Objective To evaluate the efficacy of the treatment of hilar biliary malignant obstruc tion with multiple stent drainage.Methods One hundred and twenty-seven patients with malignant biliary hilar obstruction were enrolled.The obstructions at the common hepatic duct within less than 1 cm to the junction of the left and the right hepatic duct were found in 66 cases,at the proximal common hepatic duct and the left and the right hepatic ducts in 45 cases,at the right hepatic duct in 5 cases and at the both left and right hepatic duets in 11 cases.Sixty-six patients received stent placement through the right biliary ducts and the common bile duct by puncturing the right mid-axillary line.The other 37 patients received 2 stents placement (disposed"Y"style) through the left and the right hepatic duct punc turing routway.Seven patients received 2 stents placement (disposed"┌"style) through the right hepatic duct and the common bile duct with a stent placed between the left and the right hepatic duct.Three patients had right hepatic duct stent placed first,followed by right hepatic duct and common hepatic duct stent. Twelve patients had stents placed in the right hepatic duct with external drainage from the left hepatic duct. Two patients had multiple strictures at the right hepatic duct,who got multiple external drainages.The total serum bilirubin levels were measured pre-and post-operatively.Results One hundred and twenty-seven patients with bi[iary obstraction had internal stents placed for drainage.The average total bilirubin levels among 121 patients were (283.4?175.4 )?mol/L pre-operation and (63.2?11.8)?mol/L post-operation (P

Animals ; Biofilms ; Caenorhabditis elegans ; metabolism ; Genes, Bacterial ; Yersinia pestis ; genetics ; metabolism

Objective To evaluate the effect of a novel orthopedic biomaterial,graded composite zireonia(ZrO2)hydroxyapatite(HAP)on activity of rat osteoblast ceils(OB)cultured in vitro. Methods The pure zirconia material was used as control to measure surface roughness of the composite material that was examined by using scanning electron microscope(SEM)and X-ray diffraetometer (XRD).The rat osteoblast cells were cultured on the two materials.Alkali phosphatase(ALP)of the two groups was measured and ELISA was used to detect IL-6 and TGF-?eoncentration of the supematant of OB cells.Tumor growth factor-?(TGF-?)mRNA was detected by RT-PCR.SEM was used to observe OB cells on the two materials.The extract of the composite material was used for a eytotoxicity test to cal- culate the relative proliferation rate(RGR)and classify the toxicity.Results The surface roughness of the gradual composite materials was significantly higher than that of the control materials(P＜0.01). The ALP of the gradual material group was markedly higher than that of the control group at different in- tervals.There was significant difference of the IL-6 and TGF-?concentrations 2-4 days after culture be- tween two groups(P＜0.05,P＜0.01).The mRNA level of TGF-?of the two OB groups also showed marked statistical difference(P＜0.01).The ossification of the OB cells on the composed material was marked after 14 days.The MTT color experiments showed no statistic significance between materials group and negative group,with the toxicity at levelⅠand 0(P＜0.05).Conclusion Graded composite ZrO2 HAP can significantly promote proliferation and differentiation of OB cells cultured in vitro and has good biocompatibility.

Objective To investigate the efficacy of the bioactive artificial vertebrae of a nano- hydroapatite crystals and polyamide 66 composite(n-HA/PA66)to restore the height and architecture of thoracolumbar burst fracture.Methods From December 2003 to February 2006,38 patients(29 males and 9 females)with a mean age of 35.6 years(17-63 years)were treated surgically through anterior ap- proach for decompression and implanted with the bioactive artificial vertebrae of n-HA/PA66 composite to reconstruct the structure of the thoracolumbar burst fractured vertebra.Results All the patients were successfuly followed-up for an average of 8 months,ranging from 6 to 21 months.The bioaetive artificial vertebrac of n-HA/PA66 composite were fused with the receptor bone 3-4 months after operation.The neu- rological function of the patients was restored partially or completely.The thoracolumbar spine was stable during physical examination and the height of thoraeolumbar burst fractured vertebrae that had been restored did not changa during the follow-up.Conclusions Our results show the bioaetive artificial vertebrae of n-HA/PA66 can restore the height and structure of thoracolumbar burst fractured vertebrae and reconstruct the structure of the tboraeolumbar vertebrae effectively,indicating that the bioaetive artificial vertebrae of n- HA/PA66 can be used extensively in clinical spinal surgery.

