Adult ; Aged ; Budd-Chiari Syndrome ; diagnostic imaging ; Female ; Humans ; Liver ; diagnostic imaging ; Liver Circulation ; Male ; Middle Aged ; Ultrasonography, Doppler, Color ; Young Adult

OBJECTIVETo investigate the relationship between the abnormal characteristics of sublingual collateral (SC) and portal vein hemodynamic changes in patients with primary hepatic carcinoma (PHC).

METHODSA total of 123 patients of PHC with abnormal SC were enrolled. The SC characteristics were classified and evaluated. The principal components (PC) of SC extracted from them by principal component analysis and the relationship between PC and the dynamic changes of portal vein flow were analyzed by correlation analysis.

RESULTSThree groups of PC were extracted, namely PC-1 (length, width, presentation type of visualization), PC-2 (circuitous, vesicular change), and PC-3 (color, collateral hemostasis, petechiae, ecchymosis). Their total accumulative contribution degree reached 56.803%. Correlation analysis shows that PC-1 was significantly positively correlated with the hemodynamic parameters of the portal vein (P<0.01), while PC-2 and PC-3 were not (P>0.05).

CONCLUSIONLength, width and presentation type of SC could be used for predicting the changes of portal venous pressure in PHC patients.

Adult ; Aged ; Collateral Circulation ; Female ; Hemodynamics ; Humans ; Liver Neoplasms ; physiopathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Portal Vein ; physiopathology ; Principal Component Analysis ; Tongue ; blood supply

Objective: To discuss the clinical outcomes of treating delayed acetabular fractures by combined anterior and posterior approach. Methods: A retrospective analysis was conducted of 31 delayed acetabular fractures from February 2012 to February 2017 in the First Affiliated Hospital of Chongqing Medical University, including 18 males and 13 females with age of 48.5 years(23 to 67 years) .The injury to the operation time was 35.9 days(22 to 183 days). Of these 31 cases, there were 6 cases of transverse and posterior wall fracture, 8 cases with anterior column+ posterior half transverse fracture, 12 cases with double column fracture and 5 cases of "T" type fracture according to Letournel-Judet classification.All fractures were treated combined anterior and Kocher-Langenbeck approaches, including 13 cases of ilioinguinal approach+ Kocher-Langenbeck(K-L approach), 4 cases of extensile acetabular approach, 7 cases of stoppa approach + K-L approach and 7 cases of side rectus femoris approach.Correlation was analyzed by Pearson correlation regression testing. Results: Follow up to August 2017, all patients were followed up with 36.0 months(from 6 to 55 months). As calculated, the restorational effect was positively with result of the X-ray film and the clinical effect(r=0.823, 0.856; both P<0.05). The evaluation was conducted with Matta′s reduction criteria: there were 11 cases classified as anatomic reduction(35.5%), 13 cases as satisfactory reduction(41.9%), and 7 cases as unsatisfactory reduction(22.6%). Excellent and good rate was 77.4%. Functional reductions were categorized by the standard of Matta hip score: 8 excellent cases(25.8%), 11 good cases(35.5%), 8 fail cases(25.8%), and 4 poor cases(12.9%). Conclusion The treatment of delayed acetabular fracture by combined anterior and posterior approach can fully exposure the anterior and posterior acetabular fcloumns, which is beneficial to the release and fixation of the old acetabular fractures.

OBJECTIVETo study the clinical significance of CD163 in the diagnosis and the evaluation of severity and prognosis of childhood hemophagocytic lymphohistiocytosis (HLH).

METHODSNinety-four children were classified into Epstein-Barr virus (EBV)-positive (n=55) and EBV-negative groups (n=39; control group). The EBV-positive group was subgrouped into infectious mononucleosis (IM; n=47) and HLH (n=8). Serum levels of soluble CD163 were measured using ELISA. Expression of CD163 on mononuclear cells was detected by flow cytometry.

RESULTSThe serum levels of soluble CD163 were>10 000 ng/mL in all eight HLH patients (>30 000 ng/mL in 3 cases). The mean serum levels of soluble CD163 in the HLH group were significantly higher than in the control and IM groups (P<0.05). The serum levels of soluble CD163 in EBV-positive children were positively correlated with EBV-DNA copies and serum levels of ferritin and LDH, but were negatively correlated with white blood cell count, neutrophil count, hemoglobin and platelet count. The follow-up after treatment for three HLH patients showed that serum levels of soluble CD163 were significantly reduced, but the soluble CD163 levels rebounded in one patient who was complicated by fungal pneumonia infection.

CONCLUSIONSThe levels of serum soluble CD163 may be related to the severity in children with HLH. The EBV-positive children with soluble CD163 levels >10 000 ng/mL should be considered the possibility of HLH.

Adolescent ; Antigens, CD ; analysis ; Antigens, Differentiation, Myelomonocytic ; analysis ; Child ; Child, Preschool ; Epstein-Barr Virus Infections ; immunology ; Female ; Humans ; Infant ; Male ; Receptors, Cell Surface ; analysis

OBJECTIVETo scrutinize the epidemiological characteristics of assaultive injuries in Sichuan province, China.

