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1.
Article in Chinese | WPRIM | ID: wpr-885710

ABSTRACT

Objective:To discuss the type, treatment and results of different therapies of biliary fistula after orthotopic liver tansplantation(OLT).Methods:Data of 24 patients who developed biliary fistula after OLT in the First Affiliated Hospital of Xi′an Jiaotong University from January 2000 to March 2019 were retrospectively analyzed. Patients with biliary fistula were classified into 4 types according to presence or absence of stricture. All patients were treated by endoscopic retrograde cholangiopancreatography (ERCP) or interventional therapy, including endoscopic nasobiliary drainage (ENBD), endoscopic retrograde biliary drainage (ERBD) or percuteneous transhepatic cholangial drainage (PTCD). Main outcome measurements were the onset time of biliary fistula, the site of biliary fistula, the complications of ERCP or PTCD, the time of removing abdominal or biliary drainage tube, and the onset of new biliary stricture.Results:Biliary fistula was found in (46.5±36.6) days (6-122 days) after OLT. The numbers of patients in four types of biliary fistula were 6, 14, 2 and 2, respectively. Biliary fistula was cured in 22 patients, with clinical cure rate of 91.7%. All patients underwent ERCP first, and the technical success rate and clinical cure rate were 87.5% (21/24) and 85.7% (18/21), respectively. The clinical cure rates of ERCP forⅠ-Ⅳ biliary fistula were 6/6, 84.6%(11/13), 1/2, and 0, respectively. The clinical cure rates of ENBD and ERBD were 8/10 and 6/8, respectively. Five cases in whom ERCP failed, underwent PTCD, with technical success and clinical cure rates of 4/5 and 3/4 respectively. Eight patients(33.3%)developed cholangitis after treatment, and the incidence rate seemed higher in type Ⅱ biliary fistula than that in type Ⅰ [35.7% (5/14) VS 16.7% (1/6)]. Incidence of cholangitis was higher in patients with non-anastomotic stricture than those with anastomotic stricture [83.3%(5/6) VS 16.7%(3/18)].Conclusion:The first line treatment for biliary fistula after OLT is ERCP, followed by PTCD. The best procedures of biliary fistula typeⅠ-Ⅳ were ENBD, ENBD combined with ERBD, ENBD and PTCD, respectively.

2.
Cancer Research and Clinic ; (6): 304-308, 2020.
Article in Chinese | WPRIM | ID: wpr-872488

ABSTRACT

Objective:To systematically evaluate the effect of SRSF2 gene mutation on the prognosis of patients with myelodysplastic syndromes (MDS).Methods:Databases including PubMed, Embase and Cochrane Library were searched for relevant studies that conducted the effect of SRSF2 gene mutation on the prognosis of MDS. The retrieval time limit was from the time of establishing database to December 2018. All cohort studies related to the effect of SRSF2 gene mutation on the prognosis of MDS were screened according to the inclusion and exclusion criteria. Data extraction and bias risk assessment were conducted for the eligible literature. The observation indicators were statistically analyzed by using RevMan 5.3 software.Results:A total of 11 studies were included in the final Meta-analysis. Compared with MDS patients without SRSF2 mutation, MDS patients with SRSF2 mutation had shorter overall survival time (HR = 1.67, 95% CI 1.40-2.00, P < 0.01) and progression-free survival time (HR = 6.20, 95% CI 2.64-14.58, P < 0.01). MDS patients with SRSF2 mutation was easier to transform into acute myeloid leukemia (AML) with shorter time (HR = 2.02, 95% CI 1.49-2.74, P < 0.01) compared to patients without SRSF2 mutation.Conclusion:SRSF2 gene mutation is an independent poor prognosis factor in patients with MDS.

