Objective To assess the clinical efficacy of fluoroscopically-guided percutaneous cholecystostomy in the treatment of severe acute cholecystitis and to summarize the experience in clinical practice. Methods During the period of Jan. 2006 -Dec. 2008,fluoroscopically-guided percutaneous cholecystostomy was performed in 31 patients with severe acute cholecystitis. The therapeutic results were evaluated by comparing the pre-operative and post-operative laboratory findings and clinical manifestations. Results The procedure of puncture and drainage-tube placement was successfully accomplished in all 31 cases without any complications. One patient with acute renal failure died after the procedure,the remaining 30 patients showed obvious alleviation of symptoms and were discharged with retention of the indwelling drainage-tube. Selective cholecystectomy was carried out in 16 patients with lithic cholecystitis in 1-3 months after percutaneous cholecystostomy. Living with retention of indwelling drainage-tube was chosen by eight patients with lithic cholecystitis. The drainage-tube was extracted in 6 patients with non-lithic cholecystitis in 3-6 weeks after the cholecystitis was cured. Conclusion Fluoroscopically-guided percutaneous cholecystostomy is technically-simple,minimally-invasive and highly-safe treatment for severe acute cholecystitis,it may be regarded as an effective transitive,or even permanent therapy.

Objective To explore the diagnostic value of conventional ultrasound(US) and contrast enhanced ultrasound(CEUS) in predicting extrathyroidal extension of papillary thyroid cancer(PTC).Methods Eighty-five PTCs in 75 patients were selected for thyroid surgery underwent ultrasound and contrast-enhanced ultrasound.The degrees of contact between PTCs and capsule were observed by US and CEUS respectively(0,0-25％,25％-50％,≥50％),and the diagnostic efficiency in different degree of contact (＞0 ％,≥25 ％,≥50％) as preoperative diagnostic criteria were analyzed.The diagnostic efficiency between US and CEUS in predicting extrathyroidal extension of PTC were compared.Results Of the 85 PTCs,extrathyroidal extension was presented in 57 (67.06％) based on pathologic results.When the degree of contact (＞ 0 ％,＜ 25 ％,25 ％-50 ％,≥ 50 ％) was gradually increased,the incidence of extrathyroidal extension of the thyroid cancer was also gradually risen (P ＜0.001).Comparing the sensitivity,accuracy,odds ratio,and Az value of three groups(＞0％,≥25％,≥50％),it showed that the general diagnostic efficiency between two groups(＞0％,≥25％) was similar by US and CEUS.However,the sensitivity and accuracy of ＞0％ contact with the adjacent capsule were markedly higher than those of the other two groups(P ＜0.001).Selecting ＞0％ contact with the adjacent capsule as preoperative criteria,the Az value of CEUS was markedly higher than that of US (Z =2.208,P =0.027).Conclusions The preoperative imaging feature of more than 0％ contact with the adjacent capsule is more sensitive and accurate degree in predicting extrathyroidal extension of PTC.Compared with US,CEUS may serve as a better useful tool to predict extrathyroidal extension of PTC.

The composition of volatile compounds of soils and that of soil bacterial metabolites were identified by using the SPME-GC/MS method. Results showed that some compounds, trimethylamine, 3-methyl-2-pentanoe, dimethyl disulfide, methyl pyrazine, 2,5-dimethyl-pyrazine, benzaldehyde, N,N-dimethyloctylamine and nonadecane, subsisted commonly in soils and soil bacterial metabolites with strong fungistatic activity. These compounds may be the key antifungal factors in soil fungistasis, especially soil volatile fungistasis. Otherwise, the method used in this study was a good tool for further study of soil volatle fungistasis.

Objective To investigate the effect of electroacupuncture on the rehabilitation of rheumatoid arthritis (RA) and level of nuclear factor-κB (NF-κB), tumor necrosis factor-α (TNF-α) and interleukin 1β (IL-1β). Methods 140 cases of RA meeting the inclusion criteria were divided into control group and observation group equally according to therapeutic schemes. All the patients accepted medicine and rehabilitation training, while the observation group accepted electroacupuncture in addition. The effective rate and the symptoms were observed, the serum level of rheumatoid factor (RF), antistreptolysin O antibody (ASO), C-reactive protein (CRP), NF-κB, TNF-α and IL-1β were tested before and after treatment. Results The effective rate was 92.8% in the observation group, which was significantly more than that of 80.0% in the control group (P<0.05). The joint pain index, joint tenderness index and joint swollenness index reduced in the observation group compared with those in the control group (P<0.05), as well as the serum level of RF, ASO, CRP, NF-κB, TNF-α and IL-1β (P< 0.05). Conclusion Electroacupuncture may improve the effects of rehabilitation training for RA and inhibit the inflammation, which may associate with the inhibition of activation of NF-κB.

