Objective To investigate the clinical efficacy of laparoscopy combined with cholangioscopic FREDDY laser lithotripsy for the treatment of difficult central type bile duct calculi.Methods Fifty-five patients with difficuh central type bile duct calculi undergoing laparoscopy combined with cholangioscopy were analyzed retrospectively.There were 31 patients in FREDDY laser lithotripsy group (FREDDY group) and 24 patients in routine instrunent group (routine group).Operative time,intraoperative blood loss,conversion rate,time to first flatus,incidence of postoperative complications (such as pancreatitis,hemobilia and biliary leak),postoperative hospital stay and first session bile duct clearance rate were compared.Results Operative time,intraoperative blood loss,time to first flatus,postoperative hospital stay in FREDDY group [( 106.2 ± 49.4) min,(37.7 ± 28.6) ml,(25.8 ± 19.3 ) h,(5.9 ± 3.3 ) d]were significantly lower than those in routine group[( 142.2 ± 64.8 ) min,(60.3 ± 32.1 ) ml,(37.2 ± 21.6 ) h,(8.4 ±4.9) d] (P＜ 0.05 or ＜0.01 ).There were no statistically significant differences in conversion rate,incidence of postoperative complications and first session bile duct clearance rate between the two groups (P ＞ 0.05).There were no dead in both groups.Seven patients with residual bile duct stones were cured by cholangioscopy through T-tube sinus 6 weeks after prior surgery.Forty-three patients were followed up 6 to 12 months with no recurrent bile duct stones and bile duct stenosis.Conclusions Laparoscopy combined with cholangioscopic FREDDY laser lithotripsy is recommendable to treating difficult central type bile duct calculi with good short-term results and has the advantages of minimal invasiveness,safety,efficiency and rare complications.

Adult ; Benzene ; poisoning ; Chronic Disease ; Cytochrome P-450 CYP2E1 ; genetics ; Female ; Humans ; Leukocyte Count ; Leukopenia ; chemically induced ; Male ; Middle Aged ; Polymorphism, Genetic

OBJECTIVETo study the phylogeny relationship and molecular identification of 10 species from Huperzia (Huperziaceae) based on matK gene sequences data.

METHODTotal DNA of nine species from Huperzia was extracted; matK gene sequence was amplified by PCR. PCR product was directly sequenced after purification.

RESULTThe chloroplast matK gene nucleotide sequences from 9 species of Huperzia species were sequenced. The matK gene nucleotide sequences length was 1 589 bp. Analysis with Huperzia lucidula matK gene nucleotide sequences (download from GenBank) and taking Lycopodiella cernua as outgroup, Maximum Parsimony, Neighbor-Joining analyses and genetic distances were conducted using MEGA 3.1 software. 35 variable sites and 35 parsimony informative sites have been found. Pairwise genetic distances among 10 species of Huperzia was 1.59% - 0.25%.

CONCLUSIONThe results were consistent with the taxonomy in morphological of Huperzia. But H. longipetiolata and H. serrata were resolved into in different clade. There are 19 different sites of matK gene sequences between H. longipetiolata and H. serrata, the genetic distances is 0.121%. It is suggested H. longipetiolata should be as an independent species.

DNA, Chloroplast ; genetics ; DNA, Plant ; chemistry ; genetics ; Endoribonucleases ; genetics ; Huperzia ; classification ; enzymology ; genetics ; Molecular Sequence Data ; Nucleotidyltransferases ; genetics ; Phylogeny ; Plant Proteins ; genetics ; Plants, Medicinal ; classification ; enzymology ; genetics ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Species Specificity

OBJECTIVETo assess the feasibility of University of Washington Quality of Life (UW-QOL) questionnaire in laryngeal cancer patients treated by total or partial laryngectomy and their prognostic factors in China.

METHODSWith UW-QOL questionnaire, a survey was conducted in patients treated by partial (81, Group A) or total (37, Group B) laryngectomy for laryngeal cancer.