3.
Article in Chinese | WPRIM | ID: wpr-733564

ABSTRACT

Objective To investigate the clinical effects and prognostic factors of radical surgery for primary gallbladder cancer (GBC).Methods The retrospective case-control study was conducted.The clinicopathological data of 305 patients with primary GBC who underwent radical Ro resection in the First Affiliated Hospital of Xi'an Jiaotong University from 2013 to 2017 were collected,including 108 males and 197 females,aged from 30 to 88 years,with a median age of 62 years.According to the different tumor staging,patients underwent corresponding operation and adjuvant treatment based on the postoperative indication of chemotherapy.Observation indicators:(1) results of imaging and laboratory examinations;(2) treatment situations:① surgical situations,② postoperative adjuvant treatment;(3) results of postoperative pathological examination;(4) followup;(5) prognostic factors analysis.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to December 5,2018,and death was used as the end point.Measurement data with normal distribution were represented as Mean±SD.Measurement data with skewed distribution were described as M (range).Count data were represented as percentage.The survival curve and survival rate were respectively drawn and calculated using the Kaplan-Meier method.The univariate analysis and multivariate analysis were respectively done using the Log-rank test and COX regression model.Results (1) Results of imaging and laboratory examinations:results of imaging examination showed that diagnostic rates of ultrasound,CT and MRI examination were respectively 84.06% (174/207),85.71% (168/196) and 63.11% (65/103).Results of laboratory examination showed that the positive rates of CA19-9,CA125 and carcinoembryonic antigen (CEA) were respectively 55.34% (145/262),48.06% (124/258) and 46.15% (126/273).(2) Treatment situations:① surgical situations:305 patients underwent radical R0 resection for primary GBC,including 145 undergoing liver wedge resection + D2 lymph node dissection,61 undergoing liver wedge resection + D1 lymph node dissection,55 undergoing liver Ⅳ B and Ⅴ segmentectomy + D2 lymph node dissection,11 undergoing liver Ⅳ B and Ⅴ segrnentectomy + D1 lymph node dissection,9 undergoing right hepatectomy + D2 lymph node dissection,5 undergoing liver wedge resection + D2 lymph node dissection + partial colectomy,4 undergoing pancreaticoduodenectomy,3 undergoing simple cholecystectomy in Tis stage,3 undergoing right hepatectomy + D1 lymph node dissection,2 undergoing liver ⅣB and Ⅴ segmentectomy + D2 lymph node dissection + partial colectomy,1 undergoing liver Ⅳ B and Ⅴ segmentectomy + resection and reconstruction of portal vein + D2 lymph node dissection,1 undergoing liver ⅣB and Ⅴ segmentectomy + D2 lymph node dissection + partial resection of the stomach or duodenum,1 undergoing pancreaticoduodenectomy + resection and reconstruction of portal vein,1 undergoing right hepatectomy + pancreaticoduodenectomy,1 undergoing right hepatic lobectomy + partial gastrectomy + D2 lymph node dissection,1 undergoing right hepatic lobectomy + D1 lymph node dissection and 1 undergoing right hepatic trilobectomy + D2 lymph node dissection.Of 94 patients with unsuspected GBC,78 who were diagnosed in the other hospitals received salvage surgery in the authors' center.Twenty-one patients had postoperative surgery-related complications,including 11 with bile leakage,8 with pulmonary infection and 2 with abdominal bleeding.Two patients died in the perioperative period.② Postoperative adjuvant treatment:26 patients underwent postoperative adjuvant chemotherapy.Chemotherapy regimen:gemcitabine + oxaliplatin were used in 12 patients,gemcitabine + tegafur in 7 patients,gemcitabine + cisplatin in 6 patients,oxaliplatin + tegafur in 1 patient.(3) Results of postoperative pathological examination.The postoperative pathological type of 305 patients:257,23,6,5,4,3,3,2,1 and 1 patients were respectively confirmed as pure adenocarcinoma,adenocarcinoma combined with squamous cell carcinoma,adenocarcinoma combined with neuroendocrine carcinoma,mucinous adenocarcinoma,neuroendocrine carcinoma,adenocarcinoma combined with mucinous carcinoma,squamous cell carcinoma,sarcomatoid carcinoma,adenocarcinoma combined with sarcomatoid carcinoma,adenocarcinoma combined with signet-ring cell carcinoma.Degree of tumor differentiation:highdifferentiated,moderate-differentiated and low-differentiated tumors were detected in 37,130 and 121 patients,respectively,17 with unknown differentiated degree.Of 305 patients,16 and 32 patients had respectively vascular invasion and nerve invasion.The number of lymph node dissected of 305 patients was 8±5,with positive lymph node of 0 (range,0-9),including 121 with lymphatic metastasis (26 with jumping lymphatic metastasis).TNM staging of 305 patients:stage 0,Ⅰ,Ⅱ,ⅢA,ⅢB,ⅣA and ⅣB were detected in 7,18,13,137,57,11 and 62 patients,respectively.(4) Follow-up:245 of 305 patients were followed up for 18.0 months (range,6.0-70.0 months).The survival time,1-and 3-year survival rates were respectively 29.5 months (range,0.5-69.9 months),71.6% and 45.8%.One hundred and twenty-two patients died during the follow-up.(5) Prognostic factors analysis:the results of univariate analysis showed that preoperative level of bilirubin,pathological type,degree of tumor differentiation,liver invasion,vascular invasion,nerve invasion,T staging,N staging and postoperative chemotherapy were factors affecting prognosis of patients with primary GBC (x2 =10.26,3.96,45.89,34.64,12.75,27.05,35.09,39.44,4.40,P<0.05).The results of multivariate analysis showed that low-differentiated tumor,liver invasion and N2 staging were independent risk factors affecting prognosis of patients with primary GBC [odds ratio (OR)=1.90,1.71,1.46,95% confidence interval (CI):1.34-2.70,1.15-2.52,1.17-1.82,P<0.05],and postoperative chemotherapy was a protective factor affecting prognosis of patients with primary GBC (OR=0.35,95% CI:0.15-0.82,P<0.05).Conclusions For patients with primary GBC undergoing radical resection,D2 lymph node dissection should be performed routinely.The low-differentiated tumor,liver invasion and N2 staging are independent risk factors affecting prognosis of patients,and postoperative chemotherapy is a protective factor.

