MEDLINE,Ovid,CNKI,and Vip Database were retrieved for articles of diuretics induced hyponatremia.6 retrospective studies,2 prospective studies,and 31 case reports were included.Pearson correlation coefficient of the cumulative dose and serum sodium level was-0.121 (P =0.757).It is suggested that serum sodium level should be closely monitored while administrating diuretics,especially in patients with high-risk of hyponatremia.

objective To evaluate endoscopic surgery for high risk patients over 70 years old with severe acute cholangitis. Methods From October 1991 to October 2003, 84 high risk patients over 70 years old suffering from severe acute cholangitis were included and divided into laparotomy surgery (ST) and endoscopic surgery (ET) group. Results 80 patients were cured. The care rate was 81.2% in ST group and 91.6% in ET group. The mortality rate was lower in ET compared with ST (9.1% vs 18.8%). The rate of complication was reduced from 37.5% in ST group to 13.9% in ET group. The average duration of drainage was reduced from 49.4 days in ST group to 18.6 days in ET group. The total treatment days were shortened from 46.2 days to 22.8 days comparing ST with ET. Conclusions Endoscopic surgery should be the first choice for the senile and high risk patients with severe acute cholangitis. Endoscopic surgery was convenient, with mininal injury, safe and effective, and period of treatment was shortened, especially for elderly or critically ill patients, as well as those with MODS or previous billiary operations.

Objective To evaluate the anatomic relationships between the portals and radial nerve of three different operations of antrolateral approach elbow arthroscopy.Methods The dissections were pedormed in 10 formalin soaked adult cadaver elbows.The distances from the three different antrolateral portals to the radial nerve in extension and flexion 90° position were measured.The portal A was located at 3 cm distal and 1 cm anterior to the lateral epicondyle;the portal B was located at 2 cm distal and 2 cm anterior to the lateral epicondyle;the portal C,1 cm distal and 1 cm anterior to the lateral epicondyle.Results The nearest distances from the anterolateral portal A,B,and C to the radial nerve in extension position were (2.30 ± 0.95) mm,(3.00 ± 1.56) mm,and (3.60 ± 1.65) mm,with significant differences (F =11.097,P =0.001).Statistical difference in distances from the anterolateral portal to the radial nerve between portal A and C was found (P =0.006).No statistically significant difference was seen between A and B or B and C (PA-B =0.134,PB-c =0.072).The distances from the anterolateral portal A,B,and C to the radial nerve in flexion 90° position were (4.40 ± 2.01) mm,(6.10 ± 1.79) mm,and (7.90 ± 1.85) mm,with significant differences (F =54.775,P =0.000).There were statistically significant difference among the three approaches (PA-B =0.000,PA-c =0.000,PB-c =0.002).The distances increased when the position changed from extension to flexion 90° for portal A (t =-5.161,P =0.001),portal B (t=-8.188,P=0.000),and portal C (t =-10.167,P =0.000).Conclusion The anterolateral portal 1 cm distal and 1 cm anterior to the lateral epicondyle is the safest apporach.

Objective To investigate which subfamily genes of T cell receptor (TCR) V? expand predominantly during the course of experimental allergic neuritis (EAN). Methods Using RT-PCR and in situ hybridization techniques,the expression levels of TCR V? 2,6,8,10,14 in the peripheral blood,lymph nodes,peripheral nerves of group EAN and those of the control group were compared. Results In group EAN,the expression of TCR V? 6?8 mRNA increased at the early phage(41.1?1.1 and 74.4?1.9 vs 25.9?1.5 and 26.1?1.6) and became more significantly at the peak of the disease,and resolved to normal at the recovery phage in the lymph nodes.But they amounted up gradually from the early stage to the peak,and then decreased a little in the infiltrating T-lymphocytes in peripheral nerves,the difference was significant.In addition,the expression of TCR V? 8 was notably higher than that of TCR V? 6 in the levels of mRNA. Conclusion The subfamilies of TCRV? genes which restrict the development of EAN due to recognizing the specific antigens are TCRV? 8 and TCRV? 6. T lymphocytes specifically expressing TCR V?6?8 genes are activated and clonally proliferated in the lymph nodes,and then migrate to the involved peripheral nerves,which might induce a series of immune lesions consequently.

Objective To evaluate the efficacy and toxicity of chemotherapy containing paclitaxel in patients with advanced breast cancer.Methods Chemotherapy containing paclitaxel was used in 30 patients with advanced breast cancer.Paclitaxel was administered by iv infusion at a dose of 135*!mg/m 2 in 3-hour every 3～4 weeks for an average of 4 sessions. All patients received premedication of dexamethasone, diphenhydramine and cimetidine to prevent allergic reactions. Results The overall response rate was 43%(13/30),including complete remission(CR) in 3(10%) cases and partial remission(PR) in 10(33%). The average duration of remission was 1.6 months in CR cases and 5 months in PR cases respectively.The major toxicity associated with paclitaxel administration includes neutropenia,myalgia,arthralgia, numbness of hands and feet,alopecia and flushing of face. Conclusion Paclitaxel is an effective agent for treatment of advanced breast cancer and its side effects are tolerable.

To explore the relationship between the activity of polyol pathway and diabetic microangiopathy, the level of red blood cell sorbitol(RBCS)in 106 patients with NIDDMwas determined. The results indicated that the level of RBCS in diabetic patients was significantly increased, and was positively correlated with 24-h urinary albumin excretion rate(UAER)and the degree of diabetic retinopathy(DR). Besides,the value of RBCS in patients with both pro-teinuris and DR or proteinuria was markedly higher as compared with that in patients with either proteinuria or DR,and the concentration of RBCS in the patients with DR of proteinuria was also significantly higher than those wth neither proteinuria nor DR. In addition.it was also found that the value of RBCS gradually elevated with the aggravation of UAERand DR. These findings suggest that the elevation of RBCS level plays an important role in the formation and development of diabetic microangiopathy.

