Objective To evaluate the effect of ultrasound-guided botulinum toxin A injection into the salivary glands in treating patients with sialorrhea attributable to brain damage.Methods Nine subjects with sialorrhea attributable to traumatic brain injury (n =5),cerebral infarction (n =3) and hypoxic ischemic encephalopathy (n =1) were recruited into the study.With the guidance of ultrasound,15 units (U) of botulinum toxin type A was injected into the highest and lowest points of the two parotid glands,and 20 U was injected into two points of both submandibular glands.The saliva flow rate and the severity and frequency of sialorrhea were recorded before the treatment and 1 week,4 weeks and 12 weeks later using the Drooling Scoring System (DSS).Results The saliva flow rate before treatment (0.49 ± 0.12 g/min) decreased significantly to 0.24 ± 0.08 g/min after 1 week,but then increased again to 0.28 ±0.12 g/min after 4 weeks and 0.34 ±0.11 g/min after 12 weeks.The average DSS severity score showed the same pattern:4.35 ± 0.48 initially 1.92 ± 0.37 after 1 week,1.92 ± 0.37 after 2 weeks and 2.32 ± 0.64 after 12 weeks.The DSS frequency score,however,remained significantly lower:3.56 ± 0.49 initially,2.01 ± 0.42 after 1 and 4 weeks and 2.28 ± 0.63 after 12 weeks.Conclusion Botulinum toxin type A can effectively improve the salivary secretion and sialorrhea attributable to brain damage.

Objective To explore the clinical significance of the precision evaluation of computed tomography angiography and color Doppler image formation technology to the condition of the vascular system in the donor site.Methods From January,2014 to December,2014,CTA and color Doppler were used to examine conditions of the first dorsal metatarsal artery's courser and the size of original caliber in 25 patients with thumb or finger defected.Also the distance between skin and the first dorsal metatarsal artery.The accurate positions and adjacent relations of vessels in donor site were precisely marked and then the vessel original caliber was measured.Results All the first dorsal metatarsal arteries of 25 cases can be appeared clearly in CTA and color Doppler.Blood vessels line and filling results were completely consistent in intraoperative findings.The difference of the vessel original average caliber was statistically significant (P ＜ 0.05) (1.20 ± 0.25 mm,1.41 ± 0.15 mm and 1.3 ±0.2 mm in Doppler,CTA and operation,respectively) while the distance was not significant (P ＞ 0.05)(9.20 ±3.06 mm,10.32 ± 2.76 mm and 0.2 ± 2.6 mm in Doppler,CTA and operation,respectively) All the 25 transplanted toes were survived.Conclusion CTA combined color Doppler image formation technology in thumb or finger reconstruction can objectively reflect the real situation of the vessels in donor sites,and the structural characteristics and classification of anatomy for individualized,and has important clinical value in preoperative foot blood supply assessment.

Objective To observe the inhibitory effect of DPC4 gene on growth of pancreatic carcinoma in vitro. Methods The human DPC4 cDNA was subcloned to the retroviral vector pLXSN and then packaged with GP+E86 and PA317 packaging cells respectively. AntiG418 clones were acquired and named as PA317/ pLXSN DPC4+ cells. The DPC4 gene was restored to the human pancreatic cancer cell line BxPC-3 by the infection of the pLXSN/DPC4 and then had a stable expression after antiG418 selection, which was demonstrated by RT-PCR and Western blot. The inhibitory action of DPC4 gene expression on growth of these daughter cells was observed.Results DPC4/Smad4 gene integration in GP+E86、PA317/ pLXSN DPC4+ cells was detected by polymerase chain reaction. The BxPC-3 cells, which were null for DPC4, had stable expression of DPC4 after the infection of the pLXSN/DPC4. The expression of DPC4 gene was able to inhibit the growth of these cancer cells in vitro and downregulate the VEGF mRNA level.Conclusions This study suggested that there can be marked inhibition of growth and angiogenetic ability of pancreatic cancer cells after infection by retrovirus vector containing DPC4.

Objective To establish nude mice model of bone metastasis of breast cancer,and study the best method to evaluate the model.Methods The human breast cancer cell,MDA-MB-231PEGFPN,was injected into left ventricule of nude mice to construct the bone metastasis of breast cancer animal model.Methods of X-ray,whole body optical imaging and pathology were used to evaluate the bone damage after six weeks.Results After six weeks,the result of pathology showed that breast cancer cells had already spread to brain,bone marrow and lung of nude mice.The degree of bone destruction was seen clearly in X-ray,and location of breast cancer cells was observed by whole body optical imaging system.Conclusions The results showed that combined application of X-ray,whole body optical imaging and pathology are the best modalities to evaluate bone metastasis of breast cancer in nude mice.