4.
Article in English | WPRIM | ID: wpr-773606

ABSTRACT

In the present study, three compounds were isolated from Argyreia acuta, among them, compounds 1 and 2 were new and Compounds 1 and 3 were isomers. They were separated by several types of columns, such as normal phase, RP, size exclusion and preparative HPLC, and their structures were elucidated by several spectroscopic methods, such as 1D- and 2D-NMR and HR-TOF-MS.


Subject(s)
Convolvulaceae , Chemistry , Drugs, Chinese Herbal , Chemistry , Glycosides , Chemistry , Isomerism , Mass Spectrometry , Molecular Structure , Nuclear Magnetic Resonance, Biomolecular , Plant Components, Aerial , Chemistry , Resins, Plant , Chemistry , Spectrophotometry
5.
Article in English | WPRIM | ID: wpr-812395

ABSTRACT

In the present study, three compounds were isolated from Argyreia acuta, among them, compounds 1 and 2 were new and Compounds 1 and 3 were isomers. They were separated by several types of columns, such as normal phase, RP, size exclusion and preparative HPLC, and their structures were elucidated by several spectroscopic methods, such as 1D- and 2D-NMR and HR-TOF-MS.


Subject(s)
Convolvulaceae , Chemistry , Drugs, Chinese Herbal , Chemistry , Glycosides , Chemistry , Isomerism , Mass Spectrometry , Molecular Structure , Nuclear Magnetic Resonance, Biomolecular , Plant Components, Aerial , Chemistry , Resins, Plant , Chemistry , Spectrophotometry
6.
Chinese Journal of Cardiology ; (12): 543-548, 2018.
Article in Chinese | WPRIM | ID: wpr-806862

ABSTRACT

Objective@#To investigate the efficacy of periprocedural use of bivalirudin for patients with chronic total occlusion(CTO) lesion undergoing percutaneous coronary intervention(PCI) therapy. @*Methods@#In this randomized controlled study, 74 patients with CTO lesions confirmed by coronary angiography or CT angiography, hospitalized in the general hospital of Shenyang military region from September 2015 to December 2016, were randomly divided into unfractionated heparin(UFH) group (n=38) and bivalirudin group (n=36) by the random number table.Patients in the UFH group were treated with injection of UFH 5 000 U through the artery sheath catheter before coronary angiography,and the UFH was intravenously administered at 100 U/kg before PCI. Patients in the bivalirudin group received intravenous injection of bivalirudin (0.75 mg/kg) before coronary angiography, followed by intravenous infusion of 1.75 mg·kg-1·h-1 until at least 2 hours after the PCI. The values of the activated coagulation time (ACT) were measured,and the value was remained at 250 to 350 seconds during the PCI. The incidence rate of adverse events including hemorrhage events, no-reflow/slow flow, and contact thrombus in perioperative period were observed in all patients. In addition, the incidence rate of the major adverse cardiovascular events (MACE) including recurrent angina, heart failure, target vessel revascularization, cardiac death, non-fatal myocardial infarction,and stroke within 1 year follow-up period were also observed in the 2 groups. @*Results@#Baseline clinical and PCI data were similar between the 2 groups (all P>0.05). During the perioperative period, the incidence of the bleeding was significantly lower in the bivalirudin group than in the UFH group(5.6% (2/36) vs. 23.7% (9/38) , P=0.028).The incidence of no-reflow/slow flow was also significantly lower in the bivalirudin group than in the UFH group(0 vs. 15.8% (6/38) , P=0.025). There was no significant difference in the incidence of contact thrombosis between bivalirudin group and UFH group(8.3% (3/36) vs. 0, P=0.110). There was no cardiac death or non-fatal myocardial infarction in the 2 groups within 1 year after PCI, and there was no significant difference in the incidence of MACE in 1 year follow-up after operation between bivalirudin group and UFH group (11.1% (4/36) vs. 21.1% (8/38) , P=0.246). @*Conclusion@#The application of the anticoagulant bivalirudin during PCI in patients with CTO lesion can reduce the incidence of perioperative bleeding and no-reflow/slow flow, and does not increase the risk of MACE within 1 year after PCI.

