Gastrointestinal bleeding is a common complication of gastrointestinal diseases and gastrointestinal surgery, which may lead to hemorrhagic shock or cause death if not treated properly and promptly.Currently, endoscopic treatment for gastrointestinal bleeding includes clip closure, endoscopical injection of saline/adrenaline, argon plasma coagulation (APC), electrocoagulation and heater probe coagulation etc..Endoscopic clip closure mainly includes traditional closure through-the-scope clip (TTSC) and more novel closure over-the-scope clip (OTSC).This article reviewed the use of OTSC in the treatment of gastrointestinal bleeding.

Objective To determine the prevalence and characteristics of the del(GJB6-D13S1830) in Connexin30(Cx30) gene in children with prelingual deafness.Methods Forty-six prelingual deaf children and 30 children with normal comprehension were obtained,and the del(GJB6-D13S1830)in the Cx30 gene were screened by polymerase chain reaction(PCR) in 2 groups.Results Three cases of 46 deaf children were found to have heterozygous del(GJB6-D13S1830) in Cx30 gene.The rest deaf children and the normal controls did not harbor this deletion.Conclusion The heterozygous del(GJB6-D13S1830) in Cx30 gene is one of causes of prelingual deafness.

Objective:Characteristics of the retroperitoneal tumor blood supply arteries were analyzed to evaluate the safety and effec-tiveness of preoperative interventional embolization for benign and malignant retroperitoneal tumors. Methods:A total of 241 cases were divided into benign retroperitoneal tumor group and malignant retroperitoneal tumor group. Each group was divided into groups A, B, and C according to the long diameter of the tumor tissue. Group A>10.0 cm, 5.0 cm0.05). Significant differences in intraoperative bleeding and intraoperative blood transfusion were found between groups A and B (P<0.05). Main arteries of the abdominal retroperitoneal tumor are the lumbar, internal iliac, and adrenal arteries. The main artery of pelvic retroperitoneal tumor is the internal iliac artery. Conclusion:Preoperative interventional embolization can effec-tively reduce the risk of bleeding during malignant retroperitoneal tumor surgery and improve the perioperative safety of patients. No significant benefit of benign retroperitoneal tumors and no increased risk of bleeding during surgery were observed. Retroperitoneal tumor preoperative embolization should focus on investigating the lumbar, internal iliac, and adrenal arteries.

A comparable study were carried out by determination of trace elements on five marine-derived shell traditional Chinese medicine (TCM) (Ostreae Concha, Haliotidis Concha, Margaritifera Concha, Meretricis Concha, and Arcae Concha), which were recorded in the Chinese Pharmacopoeia (2010 version). Seven trace elements in 51 batches of this type of shell TCM were analyzed by Inductively Coupled Plasma Mass Spectrometry (ICP-MS), combined with principal component analysis (PCA) methods. The content of element Se, which exhibited significant differences among different drugs, could be used as a key element to distinguish this type of drugs. Meanwhile, the contents of elements Co, Cu, Mo, and Ba in Haliotidis Concha, Co and As in Margaritifera Concha, Mo and As in Meretricis Concha, Mo, As, and Ba in Arcae Concha, and Zn in Meretricis Concha were relatively stable. In the PCA plot, Arcae Concha and Meretricis Concha could be efficiently distinguished from Ostreae Concha together with Haliotidis Concha, and Margaritifera Concha. The results also showed a correlation with their medicinal function. In conclusion, trace elements in marine-derived shell TCM could not be neglected for their quality control.
Animal Shells ; chemistry ; Animals ; Aquatic Organisms ; chemistry ; Bivalvia ; chemistry ; Mass Spectrometry ; Medicine, Chinese Traditional ; Trace Elements ; analysis

