This study aimed to summarize the diagnosis and treatment of uncommon complications in esophageal and cardiac cancer operations as well as obtain lessons from the failure. Methods:The etiology, clinical diagnosis, treatment, prevention measures, and factors that contribute to the failure of the uncommon complications were analyzed retrospectively. Results: Results showed ten cured cases and eight death cases (except for the reported eight cases). Conclusion:The following conclusions were ob-tained. 1) The complications described in this paper were rare, but they sometimes occur clinically. If wrong treatment was taken, seri-ous consequences would be expected. 2) Once a jet-like bleeding of aortic esophagus avulsion injury occurs, the surgeon must be calm and take proper treatment to successfully patch up the wounds. 3) The right thoracic approach is a new approach to prevent the injury of azygos vein. 4) Patients with anastomotic stoma fistula easily cause a delay in diagnosis if the leakage was wrapped in the inferior phrenic. 5) Taking preventive measures is the key method for the anastomotic aortoesophageal fistula. 6) Occurrence of pulmonary em-bolism after operation should be monitored. 7) Thoracic gastric mediastinal hernia would cause serious consequences if treatment was not taken at a proper time.

Objective To learn the emergency response capacity of health authorities at city level in Shandong province in order to discover loopholes and make improvement. Methods The health emergency questionnaire designed by China Health and Family Planning Commission was used for survey of 1 7 city-level health authorities in Shandong province.Results 52.94% of the health authorities were found with health emergency reserve funding; 100.00% of them with public health emergency contingency plans;94.12% of them having health emergency supplies in kind;100.00% of them having health emergency training for all of the staff;100.00% of them with direct web reporting for public health emergency.Conclusion Such authorities were found with satisfactory health emergency capacity in general.Defects were found with emergency funding shortage,poor training and drilling outcomes, poor material reserves management,and insufficient health emergency personnel.

Objective To explore the TCM syndrome characteristics of cardiac syndrome X(CSX).Methods The signs and symptoms of 51 patients with CSX were analyzed according to the diagnosis of TCM syndromes to summarize their syndrome character- istics.Results of the 51 CSX cases,the following signs and symptoms took dominance:chest pain,fullness in chest,epigastric and abdominal distention,emotional distress,dark purple tongue with petechia,greasy coating,string-taut pulse.The syndromes were mainly of Biao-Superficial excess,including qi stagnation,phlegm retention and blood stasis,occupying 66. 7%,accompanied with Benroot deficiency,including qi deficiency,yin deficiency,qi and yin both deficiency,occupying 33.3%.Conclusion Qi stagnation, phlegm retention and blood stasis are the primary syndromes of CSX.

Objective To identify risk factors associated with the severity of acute kidney injury (AKI) in-duced by crush syndrome and whether the patient required hemodialysis (HD). Method A retrospective study was designed. Within 19 days after the Chinese Wenchuan earthquake (May 12, 2008), 63 victims (33 men, 30women) of 2139 cases were hospitalized at Mianyang Central Hospital (Siehuau, China) because of crush syn-drome caused by crush injuries. The patients with renal dysfimcfion before the earthquake were excluded. Totally 63 patients with AKI associated with crush syndrome were included in this study and were divided into two groups: group 1, 25 patients, requiring HD (when urine volume <250 mL/d;serum potassium> 6 mmol/L) ; and group 2, 38 patients, without HD. The following data were collected retrospectively for all patients: (1) epidemiological parameters: age, gender, race, time under the rubble, liquid treatmem before being rescued; (2) clinical param-eters: blood pressure, body area crushed, amputation, fasciotomy, blood transfusion, quantity of fluid infusion, urine output in the first 24 hours; (3) initial laboratory data: complete blood count, urine analysis, serum chem-istry, arterial blood gas analysis. Comparisons between the two groups were made using SPSS 10.0. The quantita-tive data and categorical data were analyzed using t tests and χ2 tests, respectively. P -values < 0.05 were consid-ered to indicate significant differences. The significant variables were entered into logistic regression models to de-termine the risk factors for the severity of AK1 in patients with crush syndrome and whether the patient required HD. Results Four significant risk factors with P -values < 0.05 were identified: fasciotomy, cystatin C (Cys C)level, myoglobin (MB) level and lactic acidosis. The odds ratios (95% confidence intervals) were 8.641 (3.027～76.479), 6.956 (3.027～76.479), 5.379 (3.027～76.479) and 4.833 (2.569～32.764), respectively. Conclusions In addition to urine output and potassium levels, we found that four risk factors, namely faseiotomy, Cys C and MB levels, and lactic acidosis, were significanfly associated with the severity of AKI and whether the patient required hemodialysis.

