Objective To analyze the complications associated with pelvic intraarterial therapy in patients with recurrent and advanced gynecologic cancer and to discuss the causes, the prevention and management measures of the complications in details. Methods One hundred and thirty procedures of pelvic intraarterial therapy were performed in 78 patients with pathologically confirmed recurrent and advanced gynecologic cancer, with one to six procedures per case. The Seldinger technique was used in all patients. The catheter was introduced via femoral artery on one side (mostly on the right side), and the combined antineoplastic agents were infused into contralateral internal iliac artery and(or) ipsilateral branches supplying the involved area. Common iliac arteries and inferior mesenteric arteries were also used in some cases. Results Six patients (7.69%) developed severe skin and subcutaneous necrosis (erosion or ulceration) on the buttock and vulvae. Five of them recovered from the injuries after heteropathy in less than 2 months. One patient received surgical debridement 4 months after the pelvic chemotherapy, whose wound healed one month later. Conclusion The causes of the severe complications of pelvic intraarterial therapy were as follows: the infusing chemotherapeutic agent was too large in dosage and too dense in concentration; the infusing time was too short; the internal iliac artery gave off a lot of abnormal skin branches; the catheter was placed too distal in small branches; the embolic pieces was too small; and the development of collateral arteries was poor especially in pretreated patients with pelvic surgery and(or) radiotherapy, etc. Heteropathy should be given in no time when the severe complications were encountered, and surgical debridement and(or) skin grafting was a need in some cases. So the interventional performers should be familiar with pelvic arteriograms to select the proper location of catheter, administer the suitable dosage of therapeutic agents dilutedly and slowly, and use large emboli, such as larger Gelfoam particles or strips.

Objective To determine gene bcl 2 and bad protein expression in tissues of breast cancer and precancerous lesions, its relation with estrogen receptor (ER) and progesterone receptor(PR), and lymph node metastasis.Methods Using immunohistochemical method, the expression of bcl 2 and bad gene were observed in 8 cases of normal breast tissues, 19 cases of simple breast hyperplasia, 20 cases of breast atypical hyperplasia and 48 cases of breast cancer. Results bcl 2 expression was positive in all normal breast tissues and simple hyperplasia, compared to 58 33% in breast cancer and 85 0% in atypical hyperplasia(all P

Objective To investigate the effect of esophageal variceal ligation (EVL) on portal hypertensive gastropathy (PHG). Methods Gastroscopic examinations were performed both before and after the EVL in 37 cases of PHG. Results The severity of PHG was correlated with the liver functions, and the morbidity of PHG was higher in cases of Child C (100%, 9/9) than in cases of Child A (60%, 12/20) or Child B (80%, 16/20) ( ? 2=18 452,P =0 001). PHG could be exasperated by the application of EVL, but no statistical significance was seen ( ? 2=3 512,P =0 173). On re-examination of gastroscopy 6~12 months later, no relapse or re-bleeding of esophageal varices or gastric mucosa hemorrhage occurred. Conclusions The worse the liver functions, the higher is the incidence of PHG. EVL treatment creates a tendency to aggravating PHG.

Objective To explore the inhibitory effect of decorin(DCN) on rat mesangial cell (MsC) growth and on the expression of mitogen-activated protein kinases (MAPKs) and p21 protein. Methods Lipofectin-mediated method was used to transfect DCN vector into MsC. After the screen and identification of transfected MsC, DCN-containing supernatant was collected and added into the culture medium of normal MsC, then flow cytometer was used to detect the cell cycle. Western blot analysis was used to explore the changes of MAPK and p21 protein. Immunofluorescence was adapted to detect the expression of p21 on cultured MsC. Results Compared with normal MsC, the number of G2-M cells treated with DCN-containing supernatant decreased to 35%(P

Objective To investigate the value and nursing of persistent balloon dilatation for anastomotic stricture after choledochojejunostomy. Methods The clinical data of 14 cases of anastomotic strictures after choledochojejunostomy accepted the treatment of persistent balloon dilatation were analyzed retrospectively. The effect, adverse reactions and approriate nursing were evaluated. Results Five patients were performed with persistent balloon dilatation thorough the output loop of intestine after choledochojejunostomy and 9 patients through percutaneous transhepatic cholangiography. There was no hemobilia, bile leak or other serious complications. There were 2 cases of balloon dilatation catheter damage, 5 cases of pressure pump damage and 4 cases of balloon migration with 25.0% (7/28) instrument damage rate and 4 cases of balloon migration. After persistent balloon dilation for 6 to 8 months, no anastomotic stricture was found by choledochoscopic examination. Follow up for 6 to 18 months, 2 cases had recurrent anastomotic stricture. Conclusions Persistent balloon dilatation by percutaneous transhepatic cholangiography is a simple, safe and effective method for anastomotic stricture after choledochojejunostomy. In the course of nursing, the balloon catheter and pressure pump damage, and balloon migration should be noted.

