OBJECTIVE: To investigate the clinical features of primary biliary cirrhosis (PBC) and its treatment by integrated traditional Chinese and western medicine. METHODS: 16 PBC patients were observed. Ursodeoxycholic acid (UDCA) was used in the dose of 13 to 15 mg.kg(-1).d(-1), with some traditional Chinese herb prescription. Results (1) The proportion of women to men was 15:1, the mean age was 52.5 years. AMA-M2 was positive in 14 subjects (87.5%). Biliary tract enzymes and ESR were elevated in all subjects. The ratio of hypercholesterolemia (CHOL) and abnormality in IgM was high (62.5%). Fatigue, pruritus, arthralgia, jaundice, splenomegaly were noted in more than half cases. Every patient had one to four complications. (2) ALP, GGT and Glb declined evidently after 3 months' treatment by western medicine associated with traditional Chinese medicine, and declined markedly after 12 months' treatment (P<0.05 respectively). TBIL and CHOL declined gradually during the treatment course. Symptoms and signs were lightened. CONCLUSION: PBC has complicated and especial clinical features. UDCA therapy is effective in PBC, while traditional Chinese medicine has extraordinary effect in treating the symptoms and signs.

Objective To investigate the surgical methods for thyroid microcarcinoma (TMC) and prevention of recurrent laryngeal nerve injury. Methods We retrospectively analyzed 238 TMC patients during the January 2006 to December 2013 in 309 Hospital of PLA. All the 238 patients had no clinical symptoms and the diagnosis was made by thyroid ultrasound. Thyroid ultrasound exhibited very small nodules (<1cm). At preoperation, 84 patients received fine needle aspiration (FNA). Among the 84 patients, 72 were diagnosed with TMC and 12 were false-negative for TMC by FNA. The remaining was proved by postoperative pathological examination. All of these 238 cases, 144 were of unilateral and solitary, 46 unilateral and multiple, and the remaining 48 multiple unilateral. Results Ninety-seven patients were operated for affected side and isthmus resection plus contralateral subtotal resection, 56 for affected side plus isthmus resection, 23 for bilateral thyroid resection, 62 for bilateral thyroid subtotal resection. 132 patients underwent cervical lymph node dissection and the remaining 106 did not. During operation, the recurrent laryngeal nerve was exposed in 122 patients, involving a total of 182 recurrent laryngeal nerves. In the postoperative period (1–7 years), 6 cases of recurrent and 6 cases of laryngeal nerve injury were found. Conclusions High-intensity focused ultrasound (HIFU) is an important method for diagnosis of TMC. FNA is the most reliable procedure for preoperative determination of the nature of thyroid nodule. Finally, the reasonable and effective surgery is the key to optimize the long-term therapeutic effect and reduce side-effects. During thyroid surgery, to expose and protect recurrent laryngeal nerve is the best means for preventing injury to the recurrent laryngeal nerve.

Objective To compare the long term therapeutic effects of the preoperative regional arterial infusion chemotherapy and the preoperative systemic venous chemotherapy in advanced breast cancer. Methods One hundred and eighty-six patients with advanced breast cancer, admitted to the Department of General Surgery of PLA 309 Hospital from Jan. 2003 to Dec. 2008, were followed up for a long time. Of them 97 patients received preoperative regional arterial infusion chemotherapy (IAIC groups), and 89 patients received preoperative systemic vein chemotherapy (IVIC groups). The local recurrence rate, distant metastasis rate, overall survival rate (OS) and disease free survival rate (DFS) in the two groups were statistically analyzed, and the long term therapeutic effects of the two groups were compared. Results There were no statistically significant difference in distant metastasis rate (15.5% and14.6%), 1-year OS (99.0% and 96.6%) and DFS (81.8% and 68.5%), and 3-year OS (88.7% and 79.8%) between the two groups (P>0.05). While significant differences were found between the two groups (P<0.01) in post-operative local recurrence rate (7.2% and 18.0%), 3-year DFS (70.1% and 52.8%), and 5-year OS and DFS. Conclusion Compared with preoperative systemic venous chemotherapy, pre-operative regional arterial infusion chemotherapy can decrease the local recurrence rate, improve the 5-year total survival rate and disease free survival rate for advanced breast cancer.

Actins ; metabolism ; Adult ; Amputation ; Arthroplasty, Replacement, Knee ; Bone Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Calmodulin-Binding Proteins ; metabolism ; Humans ; Leiomyosarcoma ; diagnosis ; metabolism ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Radiography ; Tibia ; diagnostic imaging ; surgery

Acute Disease ; Adult ; Cholecystitis, Acute ; diagnosis ; pathology ; Diagnostic Errors ; Female ; Humans ; Myocarditis ; diagnosis ; pathology

Adult ; Aged ; Antigens, CD20 ; metabolism ; Diagnosis, Differential ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Immunohistochemistry ; Leukocyte Common Antigens ; metabolism ; Lymphoma, B-Cell ; genetics ; metabolism ; pathology ; surgery ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Tonsillar Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Tonsillectomy ; Tonsillitis ; pathology ; Young Adult

