Objective To study the diagnosis and radical resection of hilar cholangiocarcinoma. Methods Retrospective analysis was made on the clinical feature and the effect of radical resection on 38 cases of hilar cholangiocarcinomas.Results Diagnosis was made in all of the patients preoperatively.The radical resection was perfomed on 38 patients.Of them, 3(7.9%) died after operation.After operation, 5 cases (13.2%) developed bile leakage,and 2 of the 5 cases developed subphrenic abscess,which were cured by drainage; 4(10.5%) had right hydrothorax that was cured by conservative therapy; and 3(7.9%)had incision split that was cured by resuture. Among the 35 postoperative survivors,34 (97.1%) were followed up, the 1- and 3-year survival rates were 91.9% and 35.2%.None of the patients survived for 5 years. Conclusions It′s still difficult to make early diagnosis in hilar cholangiocarcinoma.The diagnosis mainly depends on the combination of imaging examinations. Nowadays the radical resection rate of hilar cholangiocarunoma is still low, the recurrence and metastasis are common after operation, and few patients can survive for a long time. It suggests that even in radical operation for hilar cholangiocarcinoma, the regions of resection and sweep are not enough,and the operative procedure needs to improve further.

Objective:To analyze the podocalyxin (PCX) expression in the kidney and the number of urinary podocytes in different pathological grades of Henoch-Sch(o)nlein purpura nephritis (HSPN),and to determine whether the number of urinary podocytes reflects the renal damage in HSPN.Methods:Fifty-six children diagnosed with HSPN in our hospital were enrolled in the study and classified into 4 groups by renal pathology:grade Ⅱ (Ⅱa+Ⅱb) (n=10),grade Ⅲ (Ⅲa+Ⅲb) (n=21),grade Ⅳ (n=16),and grade Ⅴ (n=9).Four kidney autopsy specimens without histomorphologic lesions and 8 urine samples from healthy children served as controls.With immunofluorescence assay,the PCX expression in 4 normal renal tissues and in the renal tissues of the 56 HSPN children was detected and quantitatively analyzed.Positive rate and the number of urinary podocytes were detected in the 8 healthy children and 56 HSPN children.Results:In the renal tissues of the normal control group and grade Ⅱ (Ⅱa+Ⅱb) HSPN group,the PCX expression was complete.The percentage of the PCX positive area out of the total glomerular area in the renal tissues of 2 groups had no significant difference (P＞0.05).In the renal tissues of grade Ⅲ (Ⅲa+Ⅲb),Ⅳ,and Ⅴ HSPN groups,the PCX expression showed various degrees of loss,decreasing in turn from grade Ⅱ (Ⅱa+Ⅱb),Ⅲ (Ⅲa+Ⅲb),Ⅳ to Ⅴ,with significant differences between each group (P＜0.01).For HSPN with grade Ⅲ (Ⅲa+Ⅲb) or higher,positive PCX expression was found in the urine,suggesting the presence of enough podocytes in the urine.The percentage of fluorescence positive area out of the total glomerular area of PCX in the renal tissues was negatively correlated with the total number of urinary podocytes (r=-0.637,P＜0.01).Conclusion:Podocyte injury plays a certain role in the pathological progression of HSPN.The urinary detection ofpodocytes can reflect the degrees of pathological damage in HSPN.

The process of diagnosis,epidemiological survey and treatment of two cases of African imported quartan malaria is reported in this paper.

Objective: To investigate the relationships between constitutional types of traditional Chinese medicine (TCM) and motion sickness. Methods: A survey of TCM constitutions in ocean sailors participating in a voyage was performed by using the TCM Constitution Questionnaire developed by Beijing University of Traditional Chinese Medicine, while the survey of motion sickness was operated by Graybiel's diagnostic criteria. The incidences of motion sickness among sailors with different types of constitutions were compared. Results: Prior to the voyage, 50.3% of sailors exhibited a gentleness constitution, 14.5% were of dampness-heat constitution, 10.3% were of qi-stagnation constitution, whereas the percentages of qi-deficiency, yang-deficiency, yin-deficiency, blood-stasis and special diathesis constitutions were 6.2%, 7.6%, 6.2%, 4.1% and 0.7%, respectively. None exhibited a phlegm-dampness constitution. By the end of the 176-day voyage, the percentages of gentleness, dampness-heat, qi-depression, qi-deficiency, yang-deficiency, yin-deficiency, blood-stasis, special diathesis and phlegm-dampness constitutions were 33.8%, 13.8%, 13.1%, 11.0%, 6.9%, 9.7%, 4.1%, 0.7% and 6.9%, respectively. The incidence of motion sickness was 69.7% (101 sailors) during this voyage. The incidences of motion sickness among sailors with different types of constitutions before the voyage showed significant difference (P<0.001). The incidence of motion sickness was higher in the sailors with dampness-heat constitution than in those with gentleness constitution. Conclusion: Types of Chinese medical constitution can be related to susceptibility to motion sickness. Furthermore, ocean voyage may have an effect or influence on the type of Chinese medical constitution of sailors involved.

