Objective To compare the operation situation of pancreatico duodenectomy (PD) and pylorus‐preserving pancreatico duodenectomy (PPPD) ,and analyze the clinical efficacy of PPPD .Methods Data of 47 patients with periampullary carcinoma and pancreatic head carcinoma underwent pancreatico duodenectomy from January 2010 to December 2013 were retrospectively analyzed and divided into PPPD group (20 cases) and PD group (27 cases) according to different surgery method .Then compare the situa‐tion of intra‐operative and post‐operative situation in two groups of patients .Results The operation time of PPPD group was sig‐nificantly lower than that of PD group (P<0 .05);the incidence of postoperative complication rate of PPPD group was obviously lower than PD group (P< 0 .05);and postoperative infection rate of PPPD group was significantly lower than PD group (P<0 .05);there was no significant difference between two groups in pancreatic leakage ,bile leakage ,gastrointestinal leakage ,post oper‐ative bleeding ,mortality and the incidence of delayed gastric emptying after surgery (P>0 .05) .Conclusion PPPD operation could shorten the operation time ,promote post‐operative recovery ,lower complication rates and shorten hospitalization time ,and could al‐so help to improve the nutritional status of patients ,improve the postoperative quality of life of patients ,thus it should be further promoted .

Objective To observe the effect of somatostatin on liver function in patients after splenectomy combined with de-vascularization.Methods The clinical data of 48 patients with liver cirrhosis,portal hypertension and esophageal varices were retro-spectively analyzed,26 cases (somatostatin group)were used somatostatin after splenectomy combined with devascularization,and the other 22 cases (control group)were not used.The changes of serum albumin (Alb),alanine aminotransferase (ALT),aspartate transaminase (AST),prothrombin activity (PTA)and total bilirubin (TBIL)was observed.Results All patients recovered well af-ter surgery,and no deaths occurred.However,ALT,AST and TBIL of using somatostatin group were significantly reduced than those of control group(P <0.05),Alb and PTA were also improved significantly (P <0.05).Conclusion The combination of som-atostatin can not only reduce postoperative portal pressure,control of bleeding,but also to be significantly promote recovery of liver function.

ObjectiveTo evaluate the potential value of acoustic radiation force impulse (ARFI)elastography in the characterization of solid liver tumors.MethodsForty-three patients with 56 liver tumors were evaluated with ARFI,which included 21 patients with hepatocellular carcinoma (HCC),8 patients with metastase,5 patients with cholangiocarcinoma(CCC),and 9 patients with hemangioma.The shear wave velocity of the tumor and background liver parenchyma were calculated,and results were compared with 30 healthy subjects.Statistical analysis was performed on the shear wave velocity for differentiation of normal liver,background liver parenchyma,and tumors.ResultsHCC and CCC had greater stiffness than metastase (P ＜0.05),there were no statistical differences between HCC and CCC (P = 0.179).Malignant liver tumors had significantly greater stiffness than hemangioma and normal liver (P = 0.000).34.5% (9/26) HCC and 33.3% (4/12) hemangioma appeared softer than the background liver.With a cut-off value of 1.5 m/s for the shear wave velocity,the sensitivity,specificity,positive predictive value and negative predictive value for malignancies were 79.5%,83.3%,94.5% and 52.6%,respectively.ConclusionsARFI elastography quantification is a promising noninvasive technique for assessing solid liver tumors.Use of ARFI elastography quantification may lead to new quantitative tissue characterization parameters for differentiating hemangioma and malignant liver tumors.

Bone Neoplasms ; diagnosis ; pathology ; surgery ; Child ; Diagnosis, Differential ; Femur ; pathology ; Fibroma ; diagnosis ; pathology ; surgery ; Humans ; Male

Adult ; Humans ; Male ; Military Personnel ; Models, Biological ; Muscle Contraction ; physiology ; Physical Endurance ; physiology ; Reference Values

OBJECTIVETo explore the effect mechanism of electroacupuncture (EA) at Changqiang (GV 1) or Baihui (GV 20) on autism based on molecular biology.

