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@#Objective To compare the clinical efficacy of subxiphoid video-assisted thoracoscopic surgery (XVATS) and conventional intercostal VATS (CVATS) extended thymectomy for myasthenia gravis (MG). Methods The clinical data of MG patients who underwent extended thymectomy in the Department of Thoracic Surgery of Xuzhou Central Hospital from October 2016 to October 2021 and finished the follow-up were retrospectively reviewed. They were divided into an XVATS group and a CVATS group according to the procedure. The perioperative variables and clinical efficacy of the two groups were compared. Results A total of 84 patients were collected, including 43 males and 41 females, with a mean age of 52.3 years. There were 41 patients in the XVATS group and 43 patients in the CVATS group. There was no mortality, cardiopulmonary thrombosis, prolonged air leak, or mediastinal infection. Additionally, the CVATS group recorded 5 (11.6%) patients of conversion to open thoracotomy, 1 (2.3%) patient of postoperative MG crisis, 1 (2.3%) patient of bleeding in thorax, and 1 (2.3%) patient of chylothorax. The operation time (127.4±50.4 min vs. 122.9±38.6 min), intraoperative bleeding [46.9 (25.7, 79.2) mL vs. 45.7 (21.9, 92.1) mL], incidence of complications [0 vs. 7.0% (3/43)], chest tube duration (4.3±1.9 d vs. 4.8±2.8 d), follow-up time (19.1±8.5 months vs. 22.5±13.7 months), the proportion of residual mediastinal fat tissue [12.2% (5/41) vs. 4.7% (2/43)], and total MG remission rate [29.3% (12/41) vs. 51.2% (22/43)] were not statistically different between the two groups (P>0.05). However, the two groups showed significantly different incidence of conversion to open thoracotomy [0 vs. 11.6% (5/43), P=0.024], postoperative hospital stay time (8.2±3.3 d vs. 11.4±5.8 d, P=0.003) and total drainage volume [396.7 (173.8, 542.5) mL vs. 218.8 (102.1, 430.0) mL, P=0.038]. Conclusion XVATS extended thymectomy is technically safe and feasible; however, more evidence is warranted before the recommendation of this approach for the treatment of MG.
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Objective:To explore the clinical characteristics, diagnosis and treatment of acute leukemia patients during pregnancy.Methods:The clinical data of 16 cases with acute leukemia during pregnancy from January 2009 to December 2018 in the First Affiliated Hospital of USTC were retrospectively analyzed. The diagnosis and treatment regimens, pregnancy outcome, the early fetus and survival status of patients were also analyzed.Results:All 16 leukemia cases were confirmedly diagnosed and classified by bone marrow puncture, including 13 cases of acute myeloid leukemia (5 cases of non-acute promyelocytic leukemia and 8 cases of acute promyelocytic leukemia) and 3 cases of acute lymphoblastic leukemia. At the time of confirmed diagnosis, 6 patients were in first trimester, 6 cases in second trimester and 4 cases in late trimester. As for pregnancy outcome, 1 patient had natural birthing, 5 patients underwent cesarean operation, 9 patients underwent artificial abortion and 1 patient had spontaneous abortion. Chemotherapy was performed in 15 patients during pregnancy, 11 patients received chemotherapy for treatment of primary disease after pregnancy, 3 patients died during the treatment. During the follow-up of 13 cases, 8 patients survived and 5 patients lost follow-up.Conclusions:Early diagnosis of acute leukemia during pregnancy is very important. Bone marrow puncture should be performed timely to make clear diagnosis when blood routine result is abnormal during antenatal care. Multidisciplinary consultation should be initiated in time, and the best treatment plan should be worked out to guard against serious complications during pregnancy.
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@#New Delhi metallo-β-lactamase-1 (NDM-1) is capable of hydrolyzing nearly all β-lactam antibiotics, posing an emerging threat to public health. There are currently less effective treatment options for treating NDM-1 positive “superbug”, and no promising NDM-1 inhibitors were used in clinical practice. In this study, structure–activity relationship based on thiosemicarbazone derivatives was systematically characterized and their potential activities combined with meropenem (MEM) were evaluated. Compounds 19bg and 19bh exhibited excellent activity against 10 NDM-positive isolate clinical isolates in reversing MEM resistance. Further studies demonstrated compounds 19bg and 19bh were uncompetitive NDM-1 inhibitors with Ki = 0.63 and 0.44 μmol/L, respectively. Molecular docking speculated that compounds 19bg and 19bh were most likely to bind in the allosteric pocket which would affect the catalytic effect of NDM-1 on the substrate meropenem. Toxicity evaluation experiment showed that no hemolysis activities even at concentrations of 1000 mg/mL against red blood cells. In vivo experimental results showed combination of MEM and compound 19bh was markedly effective in treating infections caused by NDM-1 positive strain and prolonging the survival time of sepsis mice. Our finding showed that compound 19bh might be a promising lead in developing new inhibitor to treat NDM-1 producing superbug.
