Purpose:To study the clinical value of percutaneous placement of biliary stents tbr treatment of malignant biliary obstruction.Materials and methods:A total of 58 stents were placed pereutaneously in 53 patients for palliative of malignant biliary obstruction. Results:The success rate of stent implantation was 98.1%(52/53).The difference between post-and pre-operation in the serum total bilirubin level of 52 patients was 182?67 ? mol/L,P

Objective:The therapeutic efficacy and side effects of combined chemotherapy of HCPT,MTX,LV and 5-Fu for metastatic or recurrent breast cancer were evaluated in our study.Methods:A total of 43 cases of advanced metastatic or recurrent breast cancer were treated with chemotherapy regimen consisting of HCPT 10mg/m2 iv gtt for dl～5,MTX 100mg iv dl,Leucovorin 150mg/m2 iv gtt for d2～4,5-Fu 500mg/m2 iv gtt for dl～5.The cycle was repeated every 4 weeks,and 2 cycles were given as one course.Results:The overall CR+PR was 47%.One year survival rate was 54% and the median survival interval was 19 months.The main side effects were bone marrow suppression and gastrointestinal reaction.Conclusion:The combined chemotherapy regimen consisting of HCPT etc is beneficial for metastatic breast cancer.

To analyze the cause and therapy of hydrops in subcutaneous scalp after repairing skull defect by using silicon-polyester fiber network, a total of 91 patients who were treated with silicon-polyester fiber network to repair skull defect from June 1996 to October 2000 in the Department of Neurosurgery, Nanshan People's Hospital were analyzed retrospectively. And 56 cases of them had hydrops of subcutaneous scalp and treated with suction and pressure dressing, including 11 cases of less than 20 mL hydrop quantity, 27 cases of 20-50 mL, and 18 cases of more than 50 mL. They were observed for 6 weeks averagely after operation and were healed within 4 weeks by simple management. No recurrence of hydrops was found in subcutaneous scalp. It is indicated that silicon-polyester fiber network in repair of skull defect may complicate with hydrops of subcutaneous scalp usually. However, the prognosis will be good by means of drainage, so it can be used as a therapy for skull defect.

Objective To analyze the accuracy,sensitivity and safety of multidetector CT angiography(MDCTA) and DSA;furthermore to explore the clinical value of MDCTA in studying the delayed cerebral vasospasm(DCVS) .Methods Delayed cerebral vasospasm was induced in 17 rabbits by injection of autologuous blood into the cisterna magna and followed by a second injection 24 hours later.MDCTA and DSA were carried out at the 7th day before and after the procedure in order to obtain the data of vascular diameter changes for comparative study.Results The basilar artery diameters detected by MDCTA were shown preoperatively as(1.55 ? 0.14) mm and postoperatively as(0.95 ? 0.20) mm;and detected by DSA as(1.61 ? 0.19) mm and(1.00 ? 0.17) mm postoperatively;showing statistically equivalence between the two methods.Conclusions MDCTA is recommended as a reliable,rapid,and minimally invasive diagnostic method,providing a new technique for the delayed cerebral vasospasm research.

AIM: To investigate the function of the prot ein tyrosine kinase of focal adhesion kinase subfamily gene, the gene regulation and the signaling pathway related to ventricular septal defect during heart dev elopment. METHODS: The ALK3 downstream genes were screened usin g microarray. The ALK3 downstream genes was identified using RT-PCR and real tim e quantitative RT-PCR.RESULTS: It was found that the protein ty rosine kinase of focal adhesion kinase subfamily gene was up-regulated 3.7 fold in the 11.5 days embryonic heart of cardiac- specific deletion of ALK3 mice. CONCLUSION: The protein tyrosine kinase of focal adhesion kinase subfamily possibly is a regulatory factor in bone morphogenetic protein signalin g pathway and may be related with the development of ventricular septal defect.

BACKGROUND:Transplantation of bone marrow mesenchymal stem cells can promote repair of brain injuries in animals. OBJECTIVE:To summarize the research progress in intranasal delivery of bone marrow mesenchymal stem cells to the brain. METHODS:A computer-based online retrieval of PubMed and Wanfang databases was performed to search papers published during January 1999 to January 2014 with the key words of“bone marrow mesenchymal stem cells, brain injury, transplantation”in English and Chinese. Thirty-eight papers were included in the final analysis. RESULTS AND CONCLUSION:Nowadays, many studies have been certified that the transplantation of bone marrow mesenchymal stem cells can significantly ameliorate the function of cranial nerve in animal models of brain injury. Many researchers have searched for the transplantation methods and approaches and have made progresses in many aspects. In this article, we compare the different transplantation ways of bone marrow mesenchymal stem cells to the brain. We focus on the intranasal transplantation route in the fol owing aspects:processing of the nasal mucosa;delivery route to the brain;labeling and intracranial observation of stem cells;animal experiments. We conclude that the intranasal delivery of bone marrow mesenchymal stem cells to the brain has a wide clinical application as a noninvasive transplantation.

