Adolescent ; Adult ; Chronic Disease ; Dacryocystitis ; surgery ; Dacryocystorhinostomy ; methods ; Endoscopy ; Female ; Humans ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Nasal Cavity ; surgery ; Young Adult

OBJECTIVETo evaluate the clinical value of various kinds of interventional techniques in the treatment of Budd-Chiari syndrome (BCS).

METHODSMultiple techniques such as recanalization of the inferior vena cava (IVC) under the guidance of marker and multi-angled fluoroscopy, recanalization of the hepatic vein with a transjugular approach, PTA, Z-expandable metallic stent (Z-EMS) implantation and modified TIPSS were used to treat 103 patients with BCS.

RESULTSOf 103 patients with BCS, 59 patients with obstruction of IVC were treated using recanalization of IVC. Seventeen patients with hepatic vein obstruction had their hepatic veins recanalized. The rest of the patients were given other methods of interventional treatment. Of all the subjects, 101 successfully underwent their procedures, with a success rate of 98.06%; and only 2 failed to recanalization of the IVC. Fifty-three patients were treated using PTA for the first time, with a success rate of 100%. In the 48 patients undergoing Z-EMS implantation for the first time, the success rate was 95.8%. Five patients were treated with modified TIPSS. After these interventional treatments, the success rate was 100%. Two patients died 16 h and 72 h respectively after operation because of DIC and severe hemoptysis. Seventy-two patients were followed up for 1 - 94 months (with a mean of 42.3 months). The mean follow-up of a BCS patient treated with PTA was 52.1 months, resulting in a primary patent rate of 59.4% and a restenosis rate of 40.6%. The mean follow-up of BCS treated with stenting was 33.5 months, with a primary patent rate of 87.5% and a restenosis rate of 12.5%. Eight patients died 7 - 64 months after the interventional procedure.

CONCLUSIONRecanalization of IVC or the hepatic vein transjugularly, PTA, Z-EMS implantation and modified TIPSS can be regarded as safe and effective micro-invasive methods in the treatment of BCS.

Adolescent ; Adult ; Angioplasty, Balloon ; Budd-Chiari Syndrome ; therapy ; Female ; Hepatic Veins ; surgery ; Humans ; Male ; Middle Aged ; Portasystemic Shunt, Transjugular Intrahepatic ; Stents ; Vena Cava, Inferior ; surgery

OBJECTIVETo report the serious complications of microvascular decompression and (or) selective neurectomy in cerebellopontine angle.

METHODSTo review 322 cases of microvascular decompression and (or) facial nerve splitting, selective neurectomy for hemifacial spasm, trigeminal neuralgia and glossopharyngeal neuralgia respectively. Among 322 cases, hemifacial spasm 164, which 96 underwent facial nerve splitting, 68 underwent microvascular decompression and facial nerve splitting. The selective neurectomy and neurectomy were performed in 128 cases of trigeminal neuralgia and 30 cases for glossopharyngeal neuralgia respectively.

RESULTSOf the serious complications 2 died (0.6%), The mild to severe hearing impairment occurred in 21 cases (6.5%), in which 3 cases presented total hearing loss (0. 9%); Postoperative cerebellospinal leakage in 20 (6. 2%).

CONCLUSIONSIt was demonstrated that, even though the microvascular decompression and /or neurectomy was a safe procedure for posterior neuropathy, mortal and serious complications might occur. It was essential to pay great attention to the entire decompression procedure in avoiding cerebellar injury. Using of intraoperative ABR and avoiding of impairment of the acoustic nerve might contribute to the prevention of the postoperative hearing loss.

Adult ; Aged ; Cerebellopontine Angle ; surgery ; Decompression, Surgical ; adverse effects ; Female ; Hearing Loss ; etiology ; Humans ; Male ; Middle Aged ; Neurosurgical Procedures ; adverse effects ; Postoperative Complications

