ObjectiveTo investigate the influence of timing of definitive operation on prognosis of patients with iatrogenic bile duct injury (IBDI). MethodsThe clinical data of 38 patients with IBDI were retrospectively analyzed. Of the 38 patients, the injury happened in 7 patients in our hospital while 31 patients were transferred in from other hospitals. We analyzed the previous operative records, the clinical manifestations of the patients, the radiological images and our operative findings in the definitive operations. According to the timing of the definitive operation, the patients were divided into the intraoperative repair group (n=26), the early repair group (n=15) and the delayed repair group (n=17). ResultsPatients in the intraoperative repair group had the best short-and long-term results, the shortest length of hospital stay and the lowest total cost. The early repair group, though having worse Results than the intraoperative repair group was still better than the delayed repair group. However, early detection of injuries and the ability to carry out timely corrective procedures depended on the availability of surgical expertise in the hospital. ConclusionsThe timing of definitive operation to provide corrective surgery to IBDI was a vitally important factor which affected prognosis.It is best to repair the injury within the same operation. The repair should be carried out by a doctor with ample experience in bile duct surgery.

Objective To investigate the expression of Ezrin protein and c-met in esophageal squamous cell carcinoma, their significance in the progress of esophageal squamous cell carcinoma development and metastasis. Methods The expression of Ezrin protein and c-met in 50 patients with esophageal squamous cell carcinoma was studied using immunohistochemical (SP) method. The correlation of each score according to the intensity and percentage of labeled cells or intercellular substance with relevant clinical data was statistically analyzed. Results In normal esophageal squamous epithelium, the positive expression of Ezrin protein was 34 %, the positive expression of c-met was 8.0 %. In esophageal squamous cell carcinoma, the positive expression of Ezrin protein was 76.0 %, the positive expression of c-met was 58.0 %. The expression of Ezrin protein had close relation to depth of invasion and lymph node metastasis(P < 0.05). The positive rate of c-met protein expression in lymph node metastasis was obviously higher than those without lymph node metasis (P <0.05). The expressinn of Ezrin protein in c-met positive eases was obviously higher than those of c-met negative cases(P <0.05). Conclusion The test of Ezrin protein and c-met may have significant prognostic value for assessing the degree of malignancy and potential lymph node metastasis probability of esophageal squamous cell carcinoma. Ezrin protein may be a target to evaluate the tumor prognosis.

Objective The aim of this study is to establish a practical VX2 tumour model less than or equal to 10 mm from large blood vessel(as standard) for HIFU ablation .Methods 15 New Zealand rabbits were involved ,VX2 tumour blocks were inoculated near postcava through spine path ,and tumour rate was observed two weeks later by anatomy and MRI .Results Three experimental rabbits did not survive ,all the rest of the 12 into the tumour ,assembly tumour rate was 100% (12/12);The tumour rate reaching the standard accounted for 75% (9/12) ,the average distance between the tumour and the inferior vena cava was (5 .6 ± 3 .4)mm . Conclusion It is feasible to establish the VX2 tumor model less than or equal to 10 mm from large blood vessel through spine path .

Objective To optimize the extraction process of volatile oil and inclusion preparation of hydroxypropyl-β-cyclodextrin from compoundJinling Sini Siwu Shixiaosan Granules.Methods The orthogonal approach of L9 (34) was applied to investigate the volume of volatile oil extraction by 3 factors to obtain the optimum extraction conditions. With inclusion rate of volatile oil and yield of inclusion compound as comprehensive evaluation indexes, the optimum preparation conditions were discussed. The characterization of this prepared inclusion was analyzed by TLC.Results The optimum extraction conditions were as follows:the crude medicine with medicinal powder was shattered into 20 meshes;8 times the amount of water was added and was extracted for 8 h. The best inclusion conditions were as follows:the proportion of volatile oil to HP-β-CD was 1∶6, with inclusion temperature of 30℃, grinding time of 2 h. Analysis results of TLC showed that stable inclusion compound was formed from volatile oil and HP-β-CD.Conclusion The optimized extraction process and inclusion preparation are with stable quality and high feasibility.