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Rosemary is an aromatic evergreen shrubby herb that is native to the Mediterranean region. This herb is now widely cultivated in many regions of the world. Rosemary is widely used in traditional Chinese medicines, foods, nutraceuticals and cosmetics. Hydro distilled essential oils, obtained from rosemary in China and the Mediterranean region, were analysed by gas chromatography-mass spectrometry [GC-MS]. Thirty-seven compounds accounting for 94.97%-99.72% of the oils were identified. The majority of the compounds in the essential oils exhibited no significant differences [table 1 and fig. 1]. The extracts were prepared with three solvents of different polarity [dichloromethane, ethyl acetate and aqueous]. The ethyl acetate fractions exhibited the highest phenol content and were found to be significantly more active than the dichloromethane and aqueous fractions [fig. 2]. Antioxidant activity [by DPPH radical scavenging, ferric ion reduction [FRAP] and thiobarbituric acid reactive substance [TBARS]] was also assessed. The ethyl acetate extracts of Yunnan had the highest amount of antioxidant capacity from China by DPPH and TBARS, with the lowest IC50 values being 0.0011 mg/ml, and 1.6611 mg/ml, respectively. In conclusion, the antioxidant activities of the essential oils and ethyl acetate extracts from rosemary obtained by three different testing methods revealed higher antioxidant activity from rosemary grown in China than in the Mediterranean region. These results suggested that Chinese rosemary should be widely used in food, traditional medicine, cosmetics and perfume products, as well as other chemical industries
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Objective To determine the anatomic distribution of metastatic inguinal nodes in gynecological malignancies,and to explore the delineation of clinical target volume(CTV). Methods A retrospective study was performed among 34 patients with gynecological malignancies and inguinal lymph node metastases. According to the anatomic distribution of metastatic inguinal nodes, CTV covering more than 95% of inguinal lymph nodes and the relationship of inguinal nodes with the femoral vein, greater saphenous vein and its branches, superficial fascia, and deep fascia were analyzed using vascular enhancement images obtained by computed tomography and magnetic resonance imaging as well as 3D reconstruction using the Eclipse Planning System. Results The 34 patients had a total of 145 positive inguinal nodes. In the 131 superficial nodes below the inguinal ligament, 129 were located between the superficial fascia and the deep fascia;the upper group of superficial nodes,containing 25 nodes,was located at 1 cm above the public symphysis and along superficial iliac circumflex vein;the middle group,containing 85 superficial nodes and 11 patients with single superficial node metastasis,was located at the same level of the public symphysis and close to the junction of the saphenous vein and the femoral vein;the lower group, containing 21 superficial nodes,was beneath the public symphysis and along the greater saphenous vein and medial and lateral superficial femoral veins.The 14 deep nodes were located on the medial side of the femoral vein. There were no positive nodes on the posterolateral side of the link between the posterolateral edge of the femoral vein and medial edge of the sartorius muscle. The upper edge of CTV kept 142 lymph nodes beneath the upper edge of the superior pubis ramus and left 3 lymph nodes up to the upper edge of the femoral head. The lower edge of CTV kept 143 lymph nodes above the lower edge of the lesser trochanter and left 2 lymph nodes at 2 cm beneath the lower edge of the lesser trochanter. Conclusions For CTV covering 98% of positive inguinal nodes, the anterior edge is the superficial fascia;the medial edge is composed by the inguinal ligament and the border of medial muscle to the femoral vessels;the posterolateral edge is the link between the posterolateral edge of the femoral vein and the medial edge of the sartorius muscle;the upper edge is the upper border of the femoral head;the lower edge is the lower border of the lesser trochanter.