Objective To assess the value of 11 C-methionine (MET) PET/CT for the diagnosis of residual or recurrent glioma in comparison to 18 F-FDG PET/CT. Methods Forty-six patients suspected of residual or recurrent glioma underwent both 11 C-MET and 18 F-FDG PET/CT within 5-day interval. The glioma was considered as positive on PET/CT images based on ( 1 ) visual judgment of higher tracer uptake compared with the normal gray matter; (2) semiquantitative analysis of tumor to contralateral normal gray matter (T/G) and contralateral normal white matter (T/W) ratios. The diagnosis was confirmed by stereotsctic biopsy or radiological findings of MRI or CT and clinical follow-up ( ＞6 months). The Chi-square test and paired t test were used for statistical analysis. Results Residual or recurrent glioma was confirmed in 36 patients. The sensitivity, specificity, accuracy of 11C-MET and 18F-FDG PET/CT were 94.4% (34/36) vs 47.2% (17/36), 90.0% (9/10) vs 100% (10/10), 93.5% (43/46) va 58.7% (27/46) (x2 =19. 429, 1. 053, 15. 294, P ＜0.001, ＞0.05, ＜0.001 ), respectively. The T/G and T/W ratios of residual/recurrent giloma by 11 C-MET were significantly higher than those by 18 F-FDG (T/G ratio: 1.68 ± 0.23 vs 1.13 ±0.51, t = 5. 877, P ＜ 0. 001; T/W ratio: 2.52 ± 0.28 vs 1.42 ± 0. 57, t = 10. 470, P ＜0. 001 ). Conclusion 11 C-MET PET/CT is more sensitive and accurate than 18 F-FDG PET/CT for the detection of residual or recurrent glioma.

AIM To study the chemical constituents from Pterocephalus hookeri (C.B.Clarke) Hoeck and their neuroprotection activities.METHODS The 95％ ethanol extract from P.hookeri was isolated and purified by Sephadex LH-20,DM-130 macroporous resin,silica and HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The neuroprotection activities were studied by establishment of Parkinson's disease model of genetically modified zebrafish.RESULTS Nine compounds were isolated and identified as triplostoside A (1),cantleyoside (2),sylvestroside Ⅰ (3),sylvestroside Ⅲ dimethyl acetal (4),sylvestroside Ⅲ (5),laciniatoside Ⅰ-7-dibutyl acetal (6),laciniatoside Ⅰ (7),laciniatoside Ⅱ (8),sylvestroside Ⅳ (9).The n-BuOH fraction of P.hookeri had good performance on neuroprotection in hydrogen peroxide model.CONCLUSION Compound 4 is isolated from this plant for the first time.P.hookeri has neuroprotection activities.

OBJECTIVETo discover the central mechanisms of antipyretic effect of moxibustion and its relationship with the acupoint sensor so as to provide the scientific evidence for "the treatment of heat syndrome with moxibustion".

METHODSEighteen New Zealand Rabbits were randomly assigned into three groups, named group A (modeling with intravenous injection of Endotoxin), group B (moxibustion at 40 degrees C after Endotoxin injection) and group C (moxibustion at 48 degrees C after Endotoxin injection), 6 rabbits in each one. The experiment was undergoing in the condition of muscular relaxation and artificial respiration for the animals. The spotlight moxibustion at constant temperature was applied to "Zhiyang" (GV 9). The discharge of heat sensitive neurons (HSNs) at the preoptic region and anterior hypothalamus (POAH) was taken as the index. The impacts of the treatment on HSNs were observed in each group.

RESULTS AND CONCLUSIONMoxibustion had significant antagonism to the pyrogen on its inhibition to the activity of HSNs in the thermotaxic center. As a result, the antipyretic effect was obtained. It is concluded that the effective result of moxibustion is achieved by stimulating polymodal receptors of acupoints.

