Objective To evaluate the feasibility and safety of interventional microinvasive techniques in the management of high level cervical esophageal strictures.Methods Among 20 cases of high level cervical esophageal strictures,13 cases of strictures at the level of C_7~T_3 were given an oral placement of nitinol metal stents woven by single thread under fluoroscopic guidance,while 7 cases of strictures at the level of C_7 and above were given a percutaneous gastrostomy(PG) under endoscopic or fluoroscopic guidance.Results All the operations were successfully accomplished without complications.Out of 13 cases of intraesophageal stent implatation,the improvement of dysphagia was classified as grade 0 in 10 cases and as grade Ⅰ in 3 cases.Esophago-tracheal fistula was completed occluded in 5 cases.Slight downward stent shift was found in 2 cases and no further management was carried out.Follow-up in 11 cases for 1~30 months(mean,18 months) revealed 3 cases of recurrence of esophageal stricture and 8 fatal cases.No stentinduced esophago-tracheal fistula occurred.Of 7 cases of percutaneous gastrostomy,liquid diet was given 2 days after operation.Infection with redness and swelling in the area of fistula wound was noted in 1 case at 1 week postoperatively and the fistula tube was found loosened in 1 case at 5 months postoperatively.No intraabdominal infection,peritonitis,or internal fistula occurred.Follow-up in 7 cases for 1~18 months showed 5 fatal cases.Conclusions Stent implantation should not be contraindicated in patients with high level cervical stricture of esophagus.Radiologically guided percutaneous gastrostomy is safe and feasible,which is preferred as the first choice of treatment.

BACKGROUND:Methods after mechanical stimulation can be combined with various kinds of cells to produce many conversion types so as to start the various physiological functions of the body. OBJECTIVE:To analysis the reason why rol ing massage can improve the intracellular concentration of Ca2+METHODS:A biodynamic experimental device was set up, composed of pressure generating device, pressure forming device, pressure display device and related data recording device. We detected the effects of rol ing massage on Ca . 2+concentration in normal skeletal muscle cells and damaged cells through the different functions of the experimental device and system software. These functions consisted of pressure display, data transmission and recording, signal acquisition and processing, pressure signal acquisition, control and processing of signal acquisition, wireless signal transmission and receiving system, display system, storage system, system implementation function. RESULTS AND CONCLUSION:The experiment results showed that rol ing massage could reduce the Ca 2+concentration in the normal skeletal muscle cells and damaged cells. These findings suggest that rol ing massage can improve the overload of intracellular Ca2+in damaged cells, and it is superior to the sinusoidal mechanical stimulus.

Objective To evaluate the effect and safety of trans-arterial chemotherapy embolization (TACE) in the treatment of primary hepatic carcinoma ( PHC ) with portal vein tumor thrombus. Methods There were 83 PHC patients complicated with portal vein tumor thrombus, age ranging from 29 to 76 years. Fifty-three cases underwent TACE ( Group A) , 30 receiving trans-arterial chemotherapy infusion only (TAI, Group B). Results The survival rate in group A at 6,12,24 and 36 months was 97. 8% , 85.2%,45.8% and 4.4%, respectively, significantly higher than that in group B (37. 6% ,5. 3% ,0,0, P

BACKGROUND:Currently, human umbilical cord derived-mesenchymal stem cel s are mainly for local transplantation, which has some shortcomings, such as large trauma, bleeding, complications, that limit its widespread application in clinical practice. OBJECTIVE:To investigate the feasibility of intravenous transplantation of human umbilical cord derived-mesenchymal stem cel s for repair of spinal cord injury. METHODS:Eighty Wistar rats with spinal cord hitting were divided into five groups:blank control group with no transplantation (n=10), DMEM local transplantation group (n=15), DMEM intravenous transplantation group (n=15), cel local transplantation group (n=20), cel intravenous transplantation group (n=20). The functional recovery of spinal cord injury was observed with Basso, Beattie and Bresnahan scores at regular time as wel as hematoxylin-eosin staining and immunohistochemistry staining. RESULTS AND CONCLUSION:During 1 day to 2 weeks after transplantation, there was no significant difference in the Basso, Beattie and Bresnahan scores between the five groups;within 4-12 weeks after transplantation, the Basso, Beattie and Bresnahan scores were significantly higher in the two cel transplantation groups than the other three groups, but there was no difference between these two cel transplantation groups (P>0.05). Histological observation showed that the number of voids and glial scars was less in the cel local transplantation group and cel intravenous transplantation group compared with the other three groups, and there was also no difference between the two cel transplantation groups. These results indicate that the intravenous transplantation of human umbilical cord derived-mesenchymal stem cel s is similar to the local transplantation in the repair of acute spinal cord injury, which is simple and avoids secondary injuries and various complications. It is recommended that this method provide a new approach for cel transplantation.

