Enhanced recovery after surgery in transurethral surgery for benign prostatic hyperplasia / 亚洲男科学杂志(英文版)

Enhanced recovery after surgery (ERAS) measures have not been systematically applied in transurethral surgery for benign prostatic hyperplasia (BPH). This study was performed on patients with BPH who required surgical intervention. From July 2019 to June 2020, the ERAS program was applied to 248 patients, and the conventional program was applied to 238 patients. After 1 year of follow-up, the differences between the ERAS group and the conventional group were evaluated. The ERAS group had a shorter time of urinary catheterization compared with the conventional group (mean ± standard deviation [s.d.]: 1.0 ± 0.4 days vs 2.7 ± 0.8 days, P < 0.01), and the pain (mean ± s.d.) was significantly reduced through postoperative hospitalization days (PODs) 0-2 (POD 0: 1.7 ± 0.8 vs 2.4 ± 1.0, P < 0.01; POD 1: 1.6 ± 0.9 vs 3.5 ± 1.3, P < 0.01; POD 2: 1.2 ± 0.7 vs 3.0 ± 1.3, P < 0.01). No statistically significant difference was found in the rate of postoperative complications, such as postoperative bleeding (P = 0.79), urinary retention (P = 0.40), fever (P = 0.55), and readmission (P = 0.71). The hospitalization cost of the ERAS group was similar to that of the conventional group (mean ± s.d.: 16 927.8 ± 5808.1 Chinese Yuan [CNY] vs 17 044.1 ± 5830.7 CNY, P =0.85). The International Prostate Symptom Scores (IPSS) and quality of life (QoL) scores in the two groups were also similar when compared at 1 month, 3 months, 6 months, and 12 months after discharge. The ERAS program we conducted was safe, repeatable, and efficient. In conclusion, patients undergoing the ERAS program experienced less postoperative stress than those undergoing the conventional program.

Application of artificial intelligence based on data enhancement and hybrid neural network to site identification during esophagogastroduodenoscopy / 中华消化内镜杂志

Objective:To evaluate artificial intelligence constructed by deep convolutional neural network (DCNN) for the site identification in upper gastrointestinal endoscopy.Methods:A total of 21 310 images of esophagogastroduodenoscopy from the Cancer Hospital of Chinese Academy of Medical Sciences from January 2019 to June 2021 were collected. A total of 19 191 images of them were used to construct site identification model, and the remaining 2 119 images were used for verification. The performance differences of two models constructed by DCCN in the identification of 30 sites of the upper digestive tract were compared. One model was the traditional ResNetV2 model constructed by Inception-ResNetV2 (ResNetV2), the other was a hybrid neural network RESENet model constructed by Inception-ResNetV2 and Squeeze-Excitation Networks (RESENet). The main indices were the accuracy, the sensitivity, the specificity, positive predictive value (PPV) and negative predictive value (NPV).Results:The accuracy, the sensitivity, the specificity, PPV and NPV of ResNetV2 model in the identification of 30 sites of the upper digestive tract were 94.62%-99.10%, 30.61%-100.00%, 96.07%-99.56%, 42.26%-86.44% and 97.13%-99.75%, respectively. The corresponding values of RESENet model were 98.08%-99.95%, 92.86%-100.00%, 98.51%-100.00%, 74.51%-100.00% and 98.85%-100.00%, respectively. The mean accuracy, mean sensitivity, mean specificity, mean PPV and mean NPV of ResNetV2 model were 97.60%, 75.58%, 98.75%, 63.44% and 98.76%, respectively. The corresponding values of RESENet model were 99.34% ( P<0.001), 99.57% ( P<0.001), 99.66% ( P<0.001), 90.20% ( P<0.001) and 99.66% ( P<0.001). Conclusion:Compared with the traditional ResNetV2 model, the artificial intelligence-assisted site identification model constructed by RESENNet, a hybrid neural network, shows significantly improved performance. This model can be used to monitor the integrity of the esophagogastroduodenoscopic procedures and is expected to become an important assistant for standardizing and improving quality of the procedures, as well as an significant tool for quality control of esophagogastroduodenoscopy.

