Objective:To study the effects of somatostatin on portal pressure and operative complications in patients of portal hypertension treated with porta-azygous disconnection. Methods:Twenty patients with portal hypertension were treated with azygoportal disconnection. The severity of liver disease according to the Child-Pugh's grade was B in all patients. The patients were divided into two groups. The patients in group A were treated with intravenous infusion of somatostatin (6 mg/24 h) one day before operation and five days after operation. The patients in group B were treated with azygoportal disconnection without the use of somatostatin. The portal pressure, the volume of bleeding during operation, and the ascites and complications after operation were evaluated. The serum concentration of GLU, NO and ET-1 were determined. Results:The portal pressure and GLU concentration in patients of group A were lower than those in patients of group B. There were no differences of NO, ET-1 in patients between group A and group B. The volume of bleeding, ascites and complications in patients of group B were higher than in patients of group A. Conclusion:The use of somatostatin before and after porta-azygous disconnection can decrease portal pressure. It is beneficial in reducing the volume of bleeding in operation, ascites and complications after operation.

The common therapy of colorectal cancer is FOLFOX scheme,which contains flurouracil,leucovorin and oxaliplatin.Numerous clinical trials have demonstrated that bevacizumab combined with FOLFOX scheme in cancer's therapy is safe and effective.But the adverse reactions including hypertension,neurovirulence,gastrointestinal bleeding and perforation are raised up.Scholars have carried out a series of studies for the overall survival times,tumor response rates and survival qualities for the patients with metastatic colorectal cancer which using the joint scheme,but they draw different conclusions the usefulness and safety of the joint scheme still need more RCT and meta-ananlysis to be proved.

Objective The objective of this study was to explore the difference factors for PHC patients by transcatheter arterial chemoembolization of different age groups of senior people in China and support reference for individualized intervention by clinical medical workers.Methods 153 cases of PHC patients by TACE were selected by convenience sampling method from October 2013 to June 2014.The data were collected using general data questionnaire,Health Promotion Strategy Scale,QOL-LC,Memorial Symptom Assessment Scales and Social Support Scale to evaluate the physical,psychological and social aspects of the PHC patients.We divided the patients into young,middle-aged and elderly groups.Single factor and multiple factors regression analysis were used to compare the status and influencing factors.Results Psychological function,value of blood AFP,marital status entered the model and were self-care efficacy and correlated factors of young-aged patients,which could explain 50.6％ of the total varience.Physical symptoms,exploitation degree of support and intervention treatment times entered the model and were self-care efficacy and correlated factors of middle-aged patients,which could explain 47.8％ of the total varience.Symptom distress,degree of cuhural and psychological function entered the model and were self-care efficacy and correlated factors of elderly-aged patients,which could explain 42.4％ of the total varience.Conclusions The self-care efficacy were low in all ages of PHC patients by TACE,it is associated with a variety of factors.Doctors and nurses should pay more attention to the self-care efficacy for PHC patients by transcatheter arterial chemoembolization with different age groups.Also we should evaluate and make well-targeted policies and personalized inter-ventions to promote self-management self-efficacy.

OBJECTIVETo explore the effects of warm needling combined with Zhangmo decoction (see text) on endometrial receptivity in patients with clomiphene (CC)-induced ovulation.

METHODSOne hundred and sixty cases were randomly divided into a CC group (group A), a CC+ progynova group (group B), a CC+ Zhangmo decoction group (group C) and a CC+ Zhangmo decoction + warm needling group (group D), 40 cases in each one. In the Group A, CC alone was applied. In the group B, progynova was jointly used on the 8th day of menstrual cycle. In the Group C, Zhangmo decoction was jointly used on the 5th day of menstrual cycle. In the group D, based on treatment of the Zhangmo decoction, warm needling was applied at Guanyuan (CV 4), Zhongji (CV 3) and Zigong (EX-CA 1) etc. The endometrial thickness and type, pulsatility index (PI), resistance index (RI), ratio of S/D on day of human chorionic gonadotropin (HCG) and pregnancy rate were observed in fou groups.

RESULTSThe PI, RI and S/D in the group C and D were obviously lower than those in group A and B (all P < 0.01). The endometrial thickness was (7.7 +/- 1.49) mm in group B, (8.2 +/- 1.54) mm in group C and (8.9 +/- 1.51) mm in group D, which were significantly different from (6.4 5 +/- 1.26) mm in the group A (all P < 0.01) also there was a significant difference between group C and D (P < 0.05). The rate of endometrial type A was 65.0% in the group D, which was significantly higer than 27.5% in the group A, 32.5% in the group B and 35.0% in the group C (all P < 0.01). The pregnancy rate was 30.0% in the group D, which was obviously higher than 12.5% in the group A, 15.0% in the group B and 17.5% in the group C (P < 0.05). The endometrial thickness and rate of endometrial type A in the pregnant were obviously higher than those in the non-pregnant (both P < 0.01) while PI, RI and S/D was lower than those in the non-pregnant (P < 0.01, P < 0.05).

CONCLUSIONWarm needing combined with Zhangmo decoction could improve endometrial thickness, morphology and uterine spiral artery to improve pregnancy rate, which has superior effect to clomiphene, clomiphene combined with progynova and clomiphene combined with Zhangmo decoction.

