Objective To evaluate the long-term efficacy of modified loop choledochojejunostomy (MLC). Methods The clinical data of 259 patients who had underwent choledochojejunostomy in First Affiliated Hospital of Sun Yat-Sen University from January 2000 to December 2006 were retrospectively analyzed. Of all the patients, 130 underwent MLC (MLC group) and 129 underwent Roux-en-Y choledochojejunostemy (RYC, RYC group). The changes in incidence of cholangitis and liver function between the 2 groups were compared. All the data were analyzed by t test, chi-square test or Fisher exact probability. Results The levels of alaninetransa-minase and alkaline phosphomonoesterase were (63±42) U/L and (147±147) U/L in MLC group, and (84±52)U/L and (256±201)U/L in RYC group, with statistical difference between the 2 groups (t=1.634, 1.655, P>0.05). The level of gamma-glutamyl transferase in MLC group was (116±91)U/L, which was signifieandy lower than (169±96)U/L in RYC group (t=2.461, P<0.05). Three patients (2.3%) in MLC group and 9 (7.0%) in RYC group suffered from acute cholangitis after operation, with no statistical difference in the incidence between the 2 groups (P>0.05). Of the 12 patients with acute cholangids, 1 in MLC group and 7 in RYC group were hospitalized, with statistical difference between the 2 groups (P<0.05). Conclusions The incidence of acute cholangitis in patients who underwent MLC is comparable to that of RYC. However, the procedure of MLC is simpler than RYC, and patients have milder symptom and lesser frequency of reflux cholangitis onset after MLC.

Objective To investigate Anti-aging function of Placenta freeze-dried powder on mice. Method 2 month old female-KM mice were divided into five groups:normal control group, aging model group, positive control group, placenta freeze-dried powder low dose group and high dose group. Except normal control group,the rest of groups were treated with method of subcutaneous continuous injection of D-galactose for 42 days in order to establish mice aging model. Meanwhile, the corresponding drugs, via intragastric administration, were ingested by different treated groups and observe the change of immunity and physiological regulation related in mice. Results Compared with aging model group, thymus index and spleen index in placenta freeze-dried powder low dose group and high dose group increased obviously (P<0.05), content of MDA in brain decreased significantly (P<0.05), proportion of CD 4 and CD 8 lymphocyte in total lymphocyte, female hormone(P and E 2), IgG and haemopoietic factor in peripheral blood increased remarkably. Conclusion Placenta freeze-dried powder could slow the aging process on mice via immunity enhancement and improving physical regulation.

Objective To study the effects of mild hypothermia on nervous cell apoptosis and activity of Caspase - 3 after hypoxia -ischemia brain damage (HIBD) in neonatal rats. Methods Seven - day SD rats were divided into sham operation group,normothermia HIBD group (HIBD group) and mild hypothermia HIBD group(mild hypothermia group). In HIBD group,the left carotid of rats was ligated and animals were exposed to 8% oxygen for 2 h.and in mild hypothermia group,hypothermia of 31 - 32 1C lasting 8 hours was used just after HIBD. L sing methods of TUNEL and AC - DEVI) - AMC, the apoptotic cell rate and Caspase - 3 activity level were determined in sham operated group, HIBD group and mild hypothermia group separatively. Results The apoptotic cell rate and Caspase - 3 activity level were significantly lower in sham - operated group and mild hypothermia group than those in HIBD group. Conclusion One of the mechanisms of brain protection by mild hypothermia may be contributed to the decrease of neural cell apoptosis and the activity level of Caspase 3 HIBD.

Objective To explore the effects of intensity modulated radiation therapy (IMRT) on lung function in patients with non small cell lung cancer (NSCLC) ,analyze relationship between lung function indexes and radiation pneumonitis (RP) incidence rate ,dose volume histogram (DVH) parameters and incidence degree of RP .Methods 52 patients without operation first radiother‐apy patients were included ,all with Karnofsky score (KPS) ≥ 80 points .Detection of IMRT ,before the end of the end ,first months ,third months of forced vital capacity (FVC) ,forced expiratory volume in one second (FEV1 .0) and diffusion capacity of carbon monoxide (DLCO) change were conducted .The incidence and degree of RP were measured ,and got the V20 and V30 value in DVH .By Spearman correlation analysis ,the relationship between pulmonary function index and the incidence of RP ,V20 ,V30 and RP was analyzed .Results Among the 52 patients ,49 patients were followed up ,the follow -up rate was 94 .2% .In the 49 pa‐tients ,two cases were excluded in the lung recurrence or lung metastasis patients ,thus a total of 47 patients were included in the fi‐nal study .There were 18 cases of RP ,the incidence of RP was 38 .30% .In the third month ,FEV1 .0 and DLCO were significantly decreased than that before radiotherapy (P<0 .05) ,FVC had no significant change (P>0 .05) .Correlation analysis showed that FVC ,FEV1 .0 and DLCO and RP were positively correlated (r=0 .451 ,0 .405 ,0 .635 ,P<0 .05);and V20 ,V30 and RP was posi‐tively correlated (r=0 .689 ,0 .725 ,P<0 .05) .Conclusion the larger the NSCLCV20 ,V30 value ,the more serious the RP would be ,thus they could be predictor of RP degree .