An investigation of hepatitis D virus infection among patients with chronic hepatitis B virus infection in some regions of China / 临床肝胆病杂志

Objective To investigate the prevalence of hepatitis D virus (HDV) infection among patients with chronic hepatitis B virus (HBV) infection in some regions of China. Methods Serum samples were collected from 3 131 patients with chronic HBV infection in 10 provinces, cities, and autonomous regions of China from March 2021 to June 2022, and anti-HDV IgG ELISA was used for the detection of all serum samples. Nested reverse transcription-polymerase chain reaction (nRT-PCR) was used to detect HDV RNA in anti-HDV IgG-positive samples, and the nRT-PCR amplification products of HDV RNA-positive samples were sequenced and analyzed to determine HDV genotype. The clinical features of anti-HDV IgG-positive patients were analyzed. The Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results The positive rate of anti-HDV IgG in the 3 131 patients with chronic HBV infection was 0.70% (22/3 131), and that in the patients with chronic HBV infection in Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, Beijing, and Hunan Province was 1.81% (16/886), 0.88% (2/226), 0.28% (2/708), and 1.00% (2/200), respectively; the patients with chronic HBV infection in Inner Mongolia Autonomous Region had a significantly higher positive rate of anti-HDV IgG than those in Beijing ( P =0.004), and there was no significant difference between the other regions ( P > 0.05). Clinical features of the patients with chronic HBV infection in Inner Mongolia Autonomous Region showed that compared with the anti-HDV IgG-negative group, the anti-HDV IgG-positive group had a significantly higher proportion of patients with Mongol nationality ( P =0.001), abnormal alanine aminotransferase ( P =0.007), or antiviral treatment ( P =0.029), as well as a significantly lower median HBV DNA level ( P =0.030). A total of 19 HDV RNA-positive samples were identified, all of which had HDV genotype 1. Conclusion The prevalence rate of HDV varies greatly across different regions of China, with a higher prevalence rate of HDV in patients with chronic HBV infection from Inner Mongolia Autonomous Region. HDV genotype 1 is the predominant genotype in some provinces and cities of northern China.

Value of high-frequency ultrasonography in diagnosis of proximal radial nerve injuries associated with humeral shaft fractures / 中华创伤杂志

Objective:To evaluate the diagnostic accuracy and application value of high-frequency ultrasonography in proximal radial nerve injuries associated with humeral shaft fractures.Methods:A retrospective case series study was performed for 19 patients with proximal radial nerve injuries associated with humeral shaft fractures treated in Huashan Hospital Affiliated to Fudan University from August 2014 to September 2020. The were 17 males and 2 were females，with the age range of 16-55 years ［（38.1±12.7）years］. Of all，11 patients were injured at the left side and 8 at the right side. All the patients had histories of traumatic humeral shaft fracture and were treated in other hospitals，including internal fixation in 17 patients，external fixation in 1 and internal fixation combined with external fixation in 1. All patients underwent radial nerve exploration surgeries，among which 8 had high-level radial nerve release and 11 had high-level radial nerve suture or graft transplantation. All patients underwent high-frequency ultrasound examination before surgery. The ultrasonographic characteristics of the radial nerve were recorded，including the continuity of the epineurium，honey-comb structure on the transversal section，neuromas on the longitudinal section and external scar or callus or metal fixation compressing the nerve. The injury type and neural continuity of each radial nerve were evaluated. The radial nerves of type Ⅰ，type Ⅱ，type Ⅲa ，type Ⅲa ，type Ⅲb and type Ⅳ appeared as normal，swelling，short-segment compressed，neuroma-like and ruptured，respectively. Taking the intraoperative findings as the gold standard，the diagnostic coincidence rate，sensitivity，specificity，positive predictive value and negative predictive of high-frequency ultrasound were analyzed in diagnosis of proximal radial nerve injuries associated with humeral shaft fractures.Results:According to ultrasonographic characteristics，proximal radial nerve injuries were classified into 4 types in 5 subtypes. It was confirmed by surgeries that there were 1 patient with type Ⅱ，4 with type Ⅲa，1 with type Ⅲb and 13 with type Ⅳ，with no type Ⅰ. The diagnostic coincidence rate of high-frequency ultrasound was 89%. The diagnostic coincidence rate of type Ⅱ，type Ⅲa，type Ⅲa，type Ⅲb and type Ⅳ was 100%，100%，100% and 85%，respectively. The sensitivity of high-frequency ultrasound for evaluating the neural continuity was 75%，the specificity was 100%，the positive predictive value was 100%，the negative predictive value was 85%.Conclusions:The high-frequency ultrasound has a relatively high sensitivity and specificity in diagnosis of proximal radial nerve injuries associated with humeral shaft fractures，which can provide relatively accurate morphological information for clinical diagnosis and treatment.