7.
Article in Chinese | WPRIM | ID: wpr-673070

ABSTRACT

Objective To explore the application value of plastic biliary stent and fully covered self-expandable metallic stent (FCSEMS) in endoscopic retrograde cholangio pancreatography (ERCP) for treatment of benign biliary stricture after liver transplantation.Methods The retrospective cross-sectional study was conducted.The clinical data of 54 patients with benign biliary stricture after liver transplantation undergoing ERCP treatment who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University between January 2010 and August 2016 were collected.Among 54 patients,44 had simple anastomotic stricture and 10 had non-anastomotic stricture.All the patients underwent stent implantation by ERCP.Patients with stricture within 1 month postoperatively initially selected single plastic stent or endoscopic nasobiliary drainage (ENBD),and then changed into multiple plastic stents at the second stent replacement.Patients with stricture after 1 month postoperatively selected multiple plastic stents,multiple plastic stents after balloon dilation or FCSEMS.Observation indicators:ERCP situations,stent implantation,time of stent indwelling,postoperative complications,stent dislocation,treatment outcome and follow-up situations.Patients were followed up by outpatient examination and telephone interview up to November 2016.Clinical symptoms of patients were observed within 1 month postoperatively and liver function and abdominal ultrasound were retested.Liver function and remission degree of biliary stricture were monitored regularly once every 3 months.Measurement data were described as average (range).Results All the patients underwent successful ERCP,of which 53 completed the process of ERCP and 1 rejected treatment due to economic problems.All the 54 patients received 140 times ERCPs with an average of 2.59 times per person,21 times ENBDs,11 times FCSEMSs and 108 times plastic stent implantations (including 35 times single stent implantations,46 times double stents implantations,23 times 3-stents implantations and 4 times 4-stents implantations).All the 54 patients were followed up for 3-143 months,with an average time of 73 months.Of 44 with anastomotic stricture,34 received plastic stent implantation and 98 times ERCPs,with an average number of stent implantation of 2 (range,1-4) and an average time of stent indwelling of 10.7 months (range,9.0-13.0months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 4 persons every time,7 persons every time,10 persons every time and 3 persons every time,respectively;26 patients were cured and 5 were improved,with an effective rate of 91.2% (31/34);3 patients with noneffective treatment continued to undergo ERCP and 3 patients had recurrence of anastomotic stricture.Among 10 patients with initial FCSEMS implantation,12 times ERCPs were performed,with an average time of stent indwelling of 7.6 months (range,6.0-12.0 months);postoperative biliary infection,hyperamylasemia and stent dislocation were detected in 1 person every time,1 person every time and 1 person every time,respectively;8 patients were cured,with an effective rate of 8/10;of 2 patients with persistent stricture,1 patient received contrast examination after stent removal,showing a comparative stricture in level 1 branch of intrahepatic duct and considering combined ischaemia,and then underwent the second implantation using multiple plastic stents;the other patient had elevated level of jaundice at 3 months after stents removal and received ERCP,showing anastomotic inflammatory polyp,and then underwent FCSEMS implantation again.Ten patients with non-anastomotic stricture received plastic stent implantation and 30 times ERCPs,with an average number of stent implantation of 3 (range,2-4) and an average time of stent indwelling of 11.3 months (range,10.0-14.0 months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 2 persons every time,5 persons every time,2 persons every time and 1 person every time,respectively;3 patients were cured and 3 were improved,with an effective rate of 6/10;of 4 patients with noneffective treatment,2 died of gradually deteriorating liver function and 2 underwent the second liver transplantation.Conclusions Stent implantation in ERCP is safe and effective for treatment of benign biliary stricture after liver transplantation,single plastic stent should be used in the early period (within 1 month) and multiple plastic stents should be used in the later period.Although FCSEMS has a higher displacement rate,it should be recommended due to a better clinical effect,lower incidence of complications and simple operation.For patients with non-anastomotic stricture,plastic stent should be used for extrahepatic biliary stricture,with a good clinical effect,and there is worse effect in stent implantation through ERCP for multiple intrahepatic biliary strictures.

8.
Chinese Journal of Biotechnology ; (12): 1292-1303, 2017.
Article in Chinese | WPRIM | ID: wpr-242256

ABSTRACT

In this study, a multiplex RT-PCR method was developed for detection of seven diarrhea-associated porcine viruses, including porcine teschovirus (PTV), porcine sapovirus (PSV), porcine deltacornavirus (PDCoV), porcine kobuvirus (PKV), porcine sapovirus (PSaV), porcine astrovirus (PAstV) and porcine torovirus (PToV). A total of 419 samples were screened by this method and results showed that PKV had the highest positive rate of 26.98%?45.79% and its mixed infection rate reached 9.52%-18.54%. On account of high positive rate of PKV and its important role in diarrhea disease, complete genomic sequences of three PKV positive samples were further sequenced. Three PKV labeled as PD-PKV, JS-PKV and CM-PKV were classified into porcine kobuvirus genus and had far genetic distance with other kobuviruses. The complete genome homologies among them were 88.1%-89.1%. CM-PKV had the highest identity with the Chinese strain JS-02a-CHN/2013 reported in 2013 while JS-PKV and PD-PKV were most closed to the K-30-HUN/2008/HUN strain reported in Hungary in 2008. This illustrates the significant genetic differences of the different PKV isolates in Shanghai while its relationship with the viral pathogenicity still needs to be explored. This research provides references for further understanding the prevalence of PKV and its role in swine diarrhea.