Objective To investigate the clinicopathological characteristics, diagnosis and treatment of primary duodenal malignant tumors (PDMTs). Methods The clinical data of 47 PDMTs confirmed by pathology were retrospectively analyzed. Results Pathological types were adenocarcinoma in 42 cases, leiomyosarcoma in 4, and carcinoid in 1.The most common location of the tumor was the descending portion (35), especially the peri-papillary region (28) of the duodenum. The most common symptoms and signs were abdominal pain, jaundice, upper gastrointestinal hemorrhage, obstruction ,and weight loss. The main diagnostic modalities were gastroduodenoscopy, GI barium meal, ERCP, ultrasound (US) and CT. US together with ERCP was the most useful in improving the diagnosis of peripapilla tumors in the duodenum. Panceraticoduodenectomy and some palliative procedures were performed for 25 and 20 cases, respectively.Surgical mortality and postoperative morbidity were 2.2% (1/45) and 20% (9/45),retrospectively. The 3-year and 5-year survival for those adenocarcinoma without distant metastasis undergoing pancreaticoduodenectomy were 50% and 32%. No long survival was found after the palliative operation. Conclusions Adenocarcinoma is the most common pathological type of PDMTs.No specific symptoms were shown in the early stage of PDMTs, US, CT and ERCP are the main diagnostic procedures. Radical pancraticoduodenectomy can prolong survival time and should be attempted for those without systemic dissemination.Palliative operations should be considered for tumors in advanced stage.

Objective To observe the effect of DPC4 gene transfection on the chemotherapy sensitivity of pancreatic carcinoma cells. Methods The human DPC4 complementary DNA was subcloned to the retroviral vector pLXSN to obtain recombinant pLXSN/DPC4 with direct inserting potential. The daughter cell BxPC-3/DPC4 which had DPC4 stable expression was acquired after the pancreatic carcinoma BxPC-3 cells had been transfected with pLXSN/DPC4. The sensitivity of the carcinoma cells for 5-Fu and gemcitabine was observed. Meanwhile, the mRNA level of Mdr-1 and Chk1was detected by semi-quantity PCR assay. Results The 50% inhibiting concentrations (IC50)of 5-Fuand gemcitabin4e for BxPC-3 (culturing for 72 h) were rather lower than those of BxPC-3/pLXSN and BxPC-3/-cells. Moreover, the semi-quantity PCR assay revealed that the mRNA level of Mdr-1 and Chk1 was down-regulated. These findings indicated that pLXSN/DPC4 vector, 5-Fu and gemcitabine could inhibit the growth of pancreatic cancer cells. The combined therapy with pLXSN/DPC4 vector and chemotherapeutic drugs could further inhibit the growth of cancer cells. Conclusion The DPC4 gene transfection could enhance the sensitivity of pancreatic cells to chemotherapy, which may be realized through the down-regulation of Mdr-1 and Chk1 gene expression.

Objective To eveluate the clinical curative effects of combination of Ma Yinglong She Xiang Zhi Chuang Gao,Jin Xuan Zhi Ke Xun Xi Xan,Diosmin,Macrogol 4000 powder in treating postoperative complications of ring mixed hemorrhoids.Methods Ninty cases of postoperative ring mixed hemorrhoids patients were divided into two groups randomly from January 2008 to June 2009.Experimental group:From the first day on Jin Xuan Zhi Ke Xun Xi San 55 g and the 1000 mL boiling water were added flushing,and Maying Long She Xiang Zhi Chuang Gao 2.5 g,2 times daily.The Macrogol 4000 powder 10 g and water 200 mL were admistrated orally,Diosmin 1.0 g orally,2 times daily.Oral administration of two kinds of medications was done each two hours.Control group:Using 1:100 Sterile warm salt water hip bath,and Ma Yinglong she xiang zhi chuang gao 2.5 g,2 times daily;Phenolphthalein tablets 100 mg orally,2 times daily.Results The experimental group surpassed the control group in the anus ache,the hemorrhage,edema (P<0.05).The heal time reduced obviously(P<0.01).Conclusion To combination of Ma Yinglong She Xiang Zhi Chuang Gao,Jin Xuan Zhi Ke Xun Xi San,Diosmin,Macrogol 4000 powder has the distinct improvement in the anus ache,the hemorrhage,dropsy of ring mixed hemorrhoids and reduces the injured area heal time obviously.