The concentrations of prostaglandin in high mobility group box-1 ( HMGB1 ) and highsensitive C-reactive protein (Hs-CRP) in serum and peritoneal fluid were detected in 76 patients with endometriosis (study group) and 30 patients without endometriosis (ovary cysts or uterine myoma, as control group). The peritoneal fluids were collected during laparoscopic operation, and the serum samples were collected before surgery. The HMGB1 and Hs-CRP concentrations in serum and peritoneal fluid of study group were significantly higher than those of control group, ( 8. 2 ± 0. 8) mg/L vs. (2. 1 ±. 0. 2) mg/L、 ( 14. 4 ±3.0) mg/L vs. (4.5 ±2.3) mg/L (both P＜0. 01);HMGB1 and Hs-CRP levels in serum and peritoneal fluid of stage Ⅲ-Ⅳ endometriosis were significantly higher than those of stage Ⅰ-Ⅱ, ( 9. 2 ± 0. 8) mg/L vs.(6.7 ±0.7) mg/L,(18.7 ±2.9) mg/L vs. (11.2 ±2. 8) mg/L,(6.5 ±0.6) mg/L vs. (3.4 ±0.5) mg/L,(8.4 ±2.7) mg/L vs. (5.4 ±2.4) mg/L (all P ＜0.05). The concentrations of HMGB1 were positively correlated with Hs-CRP in endometriosis group (r =0. 72, P ＜0. 01 ). The results indicate that concentrations of HMGB1 and Hs-CRP may be of value in assessing the severity of endometrosis.

目的探讨胸腰段椎体骨折脊髓损伤患者康复治疗效果。方法65例脊髓损伤患者，其中T11 3例，T11-12 5例，T12 12例，T12-L1 5例，L1 31例，L2 9例。入院时检查患者感觉损伤平面和运动损伤平面，记录在脊髓损伤积分评定表中，评定日常生活活动能力(ADL)，制订康复计划，进行心肺功能、肌力、二便功能、转移、配戴矫形器站立、行走及ADL指导性训练。结果中途有5例患者脱落。出院后患者ADL等级提高到良30例、中30例。根据ADL变化，显著有效50％，有效50％。步行能力达到社区功能性步行29例，家庭功能性步行31例。结论胸腰段脊髓损伤患者经过系统康复训练，配备支具、使用辅助具，对恢复患者步行能力及ADL水平的提高有满意的效果。

Although endovascular therapy improves the recanalization rate of acute large vessel occlusive ischemic stroke, about half of the patients still have poor functional outcome at 90 d, which is called " futile recanalization" . This article reviews and summarizes the predictive factors of futile recanalization after endovascular therapy in acute anterior circulation ischemic stroke, in order to provide help for clinical work and scientific research in the future.

Objective To conduct a prospective,randomly controlled trial,evaluating the combination of tacrolimus,corticosteroids and entecavir for the treatment of adult patients with biopsyproven hepatitis B virus-associated membrane nephropathy (HBV-MN).Methods A total of 38 patients with biopsy-confirmed HBV-MN were randomized to the tacrolimus group (n=19) and the control group (n=19).Patients in tacrolimus group received combination therapy of tacrolimus (0.05 mg·kg-1 · d-1),corticosteroids (prednisone acetate,0.5 mg· kg-1 · d-1) and entecavir (0.5 mg/d),whereas patients in control group received entecavir mono-therapy (0.5 mg/d).The primary end point was the percentage of patients reaching complete remission (CR) or partial remission (PR).Results The probability of remission in the treatment group was 88.89％ and 94.44％ after 6 and 12 months,but only 38.89％ and 58.82％ in the control group,respectively.The decrease in proteinuria was significantly greater in the treatment group.Entecavir was used for the treatment of hepatitis in all patients,which caused the disappearance of serum hepatitis B viral DNA(HBV-DNA) and the normalization of ALT and AST levels in 3 months.Notably,two patients in the control group and one patient in the treatment group reached the secondary end point.One patient in the tacrolimus-treated group showed a relapse during the taper period.Conclusion This treatment protocol not only can control the replication of HBV-DNA but also can reduce proteinuria and preserve renal function,it is one of useful therapeutic options for patients with HBV-MN.

Objective To study the nursing method about percutaneous biliary tract stent implantation to cure malignant obstructive jaundice.Methods Careful perioperative nursing cares and finished post-hospital direction were applied among 21 patients with malignant obstructive jaundice when by percutaneous biliary tract stent implantation.Results There were 20 patients obtained successful operation,the successful rate was 95%.The postoperative of glutamic pyruvic transaminase were(96.60?89.36) U/L,the total bilirubin was(137.96?103.95) ?mmol/L,the directed bilirubin was((85.67)?62.95) ?mmol/L and the indirected bilirubin was(56.76?37.37) ?mmol/L.All the indexes which have mentioned above were significant lower than those of before operative,P

Objective To observe the clinical effect and complications of intravenous immunoglobulin(IVIG)in the treatment of severe adenovirus pneumonia(SAP)in children. Methods Clinical data of 210 hospitalized children with SAP from June 2009 to June 2011 were retrospectively analyzed. Patients were divided into IVIG group (109 cases) and control group (101 cases) to compare the therapeutic effects, duration of fever, length of stay in hospital, duration of mechanical ventila-tion, and complications between the two groups. Results There was no difference in the severity of illness on admission and un-derlying diseases between the two groups. Both groups were given antiviral, antibacterial and comprehensive supporting thera-py, and in the IVIG group IVIG 250-400mg/(kg.d) were administered for 3-5 d. The mean hospital stay and fever time of the IVIG group were significantly shortened comparing to that of the control group, and the time of mechanical ventilation on the IVIG group is less than that of the non-IVIG group. Incidence rate of pleural effusion, atelectas is, myocarditis and toxic enceph-alopathy in the IVIG group is lower than the control group, and the cure rateand effective therapy of the IVIG group is higher than control group, all of the difference was statistically significant (P<0.05). No adverse drug reaction was observed. Conclu-sions IVIG is safe and effective in the treatment of SAP in children.