The development and status of acupuncture-moxibustion in Turkey in the fields of education, legal establishment, treatment, etc. are introduced. There are four distinguished features of acupuncture-moxibustion development in Turkey: (1) The geographical position of the country as the link of Europe and Asia, has resulted in the special feature of acupuncture-moxibustion transmission and development. It combines both the traditional theories from the East and the modified and modern techniques from the West. (2) The combination of theories and clinical practice started when acupuncture-moxibustion was first introduced. (3) The application of acupuncture-moxibustion has gone through a process from spontaneous transmission among the people to legalization by the government, from disorderly to orderly, and from market behavior to government-lead regulation, which has powerfully promoted healthy development of the medicine. (4) Acupuncture-moxibustion education provided by registered universities has guaranteed the quality of the education itself and the competency of the professionals. It has raised the scientific and normative character of application and increased the credibility of the people, and also has ensured the sustainability of acupuncture-moxibustion development by providing qualified professionals.
Acupuncture ; education ; Acupuncture Therapy ; trends ; Humans ; Moxibustion ; trends ; Turkey

Three kinds of fortified biscuits and bread were given as breakfast for 5 months to 106 preschool children 4-6 years old lodged in a kindergarten, with a control group taking common biscuits and bread without fortification. 6 g protein and 160 kcal were supplied by 50 g of fortifed foods in which 0.25 g lysine, 0.25 g lysine and 0.8 mg riboflavin, and cod liver oil and calcium in addition to lysine and riboflavin were fortified respectively. The results showed that a diet with intake of 2.1 g protein and 71 kcal/kg body weight fortified on the average by 228 mg lysine or 228 mg lysine and 1.1 mg riboflavin increased the monthly increment of body weights, heights, and urinary excretions of creatinine per day. There was also a tendency of improvement, in nitrogen retention. The urinary excretion of riboflavin in load test was increased in the group taking the second kind of fortified foods.

Objective To investigate the effects of a novel |3 titanium fixation with high strength and low elastic modulus on bone healing of osteoporotic fracture and its effects on stress shielding.Methods Forty female Sprague-Dawley rats were oophorectomized before establishment of femur fracture model.The fracture of left femur was stabilized by titanium alloy pin with high elastic modulus (110 Gpa,high elasticity modulus group) and the fracture of right femur by titanium alloy pin with low elastic modu-lus (30 Gpa, low elasticity modulus group).Six and 12 weeks later, the bone volume (BV) , total vol-ume (TV) and bone volume fraction (BVF) were detected by Micro-CT, and the maximum load was de-tected by biomechanical test.The effects of two titanium alloy pins on formation of bony calluses and me-chanical properties of bones were compared.Results Compared with the low elasticity modulus group, more collagen and bony callus, thicker bone trabeculae and more regular lamellar bone were found in the high elasticity modulus group.In low elasticity modulus group, TV (ROI1) was increased obvious-ly at week 6, with no statistical differences in BV (ROI 1), BV (ROI 2) and maximum load between two groups (P < 0.05).TV and BV in region ROI 1 in the low elasticity modulus group were significantly higher than that in high elasticity modulus group (P < 0.05) , while BV in region ROI 2 in low elasticity modulus group was significantly higher than that in high elasticity modulus group at week 12 postoperative-ly (P<0.05).Biomechnical test indicated that the maximum load in low elasticity modulus group was higher than that in high elasticity modulus group.Conclusions The novel B titanium alloy with high strength and low elastic modulus helps reduce effects of stress shielding, diminish bone resorption, in-crease the fibrous callus formation at the initial phase and improve the quality of bone healing at the later phase.

An analytical method was developed for the simultaneous extraction and determination of three quaternary ammonium compouds ( QACs) in soil samples using ultrasonic extraction and gas chromatography-mass spectrometry( GC-MS) . The qualitative and quantitative analysis of the three analytes dodecyltrimethyl ammonium chloride ( DTAC) , cetyltrimethyl ammonium bromide ( CTAB) and didodecyldimethyl ammonium chloride ( DDAC) were conducted by application of EI mass spectra and selected ion monioring ( SIM ) . Characteristic ions of the QACs were m/z 58 ( DTAC and CTAB) and m/z 212 ( DDAC) . To achieve optimum extraction efficiency, several impact factors including types of extractants, pH of extraction, concentration of linear alkylbenzene sulfonates ( LAS) , extraction times and content of purification column were investigated. Methanol with pH 3. 5 and 40 μg/L LAS solution were selected as extractant. Soil sample was extracted by treated methanol each 10 mL for 20 min every time. Extract of the soil sample was purified by neutral alumina column with 4 cm in length and 1cm in diameter, and then was determineted by GC-MS. Good linear relationships of all the three QACs were obtained in the range of 0. 02-2. 0 mg/L. The limits of determination (LOD, S/N=3) was 1. 2-4. 5 μg/kg. The method was used to analyse real soil samples ( paddy soil, lateritic red soil, and ore tailings) collected from a mining district in south China. Results of determination exhibited the concerntrations of the three analytes in real soil samples ranged from 0 . 24 mg/kg to 0. 41 mg/kg, and their recoveries ranged from 76% to 113% with relative standard deviations ( RSD) of 1. 1%-12. 9% in three different spiked concentrations of 0. 2, 0. 5 and 1. 0 mg/kg.

