Effects of preoperative percutaneous transhepatic biliary drainage on surgical treatment of type Ⅲ and Ⅳ hilar cholangiocarcinoma / 中华外科杂志

Objective@#To investigate the effects of preoperative percutaneous transhepatic biliary drainage on surgical treatment of type Ⅲ and Ⅳ hilar cholangiocarcinoma.@*Methods@#Clinical data of 72 patients with hilar cholangiocarcinoma of the Bismuth-Corlette type Ⅲ and Ⅳ treated at Department of General Surgery,First Affiliated Hospital of Bengbu Medical College from January 2010 to December 2017 were analyzed retrospectively.Patients were divided into two groups based on whether PTBD was performed:a drained group and an undrained group.In the drained group,there were 31 patients,20 males and 11 females,aged (59.9±9.7)years (range: 39-73 years).Among them,14 patients underwent hepatectomy with half or more than half of the liver removed (extended hepatectomy)and 17 patients underwent non-anatomical hepatectomy in the hilar region (limited hepatectomy).In the undrained group,there were 41 patients, 26 males and 15 females, aged (60.8±7.8)years(range: 45-75 years).Among them, 17 patients underwent hepatectomy with half or more than half of the liver removed (extended hepatectomy)and 24 patients underwent non-anatomical hepatectomy in the hilar region (limited hepatectomy).Percutaneous transhepatic biliary drainage(PTBD)was used in the drained group.Under the guidance of ultrasound,one or more hepatobiliary ducts could be sufficiently drained,which had good effect and was not restricted by the obstruction location of hilar cholangiocarcinoma.The analysis of the measurement data was performed using t test,and the analysis of the count data was performed using χ2 test,and the survival curve was plotted using Kaplan-meier method.@*Results@#In total, 72 jaundiced patients with hilar cholangiocarcinoma underwent surgical treatment: 31 had PTBD prior to operation while 41 did not had PTBD.There were significant differences in ALT((93.2±21.4)U/L vs.(207.4±65.1)U/L),AST((87.6±18.1)U/L vs.(188.9±56.6)U/L)and total bilirubin((68.8±12.6)μmol/L vs.(227.5±87.7)μmol/L)between the patients after treatment and those before treatment(t=10.958, P=0.000; t=10.845, P=0.000; t=10.386, P=0.000).Compared with those in the undrained group, the operation time was shorter, the amount of intraoperative bleeding and the incidence of complications were lower in the drained group(t=-2.840, P=0.006; t=-3.698, P=0.000; χ2=4.108, P=0.043).There were no perioperative death cases in drained group and 2 perioperative death cases in undrained group.There was no significant difference in R0 resection rate between the two groups(χ2=0.778,P=0.378).The 1-,3-,5-year survival rate of patients in the drained group and the undrained group was 72.7%,34.2%, 13.7% and 72.8%, 31.5%, 11.8%, respectively.The difference was not statistically significant(all P>0.05).@*Conclusions@#The preoperative percutaneous transhepatic biliary drainage in patients with hilar cholangiocarcinoma of Bismuth-Corlette type Ⅲ and Ⅳ could effectively shorten operative time, reduce amount of intraoperative bleeding and incidence of postoperative complications,but have no significant effect on the R0 resection rate and survival rate.

To explore the method of excavation and sorting for Wuzhou medical academic mainstreams / 国际中医中药杂志

This paper tried to explore the method of excavation and sorting for local cultural knowledge of traditional Chinese medicine by confirming the research content, setting the eligibility, designing the research method, and implementing the research plan. We pointed out that the trial design, working style, policy support and funding support played an important role for the success of researches.

Comparative Study on Acupoint Thread Embedding plus Western Medication for Metabolic Syndrome / 上海针灸杂志

ObjectiveTo compare the therapeutic efficacies between acupoint thread embedding plus Western medication and dry Western medication in treating metabolic syndrome.MethodTotally 320 patients with metabolic syndrome were randomized into a treatment group and a control group, 160 cases in each group. The control group was intervened by ordinary Western medication, while the treatment group was by acupoint thread embedding in addition to the Western medication given to the control group, and Yishu (Extra), Geshu (BL17), Ganshu (BL18), Pishu (BL20), Shenshu (BL23), Tianshu (ST25), Daimai (GB26), and Guanyuan (CV4) were selected as the major points. The therapeutic efficacies, metabolism-related parameters, liver function, and kidney function were compared between the two groups, and the therapeutic efficacies of different syndromes were also compared.ResultThe markedly effective rate and total effectiverate of the treatment group were significantly higher than that of the control group (P0.05), but there were significant inter-group differences in comparing the rest parameters including liver and kidney functions (P<0.05), and the treatment group was superior to the control group. Acupoint thread embedding produced a more significant efficacy in treating metabolic syndrome due to heat in liver-stomach and phlegm-dampness stagnancy compared to the control group (P<0.05), and the efficacy of acupoint thread embedding in treating metabolic syndrome due to phlegm-dampness stagnancy was significantly different from that of the control group (P<0.01).ConclusionAcupoint thread embedding plus Western medication can produce a more significant therapeutic efficacy in treating metabolic syndrome compared to Western medication alone, and it’s safe; of all the patterns, phlegm-dampness stagnancy responds thebest to acupoint thread embedding.

