Objective To investigate the feasibility o f endoscopic resection of parathyroid adenoma. Methods Endoscopi c parathyroidectomy by anterior chest approach was performed in 5 patients with parathyroid adenoma. Results The operation was successfully ac complished in all the 5 patients, requiring no conversions to open surgery. The operating time was 120~150 min (mean, 130 min), and the intraoperative blood los s, 5~15 ml (mean,10 ml). No postoperative complications such as hemorrhage, hoar seness, choke, subcutaneous emphysema and effusion, or infection were seen. All the patients were followed for 6~24 months(mean,14 months), with satisfactory cu rative and cosmetic results. Conclusions Endoscopic resection for parathyroid adenoma gives reliable curative effects and excellent cosmetic o utcomes.

[Objective]To summarize the middle-term results of unicompartment knee arthroplasty(UKA),and postulate a new specific assessment score.[Method]From March 2004 to September 2006,unicompartment knee arthroplasty had been proformed in 22 patients(22 knees)with unicompartment osteoarthritis.The mean follow-up period was 34 months(range from 14 to 49 months).The HSS score、KSS score and WOMAC score were used to evaluate the outcomes of UKA at the time of preoperation and follow-up respectively.A new unicompartment knee arthroplasty specific score was postulated to evaluate the results of UKA.[Result]At the time of the final follow-up,pain relief was significant in all patients,and the range of motion and quality of living were improved.The HSS score,KSS score and WOMAC score were significantly improved compared with pre-operation(P

BACKGROUND: Based on previous studies, the combination of basic fibroblast growth factor (bFGF) with graft may accelerate the procedure of vascular invasion of anterior cruciate ligament (ACL) graft. The antigenicity of graft could be inhibited by the destruction of major histolocompatibility complex (MHC) through the treatment of allogenous tendon by freeze. The freeze. dried tendon showed advantages including prolonged storage time. availability for transport and possibility of commercial application. There is no experimental and clinical study on the graft substance of bFGF combined tendon in ACL reconstruction in animal model so far. OBJECTIVE: To observe histologically the effect of exogenous application or bFGF combined to freeze-dried tendon on angiogenic enhancement in early ACL reconstruction. DESIGN, TIME AND SETTING: Controlled animal study, which was performed in the Department of Orthopeadics, Xijing Hospital. Fourth Military Medical University of Chinese PLA between June 2006 and June 2007.MATERIALS: Fourteen dogs were used in the experiment. METHODS: Extensor digitorum longus tendon was harvested from the rest 2 dogs and treated by freeze-dry as graft for other experimental dogs. bFGF(100 u g/L)was combined to freeze-dried tendon and then transplanted into one side knee to substitute the original ACL. While only freeze-dried tendon was used in the transplantation at the other side as control. MAIN OUTCOME MEASURES: Twelve of them were randomly divided into 6 groups according to the 6 time points,i,e.,1,2,3,4,5,6 weeks after surgery(2 dogs in each group).The histological observation with HE staining was done under microscope to mainly observe the angiogenesis in the transplanted ACL. RESULTS: Neovascularization occurred at the 2nd to 3rd weeks and reached the peak at the 4th to 5th weeks postoperatively at the experimental sides. By contrast. The neovascularization occurred at the 4th to 5th weeks postoperatively at the control sides. Neovascularization in the combined group was longer and deeper than that in the control group. CONCLUSION: The time of neovascular formation and the depth of vascular penetration into the tendon in the group of bFGF combined to freeze-dried tendon are superior to those in the control group.

Objective To observe the efficiency and toxicity of Vinorelbine(NVB) combined with Cisplatin (DDP) in the treatment of advanced breast cancer patients resistent to Adriamycin (ADM) or Taxol treatment.Methods 34 patients with 8 cases simplex carcinoma,20 cases infiltrating duct carcinomas,3 cases medullary carcinoma,1 case large sweat gland-like carcinoma and 2 cases scirrhous carcinoma,who were relaped and refractory after ADM or Taxol treatment,were treated with NVB 25mg/m2,DDP 25mg/m2,Ⅳ.Both drugs were given in a 21-days cycle.The efficacy was evaluated every 2 or 3 cycles by using response evaluation criteria in solid tumor.Results 2 cases of 34 assessable patients achieved complete response (CR),18 patients had partial response (PR),8 cases had stable disease(S D),6 cases had progressive disease(PD).The total effective rate was 58.8％ (CR + PR).The medium duration of response and medium survival time were 8.5 months and 18.3 months,respectively.The predominant toxicity was hematological,with grade Ⅲ～ Ⅳ leukopenia occurring in 50.0％ (17/34) patients.Other toxicities were nausea,vomiting,anemia,phlebitis and so on.Conclusion The regimen of NVB combined with DDP is active and well tolerated,with an acceptable price,in treatment of advanced breast patients with refractory and relapsed after ADM or Taxol treatment.

