5cm had the highet positive rate, while tumor with diameter

Combined operation and irradiation therapy has been performed on 22 patients with primary liver cancer in our hospital.All these patients were mal s.Age ranged from 15-49 years old with an average of 44.5. Histological dingnoais were. hepatocellular carcinoma in 21 cases and cholangiocarcinoma in 1 case. Seventeen (77.3%) patients were associated with liver cirrhosis, nineteen(86.4%)patients had positive AFP by counter- immunoelectrophoretic method.Clinically, 6 patients were stage I, 11 patients were stage II and 5 patients were stage III. The operative procedures consisted of liver resection in 17 patients (local resection 5, right hemihepatectomy 5, left lateral lobectomy 2, left hemihepatectomy 2, total right hepatectomy 2,and left medial lobectomy 1)and palliative operation in other 5 patients (hepatic artery ligation or embolization in 4 patients and hepatic artery infusion in 1 patient) .Radiotherapy comprised local or whole-liver irradiation with 60Co.Up to May 1983, 19 patients were followed-up, all of them survived more than 6 months.The 1, 2, 3, 4 year survival rates after treatment were 78.9%, 66.7%, 64.3% and 44.4% respectively with a median survival duration of 36 months.Data showed that the encouraging results of this method which were better than liver resection and radiotherapy or any other cmbined methods at present.

Objective To investigate the influence and clinical effect of assisted three-dimensional conformal radiation therapy (3D-CRT ) on obstructive jaundice caused by malignant tumors .Methods 90 cases with obstructive jaundice caused by malignant tumors of liver ,gallbladder and pancreases were randomly divided into observation group and control group ,45 cases in each group . Patients in control group were given comprehensive measures ,including tumors exairesis ,assisted chemotherapy and stereotactic ra-diotherapy ,and patients in observation group were given 3D-CRT based on tumors exairesis and assisted chemotherapy .Clinical effect ,serum bilirubin were observed 2 months after treatment ,adverse reactions were recorded during the treatment ,and survival rate in 2-year follow up in two groups were observed .Results Total effective rate in observation group and control group were 75 .56% and 57 .78% (P<0 .05) ,respectively ,and adverse reactions rate were 37 .78% and 57 .78% (P<0 .05) ,respectively .After treatment ,serum total bilirubin and direct bilirubin in two groups were all lower than those before treatment (P<0 .05) .Serum total bilirubin and direct bilirubin in observation group after treatment were (26 .3 ± 6 .5)μmol/L and(18 .9 ± 3 .3)μmol/L ,and were (39 .3 ± 9 .5)μmol/L and(26 .9 ± 6 .7)μmol/L in control group ,and there were statistical difference between two groups (P<0 .05) . Observation group′s survival rate was higher than that of control group (P<0 .05) .Conclusion It has good clinical effect of trea-ting obstructive jaundice caused by malignant tumors by 3D-CRT ,and it prolongs the survival time ,decreases serum bilirubin and improves jaundice symptom ,so it has some guiding significance to its treatment .

Objective To compare strong and weak points of two different approaches of endoscopic thyroidectomy and to discuss the complication prevention of endoscopic thyroidectomy.Methods There were 10 cases of breast areola approach endoscopic thyroid surgery(Areola Group) and 11 cases of transcervical approach video-assisted thyroid surgery(Cervical Group).The operation time,intraoperative blood loss,length of hospital stay,and complications between the two groups were compared.Results The operations were completed successfully in all the 21 cases.The operation time was significantly longer in the Areola Group(132.4?39.1 min) than in the Cervical Group(89.2?16.8 min)(t=3.347,P=0.003).The intraoperative blood loss was significantly less in the Areola Group(12.9?4.3 ml) than in the Cervical Group(18.2?5.5 ml)(t=-2.442,P=0.025).The postoperative hospital stay was significantly longer in the Areola Group(4.2?1.0 d) than in the Cervical Group(3.0?0.6 d)(t=3.373,P=0.003).Follow-up observations for 6 months in the 21 cases showed no recurrence of thyroid tumor or occurrence of hypothyroidism.Conclusions Compared with video-assisted thyroidectomy through transcervical approach,breast areola approach endoscopic thyroid surgery has longer operation time,but more satisfactory exposure,fewer complications,and better cosmetic outcomes.

Objective: To assess the clinical application of transabdominal ultrasonography for the diagnosis of achalasia. Methods: The subjects were divided into 3 groups, with 8 patients suffered from achalasia as patient group, 10 normal individuals and 8 patients with cardiac carcinoma as controls. All subjects received water provocative test to study the lower esophagus and cardia. Sonographic findings were compared between the 3 groups. After treatment by administration of drugs, pneumatic balloon dilation, or intrasphincteric injection of botulinum toxin, the 8 patients were re-examined by TAUS for longitudinal comparison. Results: (1)The normal subjects had no dilation of cardia and lower esophagus before drinking water, but their cardias opened rapidly with the drinking action. (2)All the patients of achalasia were found to have dilation of lower esophagus before taking water. During 10 min continuous TAUS scanning, 5 of 8 demonstrated absence of relaxation of cardias and absence of water from the esophagus into the stomach. The other 3 showed slight and intermittent relaxation of cardias with water flow into the stomach. Thirty minutes after water provocative test, all the 8 patients had water retardation within the lower esophagus. (3)The patients of cardiac carcinoma had an ultrasound feature of cardiac ring enlargement and thickening of cardiac wall without dilation of lower esophagus before water provocative test. Water passed the cardia more slowly. Conclusion: TAUS is a readily accepted examination. It can quickly give reliable diagnostic clues to achalasia. TAUS can also be used for making assessment of therapeutic effect on achalasia.