The expression of thymosin beta 4 in the liver tissues and its clinical significance in children with hepatoblastoma / 安徽医科大学学报

Objective To investigate the expression of thymosin beta4 ( Tβ4 ) in the liver tissues of children with hepatoblastoma ( HB) , and further study the function of Tβ4 in HB metastasis in vitro. Methods Immunohisto-chemistry (IHC) was used to determine expression of Tβ4, E-cadherin andβ-catenin in liver tissues from 19 chil-dren with HB,and further to analyze its function in metastasis of HB cells. Results The positive rate of Tβ4 ( P<0.01 ) in HB liver tissues was significantly higher than it in the adjacent tissues. The positive rates of Tβ4 and nu-clearβ-catenin in HB with lymphnode metastasis were significantly higher than in HB without lymphnode metastasis ( P <0.01 ) . While expression of E-cadherin in HB with lymphnode metastasis was lower than in HB without lymphnode metastasis ( P<0.01 ) . Scratch-wound assay showed that HepG2 cells with Tβ4 knockdown had signifi-cantly lower metastatic ability (P<0.05). Conclusion Tβ4 plays an important role in HB metastasis, suggesting it is a potential target for HB metastasis.

Tissue engineered spinal cord scaffold material: Optimal pore size of poly lactic-co-glycolic acid scaffolds / 中国组织工程研究

BACKGROUND: Cytoskeleton is a carrier of cell growth, and its pore caliber is one of the most important factors to affect the curative effect of tissue engineered spinal cord.OBJECTIVE: To explore the optimal pore size of poly lactic-co-glycotic acid (PLGA) scaffolds for tissue engineered spinal cord by in vitro culture of neural stem ceils (NSCs) and various pore sizes of PLGA scaffolds.METHODS: 50 μL (cell number 10~(10)/L)NSCs suspension at passage 1 was separately seeded on 200-300 pm, 400-500 μm PLGA stant for 7 days. Two sorts of tissue engineered spinal cord were constructed in vitro. Thirty rat models of spinal cord injury were established, and then assigned to 3 groups. The detect sites of these models were filled with above-mentioned spinal cord immediately, but the blank control was not treated with any material. The cells growth and proliferation implanted on PLGA were observed by phase contrast microscope and scanning electron microscope. Relative number of NSCs in two tissue engineered spinal cords was measured by MTT assay. The effects of transplantation with tissue engineered spinal cord were evaluated by the BBB scala.RESULTS AND CONCLUSION: Neural stem cells implanted on different pore size scaffolds were seen growing by phase contrast microscope and scanning electron microscope, with good histocompatibility. After 7-day coculture, absorbance was similar between 200-300 pm PLGA and 400-500 pm PLGA groups (P > 0.05). These indicated that the pore size had no effects on NSC number. At week 4 following transplantation, in the blank control group, neural function was recovered to different degrees in the 200-300 μm PLGA and 400-500 μm PLGA groups. BBB motor functional score was significantly increased (P < 0.05). The pore size of 200-300 μm utilized in fabriceting tissue engineered spinal cord has the best transplantation effect as compared to others.

Changes of aquaporin-4 in the rats with traumatic brain injury following acute ethanol intoxication / 中华急诊医学杂志

Objective This study was designed to determine the influence of acute ethanol intoxication (AEI) on brain edema and aquaporin-4(AQP-4) levels after traumatic brain injury(TBI) in rots. The underlying mechanism was also investigated. Method Severe traumatic brain injury models were made using the Feeny method; acute ethanol intoxication models were established by gavagy. One hundred and ninety-two male SD rats were randomly divided(random number) into four groups, namely the sham operation group(A ), the acute ethanol intoxication group( B ), the traumatic brain injury group(C) and the combination of acute ethanol intoxication with traumatic brain injury group(D). Each group was further divided into four sub-groups according to the time interval between injury and death of the rats. After brain tissue was fixed by affusing paraformaldehyde, the expression of AQP-4 was detected by immunohistochemistry. Water content was detected by dry-wet analysis, and AQP-4 mRNA and protein were detected by RT-PCR and western blotting respectively after the brain tissue was got by rapid decapitation. Data were analyzed by one-way ANOVA. Results The water content of brain tissue and expression level of AQP-4 were not significantly different between groups A and B( P > 0.05); however both were significantly increased in groups C and D relative to group A( P < 0.05). The water content of brain tissue in group D increased by mere than that in group C( P < 0.05), while the expression level of AQP-4 in group D was lower than that in group C(P<0.05). Conclusions Acute ethanol intoxication inhibited the expression of AQP-4,which induced a more severe cerebral edema after traumatic brain injury.

