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 investigate the application of ultrasonic examination for patients with liver cirrhosis after transjugular intrahepatic portosystemic shunt (TIPS) in the stents in artificial channel (SIAC) and portal vein (PV).Methods The clinical data of 28 patients who were admitted into our hospital from January 2013 to February 2017 and received TIPS were analyzed.Scanned the stents in artificial channel and portal vein and their inner diameter through transabdominal probe,and then measured the blood flow velocity by doppler.ResultsAfter TIPS,the SIAC of cirrhosis patients showed parallel tubular high echo,smooth wall and clear vessel lumen.And the inner diameter of SIAC was (5.93±0.76)mm,the blood flow velocity was (97.14±28.46)cm/s,and the 95% reference value was 4.45 mm~7.41 mm and 41.36~152.92 cm/s respectively.And the inner diameter of PV was (12.40 mm±2.90)mm,the blood flow velocity was (38.33 cm±16.01)cm/s,and the 95% reference value was 6.72~18.08 mm and 22.32~49.34 cm/s respectively.Conclusion Ultrasonography can give objective evaluation of whether SIAC and PV is unobstructed after TIPS,and it can get their parameters of inner diameter and velocity.As a result, ultrasonography can be regard as a perfect means for follow-up checkup.

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 evaluate the safety and efficacy of polymethylmethacrylate/PMMA (Artecoll) as an injectable dermal filler after using laser, radiofrequency and intensive pulse light. Methods In vitro, factional photothermolysis (Affirm) was directly used on the PMMA to see if there was any change in the structure or surface smoothness. In vivo, pig and guinea pig were used as the short-term and long-term models, respectively, for Artecoll. The dermal filler was first injected and then laser treatments conducted.The skin sample was observed through light microscope, scanning electronic microscope and transmission electronic microscope to see whether there were any structural changes, infiltration of inflammatory cells and the regeneration of collagen. Results Through the microscopic observation of in vitro experiment and the animal models, no distortion or rupture of the microsphere were found after the laser treatment. No uneven surface was found in the PMMA microsphere either. The microshpere was surrounded by the inflammatory cells. The infiltration was mild to intermediate with few foreign body giant cells even after several treatments of laser. There was no macrophage seen. But the collagen regeneration was distinguishable after the laser treatment. No obvious structural change was found eventually. Conclusion Artecoll is a safe and effective permanent injectable dermal filler for wrinkle reduction and contour refining.

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.

ObjectiveTo explore the awareness rate and the influencing factors of notification in elderly cancer patients， and to improve the community health management. MethodsA total of 622 cancer patients were selected from a community health service center in Jing’an District of Shanghai， who participated in the Survey of Unified Needs Assessment of Elderly Care in Shanghai. ResultsThe overall awareness rate was 62.86%. Multivariate analysis showed that elderly patients were more likely to have disease notification than younger patients. Patients were less likely to have notification if they were without spouse， with care needs and with more diseases other than cancer. Patients with family history of cancer， living with children were more likely to have notification （P< 0.05）. Different tumor types might also influence the notification. Moreover， under the control of different factors， the influence effect on patients in specific age group may be different. （This sentence， in Chinse and English abstracts is confusing. Suggest authors to revise） ConclusionCommunity workers should develop corresponding health management strategies to improve the patients’ proper awareness， based on tumor category， of patient health status and family attitude.

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

OBJECTIVE: To observe the changes of distortion product otoacoustic emissions (DPOAE) in the patients with iron deficient anaemia (IDA). METHOD: Sixty cases who were taken health physical examination at ZhaBei District Central Hospital were divided into two groups, the normal group (30 cases, 60 ears) and the IDA group (30 patients, 60 ears) depend on the results of examination of hemoglobin and serum ferritin. The changes of DPOAEs at 4 kHz were observed. RESULT: A statistically significant decrease of DPOAE threshold level compared with the normal controls was seen at 4 kHz in the patients with IDA. CONCLUSION The decreased threshold level of DPOAE at 4 kHz in IDA patients should relate to sensorineural hearing loss directly.
Adolescent ; Adult ; Aged ; Anemia, Iron-Deficiency ; blood ; physiopathology ; Audiometry, Pure-Tone ; Auditory Threshold ; Case-Control Studies ; Cochlea ; physiopathology ; Female ; Ferritins ; blood ; Hemoglobins ; analysis ; Humans ; Male ; Middle Aged ; Otoacoustic Emissions, Spontaneous ; Young Adult

OBJECTIVETo investigate the therapeutic measures for unresectable primary liver cancer (PLC).

METHODSThe date of 312 unresectable primary liver cancer patients treated from January 1991 to March 2003 were retrospectively analyzed.

RESULTSOf these 312 patients, 73 were treated by cryosurgery-based combined modality therapy, 239 were treated by a TACE-oriented combined modality therapy. 289 patients except 23 were followed for a period of 2 to 156 months. The overall 1-,3- and 5-year survival rate in this series was 74. 0% , 34. 0% and 16. 7% , respectively. The 1-,3-and 5-year survival rate in the cryosurgery group was 64. 4% , 38. 4% and 27. 4% , respectively. The 1-, 3- and 5-year survival rate in the TACE group was 75. 1% , 29. 0% and 10. 0%, respectively.

CONCLUSIONTreatment for the unresectable primary liver cancer should be individualized and combined with suitable therapeutic modalities.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chemoembolization, Therapeutic ; methods ; Combined Modality Therapy ; Cryosurgery ; Female ; Follow-Up Studies ; Humans ; Liver Cirrhosis ; complications ; therapy ; Liver Neoplasms ; complications ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Survival Analysis

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.