At present, the percutaneous transhepatic cholangiodrainage (PTCD) and the self-expandable metal stent implantation are commonly recognized as an effective treatment for inoperable malignant biliary obstruction, but the restenosis of biliary stent significantly affect the therapeutic result and prognosis.Percutaneous transhepatic intraductal radiofrequency ablation can be used together with biliary stent implantation, which can prolong the patency time of biliary stent and control the local tumor at the narrowed segment, thus, the therapeutic effect of malignant biliary obstruction can be reliably improved. As a kind of newly-developed therapy, its clinical safety is especially important. This paper aims to make a review about the safety of percutaneous transhepatic intraductal radiofrequency ablation combined with biliary stent implantation in treating malignant biliary obstruction.

Microbiology is an important basic course of biological subject.Base on using different modern means,the teaching method was explored and attempted,such as quiz teaching,discussion teaching,inductive teaching and teaching check.It is possible for students to be- come main part for teaching course,and student enthusiasm for study was mobilized.

Objective To investigate the clinical value of whole blood red cell distribution width ( RDW) in discriminating lung cancer metastasis.Methods A retrospective analysis was conducted on the patients who were initially diagnosed as primary lung cancer.A total of 525 patients were included for analysis between January 2012 and July 2013,stratified by different stages and metastasis scenarios.RDW data was investigated.Kruskal-Wallis H tests were performed to know the difference of RDW without and within groups.Spearman correlation test was done subsequently to further analyze the correlationship among RDW and clinical parameters.Results RDW was14.5 ( 13.0-15.4 )%in patients with metastasis , which was significantly higher than those without metastasis [12.7 (12.3-13.0)%].Further analysis indicated a similar ascending trend in cases that already had distant or multiple organ invasion.For example,RDW was 14.6 (12.9-15.4) %in patients of stage ⅢtoⅣ,while was 12.6 (12.2-13.1) %in patients of stageⅠtoⅡ.RDW was correlated to lung cancer metastasis and stage advancement.Areas Under Curve ( AUCs) of ROC for lung cancer metastasis and distant metastasis were 0.823 ( 95% CI:0.787-0.859 ) and 0.710 (95%CI:0.655-0.765) respectively,indicating a promising accuracy.The Cut-off value for discriminating lung cancer with/without metastasis was 14.25% with sensitivity being 56.8% and specificity being 98.3%.Conclusion RDW may be a novel biomarker for auxiliary diagnosis of lung cancer metastasis and could be useful to understand state of illness.

Objective To evaluate the association of prognostic factors and the interval between surgery and radiotherapy in postoperative radiotherapy for non small cell lung cancer (NSCLC). Methods Between December 1982 and December 1992, 132 patients with NSCLC were retrospectively analyzed. The time interval between surgery and radiotherapy ranged from 12 to 90 days, with a median of 36 days. All patients received D T 40～72 Gy. Results Cox proportional analysis showed that stage, Karnofsky performance status, and the interval between treatments were important prognostic factors. Patients with a long interval of 37～90 days had a better survival than those with a short interval of 12～36 days (P

Objective To evaluate the value of magnetic resonance imaging in rheumatoid arthritis(RA) of the knee and compare with radiography.Methods 34 cases of RA of the knee were performed MRI and radiography.Enhanced MRI scans were obtained in 13 knees.Results On MRI there were bone erosion in 34 knees,subchondral sclerosis in 21 knees,meniscus destruction in 22 knees,cartilage damage in 15 knees,tibia movement in 10 knees,posterior cruciate ligament dragged in 8 knees.Pannus adhesion,proliferation synovium and joint effusion were showed on enhanced MRI in all of the 13 knees.On radiography bone erosion was showed in 1 knee,subchondral sclerosis in 11 knees,joint space stricture in 16 knees,tibia movement in 8 knees.Conclusion MRI is much better than radiolgraphy for diagnosis of RA of the knee.