Objective To investigate the influence of ursolic acid on vascular endothelial growth factor ( VEGF) , cycloxygen-ase-2 (COX-2), and matrix metalloproteinases-2 (MMP-2) expressed in the mouse retinal ischemic model , and to explore the mecha-nisms of anti-angiogenesis.Methods Sixty 7-day clean-class C57BL/6J mice were divided randomly into 6 groups [ n =10 mice (20 eyes) per group]:blank control, model control (PBS), positive control (triamcinolone), and ursolic acid (UA) intervention (low-dose, medium-dose, and high-dose).Mice in the blank control group were raised in air , and mice in other groups in(75%±2%)O2 high-oxygen environment for 5 consecutive days .Mice in the model control group and breastfeeding mice were put back in air environ-ment (21%O2 ) on the 12th day after the new-born mice to induce the generation of retinal neovascularization .When models were suc-cessful, the drug treatments were applied immediately to the corresponding groups , with injection of 3μl of sterile PBS in model control group, 3 μl of 1.5, 3.00 and 6.0 μg UA in UA intervention group, and 3 μl of triamcinolone (1 ml∶40 mg) in positive control group, respectively.All mice were killed after overdose anesthesia on the 17th day.Their eyeballs were made into samples and retinal tissue pathological sections with H-E dying method.The positive expressions of VEGF , COX-2, and MMP-2 were detected with immu-nohistochemical method .The fresh retinal tissue homogenate was prepared to detect the protein expressions of VEGF , COX-2, and MMP-2 in retinal tissue with western blot method ,and mRNA expressions of VEGF , COX-2, and MMP-2 were detected with real-time fluorescent quantitative polymerase chain reaction ( RT-PCR) .Results According to protein and mRNA expressions of VEGF , COX-2,and MMP-2 in retinal tissue among six groups , protein expressions of VEGF , COX-2, and MMP-2 in model group were significantly higher than those in blank group ( P <0.05 ) .Each protein expression in the high UA intervention group was significantly lower than that in the model group ( P <0.05 ) .Each protein expression in the high UA intervention group was not significantly different from that in the positive group ( P >0.05 ) .Each protein expression in the high UA intervention group was significantly lower than that in the low UA intervention group( P <0.05).Conclusions UA inhibited expressions of VEGF, COX-2, and MMP-2 in retinal ischemia model .UA also played an inhibitory role in the formation of neovascularization , and this role was positively correlated with UA dose .

BACKGROUND:Periprosthetic femoral fracture is a severe complication after total hip arthroplasty. More than 85% belongs to Vancouver B2 and B3 fractures, and the operation is difficult. OBJECTIVE:To explore the clinical effect of Cable-Ready fast system and biotype long-stem prosthesis and its effect on the recovery of joint function in patients with Vancouver B2 and B3 type periprosthetic femoral fractures after total hip arthroplasty. METHODS: A total of 60 patients receiving total hip arthroplasty suffered from Vancouver B2 and B3 type periprosthetic femoral fractures in the Huanggang Central Hospital from September 2011 to September 2012. They were equaly divided into control and observation groups according to different fixation methods. Patients in the control group were treated by ordinary steel wire cerclage fixation combined with uncemented long-stem prosthesis; those in the observation group were treated by Cable-Ready fast system combined with fast uncemented long-stem prosthesis. RESULTS AND CONCLUSION:The average operation time, the time of hospitalization and fracture healing time were shorter in the observation group than in the control group. Moreover, the intraoperative blood loss was less in the observation group than in the control group. After 1 year of folow-up, Harris hip score was higher in the observation group compared with pre-treatment (t=3.174 9,P=0.002 6), and significantly higher than the control group (t=2.479 8,P=0.015 4). The excelent and good rate of Harris hip score was significantly higher in the observation group than in the control group (χ2=11.294 5,P=0.002 6). The total incidence of complications was significantly lower in the observation group than in the control group (χ2=8.139 7,P=0.04 2). These data indicate that Cable-Ready fast system combined with uncemented long-stem prosthesis in the treatment of Vancouver B2 and B3 periprosthetic femoral fractures after total hip arthroplasty has smal injury, less postoperative complications and better recovery of hip function after operation.

