Objective To explore the effect of Renzhu Jianwei Granules(Granule of Semen Coicis and Rhizoma Atractylodis Macro- cephalae for strengthening the stomach)on the patients with precancerous lesions of gastric cancer(PLGC)and its mechanism. Methods The 58 patients of chronic atrophic gastritis(CAG)complicated with intestinal metaplasia(IM)and/or dysplasia(Dys) were randomized into treatment group and control group with 29 in each.The treatment group was administered Renzhu Jianwei Gran- ules while the control group was given Weifuchun Tablets.The numbers of positive cells of carcinoembryonic antigen(CEA)and cy- clooxygenase 2(COX-2)of gastric mueosa before and after treatment were observed.Results The scores of positive cells of CEA and COX-2 of gastric mucosa of both groups were greatly reduced after treatment(P0.05).Conclusion Renzhu Jianwei Granules can reduce CEA and COX-2 of PLGC patients,possibly being one of the mechanisms in treating PLGC.

Thirty seven patients with venous thromboembolic disease in puerperium were admitted to hospital from January 2005 to December 2008; the clinical data of patients were retrospectively analyzed.The average age of patients was (33 ± 6)years (21 -42 years); the average onset time was ( 10 ± 6) d( 1 -50 d) after delivery.Seven patients had vaginal birth and 30 by cesarean section.The risk factors included pregnancy,cesarean section,age,infection,thrombophilia.All were diagnosed by ultrasonography and treated by anticoagulant,antiplatelet and thrombolytic therapy in the acute phase,followed by wearing elastic compressive stockings for more than 2 years.Pulmonary embolism was diagnosed in 8 patients by CT angiography,in 7 of whom inferior vena cava filter was administrated emergently.The patients were followed up for (29 ± 10)months ( 12 -60 months); during the follow-up 3 developed deep vein post-thrombosis syndrome,while others kept in good condition.The results indicate that initial anticoagulant,antiplatelet and thrombolytic therapy followed by elastic compressive stockings administration is effective for venous thromboembolic disease during puerperium.

Objective To investigate the CT,MRI features and differential diagnosis of central nervous system primitive neuroec-todermal tumors (cPNET).Methods The CT and MRI findings of 1 5 cases with cPNET proved by pathology were analyzed retro-spectively,and we summarized the imaging features and differential diagnosis.Results For this group,the average age was (8.82± 2.53)and the male to female ratio was 9 ︰6.All lesions located in supratentorial region,which had relatively large volume (average diameter of 6.3 cm),cystic necrosis (12/15),and no or mild peritumoral edema.cPNET showed isodensity,slight hyperdensity or slight hypodensity on CT plain scan,and demonstrated uniform or inhomogeneous enhancement.On MRI plain scan,solid part showed isointensity or slight hypointensity signal on T1 WI,isointensity or slight hyperintensity signal on T2 WI,hyperintensity sig-nal on DWI(12/15),isointensity(9/15)or slightly hyperintensity signal on FLAIR,and showed obvious uniform,honeycombed or irregular enhancement after enhanced scan,no enhancement in cystic necrosis.Conclusion cPNET have certain characteristics,inclu-ding the lower onset age,relatively large volume with well-defined edge and no or mild peritumoral edema,hyperintensity signal on DWI,isointensity signal on FLAIR.

Adult ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; HIV Enteropathy ; complications ; metabolism ; microbiology ; pathology ; Humans ; Male ; Mycobacterium avium Complex ; isolation & purification ; Mycobacterium avium-intracellulare Infection ; complications ; metabolism ; microbiology ; pathology ; Young Adult

Objective To evaluate endoluminal repair and preoperative management for acute Standford type B aortic dissection complicating massive hydrothorax. Methods The clinical data of 27 patients (23 males, 4 females) hospitalized from January 2003 to December 2008 were analysed retrospectively. The average age was 47 ±9 years (35 ～70). Eleven patients had bilateral huge hydrothorax (40. 7% ) , while 13 had left hydrothorax (48. 1% ) and 3 had right hydrothorax (11. 1% ) only, and in 2 of them with additional pericardial effusion (7.4% ). SaO2 was below 90% in all cases. All patients underwent emergency endovascular repair. For control of massive hydrothorax found by CT or chest fluoroscopy, puncture drainage or tube drainage were administrated postoperatively. Results All the 27 operations were successful, and there was no perioperative mortality. Three type Ⅰ and one type Ⅳ endoleaks occurred but disappeared in one month. Hydrothorax disappeared 28 days to 3 months postoperatively in all patients, of which 5 cases had puncture drainage (18.5%) and 1 case had tube drainage ( 3. 7% ). Mean follow-up was 30 ± 20 m ( 6 ～ 78 m ) after endovascular management. Complications included pleural thickening (6 of 27, 22. 2% ) , pulmonary atelectasis (2 of 27, 7. 4% ) , and lung consolidation combined with chest dent (2 of 27, 7. 4% ). Conclusions Emergency endovascular therapy is safe and effective for acute Stanford type B aortic dissection with massive hydrothorax. Drainage of hydrothorax after stent-graft deployment is a must for the patient suffering from severe respiratory failure.

OBJECTIVETo study activation of dendritic cells (DC) isolated from peripheral blood monocytes of patients with chronic hepatitis B after stimulation with HBsAg or HBcAg.

METHODSDCs were isolated from peripheral blood monocytes of patients with chronic hepatitis B. DCs were impulsed with HBsAg and HBcAg separately before their maturation. The expression levels of DC surface molecule were analyzed by using flow cytometry and the ability of DC to induce T lymphocyte proliferation was evaluated by a liquid scintillation counter and the amount of interleukin-12 (IL-12) in mixed lymphocytic (IL-12) in mixed lymphocytic reaction (MLR) was measured by using ELISA.

