Objective To evaluate the therapeutic effect of radiofrequency endovenous obliteration (RFO) on superficial varicosities in lower extremity in the elderly. Methods The clinical data of 35 elderly patients (43 limbs) with primary great saphenous varicose vein, who were treated with RFO (20 limbs) or RFO in combination with high ligation procedures (23 limbs), were analyzed retrospectively. The therapeutic effects were evaluated at 1-3 years after RFO by the improvement of clinical symptom and signs, as well as results of color Doppler ultrasonography. Results Compared with single RFO group, the obstruction rate of great saphenous vein was higher [21(91.3%) vs. 14(70.0%), χ2 =5.467, P < 0. 05], and the recanalization rate was lower [2(8.7%) vs. 8(30.0%),χ2=4.251, P<0.05] in RFO combined with high ligation group. The recurrence rate of local varicose veins was lower[0 vs. 4(20. 0%),χ2 =7. 030, P<0. 013 in RFO plos high ligation group than in single RFO group. Conclusions RFO is an effective treatment with less trauma, more safety and less scars. Combined with high ligation procedure, the effectiveness may be better.

Background and purpose:Reduced peripheral blood platelet count is a common toxicity in patients with hematological malignancy after chemotherapy.The purpose of this study was to observe the eff icacy and safety of recombinant human thrombopoietin(rhTPO)in the treatment of thrombocytopenia induced by chemotherapy.Methods:A total of 25 patients with solid tumor,who developed thrombocytopenia induced by chemotherapy(PLT≤70?109/L) after the f irst cycle of chemotherapy(control group),was studied by self-cross control.6-24 h after the second cycle of chemotherapy(treatment group) with identical scheme of the f irst cycle chemotherapy,they were given subcutaneous injection of rhTPO 15 000 U/d for 7 to 14 consecutive days or until platelet count ≥100?109/L or the increasing count ≥50?109/L.Results:The mean platelet count of the patients after rhTPO treatment was higher at different time points of the treatment group than that of the control group.The minimal PLT count of the treatment group and the control group after chemotherapy were(80.3?39.30)?109/L and(34.7?21.2)?109/L(P0.05).The time of PLT count to recover was found to be more than 75?109/L and 100?109/L in treatment group after chemotherapy was(9.8?4.2)d and(12.8?3.6)d,compared to(19.1?4.5)d and(24.3?1.4)d(P

Objective To investigate the potential risk factors for the death of patients with colorectal cancer during perioperative periods.Methods The clinical data of 545 patients with colorectal cancer were analyzed retrospectively.17 factors,which may influence mortality of patients with colorectal cancer during perioperative periods were evaluated.These enumeration data were analyzed with x2 test,then those factors with obvious difference in statistics were further analyzed by multi-factor Logistic regression analysis.The independent risk factors affecting the mortality of patients with colorectal cancer during perioperative periods were obtained from the analysis.Results There were 6 independent risk factors derived that had significant impacts on perioperative death that were postoperative complications,operation method,non-planed reoperation,preoperative electrolyte disturbance,preoperative hypoalbuminemia,and age(P ＜ 0.05).Conclusions Many potential factors could affect perioperative mortality of patients with colorectal cancer undergoing surgical procedure.

Researches on monoclonal gammopathy of undetermined significance (MGUS) and smoldering muhiple myeloma (SMM) are at a low level although their incidence is high.This review discusses curent biological insights in MGUS/SMM and discusses how the integration of novel biological markers,molecular imaging,and clinical monitoring of MGUS/SMM could facilitate the development of early treatment strategies for high-risk SMM (early myeloma) patients in the future.