Objective To investigate the clinical efficacy of acupuncture plus TDP in treating stageⅡ-Ⅲ pressure sore.Methods Thirty-three patients with pressure sore meeting the inclusion criteria were randomly allocated to treatment and control groups, 17 cases each. Both groups were first given routine clean care. The control group received routine surgical asepsis dressing change and the treatment group, fire needling, surrounding electroacupuncture and TDP irradiation to the affected part. The pressure sore area was observed and the PUSH score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups of patients. Results The total efficacy rate was 88.0% in the treatment group and 71.0% in the control group; there was no statistically significant difference between the two groups (P>0.05). The total efficacy rate was 88.0% in the treatment group and 71.0% in the control group; there was no statistically significant difference between the two groups (P>0.05). The cure and marked efficacy rate was 58.8% in the treatment group and 23.5% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post- treatment difference in the pressure sore area in the two groups at one, two and three weeks after treatment (allP<0.05). There was a statistically significant difference in the pressure sore area between the two groups at two and three weeksafter treatment (bothP<0.05). There was a statistically significant pre-/post-treatment difference in the PUSH score in the two groups at two and three weeks after treatment (bothP<0.05). There was a statistically significant difference in the PUSH score between the two groups at three weeks after treatment (P<0.01).Conclusions Acupuncture plus TDP can markedly relieve the clinical symptoms and accelerate the sore healing in treating stageⅡ-Ⅲ pressure sore.

This study was aimed to explore the relationship between the Shen-Gui-Fang(SGF) formula of different proportions and treatments for diseases with the method of bibliometrics. A total of 49 formulae of SGF from ancient books of traditional Chinese medicine (TCM) were retrieved and the database was established in order to analyze the origin of herbal medicine and the relationship with the ratio of the key medicinal material, as well as the treatment for major diseases. The results showed that 49 SGF formulae were mainly used in the treatment of internal disorders for 16 times (32.65%), gynecological disorders for 17 times (34.69%) and pediatric disorders for 8 times (16.32%). Guistanded forAngelica sinensis. There were 3 types ofShen, which werePanax ginsengfor 40 times,Codonopsis pilosulafor 8 times, andSophora flavescensfor 1 time. The ratio betweenP. ginsengandA. sinensiswas less or equal to 1. The ratio betweenC. pilosulaandA. sinensiswas usually more than 1. The formulae with the highest frequency were in the treatment of internal medicine and gynecological diseases. Statistical analysis was used to find the application features and rules of the combination ofP. ginsengandA. sinensisin SGF formula, in order to provide theoretical evidences and references for clinical medication selection and new medication research.

Objective To explore the value of applying personalized medicine in the clinical teaching of gastrointestinal surgery. Methods Totally 100 undergraduates in grade 2008 were ran-domly assigned to experimental class (EC) and control class (CC), with 50 cases in each group. The experimental class accepted personalized medical teaching through introducing idea and method of personalized medicine. The control class accepted conventional teaching. The effect of teaching was evaluated by questionnaire survey and examination. The data were analyzed through t-test and Chi-square test. Results Questionnaire survey of satisfaction showed that 88 students (88%) were inter-ested in the new course, 91 students (91%) thought that the new mode of teaching was better than the old one. Questionnaire survey of teaching effect showed that in EC:44 students (88%) thought that the new course could increase interests of clinical question;43 students (86%) thought that the new course could optimize the process of diagnosis and treatment of gastric cancer;40 students (80%) thought that the new course could strengthen the communication between doctors and patients; 42 students (84%) thought that the new course could widen the minds in diagnosis and treatment;45 students (90%) thought that the new course could enhance the ability of dialectical thinking;while in CC, the proportions of the above issues were 24(48%), 23(46%), 26(52%), 25(50%) and 26(52%) (all P<0.05). Furthermore, there were statistical difference in auerage scores bertween EC and CC [(86.26 ±5.72) vs. (77.00 ±6.16)] (P=0.000). Conclusions Personalized medicine is suc cessfully practiced in the teaching course of gastric cancer, which not only meets the requirement of personal-ized medicine, but also guides the reformation of clinical teaching to certain extent.