9.
Article in English | WPRIM | ID: wpr-812632

ABSTRACT

In the present study, two new compounds from Ipomoea cairica were identified and demonstrated to have α-glucosidase inhibitory activity. They were isolated by column chromatography on silica gel and sephadex LH-20 and finally purified by prep-HPLC, with their structures being elucidated by spectroscopic methods, such as 1D- and 2D-NMR and HR-TOF-MS, and chemical methods. Compounds 1 and 2, named cairicoside A and cairicoside B, were evaluated for α-glucosidase inhibitory activity by the MTT method, with the IC50 values being 25.3 ± 1.6 and 28.5 ± 3.3 μmol·L(-1), respectively.


Subject(s)
Glycoside Hydrolase Inhibitors , Pharmacology , Ipomoea , Chemistry , Molecular Structure , Plant Extracts , Pharmacology , Resins, Plant , Pharmacology , Spectrum Analysis , alpha-Glucosidases
10.
Tianjin Medical Journal ; (12): 200-204, 2016.
Article in Chinese | WPRIM | ID: wpr-487761

ABSTRACT

Objective To investigate the relationship between the echinoderm microtubule associated protein like 4-anaplastic lymphoma kinase (EML4-ALK) and epithelial growth factor receptor (EGFR) mutation status and overall survival (OS) in Uygur patients with stageⅣnon-small cell lung cancer (NSCLC) who did not accept tyrosine kinase inhibitor treat-ment. Methods Totally 97 tissue samples were collected from Uygur patients with stageⅣNSCLC who did not accept tyro-sine kinase inhibitor treatment. EML4-ALK fusion gene and EGFR mutation status were detected by using FISH and ARMS methods. The survival rates were analysed. Results In 97 tissue samples, EML4-ALK fusion genes were found in 6 (6.2%) samples, EGFR mutations were found in 26 (26.8%) samples. The survival analysis showed that there was no significant dif-ference in OS between EML4-ALK fusion gene group and no EML4-ALK fusion gene group (P=0.941). There was no signifi-cant difference in OS between EGFR mutation group and wild-type EGFR group (P=0.607). The values of median OS were 17.7 months, 17.3 months and 16.2 months for EGFR mutant group, EML4-ALK positive group and EML4-ALK negative+EGFR wild-type group, and thre was no significant difference between them (P=0.915). Conclusion Excluding the thera-peutic influence in TKIs, EML4-ALK fusion gene and EGFR mutation status of tumor tissue can not be used as an indepen-dent factor in assessing the prognosis in Uygur patients with stageⅣNSCLC.

11.
Article in Chinese | WPRIM | ID: wpr-487167

ABSTRACT

Objective To compare safety and feasibility using radial versus femoral access during cardiac catheterization of patients who had previously undergone coronary artery bypass graft ( CABG) surgery. Methods We retrospectively evaluated 116 consecutive patients who underwent graft intervention via the transradial (TRA group, n = 46) or transfemoral approach (TFA group, n = 70), and observed the baseline clinical characteristics, angiography characteristics and complications between the 2 groups. Results The baseline clinical characteristics between the 2 groups were similar ( all P > 0. 05) . No significant difference was observed in angiography characteristics and procedural parameters including operation time, radiation exposure and puncture time between the 2 groups (all P > 0. 05). There was no significant difference in major adverse cardiac events during hospitalization. PCI to graft vessels were all successful and procedural success rates were similar between the 2 groups (P = 0. 669). Vascular access site complications were significantly lower ( P = 0. 03) in the TRA group. No access site complication was recorded in the TRA group. 7 cases (10. 0% ) with complications were recorded in the TFA group including 1 case of major bleeding (1. 4% ), 3 cases of minor bleeding (4. 3% ), 2 cases of local hematorna (2. 9% ) and 1 case of A-V fistula formation. Conclusions In contrast to the transfemoral route, the rate of major vascular complications was negligible using the transradial approach.