Retrospective analysis of the changes in the surgical treatment of benign prostatic hyperplasia during an 11-year period: a single-center experience / 亚洲男科学杂志(英文版)

The present study aimed to determine whether the number of patients with symptomatic benign prostatic hyperplasia (BPH) who preferred surgery decreased during the past 11 years at our center (West China Hospital, Chengdu, China), and whether this change affected the timing of surgery and the physical condition of surgical patients. This retrospective study included 57 557 patients with BPH treated from January 2008 to December 2018. Of these, 5427 patients were treated surgically. Surgical patients were divided into two groups based on the time of treatment (groups 8-13 and groups 13-18). The collected data comprised the percentage of all patients with BPH who underwent surgery, baseline characteristics of surgical patients, rehabilitation time, adverse events, and hospitalization costs. The surgery rates in groups 8-13 and groups 13-18 were 10.5% and 8.5% (P < 0.001), respectively. The two groups did not clinically differ regarding patient age and prostate volume. The rates of acute urinary retention and renal failure decreased from 15.0% to 10.6% (P < 0.001) and from 5.2% to 3.1% (P < 0.001), respectively. In groups 8-13 and groups 13-18, the mean catheterization times were 4.0 ± 1.7 days and 3.3 ± 1.6 days (P < 0.001), respectively, and the mean postoperative hospitalization times were 5.1 ± 2.4 days and 4.2 ± 1.8 days (P < 0.001), respectively. The incidences of unplanned second surgery and death reduced during the study period. The surgery rate decreased over time, which suggests that medication was chosen over surgery. However, the percentage of late complications of BPH also decreased over time, which indicates that the timing of surgery was not delayed.

Effect of Early Exercise Combined with Pentylenetetrazol on Neurologic Function after Cerebral Ischemia-reperfusion in Rats and Its Mechanism / 中国康复理论与实践

@#Objective:To observe the interactive effects of early exercise and γ-aminobutyric acid (GABA) receptor antagonists on the neurologic function and brain-derived neurotrophic factor (BDNF) expression in the cerebral ischemia-reperfusion (I/R) rat model. Methods:Male Sprague-Dawley rats were divided into sham (<italic>n</italic> = 10), I/R (<italic>n</italic> = 10), exercise (EX) (<italic>n</italic> = 10), pentetrazol (PTZ) (<italic>n</italic> = 10) and pentetrazol plus exercise (PTZEX) (<italic>n</italic> = 10) groups. All the rats, except the sham group, accepted middle cerebral artery occlusion (MCAO) for one hour and reperfused. Since two days after reperfusion, PTZ and PTZEX groups accepted PTZ, a GABA receptor antagonist, 0.25 mg/kg peritoneal injection, once a day for five days; while EX and PTZEX groups ran on a treadmill, 30 minutes a day for five days. Seven days after reperfusion, all the rats were assessed with neurobehavioral score, the infarct volumes were assessed with TTC, and BDNF expression in ischemic penumbra was detected with reverse transcription polymerase chain reaction and ELISA. Results:Compared with I/R group, the neurobehavioral scores of EX group, PTZ group and PTZEX group improved, the volumes of cerebral infarction reduced (<italic>P </italic>< 0.05), and PTZEX group was the best (<italic>P </italic>< 0.05). The expression of BNDF was the most in PTZEX group (<italic>P </italic>< 0.05). Conclusion:Early exerxise combined with PTZ could promote the recovery of neurologic function in I/R rats, which may be related to the up-regulation of BDNF.

Long non-coding RNA H19 modulates proliferation and apoptosis in osteoarthritis via regulating miR-106a-5p

Osteoarthritis (OA), a type of joint diseases, could result in breakdown of joint cartilage and underlying bone. Accumulating evidences suggested that long non-coding RNAs play important roles in OA progression. However, the underlyingmechanism of H19 in OA is still not fully explored. The expression levels of H19 and miR-106a-5p in OA samples frompatients or cultured chondrocytes were examined by quantitative real time polymerase chain reaction. Cell proliferation andapoptosis were analysed by MTT assay and flow cytometry, respectively. Western blotting was employed to detect theexpression levels of PCNA, CyclinD1, Caspase 3 and Cleaved Caspase 3. StarBase database, luciferase assay and RNAimmunoprecipitation were introduced to confirm the relationship between H19 and miR-106a-5p. The correlation of H19and miR-106a-5p was analysed by Spearman rank analysis. H19 expression was upregulated, while miR-106a-5p level wasdownregulated in OA samples and IL-1b-treated chondrocytes. H19 overexpression inhibited the proliferation and inducedapoptosis in IL-1b-treated chondrocytes, while H19 knockdown induced the opposite effect. Luciferase and RIP assaydemonstrated that miR-106a-5p was a direct target of H19. miR-106a-5p overexpression led to proliferation promotion andapoptosis inhibition in chondrocytes treated by IL-1b and it reversed the effect of H19 addition. We conclude that H19could regulate proliferation and apoptosis of chondrocytes treated by IL-1b in OA via sponging miR-106a-5p