METHODSA survey of all cases of assaultive injuries reported by police was performed during 8 years in eight counties of Sichuan province, China. A total of 2862 victims and 2856 offenders were registered.

RESULTSThe majority of victims and offenders were young men at the age of 20-39 and only received an education at secondary school or primary school. The largest fraction of these cases took place at farm or by-place during 10.00-11.00 o'clock, 16.00-17.00 o'clock and 20.00-21.00 o'clock. The tangles caused by trifles were the most common factors inducing assaultive injuries and accounted for 42.1 percent of the causes of assaults. Blunt injuries were mainly caused by punching (40%) and kicking (17.2%). About 37.3% of the lesions seriously happened in the regions of face and head. Open wounds accounted for 40.3% of these different injuries.

CONCLUSIONSIt is valuable to take some specific measures to prevent and control assaultive injuries according to their territorial characteristics.

OBJECTIVETo survey the status of diagnosis and treatment of biliary tract cancer in Shanghai.

METHODSA clinical epidemiology investigation was carried out on 658 new cases of biliary duct cancers aged 35-74, that registered between June 1997 and May 2001 in urban Shanghai. Clinical findings were collected in 390 gallbladder cancer, 195 bile duct cancer and 73 ampullary cancer.

RESULTSBiliary tract cancers mainly occurred in elderly patients. Ratio of males to female was 1:2.61 in gallbladder cancer, while bile duct cancer and ampullary cancer were slightly more common in men. Association with gallstones was 68.5%, 43.1% and 22.4% for gallbladder cancer, bile duct cancer and ampullary cancer, respectively. Diagnostic accuracy rate of B-ultrasonography was 63.1% in gallbladder cancer. Incidental gallbladder cancer accounted for 20%, while stage IVA and IVB patients reached up to 43.6%. Misdiagnosis rate was still high in bile duct cancer and ampullary cancer, it was 19.1% and 47.1% respectively. In addition, most patients presented jaundice at diagnosis. 69 cases (18.2%) of gallbladder cancer, 50 cases (25.6%) of bile duct cancer and 54 cases (74%) of ampullary cancer underwent radical resection, the 1-, 3- and 5-year survival rates were 58.5%, 42.8% and 40.7%, 58%, 28.3% and 11.1%, 81.5%, 39.2% and 26.9%, respectively. 79 patients with bile duct cancer underwent palliative drainage, and most cases died within 1 year. Metal endo-prostheses or plastic stents were placed into the biliary tract in 38 patients. The median survival was about 7 months.

CONCLUSIONSIt is difficult to make early diagnosis of biliary tract cancers. Standardization of the operation for gallbladder cancer must be respected. Surgical exploration should be undertaken when a bile duct cancer is suspected and there are no contraindications to surgery. Pancreatoduodenectomy should be recommended for ampullary cancer.

Biliary Tract Neoplasms ; diagnosis ; epidemiology ; mortality ; therapy ; China ; epidemiology ; Data Collection ; Female ; Humans ; Male ; Survival Rate

Objective To establish UV spectrophotometry and HPLC methods for content determinations of total flavonoids and puerarin from Puerariae Lobatae Radix and Puerariae Thomsonii Radix; To compare the ultrasonic method at room temperature, conventional refluxing method and ultrasonic method at heating conditions at the aspect of content determinations. Methods The content determinations of total flavonoids was determined by UV spectrophotometry at 250 nm; the content of puerarin was determined by HPLC with octadecylsilane-bonded silica gel as the stationary phase, a mixture of methanol and water (25:75) as the mobile phase, 256 nm as the detection wavelength, 1.0 mL/min as the flow rate. Results Contents of total flavonoids in Puerariae Lobatae Radix by ultrasonic method at room temperature, conventional refluxing method and ultrasonic method were15.09%, 14.48%, and 12.71% (n=3), respectively. The contents of puerarin were 4.37%, 4.09%, and 3.80% (n=3), respectively. Contents of total flavonoids in Puerariae Thomsonii Radix were 2.09%, 2.23%, and 2.17% (n=3), respectively. The contents of puerarin were 0.50%, 0.53%, and 0.52% (n=3), respectively. Conclusion Ultrasonic method at room temperature can replace conventional refluxing method for content determinations of total flavonoids and puerarin from Puerariae Lobatae Radix, and ultrasonic method at heating conditions also can replace conventional refluxing method for content determinations of total flavonoids puerarin from Puerariae Thomsonii Radix. Puerarin contents from Puerariae Lobatae Radix and Puerariae Thomsonii Radix in South Anhui Province are all in line with the Pharmacopoeia standards.

OBJECTIVETo investigate the therapeutic effects of repair of skin and soft tissue defects at distal end of finger with serrated flap with digital proper artery and nerve pedicle combined with bilaterally pedicled V-Y advancement flap of the injured finger.