Objective To analyse clinical and imaging characteristics of congenital airway abnormalities,and to guide the clinical diagnosis and reduce rate of missed diagnosis and misdiagnosis.Methods Clinical and imaging characteristics in children who had been diagnosed congenital airway abnormalities in Shengjing Hospital of China Medical University from 2005 to 2011 were reviewed and analysed retrospectively.Results Of 23 children,12 cases were male,11 cases were female,the age was from 1 month to 10 years,the average age was 32 months.The disease course was from 3 days to 3 months,an average was 18 days.Clinical manifestations were repeated coughing,wheezing,dyspnea and recurrent respiratory infection.Through the spiral CT and three dimensional reconstruction,enhanced CT examination,6 cases of tracheobronchial stenosis,3 cases of trachea and bronchus,1 case of dysplasia of the left pulmonary artery and vein,3 cases of pulmonary sequestration,4 cases of pulmonary cyst and 6 cases of pulmonary hypoplasia were found.Conclusion Missed diagnosis and misdiagnosis of congenital airway malformations often occurs.When the following features were observed,congenital airway malformations may be taken into account:persistent cough; repeated or persistent wheezing,treated ineffectively with anti-inflammatory agent and bronchodilators ; recurrent or persistent stridor; repeated pulmonary infections,dyspnea; repeated or persistent pneumonia in the same part and unexplainedly mediastinal shift in X ray chest radiography.Spiral CT three dimensional reconstruction and enhancement is of great value in diagnosis of airway malformation.

Cerebralvasospasmisthemostcommonandmostdangerouscomplicationofsubarachnoid hemorrhage (SAH). If it can not be diagnosed and treated early, it w il result in delayed cerebral ischemia and delayed ischemic neurological deficits, and seriously affect the outcomes of patients. SAH can cause oxidative stress and inflammation, causing vasospasm, and leading to brain tissue damage. Numerous studies have show n that the concentrations and activities of numerous metabolites w il change in these pathological physiological processes. Identification of the changes of location, time and trend of these markers has important clinical significance for investigating the mechanism of cerebral vasospasm after SAH and seeking better therapeutic targets. This article review s the molecular markers of cerebral vasospasm after SAH.

Objective To explore the effect of water analgesia on the pain relief for primiparas in labor, especially on the point of the acutest pain and total time of severe pains by tracking and comparing with remifentanil patient- controlled intravenous analgesia and the conventional vaginal delivery. Methods A total of 139 singleton and full-term primiparas who chosed analgesia labor were selected. There were 3 groups:56 cases in water analgesia group (hereinafter referred to shortly as water group), 37 cases in remifentanil patient-controlled intravenous analgesia group (hereinafter referred to shortly as vein group ) and 46 cases in traditional vaginal delivery group (hereinafter referred to shortly as traditional group). In addition, labor pain intensity was assessed with numerical rating scale (NRS). All groups were evaluated by NRS score in five different time points during the delivery:cervical dilation to 2-3 cm or 1 minute before labor analgesia; labor analgesia after 10 minutes; labor analgesia after 30 minutes; labor analgesia after 60 minutes;point of acutest pain. Meanwhile, total time of acutest pain, progress of labor, use of oxytocin, mode of delivery, postpartum hemorrhage and neonatal asphyxia were all observed. Results Comparison of labor progress and postpartum bleeding, mode of delivery and neonatal Apgar score in three groups of primipara showed no significant difference (P>0.05). Compared with the traditional group, the NRS score and point of acutest pain in water group obviously declined, the total time of severe pain shortened 36.58 min on average, which showed significant difference (t=-4.400, P<0.05). Compared with the vein group, the NRS score of water group at 10 minutes after labor analgesia was below the vein group (t=-2.358, P<0.05), so was point of acutest pain (t=-2.703, P<0.05). But the score of water group was higher than intravenous analgesia after 60 minutes, which showed significant difference (t=2.833, P<0.01). The rate of oxytocin application in water group was only 12.5%(7/56), significantly less than the rate in vein group, which was 37.84%(14/37), there were significant differences (χ2=8.182, P<0.05). Conclusions Water analgesia can effectively alleviate maternal pain and reduce intrapartum intervention, and more, less influence on maternal and newborn, and is a safe and effective analgesia method.

Objective:To construct Cyanovirin-N(CV-N) expression plasmid pET-CVN and express the protein in E.coli, and to prepare specific antibody against Cyanovirin-N.Methods:In this study, the encoding sequence of Cyanovirin-N was obtained by PCR. The expression plasmid pET-CVN was constructed by inserting the encoding sequence of CV-N into pET-His containing T7 promoter and then BL21(DE3)strain was transformed. Expression of CV-N was induced by IPTG at 30℃ for 8 h. Cyanovirin-N was refolded by using dialysis method. The target protein was purified through Ni2+-NTA Agarose Fast Flow. The purified Cyanovirin-N was used as an antigen to immunize rats,and the polycolonal antibody to Cyanovirin-N was obtained.Results:Cyanovirin-N was cloned and expressed in E.coli successfully. SDS-PAGE analysis showed that the Cyanovirin-N was expressed in the form of insoluble inclusion body,and the expression amount of Cyanovirin-N was about 42.08% of total protein. With ELISA detection the titer of antibody was more than 1∶8 000, Western blot analysis showed that the antibody can bind with Cyanovirin-N specifically.Conclusion:Cyanovirin-N expression plasmid pET-CVN has been constructed, Cyanovirin-N with bioactivity has been obtained. The prepared antibody against Cyanovirin-N has well specificity and reactivity and can be used to detect the expression products by recombinant strains of E.coli.The work lays a foundation further study of its functions.