ObjectiveTo observe prophylactic effect and reliability of warfarin n preventing recurrant ischemic stroke.Methods168 patients identified as ischemic stroke admitted in Chaozhou Central Hospital from March 2001 to May 2004 were randomly divided into 2 groups,warfarin group and ticlopidine group (set as control).82 cases were in warfarin group,receiving warfarin 0.75~2.25mg/d orally.Prothrombin and international normalized radio (INR) were monitored,and INR was 1.5~2.0.86 cases were in ticlopidine group;they received 250mg/d ticlopidine orally.All patients were followed up every monty for 3 years,and recurrent ischemic stroke and drug side-effect were documented.ResultsThere were 8 cases (9.76%) of recurrence in warfarin group and 26 cases (30.02%) of recurrence in ticlopidine group.There was statistically significant difference between the two groups (P

Delirium is defined as an acute imbalance state in the higher nervous center.It is more of ten been an accompanied syndrome,or may be a complication associated with the diagnosis and treatment of cancer.Delirium occurs frequently in cancer patients,especially in terminal patients.No more attention was paid on it yet.Its clinical feature,diagnosis and treatment were described.

Objective To evaluate the feasibility and advantage of using withdrawable Sigma stent for the treatment of tracheo-esophageal fistular. Methods The stents were placed into trachea or/and esophagus by interventional or/and endoscopic technique. Results Esophageal cancerin 17 and benign disease in 2. Totally 38 stents were placed in 19 cases of patients (trachea 19, main bronchus 1, esophagus 18). Only one tracheal stent was placed in 2 cases. Two stents(one in trachea, another in esophagus) were placed in 15 cases ( 11 cases with 2 tubular type stent, 4 cases with one tubular and one bifurcated type stent). Three stents were placed in 2 cases. One stage placement of the stent in 35, withdrawed the stent and reinserted again in 3. All the patients have normal meal 2～4 days postoperatively. Only one patient had a little contrast in the trachea during X-ray exam but without symptoms, the fistulae completely sealed in 18 cases. Follow-up was fron 3 months to 3 year. 10 patients were still alive; the longest survival is 18 months. There were 9 deaths. The causes of death were pulmonary infection in 1, hemorrhage in 1, and systemic metastasis in 7 cases. Conclusion Sigma stent is can effectively treat tracheal or/and esophageal stenosis or fistular.

Objective To observe the efficacy and safety of fluticasone propionate ointment in the treatment of psoriasis vulgaris. Methods A randomized comparative clinical observation was performed in 68 patients with pso-riasis vulgaris, they were divided into experimental group and control group. The experimental group of 34 cases was treated with fluticasone propionate ointment and the control group of 34 cases with kenacort-A ointment. The response was evaluated at 6 weeks. Results The total effective rate of the experimental group was 94.1% and 70.6% in the control group after 6 weeks. There was a significant difference between the two groups in treatment effective rate(P<0.01). Conclusion It is effective and safety for fluticasone propionate ointment in the treatment of psoriasis vulgar-is.

OBJECTIVETo explore the action mechanism of electroacupuncture (EA) at "Shenmen" (HT 7) and "Sanyinjiao" (SP 6) on insomnia.

METHODSThirty SD rats were randomly divided into a blank group, a model group and an EA group, 10 cases in each group. The insomnia model was made by immobilization method in the model group and EA group. After model establishment, rats in the blank group and model group were treated with fixation and no treatment was given. Rats in the EA group were treated with EA at "Shenmen" (HT 7) and "San-yinjiao" (SP 6) for 15 min, once a day for 4 days. After treatment, the level of daytime and nighttime activity, open-arm entry percentage and open-arm time percentage of elevated plus-maze test were measured; the content of noradrenaline (NE), dopamine (DA) and epinephrine (EPI) in plasma and NE, DA in thalamus and brainstem were detected by using euzymelinked immunosorbent assay method.

RESULTSCompared with the blank group, the daytime activity was increased and nighttime activity was reduced in the model group (both P<0. 05); the open-arm entry percentage and open-arm time percentage of elevated plus-maze test were both reduced in the model group (both P<0. 05); the contents of NE, DA, EPI in the plasma and NE, DA in thalamus and brainstem were increased in the model group (all P<0. 05). Compared with the model group, the daytime activity was reduced and nighttime activity was increased in the EA group (both P<0. 05); the open-arm entry percentage and open-arm time percentage of elevated plus-maze test were both increased in the EA group (both P<0. 05); the contents of NE, DA, EPI in the plasma and NE, DA in thalamus and brainstem were reduced in the EA group (all P< 0. 05).

CONCLUSIONElectroacupuncture at "Shenmen" (HT 7) and "Sanyinjiao" (SP 6) can restrain the over-activity of the sympathetic-adrenal medullary system to treat the insomnia.

