0.05).(2) After treatment for 7 days,APACHEⅡ score was decreased in the two groups(P

Liver tissues around hydatid from 8 patients with cystic echinococcosis were observed by transmission electron microscopy,normal hepatic tissues of 6 cases were used as control.The results demonstrated predominant atrophy and necrosis of hepatocytes.These changes seem to be the major hepatic lesion in cystic echinococcosis.

Objective To investigate the long-term effects and risk factors of arterial polyvinyl alcohol resin (PVA) embolization for ⅢB and IV non-small cell lung cancer(NSCLC) patient.Methods 126 patients with 1 B or V NSCLC were performed the perfusion with 5-FU,THP,DDP by PVA grain embolization under fluoroscopic control.All patients were followed up.Kaplan-Meier was used to calculate the survival rate and the median survival time,and Cox regression model was adopted to analyze related risk factors which affected curative effect.Results The median survival time was( 11.78 ± 3.24) months and 1 -,2-year survival rate was 39.1 ％,25.59％ in 126 patients with NSCLC.Cox model analysis showed that of the tumor staging,tumor size,location and combination chemotherapy were all independent risk factors of prognosis (all P ＜ 0.01 ).Conclusion Arterial embolization of PVA for treatment of NSCLC is effective.Tumor size,stage,location and combination chemotherapy are associated with prognosis of NSCLC.

OBJECTIVE: To build up a simple and effective comprehensive system for predicting difficult laryngeal exposure under suspension laryngoscopy. METHOD: One hundred and twenty cases of laryngeal tubor were selected. Using Logistic regression method to analyse relative factors, including weight, height, BMI, neck girth, neck upward degree, upper-lower incisor teeth distance, thyroid-mentum distance, thyroid-sternum distance, Mallampati test, Yamamoto test and Upper lip bite test. Build data-base to construct a comprehensive system for predicting difficult laryngeal exposure under suspension laryngoscopy. RESULT: The relative factors of difficult laryngeal exposure were BMI, neck girth, upper-lower incisor teeth distance, neck upward degree, thyroid-mentum distance, Mallampati test and Yamamoto test (P < 0.05). To build up a comprehensive system for predicting difficult laryngeal exposure under suspension laryngoscopy. The predicting standards included the seven relative factors, each factor has 1 score, 2 score, 3 score. Higher score means more risk. Eight score was designed as minimum, under the premise,the sensibility, misdiagnosis rate, missed misdiagnosis rate, specificity of the experiment were 95.5%, 5.3%, 4.5%, 94.7%. CONCLUSION The comprehesive system is an effective method for predicting difficult intubation. It can help to identify difficult cases according to the results of this predicting system.
Anthropometry ; Chin ; Humans ; Intubation, Intratracheal ; methods ; Laryngoscopy ; methods ; Larynx ; Lip ; Neck ; Thyroid Gland

Medical science have two sides in its nature. It is not only a subject of science, but also a social science. Medical science need social science to nourish it. At present, unsuitable language is the main cause which lead to medical tangles. The medical workers' attitude towards patients is the key factor during the solving course. Most of the medical tangles do not lead to accusing in the beginning. Both patients and the hospital wish to solve the tangle by intercession or compromise instead of law ways. Appropriate language could avoid non-malpractice tangles. It also play an important role in solving the medical tangles.

This study was aimed to observe the effect of Tao-He Cheng-Qi Decoction (THCQD) on tissue injury of different organs among rats with sepsis. A total of 100 Kunming male SD rats of clean grade were randomly divided into five groups, which were the normal control group, model 6 h control group, model 12 h control group, THCQD 6 h group and THCQD 12 h group. The normal control group received no treatment. The classic CLP method was ap-plied in the establishment of sepsis rat model in other groups. Intragastric administration of saline 1 ml/100 g (weight) was given to each rat in the model group every day. Intragastric administration of THCQD 1 ml/100 g (weight) was given to each rat in the THCQD group every day. The model was established after 7 days. Tissue speci-mens of lung, heart, kidney, liver, and small intestine were collected at 6 h and 12 h after modeling, respectively. Pathomorphological changes of each group were observed by light microscopy and electron microscope. The results showed that compared with the model group at the same time point, pathomorphological changes of tissues of the lung, heart, kidney in THCQD group were not significant. However, pathomorphology of tissues of the liver and small intestine changed significantly in the THCQD 12h group. And there were statistical differences (P < 0.05) between two groups in the score of pathomorphology. It was concluded that THCQD had protective effect on tissues of the liv-er and small intestine among rats with sepsis. However, the mechanism is not clear and requires further research.

ObjectiveTo evaluate the long-term therapeutic efficacy of muscle-region alignment needling plus dermalneedle therapy in treating post-stroke upper-limb spasticity.MethodTotally 488 patients with post-stroke upper-limb spasticity were randomized into a treatment group and a control group, 244 in each group. Besides theessentialrehabilitation treatment, the treatment group was intervened by muscle-region alignment needling plus dermal needle therapy, while the control group was given regular Western medication.Thetwo groups were intervened for 3 weeks and were followed up for 6 months. The neurologic function, Functional Comprehensive Assessment (FCA), and Stroke Speciality-Quality of Life (SS-QOL) were observed for the follow-up study.ResultThe total effective rate was 93.4% in the treatment group versus 61.5% in the control group, and the difference was statistically significant (P<0.05); the neurologic function, FCA score, and SS-QOL score in the treatment group were significantly superior to that in the control group at the end of the follow-up study (P<0.05).ConclusionMuscle-region alignment needling plus dermal needle therapycan produce a content long-term therapeutic efficacy in treating post-stroke upper-limb spasticity.

