Purpose:To investigate the relationship between expression of COX-2,VEGF in gastric carcinoma and its prognostic significance.Methods:281 patients with early and middle stage of gastric carcinoma were followed up. Expression of COX-2 and VEGF was examined by immunohistochemistry in 232 archival paraffinembedded tissue specimens.Results:The MVD value was much higher in COX-2(+) group and VEGF(+) group than that in COX-2(-) group and VEGF(-) group ( P

Objective Owing to limitations in issues of access,tissue manipulation,and secure tissue approximation/closure,natural orifice transluminal endoscopic surgery(NOTES)has been developed slowly over the years.In this study,we employed a new approach,transumbilical endoscopic surgery(TUES)to treat 26 patients with gallbladder diseases.Methods A total of 26 patients including 21 cases of gallbladder stone and 5 cases of polyps underwent TUES cholecystectomy in our hospital.Two 5-mm trocars were placed through an infra-umbilicus incision.A mini grasper was placed at the right upper abdomen to grasp the fundus of gallbladder,so that the gallbladder can be dissected and removed by using conventional laparoscopic instruments.Results The operation was completed in all the cases except in one,who was converted to conventional laparoscopic surgery because of intraoperative bleeding.The operation time was between 25 and 50 minutes with a mean of 35 minutes.No postoperative bleeding or bile leakage occurred in this group of patients.Satisfying cosmetic results were achieved on the abdomen.Conclusions Double trocar transumbilical endoscopic cholecystectomy is feasible,and is simpler and safer than NOTES technique.Patients should be carefully selected at the beginning stage.

Objective The major barrier to transumbilical endoscopic surgery is from external interference between the instruments handles around the umbilicus. We describe the technique of totally transumbilical endoscopic cholecystectomy by using improved instruments. Methods 54 cases of transumbilical laparoscopic cholecystectomy were performed with improved instruments in patients with gallbladder polyps (13 cases) and gallstones (41 cases). The new trocars without the proximal seal system on the sleeves were designed for this procedure. The instruments used in this study were 5 cm longer than commercially available ones. Results All the gallbladders were removed successfully without severe intraoperative bleeding during and postoperative complications. Mean operating time was 25-56 min (average 34±28 min). All the patients were satisfied with the abdominal cosmetic results, discharged 48 h after the operations, and returned to work within seven postoperative days.Conclusions The external interference between trocars and instruments can be partially avoided by using the improved instruments. Totally transumbilical laparoscopic cholecystectomy becomes feasible by this technique.

Adult ; Balloon Occlusion ; instrumentation ; Cardiac Catheterization ; instrumentation ; Ductus Arteriosus, Patent ; surgery ; Female ; Humans ; Ligation ; instrumentation ; Recurrence

Objective To investigate the effect of radiotherapy combined with interventional therapy on the changes of vascular endothelial growth factor (VEGF) in patients with advanced cervical cancer.Methods 62 cases of cervical cancer collected in the first people’s hospital of jingzhou city during January 2009 to February 2014 were randomly divided into two groups.The patients in group A were treated with radiotherapy, and the patients in group B were treated with radiotherapy combined with interventional therapy.The level of vascular endothelial growth factor in two groups after treatment was measured by enzyme-linked immunoassay.Results The level of vascular endothelial growth factor of group A was ( 241.77 ±85.86 )μg/L, significantly higher than ( 124.66 ±65.86 )μg/L of group B.The level of vascular endothelial growth factor was related with cervical deterioration degree, tumor stage and lymph nodes metastasis (P<0.05),not with the patient’s age, and the size of the tumors.The level of vascular endothelial growth can reflect the clinical efficacy of patients after therapy (P<0.05).Conclusion Vascular endothelial growth factor level has a close relationship with the degree of deterioration of cervical cancer, tumor staging, lymph node metastasis and the curative effect after the interventional therapy.

Purpose To explore the clinicopathologic characteristics, pathologic diagnosis and differential diagnosis of extraskeletal myxiod chondrosarcoma. Methods The clinical and pathological features were studied with HE and immunohistochemical staining in 5 cases of extraskeletal myxoid chondrosarcoma, and the related literatures were also reviewed. Results Extraskeletal myxoid chondro-sarcoma was male predominance (4 males: 1 female), and the age ranged from 32 to 62 years with an average of 52 years. Four tumors occurred in thigh and another in chest. Histologically, the neophlasm were composed of round and oval cells. Immunohisto-chemically, the tumor cells were positive for vimentin in five cases, synaptophysin expressed in one case, S-100 showed focal positivity in two cases, but negative for CK, p63, EMA, CD34, SMA in all cases. Molecular genetics detection shows chromosome exchange be-tween number 9 and 22. Conclusion Extraskeletal myxoid chondrosarcoma is a rare tumor which has no special characteristics in clinical and iconography, and its diagnosis mainly depends on the histopathologic features, immunohistochemistry and molecular genet-ics. Extraskeletal myxoid chondrosarcoma grows slowly, but have a high tendency for local recurrence and metastases.

OBJECTIVETo establish discriminant functions of diarrhea-predominant irritable bowel syndrome (IBS-D) by studying it from quantitative diagnosis angle, hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

METHODSA Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS. Initial syndromes were obtained by cluster analysis. They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides (BGP) as variables.

RESULTSClustering results were Gan stagnation Pi deficiency syndrome (GSPDS), Pi-Wei weakness syndrome (PWWS), Gan stagnation qi stasis syndrome (GSQSS), Pi-Shen yang deficiency syndrome (PSYDS), Pi-Wei damp-heat syndrome (PWDHS), cold-damp disturbing Pi syndrome (CDDPS). Of them, GSPDS was mostly often seen with effective percentage of 34. 2%, while CDDPS was the least often seen with effective percentage of 5.5%. A total of 5 discriminant functions for GSPDS, PWWS, GSQSS, PSYDS, and PWDHS were obtained by step-by-step dis- crimination method. The retrospective misjudgment rate was 4.1% (16/390), while the cross-validation misjudgment rate was 15.4% (60/390).

CONCLUSIONThe establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

Alarmins ; Brain ; Cluster Analysis ; Diarrhea ; classification ; diagnosis ; Hot Temperature ; Humans ; Irritable Bowel Syndrome ; classification ; diagnosis ; Medicine, Chinese Traditional ; Qi ; Retrospective Studies ; Surveys and Questionnaires ; Yang Deficiency

Objective:To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF)patients receiving liver transplantation.Methods:The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations(OLT)from January 2006 to January 2007 were retrospectively analyzed,and the anesthetic management expe- rience was summarized.General anesthesia was applied;the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results.Blood samples were obtained before operation, before anheptic,30 min after anhepatic phase,5 min before neohepatic phase,and 5 min,30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function;the drugs were subsequently adjusted according to analysis results.Results:All the 48 patient underwent successful anesthetic management and there was no death dur- ing opearation.The average blood loss during operation was(5 219?478)ml.Mild alkalosis,hypokalemia,hyponatrium,and hy- pocalcemia were present before operations,pH,BE and HCO_3~- were obviously reduced 30 min after anhepatic phase and in- creased 60 min after neohepatic phase.Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase.Calium concentration was decreased at the end of preanhepatic phase(P

The design principles of a noninvasive ventilator's turbine are studied and discussed in this paper. The design is completed from its several aspects and in combination of related theories, using SolidWorks tools. Abundant experimental results prove that this design's technical specifications meet all the requirements.
Equipment Design ; Respiration, Artificial ; instrumentation ; methods ; Ventilators, Mechanical

Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.