Aconitum ; poisoning ; Animals ; Disease Models, Animal ; Female ; Hemoperfusion ; methods ; Male ; Plant Poisoning ; therapy ; Rabbits

Objective To study the CT findings of traumatic bone cyst and to improve the knowledge of that disease.Methods CT features of 8 cases of traumatic bone cyst confirmed by clinical and pathology were reviewed retrospectively.There were 4 females and 4 males,from 26 to 76 years (the median age was 53 years old)of age.Three patients had traffic accidents,2 patients had trauma unrelated,1 patient had boulder crushing,1 had patient stick wounded and 1 patient had high jump wounding.The bone cyst occurred from 18 to 36 months after trauma(2 at 18 months,4 at 24 months,1 at 30 months and 1 case at 36 months).Results There were 6 fractures,1 joint dislocation and 1 frontal soft tissue hematoma in trauma.The cyst located in the ilium of 3 cases,in the calcaneus of 2 cases,in the frontal bone of 1 case,in the hooked bone of 1 case,in the lunate bone of 1 case.The cyst size was 2.0 cm × 2.6 cm to 3.0 cm × 6.0 cm (average 2.7 cm × 4.0 cm).8 cases all single capsule change,all clear boundaries.6 cystic destruction and 2 cystic expansion destruction of bone.Two see separated and 6 no divider of the cyst region.Five bone sclerosis and 3 no hardening of the cyst edge.Three sclerosis and Five no sclerosis of the adjacent bone.Four osteoporosis decalcification and 4 no osteoporosis decalcification of he adjacent bone.Conclusion The traumatic bone cyst is closely related to trauma,CT manifestations with certain characteristics,combined with a history of trauma can make a definite diagnosis.

Objective To investigate the influence of Chinese medicine ( CM) treatment on life span of middle-late primary hepatic carcinoma (PHC) patients. Results A multicenter retrospective cohort study was carried out in 489 PHC patients at the stages of Ⅱb, Ⅲa and Ⅲb collected from 15 domestic hospitals. With CM treatment as the exposure factor, the enrolled patients were divided into CM group, western medicine (WM) group and the CM-WM combination group. The main outcomes included median survival time (MST) and survival rate, and the effects of CM treatment and minimally invasive therapy on MST were observed. Results Half-a-year survival rate, one-year survival rate and two-year survival rate were 50%, 9%, 1% in CM group, 70%, 30%, 6% in CM-WM combination group, and 50%, 10%, 0% in WM group, respectively. The survival rates in CM-WM combination group differed from those in CM group and WM group (P<0.01), but the differences of survival rates between CM group and WM group were insignificant (P>0.05) . MST at the stages of Ⅱb, Ⅲa, Ⅲb in CM-WM group was obviously prolonged as compared with the other two groups (P<0.01), and MST at the stages of Ⅲa, Ⅲb in CM group was also obviously prolonged as compared with WM group (P<0.05) . The difference of MST at the stage of Ⅱb was insignificant between CM group and WM group ( P>0.05) . CM treatment and minimally invasive therapy were effective on prolonging the survival time of PHC patients ( P<0.01) . The results of COX regressionanalysis showed that Karnofsky scores, CM treatment and minimally invasive therapy were the preventive factors for the prognosis. Conclusion CM-WM combination group has the best long -term therapeutic effect. CM -WM combination treatment is effective on increasing MST and long-term survival rate, in particular for PHC patients at the stages ofⅡb, Ⅲa and Ⅲb. CM treatment and minimally invasive therapy are helpful for the prolongation of the survival time of PHC patients.

BACKGROUND:Core decompression may provide insufficient support for the subchondral bone in the treatment of early avascular necrosis of the femoral head and increase the risk of fracture and colapse. Quadratus femoris implantation cannot only provide good biological support, but also promote the revascularization at necrotic regions, thus repairing the necrosis of femoral head. OBJECTIVE: To compare the clinical effects of core decompression with bone paste implantation and core decompression with quadratus femoris implantation on early and middle-stage avascular necrosis of the femoral head. METHODS:Eighty-three patients with early avascular necrosis of the femoral head (92 hips) admitted at the Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, China, from January 2009 to January 2012 were enroled and divided into groups of core decompression with bone paste implantation (46 cases, 49 hips) and core decompression with quadratus femoris implantation (37 cases, 43 hips) that were respectively injected with bone meal and autogenous bone and osteoinductive materials. RESULTS AND CONCLUSION: Al involved patients were folowed up. After 1 year of treatment, Harris scores in the two groups were both increased (P < 0.05). But the Harris score of core decompression with bone paste implantation group was lower than that of core decompression with quadratus femoris implantation group (P < 0.05). After 3 years of treatment, X-ray scores in the core decompression with quadratus femoris implantation group were significantly higher than those in the core decompression with bone paste implantation group (P < 0.05). These findings indicate that compared with core decompression with bone paste implantation, core decompression with quadratus femoris implantation is better to prevent femoral head colapse, improve hip function and delay the process of osteonecrosis of the femoral head.