Child ; Humans ; Vesico-Ureteral Reflux ; therapy

Objective To explore the surgical safety and clinical efficacy of combined anterograde and retrograde method exposing porta hepatis for the treatment of the intrahepatic cholangiocarcinoma invading porta hepatis.Methods The retrospective descriptive study was conducted.The clinicopathological data of 3 patients with left intrahepatic cholangiocarcinoma invading porta hepatis who were admitted to the Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine from February 2015 to May 2016 was collected.All the 3 patients underwent left hemihepatectomy combined with caudate lobectomy after preoperative lab and imaging examinations and the evaluations of liver function and residual liver volume.The surgical procedures followed as:anterograde dissection of porta hepatis,exposure of hilar plate,left hemihepatectomy combined with caudate lobectomy,right artery resection and reconstruction,hilar cholangioplasty and bilioenteric anastomosis.Observation indicators included:(1) surgical situations:operation time,time of hepatic artery~ anastomosis and volume of intraoperative blood loss;(2) postoperative pathological examinations;(3) postoperative situations:postoperative complications (biliary fistula,hemorrhage,abnormal liver function,gastroplegia) and postoperative chemotherapy;(4) follow-up:postoperative patients' survival and carcinoma occurrence.Follow-up was performed to by outpatient examination up to December 2016.The follow-up included clinical symptoms such as abdominal pain,chills,fever and jaundice,liver function and tumor marker examination,and color ultrasound Doppler or abdominal enhanced computed tomography (CT) was performed to detect carcinoma recurrence.Measurement data was represented as average (range).Results (1) Surgical situations:all the 3 patients underwent successful left hemihepatectomy combined with caudate lobectomy using combined antegrade and retrograde method exposing porta hepatis,including 1 combined with right hepatic artery resection and reconstruction,without perioperative death.The average operation time,average time of hepatic artery anastomosis and average volume of intraoperative blood loss of 3 patients were 493 minutes (range,430-570 minutes),11 minutes and 526 mL (range,450-600 mL),respectively.(2) Postoperative pathological examination showed 3 patients were diagnosed with cholangiocarcinoma,2 with nerve bundles invaded and 2 with No.12 lymph node metastasis,with negative margins of bile duct and hepatic artery.(3) Postoperative situations:3 patients are not complicated with biliary fistula and gastroplegia.One patient with postoperative liver dysfunction after right artery resection and reconstruction underwent anti-infection,hepatoprotection and anti-hepatic encephalopathy therapies,and then was improved and discharged from hospital at 4 weeks postoperatively.The other 2 patients recovered steadily without complications such as hypohepatia,and then respectively discharged from hospital at 17 and 20 days postoperatively.All the 3 patients underwent chemotherapy of gemcitabine combined with S-1 for 8 courses at week 4 or 5 postoperatively.(4) Follow-up:all the 3 patients were followed up for 7-20 months,with good general conditions and normal liver function and without cholangitis symptoms.One patient received right artery reconstruction,and CT reexamination at postoperative month 3 showed fine imaging of right hepatic artery.There was no sign of carcinoma recurrence.Conclusion The combined anterograde and retrograde method exposing porta hepatis for the treatment of the intrahepatic cholangiocarcinoma invading porta hepatis can increase the radical resection rate and surgical safety.

Objective To investigate the optimum scanning parameters for multi-slice spiral CT aorta imaging so as to emphasize the contrast delay time and the method of image reconstruction.Methods 21 cases of patients were scanned with contrast enhancement by the method of bolus tracking.The contrast medicine was injected through elbow vein.Flow speed was 3.0ml/s,and contrast usage was 1.5 to 2ml/ kg.Scanning was triggered when the density of the enhancement at ROI arose to a prescribed value.After data acquisition and reconstruction,the aorta was displayed.Results The average time for the influx of contrast in aorta was 20 seconds.Data was reformatted with the thickness of 2.5mm and 50% overlapping.VR,CPR,MIP and SSD images were reconstructed.Conclusion With constant tracking of density by Smartprep software,the optimized scanning parameters and the proper image post-processing techniques,aorta can be clearly displayed.[Chinese Medical Equipment Journal,2008,29(2):88-89]