Objective To explore the effect on quality of life in traditional anti-epileptic drug and topiramate(TPM) treat for the patients with adult epilepsy. Methods 102 patients with adults epilepsy by clinical diagnosed were randomly divided into two groups: AEDs (anti-epileptic drugs) group and TPM group. QOLIE-30 was used to evaluate 102 patients and 62 normal controls. Results QOL scores were lower in AEDs group compared with control group( P

Dendritic Cells ; cytology ; immunology ; virology ; HIV ; physiology ; HIV Infections ; immunology ; Humans ; Immunity, Mucosal ; immunology ; Mucous Membrane ; cytology ; immunology ; Virus Attachment ; Virus Internalization

BACKGROUND:Tissue-engineered bone in the treatment of large bone defects has obvious advantages especial y when the autologous ilium transplantation is limited, which can effectively fil bone defects.
OBJECTIVE:To investigate the rationality of intramedul ary nailing support and tissue-engineered bone fil ing in the treatment of fibrous dysplasia of the proximal femur and the biocompatibility of the tissue-engineered bone.
METHODS:Seven patients with fibrous dysplasia of the proximal femur were subjected to intramedul ary nailing support and tissue-engineered bone fil ing.
RESULTS AND CONCLUSION:Al of the seven patients underwent more than 8 months of fol ow-up, no rejection reaction and other complications occurred. After 4-6 weeks of fixation, al the seven patients removed hip spica braces, with a good hip mobility. After 10-12 weeks, X-ray review showed no pathological fracture, internal fixation loosening and narrow neck stem angle. Using the Harris hip score evaluation of the hip function, the affected side of the seven patients was optimized. After 16-18 weeks, X-ray films reviewed good creeping substitution in the affected area treated with the intramedul ary nailing support and bone graft. After 24-26 weeks, new bone appeared within the scope of lesions. After 1.0-1.5 years, bone creeping substitution was basical y completed in the intertrochanteric region, and original lesions were invisible on X-ray films. These findings confirmed that intramedul ary nailing support and tissue-engineered bone fil ing for treating fibrous dysplasia of the proximal femur has good effectiveness, exhibiting stable internal fixation and avoiding resection of autogenous iliac bone. Tissue-engineered bone has a good biocompatibility in the medium-term fol ow-up, with good hip function activities.

Objective To analyze the clinical features of the hyperamylasemia in critically ill children and investigate the related risk factors in order to provide the basis for prevention and treatment. Methods A total of 1036 critically ill children admitted in pediatric intensive care unit (PICU)from April,2011 to Oct,2012 were studied.They were divided into the high amylase group (n=82)and the normal group (n=954).According to the outcomes,the high amylase group was divided into survival group (n=61 ) and death group (n =21 ).The related risk factors of the occurrence and outcome of hyperamylasemia were analyzed by univariate and multivariate Logistic regression.Results There were statistically significant differences in rates of coagulation disorders, convulsions, disturbance of consciousness,pediatric critical illness score (PCIS)≤80,multiple organ dysfunction (MODS)≥3, sepsis,shock,and lactic acid (LA),procalcitonin (PCT),blood glucose (BG)between the high amylase group and the normal group (P<0.05 ).The differences in the rates of coagulation disorders,convulsions, mechanical ventilation,PCIS≤80,MODS≥3,and LA,PCT,oxygenation index,albumin,C-peptide,BG were statistically significant between the survival group and the death group (P <0.05 ).Multivariate Logistic regression analysis showed that the risk factors of the hyperamylasemia's occurrence were LA,PCT, BG,PCIS<80,MODS>3.Adjusted ORs confidence intervals of them were 1.662 (1.236-2.234),1.042 (1.025-1.060),1.612 (1.411-1.843),3.219 (1.311-7.905),3.411 (1.370-8.494),respectively. The hyperamylasemia's prognostic risk factors were PCT,C-peptide,PCIS ≤80,MODS >3,shock. Adjusted ORs confidence intervals of them were 1.066(1.021-1.113),1.437(1.017 ~2.030),16.137 (1.876-138.836),10.437(1.528-71.925),20.928(1.938-226.009),respectively.Conclusions The severity of the disease,the levels of LA,PCT,BG in critically ill children were positively correlated to the occurrence of hyperamylasemia.The severity of the disease,the incidence of organ failures,the levels of PCT,C-peptide combined shock in children with hyperamylasemia were positively correlated to the prognosis of hyperamylasemia.

Biomarkers ; blood ; Child ; Child, Preschool ; Critical Illness ; Early Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Gastrointestinal Diseases ; blood ; diagnosis ; etiology ; Humans ; Infant ; Male ; Peptides ; blood ; Severity of Illness Index ; Trefoil Factor-2