Esophageal and Gastric Varices ; etiology ; surgery ; Gastrointestinal Hemorrhage ; etiology ; therapy ; Hemostasis, Endoscopic ; Humans ; Hypertension, Portal ; complications

Objective To analysis the effect of high dose metformin on serum HE4, LPA and regulatory T cells in patients with ovarian cancer.Methods 80 cases of unilateral ovarian cancer patients were given surgery and conventional chemotherapy ,were divided into four groups according to single metformin dose: (group A:0.25g each time, B group:0.25g each time, group C:0.25g each time; group D: conventional treatment only) and three times a day oral administration of metformin and two weeks in a row , before and after the treatment of detection each serum HE4, LPA, transformation growth factor beta 1 (TGF -beta 1), interleukin -10 (IL-10) content, and CD4 +CD25 +CD127 regulating T cell percentage.ResuIts Compared with B, C, and D group, the efficacy of patients in group A was better, as follows: Serum HE4 content decreased significantly ( P<0.05 ); serum LPA content decreased significantly ( P<0.05 ); blood CD4 +CD25 +CD127 regulatory T cell percentage decreased significantly ( P<0.05 ); serum TGF beta 1, IL-10 content decreased significantly ( P<0.05 ) .The results were statistically significant .ConcIusion High dose of metformin can reduce serum HE4 , LPA content, reduce the adjusting the percentage of T cells and related cytokines in patients with ovarian cancer , and play a positive role in inhibit cancer cell proliferation and invasion .

Objective To discuss the clinical feature, diagnostic main points and treatment of diffuse axonal injury(DAI). Methods The clinical materials and imaging findings and treatment and prognosis of 48 cases with DM were analyzed retrospectively. Results 18 cases showed a good outcome, while 12 were moderately disabled, 10 severely disabled or survived in a permanent vegetative state and 8 cases died. Conclusion To preserve the fluent respiratory tract, to control intracranial pressure, to treat with hyperbaric oxygenation and high-dose naloxone in early time were crucial in clinical practice to DAI.

Animals ; Biological Specimen Banks ; utilization ; Humans ; Specimen Handling ; methods ; Tissue Fixation ; methods

Objective To investigate the possibility of anti-liver fibrosis of 13-estradiol nanoparticle prepared by interfacial polymeri-zation method with butylcyanoacylate as carrier material (E2-PBCA-NP) and its effect on the expression of transforming growth factor β1 and connective tissue growth factor in pig serum induced animal fibrotic model. Methods Male Sprague-Dawley (SD) rats were random divided into five groups. Except normal control group, other four groups were all given intraperitoneal injection with pig serum. Therapeutic drugs were administered to rats from the ninth week after injection of pig serum. All rats were killed at the end of the twelfth week. Several experi-ments were done as below, the tissues of liver were observed by Masson staining, and the mRNA of TGF-β1 and CTGF of liver samples were detected by RT-PCR. Meanwhile, the expression of TGF-β1 and CTGF protein were detected by immunohistochemistry. Results It showed that both E2 and E2-PBCA-NP treatment groups had lower stage of liver fibrosis, according to the observation of pathology by Masson staining (P < 0.05). The anti-liver fibrosis effect of E2-PBCA-NP treatment group was better than that of E2 treatment group (P < 0.05). The mRNA and protein level of TGF-β1 and CTGF were markedly reduced by E2 and E2-PBCA-NP treatment, compared with liver fibrotic model groups (P <0.01). There was no statistical difference between E2-PBCA-NP and E2 treatment (P >0. 05), while no significant change was observed in blank nano -particle group (P > 0.05). Conclusion Both E2-PBCA-NP and E2 had anti-liver fibrosis activity. E2-PB-CA-NP has stronger anti - liver fibrosis activity than E2, which could be resulted from the inhibition of TGF-β1 and CTGF expression.

Objective To explore the significance, indicatinos and complications of emergency tracheotomy for patients with severe craniocerbral trauma. Methods The clinical data of 42 patients with severe craniocerbral trauma were retrospectively analyzed. Results Of them, 20 were basically cured (48%), 12 had improvement (29%) ,3 were released from the hospital(7 % ), 1 survived(2 % ) in a vegetative state,and 6 died(14%). Conclu- sion Emergent tracheotomy should be performed on patients with severe craniocerbral trauma to resolve respiratory tract obstruction, improve air current, prevent cerebral anoxia, prevent and treat pulmonary infection, increase the therapeutic efficacy.

