Objective To explore the factors related to effects and prognosis of surgical treatment of hilar cholangiocarcinoma.Methods The clinical data of 41 patients with hilar choIangiecarcinoma(HCCA) admitted in recent seven years were investigated and anlyzed retrospectively.Results Among 41 patients with HCCA,the accuracy rate of diagnosis by imaging technology was 95.1% before operation.Thirty-two cases were treated by surgical resection,of which 15 cases had radical resection and 17 cases had palliative resection,the total resection rate was 78.1%,and 9 cases had biliary internal drinage procedure.Two cases died during hospitilization.The rate of one-,three-and five-year survival for surgical resection was 70.0%,40.0% and 23.3% respectively,and for palliation drainage was 44.4%,11.1%,and 0%,respectively.The median survial time was 28 months and 8 months for surgical resction and palliation drainage,respectively.The difference between surgical resction and palliation drainage on survival rate and median survival time was signigicant(P

Objective To evaluate the effect of management by objective implementation in neurology department nurse training.Methods Divided the nursing students into the experimental group and the control group according to their student ID,there were 100cases in each group.Routine training was used in the control group,while the training based-on management by objective was used in the experimental group.Compared the intervention effects between the two groups.Results The scores of theory,skills and the comprehensive performance in the experimental group was significant higher than that of in the control group respectively,P＜0.01.The excellent rate of theory and skills in the experimental group was 57.95％ (2 434/4 200) and 49.74％ (1 691/4 200),which was significant higher than those of in the control group [28.62％ (1 202/3 400) and 21.91％ (745/3 400)],P＜0.01.The intervention measures had increased the theoretical scores 21.011 times,OR=21.011,95％CI 9.752-45.269,increased the skills scores 14.625 times,OR=14.625,95％ CI7.032-30.416,increased the comprehensive performance 23.993 times,OR=23.993,95％CI1.085-51.934.Conclusion The implementation of management by objective on nurse training can improve the trainee's theory and professional knowledge,the nursing skill can be improved also.So the comprehensive training effect is higher than before.

Multi-component Chinese medicine has been considered an important developmental direction for traditional Chinese medicine (TCM) formula.Nowadays,it is unfit to target a molecule for preventing or curing a disease because it resulted from multiple of factors and resulted in many indications.Thus,the idea focusing on the multiple targets for therapy is increasingly accepted by physicians and scientists.Here,we conceived a new simplified method for screening the active multi-component Chinese medicine based on the complexity of Chinese medicine,the multi-target property of protein signal transduction and the principle of Chinese medicine prescription.Combined with the traditional knowledge on tumor and latest antitumor research results of Chinese medicine and its compounds,the method was concretely illustrated.It helps us to transform the herbal compounds to new complex drugs targeting multiple signaling.

Objective To evaluate the safety and efficacy of the technique of transoral Orvil EEA stapler (OrVil) for laparoscopic gastrectomy of gastric cancer in our hospital.Methods Between Sep 2012 and Aug 2013,73 patients at our department underwent open (n =36) or laparoscopic (being reconstructed by OrVil,n =37) gastrectomy.Early surgical outcomes of the two groups were compared to assess the effectiveness,security and postoperative complications of OrVil procedure.Results The two groups had similar mean numbers of dissected lymph nodes (29 ± 10 vs.31 ± 14,t =-0.697,P =0.488),lengths of postoperative hospital stay (14 ± 5 vs.12 ± 3 d,t =1.933,P =0.057) and postoperative complications (11 vs.11,P =0.939).Intraoperative blood loss was significantly less (189 ± 79 vs.343 ± 90 ml,t =-7.782,P =0.000) and time to first flatus significantly shorter (2.9 ±0.5 vs.3.5 ±0.6 d,t =-4.714,P =0.000) with the use of OrVil.Operation time of laparoscopic group was significantly longer than that of open group (266 ± 97 vs.204 ± 39 min,t =3.607,P =0.001).There was one each anastomotic leakage in both groups.Conclusions With the suitable approach and skillful technique,OrVil is a technically safe and feasible surgical procedure for the treatment of gastric cancer.

