Objective To study application of hematocoelia reinjection in abdominal injury with massive hemorrhage and anemia ,and to estimate the impact of salvaged autotransfusion on blood routine and blood coagulation of patients.Methods In 75 patients with intra-abdominal injury bleeding anemia undergoing autologous hematocoelia reinfusion,compare the anemia index and coagulation indexes before and after surgery to evaluate the therapeutic effect.Results Among 75 cases,1 cases died of brain injury,the other 74 cases were cured.After the second days of review,red blood cell,hemoglobin,hematocrit,platelet were elevated,compared with preoperative,the differences were statistically significant(all P<0.01).Comparison of each index function and coagulation before operation ,the differ-ences were statistically significant (all P>0.05).Conclusion Salvaged autotransfusion can improve anemia prompt-ly without any impact on coagulation function in rescuing abdominal injured patients with massive hemorrhage and a -nemia.The treatment is effective .It has an important application in primary hospital .

Objective To investigate clinical features of alopecia areata such as sex, age, and subjective symptoms, and relationships between these factors and disease severity. Methods Clinical materials of patients who were diagnosed as alopecia areata were collected. The role of sex was analyzed in the disease and the correlation between disease severity and sex, age or psychological factors was analyzed. Results 118 patients including 101 cases of localized alopecia areata (AA), 5 alpecia totalis (AT) and 12 alopecia universalis (AU) were collected. The ratio of male to female was 1.2:1 and there was no correlation between sex and disease severity. The patients were from 1 to 76 years old while average age was 31.3?1.3 years, and that of the female patients was 28.9?1.9 and the male was 33.2?1.8; The median course was 2.5 months, while AA was 2 months, and AT/AU was 18 months; 14.4% patients (17/118), including 11 cases of AA and 6 AT/AU had subjective symptoms; 20.3% patients (24/118) had psychological factors before onset, 60.2% patients (71/118) had difficulties in sleeping, nail changes were found in 15.2% patients (18/118), and ocular symptoms were found in 5.9% patients (7/118), 5.9% patients (7/118) had family history, 3.4% patients (4/118) were accompanied by disease of thyroid gland, 1.7% patients (2/118) were accompanied by vitiligo, TGA and TMA levels elevated abnormally in 4.8% patients (3/62). Conclusion Alopecia areata often affects young to middle-aged people, and there is no correlation between sex and disease severity; Female patients are younger than male; A few patients are induced by psychological factors, and some accompanied by other autoimmune diseases. AT/AU is easier to have subjective symptoms than AA.

Objective To observe the clinical effects of Shenqifuzheng injections combined with PTX and DDP on advanced non small cell lung cancers. Methods Fifty cases of advanced non small cell lung cancers were randomly divided into pure chemotherapy and chemotherapy combined with traditional Chinese medicine groups. The former was treated with 30 mg/m2 DDP from day 1 to day 3, 135 mg/m2 PTX only at the first day. The latter was treated with 250 ml Shenqifuzheng injections every day until the twentieth-first one, three days before the beginning of chemotherapy. After two periods of treatments, the therapeutic effects were evaluated, respectively. Results The recent effective ratios of chemotherapy combined with traditional Chinese medicine and pure chemotherapy groups were 48 % and 40 %, respectively. The former could ameliorate the physical status, the numbers of peripheral leucocytes, the decreases of blood platelet, the gastrointestinal reactions of subjects. Conclusion The Shenqifuzheng injections could increase the recent treatment effect of PTX combined with DDP on advanced non small cell lung cancers, effectively meliorate the clinical symptoms and alleviate the side effects of chemotherapy leading to improve the life qualities of subjects.

Objective More early esophageal cancers are treated by endoscopy.However,whether submucosal patients are suitahle for endoscopic treatment is still controversial,and few domestic researches were conducted in this area.The present study investigated the impact of submucosal invasion depth on lymph node metastasis.Methods A total of 258 patients who underwent esophagectomy from November 2009 to March 2014 were studied.Submucosal invasion was equally categorized into inner one-third(sml),middle one-third(sm2),and deep one-third(sm3) invasion by pathologists.Demographics of patients,tumor characteristics,and surgical information were retrospectively collected through medical records.They were compared according to different submucosal invasions.Cancer characteristics and its association with LNM were analyzed by univariate and multivariate analysis.Results The study included 75 sml (29.1％),73 sm2(28.3％),and 110 sm3(42.6％) patients,and the rates of LNM were 12.0％ (9/75),11.0％ (8/73),20.9％ (23/110),respectively.sm3 might be associated with regional LN M (univariate analysis,P =0.041).Tumor volume ＞ 1.856 cm3 (P =0.022) and lymphovascular invasion (P =0.004) predicted LNM using multivariate analysis.Conclusion Submucosal ESCC showed a substantial rate of LNM and it seems that they are not suitable for endoscopic treatment.Depth of invasion was not an independent risk factor for LNM.