Purpose:To study the expression of COX 2,P53 and PCNA in esophageal carcinomas and its significance. Methods:Immunohistochemical method was used to examine the sections from 82 esophageal squamous cell carcinomas, 20 esophagitis and 16 normal esophageal mucosa tissues. Results:The positive ratios of COX 2,p53 and PCNA were 87.8%(72/82),82.9%(68/82)and 95.1%(78/82) in 82 esophageal carcinomas, respectively. But there was no expression in adjacent noncancerous tissues and normal esophageal mucosa tissues. The positive ratio of COX 2 protein was significantly higher in the well differentiated and moderately differentiated esophageal carcinomas than in the poorly differentiated esophageal carcinomas( P

Objective To classify patients with pelvic pain and to improve the understanding of etiology and to guide treatment by using a clinical phenotype system (UPOINT) and to examine the relationship between UPOINT and symptoms in patients with interstitial cystitis/painful bladder syndrome. Methods From November 2009 to October 2011,54 IC/PBS patients including 42 female and 12 male patients were treated.The mean age was 41.0 ± 12.4 yrs (range from 21 to 76 yrs).Median symptom duration was 63.0 ± 59.2 months ( range from 6 to 240 months).54 patients with interstitial cystitis/painful bladder syndrome were classified in each domain of UPOINT,that was urinary,psychosocial,organ specific,infection,neurological/systemic and tenderness.Symptoms were assessed using the Interstitial Cystitis Symptom Index,Pain/Urgency/Frequency score and visual analogue scale for pain/urgency/frequency.Clinically relevant associations were calculated. Results In the 54 IC/PBS patients,median ICSI score was 15.0 ± 1.84 points ( range from 9 to 19 points) ; Median PUF was 20.0 ± 2.3 points ( range from 14 to 25 points) ; Median pain associated with bladder score of VAS was 7.0 ± 1.0 points (range from 5 to 10 points).The percent positive for each domain was urinary 100％,psychosocial 44％,organ specific 96％,infection 33％,neurological/systemic 24％ and tenderness 28％,respectively.All patients were included in at least 2 domains,with 2 domains of 11％,3 domains of 38％,4 domains of 36％,5 domains of 13％ and 6 domains of 2％.The number of domains was associated with greater symptom duration ( Spearman r =0.76,P ＜0.01 ) but not age.The number of domains was also associated with poorer general interstitial cystitis and pain symptoms ( Spearman r =0.89,P ＜ 0.01 ) but not with frequency or urgency.The psychosocial domain was associated with increased pain,urgency and frequency,while tenderness was associated with increased ICSI score,PUF score and urgency.The neurological/systemic domain was associated with increased ICSI score while the infection domain was not associated with any increased symptoms. Conclusions The UPOINT phenotyping system can classify patients with interstitial cystitis according to clinically relevant domains.The UPO1NT system can act as the guiding theoretical basis for directing multimodal therapy,it deserves clinical promotion.

Objective To analyze the causes of under-staging in first transurethral resection of bladder tumor (TURBt) and find out solutions. Methods We retrospectively analyzed 118 cases (93 males and 25 females) of non-muscle invasive bladder cancer and compared the grade and stage between the first TURBt with the second transurethral resection (TUR) or partial cystectomy (PC) or radical cystectomy (RC) from January 2006 to March 2011.The mean patient age was 63.0 ±8.6 yrs.The tumors located in lateral,dome and posterior wall were 71,23,24 respectively; 75 of them were with single and 43 were with multifocal lesions; the sizes of tumor ranged from 0.5 -4.0 cm and 39 of them were ≥3.0 cm; The procedures performed by senior and junior urologist were 53 and 65 cases,respectively.In the study,we used the 2004 WHO/ISUP and 2002 TNM classification system for grading and staging.The data were analyzed with x2 and the logistic regression test to find out the causes of under-staging in first TURBt. Results There were 13 and 105 cases with high-grade Ta and T1 (low-grade T1 44 cases,high-grade T1 61 cases) in first TURBt,respectively.The finial stages were low-grade Ta(2),high-grade Ta(6),low-grade T1 (36),highgrade T1 ( 38 ),T2 (36) and 39 cases (33.1 ％ ) were under staged ( P ＜ 0.01 ).There were 17 and 22 under-staged cases compared with the second-TUR group (60 cases) and PC/RC groups (58 cases),respectively.The reasons of under-staging were related to tissue morphology changes (63 cases) and the absence of the detrusor muscle (56 cases) in specimens collected during the first TURBt.Multivariate analyses revealed that large tumors ( ≥3 cm),and lateral/dome/anterior wall tumors were independent risk factors to the absence of the detrusor muscle in the resected specimens with OR (95％ CI):3.766 ( 1.263 -11.225 ),and OR (95 ％ CI):5.951 (2.186 - 16.203 ),respectively.While surgery performed by senior surgeons was the protective factor to the presence of detrusor muscle,OR (95％ CI):0.274 (0.127 -0.593). Conclusions It is difficult for the first TURBt to completely avoid under-staging.The causes were related to tissues morphology changes and the absence of underlying detrusor muscle in specimens collected during the first TURBT procedure.Tissues morphology changes and the absence of detrusor muscle are related to the tumors location and size.A senior urologist and second-TUR can improve the under-staging.

ObjectiveTo review the experience with surgical removal of meningiomas in the falx cerebri and sagittal sinuses.MethodsThirteen patients with meningiomas in the falx cerebri and sagittal sinuses were retrospectively analyzed.ResultsTumors in eleven patients were totally removed( Simpson Grade Ⅰ and Ⅱ ),while in two patients they were subtotally resected( Simpson Grade Ⅲ and Ⅳ ).After operations,no patient died.ConclusionAdequate surgical exposure,efficient management of operative bleeding,protection and replacement of the sagittalsinus,and avoidence of damage to the brain tissues were the key factors to improve operative effect.