Objective To discuss the application of early intraperitoneal perfusion combined with intravenous chemotherapy in patients with advanced colorectal cancer.Methods 100 patients with advanced colorectal cancer were randomly divided into two groups, 50 cases in each group.The control group was treated with intravenous chemotherapy alone after surgery.The observation group was given low perfusion combined with intravenous chemotherapy after surgery.The clinical effect and adverse reaction of the two groups were compared.Results The total effective rate and 3-year survival rate of the observation group(86.0%,34.0%) were significantly higher than those of the control group(68.0%,20.0%).The recurrence rate and metastasis rate of the observation group(14.0%,10.0%) were significantly lower than those of the control group(34.0%,28.0%), the differences were statistically significant(x2=4.482,4.486,5.482,5.263,all P<0.05).At the same time,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Early intraperitoneal perfusion combined with intravenous chemotherapy in the treatment of advanced colorectal cancer can improve the long term survival rate of patients,and the curative effect is accurate.Therefore,it has the value of popularization and application in clinic.

BACKGROUND: Many basic researches and clinical observations prove that compound preparation of gingko extract and dipyridamole has an obvious effect on microcirculation. Methycobal is commonly used to repair nerve on clinic. Combination of compound preparation and methycobal has a great effect on treating diabetic peripheral neuropathy (DPN).OBJECTIVE: To observe the improved effect of combination of compound preparation and methycobal on conduction velocity of common peroneal nerve and hemorheology of DPN patients.DESIGN: Randomized controlled design and validated experiment on the basis of patients.SETTING: Department of Comprehensive Medicine, Tongji Hospital of Tongji Medic.al College, Huazhong University of Science and Technology.PARTICIPANTS: A total of 120 patients with type 2 diabetes mellitus (DM) combined with DPN were selected from the Department of Comprehensive Medicine in Tongji Hospital of Tongji Medical College affiliated to Huazhong University of Science and Technology between January 2002 and January 2005. Subjects were randomly divided into treatment group and control group with 60 in each group. All cases were consent.METHODS: Cases in the treatment group were venously dripped with 25 mL compound preparation and 250 mL saline (Guizhou Yibai Pharmacology Company Limited) once a day; meanwhile, 500 μg methycobal (Eisai Community, Japan) was intramuscularly injected into cases once a day for 4 successive weeks. Cases in the control group were intramuscularly injected with 500 μg methycobal once a day for 4 weeks.MAIN OUTCOME MEASURES: Conduction velocity of peroneal nerve and hemorheological indexes (blood viscosity, hematocrit and aggregative rate of platelet) of patients in the two groups at 1 day before treatment and at 4 weeks after treatment.RESULTS: A total of 120 patients were involved in the final analysis. ① Conduction velocity of motor nerve was faster in treatment group after treatment than that before treatment and that in control group after treatment [(45.6±4.3), (38.5±3.8), (41.4±6.2) m/s, t=9.585, 4.312, P ＜ 0.01]; conduction velocity of sensory nerve was faster in treatment group after treatment than that before treatment and that in control group after treatment [(45.8±4.2), (36.7±4.8), (38.2±4.9) m/s, t=11.047, 9.120, P ＜ 0.01]. ② Values of high-shearing blood viscosity, low-shearing blood viscosity and plasma viscosity were lower in treatment group after treatment than those before treatment and those in control group after treatment (P ＜ 0.01). ③Value of hematocrit was lower in treatment group after treatment than those before treatment and those in control group after treatment [(41.32 ±3.56)%,(46.32±3.43)%, (44.32±4.49)%, t=7.834,4.05, P ＜ 0.01]. ④ Aggregative rate of platelet was lower in treatment group after treatment than those before treatment and those in control group after treatment [(31.35±2.11)%,(48.44±2.68)%, (45.91±3.54)%, t=38.810, 27.367, P ＜ 0.01].CONCLUSION: Combination ofcompound preparation and methycobal can increase nerve conduction velocity and decrease blood viscosity and aggregative rate of platelet, and it is also an effective method for treating DPN.

The paper expounds the scientific management of the science of emergency treatment in the following aspects, organization and structure, quality, computerized information, and special emergency treatment combined with general emergency treatment. It also discusses the management of services facilitating emergency treatment, such as administration, goods provision, human resources, economy, and contingency plans for emergent events.

