The application of three-dimensional printing abdominal aortic aneurysm improve the teaching effect for the residents in vascular surgery department / 中华医学教育探索杂志

Objective To evaluate 3D printing abdominal aortic aneurysm model in analysis of clinical teaching effect for standardized resident doctors in vascular surgery department. Methods 48 resi-dents in vascular surgery department in our hospital from December 2016 to September 2017 were seleeected and randomly divided into control group and the experimental group. The traditional vascular surgical anatomy atlas, ultrasound, CT abdominal blood vessel 3D reconstruction, digital subtraction, video and so on were used by 24 residents in the control group, while in the experimental group, on the basis of the traditional teaching, abdominal aortic aneurysm model of 3D printing, true aortic coated stent delivery system were increased. After the teaching, the theory of evaluation (abdominal vascular anatomical features, morphological characteristics and classification of AAA, measurement of various parameters and key points of operation in the EVAR) and satisfaction questionnaire were adopted to evaluate the effect of two kinds of teaching methods. SPSS 19.0 was used to conduct t test on two groups of physician evaluation data. Results The results of theoretical assessment showed that there was no significant difference between the control group and the experimental group in the abdominal vascular anatomical features, the morphological features and the classification of the experimental group (P>0.05) in the examination of the common AAA cases and the complicated AAA cases. However, the experimental group was higher than the control group in the mea-surement of the parameters of EVAR, and the score of the operation points and the total score, and the difference was statistically significant (t=2.283, t=2.263, P<0.05). The results of the questionnaire showed that the students' satisfaction scores on the teaching satisfaction of the normal and complex AAA cases were better than those of the control group, and the difference was statistically significant (P<0.05). Conclusion The 3D printing model can increase the understanding and mastery of the anatomy and treat-ment of abdominal aortic aneurysm and improve its learning enthusiasm for vascular surgery. We should make full use of the advantages of 3D printing technology on the basis of retaining the advantages of tradi-tional teaching methods and means, and further enhance the teaching effect.

Experimental study on chronic toxicity of Guanxinning Injection in rats / 药物评价研究

Objective To observe the repeat administration toxicity of Guanxinning Injection in rats.Methods Totally 120 rats (males and females) were randomly divided into vehicle control group and three Guanxinning Injection groups with different dosages (3.40,1.70,and 0.85 g/kg).Rats were administered with Guanxinning Injection by consecutive intravenous injection for 13 weeks.Besides the general conditions were observed,the related indexes were detected,such as body weight,the routine control of blood,hepatic function,renal function,the metabolism condition of lipids,the glycometabolism indexes,and histopathology analysis were determined at 13 weeks of treatments and 4 weeks after the withdrawal,respectively.Results Rats in the Guanxinning Injection group at 3.40,1.70 g/kg apperance shortness of breath,unsteady gait,lying motionless,and other symptoms.There was no obvious abnormal reaction in the 0.85 g/kg dose group.There were two male rats in the Guanxinning Injection group at 3.40 g/kg died at about week 4 of treatments,and there was no death in the 0.85 and 1.70 g/kg dose groups.Compared with vehicle control group,the related indexes of blood,blood biochemistry,organ relative quality,and histopathological showed no obvious abnormalities in Guanxinning Injection 0.85 and 1.70 g/kg group.The levels of urea nitrogen (BUN) and the relative weight of kidney in Guanxinning Injection 3.40 g/kg group were significantly higher than those in vehicle control group at 13 weeks.The change of these parameters regained to normal at 4 weeks after withdrawal and the rest of the detection index showed no obvious abnormality in 3.40 g/kg dase group.Conclusion Intravenous administration of Guanxinning Injection for 13 weeks at high dose could induce reversible damage to kidney.

