Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Facial Injuries ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; therapy ; Retrospective Studies ; Wounds, Penetrating ; therapy ; Young Adult

Objective To study the relationship between serum tumor marker level and the apoptosis regulation gene of tumor tissue in the patients with primary hepatocarcinoma .Methods 40 cases of primary hepatocarcinoma and 40 healthy people were in‐cluded into the observation group and control group .Then the levels of tumor marker GP73 ,TK1 ,DKK1 in serum and the expres‐sion of apoptosis regulation gene in tumor tissue were detected in the two groups .Results The serum GP73 ,TK1 and DKK1 levels of the observation group were significantly higher than those of the control group ,the difference was statistically significant (P<0 .05) .The apoptosis inhibiting gene Plk1 ,Livin and Xiap levels in the hepatocellular carcinoma tissue were higher than those in the adjacent normal tissues ,while the pro‐apoptotic gene M TS1 ,Caspase‐3 and Caspase‐8 levels were lower than those in the adjacent normal tissues ,the difference had statistical significance (P< 0 .05) ;serum GP73 ,TK1 and DKK1 levels were positively correlated with Plk1 ,Livin and Xiap levels and negatively correlated with M TS1 ,Caspase‐3 and Caspase‐8 levels .Conclusion The levels of se‐rum GP73 ,TK1 and DKK1 in the patients with primary hepatocarcinoma are abnormally increased ,moreover which are closely cor‐related with the apoptosis regulating gene expression and the ideal indexes to evaluate the disease condition of primary hepatocarci ‐noma .

Objective:To discuss the role of clinical pharmacists in perioperative drug treatment for a patient after renal transplan-tation. Methods:Clinical pharmacists participated in the drug therapy for a patient after renal transplantation. Pharmaceutical care and health education were performed for the patient in the aspects of immunosuppression, anti-hepatitis B virus, gastric mucosa protection, diarrhea, acute rejection and the other treatment programs. Results:The participation of clinical pharmacists in the clinical treatment for the patient improved therapeutic scheme and promoted therapeutic efficacy. Conclusion:The participation of clinical pharmacists in clinical drug therapy for patients can provide individualized service to improve reasonable, effective and economical drug use.

Objective To determine the characteristic features of solitary necrotic nodule(SNN)of the liver on precontrast and dynamic contrast enhanced magnetic resonance(MR)imaging.Methods We retrospectively reviewed 15 patients with histopathologically proved SNN.All of the images were evaluated for lesion features including the number,shape,size,location,border,signal intensity and pattern of enhancement.Results Sixteen lesions were found in 15 patients.Nonenhaneed T1-and T2 weighted images depicted 15 lesions in 14 patients and 14 lesions in 13 patients respectively.Maximum diameter of 14 lesions was less than 3 cm.On unenhanced T1-weighted images,5 lesions were hypointense,9 lesions were slishtly hypointense,and 1 was isointense with hypointense capsule and central punctate hypointense foci.Among14 lesions demonstrated on T2-weighted images,5 were hyperintense,4 were slightly hyperintense,3 were slightly hypointense,and 2 were hypointense.Punctate or linear high signal intensities were found in2 lesions.All lesions were not enhanced after contrast injection.On portal venous and delayed phase.all lesions appeared significantly hypointense with well-defined border.The shape was irregular in 12 lesions and was round or oval in 4 lesions.No enhancement was found in the lesion except thin delayed enhancement in capsules of 3 lesions after contrast agent administration.Conclusion Characteristic MRI features of SNN are helpful for distinguishing SNN from other hepatic lesions.

OBJECTIVETo study the diagnosis and proper treatment of focal nodular hyperplasia (FNH) of the liver.

METHODSForty-eight consecutive patients with FNH treated from 1998 to 2002 were analyzed. Clinical, pathologic, and preoperative imaging findings of FNH all proved surgically and pathologically were retrospectively reviewed.

RESULTSMost of the patients were asymptomatic and serum test was normal. Helical multiphasic liver CT and MR imaging demonstrated characteristic features in 25 patients. Histologically, characteristic scar-like tissues were found in 29 cases. The overall complication rate was 2.1% and there was no death. No recurrence was observed after follow-up of 4 years after operation.

CONCLUSIONThere is little evidence for an increased risk for FNH in people using modern oral contraceptives, while characteristic imaging features exist in helical multiphasic liver CT and MR imaging. Operation is the optimal treatment for FNH, but for proved FNH less than 5 cm and asymptomatic patients, close periodic followed up should be done.