METHODSThe autism model was established by intraperitoneal injection of sodium valproate (VPA) in Wistar pregnant rats. Forty young rats with autism were selected and randomly divided into a model group, a non-acupoint group, an electroacupuncture at "Changqiang" (GV 1) (EAGV 1 for short) group and an electroacupuncture at "Baihui" (GV 20) (EAGV 20 for short) group. Another 10 normal young rats were selected as a blank group. In the EAGV 1 group, acupuncture was applied at Houhai [as Changqiang (GV 1)], then EA apparatus was connected with continuous wave, 2 Hz, 20 min, once a day for consecutive 20 days. The same EA manipulation as EAGV 1 group was used in the EAGV 20 group where "Baihui" (GV 20) was selected and non-acupoint group where non-acupoint in the right rib was selected. Blank group and model group were reared under the same conditions without any intervention. The escape latency and the ratio of swimming distance in platform quadrant to total swimming distance in each group were observed by using Morris water maze, and the PSD-95 protein expression in hippocampal CA 1 was measured by immunohistochemical techniques.

RESULTSCompared with the blank group, the escape latency in the model group and the non-acupoint group lengthened (both P < 0.05), the ratio of swimming distance in platform quadrant to total swimming distance was decreased (both P < 0.05), the PSD-95 protein expression was decreased (P < 0.05). Compared with the model group, the escape latency in the EAGV 1 group and the EAGV 20 group were decreased (both P < 0.05), the ratio of swimming distance in platform quadrant to total swimming distance was increased, the PSD-95 protein expression was increased (both P < 0.05). But the escape latency, the ratio of swimming distance in platform quadrant to total swimming distance and the PSD-95 protein expression had no significant difference between EAGV 1 group and EAGV 20 group (P > 0.05).

CONCLUSIONElectroacupuncture at Changqiang (GV 1) or Baihui (GV 20) can respectively improve learning and memory ability of rats with autism, which has no significant difference and the mechanism of action may be related to regulation of the PSD-95 protein expression.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Autistic Disorder ; genetics ; metabolism ; psychology ; therapy ; Disks Large Homolog 4 Protein ; Electroacupuncture ; Female ; Hippocampus ; metabolism ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; metabolism ; Learning ; Male ; Membrane Proteins ; genetics ; metabolism ; Memory ; Rats ; Rats, Wistar

OBJECTIVETo observe the impacts on integrated electromyogram (IEMG) of gastrocnemius muscle of the children with spastic cerebral palsy treated with different intervention order of acupuncture and kinesithera py.

METHODSTwenty-nine children with spastic cerebral palsy were randomly divided into group A (15 cases) in which the patients were treated with acupuncture before kinesitherapy, and group B (14 cases) in which the patients were treated with acupuncture after kinesitherapy. In group A, acupuncture was applied at Weizhong (BL 40) and Chengshan (BL 57). Afterward, Bobath kinesitherapy was adopted. In group B, Bobath kinesitherapy was adopted at first, and acupuncture was applied at Weizhong (BL 40) and Chengshan (BL 57) afterward. The instant changes of IEMG after treatment were recorded in each group.

RESULTS(1) Group A: after single acupuncture and the combined intervention in which acupuncture was applied together with kinesitherapy, IEMG increased apparently (both P < 0.05). There was no significant difference statistically in IEMG after acupuncture as compared with that after the combined intervention of acupuncture and kinesitherapy (P > 0.05). (2) Group B: after single kinesitherapy and the combined intervention in which acupuncture was applied together with kinesitherapy, IEMG increased in tendency, but no statistically significant difference indicated (both P > 0.05). (3) In comparison of IEMG after treatment between two groups, there was no significant difference statistically (P > 0.05).

CONCLUSIONThe different intervention order of acupuncture and kinesitherapy impacts significantly IEMG of gastrocnemius muscle of the children with spastic cerebral palsy. In order to avoid hypermyotonia of gastrocnemius muscle after treatment, kinesitherapy should be applied before acupuncture in priority.