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Objective To investigate the neuroproteetive effect of Rhubarb extract (RE) on cerebral ischemia-reperfusion injury in mice and its mechanism.Methods Twenty-eight male ICR mice were randomly divided into sham operation,ischemia-reperfusion,low-dose RE (100 mg/kg),and high-dose RE (100 mg/kg) groups.A model of middle cerebral artery occlusion and reperfusion in mice was induced by the suture method.The drug intervention groups were given intragastric RE administration (once a day) on the third day before model preparation,and the same volume of normal saline was injected into mice of the cerebral ischemia-reperfusion group.The volume of cerebral infarction was detected by triphenyltetrazolium chloride staining.The neuron-specific nuclear protein (NeuN),glial fibrillary acidic protein (GFAP),and ionized calcium binding adapter 1 (IBA-1) were used as markers of the ischemic cortical neurons,astrocytes,and microglial cells,respectively,and detected by inmunohistochemistry.The expression levels ofsuperoxide dismutase (SOD)-1,SOD-2,and catalase (CAT) in ischemic cortex were detected by Western blot analysis.Results Compared with the cerebral ischemia-reperfusion group,the neurological function score of the high-dose RE group was significantly reduced,the infarct volume was significantly reduced,and the number of neurons in the ischemic cortex was increased significantly,and the activation degree of astrocytes and microglia was decreased significantly (all P ＜0.05),the expression levels of SOD-1,SOD-2,and CAT were increased significantly (all P＜ 0.05);in contrast,there was no significant difference between the low-dose RE group and the cerebral ischemia-reperfusion group.Conclusions High-dose RE may play a protective role for cerebral ischemia-reperfusion mice through anti-oxidative mechanism.
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Objective To explore the indication,technology and clinical significance of laparoscopic choledocholithotomy and primary suture in treatment of choledocholithiasis.Methods 78 patients with choledocholithiasis were divided into two groups receiving respectively laparoscopic choledocholithotomy and T-tube drainage treatment,and laparoscopic choledocholithotomy and primary suture after common bile duct exploration.The time of operation,postoperative hospital stay and complications were analyzed and compared.Results Bile leakage occurred in 2 cases in the primary suture group and 3 cases in the T-tube drainage group;No residual stones or biliary stricture was found in either groups.The time of operation,postoperative complications were not statistically different (P ＞ 0.05).The difference in postoperative hospital stay and GI function recovery time between the two groups was statistically significant (P ＜ 0.05).Conclusion In well selected cases,the primary suture of common bile duct after laparoscopic choledocholithotomy is feasible and safe.
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Objective To evaluate orthotopic splenectomy and pericardial devascularization for the treatment of portal hypertension.Methods The modified anterior approach splenectomy includes dissection of the peri-splenic vessels and ligments before division of short gastric vessels.During pericardial devascularization,the dessection panel was close to the esophagus and the stomach,leaving intact both the anterior and posterior vagus trunks.Results 63 patients underwent this modified operation.The free portal pressure decreased from (38 ±4) cmH2O to(28 ±4)cmH2O.The average blood loss was (530 ± 37)ml.There was no mortality,nor perioperative gastric paralysis and portal venous thrombosis.By 12-36 months follow-up,there was no pancreatic leakage,hepatic coma and recurrence of bleeding.Intrahepatic portal venous thromboses were detected in 4 cases at the sixth postoperative months.Conclusions This modified splenectomy plus selective pericardial devascularization carries less bleeding and is safe and effective for the treatment of portal hypertension.
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Objective To explore perioperative risk factors for postoperative pancreatic fistu?la. Methods Six hundred and forty?three cases patients who underwent radical gastrectomy for gastric cancer from January 2010 to June 2015 in the NO. 309 Hospital of Chinese People’ s Liberation Army were selected and divided into Postoperative Pancreatic Fistula( POPF) group with 53 cases and Non?Postoperative Pancreatic Fis?tula( NPOPF) group with 590 cases. Preoperative,intraoperative and postoperative data were analyzed by statisti?cal analysis of two groups. Results POPF rate was 8. 24%(53/643). There were no significanct differences in terms of gender,age,preoperation with disease,preoperative serum albumin,TNM stage,abdominal surgery,sur?gical procedure,lymph node dissection,digestive tract reconstruction,surgical approach,blood loss and length of time between the POPF group and NPOP group(P>0. 05). The level of BMI of POPF group was higher than that of NPOPF group,the difference was statistically significant((25. 63±2. 54) kg/m2 vs. (21. 11±2. 44) kg/m2,t=2. 245,P=0. 025). The number of lymph node dissection in POPF group was (32. 25±5. 82),in NPOPF group was (27. 06±6. 79),there was significant difference between the two groups(t=2. 093,P=0. 037). The operation time in POPF group was (242. 50±52. 30) min,in NPOPF group was (229. 51±59. 21) min,the difference was statistically significant between the two groups( t=2. 398,P=0. 017) . The serum CRP of 1 d in POPF group was (85. 72±12. 05) mg/L,in NPOPF group was (76. 41±12. 52) mg/L,and there was significant difference between the two groups( t=1. 979,P=0. 048) . The serum albumin of 2?4 d after operation in POPF group was (26. 0±5. 9) g/L,in NPOPF group was (32. 6±6. 8) g/L,the difference between the two groups was statistically significant(t=-10. 185,P=0. 000). The drainage fluid amylase of 1 and 2 d after operation in POPF group was (2094+1444) U/L,in NPOPF group was (746+486) U/L,and there was significant difference be?tween the two groups( t=10. 400,P=0. 000) . Logistic regression analysis results showed that body mass index ( BMI) ,lymph node dissection number,time of operation,postoperative 1,2 d drainage fluid amylase and serum albumin of 2?4 d after operation were postoperative occurred pancreatic fistula risk factors( OR=1. 972,183. 6, 2. 004,0. 150,9. 809,P>0. 05). Conclusion BMI,number of dissected lymph node,duration of surgery,serum albumin of 2?4 d after operation and postoperative 1,2 d drainage fluid amylase have important clinical values for predicted POPF.
