To find an ideal surgical therapy for duodenal bulb macroulcer which can replace the conventional Billroth Ⅱ procedure and reduce the rate of long term complication.Methods:Forty nine patients with duodental bulb macroulcer were operated by subtotal gastrectomy and gastroduodenal end to side anastomosis.Results:One patient bleeded on the seventh operative day,because of the blood vessel's ligature sheded at the submucous of the lesser curvature of stomach,the others recoveried satisfactoryly.Bilirubin assay in the gastric juice,was negative and pH scale rose from 2.7?0 5 to 5.2?0 4. Barium meal examination showed that the"Reproduced Pyloruses"had satisfactory function of evacuation control.Conclusion: This procedure accords with normal physiolagical channel.It has satisfactory function of evacuation control and anti reflux.There is no afferent influent loop syndrome or posterior anastomotic stoma space.It is easily operated,safy and reliably.

BACKGROUND:Among various seed cel s, synovial mesenchymal stem cel s have unique advantages in the repair of articular cartilage injury. OBJECTIVE:To review the progress of synovial mesenchymal stem cel s and its intra-articular injection in the treatment of articular cartilage injury. METHODS:The first author searched PubMed and CNKI by computer to retrieve articles published from January 2004 to December 2004 using the keywords of“synovial mesenchymal stem cel s;intra-articular injection;cartilage repair”in English and Chinese, respectively. Final y, 57 articles were included in result analysis. RESULTS AND CONCLUSION:It is easy to isolate and culture synovial mesenchymal stem cel s, which has great advantages in cartilage repair. What’s more, intra-articular injection therapy for articular cartilage injury is feasible and safe. Intra-articular injection of synovial mesenchymal stem cel s is a very promising treatment for cartilage damage, but there are stil many problems to be solved in the future.

Objective To investigate the radiographic characteristics of degenerative lumbar scoliosis (DLS) and its relationship to osteoporosis. Methods 229 cases (83 males, 146 females) of DLS from January 1998 to June 2005 were reviewed. The mean age was 56.8 years (ranged from 40 to 74 years). The Cobb angle and vertebral stability in coronal plane were measured in anteroposterior radiographs and the changes of lordosis in sagittal plane were observed in lateral radiographs. The bone mineral density(BMD) and T-Score of lumbar spine (L2-L4) were measured using Dual Energy X-ray Absorptiometry. Results The mean Cobb angle is 9.45??4.79?, 151 cases(66%) with the angle less than 10?, 60 cases (26%) with 10?-20?, and 18 cases (8%) with more than 20?. Right side scoliosis were found in 52% (120 cases), left side in 48% (109 cases). 159 cases (69%) companied with gradeⅠ(Nash-Moe) vertebra rotation, 54 cases (24%) with grade Ⅱ. And the vertebra rotation was most evident on scoliosis apex. There were 20 cases (9%) with more than 4 mm lateral translation between the lumbar vertebrae which were usually the apex vertebrae with the most degenerative changes. The physical lordosis decreased in most cases in which 16 cases (7%) developed lumbar or thoracolumbar kyphosis. And the kyphosis degree was not relevant to scoliosis Cobb angle. The mean T-Score of BMD measurement was -1.88?0.17, which was -1.49?0.14, -2.56?0.24, -2.89?0.50 for the groups of with Cobb angle 20? respectively. There were 153 cases (67%) with T10?), and 98 cases (43%) with T

Objective To investigate the effects of transforming growth factor-?1(TGF-?1), fibroblast growth factor-2 (FGF-2), platelet derived growth factor-bb(PDGF-bb) and hepatocyte growth factor(HGF) on adult human articular chondrocytes(AHAC) proliferation and phenotype maintaining. Methods Isolated AHAC were cultured in DMEM/F-12 supplemented with 10% human AB serum, 50 ?g/ml ascorbic acid-2-phosphate, 0.4 mmol/L proline, 5 ?g/ml insulin and 1 mmol/L non-essential amino acids (NEAA). The cells of 2nd passage were used for proliferation kinetics studying: 2.0?103 cells/well were seeded on 96-well plate, 24 h later, the cells were stimulated with various growth factors or combinations of these growth factors respectively, and the proliferation kinetics were analyzed by MTT colorimetric method. The passaged chondrocytes' phenotype were assessed by safranine O staining and immunostaining for type Ⅰ,Ⅱcollagens and aggrecan. Results All four growth factors: FGF-2, TGF-?1, PDGF-bb and HGF, could promote the proliferation of AHAC, and the optimal concentrations,when used separately, were 50 ng/ml, 1 ng/ml, 1 ng/ml, 20 ng/ml respectively. While 5 ng/ml FGF-2 combined with 1 ng/ml TGF-?1 could achieve the best proliferation effect, additionally adding PDGF-bb, HGF or both could not enhance more. With the combination of FGF-2 and TGF-?1, the AHAC could expand over 2000-fold and passage over 10 times. Chondrocytes of 9th passage still excreted type Ⅱcollagen and glycosaminoglycan(GAG). Conclusion 5 ng/ml FGF-2 combined with 1 ng/ml TGF-?1 is a very appropriated circumstance for in vitro expanding of AHAC.