Effect of naloxone hydrochloride on neuronal cell apoptosis and cerebral edema induced by experimental brain injury / 中华急诊医学杂志

Objective To investigate the effects of naloxone hydrechloride on neuronal cell apoptosis and cerebral edema induced by experimental brain injury.Method Animal model of brain injury was established by free-falling method of Fecney.Totally 100 SD rats were randomly divided into sham operated group(n=20),op-erated comparison group(n=40),and naloxone hydrochloride treatment group(n=40).The naloxone hy-drochloride treatment group were subdivided into four sub-groups,and naloxone hydrochloride was injected at 30 min,6 h,24 h and 48 h after brain injury respectively,while the comparison groups were injected with physiologi-cal saline at the same time point.The rats were sacrificed 7 deys after the injury.Neuronal cell apoptosis were de-tected by terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL),and water content of brain tis-sue was examined with dry-wet methods.Data were analyzed by using spss 10.0 saftware package statistical analysis was carried out by using variance analysis.Results Gompared to the sham operated group,neuronal cell apopto-sis and water content of brain tissue were increased significantly in operated comparison group(P＜0.05).Com-pared to the operated comparison group,neuronal cell apoptosis and water content of brain tissue were decreased significantly in every naloxone hydirochloride treatment group(P＜0.05).Every sub-groups compared in naloxone hydrochloride treatment group,neuronal cell apoptosis of early injection group(30 min and 6 h after injury)were decreased significantly than late injection group(24 h and 48 h after injury,P＜0.05),but the water content of brain tissue had no difference between the early injection group and the late injection group(P＞0.05).Conclu-sions Naloxone can carry out its protective function to injuried neurecyte through alleviating neuronal cell apopto-sis and hydrecepahalus.and the effect was better as early as it used.

Clinical value of monitoring subdural intracraniai pressure in post-operative patients with severe brain injury / 中华创伤杂志

Objective To investigate the value of subdural intracranial pressure (ICP) monito-ring in post-operative patients with severe brain injury. Methods A total of 100 patients with severe brain injury treated with craniotomy were randomly divided into ICP monitoring group (n=50) and rou-tine treatment group (n = 50). In ICP monitoring group, the treatment methods were adjusted according to the changes of ICP, whereas the patients in routine treatment group underwent general treatment ac-cording to standard neurosurgical protocol. Results Patients in ICP monitoring group received mannitol for eight days, with the average dosage of 950 g. Marmitol was administered to patients in routine treat-ment group for 12 days, with average dosage of 1 450 g. There was statistical difference in aspects of time duration and mannitol dosage between two groups (P <0.01). Of all patients in ICP monitoring group, four were found with electrolyte disturbance (8%), seven with acute renal failure (14%), four with stress ulcer (8%) and eight with pulmonary infection (16%). The corresponding numbers of patients in routine treatment group were nine (18%), 14 (28%), five (10%) and nine (18%), respectively. The occurrence of electrolyte disturbance and acute renal failure between two groups showed significant statistical difference (P < 0.05), while the occurrence of stress ulcer and pulmonary infection were be-yond of statistical difference between two groups (P > 0.05). The post-operative initial ICP level was positively correlated with mortality rate (P <0.01). All patients were followed up for three months post-operatively. In ICP monitoring group, 27 patients (26%) obtained good prognosis without any disability (54%), 13 were under mild disability, two (4%) under severe disability, three (6%) under vegeta-tive state and five (10%) died . In the routine treatment group, 17 patients (34%) were with good prognosis without any disability , six (12%) with mild disability , six (12%) with severe disability, eight (16%) under vegetative state and 13 (26%) died. The ICP monitoring group had better prognosis than the routine treatment group(P < 0.05). Conclusion Continuous ICP monitoring postoperatively in severe brain injury patients is valuable in reducing mortality, complication and improving the prognosis.

Effect of mild hypothermia on concentration of plasma S-IOOB protein following acute severe brain injuries / 中华创伤杂志

Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.

Content Determination of Berberine in Double Yellow Antiinflammatory Tablets / 中国中医药信息杂志

Objective To establish the method to determine the content of berberine in Double Yellow Antiinflammatory Tablets. Methods Using HPLC, with Diamonnsil C18 (4.6 mm?250 mm, 5 ?m) as column, acetonitrile-0.05 mol/L potassium dihydrogen phosphate (35∶65, phosphate regulation pH value to 3.0) as mobile phase, detection wavelength was at 345 nm, flow rate was 0.8 mL/min, and column temperature was 30 ℃. Results In berberine range of 0.040 7～0.447 9 ?g, the scope and content of the sample peak area had a good linear relationship, reproducibility of RSD=0.59% (n=5), and the average recovery rate was 96.71% and RSD=0.37% (n=5). Conclusion This method is stable, reliable, with high sensitivity and good reproducibility, and easy to put into practice, so it can be used for quality control of Double Yellow Antiinflammatory Tablets.