Adenocarcinoma ; pathology ; Carcinoma in Situ ; pathology ; Digestive System Neoplasms ; classification ; pathology ; Esophagogastric Junction ; pathology ; Humans ; Liver Neoplasms ; pathology ; Neoplasm Staging ; Neuroendocrine Tumors ; classification ; pathology ; Pancreatic Neoplasms ; pathology ; Precancerous Conditions ; pathology ; World Health Organization

Objective: To investigate the feasibility and operative effect of the one-stage microsurgery for clipping of bilateral posterior communicating artery aneurysms (BpcoAA). Methods: The clinical data of 28 patients with BpcoAA were analyzed retrospectively. All patients underwent craniotomy and microsurgical clipping of BPcoAA via unilateral pterional approach. The patients were followed up for 6 months to 3 years after microsurgery. The head 3 D-CTA of the patients and their general conditions were reexamined. The Glasgow outcome scale (COS) scores were used to assess the prognosis. Results: Circled digit oneGood preoperative 3D-CTA showed 28 cases with 56 aneurysms, the aneurysms were clipped completely in 24 cases, the contralateral aneurysms were not clipped completely in 3 cases, the aneurysm was not clipped completely on the approach side in 1 case, and none of the patients died. The aneurysms ruptured in 8 cases on the approach sides during the microsurgery. Circled digit twoAfter microsurgery, 7 cases had hydrocephalus, and 5 had vasospasm on the approach sides and 3 on the contralateral sides, 3 suffered pulmonary infection, and 2 had oculomotor nerve injury on the contralateral sides. Circled digit threeThe mean follow-up time of the patients was 1.7 years. The GOS scores: 5 points in 10 cases, 4 points in 7 cases, 3 points in 9 cases, and 2 points in 2 cases. There were no aneurysm recurrence and new aneurysm formation. The patients whose aneurysms were not clipped completely had no recurrence of bleeding. Conclusion: According to 3D-CTA examination, using unilateral pterional approach, aiming at the location of the optic chiasm and the contralateral aneurysm pointing, the one-stage microsurgery for clipping of BpcoAA is safe and feasible.

Hyperlipidemia is an important risk factor of cardio-/cerebrovascular disease, and reducing lipids has become an important project for itsclinical preventing and treating. Western medicine, with its confirmative efficacy and clear mechanism, has played an irreplaceable role. Along with the development of modern medicine, integrative medicine has gradually become a growing trend in regulating blood lipids metabolism. It not only could make up the insufficient power for Chinese medicine in lowering lipids, but also could reduce adverse reactions and economic costs brought by long-term administration of Western medicine. As a modern practitioner of Chinese medicine, we should keep clear that integrative medicine regulating blood lipids metabolism does not mean a simple combination of traditional Chinese medicine and Western medicine. We should treat it guided by systematic theories. We combine disease identification and syndrome differentiation, guide lipids lowering by integrative medicine including selecting Western drugs for blood lipids lowering, Chinese medical prescriptions for syndrome typing, and effective Chinese herbs based on modern pharmacologies.
Drugs, Chinese Herbal ; Humans ; Integrative Medicine ; Lipids ; blood ; Medicine, Chinese Traditional ; Risk Factors

OBJECTIVETo explore clinical outcomes of posterior malleolar fractures with medial-extension type through posterioromedial and posteriorlateral incision.

METHODSFrom January 2008 to January 2011,25 patients with posterior malleolar fractures with medial-extension type were treated by hollow lag screw. Among them, 15 patients were treated through posteromedial incision,including 9 males and 6 females,aged from 21 to 67 years old with an average of 48.1 +/- 1.3; there were 5 cases with type A, 6 cases with type B and 4 cases with type C,according to Denis-Weber classification. Ten patients were treated by through posterior-lateral incision,including 6 males and 4 females, aged from 23 to 64 years old with an average of 46.9 +/- 1.5; there were 3 cases with type A, 5 cases with type B and 2 cases with type C,according to Denis-Weber classification. Operation time, blood loss, length of incision, times of X-ray exposure and complications of two groups were recorded and compared, Baird-Jackson effective evaluation were applied for evaluate clinical outcomes.

RESULTSAll patients were followed up from 12 to 49 months with an average of 20.6 months. There were significant differences in operation time, blood loss, times of X-ray exposure and complications between two group (P < 0.05). While there was no obvious meaning in clinical outcomes between two groups (P > 0.05).

CONCLUSIONTreating posterior malleolar fractures with medial-extension type through posteromedial approach can expose and fix fracture under direct vision, has advantages of shorter operation time, less X-ray exposure and blood loss, is a good choice of surgical approach.

Adult ; Aged ; Ankle Fractures ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tarsal Bones ; injuries ; surgery

OBJECTIVETo explore optimal choice of surgical treatment for subtrochanteric fractures in older children.