12.
China Journal of Endoscopy ; (12): 85-89, 2016.
Article in Chinese | WPRIM | ID: wpr-621238

ABSTRACT

Objective To investigate the causes, diagnosis and surgical treatment of ERCP related duodenal per﹣foration. Methods Clinical data of 6 cases of surgical treatment of ERCP related duodenal perforation were retro﹣spective analyzed. All the 6 perforation patients underwent emergency surgical procedure, including 3 cases trans﹣fered from other hospital after duodenal perforation. 4 cases with a history of abdominal surgery. Preoperative con﹣firmed bravery manager stone 4 cases, 1 case of obstructive jaundice after gallbladder surgery, bile duct expansion in 1 case. Results Perforation causes include duodenum mirror improper operation related in 2 cases, duodenal papilla sphincterotomy related 3 cases (1 case of pre-dissection operation with needle knife), small endoscopic sphincteroto﹣my combined with endoscopic papillary balloon dilation lead to perforation in 1 case.4 cases of intraoperative found right kidney week pneumatosis, 2 cases of postoperative CT found after peritoneal pneumatosis, effusion. All patients with surgery including common bile duct exploration, T tube drainage, duodenal perforation repair, jejunum colostomy, among them 2 cases at the same time line of gastrointestinal anastomosis. 5 cases recovered, 1 case died. Conclusions Inappropriate duodenal papilla sphincter incision indications and Many previous abdominal surgery have higher perforated ration;Found in time, reasonable treatment is the most important;For serious typeⅠand typeⅡperforation, active surgical treatment in time, can effectively reduce serious consequences caused by the ERCP related perforation.

13.
Article in Chinese | WPRIM | ID: wpr-328270

ABSTRACT

Facing current situation of integrative medicine (IM), authors put forward that clinical and diagnosis program of IM could be carried out from clinical path, pathogenesis, treatment theory and philosophy, and so on, but with different integration degrees. Meanwhile, formulation of concrete program should be disease-targetedly set up, and adjusted from person to person, from place to place, from time to time. As for settled IM program , authors could evaluate it from whether Chinese medicine and Western medicine have formed complementary, synergistic, excitatory actions, and toxicity attenuation; whether more problems could be solved in efficacy, safety, practicability, and economy than previous single mode.


Subject(s)
Critical Pathways , Integrative Medicine , Medicine, Chinese Traditional
14.
Clinical Medicine of China ; (12): 936-939, 2016.
Article in Chinese | WPRIM | ID: wpr-503614

ABSTRACT

Objective To explore the feasibility,efficacy and safety of endoscopic retrograde cholangio?pancreatography ( ERCP ) drainage during peroperation of hilar cholangiocarcinoma for alleviate jaun?dice. Methods Nineteen cases patients with hilar cholangiocarcinoma who were treated with ERCP in the First Affiliated Hospital of Xi'an Jiao Tong University from January 2013 to December 2013,the drainage way,efficient rate,complication rate,and surgical situation were retrospective analyzed. Results Bilateral endoscopic drain?age was one?time achieved in all 19 patients. Among them,Eendoscopic nasobiliary drainage( ENBD) for unilat?eral bilateral drainage was 4 cases,ENBD and plastic stent for unilateral( left or right) drainage was 9 cases,EN?BD and plastic stent for bilateral drainage was 6 cases. The drainage efficiency rate was 89. 5% ( 17/19) . Serum alanine aminotransferase(ALT),total bilirubin(TBIL),direct bilirubin(DBIL),alkaline phosphatase(ALP) and Prothrombin time (PT) were significantly decreased after 7days post?ERCP((208. 4±47. 7) U/L vs. (90. 3 ±31. 57) U/L,(421. 7±85. 9) μmol/L vs. (150. 1±49. 7) μmol/L,(294. 6±30. 6) μmol/L vs. (95. 4±23. 2)μmol/L,(853. 1±133. 7) U/L vs. (600. 0±116. 4) U/L,(17. 7±1. 8) s vs. (13. 8±1. 0) s;P=0. 000,0. 001, 0. 000,0. 001,0. 004) . There were 6 cases occurred ERCP postoperative complications,including 2 cases of hy?peramylasemia, 1 case of pancreatitis, 3 cases of cholangitis. Seven cases of hilar cholangiocarcinoma patients were received hilar radical surgery by combination caudate lobectomy of the left or right hepatectomy,no postop?erative cholangitis was occurred. Conclusion ERCP biliary drainage is an important means to ensure the perio?perative safety and efficacy of hilar cholangiocarcinoma.