Synergism and attenuation effects of Pini Pollen on cyclophosphamide / 中国比较医学杂志

Objective To investigate the synergism and attenuation effects of Pini Pollen on cyclophosphamide chemotherapy in model mice.Methods The models of mouse were induced with S180 tumor and cyclophosphamide.The tumor inhibiting rates, hematology, Liver function, giant cell phagocytosis, hemolysin level and indexes of thymus and spleen were determined to evaluate the synergism and attenuation effects of Pini Pollen(150,300,600 mg/kg) on cyclophosphamide chemotherapy.Results Compared with cyclophosphamide chemotherapy group,the tumor inhibiting rates,white blood cell number,giant cell phagocytosis, hemolysin level and indexes of thymus and spleen were increased, at the same time liver function damage were alleviated significantly in cyclophosphamide plus Pini Pollen groups.Conclusions Pini Pollen has a remarkable synergism and attenuation effects on cyclophosphamide chemotherapy through its immune adjustment functions.

Comparison of the repeated dose toxicity of doxorubicin liposome injection and doxorubicin injection in rats / 中国比较医学杂志

Objective To investigate the repeated dose toxicity of doxorubicin liposome injection and doxorubicin injection in rats. Methods Ninety SD rats ( body weight 180-220 g, male:female=1:1 ) were divided into 3 groups (30 rats in each group), and were administered intravenously with physiological saline, doxorubicin liposome injection (1 mg·kg-1 ) and doxorubicin injection ( 1 mg·kg-1 ) , respectively, once every three days for thirteen times. The body weight, blood biochemistry, hematology, organ coefficient and histopathology were analyzed for the overall toxicity assessment. Results The rats administered with doxorubicin liposome injection (1 mg/kg) showed hair loss and skin ulcer, significantly reduced growth of body weight, increased levels of urea nitrogen ( BUN ) , alanine aminotransferase ( ALT ) , blood platelet ( PLT ) , and kidney and heart coefficients, decreased thymus and testicular coefficients, myofibrillar rupture and lysis, and partial loss of cell nuclei, hyaline casts in the renal convoluted tubules, interstitial edema and loss of spermatogenic cells in the testicular tubules. Compared with the doxorubicin liposome injection group, similar abnormal changes were also observed in the doxorubicin injection group, but the hair loss and skin ulcer were milder and the heart and kidney toxicities were severer. Conclusions Compared with doxorubicin injection, the doxorubicin liposome injection causes milder heart and kidney toxicity but more serious skin toxicity.

Neuroprotective effect of acupuncture combined with Danhong injection on focal cerebral ischemia/reperfusion injury in rats / 中国比较医学杂志

Objective To investigate the neuroprotective effect of acupuncture combined with a Chinese medicine, Danhong injection, on focal cerebral ischemia/reperfusion injury in rats.Methods Middle cerebral artery ( MCA ) occlusion was prepared by putting a nylon suture in the MCA.The MCA blood flow in the animals was restored at two hours after the MCA occlusion by withdrawing the suture to the external carotid artery (ECA).The acupoints“Baihui”(DU20) and “Zusanli”(ST36) were acupunctured and stimulated by twirling the acupuncture needle after reperfusion, and the rats were also administered with Danhong injection by intravenous injection, once every day for three days.Zea-Longa scores were recorded to assess the changes of neurological function. The rats were sacrificed at 72 h after reperfusion. Triphenyltetrazolium chloride ( TTC) staining was used to measure cerebral infarction size.Western blot was used to test the level of Bcl-2 and Bax in the ischemic penumbra.Results The acupuncture combined with Danhong injection treatment group displayed markedly lower neurologic deficit scores, reduced ischemic infarct surface, increased expression of Bcl-2 protein, and reduced expression of Bax protein, compared with those in the model group and Danhong injection alone group.Conclusions Acupuncture combined with Danhong injection show more significant neuroprotective effect than Danhong injection treatment alone on rat models of cerebral ischemia/reperfusion injury.

