Objective To compare the effect of emergency abdominal surgery and emergency endoscopic treatment of acute obstructive suppurative cholangitis stone.Methods A retrospective analysis of acute obstructive suppurative cholangitis stones were carried out within 30 cases.Among them,15 patients underwent emergency laparotomy choledocholithotomy + T-tube drainage,15 underwent routine emergency laparotomy choledocholithotomy + T tube drainage and cholecystectomy.Results All patients were successfully implemented treatment.In resection group,blood loss was (128.32 ±46.17) mL,with average length of stay (7.3 ±3.6) days.Blood loss was significantly higher than the amount retained (148.13 ± 2.07) mL(t =13.75,P ＜ 0.05) ; average length of stay (8.5 ± 2.9) days (t =8.73,P ＜ 0.05),the difference was statistically significant.Conclusion Emergency laparotomy choledocholithotomy + T tube drainage and cholecystectomy is not superior efficacy of emergency laparotomy choledocholithotomy + T tube drainage treatment.

Objective This study aimed to evaluate the relationships between preservation of the intercostobrachial(ICB) nerve and abnormal sensation of the arm,the total time of the surgery,and the number of dissected nodes in patients submitted to axillary lymphadenectomy in surgical treatment of breast cancer.Methods An prospective,randomized,and double blind intervention was performed on 85 patients at the Qinhuangdao Military Hospital in Hebei Province from July 2007 to August 2010.The patients according to whether the ICB nerve was preserved or not were randomly divided into two groups.The surgeries were performed by the same two surgeons.The postoperative evaluations were performed at 2 days,30 days,and 90 days.The abnormal sensation of the arm was subjectively evaluated with an questionnaire and objectively assessed with a neurologic examination.Results In the never preserved group,questionnaire found asymptomatic patients' proportion is up to 16/42,19/41,25/41 after 2 d,30 d and 90 d respectively; while in the resection group the result is 12/43,7/43,12/42.In the never preserved group,neurologic examination reported asymptomatic patients' proportion is up to 22/42,16/41,22/41 after 2 d,30 d and 90 d respectively; while in the resection group the result is 5/43,3/43,7/42.The results suggests that the abnormal sensation propotion in the intercostobrachial nerve preserved group is significantly less than the control group at the three above time points over (P ＜ 0.05).No significant difference was observed on the total time of the surgery and the number of dissected nodes between the two groups.During the 36 months follow up,no local relapse was found in the two groups.Conclusions The research support that the preservation of the ICB nerve is feasible and can lead to a significant decrease in the alteration of abnormal sensation of the arm,without interfering with the total time of the surgery,the number of dissected nodes,and local relapse rate.

Objective:To study the chemical components in the root of Asparagus cochinchinensis(Lour.)Merr.Methods:Chemical components of Asparagus cochinchinensis root were isolated by column chromatography on macroporous resin,Sil-gel,Sephadex LH-20,ODS,etc.and the structures of the components were identified by physiochemical and spectral analysis,such as MS,1HNMR,and 13CNMR.Results:The following 5 components were isolated and identified:diosgenin-3-O-?-D-glucopyranoside(Ⅰ),smilagenin(Ⅱ),26-O-?-D-glucopyranosyl-furost-3?,22,26-triol-3-O-?-D-glucopyranosyl(1→2)-O-?-D-glucopyranoside(Ⅲ),26-O-?-D-glucopyranosyl-furost-5,20-en-3?,2?,26-triol-3-O-\[?-?-rhamnopyranosyl(1→2)\]-\[?-?-rhamnopyranosyl-(1→4)\]-?-D-glucopyranoside(Ⅳ),and 26-O-?-D-glucopyranosyl-furost-3?,26-diol-22-methoxy-3-O-?-L-rhamnopyranosy(1→4)-O-?-D-glucopyranoside(Ⅴ).Conclusion:All the 5 compounds isolated from Asparagus cochinchinensis in this study is reported for the first time.

