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Hepatolithiasis is a common benign biliary disease in China. It is a challenge to treat hepatolithiasis. Some patients with complicated hepatolithiasis fail to achieve satisfactory outcomes after several biliary operations, and therefore, how to improve the treatment outcome of hepatolithiasis is a major problem for biliary surgeons. At present, surgery is still the main treatment method for hepatolithiasis. Percutaneous transhepatic choledochoscopic lithotripsy (PTCSL), as a minimally invasive surgical treatment for hepatolithiasis, has been accepted by many biliary surgeons and patients with hepatolithiasis and gradually gains a place in the treatment of hepatolithiasis. This article reviews the research advances in PTCSL in the treatment of hepatolithiasis.
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Objective:To observe the efficacy of benefiting Qi for warming Yang and activating blood circulation for inducing diu-resis method in the treatment of patients with chronic heart failure( CHF) and its effect on the expression of circulating miRNAs ( miR-423-5p, miR-210-3p). Methods:Totally 80 CHF patients were randomly divided into two groups,the control group with 40 patients was treated with the conventional anti-heart failure therapy, and the treatment group with 40 patients was treated with benefiting Qi for warming Yang and activating blood circulation for inducing diuresis decoction on the basis of the control group, and the treatment course was 2 weeks. The clinical efficacy and syndrome integral of traditional Chinese medicine ( TCM) were evaluated. Left ventricular ejec-tion fraction ( LVEF) and left ventricular end diastolic diameter( LVEDD) were measured by echocardiography;the plasma expression levels of circulating miRNAs(miR-423-5p, miR-210-3p) were measured by real-time PCR in the two groups before and after the treat-ment. The adverse drug reactions were observed as well. Results:The total clinical effective rate of the treatment group was significant-ly higher than that of the control group (87. 50% vs 65. 00%, P <0. 05); the syndrome integral of TCM, indices of LVEF and LVEDD and the expression of circulating miRNAs were improved in both groups(P<0. 05);the total clinical effective rate, syndrome integral of TCM, indices of LVEF and LVEDD and the expression of circulating miR-423-5p of the treatment group were better than those of the control group(P<0. 05); there was no significant difference in adverse drug reactions between the groups (P>0. 05). Conclusion:The benefiting Qi for warming Yang and activating blood circulation for inducing diuresis method can improve the clinical effects in the treatment of CHF, and improve the expression of circulating miRNAs.
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To explore innovative training model for young teachers in university,literature and practical data in university were analyzed.A new concept of research tutor system was put forward in which young teachers and tutors were linked with scientific research project and common interests.Tutors in one subject trained the young teachers from another subject.In this model,a new relationship with equality and free-talk between tutors and students was established and the advantage of talent group effect was ascended.Discipline crossing,multiple communication and interactive learning may be promoted and the number of innovative young teachers and scientific research achievements may increase.
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Objective To investigate the comparison of clinical curative effect and inflammation factors between irbesartan hydrochlorothiazide and candesartan cilexetil in the treatment of patients with hypertension.Methods A total of 86 patients with hypertension in our hospital from June 2014 to October 2015 were collected and randomly divided into two groups, 43 cases in the control group were treated by candesartan cilexetil,43 cases in the experimental group were treated by irbesartan hydrochlorothiazide.The blood pressure, CRP, IL-6 and NO indexes were detected in the two groups and the clinical curative effect of the two groups was compared.Results The systolic pressure and diastolic pressure levels in the experimental group were significantly lower than the control group ( P <0.05 ); the serum CRP, IL -6 levels in experimental group were significantly lower than the control group, the NO level was significantly higher than the control group (P<0.05).Conclusion Irbesartan hydrochlorothiazide in the treatment of patients with hypertension has a better clinical curative effect, and higher security.
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Aim To investigate the effects of panax nonstaining saponins ( PNS ) on the apoptosis of renal cells induced by cisplatin through the path of mitochon-drion . Methods Male Sprague-Dawley( SD) rats were randomized divided into normal control group, cisplatin model group and the cisplatin+PNS group,with 12 rats of each group. Animals were sacrificed to determine the N-acetyl-β-D-Glucosaminidase ( NAG ) in urine, blood urea nitrogen ( BUN) and serum creatinine ( Cr) concentrations after 8d of intraperitoneal injection. HE-staining was employed to observe renal pathologies. Transmission electron microscopy ( TEM ) was em-ployed to observe the mitochondria of the rats′ injured kidney region. TUNEL staining was employed to detect the distribution of apoptotic cells. Immunnohistochem-istry was used to detect Bax and caspase-9 expression, and expression of Bcl-2 protein was detected by West-ern blot. Results Compared with the normal control group, contents of BUN, serum Cr and urinary NAG levels of rat in the cisplatin model group were increased ( P <0. 01 ) , and some mitochondria of the epithelial cells of renal tubules got injured seriously. The apopto-sis rate of kidney cell was increased ( P<0. 01 ) . The expression of Bax,caspase-9 and Bcl-2 proteins was in-creased ( P < 0. 01 ) . Compared with the cisplatin model group, contents of BUN, serum Cr and urinary NAG levels of rats in the cisplatin model group were decreased ( P <0. 01 ) , and some mitochondria of the epithelial cells of renal tubules were significantly im-proved. The apoptosis rate of kidney cell was decreased ( P<0. 01 ) . The expression of Bax and caspase-9 pro-tein was decreased (P<0. 01),but Bcl-2 protein was increased ( P < 0. 01 ) . Conclusion PNS may in-crease the expression of Bcl-2 protein and decrease the expression of Bax and caspase-9 proteins, which may play a protective role in cisplatin nephritic damage.
