Objective To evaluate the Laparoscopic combined fiber choledochoscope common bile duct cho-lelithotomy for my own clinical experience in rencent five years.Methods Clinic data of 25 cases with choledocholi-thiasis undergoing laparoscopic common bile duct cholelithotomy from June 2010 to March 2014 were retrospectively analyzed.Results The operation was performed successfully in 24 cases,a case conversions to laparotomy,21 cases with T-tube drainage,3 cases with primary ductal submucosa closure.The operative time was 105 to 305min,mean (184.0 ±12.2 ) min, postoperative hospitalization time was 6 to 10 day, mean ( 7.7 ±0.2 ) day, a case residual stones,no bile leakage.Conclusion The beginning of Laparoscopic combined fiber choledochoscope common bile duct cholelithotomy,one-stage suture of common bile duct should be selected carefully, timely transfer laparotomy, should not aim for laparoscopic surgery success rate.

Adult ; Carcinogens ; Epoxy Compounds ; poisoning ; Female ; Humans ; Lymphocytes ; drug effects ; metabolism ; Male ; Multivariate Analysis ; Mutation ; drug effects ; Occupational Exposure ; analysis ; Regression Analysis ; Sister Chromatid Exchange ; drug effects

Regarding the needling manipulation, Chifeng Yingyuan, there are different descriptions in ancient medical literature and the current teaching materials or clinical reports, especially for the understanding recorded in Jinzhenfu Poem of Golden Needle). In the current teaching materials and clinical reports, it is described that the needle is inserted deeply at first, and then shallowly; afterward, the needle tip is pushed to the middle layer and manipulated with lifting, thrusting and rotating technique, combined with twisting and flying method. After analyzing the original description in the book and the feasibility of function and operation, the authors introduced their recognition on its manipulation and techniques in this article. This manipulation should be: the needle is inserted to the middle layer, afterward, the needle body is pulled and tilted toward each of the four directions, on this basis, then twisting and flying method is applied.
Acupuncture ; education ; history ; Acupuncture Points ; Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, 20th Century ; History, 21st Century ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

Objective To assess the potential clinical signiifcance of myocardial composite index (MCI) in the evaluation of left ventricular myocardial function in breast cancer patients with postoperative chemotherapy by speckle tracking echocardiography (STE). Methods A total of 33 consecutive breast cancer patients with postoperative chemotherapy were prospectively enrolled in Shanghai East Hospital, Tongji University, from February 2012 to February 2013. Thirty-six female healthy volunteers were enrolled as the controls. Routine echocardiographic parameters [left ventricular end diastolic volume (EDV), end systolic volume (ESV), interventricular septum thickness at diastole (IVSTd), left ventricular posterior wall thickness (PWTd) and left ventricular ejection fraction (LVEF)] were obtained. EDV and ESV were corrected for body surface area, and then end diastolic volume index (EDVI) and end-systolic volume index (ESVI) were calculated. STE-derived parameters [left ventricular global longitudinal strain (GLS), global radial strain (GRS), left ventricular twist (LVtw) and myocardial composite index (MCI)] were evaluated. All above data were obtained after 5 anthracycline-based chemotherapeutic cycles and compared with baseline measurements in controls respectively. Receiver operating characteristic (ROC) curves were constructed to determine optimal sensitivity and specificity of continuous variables for the prediction of future cardiotoxicity. Results (1)Changes in EDV, ESV, IVSTd, PWTd and LVEF showed no significant decreases compared with baseline and controls (F=1.35, 2.04, 1.28, 2.34, 2.16, P > 0.05 for all), while the changes in ESVI and EDVI showed statistically decreases (F=4.73, 6.86, P < 0.05 for all);(2)The changes in EDVI and ESVI showed signiifcant decreases compared with baseline (t=6.10, 5.13, P<0.05 for all) and controls (t=5.26, 4.24, P<0.05 respectively);(3)The change in GRS showed no statistical signiifcance compared with baseline and controls (F=1.23, P>0.05), while change in GLS, LVtw and MCI showed statistical significances compared with baseline and controls (F=4.29, 5.02, 12.35, P<0.05 for all);(4)The changes in GLS, LVtw and MCI showed signiifcant decreases compared with baseline (t=5.33, 13.94, P<0.05 respectively) and controls (t=4.97, 4.46, 7.18, P<0.05 all);(5)The area under receiver operating characteristics curve (AUC) of MCI was 0.894, and its optimal cut-off value was-265.7 (%×degree) with sensitivity of 82.6%and specificity of 78.7%. Conclusion MCI based on STE, combining myocardial strain and cardiac twist, may be an accurate predictor in identifying potential cardiotoxicity in postoperative chemotherapeutic survivors with breast cancer.