OBJECTIVEThe aim of the present study was to prepare uniform-sized silybin loaded poly (lactic-co-glycolic acid) (PLGA) microspheres in study of silybin with stainless steel membrane.

METHODSilybin PLGA microspheres were prepared by stainless steel membrane emulsification. The preparation conditions were optimized by single-factor test and orthogonal experiment, and evaluating the mean diameters, the particle size distribution, drug loading, entrapment efficiency and morphology of microsphere.

RESULTPrepared microspheres were round and surface was smooth. The mean diameter was (4.961 +/- 0.56) microm. The span was (1.75 +/- 0.18). The entrapment efficiency was (54.997 +/- 4.05)% and the average drug loading was (23.6 +/- 1.70)%.

CONCLUSIONThe stainless steel membrane emulsification can be used to prepare the silybin PLGA microspheres. The mean diameters of the silybin PLGA microspheres can be controlled in certain level. Stainless steel membrane emulsification has great potentiality exploitation and utilization.

Drug Compounding ; methods ; Emulsions ; chemistry ; Lactic Acid ; chemistry ; Microspheres ; Particle Size ; Polyglycolic Acid ; chemistry ; Silymarin ; chemistry ; Stainless Steel ; chemistry

OBJECTIVETo explore early clinical effect of acetabular cup in total hip replacement for the treatment of Crowe II developmental dysplasia of hip.

METHODSEighteen patients (18 hips) with Crowe type II developmental dysplasia of hip were treated with total hip replacement from September 2001 to July 2013. Among them,including 13 males and 5 females aged from 42 to 60 years old with an average of 47.6 years old; the courses of diseases ranged from 9 to 22 years with an average of 13.5 years. All the patients had hip joint pain, limb shortening and limited hip function before operation. Harris score of hip joint were used to evaluate recovery of function at 1 day and 12 months after operation. Prosthetic coverage of acetabular cup at 1 week after operation was observed by using radiography.

RESULTSEighteen patients (18 hips) were followed up from 12 to 24 months with an average 17 months. All incisions were healed at stage I. No deep vein thrombosis, hip dislocation, periprosthetic joint infection and prosthesis loosening were occurred. No revision surgery during follow-up period. Prosthetic coverage of acetabular cup was more than 80% at 1 week after operation. Harris score were increased from 42.67 ± 5.06 before operation to 94.79 ± 3.27 at 12 months after operation (t = -45.269, P < 0.001).

CONCLUSIONFor type Crowe II developmental dysplasia of hip patients, 15° face-changing acetabular cups in THR could obtain higher actebular component coverage rate and satisfactory early clinical effects.

Acetabulum ; surgery ; Adult ; Arthroplasty, Replacement, Hip ; instrumentation ; Female ; Follow-Up Studies ; Hip Dislocation, Congenital ; surgery ; Hip Joint ; surgery ; Hip Prosthesis ; Humans ; Male ; Middle Aged

OBJECTIVETo observe the effect of Weichang'an (WCA, a Chinese preparation) in preventing post-operative metastasis of progressive stage of gastric cancer.

METHODSA prospective randomized, controlled study was conducted by dividing the 148 patients of progressive staged gastric cancer after radical operation into the WCA group, the chemotherapy (CT) group and the WCA + CT group, to observe the survival rate, metastasis rate, quality of life (QOF) and tumor-bearing survival time after relapse (TST) in patients.

RESULTSThe 1-, 2- and 3-year survival rate after operation in the WCA + CT group was 89.51%, 69.77% and 55.76% respectively, which was significantly higher than that in the CT group (83.86%, 59.33% and 49.43%) respectively (P < 0.05), but showed insignificant difference as compared with that in the WCA group (93.23%, 79.34% and 71.78%). Only 1-year metastasis in the WCA group was 15.25%, and in the WCA + CT group was 15.52%, the two were significantly lower than that in the CT group (35.48%, P < 0.05). But the comparison of 2-year metastasis rate among the 3 groups (28.81%, 41.38% and 45.16%) and 3-year metastasis rate among them (33.90%, 46.55% and 51.61%) were insignificantly different. The QOF and TST were markedly better in the WCA group than those in the CT group.

