Objective To study the techniques of the treatment for epidermoid with endoscope-as- sisted microneurosurgery.Methods The suboccipital,infratemporal transtentorial approach and endoscope- assisted microneurosurgery were used.Results Total resection was achieved in 10 cases,and subtotal resec- tion was made only in 2, and had no complications of all.Conclusion Endoscope-assisted microneuro- surgery can increase the total-resection rate for tumors,and reduce complications.

Objective To explore the choice of pathway of early enteral nutrition after orthotopic liver transplantation.Methods 96 liver transplantation recipients were separated into nasogastric tube group(42 cases) and gastrostomy-jejunal tube group (54 cases) in our center. The preoperative general condition, nutritional status and basic diseases in two groups were collected. The complications and treatment results of two groups were compared.Results Compared with nasogastric tube group, the start time of enteral nutrition was significantly advanced[(2.33±0.25) vs (0.52±0.12), t=46.770,P<0.01]; the effective use of time of the feeding tube was markedly extended [(8.7±3.9) vs (28.6±17.9),t=7.071, P<0.01]; the supplementary from the third to the 7th day were observably increased in the gastrostomy-jejunal tube group(P<0.01). In Meld score above 15, incidence of gastric retention[5.1%(2/39) vs 25%(8/32), χ2=5.736,P=0.035] and the feeding tube accidently pulled out[0 vs 12.5%(4/32),χ2=5.166,P=0.037], postoperative hospital stay and hospital costs in gastrostomy-jejunal tube group were significantly lower than that of nasogastric tube group(P<0.05). The incidence of diarrhea and tube blockage was no significant difference(P>0.05). Meld score in different circumstances, between the two groups of pulmonary infection, abdominal infection, acute renal failure and acute rejection were not significantly different(P>0.05).Conclusions The use of percutaneous gastrostomy-jejunal tube has the advantages of early postoperative enteral nutrition in patients with Meld score above 15 ,it is worth to apply.

OBJECTIVETo investigate the antidepressant components of Polygala tenuifolia.

METHODThe chromatographic method was used to isolate and purify the chemical constituents, their structures were identified by spectral analysis, MTT method was applied to investigate their cytotoxic activities.

RESULTNine compounds were isolated from the roots of P. tenuifolia. Their structures were identified as sibiricose A, (1), sibiricose A5 (2), tenuifoliside A (3) and 3', 6-disinapoyl sucrose (4), sibiricose A6 (5), 3, 4, 5-trimethoxycinnamate (6), polygalaxanthone III (7), tenuifolioses A (8), tenuifolioses H (9) and some compounds' activities to PC12 were observed.

CONCLUSIONCompound 1 was isolated from this plant for the first time. Compounds 2,3 could protect PC12 cells damage induced by P. tenuifolia.

Animals ; Antidepressive Agents ; chemistry ; isolation & purification ; pharmacology ; Esters ; chemistry ; isolation & purification ; pharmacology ; Mice ; PC12 Cells ; Plant Roots ; chemistry ; Polygala ; chemistry ; Rats ; Sucrose ; chemistry

OBJECTIVETo study the possible role of hTERT and c-myc in endometrial carcinogenesis.

METHODSThe expression of hTERT and c-myc mRNA was examined by in situ hybridization of endometrial samples from 14 cases with simple hyperplasia, 10 with complex hyperplasia, 8 with atypical hyperplasia and 42 with endometrioid carcinoma.

RESULTSExpression of hTERT was demonstrated in samples with simple hyperplasia, complex hyperplasia, atypical hyperplasia and carcinoma at frequencies of 2/14, 4/8, 8/10 and 39/42 (92.9%), respectively. The prevalence and intensity of the hTERT signal was greater in the carcinomas and lesions with atypical hyperplasia than those with simple or complex hyperplasia (P < 0.05). The expression of c-myc was demonstrated in samples with simple hyperplasia, complex hyperplasia, atypical hyperplasia and carcinoma at frequencies of 3/14, 1/8, 5/10 and 23/42 (54.8%), respectively. The frequency of c-myc expression was higher in carcinomas and hyperplastic lesions with atypia than those in lesions with simple or complex hyperplasia without atypia (P < 0.05). The expression of hTERT was shown to be correlated with the level of differentiation (P < 0.05), while the c-myc expression appeared to be associated with the depth of myometrial invasion (P < 0.05). The expression levels of hTERT and c-myc were not found to be correlated with each other in the tissues examined (P > 0.05).