METHODSThirteen patients with skin and soft tissue defects at distal end of 13 fingers were hospitalized from September 2013 to January 2015. After debridement, the wound area of finger ranged from 1.2 cm × 0.8 cm to 1.8 cm × 1.5 cm. Serrated flap with digital proper artery and nerve pedicle combined with bilaterally pedicled V-Y advancement flap of the injured finger were used to repair the defect. The flaps were interruptedly sutured. The areas of bilaterally pedicled V-Y advancement flap and serrated flap with digital proper artery and nerve pedicle ranged from 0.52 to 1.11 and 2.60 to 5.23 cm(2,) respectively.

RESULTSAll flaps of 13 patients survived completely. The patients were followed up for 6 to 24 months. The color and texture of the flaps were good. After reconstruction, the finger tips were in round in shape. The appearance of the fingers was consistent with that of the normal fingers, and joint motility was normal. No hook-nail deformity or knuckle dysfunction was found. Sensation of the flaps was estimated as S4, and the distance of two-point discrimination ranged from 2 to 3 mm. The recovery of the joint motion function of the fingers was excellent.

CONCLUSIONSSerrated flap with digital proper artery and nerve pedicle, combined with bilaterally pedicled V-Y advancement flap from the injured finger can repair the skin and soft tissue defects at distal end of finger with reliable blood supply and simple operative technic. It also could avoid the formation of deformity subsequent to a linear scar, and a satisfactory appearance with good function could be obtained.

Arteries ; Cicatrix ; Debridement ; Finger Injuries ; surgery ; Fingers ; Humans ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; Treatment Outcome ; Wound Healing

OBJECTIVETo examine the urinary level of tissue factor (uTF) and its procoagulant activity (PCA) in patients with diabetes mellitus, and explore the relationship between uTF and renal damage in diabetes mellitus.

METHODSEighty-six patients with type 2 diabetes mellitus were divided into 3 groups according to urine albumin excretion (UACR), namely normal albuminuria group, microalbuminuria group and macroalbuminuria group. The levels of uTF, PCA, blood urea nitrogen (BUN), serum creatinine (CRE), serum cystatin C (CYSC), glycohemoglobin A1c (HbA1c), and high-sensitivity C-reactive protein (hs-CRP) were measured in all the patients and 21 healthy controls.

RESULTSCompared with normal control, the diabetic patients showed significantly increased levels of uTF and PCA. The urinary TF-PCA was positively correlated to BUN, CYSC, CRE, UACR, fasting glucose and hs-CRP, but not to uTF; only hs-CRP, UACR were positively correlated to uTF.

CONCLUSIONuTF is probably implicated in the development and progression of diabetic nephropathy.

Adult ; Albuminuria ; urine ; Blood Coagulation ; Case-Control Studies ; Creatinine ; urine ; Diabetes Mellitus, Type 2 ; physiopathology ; urine ; Female ; Humans ; Male ; Middle Aged ; Thromboplastin ; urine

OBJECTIVETo evaluate the efficacy and toxicity of a biweekly DOF regimen consisting of docetaxel, oxaliplatin, 5-fluorouracil and leucovorin for advanced gastric cancer.

METHODSThe biweekly DOF regimen was administered in 37 advanced gastric cancer patients. Docetaxel, oxaliplatin and leucovorin were given intravenously at a dose of 35 mg/m2, 85 mg/m2 and 200 mg/m2 for 1 h, 2 h and 2 h on D1, respectively, and 5-Fu was administered as continuous intravenous infusion for 48 h at a dose of 1500 mg/m2 on D1 and D2. This regimen was repeated every 2 weeks. The efficacy and toxicity were evaluated after completion of 3 cycles at least.

RESULTSThe overall response rate (RR) of this series was 67.6%, complete response rate and partial response rate were 27.0% and 40.5%, respectively. The time to progression (TTP) was 9.2 months, and median survival time (MST) was 13.7 months. The RRs of 11 chemotherpy-naïve patients and 26 patients pre-treated with chemotherapy were 81.8% and 61.5%, respectively.

CONCLUSIONOur preliminary results showed that this biweekly combination regimen of docetaxel, oxaliplatin, 5-fluorouracil and leucovorin is effective and tolerable for advanced gastric cancer. However, further investigation of this regimen is mandatory.

Adenocarcinoma ; drug therapy ; pathology ; Adenocarcinoma, Mucinous ; drug therapy ; pathology ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Female ; Fluorouracil ; administration & dosage ; adverse effects ; Follow-Up Studies ; Humans ; Leucovorin ; administration & dosage ; adverse effects ; Leukopenia ; chemically induced ; Liver Neoplasms ; drug therapy ; secondary ; Lung Neoplasms ; drug therapy ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Organoplatinum Compounds ; administration & dosage ; adverse effects ; Remission Induction ; Stomach Neoplasms ; drug therapy ; pathology ; Taxoids ; administration & dosage ; adverse effects ; Vomiting ; chemically induced ; Young Adult