Aged ; Aged, 80 and over ; Antibiotics, Antitubercular ; pharmacology ; Coal Mining ; DNA Gyrase ; genetics ; Drug Resistance, Bacterial ; genetics ; Humans ; Male ; Middle Aged ; Mutation ; Mycobacterium tuberculosis ; drug effects ; genetics ; Pneumoconiosis ; complications ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Quinolones ; pharmacology ; Tuberculosis, Pulmonary ; complications ; microbiology

To evaluate the clinical efficacy of unrelated umbilical cord blood transplantation (UCBT) on the treatment of children with hematologic malignancies and nonmalignancies, between August 2001 and June 2004, 32 patients were transplanted by using unrelated umbilical cord blood supplied by Shandong Umbilical Cord Blood Bank. Out of them, 13 patients suffered from ALL, 9 from AML, 3 from AA, 3 from HAL, 2 from CML and 2 from NHL. The median age was 8 years (range 2-15), the median weight was 31.5 kg (range 14-55). All patients received ablative conditioning regiment according to the disease and the disease status. Conditioning regiments Cy/TBI were used for 4 patients and Bu/Cy for 21 patients, other for 7 patients. All patients received cyclosporin A and/or methotrexate for GVHD prophylaxis. The mean number of infused nuclear cells were 5.57 (2.16-12.3) x 10(7)/kg, CD34+ cells 1.78 (0.85-5.59) x 10(5). All of UCB units were tested for HLA-A, -B, and DRB1 using low and high resolution techniques. There were HLA-matched in 10, 5/6 in 16 and 4/6 in 6. The results showed that 20 out of 32 patients achieved complete engraftment. Median time of neutrophil > or = 0.5 x 10(9)/L, and platelet > or = 20 x 10(9)/L were 17 (9-38) and 42 (18-102) days respectively. The incidence of aGVHD II-IV and aGVHD III-IV were 35% and 15% respectively. After a median follow-up of 18 months (1.5-28.5), overall survival rate at one year was 59.4%, overall survival rate at two years was 40.6%. It is suggested that UCBT is promising for children patients who is lack of matched bone marrow donors.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation ; methods ; Cyclosporine ; administration & dosage ; Graft vs Host Disease ; prevention & control ; Hematologic Neoplasms ; mortality ; therapy ; Humans ; Methotrexate ; administration & dosage ; Survival Rate ; Transplantation Conditioning

Small-scale intellectualized medical instrument has attracted great attention in the field of biomedical engineering, and LabVIEW (Laboratory Virtual Instrument Engineering Workbench) provides a convenient environment for this application due to its inherent advantages. The principle and system structure of the hyperthermia instrument are presented. Type T thermocouples are employed as thermotransducers, whose amplifier consists of two stages, providing built-in ice point compensation and thus improving work stability over temperature. Control signals produced by specially designed circuit drive the programmable counter/timer 8254 chip to generate PWM (Pulse width modulation) wave, which is used as ultrasound radiation energy control signal. Subroutine design topics such as inner-tissue real time feedback temperature control algorithm, water temperature control in the ultrasound applicator are also described. In the cancer tissue temperature control subroutine, the authors exert new improvments to PID (Proportional Integral Differential) algorithm according to the specific demands of the system and achieve strict temperature control to the target tissue region. The system design and PID algorithm improvement have experimentally proved to be reliable and excellent, meeting the requirements of the hyperthermia system.
Algorithms ; Computer Simulation ; Hyperthermia, Induced ; instrumentation ; Neoplasms ; therapy ; Software Design ; Ultrasonic Therapy ; instrumentation ; methods