Post-treatment neutrophil-lymphocyte ratio independently predicts amputation in critical limb ischemia without operation

OBJECTIVES: Limited information is available concerning the post-treatment neutrophil-lymphocyte ratio in critical limb ischemia patients who receive conservative therapy. Accordingly, this study was designed to evaluate the predictive value of the post-treatment neutrophil-lymphocyte ratio in critical limb ischemia patients without surgery. METHOD: From January 2009 to January 2011, critical limb ischemia patients were admitted to a vascular center. The demographic data, patient histories, comorbidities and risk factors were documented, and the differential cell count was determined at admission and seven days later after conservative therapy. The cutoff value of the post-treatment neutrophil-lymphocyte ratio was determined by an ROC curve. Patients were divided into groups A and B according to the cutoff value. Amputation-free survival was compared between groups. Univariate and multivariate analyses were used to identify independent risk factors. RESULT: A total of 172 patients were identified with a mean age 71.98±10.09 years; among them, 122 were male. A value of 3.8 was identified as the cutoff value of the post-treatment neutrophil-lymphocyte ratio. Groups A (post-treatment neutrophil-lymphocyte ratio ≥3.8) and B (post-treatment neutrophil-lymphocyte ratio <3.8) showed a significant difference in amputation-free survival (P<0.001). The 1-year, 2-year and 3-year amputation-free survival rates were 79.6%, 55.6% and 46.3%, respectively, in group A; however, in group B, these values were 89.7%, 79.3% and 75.9%, respectively. The post-treatment neutrophil-lymphocyte ratio was identified as an independent predictive factor for amputation in critical limb ischemia patients (P<0.001). CONCLUSION: The post-treatment neutrophil-lymphocyte ratio is an independent predictive factor for amputation in critical limb ischemia patients. Patients with a post-treatment neutrophil-lymphocyte ratio ≥3.8 are likely to suffer from ...

Protective effects of left-handed pantoprazole sodium on the rat model of gastric ulcer generated by pyloric ligation / 中国比较医学杂志

Objective The aim of this study was to investigate the effect of left-handed pantoprazole sodium on rat models of gastric ulcer generated by pyloric ligation .Methods The rat models induced by pylorus ligation were treated with a single intravenous injection of left-handed pantoprazole sodium .The gastric ulcer inhibition rate , volume of gastric juice, activity of pepsin, and level of serum gastrin were determined and gastric mucosa tissue was examined by pathology . Results The gastric ulcer index , volume of gastric juice , activity of pepsin and level of serum gastrin in the rats pretreated with left-handed pantoprazole sodium (0.9, 1.8, 3.6 mg/kg, i.v.) were significantly lower than those in the model group .The lesions of gastric mucosa were also improved in the pantoprazole-treated groups .Conclusions Left-handed pantoprazole sodium has remarkable protective effects on the gastric mucosa in rat models of gastric ulcer induced by pyloric ligation.

Synergism and attenuation effects of Scapharca Subcrenata Extraction on NP chemotherapy / 中国比较医学杂志

Objective To investigate the synergism and attenuation effects of Scapharca Subcrenata Extraction on NP chemotherapy in model mice.Methods The models of nude mice were induced with A549 cell line xenograft.The tumor inhibiting rates, body weight, food intake, hematology and blood biochemistry index were determined to evaluate the synergism and attenuation effects of Scapharca Subcrenata Extraction (125、250、500 mg/kg, i.g) on NP chemotherapy. Results Compared with NP chemotherapy group, the tumor inhibiting rates, body weight, food intake, white blood cell number were increased and glutamate pyruvate transaminase, glutamic oxalacetic transaminase and urea nitrogen were decreased markedly in NP chemotherapy plus Scapharca Subcrenata Extraction groups. Conclusion Scapharca Subcrenata Extraction has a remarkable synergism and attenuation effects on NP chemotherapy.

A 13-week subchronic toxicity test of Danhong injection in Beagle dogs / 中国比较医学杂志

Objective To investigate the subchronic toxicity of a Chinese medicine Danhong injection in dogs . Methods Twenty-four healthy Beagle dogs (body weigh 7-9 kg, male:female=1:1) were used in this study.The test dogs were administered with Danhong injection by intravenous injection once every day for consecutive 6 days/week for thirteen weeks.The Danhong injection was used in 3 doses:494,247,and 124 mg· kg-1, repectively.The control dogs received normal saline injection in the same volume .The body weight, blood biochemistry, hematology, viscera relative weight and histopathology were determined for the overall toxicity assessment .Results The dogs administered with 494 g· kg-1 Danhong injection showed significantly reduced body weight gain , abnormal increase of urea nitrogen ( BUN ) , creatinine (CR) levels, and histopathological changes in the liver .Conclusions Danhong injection (494mg· kg-1 ) administered Intravenously has obvious toxicity on the liver and kidney function .

