Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Chronic Disease ; therapy ; Colitis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To investigate the safety and efficacy of endoscopic duodenal papillary muscle small incision(EST)combined with duodenal papillary balloon dilation(EPBD)in the treatment of elderly patients with bile duct stones.Methods 100 elderly patients with bile duct stones were treated with endoscopic stone removal. Among them,55 patients were treated with SEST combined with EPBD(EPBD group),45 patients were treated with a single EST(EST group),the rate of stone removal,the occurrence rate of lithotripsy and the incidence of complications were compared between the two groups.Results The SEST +EPBD group at a time calculi clearance rate,postopera-tive hyperamylasemia,post pancreatitis,cholangitis were 98.2%,7.3% and 3.6%,1.8%,the EST group were 97.7%,6.7%,6.7%,3.6% and the difference between the two groups had no significant(all P >0.05).The SEST+EPBD group of gravel formation rate was 3.6%,lower than 13.3% in the EST group,the difference was statistically significant(χ2 =9.647,P <0.05).The SEST +EPBD group had no bleeding,bleeding in EST group incidence rate was 11.1%,the difference was statistically significant(χ2 =11.235,P <0.05);The recurrence rate of the SEST +EPBD group was 1.8%,which was lower than 11.1% in the EST group,the difference was statistically significant (χ2 =10.113,P <0.05 ).Conclusion EST combined with EPBD in the treatment of elderly common bile duct stones is safe and effective,which can significantly reduce the incidence of debris and bleeding,reduce the recurrence rate of common bile duct stones.

Objective To sum up the experience on the diagnosis and treatment of abdominal compartment syndrome(ACS). Methods In this report, ACS was diagnosed by special clinical features in all 5 patients. Following emergency decompressive celiotomy, the abdominal viscera were covered with a 3 L sterile plastic bag for nutrition support. Results The first case died despite abdominal decompression through uper midline incision. 4 cases underwent decompressive celiotomy through incision from xiphoid to symphysis, one died postoperatively. The overall mortality in this series was 40% (2 / 5). Conclusions Close attention paid to the abdominal and systemic signs facilitates the diagnosis of ACS.Emergent decompressive celiotomy through a incision from xiphoid to symphysis is effective in treating ACS. Temporary abdominal closure could be fulfiled with 3L sterile plastic bag for nutrition support.

Anemia, Macrocytic ; Chromosome Deletion ; Chromosomes, Human, Pair 5 ; Cri-du-Chat Syndrome ; Humans ; Trisomy

Esophagus ; Foreign Bodies ; Humans ; Infant ; Male

Cartilage ; pathology ; Catheter Ablation ; adverse effects ; methods ; Female ; Humans ; Laryngeal Nerves ; Microwaves ; Middle Aged ; Necrosis ; Thyroid Gland ; surgery ; Trachea ; pathology ; Vocal Cord Paralysis ; etiology

Child, Preschool ; Ear, External ; abnormalities ; Humans ; Male ; Nasopharynx ; abnormalities

Objective To evaluate the safety and feasibility of totally thoracoscopic anatomic pulmonary segmentectomy (TTAS) for the treatment of the peripheral stage ⅠA non small cell lung cancer(NSCLC).Methods The study involved 50 consecutive patients undergoing totally thoracoscopic anatomic segmentectomy (TTAS) from September 2010 to November 2012 in the First People's Hospital affiliatied to Nanjing Medical University.The diameter of the tumors were less than 2 cm [(mean diameter(1.35 ±0.48) cm].All lymph node sampling of N1 and N2 were neglive,All patients received symtematic lymph node dissection.The pulmonary vessels were individually ligated,and the bronchi were closed using an endoscopic stapler.The intersegmental plane was identified using the demarcation between the resected(inflated) and preserved(collapsed) lungs.Staplers were used for intersegmental dissection.Results The mean operative time and intraoperative bleeding were (191.5 ± 50.4) min and (49.2 ± 54.6) ml respectively.The chest tube drainage duration was (3 ± 1) days.The number of stapler cartridges used for intersegmental division was 3.9 ±0.8.The mean number of lymph nodes and nodal stations dissected were 12.6 ± 2.8 and 6.0 ± 1.5 respectively.No mortality and complications were observed 30 days after the surgery.Further,no local recurrence or metastases were observed during follow-up.Conclusion Totally thoracoscopic anatomic segmentectomy(TTAS) is a feasible and safe technique.With systematic lymph node dissection,TTAS can be a reasonable therapeutic option for stage ⅠA NSCLC.

Trichinella spiralis nudix hydrolase (TsNd) gene encoding a 46 kDa protein was expressed in Escherichia coli and the potential of recombinant TsNd protein (rTsNd) as an antigen for the serodiagnosis of trichinellosis was investigated by ELISA and compared with those of ELISA with T. spiralis muscle larval excretory–secretory (ES) antigens. The sensitivity of both ELISA was 100% (30/30), for the detection of anti-Trichinella IgG antibodies in sera of the experimentally infected mice, and the specificity of rTsNd-ELISA and ES-ELISA was 100% (54/54) and 98% (53/54), respectively (P>0.05). Serum anti-Trichinella antibodies were firstly detected by rTsNd-ELISA at 14 days post infection (dpi), then continued to increase with a detection rate of 100% at 36 dpi. The anti-Trichinella antibody levels at different times after infection were statistically different (P<0.05). The results showed that the rTsNd might be a potential candidate antigen for specific serodiagnosis of trichinellosis. But, it needs to be further evaluated with sera of the patients with trichinellosis and other helminthiasis.

Objective To investigate the relationship between the expression level of deleted in liver cancer-1 (DLC-1) gene and colon cancer staging or lymph nodes metastatic ratio.Methods Total 60 resection specimens were collected from colon cancer patients between September 2009 and September 2011,and 10 resection specimens from patients with trauma,colonic diverticulitis and colitis were used as the control.The DLC-1 mRNA level was measured with real time quantitative RT-PCR in colon cancer patients and the control group.TNM system was used for colon cancer staging.The linear correlation analysis was performed to determine the relationship between DLC-1 expression level and colon cancer staging or lymph nodes metastatic ratio.Results The mRNA level of DLC-1 was significantly reduced in colon cancer tissues in comparison to that in adjacent normal tissues,while adjacent tissues showed significantly lower DLC-1 level than normal clone tissues.The expression of DLC-1 was negatively correlated with both colon cancer stage and the lymph nodes metastatic ratio (r =0.46,P ＜ 0.05).Conclusions DLC-1 expression was negatively correlated with pathological stage and lymph node metastasis ratio,indicating a critical role of DLC-1 gene in colon cancer genesis,which provide a possible new direction for colon cancer research.