15.
Chinese Journal of Ultrasonography ; (12): 576-579,583, 2015.
Article in Chinese | WPRIM | ID: wpr-602217

ABSTRACT

Objective To explore the value of detection of blood flow in the brachial artery after forearm standard internal fistula (wrist radial artery-cephalic vein)operation by color Doppler ultrasound in the assessment of internal fistula function.Methods The data of the blood flow in the brachial artery after forearm standard internal fistula operation detected by color Doppler ultrasound in 103 patients were retrospectively studied.In detecting the blood flow in the brachial artery,350 ml/min and 500 ml/min were used as demarcation points and the patients were divided into dysfunction,uncertainty and good function group.In internal fistula dysfunction,dialysis flow <200 ml/min was taken as the golden criterion.ROC curve was constructed and analyzed.Results In using Doppler ultrasound to detect the blood flow in the brachial artery and to diagnose the standard internal fistula dysfunction,the area under ROC curve was 0.949 (P <0.001)and 95% of confidence interval was (0.909,0.989).The best diagnostic demarcation point was 470 ml/min.In using the blood flow 350 ml/min and 500 ml/min in the brachial artery as demarcation points and dividing the patients into dysfunction,uncertainty and good function group,the area under the ROC curve was 0.916 (P <0.001 )and 95% of confidence interval was (0.857,0.975 ).Conclusions The accuracy of using Doppler ultrasound to detect the blood flow in the brachial artery and to diagnose the standard internal fistula dysfunction is higher.Using 350 ml/min and 500 ml/min as demarcation points,the grouping method is of higher clinical applied value.

16.
Article in Chinese | WPRIM | ID: wpr-481162

ABSTRACT

Objective To construct the recombinant adeno-associated virus vector carrying cancerous inhibitor of PP2A (CIP2A)short hairpin RNA (shRNA)for preparation of high-titer viruses.Methods The small hairpin RNA of CIP2A (CIP2A shRNA)was designed,synthesized and cloned into pDC31 6-EGFP-U6 plasmid which was double digested by Bam HⅠ and Hin dⅢ.The resultant plasmid pDC31 6-EGFP-shRNA was confirmed and served as template to appraise primers.EGFP-CIP2A shRNA sequence was amplified by PCR,double digested with Eco RⅠand Sal Ⅰ and ligated to pSNAV2.0 plasmid digested with the same enzyme pair.pSNAV2.0-EGFP-CIP2A shRNA plasmid DNA was prepared,purified,identified and transfected into BHK-21 cells.BHK-21 cells expressing CIP2A shRNA (BHK-21/CIP2A-shRNA ) were obtained and subsequently infected with VGTC’s proprietary AAV packaging system to package the rAAV2-CIP2A shRNA.After purification,the functional and infectious virus was obtained and the titer of virus was detected.Real-time PCR and Western blot methods were used to detect the expression of CIP2A after infection with HepG2 cells,and the empty viral vector rAAV2-EGFP was used as control. Results A recombinant adeno-associated virus-2 vector carrying CIP2A shRNA was constructed successfully.The presence of the target sequence in the vector was confirmed by double enzyme digestion and sequencing.By transfecting the pSNAV2.0-EGFP-CIP2A shRNA plasmid into BHK-21 cells,BHK-21/CIP2A shRNA cells were infected with helper virus HSV1-rc/ΔUL2 to package the rAAV2-CIP2A shRNA to obtain a functional and infectious virus.The titer of the recombinant virus was 0.25×10 1 2 v.g./mL.The expression of CIP2A mRNA and screening value of 1×10 5 MOI effected HepG2 cells.Conclusion A high-titer recombinant adeno-associated virus-2 vector carrying CIP2A shRNA has been constructed successfully.

17.
Article in Chinese | WPRIM | ID: wpr-478440

ABSTRACT

Objective To explore the clinical effect of transvaginal repair of cesarean scar diverticulum (CSD). Methods Totally 64 patients of CSD in the First Maternity and Infant Hospital, Tongji University between Mar. 2013 and Sept. 2014 underwent transvaginal repair of CSD were reviewed retrospectively and followed. Result All the patients had a prolonged period, and the duration was (14.8± 3.5) days; all the patients were received the transvaginal repair of CSD, there was no intra-operative complications, the procedures were successfully performed in all patients. The mean operation time was (67± 12) minutes, the mean blood loss was (53±32) ml, and the mean length of hospital stay was (4.0±1.1) days. All patients were followed after the operation, the duration of menstruation was (8.1 ± 3.5) days shorter in average, which was statistically significant (P<0.01);the operation effective rate was 94%(60/64) to assess the clinic syptoms, the operation effective rate was 95%(61/64) for anatomic assessment. The distance of the CSD from the serosa became thicker after surgery significantly, the distance was thicker (3.4 ± 0.4) mm compared with preoperation (P<0.01). Conclusions Transvaginal repair of CSD offers minimal invasiveness, good exposure and accurate resection. It is worth to be popularized in the treatment of patients with CSD.

