Objective To summarize the diagnosis and surgical treatment of hepatic focal nodular hyperplasia (FNH). Methods The clinical data of 63 patients with FNH proved by pathology were analyzed retrospectively. Results The disease mainly affected young to middle aged, 50 cases (79. 4% )were of 31-50 years old. Male and female ratio was 2.94: 1. Fifty-six patients (89%) were asymptomatic, 3 cases were HBsAg positive (4.8%). Liver function was basically normal (92. 1%),5 cases (7.9%) were with elevated level of total bilirubin and rGT. AFP, CEA and CA19-9 was all negative. FNH occured as a single node in 95.2% cases, ranging from 1.5 cm to 17 cm in diameter ( average 4. 5 cm). Of these patients, 25 lesions were present in the left lobe, 29 in the right lobe, 6 in the mid lobe, and 3 in the caudate lobe. A big central artery was found in 2 cases (3. 2% ) as found by color Doppler ultrasound. CT scan showed transient immediate enhancement in 96. 8% (61/63) of patients, with central scar in 6 cases. MRI demonstrated early vigorous enhancement in 93. 7% (59/63) of patients, with central scar in 5 cases. All patients underwent surgical resection; including local resection in 34 cases;segmentectomy or hepatectomy in 13 cases; hemihepatectomy in 13 cases. There was no postoperative mortality and major complications. Conclusions FNH is a kind of hepatic benign disease and characteristic of high preoperative misdiagnosis rate (25. 4% ).

Objective To investigate the anti-inflammatory and analgesic activities of different extracts from X. mongolicum compared with that of X. sibiricum. Methods Seventy male Kunming mices were randomly divided into seven groups:control group,aspirin group,the ethanol extracts of X. sibiricum group and X. mongolicum group,the extracts from X. mongolicum with ether,ethyl acetate,and n-butyl alcohol group(n=10 each). The mice were administrated with 500 mg·kg-1 ( p. o. ) of different extracts. The hot-plate tests and the xylene-induced ear edema in mice were performed to observe the analgesic and anti-inflammatory activities,respectively. Results In the hot-plate tests,the pain threshold from the extracts of X. sibiricum and the different extracts from X. mongolicum at 60,120,180 min were prolonged,and there was no statistically significant differences(P>0. 05) between the ethanol extracts from X. sibiricum and X. mongolicum. The best analgesic activity was the ether and butyl alcohol extracts from X. mongolicum. Meanwile,the ear edema from the extracts of X. sibiricum and the different extracts of X. mongolicum were inhibited significantly(P<0. 05). There was also no significant differences between the ethanol extracts of X. sibiricum and X. mongolicum(P>0. 05). The ether and butyl alcohol extracts from of X. mongolicum showed the best anti-inflammatory effect. Conclusion X. mongolicum exhibites significant anti-inflammatory and analgesic activities comparable to that of X. sibiricum. The best anti-inflammation and analgesic activities were from ether and butyl alcohol extracts from X. mongolicum.

Objective To investigate the diagnosi s and management of inflammatory abdominal mass after appendectomy. Methods Clinical data of 42 patients wit h inflammatory abdominal mass developing after appendectomy from 1972 to 2004 we re retrospectively analyzed. Results There were two kinds of mass: on abdominal wall (26 cases) and that within the abdominal cavity (16 cases). Diagnosis was established on clinical fi ndings and the barium enema examination. Correct preoperative diagnosis was achi eved in 30 cases, with 12 cases (28.6%) misdiagnosed. Laparotomy was performed in 29 cases. Postoperative pathology revealed inflammatory mass. All the 42 case s recovered from the illness. Conclusions Post-appendectomy abdominal mass is infrequent complication. T he clinical course is most often self-limited. However, laparotomy is indicated in patients when conservative therapy fails or there is a fear of malignancy or tuberculosis.

Objective To elevate diagnosis level and improve treatment for retroperitoneal chemodectoma. Methods Clinical data of 21 cases with retroperitoneal chemodectoma in four hospitals of Songhua river drainage area were analyzed retrospectively. Results CT, Ultrasonography and arteriography delineated retroperitoneal tumor in all 21 cases including 2 cases diagnosed as having retroperitoneal chemodectoma by MRI and arteriography, 19 cases were misdiagnosed (90.5%). All cases underwent surgical resection, with tumors removed completely in 16 cases (76. 2% ) , and 5 were irresetable. Four cases who were not resected died within 11 months postoperatively and 1 died intraoperatively in an resection attempt. In tumor resected cases, 11 have survived more than 12 years, 3 died 8 years later, 2 were still alive at the follow-up of 2 years. Conclusion Surgical treatment is the only effective method to treat the retroperitoneal chemodectoma.

Objective To summarize our experience in the diagnosis and treatment of thyroid Hurthle cell neoplasms. Methods Clinical data of thyroid Hurthle cell neoplasm patients admitted from 1972 to 2003 were analyzed retrospectively. Results The main symptoms were thyroid solitary node or mass (37 cases) and multiple nodule (9 cases). 4 cases had cervical lymph node metastasis. With BUS、CT、ECT and FNAC,only 10 cases were diagnosed as HCNs preoperatively, 36 cases were misdiagnosed as nodular benign single or multiple node. Twenty-eight cases were diagnosed by FNAC and quick freezing pathology. Benign HCNs was treated by isolateral thyroidectomy and malignant HCNs by additional contralateral subtotal thyroidectomy. Eighteen cases were diagnosed by postoperative paraffin pathology, and retrival second operation was performed according to the benignity or malignancy of the thyroid lesion. All cases were followed-up for 2 to 10 years and doing well without recurrence. Conclusions We should realize thyroid Hurthle cell neoplasms fully, if HCNs is suspected intraoperatively, quick freezing pathology is helpful. With appropriate therapy, the prognosis is satisfactory.