BACKGROUND: Proximal femoral nail anti-rotation is widely used to treat various intertrochanteric fractures. Although its operation trauma is small, and the blood loss of perioperative period is still large. Tranexamic acid has been gradually used to reduce the bleeding of intertrochanteric fracture. The effectiveness and safety of reducing blood loss during perioperative period were not reported. OBJECTIVE: To explore the safety and efficacy of tranexamic acid on perioperative blood loss in patients with intertrochanteric fracture undergoing proximal femoral nail anti-rotation. METHODS: One hundred and eight patients with intertrochanteric fracture undergoing proximal femoral nail anti-rotation were selected from First Affiliated Hospital, Guangzhou University of Chinese Medicine between January 2015 and January 2017. Among all the subjects, 52 patients who received the operation before January 2016 served as the control group and 56 patients who received the operation after January 2016 were selected as the treatment group. Half an hour before operation, patients in the treatment group received 1 g tranexamic acid dissolved in 250 mL normal saline by intravenous dropping; patients in the control group just received 250 mL normal saline by intravenous dropping. The bleeding volume, blood transfusion volume, hemoglobin, hematocrit, coagulation index, D-dimer levels and complications were compared between the two groups. RESULTS AND CONCLUSION: (1) During perioperative period, actual blood loss, intraoperative blood loss, dominant blood loss, recessive blood loss, volume of drainage, blood transfusion volume and blood transfusion rate were lower in the treatment group than in the control group (P < 0.05). (2) There was no statistically significant difference in the hemoglobin and hematocrit between the two groups before operation (P > 0.05). The hemoglobin and hematocrit of the two groups gradually decreased after the operation, and there was a slight improvement in the fifth day after surgery. At postoperative 2 hours, 1, 3 and 5 days, the hemoglobin and hematocrit of the treatment group were higher than in the control group (P < 0.05). At preoperation and each time point postoperation, prothrombin time, activated partial thromboplastin time, and fibrinogen levels were not statistically significant between the two groups (P > 0.05). Postoperative D-dimer levels in the two groups were significantly higher than preoperation, and there was a return on the fifth day. There was no statistically significant difference between groups at preoperation and each time point of postoperation (P > 0.05). (3) The results suggest that the tranexamic acid can effectively reduce the dominant and recessive blood loss in patients with the intertrochanteric fracture, and it is safe and effective.

Objective:To investigate the drug resistance factors in postoperative gemci-tabine chemotherapy after radical resection of pancreatic cancer.Methods:The retrospective case-control study was constructed. The clinicopathological data of 255 patients with pancreatic cancer who were firstly admitted to the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi ′an Jiaotong University from January 2018 to June 2021 were collected. There were 140 males and 115 females, aged (59±10)years. All patients underwent radical resection of pancreatic cancer and received postoperative gemcitabine-based adjuvant chemotherapy. Observation indicators: (1) follow-up; (2) postoperative chemotherapy; (3) drug resistance and changing of regimen; (4) factors influencing postoperative chemotherapy resistance. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and compari-son between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the Pearson chi-square test. Univariate analysis was conducted using the corresponding statistical methods based on data type. Multivariate analysis was conducted using the Logistic regression model with forward method. Kaplan-Meier method was used to draw survival curve, and Log-Rank test was used for survival analysis. Results:(1) Follow-up. All 255 patients were followed up for 18.6(16.7,21.4)months. The median survival time of 255 patients was 18.2[95% confidence interval ( CI) as 15.8-20.6]months. (2) Postoperative chemotherapy. Of the 255 patients, there were 5 cases receiving postoperative chemotherapy as gemcitabine monotherapy, 167 cases receiving postoperative chemotherapy as the AG combination (gemcitabine plus albumin-bound paclitaxel), 74 cases receiving postoperative chemotherapy as the GS combination (gemcitabine plus S-1) and 9 cases receiving postoperative chemotherapy as the GP combination (gemcitabine plus platinum). (3) Drug resistance and changing of regimen. Of the 255 patients, 81 cases completed the course of postoperative chemotherapy and evaluation. Of the 81 patients, there were 18 cases with no recurrence or metastasis of tumor, 10 cases with tumor local recurrence, 40 cases with tumor lymph node metastasis or distant metas-tasis, 3 cases with tumor local recurrence combined with distant metastasis, 10 cases with elevation of CA19-9. Of the 81 patients, 18 cases responded to chemotherapy, 63 cases underwent resistant to chemotherapy, including 11 cases with primary resistance and 52 cases with acquired resistance. The 63 patients with chemotherapy resistance underwent changing of regimen. (4) Factors influencing postoperative chemotherapy resistance. Results of multivariate analysis showed that chemotherapy cycle<6 is an independent risk factor for postoperative chemotherapy resistance in patients ( hazard ratio=17.18, 95% CI as 2.07-142.28, P<0.05). Conclusion:Adjuvant chemotherapy cycle <6 is an independent risk factor for postoperative chemotherapy resistance for gemcitabine based chemo-therapy in pancreatic cancer patients receiving radical resection.