Objective To assess the operation time of laparoscopic operation for acute cholecystitis by Meta analysis.Methods The methods of computer literature retrieval and manual search were used to collect the research on the timing of laparoscopic surgery for acute cholecystitis in recent years,and the random effects model was used to conduct the Meta analyze.The quality of the literature was evaluated,and then the RevMan5.0.21 software was used to calculate the RR value and 95%CI of the operation time,bleeding volume and postoperative complications.Results A total of 13 articles were included in the Meta analysis,9 in Chinese,4 in English,2535 for a total number of cases,1401 in the early operation group,1134 in the delayed operation group,and 10 papers for low risk of bias,3 papers for bias risk.Meta analysis of the random effects model showed that the operation time of the early operation group was significantly shorter than that of the delayed operation group(P=0.00,RR=-20.25,95%CI=-24.97~15.33),and the intraoperative blood loss was also significantly reduced(P=0.00,RR=-12.58,95%CI=-29.36~5.78),then the postoperative complications were also significantly reduced(P=0.00,RR=0.63,95%CI=0.47~0.84).Conclusion The use of laparoscopic operation in the treatment of acute cholecystitis in patients with 72h could not only shorten the operation time and reduce the amount of bleeding,but also had a significant effect on reducing postoperative complications.

Objective To evaluate the effects of rebuilding stove and health education on preventing coal-burning fluorosis and arsenic poisoning in Shaanxi in 2005.Methods According to "Scheme of Impmving Stove in Preventing Coal-burning Fluorosis and Arsenic Poisoning of Shaanxi in 2005",the initial meeting was convened,while liability contracts were signed,leading and technical guiding groups were established,professional training was carried out.On the basis of the epidemiologic data,stoves were improved in 7 chosen counties in Ankang and Hanzhong City where the health education in several modalities was carried out.The project was checked and accepted when the work was completed.Thirty children in fourth grade were randomly selected in one primary school of each county.Fifleen adults aged 16 years old were chosen randomly in each village in each country.They were asked to answer the questionnaire about the health knowledge.Results There were 955 322 stoves improved in 7 countries in Ankang and Hanzhong City accounting for rebuilding stove was 100%(95 322/95 314).The awareness rates of health knowledge were 88%(444/508)in the adults and 100%(210/210)in children.Conclusions The government mangement leadership,the cooperation between the related departments, the participation of residents and the assufance of fund are the essentials in long lasting control of endemic diseases.

Adult ; Female ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Multiple Trauma ; etiology ; surgery ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries

Objective To evaluate the clinical significance of bone scintigraphy in the preoperative diagnosis of sacral tumor. Methods Preoperative 99Tcm-methylene diphosphonate (MDP) whole body bone scintigraphy was performed in total of 103 patients with sacral tumor for whole body survey and radionuclide uptake in the sacral tumor. Of these 103 patients,39 had SPECT. According to the osteoblastic reaction in bone SPECT studies,patterns of tumor with a "hot" lesion was defined as type Ⅰ,a "cold" lesion accompanied with partial uptake was defined as type Ⅱ,a purely "cold" lesion was defined as type Ⅲ,and a "cold" lesion with marginal uptake which produced "doughnut sign" was defined as type Ⅳ. Imaging interpretation was correlated with the final pathologic diagnosis. Results Of the 103 patients,18 ( 17.5% ) had polyostotic involvement. About 46.6% (48/103 ) in planar and 84.6% ( 33/39 ) in SPECT showed decreased uptake at sacrum. Of the bone metastatic patients (n =21 ) ,12 (51.7%) had sole metastasis to sacrum. Tumor with type Ⅰ (6/6) or type Ⅱ (16/19) uptake was likely to be a malignancy,whereas type Ⅲ uptake tended to occur in the benign disease in those patients without polyostotic involvement( 5/7 ),and type Ⅳ was all appeared in giant cell tumors( n = 5 ). Conclusions Preoperative bone scintigraphy is useful in examination of polyostotic involvement for the patients with sacral tumor,but it is limited for diagnosing isolated sacral metastatic disease. Tumor uptake on bone scintigraphy can be helpful in differential diagnosis of sacral tumor.

AIM To study the chemical constituents from the Polygonum amplexicaule var.sinense.METHODS The n-butanol fraction of ethanol extract from P.amplexicaule var.sinense was isolated and purified by TLC,normal-phase silica,macroporous resin column,sephadex column,preparative TLC and semi-preparative HPLC column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were identified as 2-(aminomethyl)-4-methoxy-phenol (1),p-methyl-hydroxybenzoate (2),p-methyl-hydroxyphenylacetate (3),2-[2-(methylamino) phenyl]-4-thiazolecarboxylic acid,methyl ester (4),p-methylphenylethanol (5),bergenin (6),arbutin (7),rhododendron-2-O-β-D-glucopyranoside (8),n-butyl gallate (9) and β-sitosterol (10).CONCLUSION Compounds 1-8 are isolated from this plant for the first time.