Objective To investigate the clinical therapeutic effect of filiform fire needling on tennis elbow.Method Eighty patients with tennis elbow were randomly allocated to a filiform fire needling group of 30 cases, a block group of 20 cases and an electroacupuncture group of 30 cases. The treatment group received. Pain severity was scored using the VAS after one and two weeks and one month of treatment. The therapeutic effects were evaluated and compared after one month of treatment.Result The total efficacy rate was 93.3% in the filiform fire needling group, 60.0% in the block group and 50.0% in the electroacupuncture group; there was a statistically significant difference among the three groups (P<0.05). There was a statistically significant difference between the filiform fire needling and block groups (P<0.05) and between the filiform fire needling and electroacupuncture groups (P<0.05) but no significant difference between the block and electroacupuncture groups (P>0.05). The VAS score decreased significantly in the block group (P<0.05) but did not in the filiform fire needling and electroacupuncture groups (P>0.05) after one week of treatment compared with before. The VAS score decreased significantly in the filiform fire needling and block groups (P<0.05) but did not in the electroacupuncture group (P>0.05) after two weeks of treatment compared with before. There was no statistically significant posttreatment difference in the VAS score between the filiform fire needling and block groups (P>0.05) but there was such a difference between the filiform fire needling or block group and the electroacupuncture group (P<0.05). There was a statistically significant difference in the VAS score in the filiform fire needling and block groups (P<0.01) and also in the electroacupuncture group (P<0.05) between before and after one month of treatment. There was a statistically significant difference in the VAS score after one month of treatment between the filiform fire needling group and the block or electroacupuncture group (P<0.05) and between the block and electroacupuncture groups (P<0.05). The results of the study showed that filiform fire needling, local drug blockage and electroacupuncture all had clinically a better therapeutic effect on tennis elbow and a better improving effect on the symptoms in the patients. Filiform fire needling produced a marked therapeutic effect. Its effect was superior to those of block therapy and electroacupuncture.Conclusion Filiform fire needling is a definitely effective way to treat tennis elbow.

This study was to investigate the protective effects and mechanisms of breviscapine on endothelial cells.ox-LDL was used to induce oxidative damage on human umbilical vein endothelial cells(HUVEC)for 20 h with or without 4 h pretreatment of various concentrations of breviscapine(10;20;40 μmol/L);then observe the protective effect and mechanism of breviscapine on endothelial cells insulted by ox-LDL.MTT method was used to detect cell viability;flow cytometry was used to detect cell apoptosis and reactive oxygen species;and Western blot and RT-PCR was used to detect cell signaling pathways.The results showed that breviscapine recovered HUVEC cell viability in a dose-dependent manner which inhibited by ox-LDL;and it also protected cell from apoptosis induced by ox-LDL.To explore the mechanisms of breviscapine;reactive oxygen species (ROS)was determined after pretreatment of various concentrations of breviscapine or different durations(2;4;6 h)of brevis-capine.Results showed that breviscapine decreased ROS production in a dose-and time-dependent manner.Fur-thermore;cell signaling pathway analysis showed that breviscapine increased the expression of BCL-2;decreased the expression of BAX and the release of Cytochrome C and cleavage of caspase-3.Breviscapine decreased Keap1 and activated the nuclear import of Nrf2;and subsequently increased the mRNA and protein expression of down-stream antioxidant enzyme as NAD(P)H:quinone oxidoreductase 1(NQO1)and glutathione transferase-S-Mu 1(GSTM1);and increasing the activity of NQO1.Besides;breviscapine decreased IKK and IKB;and inhibited nuclear translocation of NF-κB;while increasing the expression of eNOS.This study demonstrated that breviscap-ine has a protective role on ox-LDL-induced endothelial cell injury;which may be related to its antioxidant effects and inhibition of NF-κB activation.

This study reviewed the reasons for encounter (RFE),diagnoses and the diagnostic categories of patients aged 0-14 y in general practice clinic affiliated to a tertiary hospital from June 2011 to May 2012.The results showed that the most frequent RFE was cough,at a rate of 29.6 per 100 encounters;the second one was fever (21.4％) and the third was nasal problems (9.5％).Medical examinations,skin rashes and follow-up encounters occurred at equal rates (5.2％).The most frequent diagnosis was acute upper respiratory tract infection (41％).Medical examination (6.3％),other viral diseases (5.1％),pneumonia (3.6％) and no detected disease (3.6％) were also common diagnoses.The diagnostic categories included all systems,and the problems of the respiratory system (56.4％) were most common.The results suggest that pediatric care comprises a very important part of primary care.