ObjectiveTo investigate the effect of neoadjuvant chemotherapy in locally advanced cervical cancer on cell cycle,proliferation,and evaluate the feasibility of proportion of cell in different phase 　and proliferating cell nuclear antigen(PCNA) as sensitive indices to assess chemotherapeutical sensitivity and therapeutical effect.MethodsForty-nine cases of locally advanced cervical cancer were divided into response group and no-response group according to the clinical efficacy of neoadjuvant chemotherapy.Compared the proportion of cell in different phase and proliferation index of PCNA between two groups.The clinical therapeutic effect was evaluated after 4 weeks in the second neoadjuvant chemotherapy regimen.Results In 49 patients with locally advanced cervical cancer,clinical effective of 39 cases (response group),no effective of 10 cases(no-response group).The S-phase proportion of cell in the pre-neoadjuvant chemotherapy and post-neoadjuvant chemotherapy of response group[ (21.47 ± 5.21 )％ and(18.32 ±5.07)％] were higher than those of no-response group [ (9.63 ± 2.58)％ and ( 10.14 ± 2.32)％ ] (P ＜ 0.05 ).The proliferation index of PCNA of cervical cancer in the pre-neoadjuvant chemotherapy of response group [ ( 81.67 ± 7.14)％ ] was higher than that of no-response group [ (66.99 ± 2.29 )％ ] (P ＜ 0.05 ).Conclusion The S-phase proportion of cell and proliferation index of PCNA in the pre-neoadjuvant chemotherapy are important indexes to assess chemotherapeutical sensitivity and therapeutical effect.

Objective To compare the quality of life before ischemia postconditioning and 6 months after ischemia postconditioning in patients with acute ST segment elevation myocardial infarction,and investigate the related risk factors.Methods One hundred and twenty-nine patients with acute ST segment elevation myocardial infarction were given the ischemie postconditioning.The quality of life was evaluated before ischemia postconditioning and 6 months after ischemia postconditioning by 36-item short-form health survey (SF-36) and seattle angina questionnaire (SAQ).Results In acute ST segment elevation myocardial infarction patients treated with ischemia postconditioning,the scores of SF-36 and SAQ were significantly lower at 6 months after ischemia postconditioning than those before ischemia postconditioning [SF-36:total score of body health (76.4 ± 17.3) scores vs.(56.3 ± 16.8) scores,physiologic function (75.3 ± 18.1) scores vs.(52.4 ± 19.2) scores,physiologic functional authority (75.6 ± 16.5) scores vs.(48.5 ± 20.3) scores,body pain (77.2 ± 15.4) scores vs.(58.7 ± 16.6) scores,total health state (73.6 ± 17.8) scores vs.(50.6 ± 14.7)scores,total score of mental status (77.5 ± 15.3) scores vs.(55.3 ± 17.3) scores,vitality (69.3 ± 18.1)scores vs.(43.2 ± 17.4) scores,society function (70.3 ± 17.5) scores vs.(41.3 ± 14.2)scores,affection functional authority (80.2 ± 17.4)scores vs.(63.5 ± 14.3)scores,mental health (77.6 ± 18.4) scores vs.(55.6 ± 20.1) scores,health change (76.3 ± 17.4) scores vs.(53.4 ± 16.6) scores;SAQ:body limitation of activity (78.46 ± 12.21) scores vs.(35.34 ± 15.33)scores,angina stable state (74.23 ± 8.53) scores vs.(30.12 ± 5.38) scores,angina episode state (72.34 ± 10.33) scores vs.(27.33 ± 9.12) scores,satisfaction degree of treatment (76.42 ± 12.13)scores vs.(30.56 ± 15.57) scores,knowledge of diseases (74.22 ± 9.35)scores vs.(37.25 ± 20.32) scores] (P ＜ 0.05).The results of multiple linear regression equation showed that the older,more severe vascular lesions,and lower total score of body health score before ischemia postconditioning indicated lower total score of body health,and worse quality of life after ischemia postconditioning.Conclusions The quality of life of patients with acute ST segment elevation myocardial infarction after ischemia postconditioning is significantly improved,compared with that before ischemia postconditioning.Advanced age,vascular disease and lower total scores of body health before ischemia postconditioning are independent risk factors of total scores of body health after ischemia postconditioning.

Objective To introduce the technical key points and clinical efficacy of dual plane breast augmentation under endoscope through a transaxillary incision.Methods By analyzing the 89 surgical cases,we have summarized the key points of the pre-operative design,surgical skills and postoperative management.Results All patients had no uncontrolled bleeding during operation and loss of nipple and areola sensation.71 patients got 6-12 months follow-up,showing that only one case presented with unilateral capsular contraction,and the others had satisfied results.Conclusions Blunt dissection can reduce the risks of uncontrolled bleeding on the inner side of the pocket and the damage of the nerves on the lateral side of the dissecting pocket.The lower inner part,lower part and lower lateral part are the areas that could be sharply dissected by electrocautery under endoscope to achieve the dual plane Ⅰ.The drainage and bandage are necessary after the operation.

Female ; Humans ; Liability, Legal ; Middle Aged ; Occupational Diseases ; diagnosis ; Occupational Health ; legislation & jurisprudence ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; etiology