CONCLUSIONSThe expression of hTERT and c-myc may be involved in the progression from the endometrial aypical hyperplasia to invasive carcinoma. The correlation between hTERT and c-myc in endometrial hyperplasia and carcinoma are not found.

Adult ; Aged ; DNA-Binding Proteins ; Endometrial Neoplasms ; genetics ; pathology ; Female ; Genes, myc ; Humans ; Male ; Middle Aged ; Precancerous Conditions ; genetics ; pathology ; RNA, Messenger ; analysis ; Telomerase ; genetics

OBJECTIVETo investigate the clinical significance of plasma levels of hypersensitive C-reactive protein (hs-CRP), fibriogen and D-dimmer (D-DI) in patients with connective tissue disease (CTD)-related interstitial lung disease (CTD-ILD).

METHODSSixty-nine patients with interstitial lung disease admitted in Zhujiang Hospital between January, 2010 and April, 2016, including 29 with CTD-ILD and 40 with non-CTD-ILD were analyzed for plasma levels of hs-CRP, fibriogen and D-DI, with 25 healthy subjects as the control group.

RESULTSThe plasma level of hs-CRP, fibriogen and D-DI in patients with CTD-ILD and non-CTD-ILD were all significantly higher than those in the control group. The patients with CTD-ILD had a significantly higher hs-CRP level than those with non-CTD-ILD, but the levels of fibriogen and D-DI were comparable between the two groups. Correlation analysis indicated that Hs-CRP level was positively correlated with the levels of D-DI (r=0.539, P<0.01) and fibrinogen (r=0.534, P<0.01).

CONCLUSIONHs-CRP, fibriogen and D-DI levels show an important value in clinical diagnosis of CTD, and an obvious elevation of hs-CRP is correlated with the CTD.

OBJECTIVETo explore the application value of multi-slice spiral CT angiography (MSCTA) for the preoperative evaluation of laparoscopic right hemicolectomy.

METHODSAbdominal CT slice images of 160 patients(group A) were collected for 3-dimensional reconstruction using volume rendering technique. Interpretation and anatomical classification of the major branches and course of the superior mesenteric artery(SMA) in the reconstructed images of the arterial phase were carried out. Forty-five patients(group B) undergoing laparoscopic right hemicolectomy were evaluated with MSCT combining images obtained from the arterial phase and portal venous phase. The relationship between ileocolic artery and ileocolic vein was analyzed. The preoperative imaging findings were compared to that revealed during the procedure.

RESULTSIn group A, 70(43.8%) out of 160 patents showed anatomical variations of the superior mesenteric artery, of whom 51(31.9%) had two right colic arteries, and 14(8.8%) had two middle colic arteries. Preoperative MSCTA showed that in group B ileocolic artery was running ventrally to ileocolic vein in 13(28.9%) out of 45 patients, while running dorsally in 32(71.1%). Compared to the skeletonized vessels during the procedure, the consistency rate was 100%.

CONCLUSIONAnatomical variations of superior mesenteric artery are common, therefore, multi-slice spiral CT scan is vital for preoperation evaluation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angiography ; methods ; Child ; Colectomy ; methods ; Female ; Humans ; Laparoscopy ; Male ; Mesenteric Artery, Superior ; diagnostic imaging ; Middle Aged ; Prospective Studies ; Tomography, Spiral Computed ; methods ; Young Adult

Objective To explore the effect of continuous venovenous hemofiltration (CVVH)combined with intravenous injection of mannitol in the treatment of intracranial hypertensive patients with renal failure. Methods Nine intracranial hypertensive patients with renal failure from ICU of our hospital were treated with 2-3 times of CVVH combined with intravenous injection of mannitol; their non-invasive intracranial pressure, serum creatinine and cystatin concentrations before and after the treatments were monitored. Results The difference of intracranial pressure was statistically significant before and after CVVH (P＜0.05), so were the values of serum creatinine and cystatin before and after CVVH (P＜0.05). One patient with brain stem hemorrhage died fiom multiple organ failure 2 d after the treatment, and the other 8 patients all smoothed out the rush hours of brain edema without cerebral hernia.Conclusion CVVH combined with intravenous injection of mannitol is a kind of effective treatment for intraeranial hypertensive patients with renal failure.

