Objective To evaluate a combination therapy for huge tumors in the buttocks.Methods A total of 11 patients from our hospital were collected,among them 5 cases were of hemangioma,4 cases of neurofibroma,2 cases of soft tissue sarcoma.Before definite surgical resection all cases received tumor embolization with silk thread and gelatin-sponge article using Seldinger's technic.Subsequently,all patients underwent a successful tumor resection. Results Superselective embolization for all the cases'feeding arteries resulted in recession of the tumors and relatively well-demarcated margins,and all the lumps became softer.and the local pain was alleviated.Surgical resection could be radical with avoidance of fatal intraoperative hemorrhage.The 5 cases of hemangioma had a average operative bleeding of 450 ml,4 cases of neurofibroma had 420 ml,2 cases of soft tissue sarcoma had 150 ml.No patients needed intraoperative and postoperative blood transfusion.The operation time was about 2-3 hours,the normal tissues were preserved and the contour and function of the diseased limbs were very good.One case had a delayed incision healing,and the others had a healing by the first intention.There was no recurrence and other complications (like deep venous thrombosis)during a follow-up period of 4-8 months. Conclusions Surgical resection combined with interventional embolism for the treatment of huge tumors in the buttocks can reduce the risk of bleeding effectively during operation.It can improve the success rate of operation leading to satisfactory results.

Objective To investigate the cause,type,clinical manifestation,diagnosis and treatment of bile duct injury(BDI)during laparoscopic cholecystectomy(LC).Methods Data of 26 cases suffering from biliary injury during LC from 1997 to 2007 were retrospectively analyzed.Results Among 26 cases with BDI,5 cases suffered from type Ⅰ BDI,13 cases from typeⅡ,2 cases from typeⅢ,and 6 cases from type Ⅳ.Injuries were diagnosed as BDI intraoperatively in 3 cases,23 BDI cases were diagnosed postoperatively,including 13 cases diagnosed one week after LC,8 cases 20-60 days after LC,2 cases 2 years after LC.Twenty-four cases underwent interventional therapy,with 5 cases cured,19 cases were tideovered to operative treatment after cholangitis and jaundice were under control.Among all BDJ cases,20 cases underwent resection of impaired dile duct and hepatico-jejunostomy. Conclusion BDI is a serious complication of LC,temporary stent graft or bile dranage will help to put jaundice and cholangitis under control so as to buy a time for final definite surgical procedures.

Objective To investigate the value of interventional therapy in bile duct injury (BDI) due to laparoscopie cholecystectomy (LC). Methods Data of 24 BDI patients, who received interventional treatment after LC from June 1997 to May 2007, were retrospectively analyzed. Results According to Liu Yunyi criteria of BDI classification, there were 5 cases of type Ⅰ , 11 cases type Ⅱ , 2 type Ⅲ and 6 type Ⅳ. BDI was found during LC in 2 patients and the operation was switched to open cholecysteetomy, but bile duct infection was experienced 10 months and 2 years after the operation, respectively. BDI was diagnosed postoperatively in 22 patients, in which 13 eases occurred 3-12 days after LC, 7 cases 20-60 days after LC, and 2 cases 2 years after LC. Complete remission was achieved by interventional therapy in 5 patients, the other 19 patients received curative operation after control of cholangitis and jaundice. Among 13 patients who were diagnosed BDI 3-12 days after LC, 6 underwent emergency operation and failed. Of the 7 other patients who received interventional therapy, 3 were cured and the others underwent curative operation after cholangi-tis and jaundice were controlled. Conclusion Application of interventional therapy in BDI after LC can a-chieve successful bile duct support and drainage, and can obtain complete image of bile duct system, which is effective not only in control of cholangitis and jaundice for the safety of the following surgery, but also in cure of BDI.

Objective To investigate the death causes and risk factors of uremia patients in order to improve the prognosis of uremia patients.Methods Clinical data of 247 uremia inpatients and outpatients from 2001 to 2011 in our hospital were retrospectively analyzed.Dead patients were served as death group (n=124) and survival patients as control group (n=123).Death causes and primary disease were studied.Frequency of hemodialysis,prealbumin,albumin,natremia and pulmonary infection were compared between two groups.Results Age and gender were not associated with the death of uremia patients.The most common cause of death was cardiovascular disease followed by respiratory failure,uremic encephalopathy,cerebral hemorrhage,gastrointestinal hemorrhage,etc.Hemodialysis frequency,prealbumin,albumin and natremia of dead patients were obviously lower than those of control group.More patients in death group suffered from pulmonary infection.Logistic multivariate analysis revealed that death risk increased by 40.7％ when reducing 1 time per week of hemodialysis; death risk increased by 53.4％ when reducing 50 mg/L of prealbumin; death risk increased by 14.6％ when reducing 5 mmol/L of blood sodium; death risk of patients with pulmonary infection increased by 15.06 times of patients without pulmonary infection;death risk of diabetes mellitus increased by 4.26 times of patients without diabetes mellitus.Conclusions Cardiovascular disease,respiratory failure,uremic encephalopathy,cerebral hemorrhage,and gastrointestinal hemorrhage are common causes of death in uremia patients.Hemodialysis frequency,prealbumin,hyponatremia,pulmonary infection and diabetes can be regarded as risk factors for death of uremia patients.