Surgical treatment of pancreatic neuroendocrine neoplasms with major vascular resection / 中国实用外科杂志

The prognosis of pancreatic neuroendocrine neoplasms is significantly better than that of pancreatic cancer.Locally advanced pancreatic neuroendocrine tumors can invade the superior mesenteric vein,portal vein,superior mesenteric artery,celiac artery and other large peripancreatic vessels.Preoperative comprehensive examination should be carried out to evaluate and judge the resectability and biological characteristics of the tumor and select appropriate preoperative treatment.Surgical treatment can not only achieve the radical resection of the tumor,but also avoid the complications caused by the continued progress of the tumor.Combined portal vein-superior mesenteric vein and celiac artery resection and reconstruction is safe and effective.Combined superior mesenteric artery resection is worth further exploration and accumulation of experience.

C_(19)-diterpenoid alkaloids from Aconitum austroyunnanense / 中国中药杂志

Eight C_(19)-diterpenoid alkaloids( 1-8) were isolated from the ethyl acetate soluble fraction of 95% ethanol extract of the ground roots of Aconitum austroyunnanense through various column chromatographies on silica gel,ODS,Sephadex LH-20 and MCI gel.Their structures were elucidated as 14α-benzoyloxy-13β,15α-dihydroxy-1α,6α,8β,16β,18-pentamethoxy-19-oxoaconitan( 1),N-deethylaconitine( 2),spicatine B( 3),leucanthumsine A( 4),acofamine B( 5),macrorhynine B( 6),aconitilearine( 7),and ambiguine( 8) based on their chemical and physicochemical properties and spectroscopic data. Compound 1 was a new compound and alkaloids 2-8 were isolated from this plant for the first time. Some isolated alkaloids were tested in vitro for cytotoxic potential by employing the MTT method. As a result,alkaloid 1 exhibited weak cytotoxic activity against three tested tumor cell lines( A-549,He La,and Hep G2) with IC_(50) values less than 20 μmol·L~(-1).

Correlation of serum sICAM-1 and sVCAM-1 levels with severity of and prognosis of thyroid-associated ophthalmopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the correlation between levels of serum soluble intercellular adhesion molecule-1(sICAM-1), soluble vascular cell adhesion molecule-1(sVCAM-1)and the severity of thyroid-associated ophthalmopathy(TAO). <p>METHODS: A total of 120 patients with TAO admitted to the hospital from August 2016 to March 2018 were selected and included in the study. According to the clinical activity score(CAS), the patients were divided into active stage group and inactive stage group. According to the severity, they were divided into mild group, moderate group and severe group. There were 90 healthy persons were selected as the control group at the same time. The general data, serum sICAM-1 and sVCAM-1 levels were compared among groups and the correlation of sICAM-1 and sVCAM-1 levels with the severity of TAO was analyzed. <p>RESULTS: There were no significant differences in the clinical basic data of patients in between the different clinical active stage groups and the control group, and between the different severity groups and the control group(<i>P</i>>0.05). The levels of serum sICAM-1 and sVCAM-1 in the active stage group were significantly higher than those in the inactive stage group and the control group(<i>P</i><0.01). The levels of serum sICAM-1 and sVCAM-1 in active stage patients of different severity groups were significantly higher than those in inactive stage patients and of control groups(<i>P</i><0.01). There were no significant differences in levels of serum sICAM-1 and sVCAM-1 in inactive stage patients of different severity groups. The levels of serum sICAM-1 and sVCAM-1 in active stage patients of different severity groups increased gradually with the severity of the disease. There was no significant correlation between levels of serum sICAM-1 and sVCAM-1 in inactive stage patients and the severity of disease(<i>r</i>=0.102, 0.095, <i>P</i>=0.135, 0.167). Levels of serum sICAM-1 and sVCAM-1 in active stage patients were positively correlated to severity of disease(<i>r</i>=0.695, 0.824, <i>P</i>=0.005, 0.002).<p>CONCLUSION: The levels of serum sICAM-1 and sVCAM-1 in inactive patients will not increase with the severity of the disease. However, the levels in patients with active disease will increase with the severity of the disease, which can be used for clinical diagnosis and staging of TAO and monitoring of the prognosis.