Objective To study the influence of exchange transfusion therapy on the complications and prognosis in newborns with bilirubin encephalopathy.Methods From June 2013 to June 2016,76 children with bilirubin encephalopathy in Feicheng People's Hospital were selected and divided into study group(n =41) and control group(n =35) according to whether or not accepted the exchange transfusion treatment.The levels of total bilirubin (TBIL),indirect bilirubin(IBIL),direct bilirubin(DBIL) and the ratio of total bilirubin to plasma albumin(B/A)were detected and compared between the two groups.The complications and prognosis of the two groups were recorded.Results After exchange transfusion,the TBIL,IBIL,DBIL and B/A values in the study group were (209.49 ± 48.82) μmol/L,(201.81 ± 39.62) μmoL/L,(21.92 ± 19.47) μmoL/L and (5.15 ± 1.89),respectively,which were significantly lower than those before exchange transfusion [(492.35 ± 42.41) μmol/L,(439.44 ± 52.56) μmol/L,(69.38 ± 21.56) μmol/L and (13.28 ± 0.40)] (t =28.007,23.117,10.461,26.947,all P ＜ 0.05).The incidence rates of anemia,sinus bradycardia and electrolyte disturbances in the study group were 48.78％,48.78,60.98％,respectively,which were significantly higher than those in the control group(17.14％,14.29％,14.29％) (x2 =8.397,10.178,17.228,all P ＜ 0.05).The incidence rates of death,hearing impairment and brain damage in the study group were 7.32％,70.73％ and 12.20％,respectively,which in the control group were 11.43％,71.43％ and 14.29％,respectively,there were no statistically significant differences between the two groups (x2 =0.382,0.004,0.072,all P ＞ 0.05).Conclusion Exchange transfusion can significantly reduce the levels of bilirubin and B/A in the treatment of newborns with bilirubin encephalopathy,but it can increase the incidence rate of anemia,sinus bradycardia and electrolyte disturbances,which has no significant influence on the prognosis of patients.

Objective To investigate the expression of serum Golgi protein 73 in hepatocellular carcinoma(HCC) and analyze the clinical significance.Methods The expression of GP73 was measured by ELISA in 75 HCC ,30 chronic hepatitis and normal con -trols.Results The serum concentrations of GP73 were (128.3 ±33.6)μg/L,(80.3 ±19.2)μg/L and (78.3 ±18.5)μg/L in the HCC, chronic hepatitis patients and normal controls .The serum level of GP73 was significantly higher in HCC than those with chronic hepatitis and healthy controls .GP73 expression was positively correlated with clinical stage , humor size and metastasis.The positive rate of GP73 in stage was 60%,higher than the AFP positive rate(33%).Conclusions The serum level of GP73 is high in HCC and was helpful for distinguishing benign and malignant liver diseases .GP73 can be used as a diagnostic marker for HCC .

Objective To sudy the changes in mTOR signaling pathway in childhood aplastic anemia(AA) by detecting the expression levels of the molecules of mTOR signaling pathway in T cells,and to explore immunologoical pathogenesis of AA in children from T cell intracellular signal transduction pathway.Methods Peripheral blood samples were collected from 16 newly diagnosed severe AA(SAA) patients and 8 patiens treated with effective immunosuppressive therapy,and the findings were compared with those of 17 healthy children (normal controls) and CEM cells (positive controls).The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,p-p70S6K in CD3 + T cells in peripheral blood were detected by flow cytometry(FCM).Results 1.The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,pp70S6K of the newly diagnosed SAA group were higher than those of the normal control group (P ＜ 0.05),but were lower than the postive control group (CEM group) (P ＜ 0.05).The mean fluorescence intensity (MFI) of p-Akt of three groups was 8.04 ± 3.78,2.59 ± 1.01 and 20.23 ± 8.98 respectively ;p-TSC2 was 49.73 ± 19.49,16.10 ± 8.04 and 101.05 ± 29.78 respectively ; p-mTOR was 13.90 ± 9.32,2.92 ± 1.09 and 34.3 ± 19.03 ;p-4EBP1 was 142.69 ± 53.36,26.91 ± 13.70,256.01 ± 53.79 ; p-p70S6 K were 17.67 ± 10.48,3.69 ± 2.22,31.73 ± 12.85 respectively.2.The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,p-p70S6K of the effective treatment groups were lower than those of the newly diagnosed SAA group (P ＜ 0.05) ; the expressions of p-Akt,p-TSC2,p-mTORC1,p-p70S6K were similar to those of the normal control group(P ＞ 0.05),but the expressions of p-4EBP1 were higher(P ＜ 0.05).The MFI was followed by 3.28 ± 1.27,16.50 ± 10.91,3.54 ± 1.66,74.89 ± 49.69 and 4.21 ± 1.69.Conclusions 1.The expressions of p-Akt,p-TSC2,p-mTORC1,p-4EBP1,p-p70S6K were increased in the newly diagnosed SAA patients,the mTOR signaling pathway was activated in SAA patients.2.The expressions of p-Akt,p-TSC2,p-mTORC1,p4EBP1,p-p70S6K were lower than those of the newly diagnosed SAA patients.The degree of activation of mTOR signaling pathway was associated with disease status.The signaling pathways may be involved in the T cells of AA of the immune abnormalities.

