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Objective: The objective of this paper is to evaluate the perioperative outcomes of major hepatectomy for intrahepatic cholangiocarcinoma (ICC) in patients with cirrhosis. Methods: We retrospectively evaluated the preoperative, intraoperative, and postoperative findings in 42 consecutive patients with cirrhosis and in 102 patients with normal livers who underwent major hepatectomy for ICC. Results: Preoperative liver function was worse in patients with cirrhosis compared to patients without cirrhosis. Cirrhotic patients had significantly higher intraoperative blood loss, longer operation time, and longer hospital stay than non-cirrhotic patients. However, the two groups had similar overall morbidity and hospital mortality rates and similar rates of liver failure or other complications. Their R0 resection rates, resection margin widths and disease-free survival rates were also similar. Conclusions: Major hepatectomy for ICC can be performed in selected cirrhotic patients with acceptable morbidity and mortality rates, as compared to patients without cirrhosis. [ABSTRACT FROM AUTHOR]

Background: This was a study to evaluate the safety and feasibility of balloon valvuloplasty of the pulmonary valve through the right ventricle (RV) for the treatment of pulmonary atresia with intact ventricular septum (PA-IVS). Methods: Ten neonates with PA-IVS, who underwent balloon valvuloplasty of the pulmonary valve through the RV at our institution from January 2008 to May 2010, were enrolled in this study. The oxygen saturation range was 60% to 83% (median 76%). The Z-value range of the tricuspid valve annulus was −2 to 2 (median 0.15), the diameter range of the pulmonary valve annulus was 4.6 to 8.6 mm (median 7.3), and the RV systolic pressure range was 88 to 124 mm Hg (median 106.5). A guidewire was used to perforate the pulmonary valve through the RV, followed by balloon dilation of the valve. The procedure was guided by transesophageal echocardiography. Results: The procedure was carried out successfully in all patients. The procedure time ranged from 64 to 110 minutes (median 82.5). Mechanical ventilation time ranged from 8 to 36 hours (median 11), and hospital stay ranged from 7 to 13 days (median 9). After the procedure, the median oxygen saturation increased to 89.5%, the median RV systolic pressure decreased to 45 mm Hg, and the gradient across the pulmonary valve ranged from 20 to 45 mm Hg (median 27.5). Minor complications included transient supraventricular tachycardia (n = 1), blood loss requiring transfusion (n = 2), moderate pulmonary regurgitation (n = 1), and mild pulmonary regurgitation (n = 3). There were no cases of cardiac perforation, main pulmonary artery aneurysm, or low output syndrome. Follow-up of patients ranged from 8 to 15 months (median 12.3). All patients remained clinically well. Conclusions: Balloon valvuloplasty of the pulmonary valve through the RV is a safe and feasible alternative to surgical valvotomy or percutaneous balloon dilation. Early results are encouraging. [ABSTRACT FROM AUTHOR]

Radix Bupleuri is a traditional Chinese herb frequently used in the prescriptions for the treatment of inflammatory diseases. This study was to determine whether the crude polysaccharides isolated from the roots of Bupleurum smithii var. parvifolium (BPs) had beneficial effects on a 'two-hit' acute lung injury model in rats. A two-hit lung injury model characterized by hemorrhagic shock followed by reperfusion and intratracheal lipopolysaccharide (1 mg kg) administration was established in Wistar rats. Drugs and saline were administered 30 min after the start of resuscitation. The two-hit acute lung injury model was successfully established. After oral administration, all BPs groups ameliorated pathological injury with lessened complement C3c deposit in lung. BPs 10 and 20 mg kg diminished the ratio of wet-to-dry weight. In bronchoalveolar lavage (BAL) fluids, the protein concentration, the leukocytes counts, and the lung myeloperoxidase were significantly reduced. BPs also mediated the decreases in interleukin-6 and tumor necrosis factor-α in BAL fluids and in sera. Furthermore, BPs 20 mg kg decreased the total complement hemolytic activity. BPs had beneficial effects on two-hit acute lung injury. The mechanisms of BPs on inflammatory disease might relate to its inhibitory effect on increased production of proinflammatory mediators and on overactivation of complement. [ABSTRACT FROM AUTHOR]