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Objective To summarize the nursing of infants with cavernous transformation of the portal vein (CTPV) and gastrointestinal bleeding undergoing distal splenorenal shunt.Methods 3 cases of infants with CTPV and gastrointestinal bleeding were given with preoperative nursing for upper gastrointestinal bleeding,strengthening nutritional support; strengthening prevention measures of thrombosis and bleeding complications,monitoring of urine and urine gravity,completing the artery piezometer tube care,paying attention to the discharge guidance and follow-up work.Results The platelet increased in 3 cases post-operation.1 cases occurred abdominal bleeding,but improved after symptomatic treatment.1 case occurred leakage on the site of venous indwelling needle during intravenous infusion of high nutrient solution.3 cases of children received 3 months to 3 years follow-up after discharge,no complications such as liver,kidney and blood clots occurred.Conclusions Infants with CTPV and gastrointestinal bleeding undergoing distal splenorenal shunt is very rare in clinic.Good perioperative care and strengthening the observation of the postoperative complications,attaching great importance to the discharge guidance and follow-up work,are the assurances of successful treatment.
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Objective:To observe the protective effect of Yulangsan polysaccharide ( YLSP) on liver injury induced by cyclophos-phamide(CTX) in mice. Methods:Liver injury induced by CTX in mice was used as the animal model and the mice were randomly di-vided into the normal group, CTX model group, biphenyldicarboxylate ( BPDC) group, YLSP group respectively with high, medium and low dose. Except the normal group, the other groups were injected with CTX, i. p. , for 7 days to make the model. Then the ani-mals in the YLSP groups were intragastrically administered with YLSP for 7 days. The activities of alanine aminotransferase( ALT) , as-partate aminotransferase( AST) in serum, malondialdehyde( MDA) , superoxide dismutase( SOD) , glutathione( GSH) and glutathione peroxidase ( GSH-Px) in liver tissue were investigated. Hematoxylin and eosin ( HE) stain was used to study the changes in hepatic tissue of the pathological mice. Results:Compared with the model group, YLSP could obviously reduce the activities of ALT, AST and the content of MDA, and increase the content of GSH, SOD and GSH-Px (P<0. 05 or P<0. 01). HE staining showed that YLSP had significant protective effect on liver injury induced by CTX. Conclusion:YLSP has protective effect on liver injury induced by CTX.
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Objective To explore clinical features and drug sensitivity of Streptococcus pneumoniae (SP) isolated from pediatric patients with lower respiratory tract infection, and to provide evidence for clinical use of antibiotics. Methods A total of 6 358 clinical SP isolates from children with lower respiratory tract infection from January 2008 to December 2012 were col-lected and retrospectively analyzed. The antibiotic sensitivity was done by Kirby-Bauer method and E-test, and all results were in strict accordance with the rules of CLSI. Results The isolated SP strains were mainly from different departments of pediatrics. All clinical cases with SP infection mainly included pneumonia and bronchitis. The resistance rates of 6 358 SP strains to penicil-lin, cefotaxime, erythromycin, clindamycin, cotrimoxazole, tetracycline, chloramphenicol, levolfoxacin, vancomycin were 5.0%, 12.9%, 98.7%, 96.0%, 92.2%, 7.3%, 5.6%, 0.2%and 0.0%respectively, and the resistance rate to penicillin and cefotaxime was signiifcantly different in every years (all P<0.05). The resistance rates of the 318 penicillin-resistant SP strains to the above anti-biotics were 100.0%, 42.6%, 100.0%, 100.0%, 99.2%, 23.6%, 6.8%, 0.6%, 0.0%respectively, and the resistance rate to penicillin and cefotaxime was signiifcantly different (P=0.001). Conclusions The antibiotic resistance rates of SP strains isolated from children with lower respiratory tract infection were higher to erythromycin, clindamycin, cotrimoxazole and tetracycline, and an increasing rate in drug resistance to cefotaxime was observed in recent years. Appropriate antibiotics should be selected for the treatment of infection according to drug sensitivity.
