Bile reflux is not only related to diseases such as gastritis,esophagitis,pharyngitis,chorditis,bronchitis and pneumonia,but also related to residual gastric ulcer,residual gastric cancer,intestinal metaplasia,dysplasia and carcinogenesis. Risk factors related to bile reflux include various operation modes, various anastomosis methods, gallbladder stone, cholecystectomy and various non-operative factors such as age, gender, allergy, mental and psychological factors,congenital factors. This article reviewed the advances in study on risk factors related to bile reflux.

Objective To investigate the morphological difference of spinal single vertebral tuberculosis and metastasis by means of CT.Methods CT features of 16 cases of single vertebral tuberculosis and 17 cases of single vertebral metastasis which were proven by clinically and/or pathology, were retrospectively analyzed,and then the CT differential criteria of the two categories of diseases was recommended.Results The reliable CT findings for vertebral tuberculosis were as follows: involvement of anteriomedial potion of vatebral body,presence of sequstra in lesion ,marginal sclerosis in the edge of lesion,calcification within paravertebralmass or abscesses ,only edge enhancement of more of paravertebralmass.Metastasis was characterized by involvement of posteriomedial portion of vertebral bone,absence of sequestra within lesion ,no calcification within paravertebralmass.Both of them had normal intervertebral disc.Conclusion The different CT features of the single vertebral tuberculosis and metastasis are helpful in differerntiating diagnosis ,the morphological change of intervertebral discs is not helpful in differerntiating diagnosis .

Aged ; Humans ; Lung Diseases, Fungal ; complications ; microbiology ; Male ; Pneumoconiosis ; complications

Protein Kinase C (PKC) is an important messenger in intracellular signal transduction. So far, at least 11 members of PKC isoforms have been isolated and purified. The mutation of the non-synonymous SNP (1425G/A) of the η isoform of protein kinase C (PKC η), a protein kinase Cη gene (PRKCH) may result in the increased PKCη activity, which is considered as a new risk factor for lacunar infarction. In recent years, the studies about the role of PRKCH in cell differentiation and apoptosis and its relation with some signal transduction pathways have made some new advances, especially, PKCη participates in the regulation of some key enzyme activity that mitogen-activated protein kinase, inducible nitric oxide-synthase and matrix metalloproteinase are closely correlated with the process of atherosclerosis. It will provide a new way of thinking for the clinical intervention of cerebral infarction in the future.

Objective To evaluate the association between C-reactive protein (CRP) blood levels and specific survival time of non-small cell lung cancer (NSCLC) patients treated with chemotherapy.Methods Data from 96 advanced (stage ⅢB/Ⅳ) NSCLC patients were analyzed.All patients were divided into two groups based on the enrolled time as follows the initial treatment group (48 cases) and retreatment group (48 cases).According to 0.6 mg/L and 7.3 mg/L of CRP which were the 1/3 and 2/3 of CRP concentrations,respectively,the 96 patients were divided into low,intermediate and high groups.Kaplan-Meier and Cox proportional-hazard models were used to evaluate the relationship between the CRP level and survival time.Results After adjusting for age,sex,smoking history,histological type and stage of lung cancer,a significant relationship between CRP and survival time was observed (P ＜ 0.05).Such significant differences of survival time were also observed in both of the adenocarcinoma (P ＜ 0.001) and squamous with poorly differentiated (P =0.032) subtypes.On stratification analysis by chemotherapy status,the circulating CRP level in retreatment group was correlated well with survival time (P ＜ 0.001).However,the influence of circulating CRP levels on survival time in initial group did not reach statistical significance (P =0.296).For all patients,the hazard ratio with high CRP levels for NSCLC-specific survival was 1.15 (95 ％ CI 0.82-1.61) compared with that of low CRP levels.The hazard ratio for the initial treatment group and retreatment group were 0.52 (95 ％ CI 0.16-1.74) and 1.77 (95 ％ CI 0.73-4.26),respectively.Patients with high circulating CRP level also responded poorly to chemotherapy.Conclusion A high level of circulating CRP is associated with an inferior response and survival outcome in NSCLC patients treated with chemotherapy.

Objective To evaluate the effectiveness and safety of dexmedetomidine for the sedation of the patients after coronary artery bypass grafting (CABG).Methods The selective 96 CABG patients,ASA Ⅱor Ⅲ,aged 36 to 68 years old,58 males and 38 females,were randomly divided into 2 groups (n =48):dexmedetomidine group (group A) and midazolam group (group B).Group A patients received Dexmedetomidine (1.0 μg/kg)over 10 min,followed by 0.2-0.7 μg · kg-1 · h-1 to maintain sedation,whereas the other group patients received midazolam (0.05 mg/kg) over 10 min,followed by 0.02-0.10 mg · kg-1 · h-1 to maintain sedation.Two groups of patients stopped using drug when they were fit off-line and extubation.Observe the percentage of time within target sedative scope (Riker range 3-4),the changes of vital signs before and after treatment,the prevalence of delirium,the awakening time,the duration of mechanical ventilation,ICU length of stay,the adverse events of blood pressure and heart rate.Results There were no significant difference in the percentage of time within target sedative scope between two groups (75.5％ for dexmedetomidine group vs 74.6％ for midazolam group,P ＞ 0.05).Compared to midazolam group,the Dexmedetomidine group has a shorter awakening time [(14.0 ± 6.2) min for dexmedetomidine group vs (50.4 ± 12.8) min for midazolam group,P ＜ 0.05] and duration of mechanical ventilation,and also the prevalence of delirium was lower(15.3％ for dexmedetomidine group vs 34.6％ for midazolam group,P ＜0.05).ICU length of stay was similar.Dexmedetomidine-treated patients were more likely to develop bradcardia,with a non significant increase in the proportion requiring treatment,but had a lower likelihood of tachycardia or hypertension requiring treatment.Conclusion Dexmedetomidine is safe and effective in patients after CABG surgery.