Characteristic fingerprint and multi-components quantitative determination for Fuke Qianjin Capsules by HPLC / 中国中药杂志

To establish an HPLC characteristic fingerprint method of Fuke Qianjin Capsules,and determine the contents of its main components. The analysis was carried out on a Kromasil 100-5-C18 analytical column(4. 6 mm ×250 mm,5 μm) with gradient elution by acetonitrile(A)-0. 1% phosphoric acid aqueous solution(B),a flow rate at 1. 0 m L·min-1 and the detection wavelength of 254 nm.The column temperature was 30 ℃,and the injection volume was 10 μL. The determination method of genistin,jatrorrhizine,andrographolide and 14-deoxy-11,12-didehydroandrographolide index components were studied methodologically. The common mode of the characteristic fingerprint of Fuke Qianjin Capsules was set up with 8 common peaks,which were identified as genistin,jatrorrhizine,palmatine,berberine,andrographolide,14-deoxy-11,12-didehydroandrographolide,Z-ligustilide,and Z-3-butylidenephthalide,respectively,in comparison with the references. The similarities of 20 batches of Fuke Qianjin Capsules samples were above 0. 95. All of the above-mentioned 4 analytes could be well separated under the optimized chromatographic conditions. RSD of precision and repeatability experiment were both less than 1. 5%,and the sample solution was stable during 72 h. All of the compounds had a good linearity and linear range. The contents of genistin,jatrorrhizine,andrographolide,and 14-deoxy-11,12-didehydroandrographolide in 20 batches of Fuke Qianjin Capsules samples were 28. 66-56. 04,94. 77-197. 92,1 705. 33-4 148. 93 and 462. 16-1 225. 96 μg in each capsule,respectively. The developed HPLC characteristic fingerprint and quantitative analysis methods were reliable,accurate and sensitive,and could be used effectively evaluate the quality of Fuke Qianjin Capsules samples.

Application of intravoxel incoherent motion diffusion weighted imaging for assessment of early chronic allograft nephropathy / 中南大学学报(医学版)

To investigate the feasibility and clinical application of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) technique in non-invasive assessment for early chronic allograft nephropathy (CAN).
 Methods: A total of 23 renal allograft recipients were recruited from inpatients or outpatients according to the inclusion and exclusion criteria for this study. Recipients were divided into a CAN group (n=12, pathologically confirmed early CAN patients) and a control group (n=11, volunteers with long-term stable renal function). Abdominal MRI was performed on patients of renal allograft with a multi-b value DWI sequence. IVIM2b-new software was used for obtaining the IVIM-DWI quantitative parameter pseudo-color maps and the values of IVIM-DWI of renal parenchyma, including the pure diffusion coefficient (D), perfusion correlation diffusion coefficient (D*) and perfusion fraction (f). The IVIM quantitative parameters between the two groups were compared using independent sample t test. ROC analysis was performed when the differences in parameter were statistically significant and the area under curve (AUC) was calculated.
 Results: In IVIM bi-exponential analysis, The D value was significantly decreased in the CAN group compared with the control group (P0.05). The AUC of D value for distinguishing the early CAN from the control were 0.784 with sensitivity and specificity at 58.3% and 90.9%, respectively.
 Conclusion: The IVIM-DWI quantitative parameter D can non-invasively assess early CAN to some extent. IVIM-DWI technique is expected to be an effective, easy and non-invasive method to detect early CAN, and assist early diagnose as well as dynamically monitor CAN.

Prevalence,antimicrobial resistance patterns and virulence gene analysis of Salmonella spp.originated from ducks in Chengdu area,China / 中国人兽共患病学报

We investigated the contamination,antimicrobial resistance and the virulence genes carriage of Salmonella spp. in duck slaughter chain.Suspected strains were isolated from slaughterhouse samples according to GB 4789.4-2010 and identi-fied by duplex PCR,and then the positive strains were used for serotype analysis.Subsequently,positive strains were tested against 10 different antimicrobial agents using Kirby-Bauer disk diffusion method,the results were determined on the basis of CLSI standard.Finally,9 virulence genes were detected among positive strains by PCR.The results showed that 9 9 Salmonella isolates were recovered from 343 samples and total isolation rate was 28.86%.The prevalence of Salmonella before slaughte-ring,at depilation stage,at evisceration stage,in duck meat and after slaughtering was 45.71%,22.68%,24.72%, 38.33% and 25.81%,respectively.Seven serotypes were de-tected and most of them were S.Indiana,S.Newlands,S. Anatum.The Salmonella isolates were most frequently re-sistant to nalidixic acid(91.92%),the resistance rates of tet-racycline (43.43%),ampicillin (42.42%),trimethoprim-sulfamethoxazole (34.34%),ciprofloxacin (29.29%),ceftri-axone (27.27%),gentamycin (24.24%),and kanamycin (22.22%)were at a medium level.The resistance rates of amoxicillin-clavulanic acid (9.09%)and minocycline (6.06%)were relatively low.The multi-drug resistance rate of Salmonella isolates,which was 47.47%,showed a high especially in S.Indi-ana,S.Typhi and S.Typhimurium.It was notable that the harboring rates of virulence gene spvR(94.95%),avrA (93.94%),ssaQ(90.91%),mgtC(87.88%),sopB(83.84%),bcfC(80.81%),siiD(77.78%)among Salmonella isolates were at high level,in contrast to the lower carriage rates of spvB(29.29%),spvC (11.11%).In summary,the results indica-ted that the duck slaughter chain was easily contaminated by Salmonella spp.with different serotypes,different antibiotic re-sistant patterns and high virulence genes harboring rate.Relevant slaughterhouse and departments should strengthen supervi-sion in sanitation and manage the use of antimicrobial agents,to guarantee food safety and public health．