Objective To investigate the pathological change in articular cartilages after firearm injury.Methods Four rabbits from 28 New Zealand healthy rabbits were chosen as control group and subjected to joint capsule incision only. Another 24 rabbits were equally divided into 6 experimental groups( groups B to G) and subjected to medial femoral condyle cartilage surface damage by the nail gun.After the operation, their specimens were collected after 6 h,3 d,7 d,14 d,28 d and 56 d, respectively.Tissue sections were observed and stained by HE staining and toluidine blue staining.The histolopathological changes in articular cartilage after firearm injury were detected.Results The color of articular cartilages in experimental groups became lighter, the cell number increased but then decreased, the articular cartilage layer disappeared, the cell shape became uneven, cells began to cluster and the Mankin score increased, and the statistical differences between experimental groups and control group were significant.Conclusion The histological pathological changes in articular cartilages after fiream injury seem to follow some pattern.The degeneration seems obvious after 7 days and then becomes heavier.

Objective To assess the quality of life(QOL) in rheumatoid arthritis(RA) patients treated with 12weeks of aerobic exercise(AE) plus medication(methotrexate, MTX, and NSAIDs). Methods The research design was a randomized controlled trial. The patients in AE group received AE plus MTX and NSAIDs, and the patients in the control group received drug therapy only. Results One hundred and twenty six patients completed the trial, AE patients with improvement of 12%～28% from the baseline were better than medicine treated patients in the physical, social, emotional function, self recognized health status and total QOL. Conclusion AE is effective for the patients with RA in the improvement of QOL.

Objective To observe the effects of instant hyperbaric oxygen (HBO) therapy on brain edema and aquaporin-4 (AQP4) expression after cerebral ischemia in rats. Methods 18 healthy adult male Sprague-Dawley rats were randomly divided into sham group (n=6),control group (n=6) and HBO group (n=6). Middle cerebral artery occlusion model was established with modified Longa method in the control group and HBO group. HBO was administered after cerebral ischemia immediately in HBO group for 60 min. They were observed with the neurological function score, brain tissue water content and AQP4 experssion 6 h after operation. Results Compared with the control group, the neurological score in HBO group improved significantly (P<0.05), while the brain tissue water content and brain AQP4 expression decreased (P<0.05). Conclusion HBO may improve the neurological function and brain edema after cerebral ischemia, which may relate with inhibiting the expression of AQP4.

Objective To observe the clinical effect of Xiaoke-Yuzu decoction on diabetic peripheral neuropathy (DPN). Methods A total of 100 DPN inpatients were recruited and randomly divided into the treatment and control groups. The two groups were both received basic therapy, while the treatment group additionally received Xiaoke-Yuzu decoction. Toronto clinical scores and Chinese medicine symptom scores of both groups were collected to evaluate the clinical effect before and after the therapy. Results The Toronto scores of treatment group were significantly lower than control group after treatment (symptoms score 1.50 ± 0.94 vs. 2.23 ± 1.01, reflection score 3.60 ± 1.77 vs. 4.27 ± 1.72, feeling test score 1.53 ± 0.63 vs. 2.10 ± 0.84,all P<0.05). Meanwhile, the Chinese medicine symptom scores of treatment group were also significantly lower than the control group (main symptom score 1.77 ± 1.17 vs. 3.17 ± 1.82, posterior symptom score 2.23 ± 1.59 vs. 4.27 ± 1.57, the tongue and pulse score 1.83 ± 0.65 vs. 2.47 ± 0.51, all P<0.05). Conclusion Xiaoke-Yuzu decoction plus basic therpy could improve the clinical symptoms of DPN patients.