RESULTSThe composite QOL scores of group A (692.34 +/- 127.94) were higher than those of group B (636.35 +/- 139.97), with a difference statistically significant (P < 0.05). Group A (74.32 +/- 23.82; 80.86 +/- 20.26) was better than group B (40.27 +/- 25.76; 69.59 +/- 27.09) in speech and appearance (P < 0.001; P < 0.05); but group B (92.57 +/- 13.00) was superior to group A (83.02 +/- 20.47) in pain (P < 0.01). Six factors including stage, operative, modality, complication, postoperative radiotherapy or chemotherapy, with whom to live, chronic disease before or after operation were related to postlaryngectomy QOL.

CONCLUSIONPartial laryngectomy is superior to total laryngectomy in speech, appearance and overall QOL. UW-QOL questionnaire is suitable for QOL research in laryngeal cancer in China.

Aged ; Aged, 80 and over ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; psychology ; surgery ; Laryngectomy ; Male ; Middle Aged ; Quality of Life ; Surveys and Questionnaires

Objective To compare the efficacy of different models of attention rehabilitation on attention deficits after acquired brain injury. Methods According to the training models, 47 patients with attention deficits were randomly assigned to 3 groups: computer-assisted training group(n=16), face-to-face training group(n=21) and control group(n=10). The training groups were given attention training once a day which sustained 30 minutes for 6 weeks. All patients were tested with the Montreal Cognitive Assessment (MoCA) and the Loewenstein Occupational Therapy Cognitive Assessment Battery (LOTCA) before and 6 weeks after the rehabilitation. Results The performance of both the computer-assisted training group and the face-to-face training group significantly improved (P<0.05). The various of the scores was the most in the computer-assisted training group among them (P<0.05). Conclusion The computer-assisted training is a high-effective method for attention deficits.

Crosslinked chitosan microcarries were prepared by the reaction of glutaraldehyde with fructose-modified chitosan. Various factors that influence the preparation were studied and the reaction conditions were optimized. Morphology of rat hepatocyte cultured on chitosan microcarriers was observed using phase contrast microscopy and scanning electron microscope, the metabolic activity was measured. Rat hepatocytes cultured on chitosan microcarrier retained the spherical shape as they have in vivo and had high metabolic activity. Fructose can enhance the metabolic activity of hepatocytes and fructose-modified chitosan microcarrier is a promising scaffold for hepatocytes attachment, which can be used in bioartificial liver support system.
Animals ; Biocompatible Materials ; chemistry ; Cell Culture Techniques ; Cells, Cultured ; Chitosan ; chemistry ; Fructose ; chemistry ; Hepatocytes ; cytology ; ultrastructure ; Liver, Artificial ; Microscopy, Electron, Scanning ; Microscopy, Phase-Contrast ; Rats

OBJECTIVESTo investigate prognostic effect of postoperative resection-margin status for intraoperatively positive resection margin in advanced gastric cancer and discuss the treatment choice for intraoperatively positive resection margins.

METHODSA retrospective study was investigated in 64 advanced gastric cancer patients with positive resection margin after potentially curative resection. The survival between 50 patients who was re-excised to a negative resection margin (NR group) and 14 patients who were left with positive resection margin (PR group) was compared. Prognostic factors were analyzed using univariate and multivariate Cox regression model analysis.

RESULTSThe median survival in the PR group was 17.0 months (95%CI: 11.6 - 22.4) as compared with 23.0 months (95%CI: 20.5 - 25.5) in the NR group (P = 0.045). However, resection-margin status lost significance on multivariate analysis. In the subgroup of D2 lymphadenectomy, the median survival in the PR group and NR group were 17.0 months (95%CI: 12.0 - 22.0) and 24.0 months (95%CI: 19.8 - 28.1) respectively; multivariate analysis further identified resection margin status as an independent prognostic factor.

CONCLUSIONSRe-excision for intraoperatively positive margin to negative margin improves the prognosis of the patients with advanced gastric cancer, and re-excision is the first choice when intraoperative frozen section detects a positive margin. Routine frozen section of resection margin should be mandatory in all advanced gastric cancer undergoing potentially curative surgery.