Objective To evaluate the efficacy of microwave ablation in the treatment of small hepatic carcinoma with liver cirrhosis.Methods Altogether 50 patients with small hepatic carcinoma with liver cirrhosis from April 2009 to June 2013 were divided into microwave ablation group (n =26) or resection group (n =24).The microwave ablation group was treated by laparoscopic microwave ablation while the resection group was treated by laparoscopic resection.The time of operation,intraoperative blood loss,length of hospital stay,postoperative complications,postoperative liver functions,and 1-year,2-year,3-year survival rate of each group were observed.Results The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were increased and the albumin (ALB) was decreased postoperatively in both groups,and all recovered in 7 days after operation.The ALT and AST in microwave ablation group were lower than resection group,and the ALB was higher than resection group,with statistical significances (P ＜ 0.05).The operation time in microwave ablation group was (53.5 ± 8.5) min,significantly less than the resection group [(92.9 ± 19.8) min,t =-9.019,P =0.000].The intraoperative blood loss in microwave ablation group was (41.9 ± 17.2) ml,significantly less than the resection group [(131.3 ± 66.0) ml,t =-6.663,P =0.000].The length of hospital stay in microwave ablation group was (7.8 ± 1.0) d,significantly less than the resection group [(10.4 ± 1.3) d,t =-7.742,P =0.000].The rate of postoperative complication in microwave ablation group was 19.2％ (5/26),significantly less than the resection group [45.8％ (11/24),x2 =4.059,P =0.044].The 1-year,2-year,and 3-year survival rates in microwave ablation group were 100％,88.5％,80.8％,respectively,and those in resection group were 100％,91.7％,83.3％,respectively.There were no statistical differences between the two groups (log-rank x2 =0.077,P =0.792).Conclusions Microwave ablation therapy is feasible in the treatment of small hepatocellular carcinoma with cirrhosis that located in the special area and endoscopic surgery is not easy to remove.Microwave ablation has advantages of less trauma,simple performance and less complications.

Objective To observe the effect of ultrafiltrated components of three kinds of serum containing phlegm-resolving prescriptions (Huanglian Wendan Decoction, Gualou Xiebai Banxia Decoction, and Erchen Decoction, respectively) on viability of human leukemic monocytic cell line THP-1 derived macrophages and macrophage differentiation to foam cells. Methods THP-1 cells were induced to differentiate into macrophages with phorbol-12-myristate-13-acetate ( PMA) . And then the achieved macrophages were used for the establishment of the atherosclerotic foam cell model after co-incubation with oxidized low density lipoprotein ( ox-LDL ) . Three kinds of serum containing phlegm-resolving prescriptions and blank serum were prepared and ultrafiltered by 10 KD ultrafiltrator, and then were co-cultured with the foam cell model, respectively. The viability of macrophages and the macrophage differentiation to foam cells were tested by methyl thiazolyl tetrazolium ( MTT) assay and oil red staining. Apoptotic rate of macrophages was determined by flow cytometry. Results After THP-1 cells were induced by PMA (100 nmol/L) for 20 hours and then were co-incubated with ox-LDL (50 μg/mL) for 24 hours, a typical atherosclerotic foam cell model was established successfully. The ultrafiltrated components of serum containing Huanglian Wendan Decoction had obvious effects on increasing the macrophage survival rate, decreasing macrophage apoptotic rate, and inhibiting macrophage differentiation to foam cells. The ultrafiltrated components of serum containing Gualou Xiebai Banxia Decoction or Erchen Decoction had an effect on enhancing the macrophage differentiation to foam cells but had no anti-apoptosis action. Conclusion Huanglian Wendan Decoction has anti-atherosclerosis action, which may be related to resisting macrophage apoptosis and decreasing macrophagic lipid-endocytosing function. Erchen Decoction and Gualou Xiebai Banxia Decoction are effective on increasing macrophagic lipid-endocytosing function.

OBJECTIVETo study the effect of ethyl acetate fraction of Blumea balsamifera (BBE) residue on treating rats of adjuvant arthritis (AA) and its mechanism.

METHODThe rats were immunized with the Freund's complete adjuvant (FCA). After modeling, 28 days' treatment with BBE was performed. During the experimental process, rat mass, toe girth, arthritic index (AI), proliferation of immune organs and pathological section were measured. After treatment, blood samples were collected through fossa orbitalis vein for detection of serum SOD, MDA, GSH, NO, OH*, ALP, AST, ALT, NAG and SA content using colorimetric method and IL-1, IL-6, TNF-α content using ELISA method.

RESULTAdministration with BBE (high dose) could significantly ameliorate joint swelling and arthritis index, effectively inhibit synovial hyperplasia, down-regulate the levels of MDA, NO, OH*, ALP, AST, ALT, NAG, SA, IL-1, IL-6, TNF-α and up-regulate the SOD and GSH levels in serum.

CONCLUSIONThe results suggested BBE possesses substantial anti-arthritis and antioxidant activities.

Acetates ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; administration & dosage ; isolation & purification ; Arthritis, Experimental ; blood ; drug therapy ; metabolism ; Asteraceae ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; Humans ; Interleukin-1 ; blood ; Interleukin-6 ; blood ; Male ; Malondialdehyde ; blood ; Oxidative Stress ; drug effects ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; blood