CONCLUSIONWCA has preventive effect on relapse and metastasis in post-operational gastric cancer patients.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Doxorubicin ; administration & dosage ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fluorouracil ; administration & dosage ; Humans ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Neoplasm Metastasis ; Phytotherapy ; Postoperative Period ; Prospective Studies ; Stomach Neoplasms ; drug therapy ; pathology ; surgery

Objective To evaluate the efifcacy and safety of hemostatics of injected gelatin matrix (HIGM) under the guidance of contrast-enhanced ultrasound (CEUS) for treating splenic trauma in canine model. Methods A total of 24 commercial hybrid dogs underwent celiotomy with creation of uniformly blunt splenic trauma lesion of 4.0 cm×4.0 cm×2.5 cm (length, width and depth, respectively) by hemostatic clamp. Subjects were prospectively randomized into two groups. The treatment group was treated with HIGM under the guidance of CEUS and the positive control group received thrombin solution. Conventional ultrasound and CEUS were performed to record the ascites and the splenic lesion areas at 1st, 3rd, 7th, 14th and 21st day. The ifne needle biopsy and splenectomy were performed for histopathologic examination. The weight, free intraperitoneal lfuid and injury site were compared with t test between HIGM and postive group. Results All animals in two groups survived. All dogs stopped hemorrhage after injection of HIGM under CEUS guidance. The area of injury site was (12.91±0.89) cm2, (4.45±0.75) cm2 and (1.38±0.23) cm2 at 1st, 3rd and 7th day and splenic lesions were not found at 14th and 21st day in all dogs (n=12) of HIGM group. The splenic lesion was (16.74±0.91) cm2, (11.26±0.99) cm2, (8.02±0.82) cm2 and (1.58±0.36) cm2 in the postive group at 1st, 3rd, 7th and 14th day and splenic lesions were not found at 21st day in all dogs (n=12). At 7th and 14th day post-injection, lesion areas were statistically significant between two groups (t=27.162, P=0.008;t=15.129, P=0.001). Free intraperitoneal lfuid was (0.91±0.05) cm at 1st day detected by conventional ultrasound and free intraperitoneal fluid was not found at 3rd, 7th, 14th and 21st day in all dogs (n=12) of HIGM group. The free intraperitoneal fluid in thepositive group was (1.96±0.17) cm, (1.30±0.11) cm and (0.81±0.12) cm at 1st, 3rd and 7th day and free intraperitoneal lfuid was not found at 14th and 21st day in all dogs (n=12). At 1st, 3rd and 7th day post-injection, free intraperatitoneal lfuid was statistically significant between two groups (t=20.934, P=0.003; t=41.310, P=0.000; t=22.520, P=0.000). Histopathological examination showed that there was no foreign body and foreign body granuloma and the structure of red pulp was recovered at 7th, 14th and 21st day. Gross anatomy showed that the splenic injury site was recovered completely without complications. Conclusion This study explored the value of HIGM for splenic trauma and provided a preliminary experimental evidence for clinical treatment.

Objective To investigate the effect of acupunctures variable with stages on lumbar intervertebral dise protrusion (LIDP). Methods 98 LIDP patients in our hospital from October, 2014 to July, 2015 were randomly divided into control group (n=49) and observa-tion group (n=49) according to the sequence of first diagnosis time. The control group received routine acupuncture, and the observation group acupunctured at Ouch point and Huantiao point (GB30) with different acupuncture according to manifestations and courses. Modified Yang acupuncture was adopted in acute phase, triple acupuncture was used in remittent phase, and lateral needling was used in the recovery phase. They were both treated once a day, 7 days as a course for 3 courses with 2 days of interval. Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and clinical effects were assessed before and 1, 2, 3 courses after treatment. Results Both VAS and ODI scores im-proved after treatment (F>7.12, P<0.05), especially in the observation group (t>4.43, P<0.05). The efficiency was higher in the observation group than in the control group (χ2=5.594, P<0.05). Conclusion Compared with normal acupuncture, the acupunctures variable with stages is more effective on LIDP than routine.

Vasculogenic mimicry (VM) is a process by which aggressive tumor cells generate non-endothelial cell-lined channels in malignant tumors including hepatocellular carcinoma (HCC).It has provided new insights into tumor behavior and has surfaced as a potential target for drug therapy.The molecular events underlying the process of VM formation are still poorly understood.In this study,we attempted to elucidate the relationship between Notch4 and VM formation in HCC.An effective siRNA lentiviral vector targeting Notch4 was constructed and transfected into Be17402,a HCC cell line.VM networks were observed with a microscope in a 3 dimensional cell culture system.Cell migration and invasion were evaluated using wound healing and transwell assays.Matrix metalloproteinases (MMPs) activity was detected by gelatin zymography.Furthermore,the role of Notch4 inhibition in Be17402 cells in vivo was examined in subcutaneous xenograft tumor model of mice.The results showed that downregulation of Notch4 destroyed VM network formation and inhibited migration and invasion of tumor cells in vitro (P＜0.05).In vivo,tumor growth was also inhibited in subcutaneous xenograft model (P＜0.05).The potential mechanisms might be related with down-regulation of MT1-MMP,MMP-2,MMP-9 expression and inhibition of the activation of MMP2 and MMP9.These results indicated that Notch4 may play an important role in VM formation and tumor invasion in HCC.Related molecular pathways may be used as novel therapeutic targets for HCC antiangiogenesis therapy.