Aim of the study: Radix Bupleuri, one of the most frequently prescribed crude herbs in traditional Chinese medicine, has been used for centuries to treat inflammatory diseases. However, little is known about the therapeutic mechanisms of crude polysaccharides (BPs) isolated from the roots of Bupleurum smithii var. parvifolium. Macrophages play important roles in inflammatory diseases such as systemic lupus erythematosus (SLE). The purpose of the present work was to investigate immunomodulative effects of Bupleurum polysaccharides on murine peritoneal macrophages. Materials and methods: BALB/c mice were administered intragastrically with Bupleurum polysaccharides 20, 40, and 80mgkg−1 day−1, or prednisone 3mgkg−1 day−1 or levamisole 25mgkg−1 day−1 from day 0 to day 6. Peritoneal macrophages were isolated 5 days after intraperitoneal injection of 1mL 5% sodium thioglycollate. Phagocytic functions of macrophages were studied; cytokines concentrations in the culture supernatants were determined by enzyme-linked immunosorbent assay and the secretion of nitric oxide (NO) was quantified by Griess reaction. Results: Treatment with BPs enhanced phagocytic functions of macrophages (phagocytosis of apoptotic thymocytes, IgG-opsonized sheep red blood cells and chicken red blood cells) and inhibited LPS-induced productions of NO and proinflammatory cytokines (interleukin-1β, interleukin-6 and tumor necrosis factor-α). Conclusions: Bupleurum polysaccharides up-regulated phagocytic activities but inhibited LPS-induced productions of proinflammatory mediators. These data suggested that at least part of the traditional beneficial effects of Bupleurum on inflammatory diseases could be ascribed to the immunomodulatory effects of Bupleurum polysaccharides on macrophages. [Copyright &y& Elsevier]

Abstract: Seven new dibenzocyclooctane lignans, schisanwilsonins A–G (1–7), were isolated from the fruits of Schisandra wilsoniana, together with five known lignans (8–12). The structures of these new compounds were elucidated by spectroscopic methods including 2D-NMR techniques. The 12 lignans were tested for anti-hepatitis B virus (HBV) activity in vitro. Schisanwilsonin D (4), schisantherin C (9), deoxyschizandrin (10) and (+)-gomisin K3 (11) showed anti-HBV activity. 9 exhibited the most potent anti-HBV activity with potency against HBsAg and HBeAg secretion by 59.7% and 34.7%, respectively, at 50μg/mL. [Copyright &y& Elsevier]

Abstract: Aim of the study: Radix Bupleuri, is one of the most frequently prescribed crude herbs in the prescriptions of traditional Chinese medicine for the treatment of inflammatory diseases and auto-immune diseases. This study was to determine whether the crude polysaccharides (BPs) isolated from the roots of Bupleurum smithii var. parvifolium, had beneficial effects on autoimmune disease. Materials and methods: BALB/c mice were immunized with CJ-S131 in Freund''s complete adjuvant on day 0, and then boosted on day 14. BPs 15 or 30mgkg−1 day−1, or prednisone 5mgkg−1 day−1 was given to BALB/c mice intragastrically from day 0 to day 34. Results: Treatment with BPs 15 or 30mgkg−1 day−1 for 35 days protected kidney from glomerular injury with reduced immunoglobulin deposition and lowered proteinuria. The increased production of serum autoantibodies and total immunoglobulin G (IgG) was also inhibited. BPs 30mgkg−1 day−1 improved weight loss and spleen swelling when compared with vehicle-treated group. Conclusions: These findings suggested that Bupleurum polysaccharides had a beneficial effect on systemic lupus erythematosus-like syndroma induced by CJ-S131 in BALB/c mice. [Copyright &y& Elsevier]

Cimicifuga racemose is previously proved effective on nature menopausal syndrome (MPS). However, its clinical value in treating with MPS induced by luteinizing-hormone releasing hormone analogue (LHRH-a) therapy of pre-/peri-menopausal breast cancer patients is still unknown. This perspective randomised-design study is to investigate the effect and safety of cimicifuga racemosa on MPS induced by LHRH-a in breast cancer (clinical trial registered: NCT03339882). Breast cancer patients planning for LHRH-a treatment were randomly divided into 2 groups. The control group which was being treated with the standard treatment of LHRH-a. The other group was being treated with Remifemin, the commercialized product of cimicifuga racemose extract, combined with LHRH-a, called Remifemin group. Our main endpoint was Kupperman menopause index (KMI). Hormone levels in peripheral blood and gynecological complications were also evaluated. Totally, 85 patients (42 in Remifemin group and 43 in control group) were enrolled in Zhejiang Cancer Hospital. At the 4th, 8th and 12th week after using LHRH-a, the KMI were all significantly lower in Remifemin group than in control group (P < 0.01), while the hormone levels, including estradiol (E 2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were similar in the two groups. In addition, the incidence of cervical cyst in Remifemin group was higher than that in control group (P = 0.02), and there was no significant difference in the other gynecological complications, including endometrial thickening, ovarian cyst or uterine fibroid (P > 0.05). Cimicifuga racemose is effective, oncological safe and reliable for treatment of MPS caused by LHRH-a in breast cancer. Image 1 [ABSTRACT FROM AUTHOR]