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Objective To detect the expressions of decoy receptor 3 (DcR3) in pancreatic cancer tissues and to analyze the significance of DcR3 in the diagnosis, treatment and prognosis of patients with pancreatic cancer.Methods The expressions of DcR3 in pancreatic cancer tissues (n =100), paracancer tissues (n =15) and normal tissues (n =15) were detected with immunohistochemical method (Envision method).Results The positive rate of DcR3 in pancreatic cancer tissues was significantly higher than that in adjacent-tumor pancreatic cancer tissues (86.0％ vs.46.6％, P ＜ 0.05).The positive rate of DcR3 in adjacent-tumor pancreatic cancer tissues was significantly higher than that in normal tissues (46.6％ vs.13.3％, P ＜ 0.05).In clinical stage Ⅲ, the positive rate of DcR3 was significantly higher than that in stage Ⅱ and stage Ⅰ (100％ vs.87.0％, P＜0.05;100％ vs.62.5％, P＜0.05).There were significant differences among the three groups (P ＜ 0.05).With lymph node metastasis, the DcR3 positive rate was significantly higher than that in the group without lymph node metastasis (93.4％ vs.79.6％, P ＜ 0.05).In poorly differentiated pancreatic cancer, the positive rate of DcR3 was significantly higher than that in the highly differentiated group (100％ vs.64.0％, P ＜0.05), the positive rate of DcR3 was significantly higher in the moderately differentiated group than that in the highly differentiated group (88.6％ vs.64.0％, P ＜ 0.05) , There were significant differences among the three groups (P ＜ 0.05).There was no significant difference in the positive rate of DcR3 between the different age groups or the different gender groups (P ＞ 0.05).Conclusions The expression levels of DcR3 in patients with pancreatic cancer gradually increased from normal tissues to paracancer tissues, to pancreas tissues.The expression level of DcR3 protein was closely related to clinical stage, degree of tissue differentiation and presence of lymph node metastasis, but not associated with age, sex, and tumor diameter size.
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Objective To explore the effectiveness and safety of temporary immunosuppressant withdrawal for the management of severe infection after liver transplantation.Methods Fifty-one patients with severe infection after liver transplantation were divided into control group (24 cases) and withdrawal group (27 cases ) according to the immunosuppression protocol.In the withdrawal group, the immunosuppressive drugs were temporarily suspended according to ATP values of CD4 + T cell and CD4 + T lymphocyte subsets counting until infection was controlled.The liver function,the incidence of acute rejection and the graft survival rate were monitored during the process.The side effects were observed.Result Severe infection was cured in 39 patients.There were 9 deaths in the control group in which the immunosuppressant was continued during the course of infection and 3 in the withdrawal group,respectively.The median suspension of immunosuppressant in trial group was ( 15.5 ± 4.8 ) d ( 6 ～ 22 d) ; CD4 + T lymphocyte subsets counting rose from (65.60 ± 32.58)/μl to (103.04 ± 12.39)/μl,ATP values of CD4 + T cell rose from (79 ±23) μg/L to ( 112 ± 11 ) μg/L; meanwhile,the temperature dropped from (38.3 ± 1.2) ℃ to (36.4 ± 1.1) ℃,WBC dropped from (15.7 ± 4.4) × 109/L to (6.3 ± 3.8) × 109/L,CRP dropped from ( 153.4 ± 37.1 ) mg/L to ( 16.5 ± 4.8) mg/L.During the course of treatment and follow-up,liver function of patients in the trial group remained normal and no acute rejection occurred.Compared with the control group,the temperature recovery time in the trial group was shorter ( respectively F =5.32,8.37,9.12,all P ＜ 0.05) and the therapeutic outcome was better.Conclusions The cellular immune function test could be evaluated according to the ATP values of CD4 + T cell and CD4 + T lymphocyte subsets counting.For severe infection after liver transplantation, anti-infection treatment and simultaneously withdrawing immunosuppressants help to control the infection.