ObjectiveTo study the different clinical effects of using 5 kinds of hemostatic surgeries to manage the intractable postpartum hemorrhage and analyse the risk factors of failed hemostasis.Methods From Jan.2007 to Jul.2011,96 patients with intractable postpartum hemorrhage were studied retrospectively and grouped by the first step surgical treatment.The hemostatic surgeries included uterine tamponade (tamponadegroup ), pelvicbloodvessels ligation(ligationgroup), pelvical arterial embolization (embolization group), uterine compression sutures (sutures group)and uterine compression sutures combining tamponade (combined group).The intraoperative and postoperation datum were compared among groups,so dose the treatment outcomes.Multivariate analysis were used for failed hemostasis.Results( 1 ) The blood loss of 96 patients ranged from 1200 to 9100 ml,and 71 patients had a succeed hemoatasis after employing these surgeries and 25 failed.(2) The blood loss before hemostasis surgeries in tamponade group and embolization group was statisically greater than in sutures group ( P ＜ 0.05 ).Blood loss during the hemostasis surgeries in ligation group was statistically greater than in embolization and sutures groups ( P ＜0.05).The operating time of embolization group was statistically shorter than ligation group,sutures group and the combined group (P ＜ 0.05 ).(3) Fine of 96 patients had uterine atony and 43 had a successful hemostasis with the success rate about 78％.Forty-six had placenta previa and 39 success with success rate 85％.Thirty-three had placenta accrete and 13 of which succeed in hemostasis with success rate about 39％.In patients with uterine atony and placenta previa,the difference of hemostasis rate in groups had no statistically significant ( P ＞ 0.05 ).In patients with placenta accrete,the hemostasis rate in embolization group was higher than in others groups (P ＜ 0.01 ). (4) The multivariate analysis found that scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemotasis.The OR value respectively was 2.9 (95 ％ CI:1.1 - 7.6 ),17.9 ( 95 ％ CI:5.6 - 56.3 ) and 16.2 ( 95 ％ CI:3.2 - 83.5 ).Embolization had some extent of protective effection ( OR =0.9,95 ％ CI:0.8 - 0.9 ).Conclusions ( 1 ) Five kinds of hemostatic surgeries were all effective.Though the success rate among groups did show statistical difference,pelvical arterial embolization has the comparative advantage of shorter operating time,less operating blood loss and higher success rate in placenta accrete.(2) Since scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemostasis,sufficient preparation should be made for patients with these risk factors and the hemostatic surgeries should be choosed individually.

Objective:To compare the clinical effects of ultrasound-guided intra-articular and coracohumeral ligament glucocorticoid injections versus ultrasound-guided intra-articular glucocorticoid injections alone on frozen shoulder in the elderly.Methods:A total of 44 patients with frozen shoulder admitted to the rehabilitation department of the Affiliated Hospital of Sichuan Nursing Vocational College from September 2019 to June 2020 were enrolled.They were randomly divided into the experimental group and the control group, with 22 patients in each group.The experimental group received two consecutive ultrasound-guided intra-articular injections and two coracohumeral ligament injections, while the control group received two consecutive ultrasound-guided intra-articular injections.The shoulder's passive range-of-motion(PROM), the 11-point numeric rating scale(NRS)as well as the Shoulder Pain and Disability Index(SPADI)were conducted before treatment, 1 week after the first treatment(1 week), 1 week after the second treatment(2 weeks)and 10 weeks after the second treatment(12 weeks).Results:There was no significant difference in baseline characteristics between the two groups(all P>0.05). Flexion, abduction, extension and external rotation increased whereas NRS and SPADI decreased after treatment, compared with pre-treatment in the experimental group( F=11.341, 20.965, 20.403, 32.470, 82.970 and 102.154, all P<0.05)and in the control group( F=7.012, 8.937, 23.265, 31.966, 52.500 and 41.356, all P<0.05). Compared with the control group, extension( t=0.365, 0.143 and 0.236, all P<0.05)and external rotation( t=0.205, 0.620 and 2.751, all P<0.05)increased at 1, 2 and 12 weeks after treatment.SPADI scores were lower in the experimental group than in the control group at 12 weeks after treatment( t=2.063, P=0.045). There was no significant difference in NRS, flexion or abduction between the two groups at any time point after treatment(all P>0.05). No serious adverse reactions occurred during treatment in either group. Conclusions:Both ultrasound-guided intra-articular injections plus coracohumeral ligament injections and ultrasound-guided intra-articular injections can effectively alleviate pain and improve function in elderly patients with frozen shoulder, but the former has better effects on extension.For patients with clear restricted extension and external rotation, ultrasound-guided intra-articular injections combined with coracohumeral ligament injections may achieve better clinical effects.