Objective To observe the poisoning components in plasma and histological changes of rabbits with acute toxicity of aconitum kusnezoffii (草乌).Methods Eight rabbits were garaged with aconitum kusnezoffii liquor,aconitum poisoning model was reproduced,electrocardiogram (ECG) and blood pressure were recorded,the concentrations of aconitine,hypaconitine and mesaconitine in plasma after 0.5,1, 2,3 and 6 hours were measured,and the pathological changes of heart,liver and cerebral cortex were observed.Results After garage with poisoning liquor,arrhythmias and the declination of blood pressure, presenting a tendency of progressive aggravation [before garage:(121.98?16.77)/(110.66?8.78) mm Hg, 1 hour after garage:(102.98?8.34)/(90.22?5.85) mm Hg,2 hours after garage:(66.81?9.13)/ (53.40?6.32) mm Hg,1 mm Hg=0.133 kPa,all P

Objective To investigate the indications and clinical efficacy of combined application of laparoscope,choledochoscope and duodenoscope in the treatment of extrahepatic cholangiolithiasis.Methods The retrospective cohort study was adopted.The chnical data of 2 364 patients with extrahepatic cholangiolithiasis who were admitted to the First Hospital of Jilin University from January 2008 to December 2015 were collected.Of the 2 364 patients,861 patients had cholecystolithiasis combined with extrahepatic cholangiolithiasis and the diameter of common bile duct ≥ 8 mm,720 patients had cholecystolithiasis combine with extrahepatic cholangiolithiasis and the diameter of common bile duct ＜ 8 mm,783 patients had only extarhepatic cholangiolithiasis.In the patients diagnosed as cholecystolithiasis combined with extrahepatic changiolithiasis,laparoscopic cholecystectomy (LC) + laparoscopic common bile duct exploration (LCBDE) were applied to patients with the diameter of common bile duct≥8 mm,and the T-tube placement or primary suture was used intraoperatively according to the status of individualized patients;endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation (EPBD) + LC were applied to patients with the diameter of common bile duct ＜ 8 mm.For patients with only extrahepatic cholangiolithiasis or recurrent stones after cholecystectomy,EST or EPBD was applied,and LCBDE was applied to patients with multiple stones and maximum diameter ＞ 2 cm and unsuitable for EST or EPBD.If residual stones were found after operation in patients with T-tube placement,choledochoscope was used to extract stone;otherwise,EST or EPBD was used.Treatment outcomes including treatment method,success rate of minimally invasive lithotomy,operation time,incidence of complication,duration of postoperative hospital stay and treatment expenses,and the results of follow-up including 1-,3-year recurrence rate of stones were recorded.The follow-up was done by outpatient examination and telephone interview till January 2016.All the patients were reexamined blood routine,liver function and color doppler ultrasonography of the abdomen at 1 month,3 months,6 months,1 year and 3 years after operation.Suspected residual cholangiolithiasis found by ultrasound was varified by computer tomography (CT) or magnetic resonanced cholangiopancreatography (MRCP) imaging examination.For patients with T-tube placement,CT scan and biliary photography were performed at 2-3 months postoperatively to determine whether residual stones existed and T tube could be pulled out.Measurement data were presented as mean (range).Results Of 2 364 patients,2 271 patients received minimally invasive lithotomy successfully.Of 861 patients of cholecystolithiasis combined with extrahepatic cholangiolithiasis and the diameter of common bile duct≥8 mm,836 succeeded in minimally invasive lithotomy,with a success rate of 97.10％ (836/861),the other 25 patients were converted to open surgery.Seven hundred and three patients of 836 patients received T-tube placement in LCBDE,and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses were 97 minutes (range,41-167 minutes),3.70％ (26/703),6.7 days (range,3.0-32.0 days) and 3.4 × 104 yuan (range,1.5 × 104-6.7 × 104 yuan),respectively.One hundred and thirtythree patients of 836 patients received primary suture,and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses were 89 minutes (range,39-123 minutes),3.01％ (4/133),4.1 days (range,2.0-17.0 days),2.1 × 104 yuan (range,1.6 × 104-3.4 × 104 yuan),respectively.Of 720 patients with the diameter of common bile duct ＜ 8 mm who underwent EST or EPBD + LC,687 succeeded in minimally invasive lithotomy,with a success rate of 95.42％ (687/720),the other 33 patients were converted to open surgery.The mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses of 687 patients were 101 minutes (range,69-163 minutes),2.91％ (20/687),5.6 days (range,2.0-15.0 days) and 2.8 × 104 yuan (range,2.0 × 104-6.4 × 104 yuan),respectively.In 783 patients with only extrahepatic cholangiolithiasis or recurrent stones after cholecystectomy,701 of 725 patients who were treated with EST or EPBD succeeded in minimally invasive lithotomy,with a success rate of 96.69％ (701/ 725),and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses of 701 patients were 47 minutes (range,11-79 minutes),2.28％ (16/701),3.7 days (range,2.0-19.0 days),1.7 × 104 yuan (range,1.3 × 104-5.5 × 104 yuan),respectively;47 of 58 patients who were treated with LCBDE succeeded in lithotomy,with a success rate of 81.03％ (47/58),and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses were 124 minutes (range,94-170 minutes),8.51％ (4/47),7.9 days (range,5.0-21.0 days) and 3.8 × 104 yuan (range,2.3 × 104-7.9 × 104 yuan),respectively.Of 2 364 patients,2 207 were followed up for a mean time of 38 months (range,1-72 months).The 1-,3-year recurrence rates were 2.74％ (19/693) and 5.08％ (24/472) in patients receiving LC + LCBDE,3.10％ (21/677) and 5.69％ (30/527)in patients receiving EST or EPBD +LC for cholecystolithiasis combined with extrahepatic cholangiolithiasis.The 1-,3-year recurrence rates were 3.22％ (20/621) and 6.11％ (25/409) in patients receiving EST or EPBD + LC,7.32％ (3/41) and 11.11％(2/18) in patients receiving LCBDE for only extrahepatic cholangiolithiasis or recurrent stones after cholecystectomy.Conclusions It is safe and effective to treat extrahepatic cholangiolithiasis based on combined application of laparoscope,choledochoscope and duodenoscope,with choosing appropriate indications as the key to improve the therapeutic effect.Primary suture in the LCBDE is recommended because it can protect patients from T-tube placement.