Acupuncture Points ; Acupuncture Therapy ; Cerebral Palsy ; physiopathology ; therapy ; Child ; Child, Preschool ; Combined Modality Therapy ; Electric Stimulation Therapy ; Electromyography ; Female ; Humans ; Muscle, Skeletal ; physiopathology

To systematically evaluate the efficacy and safety of tripterygium glycosides (TG) combined with ACEI/ARB preparation in treating diabetic nephropathy stage IV. The computer retrievals were made in Cochrane Libarary, PubMed, Embase, SCI, Sinnomed, CNKI, Chinainfo and VIP, and hand retrievals were conducted for meeting and academic papers (updated to December 30, 2014), in order to collect randomized controlled trials and quasi-randomized control trials for TG combined with ACEI/ARB preparation in treating diabetic nephropathy stage IV and set the literature inclusion and elimination standards. Eligible literatures were included and evaluated according to standards in Cochrane Handbook. RevMan 5.3 and Stata 12.0 were used for a Meta-analysis. A total of 13 randomized controlled trials and quasi-randomized control trials involving 1119 patients with diabetic nephropathy were included. The Meta analysis result showed that compared with the control group, the combination group showed better effects in reducing the 24-hour urinary protein [MD = -0.84, 95% CI (-1.02, -0.66)], raising albumin [SMD = 0.98, 95% CI (0.81, 1.16)], the total efficiency [OR = 4.23, 95% CI (2.77, 6.46)] and the significant efficiency [OR = 5.35, 95% CI (2.70, 10.60)], with no statistical difference in Serum Creatinine between Both groups [MD = -0.82, 95% CI (-4.30, 2.66), P = 0.64]. However, the risk of adverse reactions increased by 7% [RD = 0.07, 95% CI (0.03, 0.12)]. The Egger's test showed no publication bias. Tripterygium Glycosides combined with ACEI/ARB in treating diabetic nephropathy stage IV is supper than the single administration of ACEI/ARB, with a good prospect in clinical application. Nevertheless, due to the small-size and low-quality samples in this study, more high-quality and large sample-size randomized controlled trials shall be conducted to verify the findings.
Angiotensin Receptor Antagonists ; administration & dosage ; Angiotensin-Converting Enzyme Inhibitors ; administration & dosage ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Glycosides ; administration & dosage ; Humans ; Tripterygium ; chemistry

Objective To investigate the effects of a new sling exercise treatment combined with injections of sodium hyaluronate on the radiographic findings and clinical variables of patients with patellofemoral pain.Methods Seventy patients with patellofemoral pain syndrome were divided into a group which was treated using a new sling exercise therapy combined with injections of sodium hyaluronate (the combined therapy group,n=34) and another which received only sodium hyaluronate injections (the control group,n=36).The patients of both groups were assessed pre-and post-treatment.The clinical assessment modalities were pain scores (using a visual analogue scale,VAS),quadriceps and hamstring strength and range of motion in the active flexion and extension of the knee.Q angles were measured supine and standing.Patellofemor tilt angle and congruence and sulcus angle were determined by CT scanning.Results After 5 weeks the average VAS pain score of the combined therapy group was significantly lower than that of the control group.Muscle strength and range of motion in the combined therapy group were both significantly higher than pro-treatment,the Q angles were significantly smaller,and the congruence and sulcus angles were significantly better.Conclusion Five weeks of practicing the new sling exercise therapy combined with injections of sodium hyaluronate can yield satisfactory clinical and radiologic outcomes in patients with patellofemoral pain syndrome.

AIM To study the effect of astragalosides (AST) on pr ol iferation and collagen production of hepatic stellate cells (HSC). METHO DS The proliferation and collagen production of rat hepatic stellate cell s, HSC-T6, stimulated with Kupffer cell-conditioned medium (KCCM), mixed sera containing new bovine serum (NBS) and rat serum (RS) were measured with 3H -TdR and 3H-proline incorporation. RESULTS Both of the p roliferation and collagen production of HSC-T6 stimulated with KCCM at the dilu tion of 1∶4 were suppressed after being treated with AST (16, 32, 64, 128 and 2 56 mg?L -1 ). When HSC-T6 cells were stimulated with mixed sera containing 10% NBS and 3% RS, their proliferation was suppressed after being treated with AST(32, 64, 128 and 256 mg?L -1 )for 48 h and so was the collagen produ ction after being treated with AST(16, 32, 64, 128 and 256 mg?L -1 )for 72 h. CONCLUSION The suppression of hepatic stellate cell prolif eration and collagen production by astragalosides may be one of the mechanisms f or the depression of hepatic fibrosis by astragalosides.