Objective To investigate the value of fast track surgery (FTS) principles in the perioperative management of liver cancer patients after hepatectomy.Methods Forty patients with primary liver cancer who were admitted to the First People's Hospital of Qinzhou from September 2011 to July 2013 were enrolled in this prospective study.All the patients were randomly divided into the FTS group (20 patients) and the control group (20 patients) according to the random number table.The perioperative management of patients in the FTS group was guided by the FTS principles,patients in the control group were managed with traditional methods.The intraoperative condition,time for portal occlusion,operation time,volume of intraoperative blood loss and blood transfusion,time to drainage tube removal,time to flatus and defecation,duration of postoperative hospital stay,expenses,changes of C-reactive protein on postoperative day 1,3,6,recovery of hepatic function and incidence of postoperative complications.All patients were followed up via phone call and out-patient examination till September 2013.All data were analyzed using the t test or chi-square test.The non-normal distribution paramenters were analyzed using the rank sum test.Results All patients were cured with no perioperative death.The time for postoperative drainage tube removal,time to flatus and defecation,duration of postoperative hospital stay and expenses were (2.3 ± 1.0)days,(2.5 ±0.5)days,(3.1 ±0.7)days,(7.0 ±0.8)days and (3.6 ±0.3) × 104 yuan in the FTS group,and (4.6 ± 0.7) days,(4.3 ± 0.7) days,(4.8 ± 0.4) days,(8.5 ± 0.9) days and (4.1 ± 0.3) ×104 yuan,with significant differences between the 2 groups (t =0.74,0.34,1.70,0.23,0.57,P ＜ 0.05).The levels of C-reactive proteins at postoperative day 1,3,6 were (56 ±7)mg/L,(122 ±7)mg/L and (35 ±7)mg/L in the FTS group,and (198 ± 24) mg/L,(137 ± 5) mg/L and (49 ± 8) mg/L,with significant differences between the 2 groups (F =64.91,P ＜0.05).The levels of prealbumin at postoperative day 1,3,6 were (196 ± 14) mg/L,(243 ± 17) mg/L,(260 ± 10) mg/L in the FTS group,and (198 ± 24) mg/L,(199 ± 16) mg/L and (245 ± 7) mg/L in the control group,with significant differences between the 2 groups (F =22.69,P ＜ 0.05).The levels of alanine transaminase at postoperative day 1,3,6 were (379 ±34)U/L,(166 ± 12)U/L,(49 ± 14)U/L in the FTS group,and (367 ±75)U/L,(210 ±28)U/L,(197 ±22)U/L in the control group,with significant differences between the 2 groups (F =4.51,P ＜ 0.05).One patient was complicated with peritoneal effusion and 1 with thoracic effusion in the FTS group; 4 patients was complicated with peritoneal effusion,3 with thoracic effusion,4 with pulmonary infection and 2 with incisional infection in the control group,with no significant difference in the complication between the 2 groups (x2 =0.78,1.11,4.44,2.11,P ＞ 0.05).All the patients were followed up for 2-24 months,no patients received reoperation or re-admitted to the hospital due to complications.Conclusion The application of FTS principle in the perioperative management of liver cancer patients after hepatectomy is safe and effective,it could alleviate the post-operative stress reaction and accelerate the recovery of liver function and patients' condition.

Purpose To investigate the clinical value of three-dimensional hysterosalpingo-contrast-sonography (3D-HyCoSy) in the assessment of fallopian tubal patency.Materials and Methods Fallopian tubal patency of 33 infertile women was assessed using transvaginal 3D-HyCoSy, and the results were compared with laparoscopically salpingoraphy, the sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of 3D-HyCoSy were evaluated.Results 3D-HyCoSy showed 20 passable fallopian tubes, 10 partially passable fallopian tubes and 36 obstructed tubes, while lapascopically salpingoraphy showed 23 passable fallopian tubes, 7 partially passable fallopian tubes and 36 obstructed tubes. The total coincidence rate of 3D-HyCoSy to assess the fallopian tubal patency was 86.4% (57/66), with the sensitivity of 93.0% (40/43), specificityof 73.9% (17/23), positive likelihood ratio of 7.15, and negative likelihood ratio of 0.20.Conclusion Tubal patency can be efficiently and accurately assessed using 3D-HyCoSy, but patients with obstructed or partially passable fallopian tubes should undergo laparoscopy to clarify.