Intraoperative internal carotid artery shunt in the resection of carotid body tumors (CBT) / 中华普通外科杂志

Objective To summarize the experience of surgical management of carotid tumors ( CBT ) and application of shunt between common and internal carotid artery intraoperatively. Methods Thirty patients of CBT (mean age:39. 2 ±2. 3 years old,10 male and 20 female, 15 in left, 14 in right and 1 in both sides) who underwent surgical resection, were retrospectively reviewed. The average size of CBT was 4.9 ±0.3 cm. The diagnosis was established by ultrasound, CT, MRI or carotid arteriography. 16 patients underwent surgical resection of CBT, 10 patients underwent additional ligation of external carotid artery, and 4 patients underwent additional intraoperative shunt between common and internal carotid artery. Results Surgical procedures were successfully performeded in all 30 patients with CBT. Intraoperative shunts were successfully used between common and internal carotid artery in 4 patients. The postoperative complications included hoarseness (15) , bucking (11), crooked tongue ( 17) , dyspnea (1), dysphagia(3). There was no hemiplegia and death. Conclusion Surgical resection is the choice of treatment of carotid body tumor. The application of intraoperative shunt between common and internal carotid artery in complicated Shamblin Ⅲ stage is safe and effective.

Preliminary Experience with Indications for Liver Transplantation for Hepatolithiasis / 中国普外基础与临床杂志

Objective To explore the indications for liver transplantation among patients with hepatolithiasis.Methods Data from 1 431 consecutive patients with hepatolithiasis who underwent surgical treatment from January 2000 to December 2006 were retrospectively collected for analysis.Surgical procedures included T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones,hepatectomy,cholangiojejunostomy,and liver transplantation.Results Nine hundred and sixty-one patients who had a stone located in the left or right intrahepatic duct underwent hepatectomy or T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones.The rate of residual stones was 7.5%(72/961).Four hundred and seventy patients who had a stone located in the bilateral intrahepatic ducts underwent surgical procedures other than liver transplantation;the rate of residual stones was 21.7%(102/470).Only 15 patients with hepatolithiasis underwent liver transplantation;they all survived.According to the degree of biliary cirrhosis,recipients were divided into 2 groups: a group with biliary decompensated cirrhosis(n=7),or group with biliary compensated cirrhosis or noncirrhosis group(n=8).There were significant differences in operative times,transfusion volumes and blood losses between 2 groups(P

Reconstruction of hepatic artery in adult-to-adult living donor liver transplantation: a report of 50 cases / 中华消化外科杂志

Objective To summarize the experience in hepatic artery reconstruction in adult-to-adult living donor liver transplantation(ALDLT).Methods Fifty patients underwent ALDLT in our hospital from January 2002 to July 2006.All the hepatic a~ery reconstructions were done under surgical microscope.ResultsTwo patients(4%)presented with hepatic artery thrombosis.All the patients were followed up for 2 to 52 months (median,9 months),and no hepatic artery stenosis nor hepatic artery pseudoaneurysm occurred.The 1-year survival rate was 92%(46/50).Conclusions Systematic evaluation of hepatic artery reconstruction and use of microsurgical technique are key to the reduction of complications of hepatic artery reconstruction in ALDLT.

An in vivo study on pharmacodynamics of 4-aminosalicylic acid oral colon-specific delivery coated tablets / 中国新药与临床杂志