Aim To determine whether pranlukast (ONO-1078), a cysteinyl leukotriene receptor antagonist, possesses therapeutic effect when administered after focal cerebral ischemia in mice. Methods Persistent focal cerebral ischemia was induced by middle cerebral artery occlusion. Pranlukast and edaravone, a positive control drug, were ip injected 1, 6 and 24 h after ischemia. The neurological deficits were evaluated by neurological scores and inclined plane test 24 and 48 h after the surgery. Forty-eight h later, the brain slices were prepared for measurements of infarct volume and the ratio of ischemic/non-ischemic hemispheres. Brain sections were cut and examined for neuron densities in different regions of the brain. The effects of pranlukast and edaravone were evaluated by the changes of these variables. Results Pranlukast (0.1 and 0.2 mg?kg -1) and edaravone (3 and 10 mg?kg -1) significantly reduced the neurological deficits, infarct volume (maximally 82.3%), ratio of ischemic/non-ischemic hemispheres, and attenuated the reduction of neuron densities in hippocampal CA1 region, cortex and striatum. Conclusion Pranlukast possesses therapeutic effect on ischemic insults when administered after ischemia as effective as edravone, indicating a therapeutic potential in the treatment of ischemic stroke.

OBJECTIVE: To clarify the correct diagnostic methods of FBPS of children, and to explore techniques and technology of surgical operation aim to complete excision of sinus tract and preservation of the recurrent laryngeal nerve through analyzing the clinical characteristics and the characteristics of open neck surgery in FBPS of children. METHOD: Clinical materials of 6 children FBPS with internal pyriform sinus were retrospectively analyzed, and literatures were studied to explore the appropriate surgical management of children FBPS; lesions of 6 patients were completely dissected by open neck surgery with the help of di-direction catheterization revealing the tract of fistula, and the openings of the fistula to pyriform apex were cauterized by monopolar coagulation at the end of the procedure; all 6 cases were with systematic endoscopic follow-up. RESULT: All cases of 6 children patients were cured by open neck surgery, no recurrence of clinical symptoms were observed during a mean follow-up of 14 months (1-3 years); 2 cases were diagnosed with an "anatomical" relapse (persistence of the sinus tract orifice without clinical symptoms) at the follow-up endoscopy(at 3 and 4 months after surgery); all 6 cases had no complication of laryngeal paralysis. CONCLUSION The children patients presenting recurrent acute suppurative thyroiditis and deep neck abscess of anterior area in the lower part of neck, especially locating left neck, should be considered as the diagnosis of FBPS. also the same as confirmed by enhanced neck CT scan and direct laryngoscopy. Patients with identification of internal pyriform sinus and Betz fold by direct laryngoscopy, and with identification of fistula which passes through the cricothyroid membrane beneath the superior laryngeal nerve can be confirmed FBPS. Completely dissection of sinus tract by open neck surgery was the effective management of children FBPS and di direction catheterization aids to reveal and identify the tract of fistula. Resection of the posterior part of the thyroid cartilage ala can be useful to aid exposure and preservation of the recurrent laryngeal nerve; but co-excision of a portion of the upper of the thyroid gland aids to the entire dissection of lesions. In addition, cauterizing the opening of the fistula to pyriform apex may be useful to obliterate the internal opening of pyriform sinus.
Adolescent ; Branchial Region ; abnormalities ; Child ; Child, Preschool ; Female ; Fistula ; diagnosis ; surgery ; Humans ; Male ; Neck ; Retrospective Studies