Objective To compare the effect of naive porto-azygous devascularization and that as a remedy therapy after a failed endoscopy for the treatment of bleeding portal hypertension.Method From June 2005 to June 2010,230 portal hypertension patients were treated with porto-azygous devascularization,among them,202 cases were of portal hypertensive cirrhotics,28 cases of alcoholic cirrhosis.Group A (16 patients)received remedial porto-azygous devascularization after endoscopic treatment failed (esophageal variceal ligation,esophageal variceal selerotherapy).Group B(214 patients)received naive porto-azygous devascularization.Results The average operation time in group A was 198 min(115-335)min,mean bleeding amount was 750 ml(300-2000)ml,average post-operative hospital stay was 11 days (8-15)days.The average operation time in group B was 120 min(90-190)min,mean blood loss was 250 ml(150-500)ml,average post-operative hospital stay was 7 days(6-9)days.The average operation time,bleeding amount and post-operative hospital stay was significantly different between the two groups (P＜ 0.05).212(92.2％)patients were followed up,and the mean follow-up time was 2.5 years (1-6)years,mortality rate was 4.2％,rebleeding rate was 5.7％.Conclusions Surrounding the perioesophageal and gastric tissues were fibrotic and hard after the endoscopic treatment,this significantly increased the difficulty of surgery,therefore,porto-azygous devascularization is the choice of therapy for portal hypertension patients.

0.05),which were (5.64?2.00)d in single-circle group,(5.80?3.74)d in double-circle group,(6.22?2.76)d in triple-circle group.According to the treatment effects,CEA value decreased during pre-and post-neoadjuvant chemotherapy in each groups(P0.05).Through our survey,used different neoadjuvant chemotherapy circle,patients in single-circle group and double-circle group were completely accepted within full confidence;but receptance of strategy in triple-circle group was 66.7 %(12/18).All operations were suc- cessful.The difference of postoperative aerofluxus time between single-circle group and double-circle group had sta- tistical significance(P0.05).Conclusion Analyzing neoadjuvant chemo- therapy circles,time between neoadjuvant chemotherapy and operation,treatment effect and operation results,it is a feasible and secure colorectal cancer multi-discipinary strategy for patients in West China that choose the treatment of neoadjuvant chemotherapy with double-circle and short preparation time.

