Objective To investigate the feasibility and safety of minimally-invasive video-assisted parathyroidectomy ( MIVAP) for parathyroid adenoma ( PA) . Methods Clinical data of 14 patients with primary hyperparathyroidism ( PHPT) caused by PA between April 2011 and September 2014 in our hospital were analyzed retrospectively.Coexistent thyroid lesions were found in 6 patients.With preoperative definite diagnosis and localization, we performed parathyroidectomy and local excision or lobectomy of the thyroid gland.All the patients were confirmed by intra-operative fast frozen section pathological examination and postoperative pathological immunohistochemistry.Intra-and post-operative parathyroid hormone monitoring was conducted.Hoarseness, choking cough, and active bleeding were observed. Results All the procedures were accomplished successfully, without intra-operative abnormal blood loss or conversion to conventional operation.The operative time was 35-60 min ( mean, 50 min);the intra-operative blood loss was 1.7-32.0 g (mean, 9.75 g).Neither transient nor everlasting injury to recurrent laryngeal nerve or superior laryngeal nerve happened.No hemorrhage was observed.All the patients were followed up for 2-43 months ( mean, 16 months) , during which there was no recurrence. Conclusion MIVAP with thyroidectomy is feasible and safe for PA and coexistent benign thyroid lesions, on the basis of pre-operative adequate diagnosis and proper localization and intra-operative parathyroid hormone monitoring.

Objective To improve the diagnosis and treatment of primary duodenal malignant (neoplasms)(PDMN).Methods The clinical data of 19 patients with primary malignant neoplasms of the (duodenum) were anayzed retrospectively.Results The clinical manifestations were jaudice in 9 cases, upper abdominal pain in 7 cases, gastrointestinal hemorrhage in 6 cases,abdominal mass in 3 cases,and vomitting in 1 case. Diagnostic procedure and detection rate: The detection rate of PDMN by duodenoscopy was 83.3%(15/18), by hypotonic duodenography was 82.3%(14/17), 77.8%(7/9) by CT, and 1 case by MRI.16 cases (underwent) surgery with resection rate of 68.8 %(11/16).Pancreaticoduodenectomy was (performed) in 9 (cases), simple tumor resection and regional lymphadenectomy in 1 case,resection of duodenal bulb plus partial gastrectomy in 1 case,and gastroenterostomy or choledochojejunostomy in 5 cases.The radical resection rate was 62.5%(10/16).The postoperative 1-,3-,and 5-year survival rate in radical (resection) (patients) was 90.0%(9/10),40.0%(4/10) and 30.0%(3/10),respectively.In those with (gastroenterostomy) or (choledochojejunostomy), the survival time was 6~15 months. Conclusions (Duodenoscopy) and hypotonic (duodenography) are ideal tools for the diagnosis of all locations of PDMN.(Pancreaticoduodenectomy) might result in prolonged survival of patients with PDMN.

Objective To explore the effect of preventive antibacterial treatment on spontaneous bacterial peritonitis (SBP) in the patients with severe hepatitis. Methods 120 cases of the patients with severe hepatitis were divided into two groups randomly. The patients in group A (n=62) received preventive antibacterial treatment except therapy for protecting liver. The patients in group B (n=58) only received therapy for protecting liver and served as control. Results In the group A and group B, the SBP frequency was 27.4% (17/62) and 44.8%(26/58) respectively (? 2=3.95,P

0.05). Positive stains were located in cytoplasm of cancer and stromal cells, especially in invasive margin of cancer. Slight positive stains were observed in non-cancer tissues. But in the control samples, there wasn't specific stain. In ELISA, the uPA antigen levels in cancer and non- cancer tissues were (4.23?0.57)ng/mg protein and (1.26?0.14)ng/mg protein; the uPAR antigen levels in caner and non-cancer tissues were(4.25?0.21)ng/mg protein and (3.15?0.23)ng/mg protein respectively. Significant difference existed in both uPA and uPAR antigen levels in these two kinds of tissue ( t=18.963,P=0.000;t=13 693,P=0 000 ). Furthermore, these antigen levels in progressive and aggressive tumors significantly higher than those in non-progressive and non-aggressive tumors ( P

Objective The purpose of this study was to determine the efficacy of forced expiratory volume in six seconds(FEV6) as an alternative for forced vital capacity(FVC)and the fixed eat-off points for FEV1/FEV6 in the diagnostic screening for chronic obstructive pulmonary disease (COPD).Methods From August 2007 to December 2008,a total of 1210 spirometric examinations in were analyzed,FEV6 was measured on volume-time curves.The correlation between FEV1/FVC and FEV1/FEV6 was evaluated by the Kendall correlation test.Considering FEV1/FVC