To optimize the belt drying process conditions optimization of Gardeniae Fructus extract from Reduning injection by Box-Behnken design-response surface methodology, on the basis of single factor experiment, a three-factor and three-level Box-Behnken experimental design was employed to optimize the drying technology of Gardeniae Fructus extract from Reduning injection. With drying temperature, drying time, feeding speed as independent variables and the content of geniposide as dependent variable, the experimental data were fitted to a second order polynomial equation, establishing the mathematical relationship between the content of geniposide and respective variables. With the experimental data analyzed by Design-Expert 8. 0. 6, the optimal drying parameter was as follows: the drying temperature was 98.5 degrees C , the drying time was 89 min, the feeding speed was 99.8 r x min(-1). Three verification experiments were taked under this technology and the measured average content of geniposide was 564. 108 mg x g(-1), which was close to the model prediction: 563. 307 mg x g(-1). According to the verification test, the Gardeniae Fructus belt drying process is steady and feasible. So single factor experiments combined with response surface method (RSM) could be used to optimize the drying technology of Reduning injection Gardenia extract.
Chemistry, Pharmaceutical ; instrumentation ; methods ; Desiccation ; instrumentation ; methods ; Drugs, Chinese Herbal ; chemistry ; Fruit ; chemistry ; Gardenia ; chemistry ; Research Design ; Vacuum

OBJECTIVETo investigate the therapeutic effect and safety of Sorafenib in the treatment of tumor recurrence after orthotopic liver transplantation (OLT).

METHODSBetween January, 2009 and June, 2011, 10 patients with tumor recurrence after OLT were treated with Sorafenib (group A) and another 8 recipients received no Sorafenib treatment (group B); 25 patients with hepatocellular carcinoma (HCC) also received Sorafenib treatment (group C). The tumor-bearing survival time, adverse effect and toxicity associated with sorafenib were compared between the 3 groups.

RESULTSIn group A, the median tumor-bearing survival time was 10 months (5-22 months), as compared to 4 months (1-8 months) in group B and 4 months (2-21 months) in group C, showing a significant difference in the survival time among the 3 groups (Kaplan-Meier, log-rank test, P=0.045). No recipient experienced acute graft rejection, but one recipient in group A died due to gastrointestinal bleeding. No significant difference was found in adverse effects associated with Sorafenib between groups A and C (P<0.05).

CONCLUSIONSorafenib can prolong the survival time of patients with tumor recurrence after OLT without increasing the risk of acute graft rejection.

Carcinoma, Hepatocellular ; drug therapy ; surgery ; Female ; Humans ; Liver Neoplasms ; drug therapy ; surgery ; Liver Transplantation ; Male ; Neoplasm Recurrence, Local ; drug therapy ; Niacinamide ; analogs & derivatives ; therapeutic use ; Phenylurea Compounds ; therapeutic use ; Postoperative Period ; Survival Rate ; Treatment Outcome

OBJECTIVETo investigate the diagnostic methods and reasonable treatment of Peutz-Jeghers syndrome (PJS).

METHODSClinical data of six patients with PJS were reviewed.

RESULTSRepeated abdominal pain, intussusception and intestinal polyp with bleeding were main manifestations. Four patients father,three patients grandfather and one patients mother were diagnosed with PJS. Three patients had family history of cancer. Case 4 and case 5 underwent laparotomy for many times because of intussusceptions caused by polyps or recurrent abdominal pain. Case 1 and case 4 had polyps synchronous with adenoma, and case 2 had polyp with gastric cancer. Main treatment included polyp resection and partial small intestinal and colon resection.

CONCLUSIONSPatients with PJS have family history of cancer and a high incidence of polyp recurrence of small intestine. Surgical intervention is the first choice regimen. Surveillance should be emphasized on gastrointestinal tract and other potential malignant organs in PJS patients.

Adolescent ; Adult ; Female ; Humans ; Intestine, Small ; surgery ; Male ; Pedigree ; Peutz-Jeghers Syndrome ; diagnosis ; genetics ; surgery

OBJECTIVETo investigate the effects of enriched environment and impoverished environment on the learning and memory ability of manganese-exposed mice and the mechanism.

METHODSForty female Kunming mice were randomly and equally divided into 4 group: control group (CG), standard environment and manganese exposure group (SEG), enriched environment and manganese exposure group (EEG), and impoverished environment and manganese exposure group (IEG). The mouse model of manganese poisoning was established by intraperitoneal injection of manganese chloride. The learning and memory ability was tested by Morris water maze. The expression of cAMP response element-binding protein (CREB) in area CA1 of the hippocampus was measured by immunohistochemistry.

