Primary gallbladder carcinoma is a common biliary malignant tumor,with highly malignant,high mortality and poor prognosis.Its atypical clinical manifestation is often associated with cholecystitis and gallstone.Early diagnosis is very difficult.Laparoscopic cholecystectomy in clinical is popularity and cases of postoperative diagnosis of gallbladder cancer are gradually increasing.Therefore,how to improve the diagnosis of early gallbladder cancer, early treatment of gallbladder carcinoma has been to create concerns. Modern medical studies about the gene level and the biological behavior of gallbladder cancer, help to improve the early diagnosis of gallbladder cancer.In this article,the recent advances in research the genetic diagnosis of primary gallbladder carcinoma will be summarized.

Adult ; Disease Progression ; Facial Hemiatrophy ; complications ; diagnosis ; physiopathology ; Female ; Humans ; Keratoconus ; etiology ; physiopathology ; therapy

Objective To investigate the clinical efficacy of acupuncture and massotherapy for cerebral palsy-salivation. Method Forty-eight patients with infantile cerebral palsy were randomly allocated to two groups. The control group of 24 patients received acupoint application of Chinese herbal medicine and did the tongue exercises. The observation group of 24 patients received acupuncture and massotherapy in addition. Result Of the control group, five patients were assessed as grade Ⅰ, four patients as grade Ⅱ, 10 patients as grade Ⅲ, two patients as grade Ⅳ and three patients as grade Ⅴ in the TDS grading after treatment. Of the observation group, 10 patients were assessed as grade Ⅰ, seven patients as grade Ⅱ, four patients as grade Ⅲ, two patients as gradeⅣ and one patients as grade Ⅴ in the TDS grading after treatment. The TDS grading assessment was better in the observation group of patients than in the control group. After treatment, middle cerebral artery blood flow velocity and vessel pulsation index were (135.64±13.72)cm/s and (1.05±0.17), respectively, in the control group and (144.78±16.45)cm/s and (0.90±0.18), respectively, in the observation group. There was no statistically significant difference in speech training between the two groups (P>0.05). The number of independent eating patients was significantly larger in the observation group than in the control group; there was a statistically significant difference (P<0.05). Fine action, adaptive behavior and personal social behavior development levels were significantly higher in the observation group than in the control group; there was a statistically significant difference (P<0.05). Both groups of patients could tolerate the therapeutic dosage and course and had no severe adverse reactions. There was no statistically significant difference in safety grade between the two groups (P>0.05). Conclusion Acupuncture and massotherapy is safe and of a fair effect in treating cerebral palsy-salivation. It can increase cerebral blood flow, promote the contraction of local muscles, control salivation and improve the quality of life in cerebral palsy patients.

OBJECTIVE: Postpartum hemorrhage is most common cause of maternal mortality. Active management of third stage of labor minimizes the risk of postpartum hemorrhage. To compare the effect of methylergonovine and 15-methyl prostaglandin F2alpha (15-methyl PGF2alpha) in active management of third stage of labor. METHODS: A randomized open labelled parallel study with 50 women in normal labor, 25 in each group were included. The drugs methylergonovine (0.2 mg) intravenous and 15-methyl PGF2alpha (250 microg) intramuscular were administered at the time of delivery of anterior shoulder. Main outcomes measured were amount of blood loss during the first four hours of delivery and objective measurement of hemoglobin and hematocrit levels before delivery and third day postpartum. RESULTS: There was no statistically significant difference in the blood loss between the two groups at delivery (P = 0.130), at 1 hour of delivery (P = 0.453). The blood loss with 15-methyl PGF2alpha was significantly less as compared to that of blood loss with methylergonovine at four hours of delivery (P = 0.014) and the total, i.e., during first four hours, amount of blood loss was significantly less with 15-methyl PGF2alpha (P = 0.026). There was no statistically significant difference in the hemoglobin and hematocrit levels measured predelivery and postpartum third day between both the drugs. CONCLUSION: Both the drugs were effective in controlling the amount of blood loss during the third stage of labor, 15-methyl PGF2alpha being more efficacious.
Dinoprost ; Female ; Hematocrit ; Hemoglobins ; Humans ; Maternal Mortality ; Methylergonovine ; Postpartum Hemorrhage ; Postpartum Period ; Shoulder