Objective To provide medication references for children with new cryptococcal meningitis with nephrotic syndrome.Methods The clinical pharmacists participate in formulation of treatment plans,and monitor the curative effect of anti-infective treatment,intracranial pressure depressing,and nephrotic syndrome treatment during therapy.They should adjust the usage and dosage of nephrotoxic drugs by monitoring patients' renal function and electrolyte condition,and propose individualized drug administration advices according to patients' conditions and adverse reactions.Results and conclusion The anti-cryptococcus treatment was effective,the nephrotic syndrome was stable,the symptoms of intracranial hypertension were improved,hypokalemia and hypomagnesemia were corrected,and the renal function impairment was not aggravated.The clinical pharmacists' combining of pharmaceutical theory with clinical practice received clinicians'recognition,and promoted children's medication safety and rational drug use.

Objective To observe the risk factors of the short-term prognosis of anti-N-methyl-D-aspartic acid (anti-NMDAR) encephalitis.Methods The clinical data of 66 children with anti-NMDAR encephalitis was analyzed retrospectively,and the scores of modified Rankin scale (mRS) were used before and after treatment.According to the treatment results,the children with mRS less than or equal to 2 points were used as treatment group,those with mRS score more than 3 points were set as the control group.Single factor and multiple factor Logistic regression analysis were used to analyze the risk factors of poor prognosis.Results Of the 66 cases,39 had good prognosis and 27 had poor prognosis.The results of single factor analysis showed that age,days of hospitalization,epilepsy,dyskinesia,mRS scores score were associated with poor prognosis.Multiple factor Logistic regression analysis showed that age,epileptic seizures,and mRS scores before treatment were independent risk factors for the short-term prognosis of anti-NMDAR encephalitis.Conclusion Patients with anti-NMDAR encephalitis have small age,seizures and high mRS scores before treatment,which may predict poor prognosis in the near future.

OBJECTIVETo evaluate the efficacy of nucleos(t)ide analogues (NA) treatment and to assess the long-term outcomes, including survival, liver function improvement and virologic response, in patients with decompensated cirrhosis due to hepatitis B virus (HBV) infection.

METHODSPatients with Child-Turcotte-Pugh (CTP) scores more than or equal to 7, who had been treated with either lamivudine or other agents, but who were free of co-infection with other hepatitis virus were enrolled between January 2005 and December 2009. The study participants were subgrouped according to the antiviral drugs received or model for endstage liver disease (MELD) score for comparative analyses.Additionally, the 19 patients who were treated with NA for more than 5 years were investigated for changes in biochemical and virological indices, before and after the antiviral treatment.

RESULTSA total of 166 patients (125 males; 89 e-negative) and 52 untreated healthy patients (as control) were analyzed.The cohort of patients receiving antiviral therapy had significantly better 5-year actuarial survival than the untreated patients (74.1% vs.34.9%, P less than 0.001). For patients with MELD score more than or equal to 18, actuarial survival was not significantly different between the two groups (P=0.073).

CONCLUSIONAntiviral therapy significantly increases survival and improves the clinical long-term outcome of patients with HBV-induced decompensated cirrhosis.Antiviral treatment should be initiated at an early stage to maximize benefit in the improvement of clinical status.

Administration, Oral ; Antiviral Agents ; administration & dosage ; therapeutic use ; Cohort Studies ; Coinfection ; Female ; Hepatitis B virus ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Lamivudine ; Liver Cirrhosis ; etiology ; Male ; Retrospective Studies ; Treatment Outcome