Objective:This study aims to investigate the method and clinical outcomes of feeding tube placement and periopera-tive nutritional support for esophageal carcinoma patients. Methods:A total of 513 esophageal carcinoma patients who have undergone radical resection and reconstruction by a single operating group between January 2012 and December 2013 participated this study. Feed-ing tubes were inserted via the nasal path of 497 cases and by jejunostomy in 16 cases. Early enteral nutrition (EN) was administered through the feeding tubes 24 h postoperatively with a stepwise increase, whereas supplementation of parenteral nutrition (PN) was ter-minated until total EN. Results:Feeding tubes were successfully inserted in all patients during operation. No death or nutritional and metabolic disorders were documented during the observation period. No differences in anastomotic fistula, pulmonary complication, and incision infection were identified between the nasointestinal and jejunostomy groups (P>0.05). A higher incidence of intestinal ob-struction was observed in the jejunostomy group than in the nasointestinal group (P<0.05). Conclusion:Effective placement of nasoin-testinal tube and early enteral feeding are safe and effective methods for patients who have undergone esophagectomy for esophageal carcinoma.

Objective To investigate the imaging differentiation between high-grade and low-grade limb of long bone chon-drosarcoma.Methods The MRI imaging features in 23 cases of pathologically proven limb long bone chondrosarcomas were retro-spectively analyzed,including 13 cases of low-grade and 10 cases of high-grade.The MRI imaging features including endosteal scal-loping lesion,cortical thickening,cortical destruction,bone expansion,soft tissue mass,bone marrow edema,soft tissue edema,calci-fication,hemorrhage,tumour maximal radial line and enhancing features were performed the statistical analysis.Results 13 cases were the low-grade chondrosarcomas,including atypical cartilaginous tumour and grade 1 chondrosarcomas,10 cases were high-grade chondrosarcomas (8 cases of grade Ⅱ chondrosarcomas,1 case of gradeⅢ chondrosarcomas and 1 case of dedifferentiated chondrosarcomas).Cortical destruction,soft tissue mass and soft tissue oedema had statistical differences between the low-grade and high-grade.Bone marrow had statistically significant difference.Calcification +(SC<1/3ST)had statistical difference between the low-grade and the high-grade.Calcification ++(1/3 ST

An 82-year-old Chinese woman presented with skin eruptions on the thigh and abdomen accompanied by intermittent fever of unknown origin for more than 2 months.No hepatosplenomegaly,lymphadenopathy or neurological abnormality was found with physical examination.There were irregular,tender,indurated,dark-erythematous plaques on bilateral thigh and lower abdomen.along with nonpitting edema and peau d'orange appearance.A significant decrease was observed in the count of white blood cells,red blood cells and platelets,but the serum level of lactate dehydrogenase was elevated.Tumor aspiration and the first pathology yielded no confirmed diagnosis,and the patient had ever been diagnosed with chronic lymphangitis,allergic cutaneous vasculitis and fever of unknown origin in other hospitals.Antibiotic therapy leaded to no improvement,and the lesions gradually spread from the migh to lower abdomen.The second histopathology revealed the presence of atypical lymphoid cells with hyperchromatic nuclei and irregular morphology in the lumens of small blood vessels in subcutaneous tissue.Immunohistochemically,the atypical lymphoid cells were positive for lymphocytotoxic antibody (LCA),CD20,CD790t and bcl-2,but negative for bcl-6,CD10,CD3,CD45RO,CD30,EMA,AEI/3 or CK and vascular endothelial cells were positive for CD34.The diagnosis of intravascular large B-cell lymphoma was made based on the hisstopathological features and immunohistochemical findings.The patient died in two months.

Background Phakic posterior chamber implantable contact lens (PPC-ICL) or phakic posterior chamber Toric implantable contact lens (PPC-TICL) implantation is an effective way for the correction of high myopia or high myopia with astigmia,but it often has residual myopic power.Excimer laser-assisted subepithelial keratectomy (LASEK) can correct the residual myopia following PPC-ICL or PPC-TICL,but its effectiveness and safety deserve attention.Objective This study was to analyze the clinical effectiveness and safety of LASEK for residual myopia after PPC-ICL implantation for extreme high myopia.Methods A prospective cases-observational study was performed,and written informed consent was obtained from each patient before any surgery.Fourteen eyes of 9 patients with residual myopia following PPC-ICL or PPC-TICL for the eyes with spherical equivalent refraction of ≥-20.00 D were collected in the Affiliated Hospital of Guizhou Medical University from July 2010 to March 2015,including PPCICL implantation in 8 eyes and PPC-TICL implantation in 6 eyes.LASEK were performed on the eyes to correct the residual myopic power.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),haze,the distance of intraocular lens to lens,corneal thickness,corneal topography,corneal endothelial cell counting,intraocular pressure (IOP) and fundus were examined and compared before and after surgery.The effectiveness and safety of the surgery were evaluated.Results The operation was smooth and no complication was found after surgery in all of the eyes.The UCVA and BCVA were significantly different in the eyes among before surgery,6 months after PPC-ICL implantation and 12 months after LASEK (F =31.360,1.778;both at P＜0.05),and the UCVA after LASEK was higher than BCVA before LASEK.The refractive powers were (-22.27-±4.29),(-3.75±2.25) and (-0.42±0.63) D before surgery,6 months after PPC-ICL implantation and 12 months after LASEK,showing a significant difference among them (F=46.370,P＜0.05),and the refractive power was considerably lower after LASEK than that before surgery and after PPC-ICL implantation (both at P＜0.05).No significant difference was found in IOP or corneal endothelial cell counting in operated eyes among before surgery,6 months after PPC-ICL implantation and 12 months after LASEK (F=1.663,1.055;both at P＞0.05).The distance of intraocular lens to lens was (0.69±0.26)mm in the eyes after LASEK and (0.71 ±0.29)mm in the eyes after PPC-ICL implantation,with no significant difference between them (t =0.192,P＞0.05).Conclusions PPC-ICL or PPC-TICL implantation for the correction extreme high myopia often remains a certain degree of myopia,and LASEK for the correction of residual refractive power is safe and effective.

