ObjectiveTo evaluate the effects of various surgical procedures on liver carcinoma accompanied by portal hypertension. MethodsOne stage surgical procedure was performed in 28 cases of liver carcinoma accompanied by portal hypertension in our department from January 1992 to June 2000. ResultsThere was no operative mortality. The postoperative complications developed in 39%(11/28). The postoperative survival rates of 1?2 and 3 years were respectively 91%, 61%, and 48%. Postoperative upper digestive tract hemorrhage developed in 9 cases, 13 cases died during follow-up period, of whom 6 cases died of the recurrence of liver carcinoma, 2 cases died of liver failure, 5 cases died of upper digestive tract hemorrhage.Conclusions The survival time can be prolonged and the postoperative complications reduced through prudent selection of surgical procedures in patients suffering from concurrent liver cancer and portal hypertension. Postoperative recurrent bleeding can be prevented by pericardial devascularization. In poor risk cases with huge carcinoma, simple surgical procedure should be applied,and with a discreet application of chemoembolization.

BACKGROUND: Intravascular low-level laser irradiation (ILLLI) therapy with He-Ne laser can effectively inhibit the occurrence of heroin withdrawal syndrome, but the therapeutic effect should be evaluated by quantitative standards.OBJECTIVE: To evaluate the effect of intravascular low-level He-Ne laser irradiation against withdrawal syndrome with intravenous according to the criteria proposed by the authors.DESIGN: Randomized controlled trial in heroin-addicted patients.SETTING: Analysis and Testing Laboratory of Xinxiang Medical College and Center of Laser Medical Research of Zhenzhou University Medical CollegePARTICIPANTS: The study was completed in Center of Laser Medical Research in Zhengzhou University in January 2003. Thirty heroin addicts from the Detoxification Center of Zhengzhou including 25 male and 5 female patients aged 19- 45 years were divided randomly into experimental group and control group with 15 cases in each. The patients' history of drug abuse ranged from 0. 5 to 5 years and the daily doses they took was 1.0-4.0 g.INTERVENTIONS: Patients in the experimental group were treated by ILLLI therapy after hospitalization. The therapy was administered once daily for 60 minutes in each session, for a total of 10 days for a treatment course. The irradiating power of the laser was 2.0-3.0 mW with a power density of 7.07-10.6 mW/mm2. Patients in the control group were treated with conventional therapy with algidon combined with buprenorphine hydrochloride. The 12 main symptoms(vomiting, goose pimples, sweating, agitation, shaking, lacrimation, nasal congestion, insomnia, abdominal pain,body temperature changes, muscular pain, and heart rate changes) were scored for 0, 1, 2, and 3 corresponding to absent, mild, moderate, and severe symptoms, with the total score of 36.MAIN OUTCOME MEASURES: Comparison of the scores for the withdrawal symptoms between the two groups.RESULTS: The 30 cases were all available for result analysis. The scores of vomiting, insomnia, agitation, shaking, goose pimples and abdominal pain in the experimental group were 2.0±0.5, 2.5±0.4,4.6±0.3,3.6±0.7,3.1±0.3 and 5.7±0.6 respectively, which were obviously lower than those in control group(5.1±0.7,6.0±0.7,7.4±0.6, 7.1±0.6,5.7±0.6 and 6.4 ±0.7 respectively, t =9.90-16. 81, P＜0.01).CONCLUSION: Intravascular low-level He-Ne laser irradiation can effectively relieve heroin withdrawal syndrome.

BACKGROUND: The blocking treatment can improve the clinic symptom of facial spasm. But the site, depth and the angle of puncturing point are very difficult to be defined, which will seriously infect the curative effect.OBJECTIVE: To study the applied anatomy of the related structures of facial muscle for blocking the facial nerve, and to provide anatomical bases for accurate puncturing point and preventing complications.DESIGN: An observation study based on cadavers and making the mimic puncture and measuring the correlative structures with anatomical method.SETTING: Department of anatomy in a medical college.PARTICIPANTS: Totally 28 adult male cadavers(56 sides) were used and the correlative index were measured.METHODS: The blocking point was located at the convergent point of the interior edge of cartilage of the external acoustic canal, the anterior fringe of mastoid processes and the posterior fringe of mandible ramus, the needle must be thrust vertically to the median sagittal plane. The puncturing needle stopped until it was barred. A longitudinal incision was made from the puncturing point to mandibula angle, and skin, superficial fascia were cut separately. Then carotid superficial fascia was cut from the posterior fringe of parotidean. The facial nerve trunk and the posterior auricular artery were preserved in site. A blunt isolation was made along its incision. Jugular glomus was appeared. Then the correlative index were measured and dealt with statistics method.MAIN OUTCOME MEASURES: The puncturing point, angle and depth,the distance between facial nerve trunk and puncturing point, the position relationship between facial nerve and puncturing needle and the distance relationship between facial nerve and principal structures adjacent to it.RESULTS: The blocking point was located at the convergent point of the interior edge of the external acoustic canal, the anterior fringe of mastoid processes and the posterior fringe of mandible ramus, the needle must be thrust vertically to the median sagittal plane. On the left side, the puncturing depth was (19.91 ± 0.09) mm, On the right side, the puncturing depth was(19.28±0. 10) mm.CONCLUSION: The experimental study could provide accurate puncturing point, angle and depth for blocking the facial nerve and bring the blocking treatment into full play.