OBJECTIVETo analysis and discuss the early diagnosis and treatment of fat embolism syndrome caused by the injuries in Wenchuan earthquake happened in May 12th, 2008.

METHODSTo carry out dynamic blood and oxygen analysis and blood routine examination for the 13 fat embolism syndrome patients wounded in the earthquake, and combine with clinical features and early diagnosis, inject hydrocortisone injection, dextran 40 glucose injection and Dan Shen Root injection. Meanwhile, pay attention to supporting the respiratory function and correcting hypoxemia.

RESULTSOf 13 patients, 12 cases were rescued successfully, and the successful rate was 92.3%, while one cases died from respirometric failure with fat embolism syndrome and secondary hemorrhagic pneumonia.

CONCLUSIONSThe key to treating fat embolism syndrome is the early diagnosis and timely and accurate treatment. Supporting the respiratory function, correcting hypoxemia and early high-dose combination of hormone treatment are the effective treatment methods.

Adult ; Early Diagnosis ; Earthquakes ; Embolism, Fat ; diagnosis ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Wounds and Injuries ; complications

OBJECTIVESTo investigate the effect of particle size distribution (PSD) of dental poly (methyl methacrylate) (PMMA) beads on the microstructure of denture.

METHODSIt was compared and analyzed that the porosity of three groups of spherical specimens which were made of PMMA beads with different PSD at proper polymer/monomer ratios. And the final microstructure of each group was investigated using Digital High Definition Microscope.

RESULTSWith proper polymer/monomer ratio increasing, the occurrence of porosity tended to decrease. The final microstructure of denture varied with PSD of PMMA beads.

CONCLUSIONBy means of optimizing PSD of beads, the microstructure of denture could be improved, and the occurrence of porosity could be reduced.

Dental Materials ; chemistry ; Dentures ; Particle Size ; Polymethyl Methacrylate ; chemistry

OBJECTIVETo analyze the location, early diagnosis and treatment of osteofascial compartment syndrome (OCS).

METHODSThere were 38 males and 29 females with age range of 8 - 69 years (mean 38.1 years). All 67 cases were suffered from Wenchuan earthquake happened in May 12th, 2008, of which 34 focuses with tibia-fibular fracture, 9 focuses with femoral fracture, 4 focuses with humeral fracture, and 13 focuses with radius and/or ulna fracture. The occurred place of OCS involves calf (41 focuses), legs (25 focuses), hands (2 focuses), feet (3 focuses), hip (19 focuses), forearms (15 focuses) and upper arms (10 focuses). The clinical symptoms and characteristics were closely observed and treated with decompression posterior to conservative treatment or with prompt open decompression.

RESULTSOf 67 cases (115 focuses), 82 focuses with secondary suture won satisfactory recovery of blood circulation and extremity function, 23 wounds were closed with secondary suture and skin grafting, 5 limbs were amputated due to avascular necrosis and 2 cases died (5 focuses OCS). Of 115 focuses 11 focuses obtain part function, 7 focuses lost join function.

CONCLUSIONSThe proportion of some rare parts' pathogenesis of osteofascial compartment syndrome caused by the earthquake rises. Early diagnosis, close observation and open decompression are important for treatment of osteofascial compartment syndrome.

Adolescent ; Adult ; Aged ; Child ; Compartment Syndromes ; diagnosis ; etiology ; surgery ; Decompression, Surgical ; Early Diagnosis ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Wounds and Injuries ; complications

AIMTo investigate the effect of resveratrol on EMMPRIN expression of macrophages.

METHODSHuman monocytic cell line THP-1 cells were co-cultured with EMMPRIN-highly-expressed MCF-7 cells; MMP-9 production was assayed by zymography. THP-1 cells were induced by PMA, expression of EMMPRIN was assayed by Western blotting. Cells were treated with resveratrol or PPARgamma agonist--pioglitazone during differentiation, EMMPRIN expression and MMP-9 activity were assayed. U937 cells were co-transfected with PPARy expression and luciferase-coding reporter vector, then cultured with pioglitazone or resveratrol, the activating capability of resveratrol on PPARgamma was evaluated by measuring the luciferase activity. THP-1 cells were pretreated with PPARgamma antagonist--GW9662 before pioglitazone or resveratrol treatment, then assayed for EMMPRIN expression and MMP-9 production.

