Objective To summarize the clinical expedence in surgical treatment and prognosis of artrial septal defect(ASD)in adults and to know well the surgical indication of ASD in adults.Methods 32 patients over 20 years old with the left to right shunt and preoperative mean pulmonary artery pressure less than 8kPa underwent direct surgical repair for ASD under extra corporeal circulation.Results All patients survived after surgery,there was no surgical mortality in our group.32 patients were followed-up,29 of them with disappearing symptoms and 3 of them still had various symptoms.Conclusion The following condition ASD in adults who have slight to moderate clinical symptoms should be operated:cardiac enlargement eardiothoracic ratio over 50% and pneumonemia in X-ray films;right ventricular hypertrophy with a right axis deviation of incomplete right bundle branch block on the electrocardiogram;diameter of ASD over 1.5cm in ultrasonic cardiogram.

[Objective] To summarize Prof. YANG Jinkun gastric cancer clinical experience of diagnosis and treatment, in order to promote clinical application. [Method] Through clinical diagnosis, collecting cases, Prof. YANG Jinkun stomach cancer treatment methods are analyzed and summarized, and enumerated case evidence. [Results] Prof. YANG Jinkun offered to poison pixu(spleen deficiency) for the basic pathogenesis of gastric cancer, on the basis of the spleen and the centralizer, and combined disease according to the nature of different pathogenic toxin, chase respectively eliminating phlegm and stasis fights, qingrejiedu, etc of evil spirits, all applications in the west, comprehensive treatment, the clinical good results have been achieved. For medical record satisfactory curative effect. [Conclusion] Gastric cancer experience of diagnosis and treatment of YANG Jinkun is unique, curative effect is distinct, worthy of clinical application and promotion.

Objective To observe the clinical effects of modified Shengxian decoction in the treatment of thyroid cancer postoperative hypothyroidism patients.Methods 60 patients of thyroid cancer postoperative hypothyroidism due to deficiency of spleen and kidney were randomly divided into a control group and a treatment group.The control group (28 cases) was by levothyroxine sodium tablets conventional treatment,while the treatment group (32 cases) was treated with Shengxian decoction based on thecontrol group.The changes of the symptom integral and HAMD-17 were observed between two groups before and after treatment.Results After treatment,the total effective rate was 87.5％ in the treatment group and 64.3％ in the control group,the clinical effect of treatment group was significantly better than the control group (x2=4.499,P＜ 0.05).After treatment,the total score of HAMD-17 was 6.8±2.3 in the treatment group and 15.8±2.1 in the control group,both significantly improved than that before the treatment (which were 19.4±1.45 and 18.9± 1.32 respectively).Compared with the control group,the treatment group improved significantly (P＜ 0.01).Conclusion Shengxian decoction plus western medicine has remarkable curative effect in the treatment of thyroid cancer postoperative hypothyroidism,it can improve the depressive state of patients and improve the quality of life.

Adult ; Aged ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Injections ; Lumbar Vertebrae ; Male ; Middle Aged ; Spinal Canal ; Spinal Stenosis ; therapy

Acupuncture Points ; Acupuncture Therapy ; China ; History, Ancient ; Humans ; Hyperhidrosis ; history ; physiopathology ; therapy ; Hypohidrosis ; history ; physiopathology ; therapy ; Medicine in Literature ; Sweating

Objective:To establish an analytical method for the identification of donkey-hide gelatin in Fufang Ejiao Buxue gran-ule.Methods:The identification of donkey-hide gelatin in Fufang Ejiao Buxue granule was established by rapid resolution liquid chro -matography (UPLC) coupled with triple quadruple mass spectrometry (QQQ-MS).Results: The characteristic molecular peaks of donkey-hide gelatin were detected in ten batches of commercial samples .Conclusion:The present method is specific , precise and reli-able, and suitable for the identification of donkey-hide gelatin in Fufang Ejiao Buxue granule .The method provides scientific reference for the study of quality control method for gelatin ingredients in Chinese patent medicines .