BACKGROUND: Many animal and clinical studies have reported that the safe and effective usage of umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) transplantation for treatment of neurological genetic diseases.OBJECTIVE: To investigate the feasibility and effect of UCB-MSCs transplantation in the treatment of spinal muscular atrophy (SMA).METHODS: A child admitted at January 2010 had been confirmed as having SMA, and drug and rehabilitation therapies were invalid. Then, the child received UCB-MSCs transplantation via the first intravenous infusion and three times of subarachnoid injection, once a week, (4-6)×107 cells once and four times as a course. Neurological physical examination, biochemical test, muscle enzymes detection, FIM scoring and electromyography (EMG) examination were conducted. RESULTS AND CONCLUSION: Compared with prior to transplantation, the level of muscle enzymes decreased, FIM scores were increased from 68 to 93 points, EMG results showed that the motor units with re-contraction in each 10.0 ms were increased that the motor function was improved, the lower extremity muscle strength elevated, and the self-care ability was improved in the SMA child at 6 months after transplantation. During the 10-month follow-up, the child had no adverse effects. It is indicated that UCB-MSCs transplantation is effective to treat SMA, and the neurological function has a remarkable restoration.

Glycosylation, one of the most common and important reactions in biological systems, results in diverse functions and is often found in biologically active small-molecule natural products produced by microorganisms. Furthermore, sugar moieties are generally critical for their activities. Alternating the sugar structures thus provides the potentials for enhancing the biological activities of natural products, which evokes researchers to study the sugar biosynthetic machinery and its application in the modification of sugar moieties with an aim of generating unnaturally glycosylated natural product drugs with better activities. This review will briefly outline current studies on sugar biosynthesis and glycosyltransferase, with a few selected experiments designed to alter natural-product sugar structures.

Objective To investigate the oxidative status in systemic sclerosis (SSe) and explore the correlation between oxidative status and clinical features by measuring serum 8-isoprostaglandin-F2α (8-isoPGF2α) concentrations. Methods Serum 8-iso-PGF2α levels were detected by enzyme-linked immunosorbent assay (ELISA) in 51 SSe patients and 22 matched healthy controls. And in some SSc patients, serum homocysteic acid (Hey) concentrations were examined by cyclophorasc assay. Plasma yon Wilebrand factor (vWF) activity and serum immunoglobulin (lg) concentrations were detected by immunoturbidimetry.Antinuclear antibodies (ANA) and anti-endothelial antibodies (AECA) were detected by indirect immunofluorescence. Anti-sc170 antibody was detected by immunoblotting. Thirty-five out of 51 SSc patients were assessed for clinical features and laboratory parameters in order to analyze the correlations between 8-isoPGF2α levels and clinical features. Results Serum 8-iso-PGF2α levels were higher in sclerederma patients than in healthy controls. Values of 8-iso-PGF2α correlated with pulmonary involvement, such as diffusion capacity for carbon monoxide (DLCO) and pulmonary interstitial fibrosis by pulmonary high-resolution computed tomography (PhrCT), and correlated positively with renal vascular damage determined by the resistant index (RI) of renal glomeruli interlobular arteries. There was no correlation between 8-iso-PGF2αconcentrations and skin, peripheral vascular, heart, esophagus involvement and disease activity, diseasepattern, vWF,Hcy, lg, or autoantibedy profiles.Conclusion Increased Jevels of 8-iso-PGF2α, marker of oxidative stress, is correlated with pulmonary fibrosis and the extent of renal vascular damage in SSc and this supports the hypothesis that oxidative stress plays an important role in SSc pathogenesis.