Adolescent ; Adult ; Aged ; Child ; Female ; Focal Nodular Hyperplasia ; diagnosis ; pathology ; surgery ; Follow-Up Studies ; Humans ; Liver ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Tomography, Spiral Computed

OBJECTIVEOveractive bladder may coexist with bladder outlet obstruction induced by benign prostatic hyperplasia (BPH). This study aimed to evaluate the efficacy of the combined use of tolterodine and tamsulosin in the treatment of BPH accompanied by overactive bladder.

METHODSWe selected 53 cases of clinically diagnosed BPH, and randomly assigned them to a tamsulosin group (n = 25) to receive 0.2 mg of tamsulosin once a day and a tamsulosin + tolterodine group (n = 28) to be treated with 0.2 mg of tamsulosin once a day plus 2 mg of tolterodine twice a day, both for 12 weeks. Before and after the treatment, we obtained the International Prostate Symptoms Score (IPSS), quality of life (QOL) score and Qmax, and recorded the adverse events.

RESULTSAll the patients accomplished the 12-week treatment. The tamsulosin group showed a significant decrease in IPSS and QOL from 21.50 +/- 5.42 and 4.58 +/- 0.94 before the treatment to 14.80 +/- 4.21 and 2.78 +/- 0.91 after it (P < 0.05), but a significant increase in Qmax from (12.20 +/- 6.60) ml/s to (16.40 +/- 5.13) ml/s (P < 0.05). In the tamsulosin + tolterodine group, IPSS and QOL were decreased from 20.90 +/- 5.15 and 4.61 +/- 0.86 at the baseline to 14.90 +/- 5.32 and 2.12 +/- 0.87 after the medication (P < 0.05), Qmax was increased from (13.30 +/- 7.80) ml/s to (16.70 +/- 6.32) ml/s (P < 0.05), and the score on the urinary storage phase symptoms was reduced from 10.12 +/- 3.10 to 4.77 +/- 0.75 (P < 0.05).

CONCLUSIONTamsulosin could quickly relieve BPH-induced lower urinary tract symptoms (LUTS) , while the combined use of tolterodine and tamsulosin could even better alleviate the LUTS and improve the QOL of BPH patients.

Aged ; Benzhydryl Compounds ; therapeutic use ; Cresols ; therapeutic use ; Drug Therapy, Combination ; Humans ; Male ; Middle Aged ; Phenylpropanolamine ; therapeutic use ; Prostatic Hyperplasia ; drug therapy ; Sulfonamides ; therapeutic use ; Tolterodine Tartrate ; Treatment Outcome

Objective To study the genotypes of human papillomavirus (HPV)infection in female anus and anal canal condylo-ma acuminata(CA)tissues and their clinical significance.Methods 23 kinds of HPV-DNA were extracted from the paraffin-embed-ded anus and anal canal tissue samples in 140 cases of female CA and detected by using PCR combined with the gene-chips tech-nique.Furthermore the related clinical pathological data of the patients were analyzed.Results Among 140 female anus and anal ca-nal CA tissue samples,103 cases were HPV positive and the total HPV infection rate was 73.57%(103/140).Among them,68 ca-ses were single type HPV infection,the positive detection rate was 48.57%(68/140)and 35 cases were multiple types HPV infec-tion,the positive detection rate was 25.00% (35/140).In single type HPV infection,34 cases were HPV11 and the positive detec-tion rate was 24.29% (34/140),HPV11 was the main infection type,followed by HPV 6 in 27 cases,its positive detection rate was 19.29%(27/140).In the multiple types HPV infection,13 cases were HPV 6 + 11,accounting for 37.14% (13/35 )of multiple types infection,followed by HPV11 +18 in 3 cases and HPV 6+11+16 in 3 cases,each accounting for 8.57%(3/35)of the multi-ple types infection.Conclusion HPV 6,11 ,6+11,11 +18 and 6+11+16 are the main infection genotypes in female anus and anal canal CA.PCR combined with the gene-chips technique is a diagnostic method more suitable for clinical development of HPV geno-typing detection,which has high sensitivity and good specificity and is especially suitable for the molecular epidemiology study of HPV infection.

OBJECTIVETo study the biomechanical characteristic of maxillary Le fort- I osteotomy with rigid internal fixation (RIF) , so as to choose best fixation method.