Objective To observe the changes of water, potassium and sodium in the hypoxic cerebral tissues in mice and the effects of progesterone on the tissues and investigate the neuroprotective role of progesterone (PROG)in the cerebral anoxia. Methods Thirty - two male mice were divided into control group, simple hypoxia group, lower dosage group and higher dosage group. Progesterone was injected intraperitoneally in the dosage of 4 mg/kg or 8 mg/kg respectively 30 min before hypoxia in the last two groups. The contents of water, potassium and sodium in brain tissues in mice were evaluated at 24 hours after cerebral anoxia. Results The water, potassium and sodium contents in simple hypoxia group were significantly higher than those in control group(P0.05)in higher dosage group(8 mg/kg PROG)compared with those of simple hypoxia group. Conclusions At 24 hours after cerebral anoxia, there are significant increases of water, potassium and sodium in brain tissues. Progesterone may pro-duce neuroprotective role by inbibiting the rise of them.

OBJECTIVE: To study the assessed value of 64 slice spiral CT perfusion imaging (CTPI) in laryngeal squamous cell carcinoma after chemotherapy and radiotherapy. METHOD: Forty five patients diagnosed with local advanced laryngeal squamous cell carcinoma were selected. Conventional CT and CTPI were performed before treatment and at the time of radiation dose up to 40 Gy. Blood flow, blood volume, mean transit time and surface permeability were measured at the same time. According to the decrease of tumor volume in final examination, patients were divided into sensitive group and insensitive group. The tumor perfusion indexes were compared between groups. RESULT: Blood flow, blood volume, surface permeability after 40Gy treatment were lower than before treatment in both sensitive group and the insensitive group ascended(P<0. 05). The AUC of ROC of blood flow, blood volume, mean transit time and surface permeability were 0. 804, 0. 843, 0. 852 and 0. 826. The sensitivity, specificity and accuracy of blood flow was 89. 7%, 86.8% and 90. 9%. There were 100. 0%, 91. 4% and 93. 7% in blood volume; 100. 0%, 67. 7% and 88. 3% in mean transit time; 91. 2%, 69. 4% and 90. 6% in surface permeability(P<0. 01). CONCLUSION Sixty-four slice spiral CT perfusion imaging is able to assess tumor status of laryngeal squamous cell carcinoma after chemotherapy and radiotherapy effectively.
Carcinoma, Squamous Cell ; diagnosis ; drug therapy ; radiotherapy ; Head and Neck Neoplasms ; diagnosis ; drug therapy ; radiotherapy ; Humans ; Laryngeal Neoplasms ; diagnosis ; drug therapy ; radiotherapy ; Perfusion Imaging ; Sensitivity and Specificity ; Squamous Cell Carcinoma of Head and Neck ; Tomography, Spiral Computed ; Tumor Burden

Objective To evaluate the diagnostic and prognostic value of serum CA19-9,CA125 and CP2 in mucinous ovarian tumors.Methods In this retrospective study,the serum CA19-9,CA125 and CP2 levels of 273 hospitalized patients with ovarian tumors of either mucinous or non-mucinous type were analyzed.Results(1)CA19-9 had the biggest area under chive(AUC)in mucinous tumors followed with CA125 while CA125 and CP2 had bigger AUC in non-mucinous tumor.(2)For the diagnosis of mucinous tumors,CA19-9 and CA125 combination showed a greatly increased sensitivity compared with CA19-9 or CA125 alone(93.8%versus 75.0%and 66.7%,P＜0.05)with no significant improvement of the specificity(P＞0.05).For the diagnosis of non-mucinous tumors,CA125 and CP2 combination showed an increased sensitivity compared with CA125 or CP2 alone(85.0%versus 80.7%,P＞0.05,85.0%versus 70.6%,P＜0.05)with no significant improvement of the specificity(P＞0.05).(3)Seventy percent of tumor marker-positive patients could undergo cytoreductive surgery.Compared with those who could not undergo cytoreductive surgery,they were more likely to have normal tumor marker two months after surgery (P＜0.05)and longer interval to re-elevation of tumor markers(P＞0.05),with lower reeurrence and death rate (P＜0.05).All of the 20 tumor marker-negative patients could have eytoreduetive surgery with only 10%recurrence.(4)CA19-9 inereased mainly in recurrent mucinous tumor,while CA125 increased dominantly in recurrent non-mueinous tumor.(5)The survival rate of CA125 and CP2 positive patients was much lower than CA125 and CP2 negative patients(P＜0.05),while the survival rate was similar between CA19-9 positive and CA19-9 negative patients.Conclusions CA19-9 is a sensitive index for diagnosis of mucinous ovarian tumors.Combination of CA19-9 with CA125 can improve the sensitivity of diagnosis and postoperative monitoring of mucinous ovarian tumors.Combination of CA125 with CP2 is more valuable in the diagnosis of non-mucinous ovarian tumors.