Objective To investigate the clinical effects and complications of endoscopic tandem ligation and hemorrhoids ligation.Methods Clinical data of 120 patients with grade Ⅰ～Ⅲ internal hemorrhoids who were hospitalized due to hematochezia from November 2021 to March 2023 were retrospectively analyzed.According to the different surgical methods,60 patients who received endoscopic hemorrhoid ligation were divided into control group;60 patients who underwent endoscopic tandem ligation were divided into treatment group.The effective rate of hemorrhoidal hemorrhage,the effect of internal hemorrhoidal prolapse and the incidence of postoperative complications were compared between two groups within 6 months after operation.Results The effective rate of internal hemorrhoidal bleeding was 100.00％in both groups,and the efficacy of the treatment group in the treatment of degree Ⅱ internal hemorrhoidal prolapse was similar to that in the control group(P＞0.05),but the treatment group was significantly better than the control group in the treatment of degree Ⅲ internal hemorrhoidal prolapse(P＜0.01),the postoperative anal pain in the treatment group was significantly more than the control group(P＜0.05);There were no significant differences in postoperative perianal pain,urinary retention,and abnormal defecation between the two groups(P＞0.05).No thrombotic external hemorrhoids occured in two groups.Conclusion The short-term efficacy of endoscopic tandem ligation and hemorrhoidal ligation in the treatment of internal hemorrhoidal bleeding is similar and both achieved satisfactory results,the short-term efficacy of the two in the treatment of degree Ⅱ internal hemorrhoidal prolapse is similar,the short-term efficacy of the former in the treatment of degree Ⅲ internal hemorrhoidal prolapse is significantly better,the feeling of anal heaviness in the treatment group is more than that in the control group,and there is no striking difference in the other complications.

Objective To investigate the relationship between the levels of soluble growth stimulation expressed gene 2 protein (sST2), myoglobin (Myo), interleukin-6 (IL-6) in peripheral blood and cardiac function in elderly patients with diastolic heart failure (DHF) complicated with sarcopenia. Methods A total of 122 patients with DHF were divided into DHF complicated with sarcopenia group (60 cases) and DHF group (62 cases) according to the presence or absence of sarcopenia. In addition, 58 healthy healthy population with physical examination and 60 patients with sarcopenia alone were included in the control group and sarcopenia alone group, respectively. The levels of sST2, Myo, IL-6 and cardiac function indexes[left ventricular ejection fraction (LVEF), cardiac output (CO), heart rate (HR), stroke volume (SV), and cardiac index (CI)]were measured in each group. Pearson correlation analysis was used to analyze the correlations between sST2, Myo, IL-6 and each cardiac function index. Receiver operating characteristic (ROC) curves were drawn to analyze the diagnostic efficacy of sST2, Myo, IL-6 alone and their combination in diagnosing DHF complicated with sarcopenia. Results Compared with the control groupand the sarcopenia alone group, the levels of sST2, Myo, IL-6 and HR were increased, while LVEF, CO, SV, and CI were decreased in the DHF group and the DHF complicated with sarcopenia group (P < 0.05). Compared with the DHF group, the levels of sST2, Myo, IL-6 and HR were increased, while LVEF, CO, SV, and CI were decreased in the DHF complicated with sarcopenia group (P < 0.05). The sST2, Myo, and IL-6 were negatively correlated with LVEF, CO, SV, and CI (P < 0.001), and positively correlated with HR (P < 0.001). The sST2, Myo, IL-6, LVEF, and SV were independent influencing factors for DHF complicated with sarcopenia (P < 0.05). The area under the curve of combined detection of sST2, Myo, and IL-6 for diagnosing DHF complicated with sarcopenia was 0.936, indicating a better diagnostic efficacy than individual tests. Conclusion The levels of sST2, Myo, and IL-6 in peripheral blood are significantly increased in elderly patients with DHF complicated with sarcopenia, and these markers are significantly correlated with cardiac function indexes. Combined detection of these three markers has a higher diagnostic efficacy for DHF complicated with sarcopenia.