Objective To investigate the relationship between serum transforming growth factor- β1(TGF- β1) levels and early diabetic nephropathy and clarify whether valsartan plays a role in renal protection by reducing the level of serum TGF-β1. Methods The study subjects were divided into four groups:control group (30 cases); normal albuminuria group 1 (NA1 group with 12 cases, U MA/Cr < 10 μg/mg combined with type 2 diabetes);normal albuminuria group 2 (NA2 group with 19 cases,UMA/Cr 10-30 μg/mg combined with type 2 diabetes); microalbuminuria group ( MA group with 35 cases, U MA/Cr 31-300 μg/mg combined with type 2 diabetes). All these type 2 diabetic patients were suffering from diabetic retinopathy, and valsartan ( 80 mg/d) were medicated for those combined with hypertension. The serum TGF-β1 levels were measured by enzyme-linked immunosorbent assay in all subjects. Results Serum TGF- β1 levels in three diabetes groups were (7.41 ± 2.68 ), ( 10.52 ± 4.10), (22.98 ± 43.74) ng/L, respectively, all of which were higher than those in control group [(4.25 ± 5.82) ng/L] (P < 0.05). There were significant differences in serum TGF- β1 levels among MA group, NA2 group and NA1 group (P < 0.05 ). Serum TGF-β1 levels in NA1 group with valsartan treatment significantly decreased compared with those without valsartan treatment (P < 0.05), whereas there was no significant reduction in NA2 and MA group with valsartan treatment (P > 0.05). Conclusions High serum TGF-β1 level may be associated with type 2 diabetes and early diabetic nephropathy. Early intervention of valsartan may be delay the onset and development of diabetic nephropathy by decreasing the serum TGF-β1 level.

BACKGROUND:Accumulating studies have confirmed the excellent effectiveness of local infiltration analgesia, but the literature analysis is mainly limited to within 1 day after total knee arthroplasty or shorter period.
OBJECTIVE:To study the effectiveness of local infiltration analgesia (LIA) at low concentration after total knee arthroplasty, and to observe the analgesic effect at rest and movement states.
METHODS:Thirty patients undergoing total knee arthroplasty were randomly al ocated to control group and LIA group, receiving oral non-steroidal anti nflammatory drug (celebrex) and low concentration of ropivacaine (0.1%) for epidural analgesia. Control group was injected with 0.9%saline 150 mL, while LIA group was injected with equal volume of solution include ropivacaine 300 mg, morphine 5 mg and epinephrine 10μg. The rest pain and motion pain of patients in two groups were evaluated at 6, 12, 24, 36, 48 hours after operation by using visual analogue scale. The incidence rate and degree of nausea, vomiting, numbness and muscle weakness of the legs were observed after operation. The incision healing was also recorded.
RESULTS AND CONCLUSION:Visual analogue scale pain scores in the LIA group were significantly lower than the control group at 6, 12, 24 and 36 hours at rest (P<0.05), at 6, 12, 24, 36, 48 hours on movement (P<0.05). At 6 and 12 hours, there was no difference in the rest and motion pains in the LIA groups (P>0.05). No patient appeared drowsiness, nausea, and vomiting in both groups. Two patients in each group complained of slight numbness in legs. No case influenced function exercise because of muscle weakness. Al the wounds healed and there were no incision infections in two groups. Combined with oral non-steroidal anti-inflammatory drug and low concentration of ropivacaine for epidural analgesia, the local infiltration analgesia technique in total knee arthroplasty is effective in early post-operative pain management, and produces no analgesia related adverse reactions.

ObjectiveTo investigate whether the eight- year program students retain the skills from the endoscopy simulator gastroscopy training.Methods4 trainees accepted virtual reality simulator gastroscopy training and performed a standardized VR gastroscopy scenario at the end of training,and after a median 12 months without practice ( retention ).The intensified training was done by trainees based on the differences between the training end and the retention for a median 12 months and the number of intensified training times was found.ResultsThe significant differences existed in the overinsufflation and opeirational force and time.The score at the training end was better than after retention.Through the average 5.5 times intensified trainings the original levels could be reached.ConclusionThrough Endoscopy Simulator the key skills could be retained well and through a litde training the original levels could also be reached.