Objective To analyze predictive factors on survival in patients with completely resected high-risk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy.Methods According to random number table, 76 cases with completely resected high-risk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy were selected, who newly diagnosed and hospitalized in 2004. Their disease-free and overall survivals were followed up.Thymidylate synthase gene polymorphism and microsatellite instability were tested in these cases with microdissection combined with polymerase chain reaction and capillary electrophoresis. Correlation of these factors including clinical characteristics, thymidylate synthase gene polymorphism and microsatellite instability to survival was analyzed with SPSS13.0 software. Results Histologic grades and evaluated lymph node number had significantly difference between two groups of distinct prognosis (χ2 = 7.827, P =0.003 and χ2 = 9.265, P =0.018, respectively), which were also independent predictors on survival proved by COX regression analysis (χ2 = 40.472, P =0.000 and χ2 = 39.528, P =0.000, respectively).Kaplan-Meier survival analysis showed that the median disease-free and overall survival of poor-differentiated adenocarcinoma patients were significantly shorter than those of high and intermediate-differentiated ones (27.67 vs 61.13months, χ2 = 45.015, P =0.000 and 43.13 vs 64.21 months, χ2 = 35.514, P =0.000, respectively), as well, the median disease-free and overall survival of patients with the evaluated lymph node number less than 11 were poorer than those of more than 11 ( 45.65 vs 68.47 months, χ2 = 23.134, P =0.011 and 53.10 vs 70.18months, χ2 = 22.896, P =0.013, respectively).Conclusion Poor-differentiated adenocarcinoma and evaluated lymph node number less than 11 may be predictors on poor survival in patients with completely resected highrisk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy.

This study retrospectively reviewed 9 cases of complicated hepatic cystic hydatidosis with intrabiliary rupture who were surgically treated with pericystectomy in combination with Roux-en-Y hepaticojejunostomy in our hospital from 2004 to 2010. The clinical features, results of laboratory tests, B-mode ultrasonography and CT, post-operative recovery, days of hospital stay after the operation and post-operative complications were statistically analyzed and the patients were followed up. The subjects in our series included 7 males and 2 females, whose average age was 50.78±7.58 years. Before operation, 9 patients suffered from pain of the right upper quadrant and jaundice, which, in 4 cases (44.45%), were accompanied with fever and chills. Preoperative B-mode ultrosonography and CT showed that all the 9 patients had single hydatid cyst, with their diameter being 9.33±1.58 cm on average. The lesions involved segments V, VI in 6 cases, and segment IV in 3 cases. By WHO classification, 7 cases were classified as CE3 and 2 cases as CE4. They all had choledochectasia. The subjects underwent the surgery uneventfully. Intraoperatively, 2-4 biliary fistula orifices were found, with the average of the orifice being (0.79±0.20) cm. After the operation, one patient developed incision infection, one had pulmonary infection and one suffered from reflux cholangitis. No anastomotic leaks or peri-operative deaths took place and follow-up revealed no recurrence and implantative metastasis. We are led to conclude that pericystectomy in combination with Roux-en-Y hepaticojejunostomy can achieve satisfactory results for the treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture.

Objective To explore the value of laparoscopy in the diagnosis and treatment of recurrent inguinal hernia in children.Methods The clinical data of 67 cases receiving laparoscopic treatment for recurrent inguinal hernia in children at the Department of General Surgery,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science & Technology were retrospectively analyzed,including the type of hernia recurrence,operation time,intraoperative and postoperative complications,such as short-term hydrocele formation and testicular atrophy and so on.Results In 67 cases,there were 65 males and 2 females.Open repair surgery and laparoscopic surgery were respectively performed in 48 cases and 19 cases for the first operation and the hernia defects were found after operation.Contralateral patent vaginal process deformities were found in 11 sides in the reoperation.Among 67 cases of recurrent inguinal hernia,incomplete ligation of hernia sac was found in 21 cases,low level ligation of hernia sac in 17 cases,no ligation of hernia sac in 14 cases,omissive direct inguinal hernia in 4 cases,loose ligation of hernia sac in 4 cases,overlarge inner ring in 4 cases,weak abdominal muscles in 2 cases,and increased abdominal pressure (long-term constipation,asthma) in 1 case.All the patients were treated by laparoscopic hernia repair and no serious complications occurred during the operation.The average time of unilateral operation was (15.0±2.2) minutes (13-25 minutes),and bilateral operation was (27.0±4.3) minutes (18-41 minutes).All patients were discharged on the second day.Two patients showed short-term postoperative hydrocele and were cured with conservative treatment.During the follow-up time of (23±2) months (9-39 months),no recurrence or testicular atrophy was found.Conclusions Laparoscopy can confirm the type of recurrent inguinal hernia and contribute to reduce postoperative recurrence.Laparoscopic management of recurrent inguinal hernia in children is safe and feasible,which is expected to replace open hernia repair.