Objective To summarize the experience of surgical management of postoperative intrahepatic duct stones and strictures with choledochoscope.Methods The clinical data of 1241 patients with intrahepatic duct stones and strictures who were admitted to the Shenzhen People's Hospital from January 2000 to December 2011 were retrospectively analyzed.All patients were divided into postoperative choledochoscopy group (652 patients were treated by choledochoscope through T-tube fistula) and conservative treatment group (589 patients were treated by cholangic and antibiotic drugs) according to treatment plan.The clinical data including stricture alleviation,incidence of complications and treatment efficacies of the 2 groups were compared using the chi-square test.Results In the postoperative choledochoscopy group,the intrahepatic duct stones of 630 patients were completely removed,with the removal rate of 96.63％ (630/652),which was significandy higher than 76.23％ (449/589) of the conservative treatment group (x2=113.407,P ＜ 0.05).A total of 1237 intrahepatic duct strictures were detected in the postoperative choledochoscopy group,including 698 cases of membranous stricture (the length of strictured bile duct ＜ 2 mm),529 cases of spool-shaped stricture (2 mm ≤ the length of strictured bile duct ≤5 mm),8 cases of long tube-shaped stricture (the length of strictured bile duct ＞ 5 mm),2 cases of crackshaped stricture.The alleviation rate of the stricture was 99.35％ (1229/1237).The conditions of 6 cases of long tube-shaped stricture and 2 cases of crack-shaped stricture were not alleviated.There were 986 cases of intrahepatic duct strictures in the conservative treatment group,and the stricture alleviation rate was 80.43％ (793/986).There was a significant difference in the stricture alleviation rate between the 2 groups (x2=238.994,P ＜ 0.05).Nine patients in the postoperative choledochoscopy group had severe complications.Five patients had intrahepatic duct hemorrhage with a volume of blood loss more than 1500 ml,and they were treated by balloon dilatation hemostasis.One patient with repeated intrahepatic duct bleeding received hepatectomy.Two patients with severe intrahepatic cholangitis received choledochoscopy.Two patients had incomplete formation of sinus and they received implantation of biliary stents under duodenoscope.Conclusion Standard surgical management with choledochoscope can effectively alleviate postoperative intrahepatic duct stones and strictures.

Objective To compare the long-term outcomes of partial hepatectomy versus choledocholithotomy both combined with choledochoscopy,for the treatment of hepatolithiasis.Methods Patients who underwent either type of the operations were followed up and examined using hepatobiliary magnetic resonance (enhanced MRI + MRCP).The incidences of abnormal imaging in the two groups were compared.Results Of 268 patients,138 patients underwent partial hepatectomy and the remaining 130 patients underwent choledocholithotomy.When hepatectomy was compared with choledocholithotomy,the recurrence rate of acute cholangitis combined with bile duct stone (5.8％ vs.21.5％),the reoperation rate (5.8％ vs.21.5％),the bile duct stricture rate (8.0％ vs.44.6％),the abnormal liver parenchyma perfusion rate (4.3％ vs.23.1％),the incidence of intrahepatic bile duct enhancement or thickening (1.5％ vs.26.9％),the incidence of hepatic atrophy (3.0％ vs.30.0％) and the incidence of cholangiocarcinoma (0 vs.2.3％) were better.Conclusions The long-term adverse outcomes were significantly worse in the choledocholithotomy group than in the partial hepatectomy group.Choledocholithotomy combined with choledochoscopy should only be considered as a complementary procedure to partial hepatectomy in hepatolithiasis.

OBJECTIVE: To estimate the inevitable uncertainty of determining heroin by GC. METHODS: The source of the uncertainty was confirmed from the determining procedure. Each component's uncertainty was calculated. The combined uncertainty was then obtained by synthesizing the uncertainties of various components variables, and the expand uncertainty was finally obtained. RESULTS: The uncertainty of repeated measurement was greater than other uncertainty components introduced by balance,content vessels and instruments in determining heroin. CONCLUSION The errors of repeated measurement and GC instrumental were confirmed as the major sources of uncertainty in determining heroin by GC.
Algorithms ; Chromatography, Gas/methods* ; Forensic Medicine/methods* ; Heroin/chemistry* ; Humans ; Models, Theoretical ; Reproducibility of Results ; Solvents/chemistry* ; Substance Abuse Detection/methods* ; Uncertainty

