Malignant biliary obstruction is caused by biliary tract malignant tumors or by extrinsic compression from pancreatic cancer, liver cancer, etc. Clinically, the disease is characterized by jaundice, skin itching, hepatic failure, etc., and the patients endure a poor quality of life with a short survival time. The key point for the treatment of malignant biliary obstruction lies in dredging biliary drainage channel , timely reducing jaundice and protecting liver function. This paper reviews the relevant medical literature , that have been published both at home and abroad in recent years, concerning percutaneous transhepatic endobiliary radiofrequency ablation by using HabibTM EndoHPB catheter to treat malignant biliary obstruction in order to clarify the fact that percutaneous transhepatic endobiliary radiofrequency ablation is a safe and feasible treatment and this technique can effectively reduce the incidence of re-stenosis of implanted biliary metallic stent.

Objective To investigate the pharmacodynamic interactions between remifentanil and sevoflurane during general anesthesia for laparoscopic operation.Methods Sixty-five ASA I patients undergoing selective laparoscopic operations at the Department of Gynecology and the Department of General Surgery in People's Hospital were enrolled in this study.Sevoflurane was used for anesthesia induction with its expired concentration being kept stable,and different dosages of remifentanil(0,1,2,4,6,and 8 ng/ml)being added during the operation.When the expired concentration of sevoflurane reached an expected level(pseuto-state),the block somatic and cardiovascular responses to electrical tetanus stimuli(ETS;100 Hz,60 mA,5 s)were measured.The data were analyzed using NONMEM software to establish concentration-effect curves.Logistic regression was used to calculate the minimal alveolar concentration of sevoflurane under ETS(MACETS).Results In the cases received sevoflurane only,the somatic response was inhibited when MACETS reached 1.52%;while the cardiovascular response was inhibited when MACETS reached 2.24%.The MACETS was decreased significantly by adding low-dosage remifentanil.When the target-controlled concentration of remifentanil was 8 ng/ml,the MACETS for the inhibition of somatic and cardiovascular responses decreased by 70.0% and 76.3%,respectively.Conclusions There is a synergic effect between remifentanil and sevoflurane on the suppression of somatic and cardiovascular responses to ETS.Remifentanil produces a dose-dependent decrease of MACETS of sevoflurane.The effect is especially strong in low-dosage remifentanil group,but shows ceiling effect characteristics.

AIM: To determine the interactions with response-surface modeling methodologies when sevoflurane (Sevo) and remifentanil (Remi) were administered simultaneously. METHODS: (1) Patients, Study design and drug delivery: Based on parallel slices design, sixty-five patients were randomly assigned to inhale a specific end-tidal concentration of sevoflurane (0.3% to 3.4%), with different level of remifentanil (0-10 ng/mL). The responses to laryngoscopy were observed for each given concentration pair. (2) Pharmacokinetic/pharmacodynamic analysis with response surface mode: The probability of no response (P) was assessed in the modeling process as below. P=(Us+Ur)r/[U50/I(Q)]r+(Us+Ur)r RESULTS AND DISCUSSION: NONMEM estimated average values (RSE%) of the model parameters for laryngoscopy of C50,Sevo, C50,remi, U50, r, Imax and Qmax are 1.71% (12.9), 12.4 ng/mL (19.0), 6.62 (10.6), 1.53 (8.76), 2.31 (8.23), 0.706 (2.46), respectively. The inter-individual variability (CV%) in parameter Imax and inter-occasion variability (S.D.) in this model are 12.7 and 0.0316, respectively. It is concluded that the response-surface modeling approach provided a novel method to study drug-drug interactions.

OBJECTIVE:To study the centralized dispensing mode in outpatient pharmacy of large hospital METHODS:To establish the label dispensing system and management strategy RESULTS & CONCLUSION:Dispensing is the heart of a pharmacy Good networking system with efficient workflow and rational use of manpower could determine the success in a pharmacy,such as no dispensing error,no illegible handwriting,short wait-time automation of management of drug information and statistics of pharmacist's work load and rise of dispensing efficiency and quality of service

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pterygopalatine Fossa ; innervation ; Rhinitis ; physiopathology ; therapy ; Smell ; Treatment Outcome ; Young Adult

Objective To discuss the correlation factors of locally recurrent gastric carcinoma. Methods Clinical, pathological and periodical follow-up datas of 50 cases with locally recurrent gastric carcinoma after radical resection from 1991 to 2005 were studied retrospectively, logistic regression analysis was used to disscuse the possible correlation factors of locally recurrent gastric carcinoma. Results 66.0% of 50 cases had recurrenced within 2 years after operations; Tumor pathological stages, positive lymph nodes and radical resection extent were independent correlation factors of locally recurrent gastric carcinoma. Conclusions Most recurrences would happen within 2 years after radical resection for gastric carcinoma; Early diagnosis of reccurrent gastric carcinoma depends on periodic follow-up observation especially gastroscope; Tumor pathological stages, positive lymph nodes and radical resection extent are independent correlation factors of locally recurrent gastric carcinoma.

Chronic wound has very complicated pathogenesis and is difficult to treat;the situation has been improving owing to the progress in wound healing research and the clinical application of new techniques.This article focuses on the pathogenesis of chronic wound and introduces progress in various kinds of treatment,such as skin substitute,growth factors,negative pressure treatment,etc.

Objective To investigate the effect of estrogen on gliosis, synaptic proliferation and reorganization in hippocampus of rats with chronic epilepsy induced by pentylenetetrazol (PTZ). Methods Thirty-two Wistar rats were randomly divided into normal control group, PTZ kindling epilepsy group, estrogen+PTZ group and estrogen +Tamoxifen (mixed estrogen antagonist)+PTZ group. The PTZ kindling epilepsy group was intraperitoneally injected with 35 mg/kg PTZ once a day, then the behavior of the rats in one hour was observed. The estrogen interfered group was intramuscluarly injected of 0.6 ?g/kg ?-estradiol 6 h before PTZ injection, 1/3 d. The estrogen+Tamoxifen interfered group was injected of Tamoxifen into lateral cerebral ventricle 1 h before estrogen injection. If the severe epileptic seizures occurred three times, the rats were ready for detecting the expression of filial fibrillary acidic protein (GFAP) and synaptophysin (P38) by immunohistochemical technique. Results Epileptic seizure occoured earlier and more severely in most rats of estrogen interfered group than no estrogen interfered group. Rats in all model groups were found more astrocyte proliferation and positive synaptophysin staining, especially in the CA2, CA3 and hilar areas of dentate gyrus (DG) of hippocampus than control group. Estrogen+Tamoxifen interfered group showed significant difference as compared with other groups (P

This paper discusses the meaning of the tutorial system on clinical practice;the qualifications,tasks and a responsibility of the tutors,expounds the role of tutors,and discusses the main problems of tutorial system of the undergraduate.

Neonatal nerves exist in tumor tissues,and tumor cells can invade nerve by neurogenesis.Current research shows that cancer cells can secrete cytokines to promote the differentiation and growth of nerve cells,in turn,the differentiation and growth of nerve cells can stimulate tumor development and metastasis.Neurogenesis is one way of interaction bettween tumor cells and microenvironment similar to angiogenesis and lymphangiogcnesis,which has a major impact on biological behavior of tumor cells and prognosis.