OBJECTIVETo evaluate the efficacy and safety of Sunitinib in the treatment of metastatic renal clear cell carcinoma in our institution.

METHODSA total of 23 patients with metastatic clear cell RCC were enrolled from June 2008 to June 2009, male 16, female 7, median age 52 years. Twenty cases were treated by using Sunitinib as first-line therapy and 3 cases as second-line therapy. All pathological diagnosis was clear cell carcinoma. Sunitinib monotherapy was administered in repeated 6-week cycles of daily oral for 4 weeks, followed by 2 weeks off, until disease progression or intolerable toxicities occurred. Overall response rate and safety were evaluated.

RESULTSThe median follow-up were 7.5 months (5 cycles). Four of 23 patients (17.4%) were treated with Sunitinib achieved partial responses (PR); 18 patients (78.3%) demonstrated stable disease (SD); 1 patient (4.3%)developed progressive disease (PD) during the study. Seventeen patients received treatment over 6 months (5 cycles). The 6 months' overall survival rate was 100%, 6 months' progression-free survival rate was 88.2%. The most commonly reported grade 3 adverse events included hand-foot syndrome (13.0%), thrombocytopenia(8.7%), diarrhea (4.3%)and fatigue (4.3%). Most grade 3 adverse events were ameliorated by dose-adjustment or treatment interruption.

CONCLUSIONThe results of this study demonstrate the efficacy and manageable adverse-event profile of Sunitinib as a single therapy in first-line or second-line therapy for patients with metastatic clear cell RCC.

Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Renal Cell ; drug therapy ; Female ; Humans ; Indoles ; therapeutic use ; Kidney Neoplasms ; drug therapy ; Male ; Middle Aged ; Pyrroles ; therapeutic use ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVESTo explore the clinical, pathological features and prognosis of patients with chromophobe renal cell carcinoma.

METHODSFrom January 1998 to January 2008, clinical data of 29 patients with chromophobe renal cell carcinoma including clinical manifestations, imaging examinations, treatment models, pTNM stages and follow-up results, were summarized to investigate its features and prognosis.

RESULTSAll cases had no obvious clinical and preoperative imaging presentation. There were 23 patients underwent radical nephrectomy, and 6 cases underwent nephron sparing surgery. Postoperative pathological findings confirmed the diagnosis of chromophobe renal cell carcinoma. Macroscopically, the cut surface of the tumors were generally beige in color. Histologically, it showed polygonal chromophobe cells and small round eosinophilic cells with eccentric hyaline degeneration. These tumor cells had a clear and sharp membrane, lightly stained abundant cytoplasm with a fine reticular translucent pattern and irregular nuclei. And a perinuclear halo was often seen in these cells. Histochemically, the tumor cells generally show a diffuse and strong reaction for CK-8 with a negative expression of Vimentin. The pTNM stages of the tumor were as follows, pT1N0M0 in 11 cases, pT2N0M0 in 8 cases, pT3aN0M0 in 5 cases, pT1N1M0 in 3 cases, pT2N1M0 in 2 cases. Twenty-six cases of patients were followed up (24 to 144 months, with an average of 90 months), 3 cases died of cardio-cerebrovascular disease, and local recurrence involved in 6 cases with reoperation in 4 cases, as well as distant metastasis in 1 case. Twenty-one cases survived with tumor-free. The statistical results indicated that the survival rates of the patients with chromophobe renal cell carcinoma in five years and ten years were 83.9%, 77.9%, respectively, compared with renal cell carcinoma of the same stage 63.8% and 49.9% at the same periods, and there is no difference in the survival rate of five years (P > 0.05) but significant difference in that of ten years (P < 0.01).

CONCLUSIONSChromophobe renal cell carcinoma is a morphologically uncommon subtype of renal cell carcinoma with the good prognosis. Definite diagnosis depends on its typical pathological feature. Radical nephrectomy is the first choice for the treatment of chromophobe renal cell carcinoma.

Adult ; Aged ; Carcinoma, Renal Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Nephrectomy ; methods ; Prognosis ; Retrospective Studies

OBJECTIVETo assess the clinical diagnostic value of 18F-FDG imaging by coincidence circuit SPECT with low-dose CT in differential diagnosis of pulmonary lesions and mediastinal lymph node involvement, which can not be definitely diagnosed based on regular CT image in patients with non-small-cell lung cancer (NSCLC).