Acupuncture Points ; Animals ; Body Temperature Regulation ; Fever ; physiopathology ; therapy ; Humans ; Moxibustion ; Rabbits ; Thermoreceptors ; physiopathology

OBJECTIVETo study the E-CD and Snail expressions in colorectal cancer and their relationship with colorectal cancer invasion, metastasis and prognosis.

METHODSImmunohistochemical staining (EnVision) was used to detect the E-CD and Snail expressions in 30 normal colorectal mucosa, 30 colorectal adenoma and 142 colorectal cancer tissues.

RESULTSE-CD in the normal colorectal mucosa was strongly positive expressed (90.0%), significantly higher than that in colorectal adenomas (63.3%) and colorectal cancer tissues (41.5%). E-CD expression was significantly related to tumor differentiation, invasion depth, vascular invasion, lymph node metastasis and Dukes' stage (P < 0.05), but not to the patients' age, gender, tumor size and tumor histological type (P > 0.05). The 1-, 3- and 5-year survival rates of the E-CD positive patients with colorectal cancer were significantly higher than that in E-CD negative patients. The positive expression rate of Snail in colorectal cancer tissues (52.1%) was significantly higher than that in normal colorectal mucosa (6.7%) and colorectal adenomas (26.7%, P < 0.05). The snail expression was significantly correlated to tumor histological type, differentiation, invasion depth, vascular invasion, lymph node metastasis and Duke's stage (P < 0.05), but not to patients' age, sex and tumor size (P > 0.05). The 1-, 3- and 5-year survival rates of Snail negative patients with colorectal cancer was significantly higher than that in patients with positive expression (P < 0.05). The expressions of E-CD and Snail in colorectal cancer tissues were inversely correlated (P < 0.05). Cox multivariate analysis showed that E-CD and Snail can be used as independent prognostic indicators (P < 0.05).

CONCLUSIONE-CD and Snail expressions in colorectal cancer are related to the tumor invasion, metastasis and prognosis. Low expression of E-CD and high expression of Snail are related to the advanced stage, and poor prognosis in colorectal cancer patients. E-CD and Snail can be used as independent prognostic indicators.

Adenocarcinoma ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; Adenocarcinoma, Papillary ; metabolism ; pathology ; Adenoma ; metabolism ; Adolescent ; Adult ; Aged ; Cadherins ; metabolism ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Intestinal Mucosa ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Snail Family Transcription Factors ; Survival Rate ; Transcription Factors ; metabolism ; Young Adult

OBJECTIVETo study the significance and safety of flexible bronchoscopy and balloon dilatation in the diagnosis and treatment of respiratory diseases in children.

METHODSA total of 438 children (236 males and 202 females) with respiratory diseases who were aged from 17 days to 15 years, were examined and/or treated by bronchoscopy (including bronchoscopic intervention) under local anesthesia.

RESULTSOf the 438 children, 311 were diagnosed with pulmonary infection, 68 with atelectasis, 36 with recurrent cough and asthma, 6 with hemoptysis of unknown origin, 6 with bronchial foreign body, 5 with congenital bronchopulmonary dysplasia, 2 with bronchiectasis, 1 with ciliary dyskinesia syndrome, 1 with lung tumor, and 2 with congenital immunodeficiency disease. After bronchoscopic examination, local flushing or bronchoalveolar lavage, and foreign body extraction, marked response was seen in 379 cases and response was seen in 46 cases. High-pressure balloon dilatation under bronchoscopy was performed in 5 cases with inflammatory stricture and achieved satisfying clinical effect. No severe complications were found in bronchoscopy.

CONCLUSIONSBronchoscopy and balloon dilatation under local anesthesia is safe and effective for the diagnosis and treatment of respiratory diseases in children.

Adolescent ; Anesthesia, Local ; Bronchoscopy ; adverse effects ; methods ; Child ; Child, Preschool ; Dilatation ; methods ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Respiratory Tract Diseases ; diagnosis ; therapy

Acute Disease ; Alcoholism ; complications ; Gastrointestinal Hemorrhage ; etiology ; Humans ; Hyperglycemia ; etiology ; Infant ; Male