Biopsy ; methods ; Drainage ; Humans ; Jaundice, Obstructive ; etiology ; therapy ; Lymph Node Excision ; methods ; Neoplasm Staging ; Pancreatic Neoplasms ; complications ; diagnosis ; pathology ; surgery ; Pancreaticoduodenectomy ; methods ; Salvage Therapy

Objective To explore rational surgical treatment for rectal villous adenoma with canceration. Methods Sixty-two cases of rectal villous adenoma with canceration undergoing different surgical procedures were analyzed retrospectively. Among them 28 underwent local excision including 20 with transanal resection and 8 with Kraske resection; Thirty-four underwent extended excision consisted of 11 Miles operation, 21 with Dixon operation and 2 with other procedures. Results Among 62 cases, 82%(51/62)were in early stage. 68%(42/62) and 26%(16/62) of the patients were of high and middle differentiation in pathology respectively. Six cases suffered from recurrence or metastasis in both local and extended excision groups. The 5-year survival rate after local and extended excision were 79% and 76% respectively. Conclusions Most rectal villous adenomas with malignant change were less invasive; Prudent selection of surgical modality is both effective and less dangerous for the treatment of this entity.

BACKGROUND: Nano-hydroxyapatite has been widely used as reconstructive and prosthetic material for osseous tissue, owing to its excellent biocompatibility and bioactivity. But, its brittleness is one of the most serious obstacles for its wider applications as load-bearing implants. Therefore, hydroxyapatite/chitosan composites have been widely studied as bone substitute, due to their excellent biocompatibUity and suitable mechanical properties.OBJECTIVE: To review various preparation methods of hydroxya patite/chitosan composites and the development trend in this field.METHODS: Articles were searched in Medline Database (1995-01/2009-03), VIP Database (1995-01/2009-03) and "qinghuatongfang" Database (1995-01/2009-03) with the keywords of "nano-hydroxyapatite, chitosan, preparation, development trend".RESULTS AND CONCLUSION: Total 2 034 related articles were collected, including 1 634 in Chinese and 670 in English. Following excluding earilier published, duplicate, and similar studies, we brought into 37 sub-standard literatures. Hydroxyapatite/chitosan composite in nanometer size, with similar structure as natural bone, has better biological function compared with corresponding micrometer composite. Simultaneously, optimized material composition, structure and technology will obtain more suitable bone substitute in mechanical property compared with natural bone. This paper reviews preparation methods at home and abroad in recent years, with the rapid development of biological materials, hydroxyapatite compositematerials have been wisely used in bone tissue repair and replacement surgery, but its poor mechanical properties limits its clinical application.

Objectives To reveal the association between Helicobacter pylori infection and creatinine clearance rate in elderly patients with hypertension.Methods A total of 600 elderly hypertensive patients with different degrees of renal impairment and helicobacter pylori(HP)infection were randomly selected from Department of Health Care,General Hospital of Tianjin Medical University from 2010 to 2015.Serum creatinine concentration detection was conducted and creatinine clearance rate was calculated.Patients were divided into HP infection group(n =254)and non-HP-infection group (n =346).The multiple logistic regression analysis showed the correlation between Helicobacter pylori infection and decreased creatinine clearance rate.Results Creatinine clearance rate was significantly lower in HP-infection group[(61.1 ± 12.7)ml/min] than in non-HP-infection group[(78.5 ± 11.9) ml/min,P =0.014].Multifactorial logistic analysis revealed that Helieobacter pylori infection was significantly associated with decreased creatinine clearance rate(OR=3.5 18,95 ％ CI:1.105～4.918,P =0.011).Conclusions Helicobacter pylori infection is significantly related with decreased creatinine clearance rate in elderly patients with hypertension.

