Objective To investigate the effectiveness of choledochoscopy and duodenoscopy in the treatment of residual calculus of the intrahepatic bile duct. Methods Clinical data of 573 cases of choledochoscopy and 36 cases of duodenoscopy from February 1985 to June 2004 were analyzed. Results Stones were completely removed under choledochoscope by way of T-tube sinus tract in 96.02% of patients (507/528) and by way of subcutaneous blind loop in 84.62% of patients (22/26). Percutaneous transhepatic choledochoscope placement was successfully conducted in 84.21% of patients (16/19) and stones were completely removed in 78.95% of the patients (15/19). The success rate of duodenoscopic cholangiography was 91.67% (33/36) and stones were completely removed under duodenoscope in 80.56% of patients (29/36). Conclusions Treatment of residual and recurrent calculus of the intrahepatic bile duct by choledochoscopy and duodenoscopy is effective and convenient.

The infrastructure of Liberia has been destroyed due to the prolonged civil war.In this situation,it's critical for the Medical Contingent to have a good self-communication to carry out medical support for the United Nations Mission in Liberia.The communication instruments,their management and maintenance are introduced in this paper.The communication support for large-scale movement is emphasized on.The methods for using effectively the restricted Internet connection are discussed in detail.To cope with the problems of poor communication between the Medical Contingent and homeland,an Internet connection system is put forward which is based on VSAT(very small aperture terminal)hardware platform and subscription of international Internet connection.The system is believed to be reliable,economical,flexible and convenient.

Objective To study the change of liver micro-circulation in liver cancer patients after interventional therapy by using CT perfusion imaging.MethodThe patients were dividecl into two groups: therapy group and control group.Each group had 30 patients.CT perfusion imaging scanning was done for the patients by using the Light speed 16 CT with the MSCT "Toggling-table" technology.The data was analyzed by single variance.The interested area of liver tissue was chosen as area without iodine after interventional therapy.The parameters of perfusion imaging were MTT,BF,BV,PS and HAF.ResultsSignificance of BF and BV existed in the liver tissue between therapy group and control group.The relatively normal liver tissue and the tissue in the same side had significance of BF,BV,MTT,PS in the two groups.In the therapy group,significance of BF,BV existed in the liver tissue of both side.ConclusionThe interventional therapy combined with Chinese traditional medicine can raise life quality of the patients,relieve the clinical symptom and improve the physical sign.The perfusion imaging of liver cancer,as a simple,rapid,no trauma methed,can supply the blood perfusion information of various positions as well as displaying anatomic details,which has provided a new kind of method for evaluating the effect of chemoembolization and traditional Chinese medicine.

BACKGROUND: It has been recognized that the traditional herbal treatment and daoyin exercises(physical and breathing exercise) can relieve the symptoms such as tiredness of cancer patients and strengthen the tolerance to chemical drugs. But the criterion of quantitative evaluation for the effect should be scientific.OBJECTIVE: To evaluate the influence of Chinese herb for strengthening the body resistance and daoyin exercises on the survival state of lung cancer patients with the evaluation scale of life quality.DESIGN: Non-randomized and concurrent controlled trial.SETTING: Department of Integrated Traditional Chinese and Western Medicine, Clinical Cancer Research Center, Guangzhou Medical College;Zhaoqing First People's Hospital.PARTICIPANTS: Totally 60 inpatients of the Department of Integrated Traditional Chinese and Western Medicine of Clinical Cancer Research Center of Guangzhou Medical College were enrolled from October 1997 to March 2001 in the study. All of them were volunteers. There were 41 males and 19 females, 30 patients in the treatment group and 30 in the control group.METHODS: The treatment group was given chemical therapy, at the same time, the herbal treatment and daoyin exercises. The control group was given chemical therapy only. The same chemical therapy was applied to both groups. The appointed doctor familiar with the evaluation table of quality of life was responsible for evaluating the quality of life of the patients in the two groups before and after treatment and the observation of their accomplishment of chemical therapy. The evaluation table of quality of life of Chinese lung cancer patients was used in the evaluation. The table included 5 factors: the physiological state caused by lung cancer, social/family state, relation of altitude towards doctor and disease, emotional state, and functional state. The statistical analysis was done to see the accomplishment of chemical therapy of two groups.chemical therapy of the two groups.RESULTS: According to the intention-to-treat analysis, 60 patients all completed the whole process of study. The comparison of the score before physiological state after treatment was obviously lower than that before treatment[ (14. 1 ± 3.2), (31.7 ±2.9) scores, P ＜ 0.01] and of control state was obviously higher than that before treatment[(25.2±3.1),(12.2 ±2.3)scores, P ＜0.01] and of control group[(19.1 ±2.2) scores,after treatment was obviously higher than that before treatment[ (37.4 ± 5.2),(24.2 ±3.5) scores, P ＜0. 01 ]and of control group[ (29. 1 ±3.4)scores, P before treatment[ (43.8 ± 5.6), (28.5 ± 4. 7) scores, P ＜ 0. 01 ] and of tional state after treatment was obviously higher than that of before treatment [(26.3±2.3), (17.3±3.3) scores, P ＜ 0.01] and of control group [ (20. 3 ± 1.1) scores, P ＜ 0. 05] . The accomplishment rate of chemical control group, 26 patients accomplished 1 course(87%, 26/30) and 18rate of 2 courses of chemical therapy of treatment group was obviously higher than that of control group ( P ＜ 0.05 ).CONCLUSION: The herbal treatment combined with daoyin exercises can improve the tolerance of lung cancer patients for chemical therapy and relieve the symptoms, thus improving their quality of life.