Acupuncture Points ; Adrenal Medulla ; metabolism ; Animals ; Anxiety ; Disease Models, Animal ; Dopamine ; metabolism ; Electroacupuncture ; Female ; Humans ; Male ; Norepinephrine ; metabolism ; Rats ; Rats, Sprague-Dawley ; Sleep Initiation and Maintenance Disorders ; metabolism ; physiopathology ; psychology ; therapy ; Sympathetic Nervous System ; physiopathology

Objective:To evaluate the effects of periodontal flap surgery with the aid of microscope in the treatment of patients with chronic periodontitis(CP).Methods:30 patients with CP included in the study were randomly divided into 2 groups.Patients in the experiment group received periodontal flap surgery with the aid of microscope,while those in the control group received the routine flap surgery.The VAS pain scores were compared 1 ,3 and 7 days after surgery.The periodontal parameters were compared 3 and 6 months after surgery between 2 groups.Results:The VAS pain score in the experiment group was significantly lower than that in the control group 1 and 3 days (P =0.01 7 and 0.004)after surgery;the periodontal probing depth in the experiment group was significantly lower than that in the control group 3 and 6 months (P =0.01 0 and 0.047)after surgery.Conclusion:The periodontal probing depth,gin-gival recession and clinical attachment level can be improved and the pain can be reduced in the treatment of CP patients with the aid of microscope in the periodontal flap surgery.

BACKGROUND: Thermotherapy has achieved remarkable therapeutic effect on patients with esophageal cancer. However, there are still some problems which cannot be answered today, such as the damage of esophageal mucosa during deep thermotherapy when metal stent is placed in esophagus. OBJECTIVE: To study the metal stent-caused damages to esophageal mucosa of pigs in radiofrequency hyperthermia. DESIGN, TIME AND SETTING: Observational study which was performed in the Department of Tumor, Affiliated Hospital of Luzhou Medical College from October 2004 to January 2005. MATERIALS: 13 pigs weighing 35-40 kg were used in this study. Esophagus stent of memory alloy with membrane was provided by Zhiye Medical Apparatus Institute of Changzhou, China METHODS: Five points were located for measurement, i.e. the middle of the stent, the exit of the stent, 2 cm and 4 cm a distance from the exit and 4 cm from the entrance. Esophagus of 13 pigs was heated for 30 minutes by SR-1000 radiofrequency hyperthermia machine in frequency of 40.82 MHz, pole plate of 25 cm Ⅱ 25 cm and power of 500-700 W. MAIN OUTCOME MEASURES: The esophageal mucosa was observed with naked eyes. And optical microscopy was used to observe the changes of the esophageal mucosa. RESULTS: Because one pig died of anesthesia and there were troubles of thermal detector lines in 4 pigs, only 8 pigs were included in the final analysis. Level of damage of esophageal mucosa on five temperature checkpoints was observed from grade 0 to 1 in naked eyes, and the difference of damaged level between five checkpoints was not obvious in statistics (H=2.0, P=0.157). Level of the damage was observed from grade 0 to 2 in microscope, and the difference was not obvious in statistics too (H=2.734, P=0.255). CONCLUSION: Influence of the metal stent on esophageal mucosa can be neglected in radiofrequency hyperthermia, and metal stent does not cause obvious mechanical damage or thermal damage to esophageal mucosa of pigs. It is safe and feasible to carry out radiofrequency hyperthermia on placed metal stent esophagus.

Objective To discuss the value of transcatheter artery embolization for the treatment of GI massive hemorrhage. Methods Seventy-eight GI massive bleeding cases underwent emergency angiography. Intraarterial embolization was performed in 86 arteries of the 78 patients. All patients were followed up for 1 to 10 years. Results Bleeding stopped immediately in 100% of the patients. Bleeding recurred in 16 cases from 48 hours to 37 monthes. Conclusion Arterial embolization for digestive tract bleeding is safe and effective during emergency angiography to buy a time for definite treatment for some patients.

Objective To establish the orthotopic human pancreatic cancer model in mice and study the method to detect the tumor growth. Methods Human pancreatic cancer cell lines SW1990 in logarithmic phase was made into cell suspension and in situ injected into the envelope of pancreatic tail of BALB/c nude mice. High-frequency endoscopy ultrasound was used to observe the growth of tumor mass and its imaging characteristics were studied. Results 20 nude mice were successfully implanted, and 1 died 25 h after implantation. 14 days after implantation, the tumor of pancreatic cancer on EUS was (8.09 ± 2.61) mm3, the tumor appeared as homogeneous hypoechoic mass with clear boundary, and envelope as well as sound halo was present, and the shape was regular; there was low speed circular vasculature signal in around 30% of tumor.The tumor size increased to (12.40 ± 3.51)mm3, and the shape of 70% tumor was irregular, and some appeared as lobulated, and the tumor appeared as heterogeneous hypoechoic mass, no necrosis or liquefaction was found 28 days after implantation. There was low speed circular vasculature signal in around 70% tumors.Conclusions The orthotopic pancreatic cancer model in nude mouse can be established by in situ injection and this method is relatively ideal because it is simple and effective. The high frequency probe of endoscopic ultrasonograph is a reliable method for monitoring implanted pancreatic cancer.

Objective To investigate the effects of epidermal growth factor (EGF) on the proliferation , migration and apoptosis of adipose-derived stem cells (ADSCs) in vitro. Methods Starved cell model and FasL-induced apoptosis model were established in serum-free media. The effects of 10 nmol/L and 100 nmol/L of EGF on the proliferation, migration and apoptosis of ADSCs in vitro were observed. The exrpessions of signal pathway proteins like phospholipaseC-γ(PLC-γ) , extracellular regulated kinase (ERK) and AKT were also detected. Results The proliferation, migration and anti-ap-optosis of ADSCs were promoted by 10 nmol/L or 100 nmol/L of EGF, and the expressions of PLC-'y, ERK and AKT were up-regulated. Conclusion EGF can promote the proliferation, migration and an-ti-apoptosis of adipose-derived ADSCs in vitro.