Objective To understand the clinical features of peripheral cholangiocarcinoma (PC) developed against the background of hepatolithiasis. Methods Between 1995 and 2002, a total of 11 PC patients with definite history of hepatolithiasis were treated surgically in our hospital. The diagnosis, treatment and prognosis of this clinical entity were retrospectively analyzed. Results Peripheral cholangiocarcinoma occurred in 5 1% of patients with hepatolithiasis in this group and the tumor was located in the left lobe in 7 (64 7%) cases. All patients underwent laparotomy, with diagnosis established preoperatively in 3 (27 2%) cases and intraoperative diagnosis was missed in 2 (18 1%) cases. Radical resections were performed in only 3 (27 2%) cases. The overall operative morbidity and mortality were 72 7% and 9 1% respectively . Infection was the main postoperative complication. The postoperative 1 and 2 year survival rate was 33 3% and 11 1% respectively. Conclusions Cholangiocarcinoma may develope in patients with a history of hepatolithiasis. The prognosis of PC is still poor because of the difficulty to achieve early diagnosis and radical resection.

Objective To investigate the discharge outcome and its clinical influential factors of acute poisoning in children, and to provide the clinical references for prevention. Methods Questionaire about acute poisoning in children made by the research group,the hospitalized children and the influential factors were analyzed according to the outcome. Results Among 168 cases of acute poisoning hospitalized children,the curative rate was 80.95%, 16 cases(9.52%) were improved,6 cases (3.57%)were quitted,1.20% was ' not curative' and 4. 76% died. The factors including age,treatment time, route of entry, varieties of poison, medical examination of admission were statistically associated with the discharge outcome.Conclusion The outcome can be improved through an intensive nurse of the children under the age of three and early treatment. The cases who were not poisoned by the invasion of gastrointestinal tract,paraquat poisoning,and those with abnormalities of breathing, pupilla, awareness in medical examination of admission would have poor discharge outcomes, and should be monitored closely and treated timely.

Cholesteatoma ; diagnosis ; pathology ; Humans ; Petrous Bone ; pathology

Diabetes Mellitus, Type 2 ; complications ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myelinolysis, Central Pontine ; complications ; diagnosis ; Prognosis

Objective To evaluate the treatment modalities for local recurrent periampullary carcinoma. Methods From January 1997 to May 2007, 23 patients with local recurrent periampullary carcinoma underwent different therapy. The recurrent tumor was resected through laparotomy in 3 cases and the unresectable tumors were treated with radiofrequency ablation(RFA) in 5 patients. In 10 patients and 5 patients respectively high intensity focused ultrasound ( HIFU ) and regional chemotherapy ( RC ) were performed. Results The resection rate for local recurrent periampullary carcinoma was 13% in this group, 2 patients have survived for 10 months and 13 months respectively after reoperation while one patient achieved tumor-free survival for six months so far. The symptoms were alleviated to some extent in 20 patients treated with RFA, HIFU or RC. Conclusions Resection of local recurrent periampullary carcinoma may benefit a longer survival time, and the improvement of the quality of life. RFA, HIFU and RC are the alternative modalities for patients with unresectable tumors.

OBJECTIVE: To develop an ultra-high performance liquid chromatography-mass spectrometry method for the determination of glimepiride and its metabolites (M1) simultaneously in human plasma.

Background and purpose:Methylene tetrahydrofolate reductase (MTHFR) plays an important role in metabolism of folate and DNA methylation. This study aimed to investigate the relationship between methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and chemotherapy side effects in advanced non-small cell lung cancer (NSCLC) patients. Methods:A total of 100 patients with advanced NSCLC conifrmed by pathology were included into this study in Zhejiang Cancer Hospital from Jun. 2007 to May. 2009. All patients received the combined chemotherapy of platinum drug and gemcitabine. MTHFR genotypes were determined by allele-specific-PCR technology. Results:In the 100 cases, genotype frequency of MTHFR C677T T/T, T/C and C/C were 20%, 44%and 36%, respectively. Compared with patients of T/T and T/C genotype, patients of C/C genotype were correlated with decreased rate of thrombocytopenia to chemotherapy (P=0.039). No signiifcant differences were observed concerning gastrointestinal toxicity. Conclusion:MTHFR C677T gene polymorphism can be used to predict the adverse reactions to platinum-based chemotherapy in patients with advanced NSCLC.

OBJECTIVETo observe effects of acupuncture on serum interleukin-1 (IL-1) and soluble intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) in the patient of cerebral infarction.

METHODSEighty-two cases of cerebral infarction were randomly divided into a treatment group treated by balanced muscular tension needling method, and a control group by traditional needling method. The levels of serum IL-1, sICAM-1 and sVCAM-1 were determined with enzyme-linked immunosorbent assay (ELISA).

RESULTSThe levels of serum IL-1, sICAM-1 and sVCAM-1 in the patient of cerebral infarction were significantly higher than those in the healthy persons (P < 0.01); there were positive correlation between sICAM-1 or sVCAM-1 level and IL-1 level (r = 0.743, P < 0.001; r = 0.862, P < 0.001). The three indexes improved to a certain extent in the two groups, with the treatment group superior to the control group (P < 0.01).

CONCLUSIONThe improvement of nervous function by the balanced muscular tension needling method in the patient of cerebral infarction is possibly related with decrease of IL-1, sICAM-1 and sVCAM-1 levels.

Objective To compare the efficacy and the side-effect of three different ways in treating the patients with malignant pleural effusion. Methods 98 patients histologically proved malignant pleural effusion were randomly divided into three groups, bleomycin group(BLM), bleomycin with mycobacterium group( BLM + UTL) and blemycin with intertleukino2 ( BLM +IL). 31 patients were treated with bleomycin intrapleural injection in BLM group,32 patients were treated with bleomycin and Utilin's(mycobacterium) intrapleural injection in BLM + ULL group and 35 patients were treated with bleomycin and intertleukin-2 intrapleural injection in BLM + IL group. The therapeutic efficacy, change of performance and side effects were compared among the three groups after one period of treatment. The changes of CEA and TNF in the pleural effusion were examined before and after treatment. Results The therapeutic efficacy and performance improvement were higher in BLM+UTL and BLM+IL group than that of BLM group(P＜0. 05) ,the pleural CEA of post-treatment in three groups were lower than that of pre-treatment(P＜0.01) ,the CEA after treatment in BLM+UTL group and BLM+IL group was lower than that of BLM group(P＜0. 01,respectively). The pleural TNF of post-treatment in BLM+UTL and BLM+IL groups was higher than that of pre-treatment(P＜0. 01 ) in BLM group. The pleural TNF of post-treatment in BLM+UTL and BLM+IL group was higher than that of BLM group ( P＜0. 01 ). Conclusion Intrapleural injection of mycobacterium with bleomycin or interlekin-2 with bleomycin has better efficacy than using bleomycin only in treating malignant pleural effusion.

The treatment of advanced or recurrent cervical cancer is difficult in clinic.Most of the patients have lost the opportunities for surgery or radiotherapy.Palliative treatment with chemotherapy is the main treatment.In recent years,the intensive studies on molecular targeted therapy and immunotherapy have provided a new treatment strategy for patients with advanced or recurrent cervical cancer,improving the efficacy and quality of life of patients.