AIM: To examine the pharmacodynamics of a self-developed oral colon-specific delivery coated tablets of 4-aminosalicylic acid (4-ASA) on rats. METHODS: Ulcerative colitis rat model was developed by intrarectal administration of 2, 4, 6-trinitrobenzenesulfonic acid (TNBS) in alcohol. Rats were divided randomly into healthy control group, TNBS control group, TNBS + lower dose (coated tablets) group, TNBS +medium dose (coated tablets) group, TNBS + higher dose (coated tablets) group, TNBS + sulfasalazine (SASP) group, TNBS + medium dose non-coated tablet group. Several indices including macroscopic change,histological damage, and tissue myeloperoxidase (MPO) activity were examined after 5 consecutive oral drug administration to assess pharmacodynamics of the coated tablets. RESULTS: An experimental ulcerative colitis in rats was induced by TNBS. Compared with 4-ASA non-coated tablet group, decreased macroscopic and histological damage score and lower MPO activity were observed after the oral administration of 4-ASA coated tablets or SASP. There was no significant difference between the effects on the indices of higher dose of coated tablets and SASP (P ＞ 0.05) CONCLUSION: The self-made 4-ASA oral colon-specific delivery coated tablet showes higher effect than non-coated tablets to treat ulcerative colitis in rats.

Colon-specific delivery tablets of sodium 4-aminosalicylic acid / 药学学报

Aim To prepare a new oral colon-specific delivery formulation and to investigate the release profile in vitro and the colon-specific delivery property in vivo in dogs. Methods Sodium 4-aminosalicylic acid was selected as the model drug. The combination of Eudragit RL30D and RS30D were used as sustained-release film, and Eudragit FS30D used as enteric film, which was expected to release drug depending on pH and time. The release profile of tablets was studied in three phosphate buffers with the pH 6.5, 7.0 or 7.4 for 12 h after a simulated gastric presoak for 2 h in 0.1 mol · L-1 HCl. The tablets were radiolabelled with 99mTc to make their release times and positions in the gastrointestinal tract be followed using a gamma camera. Results For the in vitro study, there was no drug released in 0. 1 mol ·L- 1 HCl for 2 h, and release occurred slowly when pH was above 6.5. Drug was released faster while pH was higher. For the in vivo study, the coated tablets remained intact in the upper gastrointestinal tract, and drug release began after the colonic arrival. The uncoated tablets, however, disintegrated in the stomach of the dogs rapidly. Conclusion The coating could protect the drug until the tablets reached the ascending colon, where drug was released slowly for over 10 h.

Liver Transplantation for Recurrent Liver Cancer after Resection / 中国普外基础与临床杂志

Objective To evaluate the outcome of liver transplantation in patients with recurrent liver cancer after resection.Methods Data of 23 patients underwent liver transplantation for recurrent liver cancer from April 2001 to March 2008 were retrospectively collected and analyzed.Results Previous history of liver resection had little negative effect in subsequent liver transplantation in technical aspect.Liver function recovered uneventfully after transplantation in all cases.Alpha fetoprotein(AFP) recovered to normal value in 13 of 17 cases with elevated AFP before transplantation within one month after operation.Five cases(21.74%) had postoperative complications.Nineteen cases(82.61%) were followed up,average follow-up duration were 610 days.There were 5 cases(26.32%) of cancer recurrence and 6 deaths during follow-up,survival rate was 68.42%.Conclusion Liver transplantation is a reasonable treatment for recurrent liver cancer after resection.

Treatment of Acute Limb Arterial Embolism and Influencing Factors of Its Prognosis / 中国普外基础与临床杂志

Objective To present and summarize the data concerning the treatment and prognosis of acute limb arterial embolism in West China Hospital.Methods Forty three patients with 52 limbs of acute arterial embolism were treated in West China Hospital from January 2003 to March 2006.There were 15 males and 28 females,aging from 26 years to 77 years 〔(58.88?13.90) years〕.The diagnosis was based on clinical manifestations and results of color Doppler sonography or DSA.The follow-up ranged from 1 month to 39 months.The following factors,which might influence the prognosis,were analysed through multiple linear regression of SPSS 10.0:age,sex,uper limb or lower limb,location of embolus,ischemic time,clinical categories of acute limb ischemia,history of smoking,atherosclerosis and other combined diseases,pervious history of acute limb arterial embolism,operative or nonoperative treatment,and postoperative complications.Results Clinical categories of acute limb ischemia include:Ⅰ(n=0),Ⅱa(n=16),Ⅱb(n=29),Ⅲ(n=7).The ischemic time varied from 3 h to 2 weeks.The sources of embolus:heart(n=39),vessle(n=7),iatrogenic origin(n=1),unidentidied origin(n=5).The therapies included embolectomy(n=38),catheter-directed thrombolysis(n=2) and medical treatment(n=12).The following postoperative complications occured:compartment syndrome(n=12),respiratory failure(n=3),alkalolsis(n=3),acute renal failure(n=2),wound infection(n=2) and pulmonary infection(n=1).Two patients died of cerebral infarction in hospital and one patient died of heart failure 3 months after discharge.Thirty-eight patients with 45 diseased limbs were followed up.The results were excellent in 13 limbs,good in 15 ones,fair in 8 ones and poor in 9 ones.The statistically significant influencing factors of prognosis include ischemic time,clinical categories of acute limb ischemia and history of smoking(P

