Objective To study the clinical characteristics and effects of surgical treatment of children with thalamic tumors.Methods The clinical data of 22 cases were retrospectively studied and followed-up 6 months to 9 years.Results There were 13 boys and 9 girls,their ages ranging from 3 to 13 years.The average duration of symptoms before diagnosis about 2 months.Headache and papilledem were the most symptoms and signs,respectively.Most children′s thalamic tumors were low grade tumors with clear verge.In this group,good results were obtained that total remove 9 cases,subtotal remove 8 cases,partial remove 3 cases,biopsy 2 cases and no surgical death.Conclusions Clinical character of children thalamic tumors is distinct and good surgical results in the nearly future.The long results are determined by type of pathology.

Objective To identify the changes of mesenteric lymph fluid in cases of uncontrolled hemor-rhagic shock (UHS), which is most often occurred in modem trauma and battle injury. The lymph of gut plays an important role during shock and MODS. The objective of this experiment is to identify the change of mesenteric lymph fluid in UHS. Method Thirty-eight SD rats were canulated with PE 50 catheters separately into right carotid artery,left femoral artery and femoral vein. A serf-made steel catheter was inserted into main mesenteric lymph duct and the mesenteric lymph fluid was collected. The rots were divided into three groups: control group (n=10), controlled hemorrhagic shock (CHS) group (n=10) and UHS group (n=10). After the mean blood pressure was dropped to 40 mmHg by exsanguination, hemorrhage was made by amputation of 75% tail in length and let the stump keep open to bleed. The volume of mesenteric lymph fluid was recorded, and the protein and endotoxin in it were examined, too. Data were analyzed using ANOVA and Chi-square test. Results The mesenteric lymph fluid was decreasing remarkably during shock until it was below 1/4 of normal. After hemorrhage was controlled, the mesentefic lymph fluid increased slowly. However, it kept decreasing persistently in cases of UHS. So did the protein content. The eudotoxin in lymph fluid increased 2 hours after CHS and one hour after UHS. There was significant difference in endotoxin between CHS and UHS 2 hours after shock (P<0.05). Con-dusions The volume and protein content of mesenteric lymph fluid decreased mare significantly in UHS than that in CHS. And contrarily, the endotoxin in lymph fluid increased more significantly in UHS than that in CHS. The change of the mesenteric lymph fluid may be an important cause of MODS after UHS.

Objective To study the cell metabolism changes of hippocampal region in patients with vascular dementia (VD) after stroke by 1 H-magnetic resonance spectroscopy (1 H-MRS),and to observe the relationship between cell metabolism changes and clinical symptoms after donepezil hydrochloride treatment.Methods Enrolled 18 patients with VD after stroke,16 males and 2 females,with a mean age of (76.9±2.7) years,13 patients without VD after stroke,11 males and 2 females,with a mean age of (76.2±3.6) years and 14 health volunteers as control group,12 males and 2 females,with a mean age of (75.1+2.4) years.The mini-mental state examination (MMSE),activities of daily living (ADL) and Hamilton depression scale (HAMD) were used to assess the effects on cognitive function,ability of daily living and behavior symptoms.1 H-MRS examination of bilateral hippocampus was conducted in all subjects.Metabolisms of N-acetylaspartate (NAA),choline (Cho) and creatine (Cr) were examined and the ratios of NAA/Cr and Cho/Cr were calculated.The patients with VD were prescribed donepezil and given 1 H-MRS assessment half a year later.Results The patients with VD had a significantly lower NAA/Cr ratio in bilateral temporal hippocampus area than did health controls and the patients without VD (F=4.23,4.98,both P＜0.05),and a higher Cho/Cr ratio than did health controls and the patients without VD in left hippocampus (P＜0.05).The NAA/Cr and Cho/Cr ratios in patients without VD had no significant changes compared to health controls.There was a positive relationship between MMSE score and NAA/Cr ratio,and negative relationship between MMSE score and Cho/Cr ratio in the bilateral hippocampus area in patients with VD.After 6 months of treatment of donepezil hydrochloride,the MMSE and ADL scales significantly increased (both P＜0.05),and NAA/Cr ratio had no significant change in hippocampal region (t=-2.02,-2.04,both P＞0.05),whereas Cho/Cr had significant decrease (t=2.86,2.23,both P＜0.05).Conclusions The data suggest that the lower NAA/Cr ratio and higher Cho/Cr ratio in hippocampus area might be helpful in distinguishing VD and no-VD in patients with stroke.Donepezil improves general cognition function in patients with VD,which may be associated with regulating the cholinergic pathogenesis of VD in vivo and in vitro.