Observation on the relationship between intension of snails secretion and the condition of wrecked schistosoma larvae in Oncomelania hupensis dually infected with Exorchis mupingensis and Schistosoma japonicum for different intervals / 中国人兽共患病学报

The Oncomelania hupensis snails were dually infected with Exorchis mupingensis and Schistosoma japonicum at different intervals for 21 d,37 d,55 d,70 d and 85 d.The results indicated that the development of all S.japonicum larvae were blocked in the snails of co-infection,and the complexity and number of secretions in and around all the wrecked S.japonicum larvae is proportional to the intervals of co-infection.In addition,we also described and compared the detailed change of snails' secretions in different conditions of infection,and determined that the snail's secretions may involve in the destruction and damage of S.japonicum larvae.The attack degrees on larval S.japonicum in O.hupensis snails dually infected by E.mupingensis and S.japonicum with longer intervals were stronger than that of shorter intervals,and snail haemo-lymphocytes numbers were more few in that of shorter intervals.But the secretions remarkably increased in more longer interval model experimental snail tissue.This finding may provide an alternative strategy for reducing and controlling the transmission of S.japonicum,and are very helpful for better understanding the host-parasite relationship.

Preparation and physicochemical characterization of levofloxacin-loaded poly(lactic-co-glycolic acid) nanoparticles / 中国组织工程研究

BACKGROUND:Conventional formulation of levofloxacin is rapidly and completely metabolized after administration. Fortunately, nanoparticle provides a new way to solve this problem. OBJECTIVE:To prepare a levofloxacin-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticle that can reduce administration frequency, maintain a stable and effective plasma concentration, and also can be combined with tissue-engineered scaffold materials. METHODS:Levofloxacin-loaded PLGA nanoparticles were prepared by emulsion solvent evaporation method. Twenty-four rabbits were taken to investigate the effect of nanoparticle formulation on the pharmacokinetics of levofloxacin and randomized into three groups (n=8 per group): general formulation group received an injection of levofloxacin (20 mg/kg)via ear vein; non-loaded nanoparticle group received an injection of blank nanoparticles; and levofloxaxin-loaded nanoparticle group received an injection of the corresponding levofloxacin-loaded nanoparticles. At different times, blood samples were collected to analyze the drug concentration of levofloxaxin. The antimicrobial activity of the levofloxacin-loaded nanoparticle was evaluated based on the rabbit model of Escherichia coli-induced urinary tract infection. Forty-five New Zealand white rabbits were used to establish urinary tract infection models and randomly divided into three groups (n=15 per group). In negative control group, rabbits received only an injection of normal salinevia ear vein. In conventional formulation group, rabbits received an injection of levofloxacin (20 mg/kg). In nanoparticle group, rabbits received an injection of the corresponding levofloxacin nanoparticles. Subsequently, blood samples were obtained, and white blood cell (WBC) count and neutrophil percentage was tested; at the same time, the middle segment morning urine was collected to detect bacteriuria and urine WBC positive rates. At 9 days, the histopathologic analysis of the bladder mucosa was done. RESULTS AND CONCLUSION:(1)In vivo the pharmacokinetics: Compared with the conventional formulation group, the ideal levofloxacin-loaded PLGA nanoparticles prepared under optimal conditions significantly reduced the fluctuations in plasma concentration and frequency of administration. (2) Antimicrobial activity:Escherichia coli-induced urinary tract infection was gradualy in control in the conventional formulation group and levofloxacin-loaded PLGA nanoparticle group, and basically cured at 9 days after injection. In addition, the number of cured patients was basically higher in the levofloxacin-loaded PLGA nanoparticle group than the conventional formulation group at the same time point, but there was a significant difference between the two groups only at 5 days after treatment. It can be concluded that levofloxacin-PLGA nanoparticles provide a well-sustained delivery system for treatment or prevention of urinary tract infections and provide a foundation for further investigations on tissue-engineered urethral reconstruction.

