Objective To study the clinical application of laparoscopy in the treatment of closed abdominal trauma. Methods Emergent laparoscopic exploration and treatment was conducted in 21 patients with closed abdominal trauma, who had stable hemodynamic parameters,from July 2000 to December 2003. Results Diagnosis was clarified laparoscopically in all the 21 patients. There were 4 cases of open liver repair, 2 cases of laparoscopic liver repair, 5 cases of open splenectomy, 3 cases of hand-assisted laparoscopic splenectomy, 2 cases of video-assisted small incisional intestinal repair, 4 cases of partial intestinal resection and 1 case of laparoscopic greater omentum hemostasis. Conclusions Laparoscopy in the diagnosis and treatment of closed abdominal trauma is accurate, safe and effective.

Thirty patients with objective benign paroxysmal positional vertigo (BPPV) (objective group) and 30 patients with subjective BPPV (subjective group) visiting Department of Neurology from January 2014 to June 2015 were enrolled in the study.There were no significant differences in semicircular canal,gender,age,related factors of secondary onset (P ＞ 0.05).Patients were evaluated with dizziness handicap inventory (DHI) before and after the maneuver therapy.The average DHI subscale scores before treatment of all patients were higher than those after treatment (11.8 ± 2.8 vs.2.5 ± 1.8,P ＜ 0.05);there was 11.9 ± 3.0 vs.2.5 ± 2.1 (P ＜ 0.05) for objective group and 11.6 ± 2.6 vs.2.5 ± 1.6 (P ＜ 0.05) for subjective group.The scores of PI,F5,P11,P13,P25 (mean rank order value) after treatment were decreased compared to corresponding initial scores in two groups(objective group:21.30 vs.39.70,19.55 vs.41.45,19.00 vs.42.00,18.65 vs.42.35,15.90 vs.45.10,respectively,subjective group:20.93 vs.40.07,18.07 vs.42.93,19.77 vs.41.23,18.57 vs.42.43,16.47 vs.44.53,respectively;all P ＜ 0.05).The results indicate that maneuver therapy is effective both for objective and subjective BPPV patients;and subscale of DHI can be used to evaluate the degree of illness in patients with BPPV.

Objective To compare the clinical effects of perforated gastroduodenal ulcer treatment by laparoscopy and traditional open repair.Methods 70 cases of patients with perforated diagnosed as gastroduodenal ulcer were selected and divided into laparoscopic group and open group by different operation type.Laparoscopy was used in laparoscopic group,while traditional open repair was used in open group.The mean time in operation,intraoperative blood loss and intraoperative and peostoperative complications were observed and recorded.Results There was no difference in operative mean time between the two groups(P ＞ 0.05),but intraoperative blood loss was less in laparoscopic group than that in open group (P ＜ 0.05),exhaust time and hospitalization time in laparoscopic group were shorter than that in open group(P ＜ 0.05),and no complication was found in laparoscopic group(0.00％),while 10 cases in open group(22.73％),the rate in the former group was lower than that in the latter group(P ＜0.05).Conclusion Using laparoscopy to repair perforated gastroduodenal ulcer had little trauma,less pain,less complication,shorter recover time and safe.It is worthy of clinical.

Objective To investigate the expression of NKG2D and related signaling molecules adaptor protein(DAP10) and extracellular signal-regulated kinase(ERK) in the inflammatory cells of gastric adenocarcinoma and para-carcinoma tissues,the effects of vasoactive intestinal peptide(VIP) on the expression of NKG2D,DAP10 and ERK in natural killer(NK) cells of healthy volunteers.Methods The expression of NKG2D,DAP10 and ERK in the inflammatory cells of 36 gastric adenocarcinoma and para-carcinoma tissues were detected by immunohistochemistry.The peripheral blood NK cells of healthy volunteers were isolated and purified with CDC method.The expressions of NKG2D,DAP10 and ERK in NK cells were determined by immunocytochemistry and reverse transcription-polymerase chain reaction(RT-PCR) methods before and after VIP intervention.The ttest was used for comparison between two groups and rank transformation nonparametric test (Kruskal-Wallis H test) for count data analysis.Results The expression levels of NKG2D,DAP10 and ERK in the inflammatory cells of gastric adenocarcinoma were significantly lower than those of para-carcinoma tissues (H=30.640,24.910,20.320,all P＜0.01).The expression levels of NKG2D,DAP10 and ERK were much lower in poorly differentiated gastric adenocarcinoma (H =4.049,11.830,8.118),at stage Ⅲ-Ⅳ (H=4.275,11.560,7.686),and the expression levels of NKG2D,ERK were lower with lymph nodes metastasis (H=6.513,6.064,all P＜0.05).The expression levels of NKG2D,DAP10 and ERK in gastric adenocarcinoma tissues and inflammatory cells were not correlated with gender,age and the location of lesions (all P＞0.05).The expression levels of NKG2D,DAP10 and ERK in NK cells was decreased after VIP intervention (protein:H=12.438,4.798,13.745,mRNA:F=337.640,638.579,1055.015,all P＜0.05).Conclusion Gastric adenocarcinoma may downregulate the expression of NKG2D,DAP10 and ERK in NK cells through VIP secretion,which may be involved in the immune escape of gastric cancer.