Chorionic Gonadotropin ; metabolism ; Clomiphene ; administration & dosage ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; drug therapy ; metabolism ; physiopathology ; therapy ; Ovulation Induction ; Pregnancy

ObjectiveTo investigate the roles of Toll-like receptor (TLR) 3 and 9 in herpes zoster (HZ).Methods Venous blood samples were collected from 40 patients with HZ and 16 normal human controls. Flow cyometrywas usedto detect the expressionsof TLR3and TLR9inperipheralblood mononuclear cells(PBMCs) from these subjects.ResultsThe percentages of PBMCs expressing TLR3 and TLR9 were significantly higher in patients than in normal human controls(both P ＜ 0.01).The expression levels of TLR3 and TLR9 in PBMCs were negatively correlated with the age of onset(r =-6.23,-5.88respectively,both P ＜ 0.01 ),but uncorrelated with gender or age.There was a significant difference in the expression levels of TLR3 and TLR9 in PBMCs between different age groups ( ＜ 40 years,40-50 years,＞ 50 years) of patients with HZ(F =3.410,P ＜ 0.01 ),with the strongest expression observed in patients younger than 40 years.ConclusionTLR3 and TLR9 may participate in the pathogenesis of HZ.

Objective To investigate the characteristics and prevention of deep fungal infection (DFI) complicated by severe acute pancreatitis (SAP). Methods Clinical data of 135 SAP cases admitted from Oct. 1998 to Oct. 2009 were studied, the prevention and management of SAP with DFI ( 32cases) were investigated, among them there were 19 males and 13 females. Results Seven patients (21.9%) died of these 32 cases. The SAP patients with DFI were of more critical condition, longer course and having to stay in ICU about (21±6) d, most needed surgical debridement, on long-term indwelling catheters, intubation and mechanical ventilation, parenteral nutrition, long-term use of broad-spectrum antibiotics. These patients remained in the hospital for about (78 ± 14) d. Conclusions DFI is a common complication in SAP cases causing a significant mortality hence necessitating comprehensive prevention and control measures such as proper handling of the original disease, aseptic operation, prophylactic antibiotics and antifungal agents, which can reduce the incidence and mortality of SAP with DFI.

Objective To investigate esophageal response to intraesophageal balloon-distention and acid perfusion stimuli and to evaluate the visceral hypersensitivity in non erosive reflux disease (NERD) patients.Methods Thirty-one NERD patients diagnosed by reflux disease questionnaire (RDQ) and endoscopy and 10 control subjects were enrolled in this study.Esophageal mechanical sensitivity was measured by esophageal barostat and recorded as initial perception threshold and maximal tolerated pain threshold by volume.The chemical sensitivity was measured by acid perfusion test,and quantified by two parameters (trigger time and acid related symptom score).Results Initial perception threshold and maximally tolerated pain threshold of NERD patients was (9.6?4.8) ml and (12.3?3.2) ml, significantly lower than those of controls,(13.2?7.5) ml and (21.6?5.7) ml,respectively (P

Solitary fibroma often occurs in the pleura, but rarely outside the pleura. Extrapleural solitary fibroma has atypical clinical symptoms and difficult imaging diagnosis. Here, we report a case of solitary fibroma recurred and metastasized to the bladder after pelvic surgery. He was treated with palliative resection in our hospital. The patient died of systemic metastasis 3 years after operation.

Objective Knowing the BRCA gene mutational condition of high risk triple negative breast cancer (TNBC) in Xinjiang Uygur Autonomous and acquiring the differences of clinical and pathologic characteristics between person with BRCA gene mutation and person without it by means of BRCA gene mutation testing for 30 cases of TNBC in Xinjiang Uygur Autonomous.Methods The objects of this study were 30 cases of high risk TNBC from Xinjiang.All the coded sequences of BRCA1/2 gene were amplified by means of extracting genomic DNA from peripheral venous blood.BRCA1/2 gene mutation analysis were prescreened through DHPLC.Then,the result was verified by DNA sequencing.The clinical and pathologic characteristics between person with BRCA gene mutation and person without it of 30 high risk TNBC cases were contrastively analysed.Results In all the 30 cases of BRCA gene mutation testing for TNBC in Xinjiang Uygur Autonomous,there were 5 cases of pathogenic mutations of BRCA gene (5/30,16.7 ％); 4 cases of BRCA 1 mutation (4/30,13.3 ％); 1 case of BRCA 2 mutation (1/30,3.3 ％); and there was no mutation to be found in 25 cases of BRCA gene of TNBC (25/30,83.3 ％).As compared with person without gene mutation,who with it had the characteristics of earlier of TNM,the difference was statistically significant (P =0.040).Conclusion Since the rate of BRCA1 gene mutation of high risk TNBC is higher.It is suggested that the BRCA gene of every patients with high risk TNBC should be tested.Comparing with person with BRCA gene mutation and person without it,there might have differences on clinical pathological characteristics features.Therefor,individualized treatment should be taken into consideration.

With the development of optics and mechanics, endoscopic technologies are not only used as a simple diagnostic method, but also applied in therapy. Since the beginning of the 21st century, minimally invasive medicine has become the development trend. Many novel technologies have appeared, such as endoscopic mucosal resection, endoscopic submucosal dissection, and peroral endoscopic myotomy. Esophageal motility disorders are common diseases in clinic, which seriously affect the quality of life. Although esophageal manometry is the golden diagnostic standard, endoscopy also plays an important role in diagnosis. There are many therapeutic methods in achalasia and gastroesophageal reflux diseases with good efficacy, while the therapy in other esophageal motility disorders remains in dispute. According to the domestic and foreign research progressions, we introduce the role of endoscopy in the diagnosis and management of esophageal motility disorders.
Endoscopy, Digestive System ; Esophageal Motility Disorders ; diagnosis ; surgery ; Humans