ObjectiveTo study the MR Imaging features of breast phyllodes tumor (PT),and to correlate it with pathological results.MethodClinical and MRI findings were retrospectively reviewed in twenty-seven women with 28 PTs lesions confirmed by surgical pathology.Statistical analyses were one-way ANOVA for size analysis,Fisher exact test for analysis of MR appearances and Spearman correlation to study the relationship between MRI findings and BI-RADS categories.Results( 1 ) The histologic findings were benign,borderline and malignant PTs in 14.3％ (4/28),53.6％ (15/28) and 32.1％ (9/28) of lesions,respectively.(2) The mean maximum-diameter were (6.4 ± 3.9) cm,(5.7 ± 2.2) cm in borderline type and (4.8 ± 1.8)cm in benign type respectively.The results showed differences in lesion's size among the three type (F = 287.541,P =0.000),especially between malignant and benign type (P = 0.033 ).(3)Internal non-enhanced septations and silt-like changes on enhanced images,as well as time-signal curve on MRI correlated significantly with the histological grade ( P ＜ 0.05 ).( 4 ) If the category BI-RADS ≥ 4a was considered to be a suspicious sign for malignant lesion,the diagnostic accuracy of MRI would be 96.4％ (27/28),and the BI-RADS category of the MRI could reflect the PT's histological grade with a low correlation coefficient ( r = 0.382,P = 0.045 ).Conclusion The findings of PT on MRI have some characteristics,with tumor size and several MRI features correlating with the histological grade of breast PT.

Objective To investigate the diagnostic value of double balloon endoscopy (DBE) in the elderly. Methods Clinical manifestations and endoscopic findings of 42 elderly patients (aged 60-80 years) and 73 young and middle-aged patients (aged 12-59 years) with small bowel lesions were obtained and compared. Factors influencing the diagnostic outcome of DBE in patients with small bowel bleeding were identified,and the optimal check time after the latest bleeding was determined.Results The procedures of 85.7％ (36/42) in the elderly and 79.5％(58/73) in young and middle aged were completed (P＞0.05).There was no significant difference in the procedure time between the two age groups.No severe complications were observed in the elderly group.The overall positive rate by double balloon enteroscopy examination were 71.4 ％ (30/42) and 63.0 ％ (46/73),respectively in the two groups (P＞ 0.05). Ulcer and tumor lesions were the most common findings,and diverticula and angiodysplasia were the second common findings. Longer duration of bleeding and higher number of bleeding episodes were found in the elderly with positive DBE findings than those with negative findings. Positive diagnostic rate was significantly higher when DBE was performed within 7 days than that after 7 days (90％ vs. 40％). Conclusions DBE is a safe,reliable diagnostic modality,especially in the elderly patients with small bowel bleeding in which ulcer and tumor lesions are the most common identifications.DBE is of greater benefit in patients with more bleeding episodes over a long period,and should be performed within 7 days after the last bleeding.

Objective To investigate the transcription and protein expressions of chemokines CL16, CL12 and their receptors CR6, CR4 in first-trimester human cytotrophoblast cells and human choriocarcinoma cell line JAR. Methods Transcriptions of CR6, CL16, CR4, CL12 in purified first-trimester human trophoblast cells and JAR line were assessed by semi-quantitative RT-PCR, and protein expressions of CR6, CL16, CR4, CL12 were analyzed in primary cultured villous cytotrophoblasts (VCT), extravillous cytotrophoblasts (EVCT), JAR line and placentas by immunostaining. Results CR6 and CR4 were highly transcribed in primary cultured trophoblast cells with mRNA relative level of 1.12?0.25 and 1.08?0.11 respectively, and their ligands CL16 and CL12 were transcribed moderately with mRNA relative level of 0.89?0.11 and 0.78?0.10 respectively. It was demonstrated that CL16, CL12, CR6 and CR4 were expressed in primary cultured VCT, EVCT, JAR line and placentas by immunostaining. Conclusion The co-expression of CL16/CR6 and CL12/CR4 in trophoblast cells may play a role in the proliferation and differentiation of first-trimester trophoblast cells in a manner of autocrine.

LFA-1/ICAM-1 costimulation plays an important role in immunologic reaction of many different T cell populations. After TCR/CD3 complex cross-linking MHC/peptide, LFA-1, expressed on T cell increases a higher affinity and avidity for ICAM-1 rapidly. LFA-1 is a key molecule in formation of the immune synapse. LFA-1/ICAM-1 costimulation can engage various signaling events of T cell by up-regulating the activities of PI 3-kinase, sphingomyelinase, and c-Jun NH2-terminal kinase. With the costimulation of LFA-1/ICAM-1, engagement of TCR molecules results in a significant increase of T cell activities, including higher Th1 cytokines production, strongly proliferative response and higher T cell cytotoxicity.
Animals ; Cytokines ; biosynthesis ; Cytotoxicity, Immunologic ; Humans ; Intercellular Adhesion Molecule-1 ; physiology ; Lymphocyte Activation ; Lymphocyte Function-Associated Antigen-1 ; physiology ; Signal Transduction ; T-Lymphocytes ; immunology