RESULTSThe expression rate of CD86 significantly increased to (29.20 +/- 5.18)% on DC after loading with HBcAg as compared with those after loading with HBsAg (76.19 +/- 3.90)% and controls (62.37 +/- 4.24)%, P>0.01. The ability of DC after loading with HBcAg to induce T lymphocyte proliferation (34,326 +/- 3088 cpm) was significantly higher than that of DC after loading with HBsAg (20,306 +/- 2897 cpm) and controls (3454 +/- 409 cpm), P greater than 0.01. The amount of IL-12 in MLR of DC after loading with HBcAg was (348 +/- 42.8) ng/L, which was significantly higher than those of DC after loading with HBsAg (226 +/- 30.6) ng/L and controls (116 +/- 15.6) ng/L, P greater than 0.01.

CONCLUSIONHuman dendritic cell stimulated with HBcAg could more efficiently present antigen and induce specific T cell immune response.

Adult ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Cell Proliferation ; Dendritic Cells ; cytology ; immunology ; metabolism ; Female ; Flow Cytometry ; Hepatitis B Core Antigens ; immunology ; Hepatitis B Surface Antigens ; immunology ; Hepatitis B, Chronic ; blood ; virology ; Humans ; Lymphocyte Activation ; immunology ; Male ; Middle Aged ; T-Lymphocytes ; cytology ; immunology ; Young Adult

Objective To analyse the management of splanchnic artery aneurysms by open surgery and endoluminal therapy. Methods The clinical data of 10 splanchnic artery aneurysm patients (four male, six female) hospitalised from January 2002 were analysed retrospectively. The average age was (56 ± 13) years (28 - 74). Surgical or endoluminal treatment for six cases of splenic artery aneurysms or pseudoaneurysms were applied, among which multiple splenic artery aneurysms was found in one, and aberrant aneurysms at the proximal section of the splenic artery originating from a spleno-mesenteric trunk was found in three, splenic artery pseudoaneurysm in one and single aneurysm with normal splenic artery in anatomy in one. Besides, there were two superior mesenteric artery aneurysm, one of tuberculous celiac artery pseudoaneurysm and one renal artery aneurysm. Results The tuberculous celiac artery pseudoaneurysm was successfully managed by deploying a stent-graft endoluminally. One case was converted to open surgery after the splenic artery aneurysm was only paitially covered by a stent-graft. The other 8 cases were successfully treated by open surgery. All of the operations are successful. All patients were followed up from three months to six years, during which no death or other severe complications occurs. Conclusions The splanchnic artery varies from one to another anatomically. Preoperative CT scan or digital substraction angiology are helpful for the diagnosis of the splanchnic arterial aneurysms and choosing an appropriate management. Conventional open surgery is effective and reliable, while endoluminal therapy is a minimally invasive alternative.

AIM: To evaluate the changes of corneal high - order aberration (including Coma, Spab, RMSh) after laser in situ keratomileusis (LASIK) with femtosecond laser, sub- Bowman keratomileusis ( SBK ) and laser epithelial keratomileusis (LASEK). METHODS: Of 82 myopic patients ( 164 eyes ), 31 patients (62 eyes) were treated by FS-LASIK, 31 patients (62 eyes) were treated by SBK, 20 patients (40 eyes) were treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery. RESULTS: 1) Vision: The uncorrected visual acuity of the three groups had no differences (P>0. 05). 2) Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly (P<0. 05). The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS- LASIK was smaller than the other two groups, with statistical significance (P<0. 05). CONCLUSION: Compared with SBK and LASEK, FS - LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.

Objective To investigate the risk factors of electrocoagulation syndrome after endoscopic submucosal dissection (ESD) in patients with colorectal lesions.Methods Clinical data of 145 patients with colorectal mucosal lesions undergoing ESD in People's Hospital of Wuhan University between September 2010 and September 2015 were retrospectively studied.Results Among 45 patients,post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) was developed in 32 cases (22％).The median age in PEECS group was higher (t =-5.783,P =0.000),the median lesion size was larger(t =-5.590,P =0.000),the median length of hospital stay was longer (t =-6.841,P =0.000) than those in non-PEECS group.Univariate regression analysis showed PEECS was associated with the age,lesion size,lesion location,length of hospital stay,malignant tumor,polyps type,resection modality.Multivariable logistic regression analysis showed that the independent risk factors for the development of electrocoagulation syndrome were age ＞65 year (OR =1.123,95％ CI:1.013-1.244,P =0.027),lesion size ＞ 3.5 cm (OR =1.173,95％ CI:1.015-1.357,P =0.031),malignant tumor (OR =3.498,95 ％ CI:1.460-8.379,P =0.005),hospital stay ＞ 10 d (OR =2.480,95％ CI:1.346-4.569,P =0.004),non-rectal lesions (OR =12.612,95％ CI:3.446-46.157,P =0.000).Conclusion Attention should be paid for colorectal lesion patients with high risk of PEECS,when endoscopic submucosal dissection is performed.

Erchen Decoction is widely used to dampness-phlegm syndrome and it can be flexibly used in clinical application by my supervisor Professor OU Zheng-wu, especially in cough, pneumonia, asthma and influenza, which has obvious efficacy in treatment. This article reviewed five medical cases during the follow-up process with Professor OU in application of Erchen Decoction, with a purpose to share experience of famous doctors and improve TCM diagnosis and treatment level together.