Objective To acknowledge the NALP3 inflammasome expression and significance in the interstitial cystitis/bladder pain syndrome (IC/PBS).Methods The urine of 16 IC/BPS patients and 16 normal persons was collected to measure the IL-1β content by ELISA.Bladder tissue of 16 IC/BPS patients and para-carcinoma tissue of 16 bladder cancer patients were collected.And the levels of NALP3,caspase1 and IL-1β were detected by Western Blot.60 female rats were randomly divided into control group(bladder was infused with 0.5 ml saline),hyaluronidase group [bladder was infused with 0.5 ml hyaluronidase (4 mg/ml)],NALP3 antagonist group [bladder was infused with 0.5 ml hyaluronidase (4 mg/ml) and Glyburide(10 mg/kg)] and mucosal protectant group [bladder was infused with 0.5 ml hyaluronidase (4 mg/ml) and sodium hyaluronate(0.8 mg/ml)] to carried out the animal experiment,and 15 rats in each group.The models were created by long-term (1 month) intermittent intravesical hyaluronidase infusion.Voiding patterns were investigated by cystometry.Toluidine blue staining was used to detected mast cell’s changes.The levels of NALP3,caspase-1 and IL-1β were determined by Western Blot,HE staining was to detect tissue inflammation of the bladder,and the severity of pain was examined by Von-frey brush by using the strength of 0.07、0.4、1.0 g.The comparison between the chemotaxis of 200 ng,400 ng IL-1β and 200ng SCF IL-1β to mast cells was checked by Transwell experiment.Results The expressions of IL-1β in IC/PBS patients was increased in IC/PBS group than normal control group [(381 ± 112) μg/L vs.(98 ± 40) μg/L,P ＜0.01].The expressions of NALP3,Caspase-1 and IL-lβ had increased in the IC/PBS group than normal group(0.22 ±0.08 vs.0.11 ±0.02,0.25 ±0.03 vs.0.10 ±0.01,0.19 ±0.04 vs.0.11 ± 0.02,P ＜ 0.05)by Western Blot.In the IC/PBS rats,compared with the control group,the intercontraction intervals [(120.0 ± 15.6) s vs.(447.3 ± 24.6) s] and bladder capacity [(0.34 ± 0.02) ml vs.(1.33 ± 0.04) ml] of the model group were significantly decreased (both P ＜ 0.05).In mucosal protectant group and NALP3 antagonist group,the intercontraction intervals [(323 ± 16.3)s,(280 ± 12.5)s] and bladder capacity [(1.14 ± 0.05) ml,(0.84 ± 0.04) ml] were increased compared with control group (P ＜ 0.05).The amount of mast cell in model group were significantly increased than control group (3.4 ±0.8 vs.0.4 ± 0.2,P ＜ 0.05) while in mucosal protectant group (1.8 ± 0.5) and NALP3 antagonist group (1.5 ± 0.7) were decreased compared with control group (P ＜ 0.05).The protein levels in modle group of NALP3 (5.91 ±0.33 vs.1.00 ±0.12),caspase-1 (6.75 ±0.42 vs.1.00 ±0.22) and IL-1β(7.12 ±0.45 vs.1.00 ± 0.18)were increased than control group.In mucosal protectant group and NALP3 antagonist group,theNALP3 (2.921 ±0.21,2.07±0.18),caspase-1 (3.28 ±0.31,2.25 ±0.19) and IL-1β(3.33± 0.41,1.98 ±0.21) were decreased compared with control group.VonFrey pain score in model group were significantly increased than control group(0.07 g:7.5 ± 1.8 vs.2.1 ± 0.5,0.4 g:9.2 ± 1.9 vs.5.2 ± 1.1,1.0g:15.4±3.8 vs.6.8±1.5,P＜0.05) and VonFrey pain score(0.07 g:2.4±0.3,2.8± 0.7;0.4 g:5.2 ±0.4,6.5 ±1.3;1.0 g:6.4 ±0.8,7.3 ±1.1;P＜0.05) in NALP3 antagonist group were significantly decreased.In vitro,Transwell experimental results showed that 400 ng IL-1β of mast cell chemotaxis is similar with that of the 200 ng SCF (3 800 ±400 vs.4 800 ±500,P ＞0.05).Conclusions The levels of NALP3/Caspase-1/IL-1β in the urine of patients with IC/PBS were significantly higher than those in normal control group.NALP3 is activated in chronic cystitis rat model,and related to pain and frequent urination.This may be related to the down-regulation of expression of NALP3,caspase-1,IL-1β,and other inflammatory mediators,and blocking the chemotactic effects of IL-1 β on mast cells.