ObjectiveTo explore the status of social anxiety and study the relationship between social anxiety and self-consciousness,self-esteem among primary students.MethodsUsing stratified randomization sampling method,568 primary students in grade 4 ～ 6 were investigated with social anxiety scale for children( SASC ),self-consciousness scale for children(PHCSS) and self-esteem scale(SES).Results①The score of SASC in the group of primary students was obviously higher than that of Chinese norm (P＜0.01).②The SASC and negative evaluation scores in the female were higher than the male (P ＜ 0.05 ),the negative evaluation scores in the sixth grade (3.22 ± 2.82) was higher than the fifth grade (2.53 ± 2.76,P ＜ 0.01 ) and fourth grade ( 2.54 ± 2.68,P＜ 0.05 ).The primary students in migrant workers elementary school,the single parent family and the relatively low income family had higher social anxiety scores than others(P＜0.05 ).③The SASC and two major factors were significantly negative correlated with the self-consciousness and each subscale( r =-0.202 ～ -0.511,P ＜ 0.01 ),and positive correlated with the self-esteem( r =0.282,0.270,0.305,P ＜ 0.01 ).④)The anxiety and gregariousness had significant prediction function of 25.5％ on negative evaluation,and 28.2％ on SASC,anxiety,gregariousness,intelligence and school situation had significant prediction function of 20.4％ on social avoidance and distress.ConclusionsPrimary students in grade 4 ～ 6 existed social anxiety.There are significant differences for their level of anxiety in different gender,grade,elementary school,family structure,monthly income.And social anxiety is closely related to self-consciousness and self-esteem.

Objective To investigate the synergistic therapy effects of B and T lymphocyte attenuator(BTLA) extracellular domain in combination with heat shock protein 70 (HSP70)-TC-1 antigen peptide complex on the mouse model of cervical cancer and the related immunological mechanisms. Methods(1)Detecting the BTLA and herpesvirus entry mediator (HVEM) gene expression in the tumor microenvironment after C57BL/6 mice were inoculated with TC-1 tumor cells by realtime PCR; BTLA,HVEM expression on tumor infiltrating lymphocytes cell surface were detected by flow cytometry (fluorescence intensity). (2) According to different treatments, tumor-bearing mice were divided into 5 groups, which was injected with pcDNA3. 1 (empty vector plasmid as control), psBTLA (vector plasmid which expresses BTLA extracellular domain), HSP70 (HSP70-TC-1 cell peptide complex), HSP70 +pcDNA3.1 or HSP70 + psBTLA, respectively. The weight of tumor was recorded. The expression of immunoregulatory genes in tumor microenvironment were detected. The change of lymphocyte amount and cytotoxicity were detected too; lymphocyte proliferation activity was measured by tritium thymidine incorporation assay; the concentration of interleukin (IL) 2 and interferon-γ(IFN-γ) in supernatants of spleen lymphocyte were measured by enzyme-linked immunosorbent assay (ELISA). Results (1) BTLA gene expression was gradually increased after tumor cells inoculation. The highest expression level was 2. 83 + 0. 35 at 14th day, which had statistical significance difference with the 7th day expression of 1.66±0. 25 (P < 0. 05). While HVEM mRNA expression did not change significantly (P > 0. 05). The 7th and 14th day after TC-1 cells inoculation, the average fluorescence intensity of BTLA expression on the surface of tumor infiltrating lymphocytes was 33.5 and 51.8, respectively, in which there was statistically significant difference (P <0. 05); while the difference of HVEM expression was not statistically significant (57. 2 vs 49. 3 ,P >0. 05). (2)The 28th day after inoculation, tumor inhibition rate of HSP70 + psBTLA group was 88%, which was significantly higher than other treatment groups (P <0. 05). The 28th day after TC-1 cells inoculation, combination therapy not only promoted IFN-γ and IL-2 gene (3. 12 + 0.71,3.20 + 0. 62)expression but also reduced transforming growth factor-β (TGF-β), Foxp3 and IL-10 expression (0. 25±0. 03,0. 19 +0. 03,0. 31 +0. 04;P <0. 05). It also promoted CD8+ T lymphocyte infiltration(52 +6)/high power field, cytotoxicity (65.5±2.4) %, proliferation (15.0 × 103 cpm) and cytokine IL-2 , IFN-γsecretion(824±51), (1096±112) pg/ml, which were all significantly higher than other groups (P <0. 05). Conclusion The effect of immunotherapy on tumor can be augmented by the combination of psBTLA which expresses extracellular domain of BTLA and HSP70-TC-1 tumor antigen peptide complex,which could improve the expression of the related immunoregulatory genes to establish a much better microenvironment in favor of anti-tumor immune response against the mice model of the cervix carcinoma.