Objective To investigate surgical opportunity and suitable treatment approach in nodular Hashimoto's disease.Methods An analysis was performed in 388 pathologically confirmed cases with nodular Hashimoto's disease and other thyroid-related diseases.All the cases were involved with surgical treatment due to thyroid nodules from June,1995 to Dec,2005.Results Among the above-mentioned cases,64 cases (16.5%) were Hashimoto's disease with the presence of thyroid cancer,190 (48.9%) nodular thyroid tumor,94 (24.2%) thyroid adenoma,7 (1.8%) hyperthyroidism,the rest (8.5%) simple Hashimoto's disease.Prior to 2000, among 106 cases of Hashimoto's disease there were 15 cases accompanied by thyroid cancer.Since 2001,282 cases of Hashimoto's disease were dealt surgically,49 of which had thyroid cancer.Compared to the period from 1995 to 2000,the complication of Hashimoto's disease and thyroid cancer has been sharply increasing during the recent five years (P

Objective To investigate the role and potential mechanism of interleukin-17A (IL-17A) in the inflammatory response to traumatic brain injury (TBI) in rats.Methods The adult male Wistar rats were randomly (random number) divided into seven groups:control group (n =6),sham operation group (n =6),TBI group (n =24),sham operation + normal saline group (n =6),sham operation + Y320 (an immunomodulator acts as an inhibitor of IL-17A) group (n =6),TBI + normal saline group (n =6) and TBI + Y320 group (n =6).The TBI model of rat was established by using free-falling-body impact device.The levels of IL-17A and nuclear transcription factor kappa B p65 (NF-κB p65) in the cerebral cortex were assayed by using Western Blot.The capability of leaming and memory of rats was assessed by Morris water maze.The beam balance test was employed to evaluating the neurological motor performance and the capability of balance.Results Compared with the sham operation group,the levels of IL-17A and NF-κB p65 in the cerebral cortex of TBI,TBI + saline and TBI + Y320 groups increased significantly (P ＜0.05) and peaked at the 3rd day after TBI.Compared with TBI + normal saline group,the level of NF-κB p65 was significantly down regulated by Y-320 (P ＜ 0.05) at the 3rd day after TBI in TBI + Y320 group.The lengths of latency time required for rats to escape to the platform area in TBI + normal saline group were (57.72±3.29) s,(55.63±3.85) s,and (55.02±3.92) sat the3rd,5th and7th days after TBI,respectively;while those in TBI + Y320 group were (35.45 ± 3.04) s,(30.98 ± 2.92) s,and (23.90 ±2.51) s at the 3rd,5th and 7th days after TBI,respectively.Thus,the capability of learning and memory of rats in TBI + Y320 group was improved significantly 3d,5d and 7 days after TBI (all P ＜ 0.01).Conclusions This study shows IL-17A is involved in the process of secondary brain injury after TBI,and associated with inflammation by activating the NF-κB p65 signaling pathway.

Objective To compare the efficacy of small splint fixation and plaster fixation in treating distal radius fracture. Methods One hundred and four cases of type A2 distal radius fracture admitted from January of 2012 to May of 2013 were randomly divided into small splint fixation group and plaster fixation group. After reduction, patients in the two groups were fixed with small splint and plaster separately. Wrist function scores, 36-item Short Form ( SF-36) scores and roentgenographic scores were evaluated for the two groups at different time points. Results ( 1) Within 3 months of follow up, the improvement of wrist function in small splint fixation group was significantly superior to that in plaster fixation group (P<0.05), and the differences of wrist function scores were insignificant between the two groups with the prolongation of follow-up (P>0.05). (2) SF-36 scores of the two groups were gradually increased along with the follow up. After follow-up for one week, 2 weeks, one month and 3 months, the SF-36 scores in small splint fixation group were significantly higher than that in plaster fixation group ( P<0.05) , but there was no significant difference after 6 months ( P>0.05). ( 3) After follow up for one year, the excellent rate for roentgenographic scores was higher than 80% in both groups, and there was no significant difference between the two groups (P>0.05). Conclusion Both small splint fixation and plaster fixation have satisfacory efficacy in treating type A2 distal radius fracture. But during the therapeutic process, wrist function scores and life quality scores in the small splint fixation group were higher than those in the plaster fixation group.