Objective To compare the survival conditions of patients with insulinoma after enucleation of insulinoma or partial resection of pancreas.Methods The clinical data of 99 patients with insulinoma,treated with surgery from May.2003 to Aug.2015 were retrospectively analyzed.Of the 99 patients,38 received enucleation of insulinoma alone and 61 received partial resection of pancreas.The overall data were analyzed by SPSS 21.0 software.Results Average survival of patients after enucleation of insulinoma (103.3 months) was longer than that of patients after partial resection of pancreas (77.5 months),and the difference had statistical significance (P=0.006).The difference of the incidence of most chronic or temporary complications had no statistical significance between the two groups (P＞0.05),except for new-onset diabetes (P=0.004).Conclusion Enucleation of insulinoma should be firstly recommended for patients with insulinoma in suitable size,which can provide patients with better survival condition.

BACKGROUND:Autologous bone marrow aspirate concentrate is often applied in patients from Department of Orthopedics and those with severe limb ischemia, but rarely applied in Department of Oral and Maxil ofacial Surgery, especial y in Department of Oral Implantology. The effect of autologous bone marrow aspirate concentrate on promoting peri-implant bone regeneration deserves further studies.
OBJECTIVE:To evaluate the effect of bone marrow aspirate concentrate in the repair of peri-implant bone defect.
METHODS:Bone marrow 5 mL was extracted from posterior superior iliac spine of experimental dogs and bone marrow cel s were counted before and after concentration. Bone defect (4 mm × 4 mm × 4 mm) was prepared in the middle of bilateral mandibular premolar, which was randomly implanted with gelatin sponge plus bone marrow aspirate concentrate, autologous bone and gelatin sponge. At 4 and 12 weeks after surgery, bone defect specimens were histological y observed. The new bone formation rate and new bone mineral density were calculated.
RESULTS AND CONCLUSION:After centrifugation, the concentrations of nucleated cel s in bone marrow aspirate concentrate were increased by (2.78±0.22) times. More colony-forming units were found after cel culture. Histological analysis showed that, significantly higher new bone formation rate and new bone mineral density occurred in gelatin sponge plus bone marrow aspirate concentrate group, compared with autologous bone group and gelatin sponge group at 4 weeks (P<0.05). The new bone formation rate in gelatin sponge plus bone marrow aspirate concentrate group was significantly lower than that of autologous bone group, and higher than that of gelatin sponge group at 12 weeks (P<0.05). However, the difference of new bone mineral density in the three groups was not significant (P>0.05). Autologous bone marrow aspirate concentrate can significantly improve new bone mineral density and quantity in the pre-implant bone defect.

Objective To investigate the clinicial significance of continuous glucose monitoring(CGM)of patients with severe traumatic brain injury(sTBI). Methods By glucose monitoring method,80 patients with sTBI〔Glasgow coma score(GCS)3-8〕in Department of Critical Care Medicine of Qingyuan People's Hospital in Guangdong Province from January 2012 to December 2012 were divided into two groups:41 patients in CGM group and 39 in regular glucose monitoring(RGM)group. The continuous glucose monitoring system(CGMS)was applied to monitor glucose level in the CGM group,and the finger blood was taken by portable blood glucose meter in the RGM group. The two groups were treated with insulin on the basis of glucose level,respectively. The relationships between the condition of glycemic excursions and the acute physiology and chronic health evaluationⅡ(APACHEⅡ)score or prognosis and between the incidence of hypoglycemia and prognosis were seen in the two groups. Results The close linear correlations between APACHEⅡ score and glycemic excursion in two groups,i.e. mean amplitude of glycemic excursions(MAGE)and coefficient of variation of glucose(GluCV),were documented(both P<0.05). The MAGE of the especially severe patients(GCS 3-5)was obviously higher than that of severe ones(GCS 6-8),and with the increase of APACHEⅡ score,the MAGE of patients was gradually elevated,the difference being statistically significant(both P<0.05). The incidence of hypoglycemia(7.32%vs. 23.08%)and fatality rate of 30 days(12.20%vs. 30.77%)in CGM group were lower than those of RGM group(both P<0.05). The MAGE and fatality rate of 30 days were positively correlated in CGM group(r=0.597,P=0.007),and the GLuCV and fatality rate of 30 days were positively correlated in RGM group(r=0.622,P=0.019). Conclusion CGM is beneficial to timely observe condition of glycemic excursions in sTBI patients and avoid occurrence of hypoglycemia or hyperglycemia,guiding the treatment of insulin and improving patients' prognosis.

Objective To investigate the value of muhi-detector CT (MDCT) low tension dynamic enhanced scanning on the preoperative assessment of advanced gastric cancer.Methods MDCT low tension dynamic enhanced scanning,tumor diagnosis and staging and prediction of surgery operation were performed on 43 cases of advanced gastric cancer.And the above results were compared with pathology results.Results The 36 cases were treated with resection,while 7 cases were treated by gastrointestinal anastomosis.The MDCT had 76.7 ％ (33/43) of accuracy for the preoperative T staging and 74.4 ％ (32/43) of accuracy for the preoperative N staging,respectively.The stomach wall thickness was closely related to serosal invasion (x2 =20.170 9,P ＜ 0.001).Conclusions The MDCT low tension dynamic enhanced scanning can improve the comprehensiveness and accuracy of preoperative staging of T and N in advanced gastric cancer.It is valuable for the preoperative diagnosis and treatment of gastric cancer.