Female ; Follow-Up Studies ; Frozen Sections ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; surgery

Objective To explore the diagnosis and therapy experience of vascular ring combined with tracheal compression in infants and neonates.Methods Sixteen cases(including 7 boys and 9 girls,aged 1 day to 12 months)with vascular ring combined with tracheal compression hospitalized in Guangdong General Hospital from Jun.2004 to Dec.2009 were enrolled.In these 16 children,13 cases had congenital heart malformations.All children underwent X-ray,echocardiography and spiral computed tomography examination.Nine cases received bronchoscopy study.Fifteen cases performed surgical division of vascular ring with cardiopulmonary bypass and 1 case underwent vascular ring division and tracheoplasty.Eleven cases received management of congenital heart defect simultaneously.Results Vascular ring anomalies included pulmonary artery sling in 5 children,right aortic arch-left ligmentum/aberrant left subclavian artery in 8 cases,double aortic arch in 1 case,innominate artery compression in 1 case,and pulmonary sling combined with right aortic arch-aberrant left subclavian artery in 1 case.There were 2 ring-sling complex cases in this study.The diagnosis of vascular ring were correctly made by echocardiography in 7 children and made by spiral computed tomography in all 16 cases.Two cases combined with tracheal ring died.In the follow-up study of 11 cases,5 cases were still vulnerable to wheezing.Conclusions The common presentation of tracheal compression in infants and neonates associated with vascular ring are tachypea,stridor,and dyspnea.Multi-slices spiral computed tomography is an important imaging modality.Surgical divisions of vascular ring are safe procedure in most cases and tracheal compression can be relieved by this operation.In patients with severe tracheal stenosis,tracheoplasty should be recommended.

Objective To evaluate the CT findings of lymphofollicular thymic hyperplasia in adult myasthenia gravis (MG).Methods The CT findings of thymus area of 134 adult patients with lymphofolficular thymic hyperplasia in MG were reviewed,all of them with surgically and histologically proven diagnosis,and compared with the CT findings of 165 normal subjects.Results In the group of patient,CT showed enlargement of thymus in 31 patients,5 patients had nodule or mass(＜3 cm);thus 36 cases(26.9%)can confirmed diagnose by CT with thymic hyperplasia.CT showed 2 masses(＞3 em) and 9 patients(6.7%)had normal size thymus with soft-tissue density,it can considered with thymic hyperplasia.The spotty or streak shadow showed in other patients,though it could not be certain diagnosed as thymic hyperplasia,but could not be except it.The thymus area tissue complete replacement by fatty density were not found in patient group.The CT findings of patients had marked difference when compared with group of normal subjects(P＜0.01),except the spotty or streak shadows.Conclusion CT scan is an important method in diagnosing thymic lymphofollicular hyperplasia of MG in adult.

Objective To investigate effects of Danhong on the serum levels of CD137, high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) in patients with non-ST elevation acute myocardial infarction complicating metabolic syndrome. Methods A total of 126 patients with non-ST elevation acute myocardial infarction complicating metabolic syndrome were enrolled and randomly divided into a conventional treatment group and a Danhong treatment group using a random-digit table, with 63 patients in each group. All patients underwent angiography or percutaneous coronary intervention. The patients in the Danhong treatment group treated with intravenous Danhong 20 ml on the basis of conventional treatment for 1 week. The serum levels of CD137, hs-CRP and Hcy were measured at hospital admission and 10 days after treatment. The severity of coronary artery disease was assessed by the Gensini-score. Results The levels of CD137, hs-CRP and Hcy in both groups after treatment were significantly lower than before treatment (conventional treatment group: t 12.393, 17.408 and 9.458; Danhong treatment group: t 16.110, 17.573 and 13.481; all P<0.01), and the Danhong treatment group were significantly decreased than the conventional treatment group (t 2.815, 3.224 and 3.157, all P<0.01). The serum levels of CD137 and hs-CRP before treatment were significantly correlated with Gensini scores in 126 patients (r 0.720 and 0.562,all P<0.01). Conclusions The serum levels of CD137 and hs-CRP are significantly correlated with the severity of coronary artery disease, intravenous Danhong may has protective effect for coronary artery disease via decreasing CD137 and hs-CRP.