RESULTSEMMPRIN expression was greatly increased during the differentiation from monocytes to macrophages; co-culturing with MCF-7 cells significantly increased MMP-9 production by monocytes. Both resveratrol and pioglitazone markedly inhibited EMMPRIN expression during monocytes differentiation. Resveratrol significantly activated PPARgamma and GW9662 greatly decreased the effect of resveratrol on EMMPRIN and MMP-9.

CONCLUSIONEMMPRIN expression is greatly up-regulated from monocytes to macrophages, which may play a role in inducing MMPs production by monocytes/macrophages. Resveratrol can significantly inhibit EMMPRIN expression via activating PPARgamma, which may be the underlying mechanism of its inhibitory effect on MMPs production by monocytes/macrophages.

Anilides ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Basigin ; biosynthesis ; genetics ; Blotting, Western ; Breast Neoplasms ; metabolism ; pathology ; Cell Differentiation ; drug effects ; Cell Line ; Cell Line, Tumor ; Coculture Techniques ; Dose-Response Relationship, Drug ; Female ; Humans ; Luciferases ; genetics ; metabolism ; Macrophages ; cytology ; drug effects ; metabolism ; Matrix Metalloproteinase 9 ; biosynthesis ; Monocytes ; cytology ; drug effects ; metabolism ; PPAR gamma ; genetics ; metabolism ; Recombinant Fusion Proteins ; genetics ; metabolism ; Stilbenes ; pharmacology ; Thiazolidinediones ; pharmacology ; U937 Cells

OBJECTIVETo evaluate the expression of vascular endothelial growth factor C (VEGF-C) and peroxisome proliferators-activated receptors (PPARgamma) in extrahepatic cholangioadenocarcinoma (EHCAC) and to elucidate its correlation with clinicopathological factors and their significance in prognosis.

METHODSThe expressions of PPARgamma and VEGF-C were detected by immunohistochemistry in 69 cases of EHCAC, 12 cases of non-tumor bile duct epithelium, and their relationship to clinicopathological parameters and follow-up were analyzed.

RESULTSThe positive rate of PPARgamma expression in 69 cases of EHCAC was 59.4%, significantly higher than that in 12 cases of non-tumor bile duct epithelium (0%), (P < 0.01). The positive rate of VEGF-C in 69 cases of EHCAC was 84.1%, also significantly higher than 16.7% in 12 cases of benign bile duct epithelium (P < 0.05). PPARgamma expression was associated with clinical TNM stage and lymph node metastasis. VEGF-C expression was associated with lymph node metastasis. Cox analysis results showed that portal vein and/or hepatic artery invasion, lymph node metastasis and VEGF-C expression were independent prognostic factors of EHCAC (P < 0.05).

CONCLUSIONPPARgamma expression may play an important role during tumorigenesis of extrahepatic cholangioadenocarcinoma. The expressions of PPARgamma and VEGF-C are significantly correlated with the clinicopathological characteristics and biological behavior of EHCAC. Expression of VEGF-C is an independent prognosis factors in EHCAC. The detection of PPARgamma and VEGF-C is valuable for evaluation of prognosis of EHCAC.

Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; metabolism ; pathology ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; PPAR gamma ; metabolism ; Proportional Hazards Models ; Survival Rate ; Vascular Endothelial Growth Factor C ; metabolism

Clinical reports on cardiac syndrome X (CSX) have been increasing in recent years. In general, CSX does not increase the cardiovascular mortality, but it can affect the patient's quality of life (QOL) and increase the incidence rates of cardiovascular and cerebrovascular events. Although a variety of drugs and therapies have been utilized in the clinical treatment, the management of CSX still represents a major challenge due to its unclear pathogenesis. It is necessary to explore more effective treatment programs. Many attempts have been made on trials of the Chinese medicine (CM) treatment for CSX and proved that CM has a certain advantage in efficacy to improve clinical symptoms and QOL. CM may provide a new approach for the effective treatment of CSX.
Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; Metabolic Syndrome ; physiopathology ; therapy ; Quality of Life