METHODSThe 3-dimensional finite element models of maxillary Le Fort-I osteotomy with 9 kinds of RIF methods were established. Then the models were divided into three groups to calculate the stress distribution of the maxilla and the displacement of bone segment under 3 kinds of occlusion condition. The fixation stability of the different RIF methods was evaluated.

RESULTSUnder the incisor occlusion condition, the stress of the cranio maxillary complex transmits mainly along the nasal-maxillary buttress. Under the premolar and molar occlusion condition, the stress transmits along the alveolar process first, then turns to the nasal-maxillary and zygomatic-maxillary buttress. The focused stress position of the internal fixation system is at the connection between the screws and the plate and at the plate near the osteotomy line. Under the premolar occlusion condition, the displacement of bone segment with different RIF methods was (in a decreasing order) 0.396509 mm (with bio-absorbable plate), 0.148393 mm (with micro-plate ), 0.078436 mm (with mini-plate) in group 1; 0.188791 mm (fixing at the nasal-maxillary buttress), 0.121718 mm (fixing at the zygomatic-maxillary buttress), 0.078436 mm (fixing at the both buttress) in group 2; 0.091023 mm (with straight plate), 0.078436 mm (with L shape plate), 0.072450 mm (with Y shape plate), 0.065617 mm (with T shape plate) in group 3.

CONCLUSIONSThe fixation stability of using the bio-absorbable plate in Le Fort-I osteotomy is less stable than using the titanium plate. Fixing at the zygomatic-maxillary buttress is more stable than at the naso-maxillary buttress. The fixation stability is different by using different shapes of plates.

Bone Plates ; Finite Element Analysis ; Humans ; Maxilla ; surgery ; Osteotomy, Le Fort ; methods

Objective To summarize the experience in the diagnosis and treatment of hepatic trauma. Methods The clinical data of 260 patients with hepatic trauma admitted from January 1988 to December 2007 were retrospectively reviewed with regard to degree of trauma, treatment methods, therapeutical effects, complications and SO on. Results One hundred and fifty-three eases were treated by operative management,1 07 cases by nonoperative management.236 cases were cured,24 cases died,and the case fatality rate was 10.2%.There were no death among 139 patients with hepatic trauma grades Ⅰ～Ⅱ,22 death among 119 grades Ⅲ～Ⅴ patients, all death of 2 in grade VI, which demonstrated the correlation between death and hepatic trauma grade was statistically significant. Complications appeared in 82 eases, mainly including Secondary hemorrhage, abdominal infection and so on. Conclusions Nonoperative management is suitable for hepatic trauma with stable hemodynamics. Operative management is rapidly selected when the hemodynamics aren't stable. The cooperation of many specialities can enlarge the application of nonoperative management and decrease complications.

Objective:To compare clinical features of patients with pyogenic liver abscesses with and without septated lobulations.Methods:Patients diagnosed to have pyogenic liver abscesses who were treated in our hospital from January 2011 to March 2021 were enrolled into this retrospective study. There were 203 males and 132 females, with age of (56±14) years old. The patients were divided into two groups by findings on computed tomography and ultrasound into the septated lobulation group ( n=68) and the non-septated lobulation group ( n=267). The clinical data of these patients were compared. Results:In the septated lobulation group, the neutrophil count was 9.17(5.97, 12.33)×10 9/L and the TBil was 17.65(11.92, 27.84) μmol/L. These were significantly higher than the corresponding figures of 7.81(5.42, 10.81)×10 9/L, 12.90(9.00, 19.68) μmol/L, respectively in the non-septated lobulation group ( P<0.05). The difference in the maximum diameters of the septated lobulation group was also significantly larger than the non-septated lobulation group ( P=0.032). Additionally, pus culture showed the proportion of Klebsiella pneumoniae positive patients in the septated lobulation group was significantly higher than that in the non-septated lobulation group [41.18% (28/68) vs. 25.84% (69/267), P=0.013]. The use of fluoroquinolones in patients in the septated lobulation group was higher than that in the non-septated lobulation group [20.59% (14/68) vs. 10.11% (27/267), χ 2=5.54, P=0.019]. Conclusion:Compared to patients without septated lobulations, those with septated lobulations had a larger diameter of abscesses, a higher positive rate of Klebsiella pneumoniae on pus culture and a higher proportion of patients receiving fluoroquinolones.