Objective To report clinical study of diabetic foot with microsurgical treatment.Methods 32 cases basing on physical treatment underwent operation which included reconstruction of vessel under DSA and flap transfer and relaxation of nerves.Results 8 eases were examined with DSA after operation,it showed that the bypass grafts were unobstructed and the distal blood were improved;All flap were lively. Conclusion The ulcer of the patients with diabetic foot was closed early and the blood supply of the limb have been reconstructed by microsurgical treatment,it can not only avoid amputation or lower the limb amputation level,but also improve the life quality of patients and obtain social benefit.

Objective To investigate a new surgical method by using pectoralis minor muscle for its partial transplantation to reconstruct the function of the opposite thumb anastomosed vessels and nerves. Methods The proposed method was evaluated by taking 20 cases of adult cadaveric thoraxes and hands,then compared with the morphology and dimension of both pectoralis minor muscle and palmer muscle to study the feasibility of the new method.Based on the observed data.We selected five suitable cases,in which the opposi- tion function was lost,and then applied the new operation on them with partial transplantation of pectoralis mi- nor muscle anastomosed vessels and nerves according to the results of anatomic study.The follow-up study was conducted to observe the functional recovery of opposition of the thumb.Results The main results can be summarized as follows.First,the anatomical position of pectoralis minor muscle was stable,and every peetoralis minor muscle was provided with self-sustaining artery,vein and nerve.The oppostition process of cadaveric hand succeeded after similar transplantation to clinic operation.Second,follow-up studies conducted 6 - 12 months after the operation showed that all five patients recovered fully.The muscle strength in all five cases re- covered to level four or higher.The shape of palm eminence was satisfactory.Conclusion The surgical method of pectoralis minor muscle transplantation for reconstructing the opposition function of the thumb was based on the clinical and anatomical application.The function of opposition of the thumb reached the satisfacto- ry requirement after the operation.So,the new surgical method can achieve better results than other existing operation methods.

OBJECTIVETo study the polarization and immune regulation of TH cells in patients with bronchial asthma.

METHODSThirty-eight hospitalized children with bronchial asthma (ranging from 4-12 years old) and 29 age-matched healthy children (Control group) were enrolled in this study. Serum IL-2 and IFN-gamma levels were detected using ELISA. The percentage of TH1 and TH2 cells was detected by intracellular staining.

RESULTSThe serum levels of IL-2 (15.94 +/- 3.07 microg/L) and IFN-gamma (487.2 +/- 43.6 pg/mL ) in asthmatic patients were significantly lower than those in the Control group (24.73 +/- 4.37 microg/L and 654.07 +/- 14.64 pg/mL respectively; P < 0.01). The percentage of TH1 in asthmatic patients decreased significantly compared with that in the Control group [(11.24 +/- 2.43)% vs (16.67 +/- 2.73)%; P < 0.01]; in contrast, the percentage of TH2 increased compared with that in the Control group [(19.85 +/- 4.46)% vs (16.08 +/- 6.17)%; P < 0.05].

CONCLUSIONSThe serum levels of IL-2 and IFN-gamma, and the number of TH1 cells decreased in asthmatic patients. The decreased number of TH1 cells and the ratio of TH1/TH2 suggest an abnormal polarization of TH1 and TH2 cells. The changes may be associated with the inhibition of cellular immune function in asthmatic patients.

Asthma ; immunology ; Cell Polarity ; Child ; Child, Preschool ; Female ; Humans ; Interferon-gamma ; blood ; Interleukin-2 ; blood ; Male ; Th1 Cells ; immunology ; Th2 Cells ; immunology

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; External Fixators ; adverse effects ; Female ; Fracture Fixation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo study the human immunodeficiency virus (HIV) prevalence of residents living in a village located in rural region of central China where the paid blood donors used to be popular.

METHODSAll residents of one village "ZY" were asked to participate in HIV serologic screening test. Those over the age of 16 and participated in HIV serologic test was followed to undergo an indoor interview a week later, to finish a questionnaire, which including information on demography, marital status, smoking and drinking habits, history of blood donation, sexual behavior and history of drug use. Names on those either died from AIDS or having HIV serologic testing before were collected from local hospitals and the Center of Disease Control and Prevention.

RESULTSThere were in total 2364 residents in 527 households in "ZY" village including 1551 residents participated in the HIV serologic screening test, and 926 completed questionnaires. A total of 115 HIV seropositive residents were found in the HIV screening. 5 had been undergone HIV screening tests before, and 24 died of AIDS. The HIV prevalence of the whole population was 9.1% (CI: 7.7% - 10.6%). There were 19.6% households had at least one member living with HIV, out of which 25% had over two HIV seropositive members. No significant difference was found between genders with respect to HIV prevalence. 40 - 50 years old group had the highest HIV prevalence, significantly differed from other age groups. The HIV prevalence among former paid blood donors was 22.4%. The proportions of getting HIV infection through routes of blood transfusion, sex and mother-to-child, were 0.9%, 9.6% and 5.2% respectively among 115 HIV seropositive residents.

