases ; genetics ; metabolism ; Anticholesteremic Agents ; metabolism ; Catalysis ; Escherichia coli ; genetics ; metabolism ; Fermentation ; Lovastatin ; analogs & derivatives ; biosynthesis ; Naphthalenes ; metabolism ; Simvastatin ; metabolism ; Transformation, Bacterial

With the rapid development of industrial biotechnology, breakthrough in enzymology and biocatalysis has been made in recent years, especially in areas of stability and activity of enzyme in nonaqueous media, screening, construction and modification of solvent-tolerant biocatalysts, as well as the development of green solvent with excellent biological and environmental compatibility. Recent trend and future focus include: in silico virtual screening and construction of solvent-tolerant biocatalysts based on bioinformatic technology, modification and construction of native solvent-tolerant biocatalysts, the development of environmental friendly green solvent such as ionic liquids.
Animals ; Biocatalysis ; Biotechnology ; trends ; Enzymes ; chemistry ; genetics ; Humans ; Solvents

Background and purpose: 18F-FDG has been considered to be of limited value for the detection of bladder lesions because of interference by the 18F-FDG excreted in urine. Delayed pelvic images with“diluted and iflled bladder”use a method of 18F-FDG PET/CT with delayed images after oral hydration so as to increase the detection rate of 18F-lfuorodeoxyglucose(FDG) PET/CT imaging for the lesions of bladder. Methods:48 patients with bladder lesions(35 patients with bladder primary tumor and 13 patients with metastatic tumor) underwent 18F-FDG PET/CT detection and were required oral hydration of 1200-1800 mL water, urination frequently, holding urine when the more scan began. Lesions conifrmed by histopathology, MRI, CT or clinical follow-up at least 1 year. Results:89%(43/48) of patients were obtained good clearance and the urine SUVmax declined from 33.14(9-66.80)to 3.23(1.35-5.65) signiifcantly and the statistical difference was signiifcant (t=8.703, P<0.01). The interval time between two scan was 2 h approximately. At the same time, the SUVmax of bladder lesion was 2.8-25.0. Detection sensitivity, speciifcity and accuracy were 90.47%(19/21), 81.48%(22/27)and 85.41%(41/48), respectively. Conclusion: 18F-FDG activity in the bladder signiifcantly decreased in most patients with“diluted and iflled bladder”. The PET/CT scan can highly detect lesions of bladder tissues. Our method with high accuracy and better endurance could be applied to detect the lesions in bladder.

Objective To discuss the clinical application of contrast enhanced ultrasonography (CEUS) in radiofrequency ablation (RFA) treatment for residual and recurrent hepatic neoplasms. Methods A total of 517 cases of primary hepatocellular carcinoma (HCC) or hepatic metastases with residual or recurrent hepatic neoplasms after different kinds of treatment were treated with RFA. A total of 619 lesions were used as study subjects. The average size of the 290 lesions detected in 281 patients with recurrent HCC was (3.4 ± 1.5) cm. CEUS-guided RFA group included 150 cases (154 lesions in total), while conventional US-guided RFA group included 131 cases (136 lesions in total). A total of 329 lesions were detected in 236 cases with recurrent hepatic metastases, and the mean size of the lesions was (3.1 ± 1.3) cm, of which CEUS-guided RFA group included 152 cases (198 lesions in total) and conventional US-guided RFA group included 84 cases (131 lesions in total). Results In recurrent HCC, the one-month tumor necrosis rate of CEUS group and conventional US group was 96.1% and 89.7% respectively (P = 0.032), and the local recurrence rate was 9.7% and 17.6% respectively (P = 0.049). The differences between the two groups were statistically significant. In recurrent hepatic metastases , the one-month tumor necrosis rate of CEUS group and conventional US group was 88.4% and 87.0% respectively (P = 0.712), and the local recurrence rate was 16.7% and 23.7%respectively (P = 0.117). No significant differences existed between the two groups. Conclusion For the treatment of recurrent HCC, CEUS-guided radiofrequency ablation can effectively improve the early necrosis rate and decrease local recurrence rate.