Objective To evaluate the results of less invasive surgical treatment of high energy tibial plateau fracture, which involves limited open reduction, percutaneous screw fixation and Hybrid external fixation. Methods From 1999 to 2002, 12 cases of high energy tibial plateau fracture were treated with Hybrid external fixation. They were 8 males and 4 females. According to Schatzker classification, there were 9 cases of Type Ⅴand 3 cases of Type Ⅵin the group. The average age of the patients was 39.3 years old (ranging from 27 to 48). Results All were followed up for an average of 15 months (ranging from 6 to 27). All the fractures got united, with an average healing time of 3.2 months. All patients achieved 0 to 5 degrees of extension and more than 100 degrees of flexion. The patients had an average knee score of 88.7 and an average functional score of 85.2(Knee Society clinical rating system). 1 case had infection of pin holes, and 2 knees had Grade 2 arthrosis at radiographic check up two years after the operation. Conclusion Hybrid external fixation combined with limited open reduction is appropriate for treatment of the complex tibial fractures, especially those with a poor soft tissue envelope.

Objective Unstable intertrochanteric hip fractures are characterized by comminution of the posteromedial cortex and a fragment of variable size containing the lesser trochanter. This paper is to discuss whether it is necessary to perform reduction and fixation for this fragment. Methods 67 cases of intertrochanteric fractures were treated by dynamic hip screw (DHS) fixation between March 2001 and September 2002 and followed up for a minimum of 1 year. Their treatment results were retrospectively analyzed. Results No nonunion, coxa vara or failure of internal fixation occurred in all these patients. Conclusion If DHS provides stability, screw fixation of the lesser trochanteric fragment is unnecessary.

Objective To compare the effect oropivacaine combined with fentanyl or sufentanil in labor anal-gesia.Methods 116 cases of maternal birth in obstetrics and gynecology were selected.According to the random number table method,116 cases of parturients were randomly divided into observation group (58 cases,received ropiv-acaine and sufentanil analgesia)and control group (received ropivacaine and fentanyl).In two groups of maternal anesthesia before induction (T0 ),used the drug after 30min(T1 ),60min(T2 ),180min(T3 )detection of the mean arterial pressure (MAP)and heart rate (HR),and digital evaluation table Rating Scale (NRS).The complications of maternal and infant in the two groups were recorded,the change of the mode of delivery and the Apgar score of neo-nates in the two groups were analyzed.Results There were no significant differences in the levels of MAP and HR between the two groups in T0-T3 (tMAP =0.123,1.078,0.212,0.047;P =0.903,0.283,0.832,0.963;tHR =0.033, 0.289,0.288,0.036;P =0.974,0.773,0.774,0.972).The NRS scores in T1 -T3 of the two groups were significantly lower than those in the T0;the T1 -T3 scores of the observation group were (2.21 ±0.36 )points,(1.78 ± 0.24)points,(1.83 ±0.25)points,which were significantly lower than (3.61 ±0.75)points,(3.22 ±0.12)points, (2.84 ±0.26)points of the control group(t =12.816,40.871,21.325,P =0.000,0.000,0.000).In the observation group,there was 0 case (0.00%)had cardiac arrhythmia,the control group had 4 cases (6.90%),and the differ-ence was statistically significant(χ2 =4.143,P =0.042).Two groups of labor analgesia,the way of delivery and birth of the newborn after birth,1min,5min of Apgar score were compared,the differences were not statistically significant (χ2 =0.703,t =0.631,1.149,P =0.402,0.530,0.253).Conclusion Ropivacaine combined with sufentanil or fentanyl in analgesia have no effect in childbirth and maternal vital signs and neonatal,and have good analgesic effect, but ropivacaine combined with sufentanil has stronger analgesic effect,higher safety.

Postoperative X-ray films showed that the fracture healing time was averagely 5.4 months. Al of the fractures were recovered wel that subtrochanteric fractures, intertrochanteric fractures and femoral shaft fractures were al healed. There was no fracture displacement, internal fixation loosening and varus deformity. Only one case showed difficulties in nail insertion. Excellence rate of Harris hip functional scores was 88.2%postoperatively. Proximal femoral nail antirotation is a reasonable design, and the helical blade can resist the rotation and stabilize the angle. The proximal femoral nail antirotation has better effects, which is an ideal internal fixation for subtrochanteric femoral fractures.

