Objective To compare the short term outcome of PPH with Milligan Morgan hameorrhoidectomy. MethodsNinety cases of Ⅲ ? Ⅳ ?degree hemorrhoids admitted for surgical treatment were randomly assigned to PPH ( n =45) or Milligan Morgan( n =45).ResultsThe difference was statistically significant between the two groups in terms of pain index ?operative time?length of hospital stay? time required for returning to normal activity and hospital fee. The above factors were found more favourable in PPH group, with no severe complications developed in neither of the two groups.The symptom improvement rate was 88% in PPH group and 81% in Milligan group.ConclusionPPH is a safe and effective procedure for Ⅲ ? Ⅳ ?hemorrhoids and its shorter term outcome is better than Milligan Morgan procedure.

AIM: To investigate the functions of GR in the course of hepatic secondary injury after severe multiple injury. METHODS: Rat model was produced by adopting severe thoracic impact injury accompanied with mono-side femur fracture, and glucocorticoid receptor was blocked before severe multiple injury. Hepatic macropathology and alterations under light microscope were examined. Maximal binding volume of glucocorticoid receptor (GR) in hepatic tissue was assayed by radio-ligand binding assay and protein content was assayed by Western blot. RESULTS: Maximal binding volume and protein content of GR were gradually decreased in hepatic tissue after severe multiple injury, obviously lower than that in normal control at 4 h after trauma ( P

Objective To study the effects of the inhibition of nuclear factor kappa-B ( NF-κB) , on the hepatic heat shock protein 70 (HSP70) expression as well as on the changes of hepatic function and ultrastructure in a rodent model of hemonhageic shock. Method Hemorrhagic shock was produced by inducing bilateral femoral fractures in male Wistar rats. Intraperitoneal injection of pyrrolidine dithiocarbamate(PDTC)was used to inhibit NF-κB activation 1 hour before induction of shock. A total of 66 adult male Wistar rats were randomly divided into 3 groups: control group (Control, n = 6), trauma shock (TS, n = 30), and NF-κB inhibition followed by trauma shock (NF-κB inhibition, n =30). Measurements of hepatic NF-KB and HSP70, hepatic function bio-markers, TNF-α and IL-6 were obtained 0.5, 2, 4, 6, 8 hours after trauma. Histopathological changes in liver tissues were also noted. Hepatic expression of NF-κB was determined by using electrophoretic mobility shift assay, while HSP70 was assayed by western blot and analyzed with computer imaging. Results In rats with trauma shock, both hepatic NF-κB activity and HSP70 expression increased significantly compared to the control group, reaching peaks at 6 hour post injury. Serum alanine transferase (ALT) and total bilirubin (TB) also rose significantly,reaching peaks at 8 hours post trauma. Light microscopy revealed hepatic congestion with infiltration of inflammatory cells into hepatic sinusoid in the TS group at 8 hours. Inhibiting the activity of NF-κB one hour before trauma significantly decreased expression of HSP70 at 6 hours post trauma [16.9±4.4 (NF-κB inhibition) vs. 23.0±1.7 (TS), P ＜ 0.05]. In addition,levels TNF-α and IL-6 in the liver tissue also decreased, and hepatic congestion as well as hepatic cell degeneration were ameliorated, showing minimal inflammatory infiltrates in the hepatic sinusoids. NF-κB inhibition also significantly lowered the levels of ALT and TB at 4 hours post trauma [ALT, 540.8 ±66.2 nmol/L (NF-KB inhibition) vs. 640.6±80.2 nmol/L (TS), P ＜ 0.05; TB,2.3±0.3 mol/L (NF-κB inhibition) vs. 4.7 ±1.1 mol/L (TS), P ＜ 0.05]. Conclusions NF-κB and HSP70 are involved in the pathogenesis of hepatic injury during hemorrhagic shock, and the degree of NF-κB activity and HSP70 expression may be consistent with the extent of hepatocellular damage. Inhibition of NF-κB helps ameliorate liver injury due to trauma shock.