Objective To investigate the efficacy of medical therapy after conservative operation for endometriosis.(Methods)Endometriosis was confirmed in 89 patients by laparoscopic inspection,and conservative operations were performed to remove the adhesion,excise or destroy all the endometriotic tissues,including single excision of endo-(metriotic) masses or plus unilateral salpingoophorectomy,and to restore pelvic anatomy to the best possible condition.All the patients were divided into two groups randomly: treatment group(n=44),three months drug therapy of go-(nadotropin-)releasing hormone analogs(GnRHa) after operation;control group(n=45),no drug therapy after operation.Clinical symptoms,concentrations of CA-125,manual and ultrasonic pelvic check-up,as well as pregnancy rate to those who had a desire for future fertility(n=28)were followed up. Results All the patients experienced alleviation of clinical symptoms after the operation.The recurring rates: 0% in treatment group vs 4% in control group six months later;2% in treatment group vs 4% in control group 12 months later(P

AIM: To systemically evaluate the clinical efficacy and safety of intraocular implants for vitreous retinal surgery.METHODS: We performed a comprehensive search for studies reporting vitreous surgery with intraocular implants randomized controlled and a retrospective controlled clinical trials from China Hownet ( CNKI ), Wanfang database, and VIP literature database. Studies obtained from those database were filtered according to the criteria, and data were retrieved from eligible studies for further analysis. Then we performed a meta-analysis to evaluate the efficacy and safety of intraocular implants using comprehensive Meta - analysis software version 2 (Biostat, Englewood, NJ).
RESULTS: In total 36 studies were recruited for our Meta - analysis, including 5 092 cases. Meta analysis showed: 1) regarding the efficacy of repairing the retinal detachment, silicone oil was a better intraocular implants than C3 F8(OR= 1. 76; 95% CI: 1. 19-2. 60, P = 0. 0047) and SF6( OR = 4. 68; 95% CI: 1. 48 - 14. 81, P = 0. 0087); 2) regarding the risk of postoperative cataract, silicone oil showed significant higher risk than BBS (OR = 3. 24; 95%CI: 2. 10-4. 99, P= 1. 09 e-7), and C3 F8(OR= 3. 03; 95% CI:1. 50 - 6. 10, P = 0. 0019 ); 3 ) regarding the risk of postoperative intraocular pressure, silicone oil showed significant higher risk than BBS (OR= 6. 74; 95% CI: 3. 38-13. 41, P= 5. 67 e-08), and C3 F8 also showed a higher risk than BBS (OR= 4. 79; 95% CI: 2. 37-9. 68, P = 1. 29 e-05). In addition, silicone oil showed significant lower risk as compared with heavy silicone oil (OR= 0. 16; 95% CI: 0. 08-0. 53, P= 0. 0026).
CONCLUSION: The intraocular implants for the treatment of retinal detachment in vitreous retinal surgery are mainly divided into two major categories, liquid and gas implants. The silicone oil, a major liquid implant, shows higher efficacy in terms of treating retinal detachment than the gas implants. However, the silicone oil is associated with a higher risk of postoperative cataract and intraocular pressure as compared with gas implants.

Seven terpenoids and three sterols were isolated from the methanol extracts of the aerial parts of Ricinus communis by chromatography methods and their structures were identified by spectra analysis as ficusic acid( 1), phytol(2), callyspinol(3) , lupeol(4), 30-norlupan-3beta-ol-20-one(5) , lup-20(29)-en-3beta,15alpha-diol(6) , acetylaleuritolic acid( 7), stigmast4-en-3-one(8) , stig-mast-4-en-6beta-ol-3-one(9) , and stigmast4-en-3,6-dione(10). Compounds 1-3 and 5-10 were obtained from this species for the first time and 5 and 6 showed significant inhibitive activity and good selectivity against 11beta-HSD of mouse and human in vitro. [Key words] Ricinus communis; terpenoids; sterols; 11beta-HSD
11-beta-Hydroxysteroid Dehydrogenase Type 1 ; antagonists & inhibitors ; 11-beta-Hydroxysteroid Dehydrogenase Type 2 ; antagonists & inhibitors ; Animals ; Diabetes Mellitus ; drug therapy ; enzymology ; Humans ; Hypoglycemic Agents ; pharmacology ; therapeutic use ; Inhibitory Concentration 50 ; Mice ; Ricinus ; chemistry ; Sterols ; pharmacology ; therapeutic use ; Terpenes ; pharmacology ; therapeutic use