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<p><b>OBJECTIVE</b>To study the effects of continuous cropping obstacles on growth of Angelica sinensis.</p><p><b>METHOD</b>The growth indexes, photosynthetic characteristic, activity of leaf protective enzymes, and the yield, essential oil content and extract content were determined.</p><p><b>RESULT</b>Continuous cropping decreased the growth and the yield, essential oil content, extract content of A. sinensis. Photosynthetic pigment, which include Chla and Chlb, and photosynthetic rate of A. sinensis leaves decreased. Activity of leaf SOD, POD and CAT were also inhibited. The content of proline, soluble sugar and MDA increased.</p><p><b>CONCLUSION</b>Through decreasing the activity of protective enzymes and their ability of cleaning free radical, continuous cropping made free radical remain in plant so that induced membrane lipid peroxidization, electrolytic leakage became heavier, content of proline and soluble sugar increased. The external manifestation of this influences were that plant growth was inhibited, content of photosynthetic pigments decreased, so did the intensity of photosynthesis and respiration, content of dry mass.</p>
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Agriculture , Methods , Angelica sinensis , Chemistry , Biomass , Pigments, BiologicalABSTRACT
Objective To study the clinical significance for the establishment of diagnosis of small bowel obstruction by selective small bowel enterography through a nasointestinal decompression tube. Methods Tirty-five patients with small bowel obstruction, with no strangulation or other contraindications, were intubated with a 300 cm nasointestinal decompression tube till upper jejunum under X-ray monitoring. The patients firstly underwent intra-small-intestinal suction therapy. When the tube reached the diseased region, a selective small bowel enterography was performed. Under X-ray inspection, 20-100 ml of 76% meglumine diatrizoatis and 50-200 ml of air were slowly injected via the decompression tube to perform double contrast intestinal radiography. Results Intubation was successful in all the 35 patients. Mter the small intestinal decompression therapy. Obstruction was cured in 20 cases, alleviated in 15 cases, and 10 cases received operation. Small bowel enterography in this series was all of high quality, there were 6 cases in which no abnormal X-ray findings, adhesive small bowel obstruction was suggested in 15 cases, small bowel tumor was identified in 4 cases (3 metastatic tumor, 1 small bowel cancer), small bowel Crohn's disease in 3 cases, radioactive enteritis in 3 cases, enteric intussusception in 2, polyp of the small intestine in one, and carcinoma of the ascending colon in one. Conclusions The nasointestinal decompression intubation with X-ray monitoring serves a dual function for the patients with intestinal obstruction, it decompresses the small bowel and does small intestinal radiography, in this way the locale of obstruction was found and the cause of the obstruction identified.
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Objective To study the effects of four rotation system on the soil microbial populations in rhizosphere,yield,and recovery rate of Ditylenchus destructor of Angelica sinensis.Methods In rhizosphere soil,the microbe amount of various rotation system was determined with the flat dilution,the bacteria were counted with the culture medium of beef-cream and peptone,the fungi were counted with the Martin culture medium,the actinomyces was counted with the improved Gao 1 culture medium.Results Compared with the rotation cropping,the bacterium amount of companion,continuous,and 3a cropping was decreased by 15.76%,30.67%,and 34.24%,respectively;The fungi amount was increased by 24.73%,119.28%,and 135.77%;The diversity indexes of microbe were decreased by 47.90%,78.84%,and 80.63%,and the yields of A.sinensis were decreased by 10.59%,29.52%,and 57.85%;The recovery rate of D.destructor was 1.37,2.52,and 4.12 times.Conclusion The total microbes,which could be cultured in soil,will be decreased.The amount of bacterium,actinomycetes,diversity index and yields,recovery rate of the first grade of A.sinensis were decreased,while fungi and recovery rate of the third grade and substandard of A.sinensis,recovery rate of D.destructor increased with the continuous cropping increasing.