Adult ; Arsenic Poisoning ; pathology ; Chronic Disease ; Hemosiderin ; metabolism ; Hemosiderosis ; metabolism ; pathology ; Humans ; Hypertension, Portal ; chemically induced ; metabolism ; pathology ; Liver Cirrhosis ; chemically induced ; metabolism ; pathology ; Male ; Pancytopenia ; chemically induced ; metabolism ; pathology ; Splenomegaly ; chemically induced ; metabolism ; pathology

Adult ; Bone Neoplasms ; pathology ; surgery ; Femur ; pathology ; surgery ; Humans ; Male ; Osteochondroma ; pathology ; surgery ; Young Adult

Objective To investigate the treatment options of acute biliary pancreatitis.Methods A retrospective review was performed in 134 consecutive patients who presented to a single tertiary care institution from 2000 to 2010 with acute biliary pancreatitis.Results Of the 134 patients,30 had a persistent (commonbile duct,CBD)stone.Following multivariate analysis,at admission CBD size on ultrasound,alkaline phosphatase(ALP),total bilirubin(TB),significantly correlated with persistent CBD stone.Receiver operator curve analysis and linear regression were applied to obtain optimal and equitable predictive values,and variables combined.Optimal values were.,CBD≥10 mm;AP≥150 U/L;and TB≥51.3μmol/L.Presence of three variables had an associated odds ratio(OR)of29.5(P<0.001)for presence of persistent CBD stone.Zero variables conferred asignificantly decreased probability of CBD stone,OR 0.07(P<0.001).Conclusions Presence of three variables significantly correlated with persistent CBD stone.Biliary evaluation by endoscopic retrograde cholangiopancreatography(ERCP)is suggested.In the absence of any positive predictive variables,cholecystectomy may be sufficient.Decisions regarding patients with one to two be made vailables should occur on a case-to-case basis.

Objective To observe the clnical effects of influence of tanshinone type ⅡA sulfonate on preventing hepatic artery thrombosis after transplantation.Methods A total of 60 patients after liver transplantation were randomly individed into the treatment group and control group, each 30 patients. The treatment group received tanshinone ⅡA sodium sulfonate treatment (60 mg qd, ivgtt continuous 10d) , while the control group used conventional heparinization. The blood coagulation index and the thrombelastograph variables were detected after 7 days and the hepatic artery resistance index (RI) was detected by using Doppler ultrasonography. The postoperative complications and mortality rates were analyzed.Results Although it had little improvement on the coagulation function after liver transplantation, tanshinone ⅡA sodium sulfonate had significant improvement on the time of thrombelastograph parameters reaction (6.35 ± 1.59 minvs. 5.21 ± 1.37 min,t=2.453) and maximum amplitude (58.07 ± 5.42 mmvs. 61.67 ± 5.63 mm,t=-2.532). It showed that RI have significantly statistical difference between the two groups after treatment (0.73 ± 0.11vs. 0.62 ± 0.10;t=-2.948,P<0.01). During the trial, the control group had 2 cases of postoperative complications, HAT and bleeding.Conclusions The Tanshinone ⅡA sodium after liver transplantation can improve the clotting mechanism, preventing HAT.

Aim To explore the therapeutic effect of cryptotanshinone(CTS) on airway remodeling model of asthmatic mice, and the relationship between its mechanism and the TWEAK/Fn14 and TGF-β1/Smads signaling pathway. Methods Forty female BALB/c mice were used for our study, eight mice as a group, and were assigned into five groups, namely, control group, OVA model group, CTS treatment group (20, 40 mg·kg-1), and Dex positive control group (1 mg·kg-1). HE and PAS staining were used to observe lung histopathological changes in mice; Diff-Quick staining was employed to count the types of cells; ELISA was used to detect the contents of proinflammatory cytokines in BALF; Western blot was applied to analyze the contents of TWEAK, Fn14, TGF-β1, Smad2/3, Smad4 in lung tissues; immunohistochemical method was used to detect the expression levels of TWEAK and TGF-β1 in lung tissues. Results CTS reduced the exudation of inflammatory cells and proliferation of goblet cells; CTS inhibited the generation of EOS, NEU, LYM and the total cells; CTS could reduce the level of proinflammatory cytokines of airway inflammation; the results of Western blot showed that CTS inhibited the protein expression of TWEAK, Fn14, TGF-β1, Smad2/3 and Smad4; immunohistochemical results indicated that CTS increased the expression of TWEAK and TGF-β1 in lung tissues. Conclusions CTS has therapeutic effect on the OVA-induced airway inflammation mouse model through TWEAK/Fn14 and TGF-β1/Smads signaling pathways.

This review analyzed the effect of folic acid on pemetrexed efficacy and toxicity, especially high-does folic acid supplementation. The optimal duration for supplementation prior to the first dose of pemetrexed has not been defined. The review also explored whether total plasma homocysteine levels can be as a marker to predict and avoid toxicity from pemetrexed therapy.