Objective To evaluate the strategies and effect of surgical treatment for concomitant abdominal aortic aneurysm (AAA) and colorectal cancer (CRC). Methods Literatures on concomitant AAA and CRC published from January 1988 to December 2008 were retrieved from Pubmed, Sciencedirect, Ovid, CBMdisc, CNKI and et al, and correlated indexes were extracted for analysis. Differences among the groups were analyzed using the t test, chi-square test and fisher's exact test. Results A total of 367 cases of concomitant AAA and CRC treated by operation were retrieved. The length of operation delay of patients who received radical resection of CRC first was (115 ± 21 )days, which was significantly longer than (42 ± 8 )days of patients who received open abdominal aortic aneurysm repair (OAAR) first (t = 18. 9, P <0.05). The 30-day complication rate and accumulative length of hospital stay of patients who received one-stage radical resection of CRC + OAAR were 10.5% ( 12/114 )and (23 ±6) days, and 26.0% (47/181) and ( 16 ±4)days of patients who received two-stage radical resection of CRC + OAAR, with a significant difference ( χ2 = 10.42, t = 12. 01, P <0.05 ). The accumulative length of hospital stay of patients who received radical resection of CRC + endovascular aneurysm repair (EVAR) was (12 ±4) days, which was significantly shorter than that of patients who received radical resection of CRC + OAAR [ ( 19 ±5 ) days ] ( t = 9.48, P < 0. 05 ). The 4-year survival rate of patients who received two-stage radical resection of CRC + OAAR was 43.5% (27/62), which was significantly lower than that of patients who received two-stage radical resection of CRC + EVAR [69.2% (18/26) ] or one-stage radical resection of CRC + OAAR [73.7%(14/19) ] (χ2 =4.83, 5.28, P<0.05). Conclusions If the diameter of AAA is under 5 cm, radical resection of CRC should be firstly carried out; but if the diameter of AAA is above 5 cm, OAAR should be firstly carried out to prevent the rapture of tumors. One-stage surgery is better than two-stage surgery if patients could tolerate it.

Objective To investigate the diagnosis and treatment of splenic space occupying lesions associated with comorbidity.Methods The clinical data of 5 patients from Jiangyin People' s Hospital and 9 patients from Wuxi People's Hospital from January 2002 to June 2012 were retrospectively analyzed.All the patients suffered from splenic space occupying lesions associated with comorbidity.Splenectomy or multi-visceral resection were selected according to the results of preoperative B sonography and computed tomography examination.Chemotherapy regimes were selected based on postoperative pathological examination.All the patients were followed up till June 2013.Results The symptoms of patients with splenic space occupying lesions were non-specific.The first symptoms of 4 patients were discomfort or distending pain of left upper abdomen,and the other 10patients had no symptoms.The coincidence rate of preoperative diagnosis was 10/14,and the coincidence rate of preoperative diagnosis for patients with malignant tumors was 2/5.Fourteen patients received preoperative B ultra-sonography,and 9 were definitively diagnosed.Nine patients received computed tomography,and 7 were definitively diagnosed.Of the 14 patients,right ovarian cancer,bilateral ovarian cancer and sigmoid colon cancer were correlated with solitary splenic metastasis,and the main lesions of the other 11 patients were not correlated with splenic space occupying lesions.The main lesions of patients with left colon carcinoma,type 2 diabetes and vascular tumor of the spleen,patients with renal carcinoma and splenic sclerosing hemangioma,and patients with hypertension,cholecystolithiasis and splenic lymphangioma were diagnosed simultaneously with the splenic space occupying lesions,and the main lesions of theother 11 patients were diagnosed separately with the splenic space occupying lesions.Ten patients underwent simple splenectomy and 4 patients received multi-visceral resection.Chemotherapy regimens were selected according to the type of main lesions for 5 patients who were diagnosed by pathological examinations.All the patients were recovered smoothly with no occurrence of severe infections.Two patients with splenic sarcoma had tumor metastasis at postoperative 6 months and 1 year,respectively.One patient with right ovarian cancer and solitary splenic metastasis had transverse colonic metastasis at postoperative 3 years.One patient with bilateral ovarian cancer and solitary splenic metastasis had peritoneal metastasis at postoperative 2 years.One patient with sigmoid colon cancer and solitary splenic metastasis died of peritoneal tumor recurrence at postoperative 4 years.One patient with left colon carcinoma,type 2diabetes and vascular tumor of the spleen survived for 6 years and was still sound and well.The other 9 patients with benign disease survived within the period of follow-up.Conclusions The definitive diagnosis for patients with splenic space occupying disease associated with comorbidity depends on the preoperative imaging examination and postoperative pathological examination.Surgical treatment is safe when operative contraindications are excluded.The prognosis of patients is determined by the progress of main lesions and the character of splenic space occupying lesions.

Objective To explore the feasibility and superiority of the simple controllable aerocyst pressurization wrapped-up bondage for battlefield first aid in the future high tech local war. Methods The disposable infusion bag is wrapped up in the bottom of the sling in stead of partial surgical dressing. Sphygmomanometer, pressure gauge and heparin hat are connected. Inflate and pressurize the sphygmomanometer and keep the pressure between 3kPa and 5kPa. Results The structure of this bandage is simple and can be operated easily. The pressure is controlled nimblely and conveniently. Except for the accurate effect, it is versatile and inexpensive. In addition, it can be employed in the bone fracture.