In order to lower the purchasing prices of drugs, prevent unhealthy tendencies that might arise in the process of drug circulation in the hospital, and reduce the financial burdens of patients, our hospital started from March 1997 the practice of purchasing drugs through open tender. The measures adopted include: ①establishment of a leading group in charge of drug purchases and a drug purchasing group; ②formulation and earnest implementation of the system of purchasing drugs through open tender, making “five checks”; ③standardization of the scope of routine drugs used in the hospital; and ④adherence to the system of examination and approval by the Drug Management Committee when introduction of new drugs is being considered. Since the adoption of the system of purchasing drugs through tender, the purc hasing prices of drugs have on the average dropped 14.7% and the drug expenses for single entity diseases have been lowered.

Objective To discuss the strategies of lower complications of LC in the initial stage. Methods The clinical data of 168 patients,from Sep. 2008 to May. 2010 ,treated with laparoscopic cholectectomy were retrospectively analyzed. Results LC was performed in all patients(100%). None of the series had intra-abdominal bleeding,biliary tract injury and no other serious complications were observed. Conclusion Through correct perioperative management and meticulous operation, LC was safe and complications lower in the initial stage.

Objective To study the expression of gastrin receptor in 4 HCC cell lines and tis-sues and their relation to clinieopathological features. Methods Immunohistochemical staining of GR was performed for the 4 HCC cell lines and the paraffin sections of 25 HCC cases. The relationship be-tween the GR expression in HCC sections and the clinicopatho[ogical parameters were analyzed. Results Positive staining for GR in the 3 HCC SMMC-7721>HepG2>QGY-7701 cell lines and HCC tissues was observed. The expression rate of gastrin receptor was 56 % (14/25). However, there was no association between expression of GR and elinieopathologieal features such as age, gender and clini-cal stage etc except for tumor thrombosis. Concision GR exists in the HCC. Futher study is needed to identify whether GR is a applicable target for endocrine therapy in HCC.

BACKGROUND:There have been many studies on the diagnosis of osteoporotic vertebral compression fractures. However, there are few studies on the diagnostic methods of fracture in different periods. OBJECTIVE:To comparatively analyze the application value of high-intensity magnetic resonance imaging (MRI) and single photon emission computed tomography combined with CT scan image fusion (SPECT-CT) in the diagnosis of osteoporotic vertebral compression fractures. METHODS:Clinical data of 35 patients with osteoporotic vertebral compression fractures were retrospectively analyzed, including 56 vertebrae. There were 14 males and 21 females, with an average age of 72.6 years. The course of disease was within 3 weeks in 22 patients, belonging to acute fractures. The course of the disease was between 4 and 12 weeks in 10 patients, belonging to the subacute fractures. The course of disease was 6 months in 3 patients, belonging to the fracture healing period. Al patients were tested with high-intensity MRI and SPECT-CT examination, and were treated with vertebroplasty or percutaneous kyphoplasty. The Fisher exact method was used to compare the two diagnostic methods in the diagnosis of vertebral fracture. RESULTS AND CONCLUSION:(1) In the 56 responsible vertebral bodies, 32 vertebral bodies belonged to the acute-stage fractures, and 24 vertebral bodies belonged to the non-acute-stage fractures. In al the fractures, MRI diagnosed 49 segments;SPECT-CT diagnosed 52 segments. The sensitivity of SPECT-CT testing was higher than MRI, and its specificity was less than MRI. There was a high consistency of diagnosis between fractures. (2) In the 32 acute vertebral fractures, the two tests diagnosed 29 segments. The sensitivity of SPECT-CT was higher than that of MRI, but its specificity was lower than that of the MRI. There was a high consistency between the diagnoses of fractures. (3) In the 24 non-acute vertebral fractures, MRI diagnosed 20 segments;SPECT-CT diagnosed 23 segments. SPECT-CT was more sensitive than MRI;the specificity of SPECT-CT was lower than MRI. There was a high consistency between the two diagnoses of fractures. (4) There was a high consistency in the MRI and SPECT-CT examination to determine the fracture of different periods of responsibility of the vertebral body, but the sensitivity of SPECT-CT is higher than MRI examination;SPECT-CT is an effective inspection method in the diagnosis of vertebral fractures.