Objective To investigate the clinical characteristics of comorbidity of migraine and epilepsy.Methods The clinical data of 67 patients with migraine were analyzed retrospectively.Results 6 cases appeared epilepsy,focal seizure 2 cases and generalized seizures 4 cases,in the 67 patients with migraine.The epileptiform waves were recorded in 57 cases by EEG,and the fulminated waves were also recorded in 6 patients with epilepsy.Treated by Sodium Valproate,migraine attacks and seizures were all controlled in the 6 cases and also EEG anastated well.Conclusions Comorbidity is existed in migraine and epilepsy.The curative effect is well by Sodium Valproate.

Asian Continental Ancestry Group ; China ; Humans ; Medicine, Chinese Traditional ; Psoriasis ; therapy

Objective To explore a simple and effective way of establishing a 30 % small-forsize liver transplantation in rats. Methods SD rats were selected as the donors and recipients. Smallfor-size orthotopic live transplantation was performed using Kamada's two-cuff method. Donor's liver was flushed via abdominal aorta and hepatectomy in situ was done. Animals were divided into 3 groups (40 pairs of rats in each): group Ⅰ , median lobe was used as graft; group Ⅱ, right of median lobe and right lobe were used as graft; group Ⅲ, median and right lobes were used as graft. The body weight of the donor was the same as the recipient in groups Ⅰ and Ⅱ , but 100～ 120 g less than in group Ⅲ. The operating time, 7-day survival and technical complications were compared among these 3 groups. Results The operating time of hepatectomy was shorter in group Ⅲ than in groups Ⅰ and Ⅱ (8. 8±0.7 vs 11.5± 1.1 vs 10.1 ±1.0 min, P＜0.01). The cold ischemia time of graft, the anhepatic time, the operating time of recipient and the transplanting successful rate showed no significant difference among the 3 groups. Compared with groups Ⅰ and Ⅱ , the incidence of bleeding,bile leakage and IVC stricture was significantly decreased in group Ⅲ (P＜0. 05). Other complications after operation showed no significant difference among the 3 groups (P＞0. 05). Group Ⅲ had more 7-days survivors and longer median survival time, but there was no significant difference among the 3groups. Conclusion Small for donor body weight with median and right lobes as graft was a more effective and simple way of establishing a 30 % small-for-size liver transplantation in rats with shorter hepatectomy time and less complications after operation.

Objective To evaluate the clinical value of choledochoscopy combined with electrohydraulic lithotripsy (EHL) for the treatment of pancreatolithiasis. Methods From October 2002 to July 2006, choledochoscopy combined with EHL was used in 11 patients with pancreatolithiasis during a dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis (EHL group). The data of these patients were compared with the data of 12 patients with pancreatolithiasis, who were treated by routine dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis from January 1995 to September 2002 (Routine group). Results The intraoperative blood loss and the postoperative rate of residual stones in the EHL group were significantly less than those in the routine group [(145.5?82.0) ml vs (406.7?384.9) ml, t=-2.201, P= 0.039; and 0% vs 41.7%, P= 0.037]. The postoperative rate of pain relief in the EHL group was higher than that in the routine group (90.9% vs 58.3%), however the difference was not significant (P=0.155). In the EHL group, 6 patients had diarrhea before the operation, 4 of them achieved relief after the surgery (4/6), which was not significantly more than that in the routine group (5/9, P=1.000). Before the operation, 7 patients in the EHL group and 9 in the routine group had diabetic mellitus; in each group, the disease was relieved in 2 patients after the operation (2/7 vs 2/9, P=0.665). Conclusions Choledochoscopy combined with EHL is effective for the treatment of pancreatolithiasis. The procedure can increase the rate of stone removal, decrease the intraoperative blood loss, and elevate the postoperative rate of pain relief.

Objective To introduce the experience of l ap aroscopic modified Swenson pull-through procedure for the treatment of Hirschspr ung's disease (HD). Methods A modified Swenson procedure was performed in 100 cases of HD, including 21 cases of short-segment phenotype, 72 cases of common phenotype, and 7 cases of long-segment phenotype. The patients w ere aged 8 months ~ 7 years, with a mean age of 1.5 years. A 0? or 30? laparos cope, with an inner diameter of 0.5 cm, was advanced from the umbilicular port, and operating instruments were introduced into the left and right lower quadaran t of the abdomen. The carbon dioxide was insufflated in the abdominal cavity at a pressure of 8~12 mmHg. Biopsies from the colonic seromuscular layer were made for pathological examinations. Laparoscopic dissection of blood vessels of the m esocolon was carried out closely near the colon, until the level 0.5~1 cm above the dentate line. The rectum and sigmoid was mobilized outside through the anus to complete rectal dissection. The proximal colon then was anastomosed to the re ctum by means of full-thickness suture and diagonal heart-shaped closure. Results All the cases were cured, without fatal cases. The operation time was 80~170 min (mean, 110 min), and the intraoperative blood loss was less than 10 ml. There were 5 cases of subcutaneous emphysema and 6 cases of urinary retention. On a follow-up in all the cases for 6~18 months, 5 cases of colitis, 2 cases of soiling, 1 case of anastomotic stricture, and 1 case of delayed anas tomotic leakage were observed. Conclusions Laparoscopic modifi ed Swenson pull-through procedure for Hirschsprung's disease is worthy of being recommended for its minimal invasion and simplicity of performance.

