Objective To discuss which drainage method is more efficient in treatment of choledocholithiasis with obstructive jaundice. Methods Compared the difference of serum total bilirubin,direct bilirubin, the variation of serum total bilirubin and direct bilirubin before and after drainage and daily biliary drainage by endoscopic nasobil-iary drainage (ENBD) and endoscopic nasobiliary drainage with continuous negative-pressure suction after three days. Results The daily biliary drainage about the patients by ENBD with continuous negative-pressure suction is much more effective than the patients by ENBD. The serum total bilirubin and direct bilirubin about the patients by ENBD with continuous negative-pressure suction is less than the patients by ENBD after three days. The variation of serum total bilirubin and direct bilirubin before and after drainage about the patients by ENBD with continuous neg-ative-pressure suction is more than the patients by ENBD. Conclusion The ENBD with continuous negative-pres-sure suction is more effective for choledocholithiasis with obstructive jaundice.

Objective To investigate the risk factors and predictors of poor outcome in full-term neonates with severe hyperbilirubinemia. Methods Data were retrospectively collected from 326 neonates with severe hyperbilirubinemia hospitalized between January 1, 2012 and December 31, 2012. Results A total of 326 full-term neonates with severe hyperbilirubinemia were included in this study (181 males and 145 females). The average gestational age was 39.12±1.17 weeks. Two hundred and sixty (260) cases were followed up successfully by phone while 66 cases were lost to follow-up. Infection (74.40%) and hemolytic disease (51.19%) were the main causes of severe hyperbilirubinemia. Multiple factors regression analysis found that threshold TSB was an independent risk factor of poor outcome (OR=2.02, 95%CI:1.13~3.62, P=0.018). The outcome of neonates with BIND scored between 0-6 had poor prognosis and some of them were reversible, and the outcome in those scored between 7-9 were of worse prognosis. Threshold TSB, USB and B/A ratio in group of poor outcome were signiifcantly higher than those in other groups and their area under the ROC curve evaluating the prognosis was 0.682, 0.671 and 0.698, respectively. With TSB at 474.5 μmol/L, UCB at 449.15 μmol/L and B/A at 0.923 mg/g, Youden index was the higest. The results of BAEP, OSE, MRI and NBNA were not signiifcantly different between groups with or without poor outcome. Conclusions Threshold TSB is an independent risk factor of poor outcome in full-term newborns with severe hyperbilirubinemia. BIND score is a very good predictor of outcome. TSB threshold, USB and B/A ratio are the predictors of outcome, but their diagnostic values are limited. NBNA, hearing screening and hyperintense globus pallidus on T1W1 in the acute phase of jaundice might not related with neurologic prognosis.

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Aged ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antigens, CD20 ; metabolism ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; surgery ; Neoplasm Invasiveness ; Prednisone ; therapeutic use ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Proto-Oncogene Proteins c-bcl-6 ; metabolism ; Rituximab ; Uterine Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Vincristine ; therapeutic use

The identification of the specific cause in every patient has important clinical implications, because ischemic stroke is an etiologically heterogeneous disease. The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification can be used to define the etiology of stroke. However, TOAST classification can not be completed timely on admission of patients with acute stroke, which has impacted early guidance of clinical treatment. This article reviews the biological markers of early differential-diagnostic significance of the TOAST classification.

4?Gy were significantly higher than in those

Objective To evaluate the treatment of advanced endometrial cancer with californium-252 brachytherapy. Methods 21 cases of endometrial cancers who had not received any treatment were diagnosed as in the stages Ⅰ～Ⅳ according to the criteria of FIGO. Treatment schedule included: 252Cf brachytherapy, 8～12Gy/fraction/week, the total dose of reference point A was 35～45 Gy and total dose of reference point F was 35～50Gy in three to four implant sessions. On the second day after 252Cf therapy, the whole pelvis was treated with 6MV X-ray external beam radiotherapy, 200 cGy per fraction, 4 times per week. The total dose of external beam radiotherapy was 45 to 50 Gy (the middle of pelvis was shielded with 4cm of lead), and the total treatment time was 5～6weeks. The recent therapeutic effect and complications were observed. Results The average time of complete tumor regression was 25 days, the local control rate was over 90%; the late radioactive complications of bladder and rectum was low during the 5-year follow-up period. Conclusions Combined californium-252 brachytherapy and high energy X-ray external beam radiotherapy may be safe and effective on advanced endometrial cancer.

Education to medical postgraduates is relatively special. Their study and research work have something to do with their clinical practice. Based on their technical training for thoracic surgery,postgraduates were demanded to follow up and instruct their patients on postoperative recovery from surgery. In this way,these postgraduates were trained not only in clinical practice but also in other aspects,such as communication techniques,how to take care of patients,professional moral education. Instruction to outpatients is helpful to cultivate post-graduates and promote their abilities in self-thinking,self-acknowledging,initiative,creation,and so on. Instruction to outpatients is an important way to bring up excellent medical postgraduates.

There is a high incidence of esophageal cancer(EC) in China.The survival and prognosis of EC is unoptimistic due to the lack of efficient early diagnostic markers.There is an urgent demand of novel biomarkers with more stability,sensitivity and specificity.miRNAs are a class of small non-coding single stranded RNAs consisting of 21-23 nucleotides,which are involved in the pathological and physiological process of life activities.miRNAs are stable not only in tumor tissues,but also in serum/plasma.There are significant differences in the expression patterns of circulating miRNAs between two main types of EC.They are closely related to the occurrence and progression of EC,which make circulating miRNAs a novel kind of biomarkers for differential diagnosis,early supervision of esophageal cancer,and prognosis.

Objective To assess the efficacy of different types of thymectomy for the treatment of myasthenia gravis(MG).Methods A retrospective analysis on 269 cases of MG,who were treated in our hospital from 1991 to 2006 by transsternal thymectomy(January 1991 to May 2002,n=161),thoracoscopic thymectomy(February 2002 to July 2005,n=67),or video-assisted thoracoscopic extended thymectomy(VATET,February 2005 to November 2006,n=41).Results The mean operation time of the transsternal group was significantly shorter than that in the other groups [transsternal group vs thoracoscopic and VATET groups:(97.5?17.5)min vs(130.3?31.5)min(q=12.991,P