Objective To investigate the clinical effect of radiofrequency ablation (RFA) combined with non-specific sequential immunotherapy (IM) for early hepatocellular carcinoma (HCC),and analyze the factors affecting prognosis of patients after RFA.Methods The prosepctive study was conducted.The clinicopathological data of 72 early HCC patients who were admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from January 2009 to October 2015 were collected.Patients were divided into 3 groups by random number table:patients in group A underwent single RFA therapy;patients in group B underwent RFA + non-specific sequential IM (1-3 times);patients in group C underwent RFA + non-specific sequential IM (≥ 4 times).RFA was performed by the same doctors team,and non-specific sequential IM planning included thymalfasin + interleukin-2 (IL-2).Observation indicators:(1) treatment situations;(2) follow-up and survival;(3) analysis of prognostic factors after RFA.Follow-up using outpatient examination was performed to detect tumor recurrence and overall survival up to December 2015.Measurement data with normal distribution were represented as (x) ± s,and comparison among groups were evaluated with the ANOVA.Comparison of count data were analyzed using the chi-square test.The curve,rate and time of tumor recurrence after treatment,overall survival curve and time were respectively drawn and calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.The univariate analysis and multivariate analysis were respectively done using the COX proportional hazard regression model.Results Seventy-two patients were screened for eligibility,including 31 in group A,22 in group B and 19 in group C.(1) Treatment situations:patients in 3 groups underwent RFA,and contrast enhanced ultrasound showed complete tumors ablation at 5 days postoperatively.Patients in group B and C didn't have significant adverse reactions after RFA during IM therapy.(2) Follow-up and survival:72 patients were followed up for 2-66 months after treatment,with a median time of 34 months.The 1-year tumor recurrence rates after treatment in group A,B and C were respectively 19.4％,13.6％ and 10.5％,with no statistically significant difference (x2=0.714,P＞0.05).The median tumor recurrence times in group A,B and C were respectively 24.0 months,30.0 months and 33.0 months,with no statistically significant difference (x2 =3.283,P＞0.05).The median overall survival times in group A,B and C were respectively 46.0 months,56.0 months and 57.0 months,with a statistically significant difference (x2=7.079,P＜0.05).There were statistically significant differences between group A and group B and C (x2 =4.566,4.243,P＜0.05),and no statistically significant difference between group B and group C (x2 =0.078,P＞0.05).(3) Analysis of prognostic factors after RFA:results of univariate analysis showed that initial tumor,tumor number,Barcelona clinic liver cancer (BCLC)staging and sequential IM after RFA were related factors affecting prognosis of early HCC patients [hazard ratio (HR)=2.636,2.530,0.145,0.582,95％ confidence interval (CI):1.218-5.703,1.110-5.767,0.041-0.517,0.321-0.867,P＜0.05].Results of multivariate analysis showed that tumor number ＞ 1,staging B of BCLC and without sequential IM after RFA were independent risk factors affecting prognosis of early HCC patients (HR=2.376,2.683,0.567,95％CI:1.080-5.229,1.530-21.112,0.335-0.962,P＜0.05).Conclusions The non-specific sequential IM of thymalfasin + IL-2 can prolong survival time of early HCC patients after RFA.Tumor number ＞ 1,staging B of BCLC and without sequential IM after RFA are independent risk factors affecting prognosis of early HCC patients.

Cardiovascular disease has become a serious disease that threatens the health of human beings, cardiac output is an important indicator of cardiovascular function, monitoring cardiac output and related hemodynamic parameters have significant clinical value. This article summarizes the development history, principle, method, advantages and disadvantages of various monitoring technologies from three aspects:invasive, minimally invasive and noninvasive, the development and application of cardiac output monitoring technology are prospected.
Cardiac Output ; Hemodynamics ; Humans ; Monitoring, Physiologic ; instrumentation