CONCLUSIONSome villages in the rural regions of central China showed high HIV prevalence. Former paid blood donation was responsible for the main transmission route in these villages. However, sexual transmission and mother-to-child transmission were becoming dominant routes in general population which called for effective action be taken to contain the spread of HIV.

Adolescent ; Adult ; Aged ; Blood Donors ; Child ; Child, Preschool ; China ; epidemiology ; Enzyme-Linked Immunosorbent Assay ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; HIV Seroprevalence ; Humans ; Infant ; Male ; Mass Screening ; Middle Aged ; Rural Population

OBJECTIVETo investigate the effects of electro-acupuncture (EA) on the expression of triggering receptor expressed on myeloid cell (TREM)l in ankle joint synovial tissue of acute gouty arthritis (AGA) rats.

METHODSForty male SD rats were randomly divided into 4 groups: normal, AGA, medication and EA group, 10 rats in each group. AGA model was established by induced monosodium urate (MSU) method, except the normal group. Tow days before AGA model was established, normal and AGA groups were lavaged with normal saline (20 ml/kg), medication group was lavaged with colchicine solution (20 ml/kg), EA(1.5-2 Hz, D.-D.wave, 9v; 1-3 rnA) was applied to "Sanyinjiao" (SP6), "jiexi" (ST41) and "Kunlun" (BL60) for 20 min, once daily;continuously for 9 days. Then observed the changes in dysfunction, and the content of TNF-α and IL-lβ detected by ELISA, the expression of TREM-l detected by immunohistochemistry and western blot.

RESULTSCompared to the normal group, the AGA group of the dysfunction index increased significantly (P<0.01), the content of TNF-α and IL-lβ increased significantly (P<0.05), the expression of TREM-l in synovial tissue increased significantly (P<0.05); the medication and EA groups compared to the AGA group, the dysfunction index decreased significantly (P<0.01), the content of TNF-α and IL-lβ decreased significantly (P<0.05), the expression of TREM-l in synovial tissue decreased significantly (P<0.05); there were not statistically significant between the medication and EA group (P>0.05).

CONCLUSIONEA treating AGA may be through down-regulating the expression of TREM -1 in synovial tissue.

Animals ; Ankle Joint ; metabolism ; pathology ; Arthritis, Gouty ; metabolism ; therapy ; Electroacupuncture ; Interleukin-1beta ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Immunologic ; metabolism ; Synovial Membrane ; metabolism ; Triggering Receptor Expressed on Myeloid Cells-1 ; Tumor Necrosis Factor-alpha ; metabolism

Objective Exploring clinical prediction value of the ischemia modified albumin (IMA) for acute coronary syndrome (ACS) patients after the percutaneous coronary intervention (PCI).Methods A total of 109 cases of the PCI postoperative patients of ACS at the Panggang General Hospital from January 2010 to July 2012 were included.IMA was determined within 6 hours after admission,and standardized treatment after PCI.After a 6-month follow-up,they were divided into the event group and non-event group according to cardiovascular events occurrence.Results 101 cases were followed-up,including 26 cases of cardiovascular events (25.74％) and 75 cases of no cardiovascular events (74.26％).The left ventricular ejection fraction of the event group [(45 ± 7)％] was significantly lower than the non-event group [(52 ± 10) ％] (t =1.894,P ＜ 0.05).Serum IMA of the event group[(105.51 ± 13.26) U/ml]was significantly higher than the non-event group [(85.18 ± 11.36) U/ml] (t =7.3518,P ＜0.01).After controlling other cardiovascular risk factors,IMA was still independent risk factors for cardiovascular events (OR =1.69,95％ CI: 1.18 ～ 2.13,P =0.01).Conclusions IMA have very good clinical prediction value of cardiovascular events occurrence for ACS after PCI.

The present study demonstrated that bone marrow cells from diabetic rats were able to form cell clusters expressing insulin,C-peptide,glucagon,somatostatin and islet amyloid .polypeptide,and other genes associated with development and function of islets such as glucose transporter-2,glucokinase,glucagon-like peptide-1 receptor,PDX-1,Ngn3,NeuroDl,Pax-6 and NKX2.2 genes.These islet-like cells might be derived from adult stem cells in bone marrow.