Objective To evaluate the clinical value of choledochoscopy combined with electrohydraulic lithotripsy (EHL) for the treatment of pancreatolithiasis. Methods From October 2002 to July 2006, choledochoscopy combined with EHL was used in 11 patients with pancreatolithiasis during a dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis (EHL group). The data of these patients were compared with the data of 12 patients with pancreatolithiasis, who were treated by routine dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis from January 1995 to September 2002 (Routine group). Results The intraoperative blood loss and the postoperative rate of residual stones in the EHL group were significantly less than those in the routine group [(145.5?82.0) ml vs (406.7?384.9) ml, t=-2.201, P= 0.039; and 0% vs 41.7%, P= 0.037]. The postoperative rate of pain relief in the EHL group was higher than that in the routine group (90.9% vs 58.3%), however the difference was not significant (P=0.155). In the EHL group, 6 patients had diarrhea before the operation, 4 of them achieved relief after the surgery (4/6), which was not significantly more than that in the routine group (5/9, P=1.000). Before the operation, 7 patients in the EHL group and 9 in the routine group had diabetic mellitus; in each group, the disease was relieved in 2 patients after the operation (2/7 vs 2/9, P=0.665). Conclusions Choledochoscopy combined with EHL is effective for the treatment of pancreatolithiasis. The procedure can increase the rate of stone removal, decrease the intraoperative blood loss, and elevate the postoperative rate of pain relief.

Objectives To summarize the maternal and fetal outcomes of patients with essential thrombocythemia (ET), and tentatively propose possible solutions for different clinical scenarios.Methods We retrospectively studied the clinical data, treatment, outcomes and follow-up status in 18 consecutive cases of young women with ET visited Peking University People's Hospital, among whom 22 pregnancies occurred from March 2005 to January 2015.Rank-sum test, Chi-square test or Fisher exact test were applied for statistics.Results (1) Out of the total 22 pregnancies, 17 (77％) were successful (term live births) and five (23％) ended in miscarriages, among which four were spontaneous abortion in first trimester.(2) Six pregnancies did not received any therapy, while 16 received various treatments before and/or during pregnancy, including oral Aspirin(single/joint), Hydroxyurea, Interferon-α (IFN-α) and platelet apheresis.(3) Treatments before/during pregnancy improved the live birth rate significantly (15/16 vs 2/6, P=0.009).Platelet (PLT) count of the newborns were all normal till the time at follow-up.(4) The median PLT count in those patients before Aspirin therapy was 761 × 109/L[(448-1 213) × 109/L, and 639× 109/L[(283-1 908) × 109/L] thereafter, which showed no significant difference (Z=-0.405, P=0.686).(5) The PLT counts in those patients before combination therapy of Aspirin and IFN-α was 989 × 109/L[(435-1 504) × 109/L], and 498 × 109/L[(186-559) × 109/L] thereafter, which decreased significantly (Z=-2.366, P=0.018).Conclusions (1) First-trimester spontaneous abortion is the most common complication of ET in pregnancy.(2) A specific treatment strategy may improve the pregnant outcomes without long-term harmful effect up to now.(3) IFN-α and/or Aspirin might be the first-line therapy in women with ET during pregnancy.

OBJECTIVE: The objective of this study was to identify the risk factors for central lymph node metastasis (CLNM) of papillary thyroid microcarcinoma(PTMC) and to explore the necessity of central lymph node dissection (CLND). METHOD: Clinical data of 85 patients with PTMC, who had undergone surgical treatment between January 2004 and May 2012, were retrospected. Risk factors for CLNM were identified by univariate analysis and multivariate analysis,which can provide the basis for elective performance of CLND. RESULT: Of 85 patients,66 patients underwent ipsilateral CLND,while 19 patients received bilateral CLND. Concurrent cervical lymph node dissection was performed in 3 patients. The incidence of central and cervical lymph node metastasis was 38.8% and 3.53%, respectively. Univariate analysis showed that CLNM was correlated with tumor size > 5 mm, extrathyroidal extension, multifocality, bilaterality and intraoperatively suspected lymph node, but not related to gender and age. Upon multivariate analysis, tumor size > 5 mm (OR = 3.862, P < 0.05) and extrathyroidal extension (OR = 3.885, P < 0.05) were independent risk factors for CLNM. CONCLUSION Patients presenting tumor size > 5 mm and/or extrathyroidal extension may have an increased risk of central lymph node metastasis,and it is necessary to perform central lymph node dissection for them.
Adult ; Aged ; Carcinoma, Papillary ; secondary ; surgery ; Elective Surgical Procedures ; Female ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms ; secondary ; surgery

The secondary development of traditional Chinese medicines (TCMs) is an important content of TCM modernization process, as well as an important path for developing new TCM drugs. Under the guidance of the system theory, in response to the lack of the overall guideline and practical methods for the secondary development of TCMs at present, we introduced the overall thought of the secondary development of major TCM varieties, as well as the roles and contents of clinical research, pharmacology and pharmaceutics in the process of the secondary development of major TCM varieties, so as to provide systematic strategies and methods for the development of major TCM varieties.
Biomedical Research ; Drug Discovery ; methods ; Humans ; Medicine, Chinese Traditional ; methods ; Pharmacology

The secondary development of major traditional Chinese medicine varieties is one of important links during the modernization, scientification and standardization of traditional Chinese medicines. How to accurately and effectively identify the pharmacodynamic material basis of original formulae becomes the primary problem in the secondary development, as well as the bottleneck in the modernization development of traditional Chinese medicines. On the basis of the existing experimental methods, and according to the study thought that the multi-component and complex effects of traditional Chinese medicine components need to combine multi-disciplinary methods and technologies, we propose the study thought of the material basis of secondary development of major traditional Chinese medicine varieties based on the combination of in vivo and in vitro experiments. It is believed that studies on material basis needs three links, namely identification, screening and verification, and in vivo and in vitro study method corresponding to each link is mutually complemented and verified. Finally, the accurate and reliable material basis is selected. This thought provides reference for the secondary development of major traditional Chinese medicine varieties and studies on compound material basis.
Absorption ; Animals ; Drug Discovery ; methods ; Humans ; Medicine, Chinese Traditional ; methods

