Objective To compare the differences between MELD and Child-Pugh grading in assessing of hepatic functional reserve in patients with cirrhosis,and analyse the correlation of two systems.Methods Retrospective analysis was made on 92 cases of hepatitis cirrhosis hospitalized with the MELD and Child-Pugh score by ROC curve,the difference and relation between two systems were compared.Results MELD and Child-Pugh system were significantly correlated(r=0.669,P < 0.000),3-month survival in patients with two systems ROC curve areas was significantly different(P < 0.05),while the MELD in patients survived more than 6 months was not significantly different compared with Child-Pugh(P>0.05).ConclusionMELD and Child-Pugh can accurately assess the prognosis of survival for patients with hepatic cirrhosis,and MELD is suitable for assessment of risk,heavy patients,not for those survived more than 6 months.

Chordoma ; metabolism ; pathology ; Diagnosis, Differential ; Elbow ; Humans ; Immunohistochemistry ; Male ; Mucin-1 ; metabolism ; Myoepithelioma ; metabolism ; pathology ; surgery ; Soft Tissue Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism ; Young Adult

Objective To investigate the application value of urine excrement shunt surgery for the treatment of severe metabolic disorders after Sigma rectum pouch of bladder cancer.Methods From July 2011 to December 2013,4 male patients (mean age 72±10 years old,ranged from 58-82 years old),who received radical cystectomy and Sigma rectum pouch due to bladder cancer,were admitted in our hospital.Within four years after the operation,all patients complained about the recurrent fatigue,anorexia and even unconsciousness.The hyperchloremic metabolic acidosis,hypokalemia and renal dysfunction were diagnosed by blood gas analysis and biochemical tests.One week before urine excrement shunt operation,the arterial blood pH,HCO3-,serum potassium,chloride and creatinine were (7.15±0.08),(7.8±4.7)mmol/L,(3.1 ±0.2) mmol/L,(110.3±4.7) mmol/L,(314.8±66.4) μmol/L,respectively.They received urine excrement shunt surgery.The lower abdominal mid-line incision was made and the pouch was isolated from intestinal tract.The abdomen ostomy was made and the sigmoid colon and rectum were re-coincided in order to recover the intestinal continuity.The results of blood gas analysis,electrolytes and renal function after surgery were compared with those before surgery.Results The average operation time was (256.3±26.9) min and the mean volume of bleeding was (147.5±111.2) ml.There was no surgery related complication.Blood bicarbonate was (19.1±4.8) mmol/L one week after surgery,which was significantly improved than that before operation (P＜0.05).One month later,blood pH level descended to (7.38±0.05),potassium level was (3.9±0.3) mmol/L,creatinine was (208.8±50.8) umol/L.All of them were significantly improved,compared with those results before surgery (P＜0.05).Blood chloride was significantly reduced to (102.4±5.8) mmol/L (P＜0.05) after 6 months of operation.Nobody developed severe acidosis and electrolyte disturbances during 6 months to 3 years' follow-up.Conclusions Urine excrement shunt surgery can effectively corrected the acidosis and electrolyte disturbances due to the radical cystectomy and Sigma rectum pouch.It might be a alternative method to treat such kind of severe complications.

Oxidative stress-induced neuronal apoptosis plays a vital role in the development of neurodegenerative disorders;while at present its regulation pathways mainly include the NF-κB pathway;p53 pathway;MAPK path-way;PI3 K/Akt pathway;Nrf2 pathway;as well as other signaling pathways.Research findings suggest that the active components in Chinese materia medica exert significant biological activities in the treatment of oxidative stress-induced neuronal apoptosis.In the present paper;we review the recent research advances on the relative mechanisms of active components in Chinese materia medica against oxidative stress-induced neuronal apoptosis;so as to provide some references or clues for the clarification of possible mechanisms of active components in Chinese materia medica and the treatment of related neurodegenerative diseases.

OBJECTIVETo report a case of simple congenital bilateral ejaculatory duct absence (EDA) complicated with seminal vesicle cyst and review the relevant literature in order to improve the diagnosis and treatment of the disease.

METHODSWe retrospectively reviewed the clinical data of a case of bilateral congenital EDA complicated with seminal vesicle cyst, reviewed the relevant literature at home and abroad, and comprehensively analyzed the embryonic development, diagnosis, and treatment of congenital EDA.

RESULTSThe patient was a 23-year-old man, present at the clinic for infertility after married for a year. Vasography and other imaging examinations confirmed simple congenital bilateral EDA complicated with seminal vesicle cyst. Pathologic biopsy showed normal spermatogenic function of the testes.

CONCLUSIONCongenital EDA originates from embryonic developmental defect of the mesonephric duct, and it can be confirmed by vasography. Transurethral incision of the ejaculatory duct and intracytoplasmic sperm injection can be employed for the treatment of bilateral EDA.