METHODSA retrospective study of 36 older children with subtrochanteric fractures was performed between January 2010 and January 2012. Among them, 18 patients (11 males and 7 females) aged from 7 to 13 years old with an average of 9.4 were treated with titanic elastic nail (TEN) fixation, 4 cases were Type II A, 3 cases were II B, 2 cases were II C, 4 cases were III A, 3 cases were III B according to Seinsheimer classification. Eighteen patients (10 males and 8 females) aged was from 8 to 13 years with an average of 9.6 were treated with locking compression pine (LCP) fixation, and 3 cases were Type II A, 4 cases were II B, 3 cases were II C, 4 cases were IIIA, 2 cases were III B. Fracture healing time, postoperative complications (including wound infection, failure and breakage of internal fixtion, deformities of angular on the sagittal view, deformities of coxa vara) and recovery of hip joint function were observed and recorded.

RESULTSAll children were followed up from 15 to 36 months with an average of 21. Fracture were all healed, the time ranged from 7 to 16 weeks (mean 9.5). Three cases in TEN group occurred mild deformities of angular on the sagittal view, 3 cases occurred deformities of coxa vara and 2 cases occurred limb shortening; while 1 case occurred mild deformities of angular on the sagittal view, and no deformities of coxa vara and limb shortening occurred in LCP group. No early close of epiphyseal injury, avascular necrosis of femoral head occurred. Clinical efficacy were evaluated by Sanders standard, 14 cases got excellent results, 3 cases were moderate in LCP group, while 9 cases in excellent, 4 in moderate in TEN group. There were no significant differences between two group in recovery of hip joint function and complications.

CONCLUSIONFor the treatment of subtrochanteric fractures in older children,the efficacy of LCP fixation is better than that of TFN fixation, which has advantages of reliable fixation, and less complications.

Adolescent ; Bone Nails ; Child ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

Objective To study the connection between vascular endothelial growth factor(VEGF) and pool prognosis in nephroblastoma.Methods Serum VEGF was measured with immuneohistochemical(ELISA) methods in 35 children of nephroblastoma at preope-ration,1 week,2 weeks after surgery respectively. Simple visiting happened after surgery 4,8,16,32 weeks.The countrol group was 35 healthy children. Result Before surgery,the median VEGF in the children was (89.47?22.45) ?g/L.After surgery 1 week,2 weeks,levels in the children fell significantly to (2.75?0.31) ?g/L,(1.52?0.18) ?g/L.There was a significant difference compared with preoperation ( t =4.125 P

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Kidney Neoplasms ; blood ; pathology ; Male ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A ; blood ; physiology ; Wilms Tumor ; blood ; pathology

Objective To investigate the effects of high-affinity tyrosine kinase receptors TrkA, TrkC and the low-affinity neurotrophin receptor p75 (p75~ NTR) protein in laser-induced retinal injury. Methods The Wistar rats were anesthetized and exposed to frequency doubling Neodymium:Yttrium,aluminum garnet(ND:YAG,?=532nm) laser for 100 plus per eye, which were sacrificed on 12 hours,1,3,7,14 and 28 days after laser exposure and eyeball was taken out. We investigated retinal histology by hematoxylin and eosin staining, and the expression of TrkA, TrkC and p75~ NTR protein was studied by means of immunohistochemistry. Results Immunohistochemistry results showed a differential distribution for these three neurotrophin receptors in the laser injuried retina. TrkA was enhanced in nerve fiber layer (NFL), ganglion cell layer(GCL) and inner nuclear layer(INL) ,which is the most nuclei of the ganglion cells, proximal M?ller cell end feet and a little cells in the innermost part of the INL, its peak of up-regulation was after day 1-3, after day 28 there was sustained. Whereas TrkC and p75~ NTR expression was enhanced in the outer nuclear layer(ONL), which is distal M?ller cell processes, TrkC up-regulated after 12 hours, its peak was on day 1-3, after day 28 there was sustained, p75~ NTR up-regulated after 24 hours, its peak was on day 3, on day 14-28 there was sustained in the GCL, which is proximal M?ller cell processes. Conclusion The expression of TrkA, TrkC and p75~ NTR participated in the course of laser injuried retinal pathology.

0.05) in blood serum creatinine,urea nitrogen,and endogenous creatinine clearance rate between before and after using vancomycin in 65 old patients.Conclusions Mostly it is safely using the vancomycin in old patients.It can be increased in the security and validity according to endogenous creatinine clearance rate and measuration of blood drug concentration when used vancomycin.Individualization for usage of the vancomycin is helpful.

Objective:To regulate operation requirement for electric instrument using in surgery and eliminate hidden danger so as to ensure their safety in using.Methods: Through discussed the regulation of operative process for electric instrument using in surgery to develop a insulation detector which can adapt the particular case of hospital, and then to carry out relevant management for this kind of electric instrument.Results: The simplest insulation monitoring method got best reliable data, and it provide accuracy basis for clinical electric instrument. Therefore, it ensured the safety of clinical application of electric instrument.Conclusion: The special insulation monitor detects electric instrument in surgery has series of merits including low investment, fast detection and reliable performance, it not only can ensure the safety of surgery but also can provide traceable basis for preventing relevant medical dispute.