Objective To explore the predictive value of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level in anthracycline-based chemotherapy-related cardiotoxicity of breast cancers.Methods A total of 135 breast cancer patients was analyzed if NT-proBNP was associated with chemotherapy-related cardiotoxicity.The level of NT-proBNP in the diagnosis of cardiotoxicity was assessed.Results A total of 22 patients (16.29％) had subsequent claims for cardiotoxicity events.NT-proBNP in cardiotoxicity group was significantly higher than that non-cardiotoxicity group (P ＜ 0.05).According to receiver operating characteristic (ROC) curve, the cut-off value of NT-proBNP was set at 350 pg/ml, specificity and sensitivity were 70.32％ and 82.58％ , respectively.Positive and negative predictive values were 78.12％ and 65.45％, respectively.Conclusions The present study is to confirm excellent clinical value of NTproBNP on cardiotoxicity.The level of NT-proBNP for early detection of cardiotoxicity has good prospects for high risk patients.

Objective:To evaluate the curative effects of Masquelet technique and 3D printing in repair of Cierny-Mader type Ⅳ long bone osteomyelitis.Methods:A retrospective study was conducted of the 8 patients who had been treated at Department of Orthopaedics, The Third Affiliated Hospital to Peking University for Cierny-Mader type Ⅳ osteomyelitis of the lower extremity from June 2017 to December 2019. They were 6 males and 2 females, aged from 27 to 79 years (average, 54.6 years). The defects involved femoral shaft in 5 cases, femoral metaphysis in one, tibia shaft in one, and tibial metaphysis in one. The defect lengths ranged from 7.7 to 15.5 cm, averaging 10.2 cm. Stage one was local infection control and temporary stability reconstruction using Masquelet technique, stage two design and 3D printing of the prosthesis and stable pattern design, and stage three prosthesis implantation and rehabilitation. The ranges of motion of the knee and ankle were recoded postoperatively and the functions evaluated using the Johner-Wruhs scores.Results:The average follow-up time for the 8 patients was 12.6 months (from 6 to 18 months). The total treatment time from the first admission to the last discharge ranged from 62 to 125 days (average, 91.0 days), the time for stage one from 13 to 57 days (average, 28.7 days), that for stage two from 30 to 87 days(average, 48.3 d), and that for stage three from 28 to 84 days (average, 63.0 days). The infection was controlled and there was no recurrence, implant loosening or breakage. Seven patients were capable of full weight-bearing at 14.7 days (from 4 to 42 days) after surgery. One patient recovered full weight-bearing 6 months after surgery due to severe osteoporosis. Fine functional recovery was achieved in the 8 patients, with a range of motion from 0° to 100° for the knee and a range from 35° dorsal flexion to 40° toe flexion for the ankle. The Johner-Wruhs scores at the last follow-up showed 2 excellent, 5 good and one moderate cases.Conclusion:In repair of Cierny-Mader type Ⅳ long bone osteomyelitis, Masquelet technique and 3D printing can shorten the treatment process and allow for early recovery.