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Objective To analyze the clinical effect of intravascular intervention for treating the severe stenosis of bilateral renal arteries (BRASS).Methods A total of 40 patients with BRASS admitted in Fuwai Hospital from September 2008 to December 2010 were retrospectively analyzed.These patients,23 males and 17 females,aged from 21 to 76 years with average age of (59.75 ± 17.59) years,with luminal narrowing over 70％ in bilateral renal arteries,met the criteria of BRASS evidenced by angiography of renal arteries,and were subjected to renal artery interventional therapy. The etiological factors included arteriosclerosis (34 cases),Takayasu arteritis (3 cases) and congenital fibromuscular dysplasia (3 cases).After percutaneous endovascular intervention,the therapeutic effects were evaluated by lowering the systemic blood pressure and serum creatinine level in 12-month follow-up in average after operation. The data were analyzed with SPSS 13.0 statistical software.ResultsAmong the 80 reual arteries in 40 patients,18 arteries were treated with percutaneous transluminal balloon angioplasty (PTBA),while the other 62 arteries were treated with percutaneous transluminal renal artery stenting (PTRAS).Mter endovascular intervention,the mean systolic blood pressure decreased from ( 165.0 ± 27.0) mm Hg to ( 135.7 ± 25.3 ) mm Hg on the second day after operation ( P ＜ 0.01 ) ; and the mean diastolic blood pressure decreased from ( 88.9 ±15.1 ) mm Hg to (74.8 ± 13.2) mm Hg on the second day after operation ( P ＜ 0.01 ).Accordingly,the kinds of anti-hypertension drug used decreased from ( 3.1 ± 0.9 ) to ( 2.3 ± 1.2) ( P ＜ 0.01 ).Only one patient died suddenly 3 months after intervention,and one died of acute myocardial infarction 7 months after operation.The other 38 patients were followed up for 12 months.At last,the mean systolic blood pressure of patients decreased from ( 165.0 ±27.0) mm Hg to ( 133.53 ± 15.94) mm Hg and the mean diastolic blood pressure decreased from (88.9 ± 15.1 ) mm Hg to (77.37 ± 13.47 )mm Hg. Of all 38 patients,2 were cured (5.3％),27 were improved (71.1％) and 9 failed to treatment (23.7％).Of all 38 patients,76.4％ got hypertension lowered.Moreover,renal function (Scr) was improved in 2 patients (6.3％ ),steady in 21 patients ( 65.6％ ),declined in 9 patients ( 28.1％ ) resulted in azotemia stage.Of 38 patients,71.9％ patients got overall benefit from endovascular intervention in respect of renal function improved.Conclusions The procedure of PTBA or PTRAS offered a minimally invasive,relatively safe and effective technique for BRASS patients to decrease blood pressure and stabilize renal function.
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Currently, the intraoperative location of microelectrode position in the globus pallidus is subjective and qualitative; it only depends on the experience of doctors during pallidotomy for the treatment of Parkinson's disease. The fractal characteristic of neuronal discharge signals is analyzed for target localization; the factor of box dimension is extracted from the microelectrode recordings for identifying the neuronal structures at the depth of microelectrode. New objective and quantitative targeting technique is presented by processing clinical microelelctrode recordings of Parkinson's disease. Through the validation of clinical data and the critical appraisal by experts, the targeting technique can be used for improving the accuracy of localization in neurosurgery.
Subject(s)
Humans , Electrophysiology , Globus Pallidus , General Surgery , Microelectrodes , Neurons , Physiology , Pallidotomy , Methods , Parkinson Disease , General Surgery , Stereotaxic Techniques , Surgery, Computer-Assisted , MethodsABSTRACT
The microelectrode recordings of neuron discharge, which contain noises, are very complex and apt to be disturbed by many factors during the microelectrode-guided stereotactic operations. The varying signal-to-noise ratios are obstacles to the analysis of neural spikes. A novel method based on a combination of wavelet-based and non-linear energy operator is presented for the detection of neural spikes. The method is tested for neural signals of different patients and various SNR values. The results demonstrate its performance for successful detection and effective extraction of the waveform of neural spikes.
Subject(s)
Humans , Action Potentials , Physiology , Algorithms , Microelectrodes , Neural Conduction , Physiology , Neurons , Physiology , Nonlinear Dynamics , Signal Processing, Computer-AssistedABSTRACT
Intraoperative analysis of the position of microelectrode in the globus pallidus only depends on experiences and subjective interpretation of microeletrode recording discharge of neurons during pallidotomy for Parkinson's disease. In this paper is reported a method for objective localization of microeletrode during neurosurgery. This method uses the factor of interspike interval based on microelectrode recordings. It is effective for identifying the change of the globus pallidal organism along the microelectrode pathway and the departure or deviation of the needle-pathway. The classification is consistent with the anatomic structures and the results of neurosurgery. This method can be used as a guide in pallidotomy. Globus pallidus.