Objective To study the early resuscitation with intravenous administration of liquor in uncontrolled hemorrhagic shock model by four-staged abdominal aorta injury in rats in order to settle the controversy over the issue of volume resuscitation.Method Forty Sprague-Dawley rats were canulated with catheters into the left ventricle,femoral artery and femoral vein,respectively.Animals were subjected to vaseular injury of infrarenal pierced with a 25G needle leading to uncontrolled hemorrhagic shock.After aorta injury,the models were processed into 4 stages:early injured stage,early rescue stage,delayed rescue stage and observation stage.The rescue with rapid infusion of 45 ml/kg lactated Ringer's solution in 15 minutes in the early stage and the followed rescue in the late stage;and(4)sham-rescued.The MAP,CVP,lactic acid and Hct were monitored.The volume of blood loss and the survival time of rats were recorded too.Results After aorta injury,The MAP dropped from 94.3 mmHg to 25.8 mmHg and rised quickly after early resuscitation with rapid infusion of liquor and then again fell soon,and CVP did likewise.Lactic acid was increased and reached 3-4 times of baseline at 4 h in all group except Sham-resuced group.The Hct levels decreased quickly after resuscitation with liquor in early rescue stage and delayed rescue stage.The blood loss in abdomen increased after rapid infusion of lactated Ringer's solution in early rescue stage(blood loss increased from 22.8 ml/kg to 27.7ml/kg,P＜0.05).There Was no significant difference in mortality between those groups.Conclusions Rapid volume resuscitation at early stage of abdominal aorta injured with uncontrolled hemorrhagic shock cannot increase the circulatory blood volume for maintaining stable blood pressure norminimize the elevation of blood lactic acid.On the contrary,resuscitation with rapid administration of liquor at early stage can enhance blood loss and decrease the level of Hct.The survival time and survival rate can't be increased by early rescue with rapid liquor infusion.

Age Factors ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged

Objective To explore the surgical indication, the operative procedure and effect of breast-conserving surgery plus combined treatment for the patients with early breast cancer. Methods 51 patients with early breast cancer were treated with breast-conserving surgery (BCS) plus radiotherapy, chemotherapy and hormonotherapy postoperatively. The result of breast-conserving group was compared with 56 patients treated by modified radical mastectomy (control group). Results 25 patients underwent quadrant resection plus axillary lymph node dissection (ALND), 15 patients were subjected to local resection plus ALND, and 11 patients received quadrant resection only. All patients were followed-up for an average of 16.9 months. In BCS group, one patient was found to have local recurrence, and the distant metastasis rate was 0%. In the control group, no patient had local recurrence and the distant metastasis rate was 3.6%. The operative complication rate in BCS group and control group was 13.7% and 33.9% respectively (p﹤0.05). Conclusion Breast-conserving surgery plus combined treatment is safe and satisfactory for early breast cancer. It can be considered as the first choice for the treatment of patients with breast cancer in early stage.

Objective To explore the effect of adjunct intraperitoneal resuscitation (IR) on bioactivity of mesenteric lymph in hemorrhagic shock (HS) rats. Method The rat model of HS was reproduced by bleeding the rats from femoral artery. The rats were resuscitated by conventional resuscitation (CR) or CR plus adjunct IR 60 minutes after HS or sham shock (SS).The rats were then divided into six groups as follows:SS group (n=4),SS+CR group (n=4),SS+CR+IR group (n=4),HS group (n=4),HS+CR group (n=5) and HS+CR+IR group (n=5). The mean arterial pressure (MAP) of rats in HS group was maintained at 40mmHg without resuscitation. The rats in SS group underwent only artery cannulation without blood letting for pressure monitoring. The rats were resuscitated with Ringer's lactate (80ml/kg) in CR. When treated with IR,each rat was given peritoneal injection of 20ml peritoneal dialysis solution after CR. Two hours after resuscitation,mesenteric lymph was collected by laparotomy for the measurement of neutrophil respiratory burst activity after being incubated with lymph. At the end of experiment,rats were sacrificed,the intestinal tissues were collected and the ileum mucosal injury was evaluated by light microscopy. Results The bioactivity of lymph of HS group was significantly higher than that of SS group. Compared with CR,CR+IR could inhibit shock lymph-mediated respiratory burst of neutrophils and attenuate the bioactivity of shock lymph significantly (P