ObjectiveTo analyze whether association of edge to edge valve repair to artificial ring annuloplasty would result in better results in patients with severe tricuspid regurgitation (TR).MethodsFrom April,2001 to May,2010,41 patients underwent tricuspid valve repair to treat severe TR were studied.Twenty-one patients were done artificial ring annuloplasty alone (group R) and twenty patients were done artificial ring annuloplasty associated with edge to edge valve repair ( group E).All the patients received echocardiography before surgery,before discharge and in mid and long-term follow-up.The ratio between TR jet area (TRA) and right atrial area (RAA) was used to quantitatively evaluate the seriousness of TR.Movement of tricuspid valve leaflets,tricuspid valve orifice area,pulmonary artery pressure ( PAP),left ventricular ejection fraction ( LVEF) were obserbed to evaluate heart function.ResultsAt discharge in group R,no or trivial TR was presented in 7 patients,mild TR in 12 patients and moderate TR in 2 patient.Bad apposition of the free edges of anterior and septal leaflets was observed in paients with mild and moderate TR.While in group E,no or trivial TR was presented in 13 patients and mild TR in 7 patients.The follow-up ranged from 6 months to 100 months[average (54.8 ±26.7) months].In group R,no or trivial TR was present in 5 patients,mild TR in 11 patients,moderate TR in 4 patients and severe in 1 patient.Bad apposition of the free edges of anterior and septal leaflets was observed in paients with mild to severe TR.Redo tricuspid valve repair was done in one patient in group R for recurrent severe TR and the edge-to-edge valve repair was utilized.In group E,no tricuspid stenosis was found.No or trivial TR was presented in 10 patients,mild TR in 9 patients and moderate TR in 1 patient.The ratio of TRA/RAA of group R was significantly higher than that of group E (0.25 ±0.16 vs.0.13±0.10,P < 0.01).ConclusionAssociation of edge-to-edge valve technique to artificial ring annuloplasty was safe and effective for treatment of severe tricuspid regurgitation due to bad apposition of free edges of tricuspid leaflets and dilatation of tricuspid annulus,.It could decrease the incidence of residual tricuspid regurgitation and prevent the recurrence of severe tricuspid regurgitation.

OBJECTIVETo evaluate the efficacy and safety of Pai-Neng-Da Capsule (panaxadiol saponins component, PND), a new Chinese patent medicine, on patients with chronic aplastic anemia (CAA) and to explore the optimal therapeutic regimen for CAA.

METHODA total of 36 patients with CAA were enrolled and divided into three groups: the AP group (20 cases, andriol 120 mg/day + PND 240 mg/day), the ACP group (13 cases, andriol 120 mg/day + cyclosporine 3-6 mg kd(-1) day(-1) + PND 240 mg/day), and the PND group (3 cases, PND 240 mg/day). All patients were treated and followed up for 6 months. Peripheral blood counts, renal and hepatic function and Chinese medical (CM) symptoms of patients were assessed and all indices were gathered at the beginning and end of the study.

RESULTIn the AP group, no significant hematologic difference was observed at the end of 6-month treatment comparing with the beginning. In the ACP group, the blood counts were maintained at the same level after the 6-month treatment. In the PND group, trilineage hematologic improvement was displayed at the end of 6-month treatment comparing with the beginning. No significant difference was showed in renal and hepatic function in all patients. All patients' clinical symptom improved according to CM symptom score. The effective rates were 95%, 73% and 100%, respectively.

CONCLUSIONPND improved the efficacy and decreased side effects by cutting down the dosage of andriol, and it could also improve patients' clinical symptom and quality of life. PND were effective and safe in the treatment of CAA, it could be used alone or in combination with pharmacological agents such as andriol and cyclosporine.

Adolescent ; Adult ; Aged ; Anemia, Aplastic ; blood ; drug therapy ; Capsules ; Chronic Disease ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Erythrocyte Count ; Female ; Humans ; Male ; Middle Aged ; Saponins ; adverse effects ; therapeutic use ; Treatment Outcome ; Young Adult