Objective:To evaluate p53,c erbB 2,p21 and nm23 oncoprotein expression in diagnosis and treatment of gastric cancer.Methods:The expression of p53,c erbB 2,p21 and nm23 oncoproteins was detected with immunohistochemical method in 63 surgically resected specimens and its endoscopic biopsy specimens of gastric cancer.Results:The positive rates of p53,c erbB 2,p21 and nm23 oncoprotein expression were 37 6%～46 2%,34 6%～56 8%,37 8%～61 5%,70 3%～30 8% respectively.Oncoprotein expression was not observed in non tumor endoscopic biopsy specimens.The expression of c erbB 2,p21 was correlated with grade of tumor differentiation and the expression of p21,nm23 oncoproteins was correlated with the depth of tumor invasion and clinical different stage,namely tumor metastasis.Positive rates of p53,c erbB 2,p21 and nm23 oncoproteins between biopsy and resected specimens was of coincidence.Conclusion:Determination of p53,c erbB 2,p21 and nm23 oncoprotein expression was might be useful in diagnosis and treatment of gastric cancer,differentiating benign and malignant tumor and clinical stages,of gastric cancer. [

Objective To prospectively assess the influence of intensity-modulated radiotherapy (IMRT) and conventional radiotherapy on quality of life (QOL) in patients with head and neck cancer (HNC) for clinical guidance. Methods From May 2007 to May 2008, 102 HNC patients were enrolled in this study. Fifty-two patients were treated with IMRT and 50 with conventional radiotherapy. In patients with IMRT, at least one parotid gland was spared, and the contralateral submandibular gland was spared in 24 patients. The parotid and submandibular gland were not spared in patient with conventional radiotherapy.QOL was assessed using EORTC QLQ C30 and HN35 questionnaires at 4 time points (before radiotherapy,end of radiotherapy, 2 months and 6 months after radiotherapy). A change of 10% in scores of the instru-ment range had been previously demonstrated to be clinically significant. Results In the study, 94% (31/33) of the QOL domains were worse after IMRT or conventional radiotherapy, including 49% (16/33) with significant difference (U=2.72-5.98, all values of P<0.01) and 33% (11/33) with clinical signifi-cance. At 2 months after radiotherapy, 12% (4/33) of the domains showed clinically significant improve-ment, however, 15% (5/33) of the domains did not show any improvement (U=3.10-5.93,all value of P < 0.01). Continuous improvement in most domains of QOL was shown at 6 months after radiotherapy. Clini-cally and statistically significant improvement were shown in 21% (7/33) of the domains, and some were even better than pretreatment except in dry mouth and sticky saliva scales (U=4.49 , P<0.01 and U=4.87 ,P <0.01). Compared with conventional radiotherapy, the dry mouth and sticky saliva caused by IM-RT were milder (U=4.57,P <0.01 and U=5.57, P < 0.01) and continuous improvement were shown over time after radiotherapy (U=7.23, P <0.01 and U = 7.57, P < 0.01). Similar improvement weren't shown in patients with conventional radiotherapy. Conclusions QOL in HNC patients is significant worse after ra-diotherapy. QOL can be improved continuously over time after treatment except dry mouth and sticky saliva which are the main factors affecting QOL. IMBT, causing less dry mouth and sticky saliva when compared with conventional radiotherapy, has benefits for the preservation of QOL.

OBJECTIVE: To study the effect of taspine hydrochloride (TA/HCl) on skin wound healing in rats and its mechanism. METHODS: Bilateral round wounds were made on the backs of SD rats. The effect of TA/HCl on the skin wound was evaluated through determining closure time and contracting ability of the skin wound, observing histopathological characteristics and measuring contents of hydroxyproline (Hyp) and protein in the wound tissue. RESULTS: The closure time of the skin wounds was significantly shorter in the TA/HCl-treated groups than that in the model group. The percentages of wound contraction were higher in the TA/HCl-treated groups than that in the dimethyl sulfoxide (DMSO) control group of the same group (P<0.05 or P<0.01) on the 3rd to 14th days after wounding. The content of the protein in the wound tissue in the TA/HCl-treated group (2 mg/ml) was higher than that in the model group (P<0.05) on the 3rd to 7th days after wounding, and it arrived at the peak on the 7th day and gradually decreased to the normal level in skin tissue on the 14th to 21st days after wounding. The contents of Hyp in the wound tissues in the TA/HCl-treated groups were higher than that in the model group (P<0.05 or P<0.015) on the 3rd to 21st days after wounding, and they arrived at the peak on the 14th day and at the normal level in skin tissue on the 21st day. Histopathological test results showed that TA/HCl could promote the formation of newly born capillaries in the early period of the wound healing. CONCLUSION: TA/HCl has the ability of promoting skin wound healing in rats, and it can also accelerate the growth of newly born capillaries and raise the production of protein and collagen in wound tissue.