Objective To evaluate the effect of choledochoduodenostomy for the treatment of bile duct calculi. MethodsClinical data of 420 patients with choledochoduodenostomy from 1962 to 2002 were respectively analyzed. ResultsBefore 1982,this procedure was performed in 230 cases with postoperative cholangitis or sink syndrome found in 46 cases, and mortality in 6 cases. Since 1983,190 cases underwent large-sized choledochoduodenostomy with 7 cases suffering from postoperative cholangitis or sink syndrome and no mortality. The anastomotic stoma was less than 2.0 cm in 110 cases, between 2.0 to 2.5 cm in 184 cases, from 2.5 to 3.0 cm in 107 cases, no record in 19 cases. A total of 358 cases (85.2%) were followed up from 2 to 20 years. Result was excellent and good in 183 out of 190 cases(96.3%) after the year of 1983. ConclusionsCholedochoduodenostomy when the stoma was larger than 2.5 cm in diameter and was put low in position was effective for the prevention of recurrent cholangitis and sink syndrome for the treatment of bile duct calculi.

Objective To discuss influence of sulfentanyl on hemodynamics and stress reaction on patients with opera-tions on cranium and brain during anesthesia induction period. Methods A total of 100 cases of clinical information of patients with severe brain injury were divided into two groups in accordance with different anesthetic methods, with 50 cases in anesthesia group A (fentanyl as anesthetic method) and 50 cases in anesthesia group B (sulfentanyl as anesthetic method). The changes of MAP, HR, cortisol (Cor) in plasma and glucose (Glu) in blood before the anesthesia induction (T0), 2 minutes after anesthesia induction and before the trachea cannula (T1), 1 minute after the trachea cannula (T2), upon the incision of scalp (T3), upon the drilling of skull (T4), and upon the withdrawal of trachea cannu-la (T5) were observed. Results The MAP and HR of patients in anesthesia group B at T1, T2, T3, T4 and T5 were all lower than those in anesthesia group A (P<0.05). The Cor in plasma and Glu in blood of patients with severe brain injury in anesthesia group B at T2, T3, T4 and T5 were all lower than those in anesthesia group A(P<0.05). Conclusion Compared with fentanyl, the application of sulfentanyl on patients with severe brain injury has more favorable curative effect on hemodynamics and stress reaction during anesthesia induction period, which can maintain the circulatory sys-tem more stable, is more suitable for the anesthesia induction.

OBJECTIVE:To optimize the extraction technology of total polyphenol and total flavonoid in Gardenia jasminoi-des. METHODS:Plackett-burman(PB)design was used to select the ethanol volume fraction,liquid-solid ratio,particle size,ex-traction time and extraction temperature to determine the key factor affecting the extraction of total polyphenol and total flavonoids in G. jasminoides. Then central composite design (CCD) was combined with response surface method to optimize the extraction technology,and verification test was conducted. RESULTS:The optimal extraction conditions of total polyphenol were 40% etha-nol,particle size of 0.20 mm,extraction temperature of 60 ℃,liquid-solid ratio of 20,and extraction time of 20 min;the optimal extraction conditions of total flavonoids were 40% ethanol,particle size of 0.20 mm,extraction temperature of 30 ℃,liquid-solid ratio of 20,and extraction time of 20 min. In verification test,the contents of total polyphenol and total flavonoids in G. jasminoi-des were 1.70%(RSD=1.43%,n=3),3.23%(RSD=3.72%,n=3),with relative error of 1.80%,8.75% with predicted val-ues,respectively. CONCLUSIONS:The response surface method based on PB and CCD is simple,reasonable and feasible to opti-mize the extraction technology of total polyphenol and total flavonoids in G. jasminoides. The method can provide reference for its industrial extraction.

This review aims to interpret the interventions to improve physical function for children and young people with cerebral palsy, thus providing relevant suggestions.Relevant literatures published before November 2018 were systematically searched in Cochrane library, CINAHL, and Embase MEDLINE using the Grading of Recommendations Assessment, Development and Evaluation method.Consult with international experts and patients to assess evidence and recommend it.Based on 3 systematic reviews, 30 randomized clinical trials, and 5 pre-and post-treatment studies, a total of 13 recommendations were given.The guidelines recommend that, in order to achieve functional stan-dards, intervention measures should include, patient-selected goals, full-task practice in real-life settings, support for family empowerment, and a team approach.The age, ability, and child/family preferences were all needed to be considered.In order to improve walking ability, ground walking and treadmill training can be carried out.Various methods can promote the realization of hand use goals hand use, including the two-hand exercise training, constraint-induced moverment therapy, goal-oriented training and cognitive therapy.In terms of patient self-care, the guideline proposed that, the combination of full-task practice and auxiliary equipment can improve the independence of self-care and reduce the burden of care givers.Leisure goals could be achieved by the combination of the practice of the entire task with strategies to address environmental, personal, and social barriers.The intervention of children and adolescents with cerebral palsy should take into consideration of patient selection and the goal of full-task practice.The child/family preference, age and ability should be considered when clinical workers selecting specific interventions.

BACKGROUND: Particulate matter (PM) < 2.5 μm (PM METHODS: We obtained DNA methylation and exercise data of 496 participants (aged between 30 and 70 years) from the Taiwan Biobank (TWB) database. We also extracted PM RESULTS: DLEC1 methylation and PM CONCLUSIONS We found significant positive associations between PM
Adult ; Aged ; Air Pollutants/adverse effects* ; DNA Methylation/drug effects* ; Environmental Exposure/adverse effects* ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Particulate Matter/adverse effects* ; Taiwan ; Tumor Suppressor Proteins/metabolism*