Objective To observe clinical curative effect of the FLAG regimen combined donor lymphocyte infusion after granulocyte colony stimulating factor(G‐CSF) mobilization(G‐DLI) ,for the acute myeloid leukemia (AML) of allogeneic Peripheral blood hematopoietic stem cell trans‐plantation (allo‐HSCT) after recurrence of hematology .Methods For the patients with recur‐rence after allo‐HSCT ,giving the FLAG regimen chemotherapy when the WBC dropped to the lowest point ,followed by giving G‐DLI that infusion peripheral blood stem cell from the original donors ,to observe curative effect and survival situation .And searched the literature review through the PubMed etc .Results Through FLAG regimen combined G‐DLI ,3 cases of relapse after transplan‐tation again obtained complete remission (CR) .Case 1 :disease‐free survival (DFS) was 13 month and overall survival(OS) was 23 months after G‐DLI .The patient has been the central recurrence and remission in bone marrow ,he was dead after 23 months due to multipleorgan function failure .He occurred Ⅱ acute GVHD in Skin and Ⅰ acute GVHD in liver after G‐DLI and obtained effective control ,not chronic GVHD .Case 2 :DFS and OS were 12 months and 13 months ,as bone marrow relapse again and giving up treat‐ment ,so died a month later .Respectively ,he has limitations chronic GVHD in skin after G‐DLI .Case 3:DFS was 16 months after G‐DLI since the disease‐free survival ,had limitations GVHD in skin that was control for given small dose of immunosuppressive drugs .Conclusion Joint FLAG scheme and G‐DLI may be one of the effective treatment of postoperative recurrence of allo‐HSCT .

OBJECTIVETo study the current situation and factors influencing the behavior of fruit and vegetable intake in adolescents, and to discuss health education strategy related to the behavior.

METHODS1677 students were selected from primary school and middle school in urban area of Hangzhou by a multistage sampling method. The behavior of fruit and vegetable intake was surveyed by questionnaires of the patient-centered assessment and counseling for exercise plus nutrition project (PACE+) for adolescent-scale of fruit and vegetable consumption, and analyzed by Transtheoretical Model on the servings of intake, the stage of change, process of change, decisional balance and the current status of self-efficacy.

RESULTSThe average intake of fruit and vegetable in adolescents was (3.21 +/- 1.50) servings per day ("one serving" means 100 g cooked vegetable or 100 g fruit). The behavior of consuming fruit and vegetable in most of the adolescents was in the contemplation stage, accounting for 36.91% (619/1677). The process of behavior change, decisional balance (Pros) and self-efficacy existed a positive correlation with the process of stage (r(process) = 0.38, r(decisional balance (Pros)) = 0.26, r(self-efficacy) = 0.33, t values were 16.78, 11.02 and 14.31, P < 0.05). The servings of fruit and vegetable intake existed a positive correlation with stage transition and self-efficacy (beta(stage transition) = 0.665, t = 35.07, P < 0.05; beta(self-efficacy) = 0.050, t = 2.63, P < 0.05), and existed a negative correlation with decisional balance (Cons) (beta(decisional balance (Cons)) = -0.051, t = -2.84, P < 0.05).