OBJECTIVE:To systematically review the efficacy and safety of ramucirumab in the treatment of adenocarcinoma in stomach or gastroesophagealjunction,and provide evidence-based reference for clinic. METHODS:Retrieved from Wanfang database,CJFD,PubMed,EBSCO,Medline and Cochrane Library,randomized controlled trials(RCT) oframucirumab and (or) other medicines or other chemotherapy (test group) versus placebo or and Clinical Trials. gov other antibiotics(control goroup) were collected with time limit from establishment to Sept. 2015. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane systematic review manual 5.1.0. RESULTS:Totally 3 RCTs involving 1 188 patients were enrolled,including 652 patients in the test group and 536 patients incontrol group. Results of Meta-analysis showed, the overall survival[HR=0.83,95%CI(0.72,0.95),P=0.006] and progression-freesurvival[HR=0.66,95%CI(0.47,0.92),P=0.01] in test group were significantly longer than control group,the difference was statistically significant;there was no significant difference in the objective response rate[RR=1.31,95%CI(0.81,2.11),P=0.28]. The incidence of severe adverse reactions(degree level:3-4 grade) in test group was significantly higher than control group,the difference was statistically significant [RR=1.14, 95%CI (1.00,1.29),P=0.04].CONCLUSIONS:Ramucirumab can extend overall survival and progression-free survival of adenocarcinoma in stomach or gastro-oesophageal junction,but the incidence of adverse reactions should be noticed.

Objective To summarize the experience of surgical management of carotid tumors ( CBT ) and application of shunt between common and internal carotid artery intraoperatively. Methods Thirty patients of CBT (mean age:39. 2 ±2. 3 years old,10 male and 20 female, 15 in left, 14 in right and 1 in both sides) who underwent surgical resection, were retrospectively reviewed. The average size of CBT was 4.9 ±0.3 cm. The diagnosis was established by ultrasound, CT, MRI or carotid arteriography. 16 patients underwent surgical resection of CBT, 10 patients underwent additional ligation of external carotid artery, and 4 patients underwent additional intraoperative shunt between common and internal carotid artery. Results Surgical procedures were successfully performeded in all 30 patients with CBT. Intraoperative shunts were successfully used between common and internal carotid artery in 4 patients. The postoperative complications included hoarseness (15) , bucking (11), crooked tongue ( 17) , dyspnea (1), dysphagia(3). There was no hemiplegia and death. Conclusion Surgical resection is the choice of treatment of carotid body tumor. The application of intraoperative shunt between common and internal carotid artery in complicated Shamblin Ⅲ stage is safe and effective.

Objective To investigate the approach of diagnosis and therapy of particular tracheal bronchus foreign body.Methods The clinical materials of 26 cases cured in our department were analyzed retrospectively.Results All foreign bodies of cases were taken out successfully.Among them,the foreign bodies of 18 cases were removed from glottis;the foreign bodies of 4 cases were pulled out via laryngoscope;the foreign bodies of 3 cases were drawn away through tracheotomy by endoscopy and 1 case was moved out by bronchofibroscopy.Only 1 case had lung edema and then was cured by proper treatment.Conclusion Considering that the particular foreign bodies in tracheal bronchus are complicated sometimes,the diagnosis and therapy should be treated appropriately according to different situation.Furthermore,properly choosing surgical appliances and the approaches of anaesthesia and surgery is also critical.

Objective To assess the effectivity and safety of oxycodone plus acetaminophen for postoperative acute pain re‐lief .Methods Randomized controlled trials (RCT ) on combination of oxycodone plus acetaminophen treating postoperative pain re‐lief were searched from the following data‐bases as PubMed ,EMbase ,MEDLINE(Ovid) ,the Cochrane Library ,CNKI and WAN‐FANG from the date of their establishment to September 2014 .The data of RCT meeting the inclusive criteria were extracted ac‐cording to Cochrane methods by two reviewers independently ,and after the quality was evaluated and cross checked ,meta analyses were conducted using RevMan 5 .2 sotware .Results A total of 18 studies involving 2 213 patients were included .The results of Meta‐analyses showed that compared with placebo group or the equal dosage oxycodone alone group ,the combinations of oxycodone plus acetaminophen were more effective in postoperative pain relief (P<0 .01) .However ,there are no significant difference in the effective between the combinations of oxycodone plus acetaminophen and the higher dosage oxycodone alone group or the acetamin‐ophen alone group for postoperative pain relief (P>0 .05) .Adverse events occurred more frequently with combination therapy than placebo or acetaminophen alone group ,but were generally described as mild to moderate in severity and rarely led to withdrawal . There are no significant difference in the adverse events between the combination of oxycodone plus acetaminophen and the oxyc‐odone alone group .Conclusion The present study showed that combination of oxycodone plus acetaminophen is effective and high safe in postoperative acute pain relief .