BackgroundResearch demonstrated that vitamin D3 mediated by its receptor has the potent nonclassical effects,including immunomodulatory,antiinflammatory,and neuroprotective properties,and it can enhance the secretion and sensitivity of insulin and therefore down-regulate hyperglycemia and attenuate the corneal edema.ObjectiveThe present study was to investigate the protective effect of vitamin D3on ocular structure in experimental diabetic rat.Methods Twenty-two healthy SPF C57BL/6 rats were randomly divided into vitamine D3 group (8 rabbits),diabetic control group ( 11 rabbits) and normal control group ( 3 rabbits).2％ streptozotocin ( STZ,175 mg/kg)was intraperitoneally injected to create the diabetic models in the rats of the vitamine D3 group and diabetic control group.Blood glucose was examined for 3 times in the third day after STZ injection,and the rats with the blood glucose concentration ＞16.7 mmol/L was identified as the successful diabetic models.After modeling,the rat tail blood was collected for the monitoring of blood glucose.Two weeks after modeling,vitamine D3 was intraperitoneally injected in each week for 5 times.The fundus was examined using direct ophtalmoscope,and the eyeballs were obtained under the excessive anesthesia for the measurement of thickness of the central cornea,retina and choroids by histopathological examination once a week for 7 weeks after administration of vitamin D3.The administration of the animals complied with the Statement of ARVO.ResultsThe corneal edema appeared with the corneal thickness of (339.14± 11.13) μm in the first week and gradually attenuated with time elapse after modeling in the diabetic group ( F =382.446,P =0.000).The corneal thickness values were significantly decreased from the second week through the seventh week in the vitamin D3 group compared with diabetic control group(P＜0.05).The atrophy of the corneal epithelium was found from the fifth week to the seventh week in diabetic control group,but that in vitamin D3 group was slight (P＜0.05).The gradually thinning of the choroids was seen from the first week to the seventh week in the diabetic control group ( F =437.411,P =0.000 ),however,the thickness values in the vitamin D3 group were significantly increased in comparison with the diabetic control group in various time points (P＜0.05).The retina thickness was gradually reduced during the seven-week duration in the diabetic control group (F =91.859,P =0.000),but no significant change was identified in retina thickness in the vitamin D3 group(P＞0.05).ConclusionsVitamin D3 has prevent and therapeutic effects on experimental diabetic oculopathy.

Objective To evaluate the impact of early enteral nutrition (EEN) compared with parenteral nutrition (PN) on patients after hepatectomy. Methods Seventy-eight patients undergoing liver resection were randomized prospectively into two groups: EEN group receiving early enteral nutrition (n=35) and PN group receiving parenteral nutrition (n=43). The patients in both groups received isocaloric and isonitrogenous nutritional formulas 24 h after operation and the formulas were stopped on postoperative day 7. The general conditions, liver function tests, clinical complications,and clinical nutritional variables at three time points that included preoperative phase, postoperative day 1 (POD 1) and postoperative day 8 (POD 8) were observed. Results No significant differences were found in length of hospital stay, liver function and clinical nutritional variables between the 2 groups. In the EEN group, the serum prealbumin level almost returned to the preoperative level on POD 8. The nutritional complication rate of the EEN group was increased significantly but it was milder than that of the PN group. The time of gut function recovery in the EEN group was shorter than that of the PN group. The costs of nutritional drugs showed a significant decrease in the EEN group.Conclusion Early enteral nutrition is safe, rational and effective in patients who have undergone hepatectomy. Early enteral nutrition is better than parenteral nutrition in promoting liver function recovery, liver protein synthesis, postoperative recovery of gut function and decreasing costs of nutritional drugs.

Objective:To observe the clinical effect of warm needling moxibustion plus acupoint sticking therapy for cervical radiculopathy.Methods:A total of 120 cases were allocated into an observation group,a warm needling group and an acupoint sticking group according to the random number table,with 40 cases in each group.Cases in the observation group received warm needling moxibustion plus acupoint sticking therapy;cases in the warm needling group received the same warm needling moxibustion in the observation group;cases in the acupoint sticking group received the same acupoint sticking therapy in the observation group.The scores of Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) were recorded before and after treatment.Results:The total effective rate was 95.0％ in the observation group,versus 77.5％ in the warm needling group and 75.0％ in the acupoint sticking group (both P＜0.05).Inter-group differences in JOA and VAS between the observation group and the other two groups were statistically significant (all P＜0.05).Conclusion:Warm needling moxibustion plus acupoint sticking therapy is effective in treating cervical radiculopathy,and it can significantly alleviate pain and enhance clinical efficacy,and thus is worth clinical popularization.