Objective Protein chip for mucin detection was prepared to detect the serum levels of mucin1(MUC1),mucin2(MUC2)and micin5ac(MUC5AC)of colorectal cancer patients,and to discuss the relationship between colorectal cancer and the expression of MUC1,MUC2 and MUC5AC in serum.Methods The protein chip was prepared with monoclone and polyclone antibodies for the measuement of the serum levels of MUC1,MUC2 and MUC5AC in 30 patients with colorectal cancer and 30 healthy adults as control,using the method of immuno-fluorescence.Results The serum levels of mucin and CEA in colorectal cancer group were higher than that in control group.The differences were significant between the two groups concerning MUC1(5.25?2.37 vs 3.65?1.82U/ml,P0.05).The positive expression of mucin was related with the cancer differentiation.The positive expression of MUC1 and MUC5AC was higher when cancer differentiation was low as compared with high and median differentiation,but the positive expression of MUC2 was higher in high and middle cancer differentiation.When the serum level of mucin was used as an indicator for the diagnosis of colorectal cancer,the sensibility and specificity were both higher.The sensibility and specificity of MUC1 were 82.1% and 78.1%,respectively,while of combined mucins(at least 2 in 3 mucins were positive)were 96.2% and 85.3%,respectively.Conclusion The application of protein chip for mucin detection on the measurement of serum levels of MUC1,MUC2 and MUC5AC is of higher sensibility and specificity in the diagnosis of colorectal cancer.The establishment of protein chip has provided a new approach to early diagnosis of colorectal cancer,and help estimate the prognosis.

Objective To establish an abdominal-trauma-induced uncontrolled hemorrhagic shock (UHS) model, and explore the effect of staged resuscitation. Methods Indwelling catheters were inserted into left ventricle, femoral artery and femoral vein of 50 Sprague-Dawley rats, and then laparotomy was performed. 42 out of the 50 animals were subjected to vascular injury to simulate UHS by infra-renal arterial puncture with 25G needles, and the model was successfully established in 32 rats, for which the animals were divided into 3 groups: control group (n=10), with no resuscitation; hospital-resuscitation group (n=11), resuscitated in early injured stage; and staged-resuscitation group (n=11), resuscitated pre-hospital and then in-hospital. 8 out of the 50 rats, which were not subjected to vascular injury, served as sham-operated group. The mean aortic pressure (MAP), central venous pressure (CVP), serum lactic acid, alanine aminotransferase (ALT) and creatinine (Cr) were determined, and the volume of blood loss and survival time were recorded. Results The MAP decreased from 94.7mmHg to 28.9mmHg 15min after aortic injury in control group and rose slowly after continuous transfusion in staged-resuscitation group. Similar change was found in CVP. Serum lactic acid, ALT and Cr were increased in control group and hospital-resuscitation group at early injured stage, but the increase was delayed in staged-resuscitation group. The mean survival time in control group, hospital-resuscitation group and staged-resuscitation group were 76, 846 and 2480 min, respectively. The 72 h mortalities of the three groups were 100%, 72.7% and 36.4%, respectively. Conclusion Staged resuscitation which is characterized by slowly continuous transfusion at early aid stage cannot increase the blood pressure and circulating blood volume to normal level in UHS, but can reduce the level of serum lactic acid, ALT and Cr, and dose not increase the blood loss. The survival rate and mean survival time can be increased by this method.

Objective To determine the accuracy and reliability of continuous glucose monitoring system(CGMS)in intensive monitoring blood glucose level.Methods The analysis was conducted on 48 type 2 diabetes patients to compare the glucose levels of glucose meter and CGMS.Each patients received CGMS for 3 days during his/her hospitalization.The data were analyzed according to correlation coefficient analysis,mean absolute error,sensitivity and specificity.Results The mean duration of CGMS recording was(71.4?0.6)h.From the data that paired glucose readings and CGMS,the coefficients of correlation ranged from 0.79 to 0.90 and the mean absolute error ranged from 6.7% to 10.0%.The sensitivity and specificity to detect hyperglycemia were 93.15% and 95.95%,respectively.Conclusion There is a good correlation between sensor readings of interstitial fluid glucose level and capillary blood glucose readings.The results indicate that CGMS is of clinical utility as a holter-type glucose tracking device.