ObjectiveTo observe the effect of cerebellar fastigial nucleus treated by electrical stimulation on patients with acute cerebral infarction.Methods140 cerebral infarction patients with hemiplegia were randomly divided into the experimental group and control group with 70 cases in each group.The experimental group was treated with routine drugs and electrical stimulating on cerebellar fastigial nucleus;the control group was only treated with routine drugs.The changes of motor function of limbs and activities of daily living of two groups were evaluated after treatment.ResultsAfter 21 days treatment,the score of Fugl-Meyer assessment of the experimental group was 39.2±(7.7) and that of the control group was 26.3±8.1.There was a significant difference between two groups(t=4.22,P<0.01).The score of Barther index of the experimental group was 43.8±8.4 and that of the control group was 29.7±7.5.There was also a significant difference between two groups(t=4.97,P<0.01).ConclusionThe electrical stimulation on cerebellar fastigial nucleus is a new effective way to treat acute cerebral infarction.

Objective To analyze the clinical characteristic of spontaneous bacterial peritonitis (SBP) in patients with severe viral hepatitis, and explore its clinical classification and significance. Methods A retrospective research of 120 cases of SBP associated with severe viral hepatitis was performed, and main clinical symptoms and physical signs appeared at the early onset were classified and explored. Results Clinical manifestations of SBP in patients with severe viral hepatitis included 5 types, which were conventional type(41.7%, 50/120), symptomless type(15.8%, 19/120), hepatic coma type(13.3%, 16/120), refractory aacites type (17.5%, 21/120), and shock type (11.7%, 14/120). The germieuhure positive rate of SBP with hepatic coma type and shock type were relatively high, and the survival rate of these patients were low. Conclusions Clinical manifestations of SBP in patients with severe viral hepatitis may be atypical, and its classification help to enhancing the understanding and early diagnosis of SBP, and decreasing missed diagnosis. The prognosis of SBP in patients with hepatic coma type and shock type was poor, and then it must be taken high into account more than ever before in the clinical practice.

Objective To explore the fibrosis mechanism of patients with fibrosing cholestatic hepatitis(FCH) in the way of degradation of collagen.Methods The expressions of matrix metalloproteinase 1(MMP1) and tissue inhibitor of metalloproteinase 1(TIMP1),and contents of type I,III collagen proteins were detected by immunohistochemical staining in the liver tissues of 9 cases with FCH associated with HBV developed following renal transplantation and 5 cases without liver disease as controls.Results The expressions of MMP1 and TIMP1,and type I,III collagen proteins in the patients with FCH were significantly higher than those in the control group.There was a positive correlation between the expressions of type I,III collagen proteins and TIMP1/ MMP1 ratio.Conclusion Hepatic fibrosis in the patients with FCH associated with HBV developed following renal transplantation may be relative to the increase of TIMP1 expression which inhibit the degradation of collagen.

Objective To observe the expressions of matrix metalloproteinase 1(MMP1) and tissue inhibitor of matrix metalloproteinase1(TIMP1) and the collagen type Ⅰ,Ⅲ deposition in the liver tissues,and evaluate the possible fibrosis mechanism of patients with chronic hepatitis B(CHB) in the way of degradation of collagen. Methods The specimens of the biopsy liver in 50 cases with CHB were detected for the expressions of type Ⅰ,Ⅲ collagen proteins,MMP1 and TIMP1 by immunohistochemical staining. Results The expressions of type Ⅰ,Ⅲ collagen proteins and TIMP1,were significantly increased along with the advancing of hepatic fibrosis.There was a positive correlation between the expressions of type Ⅰ,Ⅲ collagen proteins and TIMP1. Conclusions Hepatic fibrosis in the patients with CHB may be related to increase of TIMP1 expression that inhibit the degradation of collagen.

Objective To investigate the clinicopathological features, postoperative survival and prognostic influencing factors of male patients with hepatocellular carcinoma (HCC). Methods The clinicopathological features and the follow-up data of 155 male HCC patients who received hepatectomy from Jan. 1995 to Dec. 2002 were retrospectively analyzed and the prognostic influencing factors were defined by uni-and multi-variate analysis. Results Compared with 24 female patients at the same period, males were about six-year older and both of their hepatitis B surface antigen (HBsAg) and liver cirrhosis positive rates were higher (P