18.
Article in Chinese | WPRIM | ID: wpr-476853

ABSTRACT

BACKGROUND:Bio-derived xenograft bone has natural pore structure of the bone, low immunogenicity, and good cytocompatibility. OBJECTIVE:To verify the biocompatibility of bio-derived xenograft bone with bone marrow mesenchymal stem cel s. METHODS:Fresh pig femoral bone was col ected to prepare bio-derived bone. Scanning electron microscope was used to observe the material structure. Passage 3 rabbit bone marrow mesenchymal stem cel s at a density of 2×109/L were inoculated into the cancel ous bone surface of the bio-dervied bone and cultured for 7 days. Cel growth was detected using scanning electron microscope. After culture for 8 days, cel number was counted. RESULTS AND CONCLUSION:The bio-derived bone had rough surface and irregularly interconnected pores constructing a mesh-like structure. After 3 days of compound culture, cel s had irregular shapes and adhered to the surface of bio-derived bone;after 5 days of culture, cel s were closely interconnected to form a layered growth;after 7 days of culture, cel s exhibited multilayered growth and the extracel ular matrix secreted local y. Under compound culture, the former 2 days were latent period, 3-6 days were logarithmic phase, and from the 6 th day, the cel growth curve became smooth gradual y and the cel proliferation decreased and entered into the plateau period. These findings indicate that the bio-derived xenograft bone has good biocompatibility with bone marrow mesenchymal stem cel s.

19.
Article in Chinese | WPRIM | ID: wpr-461888

ABSTRACT

BACKGROUND:Pelvic fractures combined with acetabular fractures are mostly caused by high-energy violence, often accompanied by severe complications and high mortality, and surgical fixation is preferred in most cases. OBJECTIVE:To investigate the internal fixation of pelvic fracture combined with acetabular fracture and to analyze the material biocompatibility. METHODS:A computer-based search of Wanfang, CNKI and PubMed databases was performed for articles related to the internal fixation of pelvic fracture combined with acetabular fracture and material biocompatibility published from 2005 to 2014. The keywords were“pelvis fractures, acetabulum fractures, internal fixators, materials”in Chinese and English, respectively. Articles published in authoritative journals or recently were preferred, and final y 29 articles were enrol ed in result analysis. RESULTS AND CONCLUSION:Steel plate reconstruction or screw internal fixation is often used for clinical treatment of pelvic fracture combined with acetabular fracture. Titanium plate is often chosen with similar elastic modulus to the bone and good biocompatibility. The titanium plate is pre-bended before implantation to match the bone surface of the fracture site. Absorbable screws have good histocompatibility and non-toxic side effects, which can avoid the electrolysis and corrosion of metal screws and maintain certain strength in early period of internal fixation;over time, the fracture is gradual y healed, the material strength gradual y decreases, and the material is final y degraded into water and carbon dioxide to achieve good clinical outcomes. It is difficult and high-risk for treatment of pelvic fracture combined with acetabular fractures, and active treatment and damage control are recommended as soon as possible. A reasonable treatment plan can be developed based on the type of fracture. Plate internal fixation and minimal y invasive fixation developed by the three-dimensional reconstruction techniques show a great progress in fracture treatment, which have broad clinical application prospects.

20.
Acta Physiologica Sinica ; (6): 271-282, 2015.
Article in English | WPRIM | ID: wpr-255948

ABSTRACT

Voltage-gated sodium channels (VGSCs) are widely distributed in most cells and tissues, performing many physiological functions. As one kind of membrane proteins in the lipid bilayer, whether lipid composition plays a role in the gating and pharmacological sensitivity of VGSCs still remains unknown. Through the application of sphingomyelinase D (SMaseD), the gating and pharmacological sensitivity of the endogenous VGSCs in neuroblastoma ND7-23 cell line to BmK I and BmK AS, two sodium channel-specific modulators from the venom of Buthus martensi Karsch (BmK), were assessed before and after lipid modification. The results showed that, in ND7-23 cells, SMaseD did not change the gating properties of VGSCs. However, SMaseD application altered the slope factor of activation with the treatment of 30 nmol/L BmK I, but caused no significant effects at 100 and 500 nmol/L BmK I. With low concentration of BmK I (30 and 100 nmol/L) treatment, the application of SMaseD exerted hyperpolarizing effects on both slow-inactivation and steady-state inactivation, and increased the recovery time constant, whereas total inactivation and recovery remained unaltered at 500 nmol/L BmK I. Meanwhile, SMaseD modulation hyperpolarized the voltage dependence of slow-inactivation at 0.1 nmol/L BmK AS and altered the slope factor of slow-inactivation at 10 nmol/L BmK AS, whereas other parameters remained unchanged. These results indicated a possibility that the lipid bilayer would disturb the pharmacological sensitivity of VGSCs for the first time, which might open a new way of developing new drugs for treating sodium channelopathies.


Subject(s)
Cell Line, Tumor , Humans , Lipid Bilayers , Chemistry , Neuroblastoma , Scorpion Venoms , Chemistry , Sodium Channel Blockers , Chemistry , Voltage-Gated Sodium Channels , Physiology
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