Objective To evaluate the clinical value of Nevin and AJCC staging system for gallbladder carcinoma. Methods In this study 90 patients diagnosed as gallbladder carcinoma underwent operation in Renji Hospital from February 2000 to October 2006. Patients were staged according to Nevin and AJCC staging system. The difference of survival rate, tumor resection rate, ratio of tumor-free resection margin and surgical procedures were analyzed. Results The survival rate, tumor resection rate and ratio of tumor-free resection margin decreased progressively with increasing Nevin and AJCC stage (P < 0. 05). There was no significant difference between the survival rate for Nevin Ⅲ or Ⅳ patients undergoing radical resection and simple cholecystectomy (P > 0. 05). In Nevin Ⅴ patients, the survival rate for radical and extensive radical resection patients was higher than for palliative patients (P < 0. 05). In AJCC Ⅲ patients, the survival rate for radical patients was significant higher than for palliative patients (P < 0. 05). Nosignificant difference was found between radical and palliative patients in survival time in AJCC Ⅳ (P > 0. 05). 52 patients in AJCC Ⅲ and Ⅳ were staged to Nevin Ⅴ according to Nevin staging system. The survival rate and resectable rate for the patients in AJCC Ⅲ were higher than in AJCC Ⅳ (P = 0. 0001, 0. 001 respectively). The rate of radical operation in AJCC Ⅲ was higher (P = 0. 001), and the rate of palliative operation in AJCC Ⅳ was higher (P = 0. 001). Conclusion Both Nevin and AJCC staging system are useful in the judgement of survival, reeectability, ratio of tumor-free resection margin and the optimal operation. AJCC staging system is more applicable for gallbladder carcinoma patients at advanced stage in terms of predicting prognosis.

AIM: To analyze the postoperative infection of pathological myopia with pocket scleral reinforcement. ·METHODS:The clinical data of 167 cases of pathological myopia treated with pocket scleral reinforcement in June to December 2014 were analyzed. The postoperative infection rate, the resistance of pathogenic bacteria were analyzed, and the related factors of infection were analyzed. ·RESULTS: A total of 286 eyes were obtained in 167 patients. The infection rate was 6. 3% in 10 patients ( 18 eyes) . There were 30 pathogenic bacteria isolated from the 18 infected eyes, in which were 10 Staphylococcus aureus, 10 Staphylococcus epidermidis, 6 Klebsiella pneumoniae, 4 Pseudomonas aeruginosa infection. Gram positive bacteria showed higher resistance to penicillin, ampicillin and ciprofloxacin, and were sensitive to vancomycin. The resistance rates of gram negative bacteria to cefotaxime were higher, but to imipenem was low. The two groups of patients age, culture level, operation time, the number of operation, intraoperative nursing staff seniority, postoperative medication compliance rate was statistically significant (P<0. 05), which related to the infection after pocket scleral reinforcement. ·CONCLUSION:The infection caused by Staphylococcus aureus is the most common after pocket scleral reinforcement, and it is sensitive to vancomycin, and gram negative bacteria is sensitive to imipenem. Shortening the operation time, using the experienced nursing staff to cooperate, reducing the number of operation and improving the compliance of the patients can reduce the postoperative infection.

Objective To assess the therapeutic effect of esomerphrazole in treating patients with gastroesophageal reflux disease (GRED) between Han and Inner Mongolia populations.Methods Those who underwent endoscopic examination and had reflux disease questionnaire (RDQ) >12 from March 2006 to March 2008 were selected. The patients were divided into Han group and Inner Mongolia group with 120 each. All patients were received esomerphrazole 20 mg daily for 6 weeks. The patients were evaluated by RDQ questionnaire at 2nd, 4th and 6th week, and were reexamined by gastroscopy at 6th week. Results After two weeks, effective rate of 50% was achieved in both groups, but it was higher in Han group than in Inner Mongolia group at 4th and 6th week. After 6 weeks, the curative rate of RE was higher in Han group than in Inner Mongolia group. Conclusion The different nations ancl habits result in the different efficacy of esomerphrazole, which may be improved by prolonging time of medication and changing habits.

Child, Preschool ; Dwarfism ; congenital ; diagnosis ; Humans ; Male ; Osteochondrodysplasias ; congenital

Administrative Personnel ; psychology ; Burnout, Professional ; Female ; Humans ; Male ; Reproducibility of Results ; Research Personnel ; psychology ; Surveys and Questionnaires

Objective: To study the reasons and prevention of residual stones after choledo- choscopic treatment of cholelithiasis. Methods:The clinical data of 219 patients who had under- gone choledochoscopic treatment were analyzed retrospectively. Results: 21 cases were found with residual stones in the bile duct after the operations. Residual stone rate was to 9.58% . Bile duct stones of 8 patients could not be removed completely during operations. 13 patients were proved that stones still remain in their bile ducts by T-tube cholangiography and choledochoscope after opera- tions. There were 5 patients with acute obstructive suppurative cholangitis accompanying septic shock, 5 patients with stenosis in intrahepatic bile ducts, 4 patients with stones of in trahepatic bile duct and variation of bile duct, 2 patients with stones in sphincter of duodenal papilla,2 patients withstones and stenosis at the inferior segment of choledochus,3 patients were founded residual stones in bile duct obviously after the operations. Conclusions: B-type ultrasonic scanning and T-tube cholangiog- raphy are useful to reduce the rate of residual stones.