Cysts ; complications ; diagnosis ; Ejaculatory Ducts ; abnormalities ; Genital Diseases, Male ; complications ; diagnosis ; Humans ; Male ; Retrospective Studies ; Seminal Vesicles

Ligusticum Chuanxiong,a traditional Chinese medicine,has the functions of promoting Qi flow and blood,dispelling pathogenic wind and relieving pain.One of effective constituents extracting from Chuanxiong is tetramethylpyrazine,which has several pharmacological activities and anti-tumor function through inhibiting expression of vascular endothelial growth factor(VEGF).Recent relative studies provided scientific basis for a better application oftetramethylpyrazine clinically.

Objective To discuss the causes of acute hematogenesis disorder after liver trans-plantation. Methods A retrospective analysis was performed to identify 6 patients with high fever,skin rash and acute haematogenesis disorder during 2005-2006 in our center. Results The 6 patients had viral infection, immunity damage, intake of marrow toxicity medicine and multiple organ dysfunc-tion syndrome after the operation. These might cause the disorder. Conclusion Infection, virus,drugs, graft versus host disease and immunity damage are the main reasons for acute hematogenesis disorder after liver transplantation.

Objective To observe clinical efficacy of probiotics agents in the prevention and treatment of severe pulmonary infection in elderly patients with antibiotic-associated diarrhea (AAD).Methods 60 cases of elderly patients with severe pulmonary infection (more than or equal to 60 years old) were randomly divided into the treatment group ( 31 cases ) and control group ( 29 cases ) , the control group received broad-spectrum antibiotics or using two linked above anti-infection treatment, the treatment group were added with probiotic agent ( lactobacillus complex capsules).The diarrhea, the use of antibiotics and the stool routine, bacteria before and after 5, 10, 15 days of group were observed.Results After 15 days treatment, the number of Escherichia coli in treatment group was lower than that in control group (P<0.05), the number of Bacterium lacticum and Bifidobacterium bifidum in treatment group were higher than those in control group ( P<0.05 ) .The AAD rate in treatment goup was 12.90%, which was lower than 41.38% in control group (P<0.05).There were significant differences in beginning time and duration of diarrhea between two groups (P<0.05). Conclusion The intestinal probiotics reduced induced by antibiotics in elderly patients with severe pulmonary infection , the probiotics agents could redress intestinal flora imbalance, keep the steady state of intestinal flora, and prevent and cure the antibiotic-associated diarrhea.

Objective: To observe the effect of moxa-stick moxibustion plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) in preventing chemotherapy infection in gastric cancer and its effect on immune function. Methods: A total of 70 patients with gastric cancer treated by chemotherapy were randomly divided into an observation group and a control group, with 35 cases in each group. The control group was given rhG-CSF, and the observation group was given additional moxa-stick moxibustion on the basis of rhG-CSF. Both groups were treated for 2 chemotherapy cycles, totally 6 weeks. The number of patients with infection, the duration of infection and the duration of continuous use of antibiotics were observed. The leukocytes and granulocytes counts, the levels of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were measured before and after treatment, and the levels of CD4, CD8 and natural killer (NK) cells were analyzed. Results: The infection rate of the observation group was significantly lower than that of the control group (P<0.05), and the duration of infection and the duration of continuous use of antibiotics were also shorter (P<0.05). After treatment, the leukocytes and granulocytes counts in the two groups were higher than those before treatment (all P<0.05). After treatment, the levels of TNF-α and IFN-γ of the patients in the two groups were improved (all P<0.05), and there were significant differences between the observation group and the control group (P<0.05). After treatment, the numbers of CD4, CD8, and NK cells in the observation group increased significantly (all P<0.05), but the changes in the control group were not significant (P>0.05). Conclusion: Moxa-stick moxibustion plus rhG-CSF can significantly reduce the incidence and severity of chemotherapy infection in gastric cancer, increase the leukocytes and granulocytes counts, and regulate the levels of inflammatory factors, which may be related to the improvement of the immune function of the patients.

BACKGROUND:Percutaneous vertebraplasty is a new means for the treatment of vertebral compression fractures and bone metastases. The multiplaner reconstruction with digital substraction angiography (DSA)-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, which can effectively prevent the leakage of bone cement. OBJECTIVE:To explore the value of DSA-Innova 3D in the guidance of puncture of percutaneous vertebroplasty. METHODS:From March 2014 to September 2014, a total of 72 patients with 94 vertebras were selected for percutaneous vertebraplasty, of whom 36 (48 vertebras) with Innova 3D (experimentalgroup) and 36 (46 vertebras) without Innova 3D (control group). Spiral CT scan was performed in al patients to assess the distribution of bone cement. The imaging quality in the two groups was compared by Mann-Whitney U test. RESULTS AND CONCLUSION:CT showed bone cement leakage occurred in 7 of the 36 patients in the control group. Leakages were into the lumber disc in two cases, paravertebral space in two cases, vertebral pedicle in onecase or veins in two cases. However, only one case of bone cement leakage was observed in the experimental group. With the guidance of DSA-Innova 3D, the experimental group had signficantly lower leakage and fluoroscopic time than the control group (P < 0.05). The multiplaner reconstruction with DSA-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, thereby effectively reducing the leakage of bone cement.