Objective To conduct a single-center retrospective analysis on the distribution characteristics and prevalence of idiopathic membranous nephropathy (IMN) patients diagnosed with pathology for the past 16 years,to investigate diagnostic and differential diagnostic value of serum antiphospholipase A2 receptor antibodies (PLA2R-Ab),and to evaluate the correlation between PLA2R-Ab and clinical disease activity.Methods (1) 6996 biopsy-proven primary glomerular nephropathy (PGN) patients,including 1567 IMN cases,admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2000 to December 2015 were involved.Demographics and pathological type were gathered from all patients.(2) 433 cases receiving renal biopsy and testing PLA2R-Ab from June 2015 to December 2015 were involved,with their clinical and laboratorial data being collected.During the period patients' follow-up time,therapeutic schedule and laboratory results were recorded.Results (1) IMN accounted for 22.4％ of primary glomerular disease,and patients above 40 years old accounted for more than 60％ of the IMN.(2) The sensitivity and specificity of serological PLA2R-Ab were 58.1％(95％CI 47.0％-68.5％) and 98.6％(95％CI 95.6％-99.6％) respectively.PLA2R-Ab positive rate was affected by immunosuppression therapy.(3) The PLA2R-Ab titers wasn't correlated with 24-hour urinary protein (r=-0.017,P=0.887),serum albumin (r=-0.072,P=0.549) and urinary red blood cell count (r=-0.030,P=0.802).There was no difference between PLA2R-Ab positive positive and PLA2R-Ab negative on proportion of IMN pathological stage Ⅰ-Ⅱ (P ＞ 0.05).Thirteen cases of patients with PLA2R-Ab positive were all prescribed glucocorticoid combined with immunosuppressant.After (2.21± 1.09) months,the decrease of PLA2R-Ab titers was in accordance with 24-hour urinary protein quantity descending and serum albumin ascending (P ＜ 0.05).Condusions The incidence of IMN increase year by year,especially in the mid-aged and the elderly.Serum PLA2R-Ab correlates not with IMN pathological stage,but with the development of IMN.Monitoring PLA2R-Ab titers individually may access the efficiency of treatment.

Adult ; Coal Mining ; Disability Evaluation ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; physiopathology ; Respiratory Function Tests

Objective An incentive system was established to promote the rapid development of scientific research and to improve the scientific management ability.Methods The research incentive system, which including research awards, research fund management, research fund matching, and performance management, was implemented in our hospital, aimed to develop a clear quantitative assessment index to encourage research activity, and maximize the research outcome.Results It is clear that the research project application and output in output have been increased;and it positively associated with the number of years of implementation with the statistical significance.Conclusions Establishment of the research incentive system has encouraged the clinicians to make effort to conduct research projects which has largely increased the number of research projects and produced better outcomes.Applying such system has enhanced the capacity of core research of the hospital.

Objective To quantify the incidental irradiation dose (ⅡD) to lymph node stations of esophagus when treating patients with T1-4N0 M0 thoracic esophageal squamous cell carcinoma (ESCC) with a dose of 60 Gy/30f.Methods Twenty-nine patients with medically inoperable T1-4N0M0 thoracic ESCC were treated with three-dimensional radiotherapy on involved-field.The conformal CTV was re-created using a 3 cm margin in the proximal and distal direction (following the course of the esophagus) beyond the barium esophagogram,endoscopic examination and CT defined GTV and a 0.5 cm margin in the lateral and anteroposterior directions of the CT defined GTV.The PTV encompassed 1 cm proximal and distal margins,0.5 cm radiaI margin on the basis of CTV.Cervical,mediastinal and abdominal lymph nodes were delineated respectively.Equivalent uniform dose (EUD) and other dosimetric paraneters were calculated for each nodal station.Nodal region whose metastasis rate is greater than 5％ was considered a high risk lymph node subgroups.Results Under a 60 Gy dose prescription,the median Dmean and EUD,V40 and V50 were ≥40 Gy,≥85％ and ≥75％ in most of the high risk nodal regions.For the subgroups whose EUD were less than 40 Gy,most of the ⅡD of these regions was significantly associated with the length and location of esophageal tumor (r =0.892,P =0.000).Conclusions Lymph node stations nearby of ESCC received considerable ⅡD with involved-field irradiation which could control subclinical lesions.But more clinical studies should be needed.

OBJECTIVETo investigate effects of elastic stable intramedullary nails for the treatment of radial neck fracture in children.

METHODSFrom July 2006 to December 2011, 25 children with radical neck fractures, which included 16 males and 9 females aged from 7 to 15 years old (means 10.7), were treated with elastic stable intramedullary nails. According to Judet classification, 6 cases were type II, 17 cases were type III and 2 cases were type IV (including 1 case with type IVa and 1 case with type IVb). The fracture healing, pain, deformity and range of motion of elbow were recorded.

RESULTSAll patients were followed up for 6 to 24 months with an average of 14 months. Twenty-five patients were obtained bone healing. According to Tibone and Stoltz evaluation standard, 18 cases got excellet results, 4 cases in good and 3 cases in moderate.

CONCLUSIONElastic stable intramedullary nails for the treatment of radial neck fracture in children has advantages of simple operation,less trauma and good results.

Adolescent ; Bone Nails ; Child ; Female ; Fracture Fixation, Intramedullary ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome

The quality control of new drug cilnical trial is the effective guaranty for the pharmaceutical safety and effective after available on market. Enhancing the inspection and quality control of new drug clinical trials provide the crucial importance to achieve a persistent profitable standard. This paper mainly discussed the problems of current clinical trials based on annual check of drug clinical trial institution.
Clinical Trials as Topic ; Drug Evaluation ; Health Facilities ; Humans ; Quality Assurance, Health Care ; Quality Control