Aged ; Carcinoma, Squamous Cell ; surgery ; Female ; Forearm ; surgery ; Free Tissue Flaps ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods

Surgical resection remains the only curative option of treatment for hepatocellular carcinoma,but centrally located tumors remain problematic.Extended right or left hepatectomy removes 60％ to 85％ of the hepatic parenchyma and is associated with more hepatic failure.Mesohepatectomy,resection of central hepatic segments (Couinaud's segments Ⅳ,Ⅴ,Ⅷ) and leaving the right and left segments in situ,preserves more functional hepatic tissues than extended hepatectomy.Despite its technical demands,mesohepatectomy should be considered as an alternative treatment for central huge hepatic tumors.

ObjectiveTo identify exon 20,24,25 mutations of ELN in patients with PFD.MethodsThe study was designed as case-control analysis.The PFD patients were from the second hospital of the Hebei medical university.30 PFD patients were examined and scored according to the Pelvic Organ Prolapse (POP-Q) classification,and the patients were divided into two groups,the low-grade ( A1 ) group and the high-grade (A2) group.20 non-PFD women were selected as the control group (B).Venous blood had been collected and DNA sequences were determined and compared with the standard sequence in NCBI GENEBANK.ResultsExon 20 114 G ｜ A mutation was found in PFD patients,which can induce protein structure change.There were seven cases in the A2 group and one in the B group; it had statistically different between two groups ( P ＜0.05).Exon 24 81C | G mutation was found in the trial group,it had no statistically difference between two groups ( P ＞ 0.05 ).None mutation of Exon 25 was found in all the groups.IVS20 17T｜ C mutation was found in the A2 group,which had statistically difference compared with control group and the low-grade group ( P ＜ 0.05 ).IVS24 69A | T mutation was found in the trial group,it had no statistical difference with control group ( P ＞ 0.05 ).ConclusionsMutations of elastingene exon 20,exon 24 were found in the PFD patients,which can induce the change of the primary protein structure.IVS20 17T | C mutation also existed in the trial group; the elastin gene mutation may be the reason that people are easy to suffer from PFD.

BACKGROUND: Early enteral nutrition (EEN) following liver transplantation can benefit to recover and guarantee the normal gastrointestinal tract function,which plays an important role on post-operational immunosuppressive therapy.OBJECTIVE: To conduct EEN on the patients undergoing liver transplantation,and observe the post-operation recovery of intestinal function.DESIGN: Case analysis.SETTING: The 81 Hospital of Chinese PLA.PARTICIPANTS: From April 2003 to June 2006,86 patients undergoing liver transplantation in Liver Transplantation Center at the 81 Hospital of Chinese PLA were enrolled,including 57 males and 29 females.They aged 21-68 years,with a mean of 48 years.Among them,there were 37 cases of primary hepatic carcinoma and 49 cases of posthepatitic cirrhosis; 8 cases graded in Child A (all hepatic carcinoma),34 cases in Child B,and 44 cases in Child C.And 5 cases were complicated with serious hepatitis liver function failure and hepatic coma.Informed consents were obtained from all the patients and relatives.Transplantation operation was approved by the hospital ethical committee.METHODS: Surgical approach was orthotopic liver transplantation through caval vein in 80 cases,typical orthotopie liver wansplantation without veno-venous bypass in 4 cases,and piggyback orthotopic liver transplantation in 2 cases.The average warm ischemia time was (4.8±2.4) minutes,and average cold ischemia time was (8.6±3.2) hours.Anhepatic phase was (84±28)minutes.Post-operational trigeminy immunity and anti-rejection therapy consisted of tacrolimus (Fujisawa product) +mycophenolate mofetil (Roche product) + prednisone (Pred).According to the presence of nasogastric feeding tube,the patients were divided into control group (n=49) and EEN group (n =37).There were no significant differences in the sex,age and general data of patients between the two groups.Control group adopted EEN mainly,while EEN group was fed with EEN via a nose-intestine nutritional tube,and they received short-peptide enteral nutrition (Pepti-2000) at 24 hours post-operation at the initial dose of 63-126 g/d,which was gradually increased to 372 g/d.Liquid diet was allowable by 3-5 days.MAIN OUTCOME MEASURES: ①Clinical recovery and complications of patients.②Liver function recovery indices such as total serum protein,albumin and prealbumin,as well as C reactive protein at days 1,3,5 post-operation.③Level of serum immune globulin at day 7 post-operation.RESULTS: Totally 86 patients were involved in the result analysis.①Clinical recovery and complications: In EEN group,abdominal distension occurred in 10 cases,diarrhea in 5 cases,and blocking or slippage of feeding tube in 3 cases; No emesia,back flow or aspirated pneumonia was found; In control group,2 cases appeared bile leakage,which was not detected in the EEN group.②Indices of liver function recovery: Compared with control group,the prealbumin level was significantly rised and C reactive protein was significantly decreased in the EEN group at days 3 and 5 (P ＜ 0.05).③Levels of serum immune globulin: Blood IgA and IgM of EEN group were significantly higher than those of control group at day 7 (P ＜ 0.05).CONCLUSION: EEN in post-operation patients can reduce stress,promote synthesize metabolism,improve the recovery of liver cells,and decrease the infection rate.