Combined Modality Therapy ; Digestive System Surgical Procedures ; methods ; Gastrointestinal Neoplasms ; surgery ; Humans ; Treatment Outcome

Antigens, CD ; metabolism ; Antigens, CD1 ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Biopsy ; Diagnosis, Differential ; Histiocytosis, Langerhans-Cell ; diagnostic imaging ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Lung ; diagnostic imaging ; metabolism ; pathology ; Lung Diseases, Interstitial ; metabolism ; pathology ; Male ; Middle Aged ; S100 Proteins ; metabolism ; Tomography, X-Ray Computed

Budd-Chiari Syndrome ; Child ; Humans ; Infant ; Male

Objective To survey symptom occurrence degree of maintenance hemodialysis (MHD) patients,and its related factors,and to provide a basis for clinical symptom management. Methods A total of 142 MHD patients were selected with convenience sampling method from a hospital in Ningxia from July 2015 to September 2015 and investigated with the Dialysis Symptom Index ,the Pittsburgh Sleep Quality Index and the family Adaptation,Partnership,Growth,Affection and Resolve(APGAR)Scale. Results The occurrence rate of various symptoms ranged from 53.5%to 92.3%. Fatigue(92.3%),itching(86.6%)and dry skin(85.9%)were the top three prevalent symptoms. Fatigue (30.3%),difficulty falling asleep (27.5%),hyposexuality (27.5%) and trouble in sleeping deeply(27.5%)were the most serious symptoms.Multivariate linear regression analysis showed that gender,nationality,sleep quality,combining with hypertension and arrhythmia had significant influence on the occurrence degree of symptom in MHD patients(P < 0.05). Conclusion Symptoms in MHD patients are preva-lent. Efficient symptom management should be performed to improve the quality of life of MHDpatients.

Objective To investigate the bone metabolism of children with leukemia and its relationship to tumor necrosis factor-?(TNF-?)pre-and post-treatment.Methods Serum bone gla protein(BGP),the excretion rate of urianry deoxypyridinoline(DPD)and TNF-? were measured in 35 children with leucocythemia pre-and post-treatment and 30 normal children(control group).Results The results showed that BGP,the excretion rate of DPD and TNF-? in children with leucocythemia before treatment were significantly higher than those in control group.However,the excretion rate of DPD decreased after chemotherapy but still significantly higher than that of control group(P0.05).Conclusions In children with leukemia,there are bone absorption and bone dissolution before chemotherapy,while there is osteogenesis dysfunction and bone absorption after chemotherapy.TNF-? can be used as a parametre for evaluating treatment effect and monitoring relapse.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

Objective To analyze characteristics of severe liver trauma and efficacy of different surgical procedures. Methods Clinical data of 109 patients with severe liver trauma treated in the recent 10 years were retrospectively analyzed. Debriding suture was performed in 32 patients, gauze tamponade in 5, debridement hepatectomy in 59 and anatomical hepatectomy in 13 patients. Results In all the 109 patients, 92 were cured and 17 died. The dead patients included 3 with grade Ⅲ trauma,9 with grade Ⅳ trauma, and 5 with grade V trauma. Among the dead patients, there were 3 patients with simple liver injury (17.6%) and 14 with associated injury (82.4%). Conclusion Right hepatic serious damage is the main type of severe liver trauma and is always complicated with associated injury and needs emergency treatment. Application of the most appropriate surgical approach according to the traumatic condition is important to promote the successful rate of treatment.

Objective To report clinical symptoms of a Chinese pedigree of familial paramyotonia congenital (PMC) with progressive myopathy (PM), and investigate the mutations of hot spots in the adult skeletal muscle sodium channel α-subunit (SCN4A). Methods The medical history and clinical phenotype of the patients from this large family with PMC were collected. Insertional and spontaneous activity were recorded by routine electromyograph (EMG), and the exercise test (ET) and cool water test were also performed on some patients during episodes. The mutations of SCN4A were screened by PCR-SSCP and DNA sequencing in affected and unaffected members. Results The family is a four-generation kindred with 15 members affected by severe, homogeneous paralysis periodiea paramyotoniea pheuotype. The onset was early, and almost all patients developed severe progressive myopathy by middle age. Routine EMG shows myotonia discharge in all affected subjects. The compound remarkably motor action potential (CMAP) decreased more than 40% after ET with greater decreases in cool water test than in ET. The mutation screening study revealed a missense mutation (Met1592Val) in SCN4A in patients. Conclusions Autosomal dominant inheritance pattern with complete penetrance was observed in this family. The phenotype is in accord with that reported in other ethnic populations with more severe symptoms. The ET and cool water tests may be used as an easy and reliable diagnostic method. Our research supports that periodic paralysis and paramyotonia can be caused by the same mutation in SCN4A. Mutation Met1592Val is a hotspot for mutation screening in patients with PMC accompanied by PM in the Chinese population.

Objective To evaluate the early clinical outcomes of anterior cruciate ligament(ACL)reconstruction combined with anterolateral tenodesis procedure in patient with high grade pivot-shift after ACL injuries.Methods Among the 140 patients diagnosed as ACL injury and undergoing operations in our hospital between June and December 2015,18 presenting high grade pivot-shift 2+ or 3+ under anesthesia were included into this study.During their surgeries,the anterolateral tenodesis procedure using iliotibial tract ITB was applied together with ACL reconstruction.The anteroposterior stability of the knee was examined and pivot-shift test was conducted right after the operation as well as 6 and 12 months after that.The Lysholm score was used to evaluate the clinical function of their knees.Results The mean follow-up period of the 18 patients was 12.7 ± 2.4 months.There were 14 males and 4 females,with an average of 28.3 ± 7.1 years.No patients complained about unstable symptoms during the follow-up.The mean side-to-side difference of anteroposterior knee laxity assessed using KT1000 at 30 degree knee flexion was 2.3 ± 0.7 mm,which was significantly improved compared with preoperative assessment(9.2 ± 2.6 mm)(P＜0.01).For the preoperative examination,the pivot-shift examination indicated 2+ in 13 patients and 3+ in 5 patients.However,all were negative right after the operation.Seventeen patients presented negative pivot-shift at the final follow-up,while 1 had 1+ rotational laxity.Significant differences were found in the Pivot-shift test before and after the operation.The average Lysholm score improved significantly from 67.7 ± 5.9(ranging from 55 to 78)before the operation to 89.0-± 4.6(ranging from 75 to 95)after that.Conclusion The high grade pivot-shift rotational instability could be effectively restored using the anterolateral tenodesis procedure,in addition to ACL reconstruction.The early stage clinical outcomes indicate significant improvement of the knee stability postoperatively.