Gallbladder cancer is the most common malignant neoplasm in biliary system,with a high degrade of malignancy,invasion and metastasis.The prognosis is heartbreaking.Radical surgery is the only possible way for curing.The current understanding of China's doctors at all levels on radical surgery of gallbladder cancer is chaotic.Based on the latest version eighth TNM staging of the American Joint Committee on Cancer(AJCC)of gallbladder cancer,making a review of the literature,combined with the author's personal experience,we have interpreted the reasonable selection of hepatectomy of gallbladder cancer,in order to improve the doctors at all levels to regulate the understanding of hepatectomy and the prognosis of gallbladder cancer.

Humans ; Lymphohistiocytosis, Hemophagocytic ; Male ; Middle Aged

Objective To evaluate the efficacy and clinical value of percutaneous transluminal angioplasty(PTA)with stenting for the treatment of superior vana cava syndrome(SVCS)with malignant causes.Methods A total of 13 patients with SVCS with malignant causes were enrolled in this study.Among the patients,2 had mediastinal cancer,and 11 had metastatic mediastinal tumor.The malignancy of the primary tumors of the 11 patients,including pulmonary cancer in 8,esophageal cancer in 2,and breast cancer in 1,were all confirmed by pathological examination.Via the right femoral vein,a pigtail catheter was introduced percutaneously into the proximate or remote end of the stenotic segment for the visualization of the SVC.After the location,length,and gravity of the stenosis were determined,Wallstent(Boston Scientific,USA)was placed into the SCV,if the patients had no local thrombosis in the stenotic segment.In one patient,a Z-shape stent(COOK,USA)was inserted simultaneously.For the cases complicated with thrombosis,the Wallstent was inserted after local thrombolysis.Results The procedure was completed in all the 13 patients with a success rate of 100%.The average length of the stenotic segment was 4.3 cm(3-6 cm).In one patient,two stents were used,while in the others only one stent was inserted.Thrombolysis was carried out before stenting in 6 patients.The intravenous pressure at the proximate end of the stenotic segment was determined with the patients supine before and after stenting.The pressure decreased from(26.2?1.6)cm H2O to(4.3?0.8)cm H2O after the operation.Postoperative angiography showed no collateral vein in the patients.The SCVS disappeared 0 to 3 days after the surgery.The patients were followed up for 8-26 months with a median of 13.During this period,8 patients died of multiple organ failure caused by multiple metastasis of the primary tumor in 4 to 10 months;the other 5 patients survived(3 of them received further therapies)without recurrence of SCVS.Conclusion PTA with stenting combined with local thrombosis is an effective and invasive treatment for patients with SCVS with malignant causes.

Child, Preschool ; Female ; Fructose Intolerance ; pathology ; Humans

Objective To explore the clinical application and value of endoscopic surgery in the treatment of hypertensive cerebral hemorrhage assisted with neuronavigation,we compared it with traditional craniotomy.Methods We collected hypertensive cerebral hemorrhage patients with the application of neuronavigation assisted endoscopic surgery from January 2012 to November 2015,and randomly selected 30 cases as experimental group;and collected hypertensive cerebral hemorrhage patients with craniotomy and then randomly selected 30 cases as the control group.What did we respectively record about the two groups were postoperative GCS score,skin incision length,operation time,bleeding volume,length of stay,postoperative complications,and KPS score of the postoperative follow-up of sixth months;after that,the dates of the two groups were compared and analyzed.Results Compared the experimental group to the control group,postoperative GCS score did not achieve statistically significant difference (P ＞ 0.05);in the skin incision,there was statistically significant difference between two groups (P ＜ 0.05),the average incision length in the experimental group was (4.25 ±0.44) cm,however it was (13.27 ± 1.01) cm in the control group;as for the operation time,it was averagely (93.93 ±21.04) min for the experimental group,and (176.50 ± 35.65) min for the control group,there was statistical difference between two groups (P ＜0.05);with regard to the amount of intraoperative bleeding,the mean amount in the experimental group was (69.83 ± 23.83) ml,and (196.17 ± 33.83) ml in the control group,the difference was statistically significant (P ＜ 0.05);and the average hospitalization days for the test group was (13.33 ± 1.79) d,(16.20 ± 4.31) d for the control group,it was considered statistically significant (P ＜ 0.05);in complications,the test group incidence was significantly lower than that in the control group,the difference between the two groups has statistical significance (P ＜ 0.05);after postoperative follow-up of 6 months,we found that the prognosis of experimental group is better than that of control group,and statistical significance was described by analyzing the KPS scores of two groups (P ＜ 0.05).Conclusions Neuronavigation assisted endoscopic technique in the treatment of hypertensive cerebral hemorrhage has many advantages,such as accurate localization,direct vision,perfect hemostasis,and less bleeding.It is minimally invasive and can also shorten the operation time as well as lengths of stay.Besides,it can reduce the incidence of complications and bring better postoperative recovery.

