Objective To evaluate the diagnostic value of CT enhanced scan and delayed CT scan in hepatic cholangiocarcinoma.Methods CT plain scan,enhanced CT scan and delayed CT scan were perfomed in 21 patients with hepatic cholangiocarcinoma pathollogically proved.Results The lesions were low density in all patients on plain CT,of them,14 patients were cystiform,7 cases were solid with intrahepatic biliary duct expansion within the lesions.Incomplete thin rim-like enhancement of the tumor periphery was seen on CT enhanced scan in 10 cases of 14 cystiform,complete enhancement in 3 cases.There was not any change in the 13 patients on portal venous phase,1 case didn't show enhancement,substantial tumors in 7 patients showed slightly enhancement after 1 minute of CT enhanced scan and delayed enhancement was seen after 3~8 minutes.The intrahepatic biliary duct expansion didn't change.The density of the tumor was equal to the liver of the same level or exceeded.Conclusion The complete or incomplete thin rim-like enhancement of the tumor of cystiform periphery on CT enhanced scan,not any change on portal venous phase or substantial tumors with intrahepatic biliary duct expansion in delayed enhancement are the characteristic signs of hepatic cholangiocarcinoma.

Objective To analysisthe evaluation clinical effects and complications of retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap for the re-pair of the leg and foot skin defect effect. Methods In January 2010 to January 2015,patients with leg and foot skin defect effect in our hospital administrated withperoneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle skin flap were retrospectively analyzed.Flap survival,necrosis rate, the function of the skin flap and complications were analyzed. Results The one stage flap survival rate of peroneal artery group(84.6%)is higher than the posterior tibial artery group(57.69%),the difference was statistically sig-nificant(P < 0.05). There were no significant difference between the flap function index(pain,activity limita-tion,wearing shoes,functional recovery satisfaction)score and posterior tibial artery group(P>0.05). The occur-rence of hyperplastic scar,itching,pigmentation,skin graft,numbness,skin graft abnormal pain complication rates inperoneal artery group were significantly lower than the posterior tibial artery ,and the difference was statisti-cally significance(P < 0.05). Conclusion Retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap can effectively repair skin and soft tissue defect ,retrograde peroneal artery perforators shows with higher survival rate and less complication.

Objective To review outcomes in randomized controlled trials comparing labetalol with other anti hypertensives/placebo/no drug for mild to moderate hypertension in pregnancy.Methods We searched PubMed,China Knowledge Resource Integrated Database and VIP Database and performed a meta analysis of randomized controlled trials of labetalol for hypertension in pregnancy.Data were entered into RevMan software for analysis [relative risk (RR) and its 95％ confidence interval (CI)].Results Seven studies were included in the meta-analysis.Four trials (553 women) compared labetalol with methyldopa for mild to moderate hypertension in pregnancy.Labetalol reduced the risk of severe hypertension (RR=0.52,95％CI:0.31-0.88) and proteinuria (RR=0.57,95％CI:0.36 0.91).The incidence of preterm birth and small-for-gestational-age infants was similar between these two groups.Five trials (720 women) compared labetalol with placebo/no drug for mild to moderate hypertension in pregnancy.Labetalol reduced the risk of severe hypertension (RR=0.29,95％CI:0.16-0.53) and proteinuria (RR-0.73,95％CI:0.56-0.95) and showed no effect on preterm birth and small-for-gestational-age infants.Conclusions The results support the use of labetalol for mild to moderate hypertension in pregnancy.Labetalol is more effective in treating hypertension than methyldopa.However,due to the quality of the included studies,clinical effects of labetalol need to be evaluated in high quality randomized controlled trials.

Nutrients have an important role in the progression of digestive tract cancer.The progress is regulated by the aberrant DNA,apoptosis,et al.This review is about the associated genes of methylation,nutrients,and molecular regulating mechanisms in esophageal cancer.