Objective To evaluate the feasibility and safety of hypothermic perfusion via renal artery balloon catheter before laparoscopic partial nephrectomy.Methods A total of 35 patients,who were arranged to receive laparoscopic partial nephrectomy during the period from March 2013 to December 2016 at the General Hospital of PLA,China,were enrolled in this study.The tumor was located in the left kidney in 22 patients and in the right kidney in 13 patients.The long diameter of the tumors was 2.3-7.0 cm,with a mean of (4.1±1.2) cm.Before laparoscopic partial nephrectomy,the implantation of renal artery balloon catheter was performed in all patients.The intraoperative renal cold-ischemia time,the time spent for operation and the amount of intraoperative blood loss were recorded.The creatinine clearance rate (Ccr) and estimated glomerular filtration rate (eGFR) were determined before operation as well as at one,3 and 7 days after operation.The intraoperative and postoperative complications were analyzed.Results Successful implantation of renal artery balloon catheter was accomplished in all 35 patients,with the technical success rate being 100％.Slipping of balloon catheter before laparoscopic partial nephrectomy occurred in one patient;in 2 patients incomplete occlusion of renal artery was found during operation and artery forceps had to be used to occlude the renal artery.In the other 32 patients,laparoscopic partial nephrectomy under the condition of hypothermic perfusion via renal artery balloon catheter was successfully carried out.No severe complications occurred during and after the operation.The average cold-ischemia time of the diseased kidney was 45 (20-125) min,the mean time for interventional procedure was 28 (20-40) min,the average surgery time was 147(95-235) min,the average amount of intraoperative blood loss was 180(50-1000) ml.The Ccr values determined before and at one,3,7 days after nephrectomy were (96.5±15.1),(75.2±10.5),(54.3±13.8) and (91.8±14.1) ml/min respectively.The eGFR values determined before and at one,3,7 days after nephrectomy were (99.5±15.3),(70.3±12.5),(65.5±11.7) and (96.8±12.3) ml·min-1·m-2 respectively.Statistical analysis indicated that in both groups the preoperative and 7-day postoperative Ccr values and eGFR values were significantly different from their one-day and 3-day postoperative values (P＜0.01),but no statistically significant differences existed between preoperative values and 7-day postoperative ones (P＞0.05).Conclusion Hypothermic perfusion via renal artery balloon catheter before laparoscopic partial nephrectomy is clinically safe and feasible,it can prolong the safe time of renal ischemia and protect renal function.

OBJECTIVE: To study the correlation of daily living activities with location and severity of trau- matic brain injury (TBI) and to provide a theoretical basis for improving the accuracy of expert opinion. METHODS: Five hundred and one cases of patients with TBI were selected. Detailed records included following: pre-injury situation, location and severity of injury, treatment and education. Daily living activi- ties scale (Barthel index) was applied to test the subjects' daily living activities. The relevance among location and severity of TBI and Barthel index was statistically analyzed. RESULTS: In mild TBI group, there was no significant difference in Barthel index among each location (P>0.05). In moderate TBI group, there were significant differences in Barthel index between subarachnoid hemorrhage and cerebral lobe injury, also between parietal, occipital lobes injury and frontal lobe injury, parietal, occipital lobes injury and temporal lobe (P<0.05), respectively, whereas no significant difference in Barthel index between frontal lobe injury and temporal lobe injury (P>0.05). In severe TBI, there were significant differences in Barthel index between every two different locations (P<0.05). CONCLUSION There is some correlation between the location of TBI and Barthel index, which provides an important reference value for analyzing and determining daily living activities after TBI.
Activities of Daily Living ; Adult ; Brain Injuries/rehabilitation* ; Female ; Humans ; Male ; Outcome Assessment, Health Care ; Trauma Severity Indices

Purpose:To clarify the diagnosis and management of ureteral obstruction owing to vena cava orcongenital crossing vessels. Methods: Preoperative sonography, intavenous urography (IVU), retrograde urogra-phy or magnetic resonance urography(MRU) were performed in 19 cases of patients for evaluation of hy-droureteronepherosis. Combined with magnetic resonance imaging(MRI) or cavography, retrocaval ureter couldbe detected. Colour Doppler imaging was used to detect crossing vessels. During operations, retrocaval (8cases) or retroiliac (1 cases) ureters were excised, crossing vessels (10 cases) were divided then ureteroureteralanastomosis or dismembered pyeloplasty (Anderson-Hynes) were completed. Results:3 to 6 months after opera-tions, hydroureteronepherosis was lightened to different extends in all patients. After median follow-up of 15.7months (range 1 to 4.5 years), hydroureteronepherosis was found in one patient. Conclusions:Disorder of bloodvessels should be considered in the differential diagnosis of extrinsic ureteral obstruction. Sonography, IVU,MRI combined with cavography, color Doppler imaging are of great value in the diagnosis of those conditions.Early diagnosis and treatment are very important.