Conventional corneal transplantation, in the form of penetrating keratoplasty (PK), involves full-thickness replacement of the cornea, and is a highly successful procedure. However, the cornea is anatomically a multi-layered structure. Pathology may only affect individual layers of the cornea, hence selective lamellar surgical replacement of only the diseased corneal layers whilst retaining unaffected layers represents a new paradigm shift in the field. Recent advancements in surgical techniques and instrumentation have resulted in several forms of manual, microkeratome and femto-second laser-assisted lamellar transplantation procedures. Anterior lamellar keratoplasty (ALK) aims at replacing only diseased or scarred corneal stroma, whilst retaining the unaffected corneal endothelial layer, thus obviating the risk of endothelial allograft rejection. Posterior lamellar keratoplasty/endothelial keratoplasty (PLK/EK) involves the replacement of the dysfunctional endothelial cell layer only. Whilst significant technical and surgical challenges are involved in performing lamellar micro-dissection of a tissue which is only 0.5 mm thick, the benefits of a more controlled surgical procedure and improved graft survival rates have resulted in a shift away from conventional PK. This review details the current advances in emerging lamellar corneal surgical procedures and highlights the main advantages and disadvantages of these new lamellar corneal procedures.
Contraindications ; Corneal Transplantation ; methods ; trends ; Humans

Objective To investigate the clinical value of laparoscopic totally extraperitoneal inguinal hernia repair.Methods One hundred and twenty patients who suffered from inguinal hernia were treated with laparoscopic totally extraperitoneal inguinal hernia repair.The operation time,wound pain,postoperative recovery of independent function,complications and recurrence rate were studied.Results One hundred and seventeen patients of inguinal hernia were performed the operation successfully,while 3 cases were converted to transabdominal preperitoneal prosthetic.Five cases of pneumoscrotum,were used in surgery to put the needle into the subcutaneous emphysema disappeared after the gas.The mean operative time 30-125 (46 ± 18) min,the postoperative stay was 2-7 (4.5 ± 1.2) d.The patients were postoperative follow-up for 1-22 months.All the patients without postoperative hydrocele,no postoperative recurrence.Conclusions Laparoscopic totally extraperitoneal inguinal hernia repair is safe with less complications,less invasive,low recurrence rate and excellent therapeutic effect and bilateral inguinal hemia repair at the same time.

Sclerosing stromal tumor is a rare ovarian tumor, occurring in young adults in the second and third decade of life. We report clinical and histopathological features of three cases of sclerosing stromal tumor of the ovary with a review of literature. The tumor has distinct histological features and is easily recognizable when a high index of suspicion is maintained in young patients presenting with an ovarian mass. These tumors are benign and can be treated successfully by enucleation or unilateral ovariotomy.
Female ; Humans ; Ovarian Neoplasms ; Ovary* ; Young Adult

A 23-year-old male presented with pulmonary tuberculosis and swelling of both lower limbs. He was put on antitubercular treatment. Hemogram showed mild anemia and Pseudo Pelger-huet cells. The bone marrow (BM) examination showed 52% promyelocytes with regular round to oval nuclei, few granules and were positive for CD13 and CD33, and negative for HLA-DR. Cytogenetic analysis of the BM aspirate revealed an apparently balanced t(11;17)(q23;q21). Final diagnosis rendered was acute promyelocytic leukemia (APL) with t(11;17)(q23;q21); ZBTB16/RARA. APL is a distinct subtype of acute myeloid leukemia. The variant APL with t(11;17)(q23;q21) cases that are associated with the ZBTB16/RARA fusion gene have been reported as being resistant to all-trans-retinoic acid (ATRA). Therefore, differential diagnosis of variant APL with t(11;17)(q23;q12) from classical APL with t(15;17)(q22;q12); PML-RARA is very important. Here we have discussed the importance of distinct morphology of variant APL and also significance of rare presentation with tuberculosis.
Anemia ; Bone Marrow ; Cytogenetic Analysis ; Diagnosis, Differential ; Granulocyte Precursor Cells ; HLA-DR Antigens ; Humans ; Leukemia, Myeloid, Acute ; Leukemia, Promyelocytic, Acute ; Lower Extremity ; Male ; Tretinoin ; Tuberculosis ; Tuberculosis, Pulmonary ; Young Adult

Pigmented villonodular synovitis (PVNS) is a rare benign condition that is locally aggressive and may destructively invade the surrounding soft tissues and bone causing functional loss of the joint and the limb. The knee is the most affected joint (range, 28% to 70%) but involvement of the bone is not a common feature seen at this site. We present a rare case of diffuse PVNS of the knee associated with subchondral cyst of the lateral femoral condyle. This posed a diagnostic dilemma because of bone invasion. The radiological image of synovitis was pathognomonic of PVNS but etiology of the osteolytic lesion was confirmed only on histopathology. The large osteochondral defect was eventually managed in a staged manner with bone grafting and osteochondral autograft transfer.
Autografts ; Bone Cysts ; Bone Transplantation ; Cartilage ; Extremities ; Joints ; Knee ; Synovitis ; Synovitis, Pigmented Villonodular