Objective To explore the reasons of biliary restenosis after interventional treatment for malignant obstructive jaundice caused by hepatic hilar cholangiocarcinoma and to discuss its management. Methods During the period from June 2010 to Sep. 2013 at authors’ hospital, a total of 36 patients with high biliary obstruction caused by Bismuth Ⅱ - Ⅳ type of hepatic hilar cholangiocarcinoma received percutaneous transhepatic cholangial stenting (PTCS), and as the patients developed biliary restenosis after PTCS percutaneous transhepatic cholangial drainage (PTCD) had to be carried out. All the patients had complete data. Serum total bilirubin, direct bilirubin, glutamyltranspetidase and alkaline phosphatase levels were determined on the operation day and at five days after PTCS and PTCD. The short - term remission of malignant obstructive jaundice produced by PTCS and PTCD were assessed. The causes of biliary restenosis were analyzed by comparing the CT and/or MRI images as well as the cholangiography and drainage test results which were performed at the first and second admission to hospital. Results The interval time from operation to restenosis was 31 - 468 days, with an average of 132.8 days. The effective rates of PTCS and PTCD for relieving jaundice were 77.8% and 75.0% respectively. The main causes of restenosis included the formation of biliary sludge, acute cholangitis and tumor growth. Conclusion PTCS is an effective means to relieve the malignant obstructive jaundice caused by hepatic hilar cholangiocarcinoma, however, the incidence of biliary restenosis after PTCS is higher, which may be mainly due to the tumor growth. Nevertheless, subsequent PTCD can effectively improve the liver function, control biliary infection, remit biliary obstruction and relieve the clinical symptoms.

Objective To explore the differences of clinical features and relationship between aplastic anemia paroxysmal nocturnal hemoglobinuria syndrome(AA PNH syndrome)and typical paroxysmal nocturnal hemoglobinuria(t PNH).Methods A case control study on the discrepancies of clinical and laboratory features between patients with AA PNH syndrome and t PNH was carried out.Results Compared with t PNH,AA PNH syndrome showed following features:①Lower frequencies of venous thrombosis,jaundice and enlarged liver or spleen.②Higher percentages of pancytopenia and bone marrow hypoplasia.③Lower percentages of positive hemolysis tests.The percentages of CD55 and CD59 of peripheral blood cells were not significantly different in most cases of both groups.④Immunoglobulins and subgroups of T lymphocytes were normal in cases of both groups.⑤Adrenocortical hormone was effective in cases of both groups.Conclusion AA PNH syndrome shares a same pathophysiology with t PNH;CD55 and CD59 tests can improve the diagnosis of AA PNH syndrome.

Objective To investigate the possibility of human gastric carcinoma cells apoptosis induced by arsenic trioxide and its mechanism.Methods After treatment with arsenic trioxide, the cytotoxicity to human gastric carcinoma cells MKN45 was quantified using trypan blue exclusion, and IC 50 was determined. Apoptotic cells were detected with flow cytometry, DNA cytofluorometry, DNA electrophoresis. Results Arsenic trioxide inhibited the growth of human gastric carcinoma cells MKN45 in a dose-dependent manner in a certain range of dose with a IC 50 of (11.05?0.25)?mol/L; Apoptotic peak, characteristic morphologic features of apoptosis and DNA ladder were observed in human gastric carcinoma cells MKN45 treated with 1~10 ?mol/L arsenic trioxide. Conclusions Arsenic trioxide can induce apoptosis of human gastric carcinoma cells MKN45, suggesting a great potential in the treatment of gastric carcinoma.