This study was purposed to investigate the changes of CD4(+) CD25(+) regulatory T cells and NK cells in peripheral blood of acute leukemia children at different stages, the function of immune system and the possible roles of the CD4(+) CD25(+) regulatory T cells as well as NK cells in leukemia immunity. The number and proportion of CD4(+) CD25(+) regulatory T cells and NK cells were detected by flow cytometry in the peripheral blood of 53 acute leukemia children, including 25 patients in new diagnosis and 28 patients in continuous complete remission (CCR), and were compared with that of 20 normal children. The results indicated that the mean proportion of CD4(+) CD25(+) CD127(+) in CD4(+) T cells of peripheral blood in newly diagnosed patients, patients with CCR and normal children were (9.55 +/- 2.41)%, (8.54 +/- 2.51)% and (6.25 +/- 0.85)% respectively, the mean proportions of CD4(+)CD25(+)CD127(+) in newly diagnosed patients and patients with CCR were higher than that in normal children, the mean proportion of CD4(+)CD25(+)CD127(+) in newly diagnosed patients were higher than that in patients with CCR (p < 0.05). At the same time, the NK cell count in patients with acute leukaemia decreased as compared with normal control, while after achieving CCR, the NK cell count in patients were also less than that in normal control (4.11 +/- 3.87% and 10.41 +/- 7.20% vs 14.06 +/- 5.95%, p < 0.05). It is concluded that the application of CD4(+), CD25(+) and CD127(+) to detect regulatory T cells is a simple, reproductive and accurate method, and the CD4(+) CD25(+) CD127(+) T cells can better reflect the proportion of CD4(+)CD25(+) regulatory T cells. The increase of regulatory T cells and decrease of NK cells in pediatric patients with acute leukemia indicate that the function of NK cells may be depressed. Treg T cells play a role in occurrence and development of leukemia, and are involved in down-regulating NK cell function.
Acute Disease ; Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Killer Cells, Natural ; immunology ; Leukemia ; blood ; immunology ; Male ; T-Lymphocytes, Regulatory ; immunology

OBJECTIVETo evaluate the efficacy of computer-aided design and computer-aided manufacturing (CAD/CAM) technique in reconstruction of zygomatic complex defect.

METHODSThree-dimensional computed tomography (3D-CT) and rapid prototyping (RP) techniques were applied to produce facsimile models in 13 patients with zygomatic complex defects resulted from trauma or tumor ablation. The zygomatic complex defect was reconstructed using a mirroring technique by CAD/CAM. Titanium mesh was prefabricated on individual facsimile models and combined with autologous bone graft and pedicled buccal fat pad flap for reconstruction.

RESULTSThe measuring data of zygomatic complex defect between facsimile model and intraoperative findings was extremely consistent. The prefabrication of reconstructive titanium mesh was matched with zygomatic complex defect in the surgery. The postoperative 3D-CT image demonstrated the symmetry of reconstructed zygomatic complex. The functional recovery and facial contours were satisfactory in all cases.

CONCLUSIONThe application of CAD/CAM technique can simulate the surgery procedures accurately, which contributes to shorten the actual operative time. RP techniques can reconstruct the facial contours symmetry and recover the function of zygomatic complex defect.

Adolescent ; Adult ; Bone Substitutes ; Bone Transplantation ; Computer-Aided Design ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Prosthesis Design ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Titanium ; Tomography, X-Ray Computed ; Young Adult ; Zygoma ; surgery

OBJECTIVE: To study expression of inducible nitric oxide synthase (iNOS) in oral squamous cell carcinomas (OSCC) and its relations to microvessel density (MVD) and lymphatic metastasis. METHODS: With 9 cases of normal oral mucosa as control, the expression rate of iNOS in 41 cases of OSCC was evaluated by immunohistochemstry SP staining. With CD34 as label, MVDs of these cases were also detected. RESULTS: The iNOS expression rate of OSCC cases was 63.41%(26/41), while no positive expression was seen in 9 cases of normal oral mucosa. Anymore, the expression rate of N+ group was 85.00% while that of N group 42.90%, the rate between them was significantly different (P<0.01). There was correlation between MVD and lymphatic metastasis (rs=0.51, P<0.01). MVDs in groups of different iNOS expression( approximate, equals +++) were 29.667+/-6.945, 34.833+/-4.579, 46.357+/-6.687, 54.167+/-5.565, respectively, and were significantly different with each other (P<0.001). CONCLUSION: There is high expression rate of iNOS in OSCC, and it has close relation to lymphatic metastasis; angiogenesis may facilitate lymphatic metastasis of OSCC, and expression of iNOS has positive relation to MVD in OSCC.