Amaryllidaceae alkaloids from Lycoris radiata / 中国中药杂志

Three aporphine-type alkaloids (1-3), three lycorine-type alkaloids (4-6), two crinane type alkaloids (7, 8) and one phenanthridine-type alkaloid (9) were isolated from the chloroform soluble fraction of 70% ethanol extract of the bulbs of Lycoris radiata through various column chromatographies over silica gel, ODS, Sephadex LH-20 and MCI. Their structures were elucidated as (+)-N-methoxylcarbonyl-1,2-methylenedioxyl-isocorydione (1), isocorydione (2), 8-demethyl-dehydrocrebanine (3), (+)-3-hydroxy-anhydrolycorine N-oxide (4), vasconine (5), pancratinine D (6), yemenine A (7), 11-O-acetylhaemanthamine (8), and 5,6-dihydro-5-methyl-2-hydroxyphenanthridine (9) based on their chemical and physicochemical properlies and spectroscopic data. Compound 1 was a new compound and alkaloids 2-9 were isolated and identified from this plant for the first time.

Application of the arterial approach in laparoscopic pancreatoduodenectomy / 中华消化外科杂志

Pancreaticoduodenectomy is the main treatment method for pancreatic head carcinoma and periampullary cancer,and is also the only possible cure way.With the development of minimally invasive surgery,laparoscopic pancreaticoduodenectomy has been widely carried out,it even has been the routine operation in some pancreatic surgery center.The traditional approach is still the main approach for laparoscopic pancreaticoduodenectomy.In recent years,the procedure of the artery approach with its advantages has been put forward and gradually developed in laparoscopic pancreaticoduodenectomy through the continuous study and exploration.On the basis of the early arterial approach,authors' center established an artery preferential disconnection procedure in laparoscopic pancreaticoduodenectomy,which has been named arterial first approach.In the clinical practices and studies,this procedure also represents its unique advantages.

Clinical value of arterial first approach in laparoscopic pancreaticoduodenectomy / 中华消化外科杂志

Objective To investigate the clinical value of arterial first approach in laparoscopic pancreaticoduodenectomy (LPD).Methods The retrospective cohort study was conducted.The clinicopathological data of 181 patients with pancreatic head and periampullay tumors who underwent LPD in the Affiliated Tongji Hospital of Huazhong University of Science and Technology between October 2014 and December 2016 were collected.Among 181 patients,96 using arterial first approach and 85 using traditional approach were respectively allocated into the experimental group and the control group.Surgery was applied to patients in the same doctors' team,and there were the same extent of surgical resection,range of lymph node dissection and digestive tract reconstruction.Observation indicators:(1) intraoperative situation;(2) postoperative situation;(3) followup and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the tumor-free survival up to February 2017.Measurement data with normal distribution were represented as x±s,and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range).Comparison of count data were analyzed using the chi-square test or Fisher exact probability.Results (1) Intraoperative situation:all the patients underwent successful LPD.Overall operation time and time of digestive tract reconstruction were respectively (268 ± 20) minutes,(33 ± 10) minutes in the experimental group and (285±25)minutes,(30± 17)minutes in the control group,with no statistically significant difference between 2 groups (t =8.529,2.741,P＞ 0.05).Time of tumor resection with superior mesenteric venous invasion were respectively (216± 13)minutes and (264±22)minutes in the experimental and control groups,with a statistically significant difference between the 2 groups (t=41.826,P＜0.05).Time of tumor resection without superior mesenteric venous invasion were respectively (224± 14) minutes and (215±21) minutes in the experimental and control groups,with no statistically significant difference between the 2 groups (t =7.423,P＞ 0.05).Volumes of intraoperative blood loss and blood transfusion were respectively (99± 16)mL,(1.3±0.8)U in the experimental group and (131±27)mL,(2.8±1.2)U in the control group,with statistically significant differences between the 2 groups (t =3.670,0.562,P＜ 0.05).Five and 8 patients had intraoperative blood transfusion in the experimental and control groups,showing no statistically significant difference between the 2 groups (x2=1.195,P＞0.05).(2) Postoperative situation:time of drainage tube removal and duration of hospital stay were respectively (5.8±2.4)days,(18.3±6.3) days in the experimental group and (6.3±3.6)days,(19.6±7.1) days in the control group,with no statistically significant difference between the 2 groups (t =0.498,1.305,P＞0.05).Eleven patients in the experimental group had postoperative early complications,including 8with grade A pancreatic fistula (4 combined with diarrhea,2 combined with biliary fistula,1 combined with delayed gastric emptying and 1 with single pancreatic fistula),3 with grade B pancreatic fistula (2 combined with intra-abdominal hemorrhage and 1 combined with intra-abdominal infection).One patient with intra-abdominal hemorrhage in the experimental group died after treatment failure.Twelve patients in the control group had postoperative early complications,including 6 with grade A pancreatic fistula (2 combined with biliary fistula,2 combined with delayed gastric emptying,1 combined with diarrhea,1 combined with digestive tract hemorrhage),3 with grade B pancreatic fistula and intra-abdominal hemorrhage (2 combined with infection,including 1 death) and 3 with diarrhea.Other patients with complications were cured by symptomatic and supportive treatment.There was no statistically significant difference in overall complications between the 2 groups (x2 =0.287,P＞0.05).Results of postoperative pathological examination showed that case with R0 resection was 93 and 76 in the experimental and control groups,with a statistically significant difference between the 2 groups (x2 =4.057,P＜0.05).(3) Follow-up and survival situations:179 patients were followed up for 2-28 months,with a median time of 14 months.Postoperative 6-month tumor-free survival rate was 92.7％ (89/96) and 88.2％(75/85) in the experimental and control groups,with no statistically significant difference between the 2 groups (x2=1.060,P＞0.05).Conclusion Arterial first approach in LPD could significantly shorten the time of tumor resection of patients with superior mesenteric artery invading pancreatic head and periampullay region,significantly reduce the volumes of intraoperative blood loss and blood transfusion,and increase the rate of R0 resection.