RESULTSIn place navigation test, the SEG had a significantly longer escape latency than the CG (P < 0.05), and the EEG had a significantly shorter escape latency than the SEG (P < 0.05); there was no significant difference in escape latency between IEG and SEG (P > 0.05). In spatial probe test, the EEG had a significantly greater number of platform crossings than the SEG (P < 0.05), and the IEG had a significantly smaller number of platform crossings than the SEG (P < 0.05). The expression of CREB in area CA1 of the hippocampus was significantly lower in IEG and SEG than in CG (P < 0.05), and it was significantly higher in EEG than in SEG (P < 0.05).

CONCLUSIONIn the enriched environment, the learning and memory ability of manganese-exposed mice can be improved, which may be due to the increased expression of CREB in the hippocampus.

Animals ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Disease Models, Animal ; Environment ; Female ; Hippocampus ; drug effects ; metabolism ; Learning ; drug effects ; Manganese Poisoning ; metabolism ; Memory ; drug effects ; Mice

Objective To investigate the clinical outcomes of patients undergoing microsurgery for cerebellar medulloblastoma. Methods This retrospective analysis of the clinical and follow-up data involves 57 patients who received microsurgery for pathologically confirmed cerebellar medulloblastorna, and the microsurgical techniques for medulloblastoma were discussed. Results Among the 57 patients, 42 had total tumor resection, 13 had subtotal and 2 had partial resection of the tumors. Patency of the midbrain aqueduct was achieved in all the cases after the surgery. Hydrocephalus was found in 43 patients before the operation and only in 16 patients after the operation. Tumor relapse occurred in 19 patients 2 years after the operation, including 8 with implantation metastasis compromising the central nervous system and 1 patient with frontal lobe metastasis who received reoperations. The earliest tumor relapse occurred 20 days after the surgery. The 2- and 5-year postoperative survival rates in these patients were 68.4% and 49.1%, respectively. Conclusion Good therapeutic effects can be achieved with total resection of the tumors and postoperative whole brain and spinal cord radiotherapy in patients with medulloblastomas.

Objective To analyze the etiologic characteristics of Vibrio cholerae in Guangdong province in 2007.Genetic relationship was observed including among predominated biotype isolates from different areas within the province and among same biotypes isolates from cholera cases and regular surveillance.Methods Isolates from cholera cases and through environmental surveillance were typed by sero-and phage-typings.Similarity of molecular fingerprinting was analyzed through comparing the pulsed field gel electrophoresis(PFGE)pattern of predominated biotype isolates,and those of the same biotype isolates from cholera cases and environment surveillance,respectively.In addition,genetic relationship was determined by clustering analysis,using bionumerics software.Results In total,31 isolates from cholera cases were collected and subtyped for 3 serogroups.V.cholerae O1 El Tor Inaba phage 1d was the predominant biotype which causing most of the cases in Guangdong province in 2007.Data from cluster analysis showed that the similarity among Inaba phage 1d strains from different areas were from 94.5% to 100%.However.16 isolates were collected from environment surveillance programs and the predominated biotype could not be found.Additionally,the biotype distribution of cases isolates was not consistent with those isolates through surveillance.High phylogenetic diversity was observed for the same biotypes isolates from cases and surveillance samples.Conclusion Our data showed that V.cholerae O1 El Tor Inaba phage 1d was the predominated biotype with multi-clone coexisting and circulating in Guangdong province in 2007.It also appeared to be the characteristics of cholera in the non-epidemic period,suggesting that it was necessary to enhance the alert surveillance programs for cholera epidemic based on the molecular typing techniques.

Objective To develop a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with hypertensive intracerebral hemorrhage (HICH).Methods Eighteen patients with HICH, admitted to our hospital from June 2008 to August 2010, were performed endoscopic minimally invasive surgery; CT three-dimensional reconstruction was employed to locate the intracerebral hematoma and select the appropriate endoscopic approach before the endoscopic surgery.The clinical data and treatmem efficacy were analyzed.Results According to the results of CT three-dimensional reconstruction, our neurosurgeons could design the best endoscopic approach; the three-dimensional relationship between intracerebral hematoma and scalp markers was shown directly and accurate positioning of the location of drilling was achieved; therefore, the time for preoperative preparation, anesthesia and operation was shortened. The mean operating time of these 18 patients was about 1.5 h; the volume of blood loss was only 30-40 mL; and the evacuation ratio was about 89.2%.After the elimination of hematoma, the brain tissues were flabby, so decompressive craniectomy was not needed. Conclusion CT three-dimensional reconstruction is a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with HICH.