Objective To evaluate the application of endoscopic needle- knife precut sphincterotomy (PST) in treating acute suppurative cholangitis. Methods After failure of routine papillary intubation during encoscopic retrograde cholangio-pancreatography (ERCP) in papillary incarcerated stone or inflammatory stenosis cases, needle-knife PST was applied to find the lower opening of the common bile duct. After that, routine papillary sphincterotomy or balloon dilation followed. Then net basket for stone extraction and nasobiliary catheter for drainage were made. Results Eleven of the 12 cases′ stones were extracted successfully, the success rate was 91.7%. In the 11 cases, 5 cases′ incarcerated stones dropped into duodenum automatically after sphincterotomy; 9 cases′ stones were extracted successfully in one treatment while 2 cases′ stones were extracted secondarily after stents were implanted; 1 case′s stone could not be extracted and need surgical treatment after nasobiliary catheter drainage because of stenosis of the lower part of the common bile duct. There was no dead case in all the cases. Conclusions Acute suppurative cholangitis patients, who have papillary incarcerated stones or inflammatory stenosis, can receive more efficacious diagnosis and treatment by applying PST when routine endoscopic papillary intubation fails. PST is an important endoscopic treatment for acute calculous suppurative cholangitis

Objective To investigate the effects of Shuangligan and Glycine on Thl/Th2 balancing on severe acute pancreatitis ( SAP) in rats. Methods Thirty-two Wistar rats weighing (260 ± 20) g were randomly divided into sham operation (SO) group, SAP group, SAP + Slg (with the treatment by Shuangligan) group and SAP + Gly (with the treatment by Glycine ) group. Each group included 8 rats, which accepted different treatment according to the experimental design. Changes of plasma level of endotoxin ( ET) and serum amylase (AMY) and the effects of Shuangligan and Glycine on Thl/Th2 ratio at the 24th hour after operation were observed respectively. Results The plasma endotoxin (ET) level ( (0. 67 ±0. 11) EU/ml),proinflammatory cytokine (INF-γ:(8.43 ± 0.86) ng/L, IL-12: (8.26 ± 1.97) ng/L) and Thl/Th2 ratio (0.36 ± 0.07) in SAP group were significantly higher than those in SO group( ET: (0. 44 ±0.07) EU/ml, INF-γ: (3. 80 ±0. 55) ng/L, IL-12: (3. 34 ± 1. 34)ng/L,Thl/Th2 ratio (0. 24 ±0. 05) ) (P <0. 05). Compared with SAP group, SAP + Slg and SAP + Gly group had remarkably decreased plasma ET level ( (0. 57 ± 0. 08,0. 52 ± 0. 04) EU/ml) (P < 0. 05) and the Thl/Th2 ratio reached equilibrium ( SAP + Slg group; (0. 29 ± 0. 04 ), SAP + Gly group: (0. 25 ± 0. 06 )) . Conclusions In the earlier stage of SAP, the rising plasma ET level may cause the overreaction of the cell mediated immune response, which leads to the aggravated damages in tissue cells. Our data indicates that Shuangligan and Glycine can restrain the formation of intestinal endotoxemia and alleviate or prevent the tissue injuries.