"Outcomes in patients with ""successful"" recanalization in anterior circulation stroke treated with mechanical thrombectomy: TICI 3 versus TICI 2b" / 国际脑血管病杂志

ObjectiveTo investigate the difference in the outcomes in patients with acute anterior circulation stroke having achieved the Thrombolysis in Cerebral Infarction (TICI) 2b and TICI 3 recanalization after mechanical thrombectomy.MethodsThe patients with acute anterior circulation stroke having achieved successful recanalization after mechanical thrombectomy were enrolled retrospectively.They were divided into TICI 2b (almost complete recanalization) group and TICI 3 (complete recanalization) group.The good outcome was defined as the modified Rankin Scale score 0-2 at 3 months after onset.ResultsA total of 83 patients were enrolled in the study, including 38 patients (45.8%) with TICI 2b and 45 (54.2%) with TICI 3;49 (59.0%) had good outcome, and 34 (40.9%) had poor outcome.The good outcome rate in the TICI 3 group was significantly higher than that in the TICI 2b group (68.9% vs.47.4%;χ2=3.946, P=0.047).After adjusting for age, hypertension, diabetes, baseline systolic blood pressure, triglyceride, intravenous thrombolysis, and ASITN/SIR collateral grades, TICI 3 was an independent predictor for good outcome at 3 months after onset (odds ratio [OR] 3.759, 95% confidence interval [CI] 1.098-12.871;P=0.035), while the higher baseline National Institutes of Health Stroke Scale score (OR 0.820, 95% CI 0.715-0.941;P=0.005) and higher fasting glucose (OR 0.610, 95% CI 0.410-0.906;P=0.014) were the independent predictors for poor outcome at 3 months after onset.ConclusionsThere are difference in the outcomes in patients with successful recanalization in anterior circulation stroke treated with mechanical thrombectomy.The outcome is substantially better in TICI 3 than TICI 2b patients.

Effect of microRNA-181b on ischemic stroke by regulating the heat shock protein A5 in mice / 解剖学报

Objective To explore the role of microRNA-181b (miR-181b) in cerebral ischemic injury in vivo and its mechanism. Methods Using middle cerebral artery occlusion (MCAO) model to mimic ischemic injury in vivo, the heat shock protein A5(HSPA5) protein level was determined by using Western blotting. The extent of neural cell loss in ischemic cortex after MCAO was assessed by Nissl staining. Neurological score was performed to evaluate the degree of cerebral ischemic injury after MCAO. Results We found that miR-181b antagomir down-regulated miR-181b expression levels in cerebral ischemic cortex of mice after MCA0(P <0.05, n =3). MiR-181 b antagomir improved neurological deficit of mice at 24 hours after transient MCAO (P < 0.05, n =6). HSPA5 protein levels were significantly up-regulated in ischemic cortex of mice after MCAO, and miR-181b antagomir further up-regulated HSPA5 (P < 0.05, n=3). Consequently, miR-181b antagonists attenuated neural cell loss in ischemic cortex after MCAO (P <0.05, n=3). Conclusion MiR-181 b plays an important role in ischemic injury of mice through regulating HSPA5 protein level.