Objective To investigate the factors influencing the image quality of prostate magnetic resonance spectroscopy (MRS),and to put forward quality control measures to improve MRS in success ratio and image quality.Methods Totally 1 255 patients with prostate diseases confirmed pathologically from October 2009 to December 2015 had their MRS data analyzed retrospectively.MRS was executed with multi-voxel 3D chemical shift imaging technique,and special-purpose software was involved in for post processing.Re-scanning would be performed in case of baseline clutter,low SNR and etc.Results There were 1 218 patients had MRS executed well in preparedness,positioning,parameters setup,post processing,baseline and chemical shift,one patient underwent unsuccessful MRS due to incorrect bed mode,9 ones due to unstable baseline resulting from unsatisfactory preparedness,26 ones due to unstable baseline resulting from bad shimming and 1 case due to non-standard post processing.Conclusion Prostate SRS depends on patient preparedness,positioning,parameters setup,shimming and post processing.

Objective:To explore the clinical feasibility and effectiveness of using 3D printed porous titanium-alloy prosthesis to repair aseptic large bone defects in the limbs.Methods:A retrospective analysis was performed on 13 patients with aseptic bone defects of long limbs treated with 3D printed porous titanium alloy prosthesis from December 2017 to December 2022, including 7 males and 6 females, aged 52.6±11.5 years (range, 35-72 years). The bone defect locations included 2 humerus, 1 radius, 5 femur, and 6 tibia. One patient suffered both femoral and tibial defects. All 13 patients suffered from bone nonunion due to internal fixation surgery, including 5 cases of hypertrophic nonunion and 8 cases of atrophic nonunion. The interval between internal fixation surgery and this treatment was 20.1±3.6 months (range, 16.5-26.6 months). The clinical treatment effect was evaluated through parameters such as gross observation, imaging evaluation, disability of arm shoulder and hand (DASH), lower extremity functional scale (LEFS), and patient satisfaction evaluation.Results:The length of bone defect after debridement in 13 patients was 11.7±4.5 cm (range, 6.0-20.6 cm), and the length of implant was 12.9±5.3 cm (range, 6.1-22.9 cm). Partial or complete weight-bearing began at 14.8±6.5 days (range, 2-22 days) after surgery. All 13 cases were followed up for 18.3±12.5 months (range, 13-58 months). The X-ray images showed that the prosthesis and the internal fixation were stable, and the new bone gradually grew gradually from the bone defect section and formed stable bone integration with the prosthesis surface, and no prosthesis displacement or fracture occurred. At the last follow-up, the DASH scores of 3 patients with upper limb bone defect were 8.9, 10.5, and 11.2 points, respectively, and the LEFS scores of 10 patients with lower limb bone defect were 49.6±5.9 points (range, 38-56 points). No significant subsidence or loosening of all prosthetics was observed. Patient satisfaction was 9.8±0.1 points (range, 9.6-9.9).Conclusion:After the application of 3D printed porous titanium alloy prosthesis to repair the aseptic large bone defect of the limbs, the patients can carry weight and function exercise in the early stage, and the function of the affected limbs can recover significantly, and the patients have high satisfaction.

BACKGROUND:Currently, neural stem celltransplantation can be performed through three main approaches:local lesions, blood circulation, and cerebrospinal fluid.
OBJECTIVE:To review the transplantation of neural stem cells or neural precursor cells via the cerebrospinal fluid in the treatment of central nervous system diseases.
METHODS:A computer-based search of PubMed and CHKD databases was performed to retrieve articles concerning transplantation of neural stem cells via the cerebrospinal fluid, and its application and therapeutic mechanism in the treatment of central nervous system diseases in both animal experiment and clinic study published from 2000 to 2009.
RESULTS AND CONCLUSION:It is suitable for neural stem cellsurvival, proliferation, and differentiation in the cerebrospinal fluid. Transplantation of neural stem cells via the cerebrospinal fluid is effective and feasible to treat central nervous system diseases. However, some problems have not been solved, such as the source of neural stem cells, the optimal time window and celldose, the safety and the long-term effect. Further studies are needed to pave the way for the intrathecal injection of neural stem cells in the treatment of central nervous system diseases.

Treatment of extremity bone defects,especially large segmental ones,is a difficult problem encountered by orthopedic surgeons in the clinic.Despite a variety of treatment techniques available,lack of uniform protocols causes patients to suffer enormous physical and psychological pain during their medical treatment.Now that new materials and new techniques are constantly evolving and patients' requirements for functional and morphological recovery of the injured limb become more demanding,it has become a great challenge for orthopedic surgeons to provide an optimal individualized treatment protocol for each patient.This review intends to help surgeons with brief update information on the research progress in the treatment of extremity bone defects.