Objective: To compare the effectiveness of vertebral arch replantation and laminectomy in the treatment of mild to moderate isthmic spondylolisthesis. Methods: The clinical data of 66 patients with isthmic spondylolisthesis treated with vertebral arch replantation or laminectomy between March 2014 and July 2016 were retrospectively analyzed. They were divided into trial group (34 cases, treated with complete replantation of vertebral arch, intervertebral fusion, and internal fixation) and control group (32 cases, treated with laminectomy with intervertebral fusion and internal fixation) according to different surgical methods. There was no significant difference in general data of gender, age, disease duration, lesion segment, Meyerding grade, and preoperative visual analogue scale (VAS) score, Oswestry disability index (ODI) score, Japanese Orthopaedic Association (JOA) score between the two groups ( P>0.05). The operation time, intraoperative blood loss, complications, vertebral arch fusion of trial group, and epidural scar formation of the two groups were recorded. The VAS score, JOA score, and ODI score were evaluated at preoperation, 3, 6, 12 months after operation, and at last follow-up. The effectiveness was evaluated according to HOU Shuxun's criteria. Results: All the patients successfully completed the surgery, without any aggravation of nerve injury, dural tear, infection, etc. There was no significant difference in the operation time between the two groups ( t=0.583, P=0.562), but the intraoperative blood loss was significantly lower in the trial group than that in the control group ( t=2.134, P=0.037). All the 66 patients were followed up 13-18 months (mean, 16.2 months). Postoperative clinical symptoms of all patients were significantly improved. In the control group, 7 cases were found to have symptoms of spinal canal stenosis with postoperative posture changes at 3 months after operation, and 5 cases showed mild lower limb numbness at 18 months after operation. No complication such as infection and nerve injury occurred in other patients. In the trial group, 34 cases of epidural scar tissue were completely blocked outside the replantation vertebral arch, while in the control group, 11 cases of epidural scar tissue invaded the spinal canal. At last follow-up, the fusion rate of intervertebral bone grafting and vertebral arch replantation in the trial group was 100%, and the fusion rate of intervertebral bone grafting in the control group was also 100%. The VAS score, ODI score, and JOA score were significantly improved at each time point after operation ( P<0.01). The ODI score and JOA score of the trial group were significantly better than those of the control group at 3 months after operation and at last follow-up ( P<0.05), and there was no significant difference in scores between the two groups at other time points ( P>0.05). According to HOU Shuxun's criteria, the excellent and good rate was 91.2% in the trial group and 84.4% in the control group, showing no significant difference ( χ2=1.092, P=0.573). Conclusion: Compared with laminectomy, vertebral arch replantation can better improve postoperative neurological symptoms, maximize the reconstruction of the bone spinal canal, restore the stability of the intraspinal environment, and it is a better surgical method for lumbar isthmic spondylolisthesis.

Acute Disease ; Adult ; Ethylene Dichlorides ; poisoning ; Female ; Humans ; Male ; Neurotoxicity Syndromes ; therapy

Objective To explore the complication and its cause and treatment of pace markers implantation in older patient.Methods Among 205 older patients aged 70 to 90 years,103 were male,the others were female.Of these patients,162 were implanted with single chamber pace marker,43 with dual chamber pace markers.Results 21 patients happened complication(10.2%),the common complications related to operation were blood effusion and hematoma formation in pocket 12 cases,lead dislodgement 4 cases and infection with or without pocket rapture 2 cases.Occurrence of blood effusion was related to aspirin administration,lead dislodgement and infection with or without pocket rapture were related to operation.Conclusion To pay attention to ample preparation,close operation and strict observation can decrease the complication rate when pace marker is implanted.The serious result will be avoided by timely and effective treatment.The older patient with pace markers implantation is safe.

Adult ; Aged ; Carotid Stenosis ; diagnostic imaging ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension ; diagnostic imaging ; drug therapy ; pathology ; Male ; Middle Aged ; Phytotherapy ; Ultrasonography

0.05)and the TNM staging (P=0.55).A mild elevated compared other pathological classification was found in small cell lung cancer (0.191?0.275).Conclusions The results showed that RFQ-PCR was suitable for measurement of the mRNA level of PLKI in bronchoscopic bioptic specimens.This study suggest elevated expression of PLK1 might play a important role in development of lung cancer,so that PLK1 might be a potential tumor marker for Lung cancers.Advanced studies will be needed to clarify that PLKI mRNA level do not relate to TNM staging and pathological classification.

BACKGROUND:Some studies have focused on bone marrow mesenchymalstem cells (BMSCs) combined with allograft bone or artificial bone substitute materials for bonedefect repair. But there is no report on BMSCs combined with Bio-oss for repair of rabbit skull defects as yet.OBJECTIVE:To observe the effect ofBMSCs combined with Bio-oss in repairing skull defects in rabbits.METHODS:BMSCs from male rabbits were isolated, cultured, and used as seed cells. In the skull of the female rabbits,three full-thickness bone defects with the same external diameter of 6 mm were made by a ring bone drill. Ninety-six female rabbits were randomly divided into four groups, and given Bio-oss/BMSCs in combination group, Bio-oss alone in Bio-oss group, BMSCs implantation in BMSCs group, and no intervention in blank group. All the implant surfaces were covered with guided tissue regeneration membrane.RESULTS AND CONCLUSION:The osteogenic effect in the combination group was better than that in the other three groups, and the Bio-oss group showed better osteogenesis in comparison with BMSCs and blank groups. But there was no significant difference between the BMSCs and blank groups. These findings indicate that the combined use of BMSCs as seed cells and Bio-oss as a scaffold material exerts overt osteogenic effects in rabbit skull defect area, which provides a new idea for the clinical treatment of bone defects.