Diagnosis and Treatment of Popliteal Aneurysm:Report of 11 Cases / 中国普外基础与临床杂志

Objective To present and summarize the data concerning the diagnosis and treatment of popliteal aneurysm in our hospital. Methods The data of popliteal aneurysm in our hospital from 1975 to 2004 were reviewed and analyzed. Eleven patients with 11 diseased limbs were treated, including 8 males and 3 females, age from 21 years to 64 years 〔(48.54?13.66) years〕. The combined diseases include syphilis, rheumatic heart disease and chronic obstructire pulmonary disease etc. Ten patients received operations, including endoaneurysmorrhaphy (n=4) and graft bypass after aneurysmal resection (n=6), through posterior approach (n=7) or medial approach (n=3). One patient, combined with advanced syphilis and heart failure, received conservative treatment because of his poor general condition. Results The common clinical manifestations included popliteal pulsating mass, claudication, difficulty in extension of the knee, pain etc. Acute ischemia occurred in 3 limbs. The diameter of popliteal aneurysms varied from 4-13 cm 〔(6.73?2.69) cm〕. There were 3 (27.3) cases of ruptured aneurysms whose diameters were 7 cm, 7 cm and 11 cm respectively. Special examinations included arteriography and Doppler sonography. Pathological results of these patients were pseudoaneurysm (n=3), syphilitic aneurysm (n=3) and atherosclerotic aneurysm (n=4). Two patients were not followed up, and postoperative follow up of the other 8 patients ranged from 18 months to 30 years. In the group of endoaneurysmorrhaphy, postoperative gangrene of the affected limb occurred in one patient, and above-knee amputation was performed. One patient suffered from intermittent claudication in the group of endoaneurysmorrhaphy and of graft bypass respectively. No manifestations of limb ischemia were found in the other 5 patients during the time of follow up. Conclusion General utilization of Doppler sonography in screening high risk patients might be helpful to detect popliteal aneurysm. For symptomatic popliteal aneurysm or asymptomatic popliteal aneurysm with diameter larger than 3 cm, operation is indicated. Asymptomatic popliteal aneurysms no more than 3 cm in diameter could be monitored with care.

Diagnosis and Surgical Treatment of Abdominal Aortic Aneurysm in 72 Patients / 中国普外基础与临床杂志

Objective To review retrospectively our experience of the diagnosis and surgical treatment in patients with abdominal aortic aneurysm(AAA).Methods The diagnosis and surgical treatment in 72 patients 〔62 men, 10 women; mean age (67.5?9.3) years)〕 with AAA from January 1995 to February 2004 were analyzed. Fifty eight patients with infrarenal AAA and 2 patients with suprarenal AAA underwent elective graft replacement operation; 12 patients with ruptured AAA underwent urgent graft replacement operation. Results Fifty eight patients with infrarenal AAA and 2 patients with suprarenal AAA were cured and 2 patients with infrarenal AAA died of multiple organ failure after elective graft replacement operation, the 30 day mortality rate in patients with infrarenal AAA after elective operation was 3.45%. Seven patients were cured and 5 patients died of multiple organ failure after urgent graft replacement operation, the 30 day mortality rate was 41.67%. Conclusion The elective graft replacement operation in patients with AAA is a safe and effective surgical approach under the improvement of surgical technique and management of perioperative period.