OBJECTIVE: Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed for the determination of opiates in biological samples according to the emerging problem in drugs abuse. METHODS: Opiates such as heroin, 6-acetylmorphine, morphine, codeine, acetylcodeine, hydrocodone and hydromorphone were isolated from human blood, urine, oral fluid and hair using a simple extraction and consequently analyzed using LC-MS/MS. The method was evaluated by real cases. RESULTS: The mobile phase give the optimum separation for opiates. The detection limit of morphine in urine with dilution and liquid-liquid extraction and in hair is 10ng/mL, 0.01 ng/mL and 0.01 ng/mg, respectively. CONCLUSION The method is simple and rapid, offering superior sensitivity and selectivity for opiates. The target compounds comprising hydrocodone and hydromorphone enlarge the applied area.
Chromatography, Liquid ; Codeine/analysis* ; Forensic Medicine/methods* ; Hair/chemistry* ; Humans ; Hydrocodone/analysis* ; Hydromorphone/analysis* ; Morphine/analysis* ; Narcotics/analysis* ; Reproducibility of Results ; Saliva/chemistry* ; Substance Abuse Detection/methods* ; Tandem Mass Spectrometry

OBJECTIVE: To focus on the main factors that may influence the stability of ethanol in blood then try to establish the best conditions for preserving ethanol in blood. METHODS: Four crucial parameters, including temperature (-20, 4, 20 degrees C), preservative (NaF, No preservative, Na2O2), percentage of air chamber in container (0%, 25%, 50%), and ethanol concentration in blood (0.2, 0.8, 2.0 mg/mL) were investigated. Blood samples were stored under different conditions designed by orthogonal design L, (3(4))method. Quantification of ethanol in blood was carried out by headspace gas chromatography with FID detector. The results were statistically evaluated by analysis of variance. RESULT: Significant changes of ethanol concentrations were observed in the samples stored in 20 degrees C without any reserveative, while there were no obvious changes in the samples under other storage conditions. CONCLUSION The best condition for keeping ethanol in blood stable is 4 degrees C with preservative and with 50% of air chamber in container. The temperature is main effective factor in the four factors.
Air ; Analysis of Variance ; Blood Preservation ; Chromatography, Gas ; Ethanol/chemistry* ; Forensic Medicine/methods* ; Humans ; Specimen Handling/methods* ; Temperature ; Time Factors

OBJECTIVE: To establish an inductively coupled plasma mass spectrometry (ICP-MS) method for determination of Hg in biological samples. METHODS: The samples were digested with microwave digestion instrument. ICP-MS was applied to detect Hg in blood, urine and hair specimens by using 115In as an internal marker. The ability of gold to eliminate the memory effect of mercury was investigated with the gold amalgamate produced by gold and mercury. RESULTS: The limits of detection were in the 0.01 microg/L, and the accuracy of the method ranged from 97.0% to 107.1%. The concentration of gold was 10 microg/L and the memory effect of mercury was resolved. CONCLUSION The method is accurate, rapid, sensitive and suitable for the cases of mercury poisoning and the clinical diagnosis and monitoring for patients with mercury poisoning.
Forensic Toxicology ; Hair/chemistry* ; Humans ; Indicators and Reagents ; Mass Spectrometry/methods* ; Mercury/urine* ; Mercury Poisoning/diagnosis* ; Microwaves ; Reference Standards ; Reproducibility of Results ; Sensitivity and Specificity ; Specimen Handling/methods*

OBJECTIVETo compare therapeutic effects between moxibustion and infrared therapy for the treatment of knee osteoarthritis.

METHODSFrom January 2007 to June 2008 period, 65 patients with knee osteoarthritis were divided into treatment and control groups randomly uniform random number table generated from SAS statistical software. Among 35 patients in the treatment group, 17 patients were male and 18 patients were female, ranging in age from 45 to 75 years, with an average of (61.2+/-6.4) years; the course of disease ranged from 9 to 43 months, with a mean of (23.6+/-13.8) months; the preoperative Lysholm score ranged from 19 to 28 scores, averaged (24.3+/-3.3) scores. In the control group, there were 30 patients, including 13 males and 17 females, ranging in age from 47 to 79 years, with an average of (62.5+/-9.3) years; the course of disease ranged from 8 to 45 months, with a mean of (24.6+/-16.6) months; the preoperative Lysholm score ranged from 20 to 29 scores, averaged (25.9+/-3.0) scores. The patients in the treatment group were treated with moxibustion, and the patients in control group were treated with infrared therapy. All the patients were followed up for 4 weeks. The Lysholm scores were compared between the two groups.

RESULTSAccording to Lysholm score for clinical efficacy, treatment group got (87.5+/-5.6) scores and the control group were (85.9+/-3.5) scores, the Lysholm score of the treatment group was higher than that of the control group (P<0.05). Among pain score, joint flexion and extension score, joint stability score, and up and down stairs score, the pain and joint stability scores of patients in the treatment group were higher than those of control group (P<0.05).

CONCLUSIONCompared with infrared therapy, moxibustion treatment for knee osteoarthritis can get better joint function, which is effect to alleviate the patient's pain, improve joint stability, improve the efficacy, and is valued to be promoted.

Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; methods ; Multicenter Studies as Topic ; Osteoarthritis, Knee ; therapy ; Treatment Outcome

This study aims to investigate the preventive role and potential mechanisms of blocking extracellular HMGB1 function on doxorubicin induced cardiac injury. Mice were treated with HMGB1 blocker glycyrrhizin 1 h before and one time every day (intraperitoneal, 10 mg per mouse) after doxorubicin injection, and sacrificed on the day 14 after doxorubicin challenge. Cardiac function was evaluated by echocardiography and hemodynamic measurement. Myocardial inflammation and collagen deposition were analyzed by immunohistochemistry and picrosirius red staining. The interaction of HMGB1 and TLR2 was assessed by co-immunoprecipitation and confocal microscopy. The protein contents of HMGB1, MyD88, p65NF-kappaB and phospho-p65NF-kappaB were measured by Immunoblot. Compared with mice treated with saline, doxorubicin treatment led to an upregulation in HMGB1 expression. Blocking HMGB1 activity with glycyrrhizin protected mice against cardiac dysfunction, inflammatory response, and cardiac fibrosis induced by doxorubicin challenge. Glycyrrhizin inhibited the interaction of HMGB1 and TLR2, and blocked the downstream signaling of TLR2. In conclusion, blocking HMGB1 protected against doxorubicin induced cardiac injury by inhibiting TLR2 signaling pathway.
Animals ; Anti-Inflammatory Agents ; pharmacology ; Collagen ; metabolism ; Doxorubicin ; Drug Interactions ; Fibrosis ; Glycyrrhizic Acid ; pharmacology ; HMGB1 Protein ; antagonists & inhibitors ; metabolism ; Heart Diseases ; chemically induced ; metabolism ; pathology ; Immunoprecipitation ; Interleukin-17 ; metabolism ; Male ; Mice ; Mice, Inbred ICR ; Myocardium ; metabolism ; pathology ; Random Allocation ; Signal Transduction ; drug effects ; Toll-Like Receptor 2 ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; Up-Regulation

OBJECTIVETo investigate the effect of short hairpin RNA (shRNA) targeting survivin on adhesion and invasion of human colon carcinoma cell line SW480 in vitro.

METHODSAccording to the sequence of the coding region of survivin gene, two strings of 19 nucleotides of inverted sequence flanking the loop sequence of two complementary 9-base oligonucleotides were designed and synthesized to prepare the hairpin construct as the DNA templates for the target shRNA. The shRNA templates were cloned into shRNA expression vector pRNAT-U6.1/Neo, and the resulted vector pRNAT-U6.1/Neo-survivin was transfected into SW480 cells using Lipofectamine 2000. Western blotting was performed to evaluate survivin gene silencing induced by shRNA transfection at the protein level, and the biological behaviors of the SW480 cells were investigated by cell-matrix adhesion, invasion and gelatin-zymography assays.

RESULTSWestern blotting revealed significantly lowered survivin protein expression in transfected SW480 cells, and survivin gene silencing induced by shRNA significantly suppressed the metastatic potential of SW480 cells in association with suppressed MMPs activity.

CONCLUSIONSSurvivin may play an important role in modulating human colorectal carcinoma cell invasion and metastasis, and survivin gene silencing can inhibit human colorectal cancer cell invasion and the production of MMP-2 and MMP-9. Survivin may affect invasion and metastasis of human colorectal carcinoma cells via regulating the production of MMPs.

Animals ; Blotting, Western ; Cell Line, Tumor ; Colonic Neoplasms ; genetics ; pathology ; Gene Silencing ; Humans ; Inhibitor of Apoptosis Proteins ; Inverted Repeat Sequences ; Matrix Metalloproteinases ; secretion ; Microtubule-Associated Proteins ; deficiency ; genetics ; Neoplasm Invasiveness ; genetics ; Neoplasm Metastasis ; genetics ; RNA, Small Interfering ; genetics

Twenty-four isolates of Newcastle disease virus (NDV) prevailing during 1997 -- 2005 in China were collected. These isolates were purified by CEF plaque assay and replicated in SPF chicken embryos. The hemagglutinin-neuraminidase (HN) genes of these viruses were cloned and sequenced. The HN gene sequences of thirty-six NDV reference strains in GenBank were also used in this study. The amino acid homologing of these viruses were compared and analyzed. The correlations among different fragments of HN gene were also analyzed. The results indicated that the homology of Chinese field NDV strains was 94.4%-99.4%, but 86.9%-89% compared with LaSota and Clone30, 87.9%-89.9% to F48E9, and 87.2%-96.2% to foreign NDV strains. There had the nearest distances among Chinese NDV isolates as compared with that of the LaSota, Clone30 and F48E9 by the phylogenetic tree. However, the distances of seven foreign NDV isolates were very close to Chinese NDV isolates as compared with these of the other foreign NDV isolates. We also found that all the Chinese field isolates were devoid of glycosylation site in position 538 -- 540. There were good correlations between different length amino acid fragments and the genomes of HN, especially the 5'-terminus first 80aa.
Animals ; Chick Embryo ; Chickens ; China ; HN Protein ; genetics ; Newcastle disease virus ; classification ; genetics ; Phylogeny