CONCLUSIONFruit and vegetable intake of these adolescents are under the recommended dietary intake. Along with behavior stage development and self-efficacy improvement, the intake of fruit and vegetable also increased correspondingly. Intervention strategies should aim at improving the awareness of adolescents on the health benefits of fruit and vegetable intake and promoting their confidence to reach the recommended servings.

Adolescent ; Adolescent Nutritional Physiological Phenomena ; Child ; China ; Eating ; Feeding Behavior ; Female ; Fruit ; Humans ; Male ; Models, Theoretical ; Students ; Surveys and Questionnaires ; Vegetables

OBJECTIVETo explore clinic characteristics of proximal anterior cerebral artery aneurysms and analyzed operative techniques.

METHODSA review was performed of a total of 362 patients whose aneurysms were surgically treated from June 1995 to December 2003, the morbidity of A(1) aneurysms was 2.2%. To reviewed clinical data of 8 proximal anterior cerebral artery aneurysms patients.

RESULTSAll of the aneurysms developed at the takeoff point of perforating arteries, the recurrent artery of Heubner in three cases, the medial proximal lenticulostriate artery in five cases. Six cases aneurysms projected posteriorly, two cases projected inferiorly in the surgical field. The shape of the aneurysms was saccular in all cases and diameter no larger than 5 mm in six cases. Patients were clipped satisfactorily, excellent condition in 7 patient, good condition in one.

CONCLUSIONIt is important to preserve the perforating arteries and use suitable clip by avoiding cerebral ischemia.

Adult ; Aged ; Anterior Cerebral Artery ; surgery ; Female ; Humans ; Intracranial Aneurysm ; surgery ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Treatment Outcome

The study was aimed to explore the mechanism of SYK and CBL family of ubiquitin ligases in Bufalin-induced HL-60 cells apoptosis. Cell viability was tested by trypan blue staining and apoptosis was detected by using flow cytometry. The expressions of CBL and CBL-b and the phosphorylation of SYK were detected by using immunoprecipitation and Western blot. The results showed that Bufalin inhibited HL-60 cell proliferation in time- and dose-dependent manners. IC(50) of suppressing cell viability at 24, 48 and 72 hours were about 26.3, 7.8 and 2.0 nmol/L respectively. The high dose of bufalin already induced apoptosis of HL-60 cells at 8 hours. SYK was quickly phosphorylated, and the expressions of CBL and CBL-b were down-regulated after treatment with Bufalin. It is concluded that SYK activation and CBL protein down-regulation may be involved in Bufalin-induced HL-60 cell apoptosis.
Apoptosis ; drug effects ; Bufanolides ; pharmacology ; Cell Proliferation ; drug effects ; Down-Regulation ; Gene Expression Regulation, Leukemic ; HL-60 Cells ; Humans ; Intracellular Signaling Peptides and Proteins ; metabolism ; Protein-Tyrosine Kinases ; metabolism ; Proto-Oncogene Proteins c-cbl ; metabolism ; Signal Transduction ; Syk Kinase

OBJECTIVESTo establish the testicular fibrosis model in rats.

METHODSWistar rats were divided into control group(n = 12) and model group(n = 40) randomly. Testicular fibrosis model was built with the classical method of establishing experimental autoimmune orchitis (EAO) combined with injecting Bacille Calmette-Guerin (BCG) into left testis.

RESULTSThe incidence rate of EAO and the rate of testicular fibrosis were 100%, 11.1% and 100%, 81.5% at 80, 140 days after the first infection, respectively.

CONCLUSIONSThe model of rat testicular fibrosis was established successfully.

Animals ; Autoimmune Diseases ; pathology ; Disease Models, Animal ; Fibrosis ; Male ; Mycobacterium bovis ; Orchitis ; pathology ; Rats ; Rats, Wistar ; Testis ; pathology