Objective To explore the advantages of the technique of bile duct mini-incision (BDM) for stone removal in choledocholithiasis,and to further clarify the indications for T tube insertion during surgery.Methods 85 BDM operations were performed.The use of MRCP (Magnetic resonance cholangiopancreatography),Advantage Workstation AW4.2 0.7sdc software,choledochoscopic imaging system and illustrations were used to study the applicability of the BDM technique in stone removal.Results The width of common bile duct (CBD) was usually over 8 mm in the patients with choledocholithiasis,and the width was related to the number and size of the stones.In the patients who had a CBD width of over 11mm (n 16),the MRCP stone imaging area (MRCP-SIA) was significantly larger when compared with that [(148±67)mm2 vs.(47±31)mm2,P＜0.05] in the patients (n=14) with CBD width of less than 11 mm.T tube insertion for secondary choledochoscopic examination should be performed when the stones were non drifting,multiple,and closely related to the lower part of CBD indicating difficulty in complete stone removal.Conclusions Unnecessary T tube insertion could be avoided by the BDM technique for stone removal which was especially suitable for patients with early diagnosis of choledocholithiasis.T tube insertion should only be performed in patients with difficulty in complete stone removal and in other complicated situations.

Objective To study the relationship between IGF-1, IGFBP-3 and prostatic volume (PV) by examining the levels of insulin and insulin-like growth fator-1 (IGF-1) and insulin-like growth factor binding protein-3 ( IGFBP-3 ) and other indicators in patients with impaired glucose regulation and benign prostate hypertrophy. Methods According to 75 g oral glucose tolerance test (OGTT) results, 109 BPH patients aged over 50 years were divided into three groups: normal glucose tolerance (NGT) group (n = 56), impaired fasting glucose (IFG) group (n = 14), impaired glucose tolerance (IGT group, n = 39). The biochemical indicators and postatic hyperplasia related factors and IGF-1, GFBP-3 were measured. Results There were no statistical differences between the three groups in terms of blood lipids, homocysteine, urinary inhibition C, fasting insulin (FINS), glycosylated hemoglobin, IGF-1 and IGFBP-3 (P > 0.05). There were no significant differences between the groups in terms of PV, prostate specific antigen, the quality of life score and the international prostate symptom score (P > 0.05). Fasting plasma glucose and insulin resistance index (HOMA IR) were higher in IFG group than NGT group (P′ < 0.017) and IGT group (P′ < 0.017). 2-hour plasma glucose and 2-hour insulin were higher in IGT group than NGT group (P′ < 0.017) and IFG group (P′ < 0.017). PV was positively correlated with FINS but not correlated with IGF-1, IGFBP- 3 by multiple multiple step wise regression analysis. Conclusion Oyperinsulinemia is a risk factor in the development of BPH with IGR, and IGF-1 and IGFBP-3 are not associated with BPH risk. Further investigation is needed to elucidate the role of the IGF-1 and IGFBP-3 in BPH.

Objective:To determine the effect of Chuju total flavonoids (CJTF) on the secreted frizzled-related protein 4 (SFRP4) expression in Wnt pathway in rheumatoid arthritis (AR) model rats. Methods:hTe role of CJTF in the treatment of AR model rats was evaluated by rat arthritis score and paw edema score. The expression regulation of the SFRP4,β-catenin and C-myc in Wnt pathway in AR model rats was detected by RT-PCR and Western blot atfer CJTF gavage treatment. Results:Atfer CJTF treatment, the rat arthritis score and paw edema score in AR model rats were signiifcantly decreased when the AR model rats were treated with CJTF, the SFRP4 expression was signiifcantly up-regulated, while theβ-catenin and C-myc gene expression were signiifcantly down-regulated in AR model rat synovial tissues. Conclusion:CJTF has significant therapeutic effect and inhibitory effect on Wnt pathway activation by targeting SFRP4 in AR model rat synovium.

BACKGROUND:Liquiritin has the protective and nutritive effects on neural stem cells. However, the effect of liquiritin on neural stem cells from the brain of mouse embryos remains unclear. OBJECTIVE:To investigate the effects of different concentrations of liquiritin on the proliferation of neural stem cells from the brain of mouse embryos. METHODS:Neural stem cells were separated from the embryonic brain of Kunming white mice at the gestational age of 14 days. The identification of embryonic neural stem cells was performed by immunocytochemistry method. The expression of neural stem cells-special genes was determined by qRT-PCR. The cell growth curve was drawn and proliferation of embryonic neural stem cells treated with 0, 1, 2, 4 or 8 g/L liquiritin for 48 hours was measured by MTT assay. RESULTS AND CONCLUSION:(1) When cultured at day 5, al individual neural stem cells gathered together into neurospheres; with the extension of time, the neurospheres were enlarged, and gathered together into larger cell masses. (2) Results from immunocytochemistry showed that all the floating neurospheres was nestin-positive. Data from qRT-PCR revealed a higher expression of nestin mRNA, but there was no expression of neuron-specific enolase and glial fibrillary acidic protein in the neural stem cells. (4) The growth of neural stem cells was slow at the beginning. After 2-3 days, the cell proliferation quickly entered the exponential phase. After 4 days, the cell proliferation gradually slowed down, and the overall cell growth entered into the platform period. (5) The cell proliferation after treatment with 2, 4 or 8 g/L liquiritin was faster than that in the control group (0 g/L). To conclude, 2-8 g/L liquiritin could increase the proliferation of neural stem cells from the brain of mouse embryos.