Surgical resection remains the only curative option of treatment for hepatocellular carcinoma,but centrally located tumors remain problematic.Extended right or left hepatectomy removes 60％ to 85％ of the hepatic parenchyma and is associated with more hepatic failure.Mesohepatectomy,resection of central hepatic segments (Couinaud's segments Ⅳ,Ⅴ,Ⅷ) and leaving the right and left segments in situ,preserves more functional hepatic tissues than extended hepatectomy.Despite its technical demands,mesohepatectomy should be considered as an alternative treatment for central huge hepatic tumors.

AlM:To evaluate the effect of intralamellar cryolysis of cornea with amniotic membrane transplantation on painful bullous keratopathy ( PBK) .?METHODS: Randomly selected 156 cases ( 156 eyes ) with PBK who underwent surgery of intralamellar cryolysis of cornea with amniotic membrane transplantation. Followed up with 2 ~ 3mo, the symptoms of eye pain, corneal epithelial blisters, foreign body sensation and postoperative complications were observed.?RESULTS:Pain symptoms disappeared in all patients, and corneal epithelial blisters disappeared in 130 cases (83. 3%). All agonizing pain symptoms disappeared, but patients had occasional foreign - body sensation, occasional corneal epithelial blisters in 24 cases ( 15. 4%) . Two weeks after surgery, corneal stroma dissolved, 2 cases ( 1. 3%) of them were cured by conjunctival flap cover.?CONCLUSlON:The operation of intralamellar cryolysis of cornea with amniotic membrane transplantation can relieve the pain in 98. 7% of PBK patients and simple therapy for treating PBK. Hence, it's be worth to advocate for relieve the pain of patients.

Arrhythmias, Cardiac ; physiopathology ; Electromyography ; methods ; Female ; Humans ; Infant, Newborn ; Male

OBJECTIVE:To optimize the drying technology of Zingiber officinale peel and establish its quality standard. METHODS:Moisture content was determined in samples after being dried for different time(0.5-10.0 h)under 50,60,70,80, 90 ℃. Optimal drying time under each temperature was screened by using moisture content of 7%-13% as dryness for controlling standard. Then contents of 6-gingerol,8-gingerol,6-shogaol,10-gingerol in samples dried for optimal drying time under different temperatures were measured,using the 4 gingerol contents as indexes to optimize the drying temperature and time. And verification test was conducted. The moisture,total ash,water soluble extract,volatile oil,6-gingerol,8-gingerol and 10-gingerol of Z. offici-nale peel from 10 different producing areas were detected to establish quality standard after being dried with the optimal technology. RESULTS:The drying time of Z. officinale peel under 50,60,70,80,90 ℃ was determined as 10.0,4.2,2.6,1.5,1.1 h,re-spectively. The optimal drying technology was 50 ℃ drying for 10.0 h. Verification test showed RSDs of 6-gingerol,8-gingerol, 6-shogaol,10-gingerol contents were 1.46%,1.09%,1.35%,1.12%(n=3),respectively. The quality standard of Z. officinale peel was suggested that total ash was no more than 18.0%;water soluble extract,volatile oil,6-gingerol,8-gingerol,10-gingerol were respectively no less than 18.0%,1.30%,0.730%,0.060%,0.100%. CONCLUSIONS:The optimized drying technology of Z. officinale peel is reasonable,reliable,stable and simple,which provides a scientific basis for standardizing the drying technolo-gy and quality standard of Z. officinale peel. The established quality standard is feasible.

OBJECTIVETo investigate the effects of external fixation combined with minimally invasive internal fixation for the treatment of distal radial fracture and dislocation of type IV based on Fernandez classification.

METHODSFrom January 2007 to October 2012,19 patients with the distal radius fracture and dislocation of type IV according to Fernandez classification were reviewed. There were 14 males and 5 females,ranging in age from 22 to 42 years old,with an average of 36.5 years old. All the patients were treated with minimally invasive reduction, and external fixation with finite internal fixation. The K-wire was used to fix radiolunate articular surface for correcting the instability of dorsal and volar intercalated segment. The radiolunate angle, scapholunate angle, and the length of the radial shorting were measured by the standard X-ray. Gartland and Werley evaluation system was used to evaluate recovery of function.

RESULTSNo complications such as injury of blood vessels and radial nerves and pin track infections occurred. After operation, the radiolunate angle, scapholunate angle and the length of the radial shorting time were (9.5 +/- 3.3) degrees, (51.3 +/- 11.2) degrees and (11.2 +/- 1.8) mm by the standard X-ray. On the 3rd month after operation, GW score was 3.02 +/- 3.05. There was no re-displacement and subluxation occurred during the follow-up period. Good functional recovery were improved wrist function significantly.

CONCLUSIONExternal fixation combined with minimally invasive internal fixation can treat distal radial fracture and dislocation of type IV based on Fernandez classification. Wrist joint stability depends on the structure of the bone and ligament around wrist joint. Emphasis on the diagnosis and treatment of carpal instability, and postoperative functional rehabilitation can improve wrist function.

Adult ; Bone Nails ; Female ; Fracture Fixation, Internal ; Humans ; Joint Dislocations ; surgery ; Male ; Minimally Invasive Surgical Procedures ; Radius Fractures ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery ; Young Adult