Carcinoma, Squamous Cell ; metabolism ; pathology ; Chemokine CCL2 ; metabolism ; Fibroblast Growth Factor 7 ; metabolism ; Fibroblasts ; metabolism ; pathology ; Gelatinases ; metabolism ; Humans ; Membrane Proteins ; metabolism ; Mouth Neoplasms ; metabolism ; pathology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Serine Endopeptidases ; metabolism

Twenty days after the operation of anterior cervical decompression fusion with internal fixation, the fistula was found at the lower end of right neck incision with purulent secretion, the intumescent mucosa was founded at the posterior wall of the esophagus, down about 5 cm of the oesophagostomum. The metal plate sample exposed under the intumescent mucosa. The diagnosed was "neck esophageal fistula".
Decompression, Surgical ; Esophageal Fistula ; surgery ; Humans ; Neck

Objective:To observe the curative effect of vinpocetine combined with Danhong injections in the treatment of posterior circulation ischemia syndrome. Methods:Totally 120 patients with posterior circulation ischemia syndrome were selected and randomly divided into the treatment group and the control group with 60 cases in each. Both groups were treated by the conventional therapy, meanwhile, the treatment group was given vinpocetine and Danhong injections, and the control group was given vinpocetine alone. The treatment course was 14 days. The curative effect was observed, blood rheology and hemodynamics were also studied. Results:The to-tal effective rate of the treatment group was 95. 0%, which was significantly higher than that of the control group (75. 0%) with statis-tically significant difference(P<0. 05). After the treatment, the blood rheology (viscosity, low shear viscosity, plasma viscosity and reduced viscosity) and TCD ( LVA, RVA, BA and PI) in the two groups were significantly improved, and the treatment group showed more significant improvement(P<0. 05). Conclusion:Vinpocetine combined with Danhong injections in the treatment of posterior cir-culation ischemia syndrome has significant effect in the effective improvement of blood rheology and hemodynamics, which is worthy of clinical promotion and application.

10.3969/j.issn.2095-4344.2013.24.014

Objective To observe the clinical and nerve electrophysiological features of sodium azide poisonin. Method The clinical data of 11 patients with sodium azide poisonin were analyzed retrospectively.Results In this group, the first symptoms was numbness in 4 cases, weakness in 3 cases, walking instability in 2 cases, dizziness and nausea in 2 cases.The major clinical manifestations were numbness in 8 cases, weakness in 6 cases, walking instability in 4 cases, dizziness and nausea in 3 cases, leptophonia in 2 cases, diplopia in 2 cases, limb muscle strength loss in 7 cases, reducing muscle tension in 3 cases, weakened tendon reflex in 3 cases, skin needle drops in 3 cases.Electrophysiological examination showed motor nerve conduction velocity ( MCV) was slower, distal latency ( DML) and amplitude ( AMP) were reduced; the sensory nerve conduction velocity ( SCV) was slower, and AMP was reduced.The latency (Lat) and wave interval of brainstem auditory evoked potential (BAEP) and visual evoked potential ( VEP) , somatosensory evoked potentials ( SEP) were prolonged, and AMP was reduced.Compared with pre-treatment, the abnormal rates of MCV, AMP, DML of median nerve, ulnar nerve, deep peroneal nerve and SCV, AMP of median nerve, ulnar nerve, superficial peroneal nerve, sural nerve and AMP of SEP after treatment had no statistically significant (all P>0.05).Compared with pre-treatment, the abnormal rates of Lat of BAEP, VEP, SEP andⅢ-Ⅴof BAEP and AMP of BAEP, VEP had no statistically significant (P<0.05-0.01).Conclusions The major clinical symptoms of sodium azide poisoning are numbness, weakness, unstable walking, dizziness, diplopia. Electrophysiological examination showed MCV is slower, DML and AMP are reduced; SCV is slower, and AMP is reduced.The Lat and wave interval of evoked potential are prolonged, and AMP is reduced.