METHODSBy using GE-Millennium VG with Hawkeye, 18F-FDG imaging was carried out in 48 patients with suspected lung cancer. Clinical value of 18F-FDG imaging for diagnosing malignancy was evaluated through comparison with the final pathological results. Mediastinal lymph node involvement was also assessed through lesion-by-lesion comparison with pathologic results in 74 lymph node regions from 24 patients.

RESULTSFinal pathologic diagnoses of these patients were 36 malignancies consisting of 20 adenocarcinomas, 12 squamous cell carcinomas, 3 small cell carcinomas and I large cell carcinoma; 12 benign tumors including 6 pneumonias, 2 tuberculosis, 2 hamatomas, 1 cyst and 1 neurofibroma. Of 48 patients, uptake of 18F-FDG in the chest was found to be abnormal in 40. Correct diagnosis were made in 34 malignancies and 6 false positive lesions were excluded based on morphology and 18F-FDG uptake status of the lesion. There were 6 false positive and 2 false negative cases. Furthermore, extrathoracic metastases which were not showed on previous CT image in 4 patients including one in the adrenal gland and 3 in the bone were detected by 18F-FDG imaging. The sensitivity, specificity and accuracy of the 18F-FDG imaging for differentiating malignant tumor from benign was 94.4%, 50.0% and 83.3%, respectively. Squamous cell carcinoma was found to uptake more FDG than adenocarcinoma. For determination of mediastinal lymph node involvement, the sensitivity, specificity and accuracy of 18F-FDG imaging was 57.9% , 90.9% and 82.4%, respectively through lesion-by-lesion comparison; whereas, which was 61.5%, 81.8% and 70.8%, respectively, based on case-by-case comparison.

CONCLUSION18F-FDG imaging by coincidence circuit SPECT with low-dose CT is quite helpful in differential diagnosis for patient with undetermined lesion on regular CT image, but it is limited for staging of lung cancer in the patients with non-small cell lung cancer.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; diagnostic imaging ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lung ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonia ; diagnosis ; diagnostic imaging ; Preoperative Care ; Radiation Dosage ; Radiopharmaceuticals ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon ; methods ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; diagnosis ; diagnostic imaging

This study aims at making full use of microbial resources, and screening the active endophytic fungi of anti-rheumatoid arthritis from Zanthoxylum simulans. The endophytic fungi were cultured and isolated by tissue culture and scribing method, and the active strain of inhibiting the proliferation of human rheumatoid arthritis synovial fibroblasts (HFLS-RA) was screened by MTT method. Morphological characteristics and rDNA ITS1-5.8S-ITS2 sequences were applied for the taxonomy of endophytic fungi. Strains were isolated from Z. simulans. Among them, MK-05, MK-17, MK-19, MK-23 having inhibiting activity to HFLS-RA, the IC₅₀ were 0.367, 0.775, 0.689, 0.757 g·L⁻¹, respectively. By classic morphologic classification and sequencing the PCR-amplified rDNA ITS1-5.8S-ITS2 regions, four effective strains were identified as Botryosphaeria dothidea, Phomopsis sp., P. liquidambari and Diaporthe perseae. The active endophyic fungi that inhibited the proliferation of HFLS-RA were screened from Z. simulans for the first time, and the results lay the foundation for the development and utilization of the Z. simulans resources.

Objective To detect the SNR and geometric accuracy of MRI based on American College of Radiology (ACR)standards.Methods The SNR and geometric accuracy of Siemens Skyra 3.0T,Siemens Trio 3.0T and GE Excite HD 1.5T MRI were measured with ACR phantom,and the detection results were calculated according to the standards.Results The SNR values of Siemens Skyra 3.0T,Siemens Trio 3.0T and GE Excite HD 1.5T MRI were 589.98,438.50 and 277.12 respectively.Siemens Skyra 3.0T MRI had the values of geometric accuracy being-1.93％ at X direction,-3.20％ at Y direction and 0.68％ at Z direction,Siemens Trio 3.0T MRI had the value of geometric accuracy being-0.87％ at X direction,-2.33％ at Y direction and 1.49％ at Z direction,GE Excite HD 1.5T MRI had the values of geometric accuracy being 0.20％ at X direction,-1.53％ at Y direction and 1.69％ at Z direction.Conclusion The detection of the SNR and geometric accuracy of MRI can effectively guarantee the image quality.