AIM: To investigate the effect of Gengnianle Granule on hypothalamic-pituitary-ovarian(HPO) axis in climacteric rats.METHODS: 12-15 months SD female rats were randomized into climacteric group and young control group was selected additionally.After being administrated for thirty days,the level of E_2、P、Te、FSH、LH in serum were examined by the radio-immunity method,the expression of GnRH in hypothalame,the expression of ER in hypothalame and pituitary appendage were examined by the immunohistochemical method. RESULTS: Compared with climacteric group,Gengnianle Granule could increase the level of E_2、P in serum(P

OBJECTIVE To investigate the resistant mechanisms of Candida albicans to azoles at molecular level.METHODS NCCLS M-27 protocols were used to test the in vitro susceptibilities of 102 C.albicans strains isolated from the patients with recurrent vulvovaginal candidiasis(RVVC) against fluconazole(FLC) and itraconazole(ITC) to screen the FLC-and ITC-resistant C.albicans isolates;six pairs of primers,A1-A2,B1-B2,C1-C2,D1-D2,E1-E2 and F1-F2 were respectively to amplify gene CYP51 of 4 strains with FLC-and ITC-resistance.The PCR products were sequenced and analyzed to identify the mutation sites by compared with the sequence of gene CYP51 of referenced C.albicans strain in NCBI site of Internet.RESULTS The analysis of full length sequence of CYP51 from 4 FLC-and ITC-resistant strains showed that from total 32 mutation sites there were 4 significant site mutations,where the mutation of GAT to GAC at 116 caused the substitution of D by E(E266D in two strains);GCC to GGT at 117 caused the substitution of A by G(A117G in 1 strain);GAA to GAC at 266 caused the substitution of E by D(E266D in 2 strains);and GTT to ATT at 488 caused the substitution of I by V(V488I in 1 strain).The site mutations of 266 and 488 were tested in 1 strain of 4 strains.CONCLUSIONS The CYP51 total gene of 4 strains has been checked out.Of FLC and ITC-resistant C.albicans alignment in this time,find out 4 significant bp mutations.Causing its amino acide change,among them,A117G has not be interrelated report still now.The details of mechanism need to be further studied.

Objective To discuss the clinical application of individualized strategy of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of bile duct stenosis after liver transplantation (LT).Methods Fifty-two patients,including 40 men and 12 women,aged 54.3 ± 9.1 years old,who suffered from bile duct stenosis and accepted 88 times of ERCP from June 2014 to May 2016 in our department were investigated.The procedures,clinical features and biochemical criteria were analyzed retrospectively.Results According to the treating occasions and clinical symptoms,single plastic stent,dilatation combined with single plastic stent,and dilatation combined with multiple plastic stents were chosen to use.ERCP in 8 patients out of 52 patients failed technically,and the therapeutic efficacy was 82.7％.The treatment duration was 8.2 ± 2.9 months.The recurrence rate was 4.7％ (2 cases) during the follow-up period.The most common complications were postERCP pancreatitis (2.3％) and cholangitis (3.4％),which would be cured by conservative treatment in most cases.Conclusion ERCP,as an effective and safe method,could be used as the first choice or bridge treatment for bile duct stricture after LT.We recommend individualization strategy,including step by step mode and different combinations of PTC or endoscopic procedures,in order to improve clinical efficacy of all kinds of stricture.

Objective To study the dynamic changes of soluble intracellular adhesion molecule-1 (sICAM-1), and to assess its role in the pathogenesis of hemorrhagic fever(HFRS) with renal syndrome. Methods A total of 30 patients with HFRS(case group) and 20 healthy subjects (control group) from Worker Hospital of Finance & Commerce of Qiqihar city were included in the study during 2006 - 2007. Double-antibody sandwich ELISA method was used to measure the level of sICAM-1 in serum samples. Results The serum levels of sICAM-1 in patients with HFRS in early stage, critical stage, convalescent stage were(47.56±6.51), (94.23±15.36), (54.19±8.42)ng/L,respectively. The serum level of sICAM-1 in control group was (22.63±3.40)ng/L. The above values were compared between any two groups, differences were statistically significant (all P < 0.01). The serum level of urea nitrogen in patients with HFRS in early stage, critical stage, convalescent stage were (5.16±0.12), (33.84±9.24),(8.20±1.30)mmol/L, respectively. The serum level of urea nitrogen in control group was (4.20±0.56)mmol/L.The above value were compared between any two groups, the differences were statistically significant (all P< 0.01). Conclusions sICAM-1 is involved in the pathogenesis of HFRS as protective factors. Cellular immune playes an important role in the pathogenesis of HFRS.