Using the enterprise resource planning(ERP)management mode,the paper analyzed the present medical insurance payment audit accounts at public hospitals,and probed into the establishment of an information management platform for medical insurance payment audit accounts in the ERP environment.The purpose is to perfect the management of medical insurance payment audit accounts,increase the efficiency of hospital's working capital,strengthen the quality and efficiency of hospital management.

Objective To analyze the specific peptide of cystatin C (CysC) and its characteristics by bioinformatics technology,and verify the predicted results by mass spectrometry.Methods Online software was applied to analyze the physicochemical properties and homology of CysC peptides hydrolyzed by trypsin and predict the associated parameters of ionized fragmentation of specific peptide by mass spectrometry.Precursor ion scan and product ion scan were conducted on the samples of synthetic specific peptide.The recombinant human CysC and serum samples were analyzed by mass spectrometry after trypsin digestion.The results of analysis were compared with the outcomes predicted by bioinformatics.Results T3 (ALDFAVGEYNK) was considered as the specific peptide of CysC by software analysis.When selecting[M + 2H] 2 + for product ion scan,almost all the y and b ions of fragmentation were observed using tandem mass spectrometry (MS/MS),showing consistency with Skyline predictions.Moreover,both the peptides from the human recombinant CysC and serum sample following the trypsin digestion were eluted at the same time with the isotope-labeled T3 * under the fixed conditions.Conclusion Bioinformatics technology could be available for picking out the specific peptides of target protein quickly and efficiently and predicting the ionized fragmentation precisely by mass spectrometry scanning.

Objective To study the profiles of decompression sickness(DCS) in various kinds of animals and to find out the target organ of decompression sickness by providing a basic experimental method for establishing animal models.Method Eleven kinds of animals were exposed to different pressures for different times at different compression/decompression rates.They were monitored at the precordial regions with Doppler flow meter for bubble sounds after decompression to normal pressure,to obtain a record about the developing course of the DCS.Pathological examinations of the bulbar conjunctiva were also made. Result Bubble sound of grade IV were recorded at the precordial regions after decompression.Among them,75%~100% incurred DCS with a diverse extent. Animals developed DCS showed vascular spasm,dysfunction and endothelial tumefaction.Conclusion Each of the 11 kinds of animals can serve as a model of DCS and the processes of development of DCS in various animals are similar.Blood vessels are the target organs of decompression sickness.

Bibenzyl is a type of active compounds abundant in Dendrobium. In the present study, we investigated the inhibitory effects of six bibenzyls isolated from Dendrobium species on vascular endothelial growth factor (VEGF)-induced tube formation in human umbilical vascular endothelial cells (HUVECs). All those bibenzyls inhibited VEGF-induced tube formation at 10 micromol x L(-1) except tristin, and of which moscatilin was found to have the strongest activity at the same concentration. The lowest effective concentration of moscatilin was 1 micromol x L(-1). Further results showed that moscatilin inhibited VEGF-induced capillary-like tube formation on HUVECs in a concentration-dependent manner. Western blotting results showed that moscatilin also inhibited VEGF-induced phosphorylation of VEGFR2 (Flk-1/KDR) and extracellular signal-regulated kinase 1/2 (ERK1/2). Further results showed that moscatilin inhibited VEGF-induced activation of c-Raf and MEK1/2, which are both upstream signals of ERK1/2. Taken together, results presented here demonstrated that moscatilin inhibited angiogenesis via blocking the activation of VEGFR2 (Flk-1/KDR) and c-Raf-MEK1/2-ERK1/2 signals.