Objective To investigate the effect of intensive insulin therapy on long-term remittance of the islet β-cell function in newly diagnosed type 2 diabetic patients. Methods 120 newly diagnosed type 2 diabetic patients were randomly divided into four groups, and intensive insulin therapy was given for 15 days, 30 days, 60 days and 90 days respectively. The islet β-cell function were measured before and 1 or 2 years after treatment, and the differences were compared among each group. Results The plasma glucose was controlled well and the islet β-cell function was significantly improved in each group after treatment. The ratio value of △I30/△G30 in groups of 30 days,60 days and 90 days were higher than group of 15 days[(1.48±0.43 )mmol/L vs (1.25±0.40) mmol/L, t＝2.40,P＜0.05, (1.83±0.37) mmol/L vs (1.25±0.40) mmol/L, t＝2.85,P＜0.01, (1.90±0.41) mmol/L vs (1.25±0.40) mmol/L, t＝2.97,P＜0.01]. The indexes of the islet β-cell secretion function all gradually declined in each group after treatment for 2 years, but still higher than before treatment, the ratio value of △I30/△G30 in groups of 60 days and 90 days were higher than group of 15 days and 30 days[(1.44±0.51)mmol/L vs (0.87±0.47) mmol/L,t＝2.92, P＜0.01, (1.44±0.51)mmol/L vs (1.09±0.55) mmol/L, t＝2.44,P＜0.05, (1.52±0.44) mmol/L vs (0.87±0.47) mmol/L, t＝2.86, P＜0.01, (1.52±0.44) mmol/L vs (1.09±0.55) mmol/L, t＝2.50, P＜0.05], there was no difference between group of 60 days and 90 days. The ratio of remittance in groups of 60 days and 90 days was very high. Conclusions Intensive insulin therapy can significantly improve the islet β-cell function of newly diagnosed type 2 diabetic patients,anddelay the natural process. An appropriate extension of treatment can further prevent the descending rate of islet β-cell function, and easily get the long-term remission.

OBJECTIVE: To investigate the clinical features and medication of unilateral idiopathic vocal fold paralysis. METHOD: Thirty-nine of medical treated patients with unilateral idiopathic vocal fold paralysis were retrospectively studied, and relevant literatures were reviewed. RESULT: After 4 to 19 days of medical therapy, 9 patients were cured, the vocal fold movement of 18 sufferers were improved, and 12 pantients were not healed. CONCLUSION Unilateral idiopathic vocal fold paralysis is common, and the treatment efficacy of medicine is almost the same with others. Unilateral idiopathic vocal fold paralysis is a disease with spontaneous recovery, which should be followed up.
Humans ; Retrospective Studies ; Treatment Outcome ; Vocal Cord Paralysis ; drug therapy ; Vocal Cords ; physiopathology

AIM: To investigate the effect of peritoneal vibration on the peritoneal permeability and the peritoneal surface layer. METHODS: Peritoneal transport rate was examined in twelve male SD rats. Six (S group) were put on an electronic shaker and the other six were used as control (C group). After that, the peritoneum was examined by electron microscopy (EM). RESULTS: The net ultrafiltration volume (NUF) in the S group was lower than that in the C group. This difference in NUF was due to both a significantly higher peritoneal fluid absorption rate and a significantly lower transcapillary ultrafiltration rate in S group as compared to C group. The peritoneal direct lymphatic absorption rate was higher in S group. The transport rates of small solutes were also significantly higher in S group. EM showed that the thickness of the peritoneal surface layer was significantly decreased in S group. CONCLUSION: Our results suggest that the peritoneal surface layer may be an important layer in modulating the peritoneal transport rate.

MTH1 (MutT Homolog1 )as MutT homologous en-zyme,is a nucleotide pyrophosphatase,mainly involved in DNA damage repair process,especially plays an important role in the process of DNA replication in tumor cells.Recent studies have found that MTH1’s function is responsible for the development of a variety of tumors.Studies have shown that,MTH1 can remove tumor cells’oxidative DNA elements detrimental to the function-al structure,protecting tumor cell division and proliferation, maintaining tumor cell survival,however,normal cells do not need MTH1.Therefore,MTH1 may be only closely associated with abnormal cell growth.This makes MTH1 as therapeutic tar-gets that have been paid much attention.This article reviewed the relationship of MTH1 and tumor,discussed the mechanisms of MTH1 in tumor growth MTH1 and tumor treatment,so as to provide reference for clinical research and treatment of tumor.