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.

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 .

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.

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 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 compare the three different methods of enzyme linked immunosorbent assay(ELISA),to select the best method for clinical diagnosis and treatment.Methods Addcare ELISA800,TECAN freedom evolyzer and manual ELISA method were used to detect hepatitis B virus Pre S1 antigen(preS1Ag) hepatitis B virus Pre S2 antigen(preS2Ag) in confrontation control product samples and serum specimens from patients with HBV,and the results were analyzed by statistical methods.Results The batch precisions of the three methods to detect pre-S1Ag were 4.73%,5.38%,11.87%,the batch precisions of the three methods to detect pre-S2Ag were 4.91%,5.04%,11.75%.The inter batch precisions of the three methods to detect pre-S1Ag were 6.63%,7.90%,13.26%,the inter batch precisions of the three methods to detect pre-S2Ag were 6.74%,7.81%,12.59%.All the sensitivities were 100.00%.Conclusion All the three methods have good consistency,which could be used in the detection of Pre-S1Ag and Pre-S2Ag.The precision of Addcare ELISA800 is the best,which could further improve the quality of clinical testing.

Objective To investigate the differences in eNOS gene expression,activity and its metabolites before and after human bone marrow mesenchymal stem cells (hBMSCs) are induced into vascular endothelial cells.Methods hBMSCs were induced into vascular endothelial cells.The morphological changes of the cells were observed under inverted microscope.Transwell assay was used to detect the cells' migration ability.The protein expression of eNOS was detected by immunofluorescence and Western blot.The activity of eNOS was detected by ELISA and the content of NO in cell culture supernatant was determined by nitrate reduction method.Results Compared with those in the undifferentiated group,the morphological changes of the differentiated cells were obvious.Cell migration ability increased by 238.10％ (73.000±7.002 vs.21.000±4.359,P＜0.05).The expression of eNOS protein increased by 114.72％ (0.423±0.011 vs.0.197±0.079,P＜0.05).The activity of eNOS was enhanced by 157.49％ (4.967±0.073 vs.1.929±±0.103,P＜0.05).The synthesis and release of NO increased by 155.67％ (184.909±1.853 vs.72.323±0.426,P＜0.05).Conclusion After hBMSCs are induced into endothelial cells,the expression of eNOS gene increases,their activities increase,synthesis and release of the metabolite NO increase.It may provide a basis for prevention and treatment of cardiovascular diseases with stem cells.

Objective To detect and explore the expression of ARD1 and its clinical significance in the nasopharyngeal in-flammatory tissue ,nasopharyngeal carcinoma group and its subgroups .Methods Expression of ARD1 in nasopharyngeal carcinoma (56 cases) and nasopharyngeal inflammatory tissue (20 cases) were detected by immunohistochemical staining SP ,the correlation between the expression of ARD1 and age ,gender ,histological grade ,TNM clinical stage and tumor metastasis were analysed . Results The positive expression rate of ARD1 were 10 .00% (2/20) ,55 .35% (31/56) in the nasopharyngeal inflammatory tissue and nasopharyngeal carcinoma ,respectively .The expression level of ARD1 in nasopharyngeal carcinoma was significantly higher than in the nasopharyngeal inflammatory tissue ,the difference was significant (P< 0 .05) ;expression of ARD1 in the nasopharynge-al carcinoma was correlated with the histological grade of nasopharyngeal carcinoma(P< 0 .05) and the expression was increased in poor differenciation tissue .But there was no statistical difference between the expression of ARD1 and the patient′s age ,gender , TNM clinical stage ,tumor metastasis(P> 0 .05) .Conclusion The expression of ARD1 is high in nasopharyngeal carcinoma ,and has a closely correlation with diffferentiation level of tumor ,which suggested that ARD1 may be involved in the the occurrence and development of nasopharyngeal carcinoma .However ,further research needs to be done for its mechanism in the nasopharyngeal car-cinoma .