Objective To investigate the cause,prevention methods and curative effect on two different drainage methods of subcutaneous effusion after breast cancer surgery.Methods The clinical data of 68 cases subcutaneous effusion among 2 100 cases underwent breast cancer modified radical surgery in our hospitial were analyzed retrospectively from January 2010 to December 2016.The vacuum sealing drainage was performed in 1 032 cases and wound high negative pressure drainage system was performed in 1068 casess.Both the elastic bandage compresstion dressing didn't used.Results In 2 100 cases,68 cases of subcutaneous effusion occured (3.2％),including longitudinal incision 48 cases and transverse incision 20 cases.Among 1 068 cases of high negative pressure drainagesystem,subcutaneous effusion occured in 36 cases including 28 cases of incisional infection and 8 cases of skin flap necrosis.The extuhation time was 8-36 days,average 12 days.Among 1 032 cases of vacuum sealing drainage,subcutaneous effusion occured in 32 cases including 22 cases of incisional infection,10 cases of skin flap necrosis.The extubation time was 6-12 days,average 8 days.All cases were followed up for 3 months,no subcutaneous effusion and axillary effusion occurred.Conclusions Adequate drainage is the key to prevent subcutaneous effusion.Both vacuum sealing drainage and wound high negative pressure drainage can effectively reduce the occurrence of subcutaneous effusion,however,vacuum sealing drainage is more suitable for wounds with more exudation,larger lacuna and deeper incisions,especially the infected wound and abscess.

Objective To summarise the imaging features of rare mastitis and explore the diagnostic value of ultrasound, mammography and MRI for rare mastitis. Methods The record of 24 patients diagnosed as rare mastitis in our hospital from Jan. 2000 to Jun. 2009 was reviewed, including clinical manifestations, pathological results, imaging diagnosis and diagnostic accurate rate. Results Of the 24 patients, 14 patients were ductal ectasia with chronic mastitis, 3 granulomatous mastitis, 6 chronic abscess and 1 mammary tuberculosis. 13 patients underwent ultrasonic scan, 12 patients underwent mammography and 3 patients underwent MRI, with the diagnostic accurate rate 77%, 25% and 100% respectively. Conclusions There are no special imaging manifestations for most rare mastitis, however, some differential characteristics still exist. MRI has a higher accuracy compared to ultrasound and mammography. The combination of multiple imaging methods can improve diagnostic accuracy.

Seventy-four patients aged 26-63 yr who had suffered cervicogenic headache for 3 months-21 yr were treated with puked radiofrequency applied to C2 dorsal root ganglion, which is located in the middle of the posterior side of lateral atlantoaxial joint. A trochar was introduced percutaneously under the guidance of X-ray aiming at the target point. As it was inserted through the deep fascia, the stylet was withdrawn and a 10 cm long 22 gauge curved blunt electrode was inserted into the trochar and advanced until the patients felt radiating pain from the point of puncture to occiput. Lateral radiograph was obtained to verify the placement of electrode. The tip of the electrode was usually located in front of spinal canal at the atlantoaxial joint level. Sensory stimulation was performed with 50 Hz and 0.1-0.5 V and the patients could feel radiating pain at occiput. Motor stimulation was performed with 2 Hz and 0.4-1.0 V and regular pulsation of the patient's muscle of occiput could occur. Pulsed radiofrequency was applied at 42 ℃7 for 240 s and was performed twice on each side. VAS scores and disturbances of daily activity, mood and sleep were recorded before operation and at 1 week and 1, 3, 6, 12 and 18 months after pulsed radiofrequency treatment. Complications and recurrence within 12 and 18 months were recorded. Follow-up was lost in 22 patients. VAS scores and disturbances of daily activity, mood and sleep significantly decreased after procedure. All of the patients responded without complications like infection, spinal cord and vertebral artery injury. Some patients had transient occipital neuralgia which was usually relieved within 24 h. The recurrence rate in 12 and 18 months after operation was 19% and 31% respectively.

From November 2003 to May 2010, intrathecal drug delivery system (IDDS) was implanted in 18 patients with chronic intractable pain. Analgesia was provided with morphine. Thirteen patients suffered from late stage cancer and 5 from diseases other than cancer. VAS score was used to measure intensity of pain in all 18patients. QLQ-C30 score was used to evaluate quality of life in cancer patients. The patients were followed up for 3-62 months in 5 non-cancer patients. All 13 cancer patients died at 57 days-10 months after operation. VAS scores were significantly decreased and QLQ-C30 scores increased by intrathecal administration of morphine. Side effects developed in all patients to some extent including nausea, vomiting, constipation, urinary retention, pruritus and over-sedation and vanished in a week. Intrathecal catheter was cut while being pulled out of the needle in 1 patient. Two patients developed low intracranial pressure after operation. Cerebrospinal fluid leakage occurred in 1 patient. One patient developed neuropathic pain in the posterolateral side of right leg.

Animals ; HSP70 Heat-Shock Proteins ; metabolism ; Liver Failure ; etiology ; metabolism ; Male ; Rats ; Rats, Wistar ; Receptors, Glucocorticoid ; metabolism ; Wounds and Injuries ; complications ; metabolism