Objective To discuss the opportunity of hemilateral craniotomy in treatment of a large area combined middle cerebral artery (MCA) infarction.Methods Thirty-two patients with a large area combined MCA infarction were performed by hemilateral craniotomy.Initial clinical presentation was evaluated by the Glasgow coma scale(GCS).All survivors were assessed three months after surgical decompression according to Barthel index(BI).The effects of pre-hemia decompressive surgery(before any signs of cerebral hernia,based on clinical status and CT or DWI findings)versus post-hernia surgery (after signs of hernia) on mortality,functional outcome.Results In 18 patients with pre-hernia decompressive surgery,3 patients (16.7%)were dead and average BI was (66.94±7.75)scores.The mortality was 57.1%(8/14)and average BI was (38.43±9.82)scores of post-hernia surgery with 3 cases severe aphasia.Conclusion Hemilateral craniotamy is performed before occurrence of cerebral hernia may decrease the mortality and improve outcome in these patients.

OBJECTIVETo compare the efficacy of the patients of xerosis conjunctivitis with liver and kidney yin deficiency among the combined therapy of acupuncture and Shi's manipulation, common acupuncture and artificial tears therapy.

METHODSOne hundred and eight patients were randomized into an acupuncture group, a SHI's manipulation group and an artificial tears group, 36 cases in each group. A total of 15 cases dropped out before the end of the study, including 4 cases in the acupuncture group, 6 cases in the SHI's manipulation group, and 5 cases in the artificial tears group. In the acupuncture group, acupuncture was applied to Jingming (BL 1) and Qiuhou (EX-HN 7) on the affected side, and the bilateral Sanyinjiao (SP 6) and Taixi (KI 3). The needles were retained for 20 min. In the SHI's manipulation group, on the basis of the treatment as the acupuncture group, Shuigou (GV26) was added and stimulated with SHI's acupuncture manipulation. In these two groups, acupuncture was given 3 times a week totally for 3 weeks. In the artificial tears group, sodium hyaluronate eye drops were used, 5 times a day, for 3 weeks totally. Separately, before treatment, at the moment after the 1st treatment and 3 weeks after treatment, the subjective symptom score, Schirmer I test, breakup time (BUT) of tear film were observed in each group.

RESULTS(1) Subjective symptom score: at the moment after the 1st treatment and 3 weeks after treatment, the scores in each group were all reduced significantly as compared with those before treatment (all P < 0.05). At the moment after the 1st treatment, the score in the SHI's manipulation group and the artificial tears group was reduced apparently as compared with that in the acupuncture group (both P < 0.05). In 3 weeks of treatment, the score in the SHI's manipulation group was reduced apparently as compared with the acupuncture group and the artificial tears group (both P < 0.05). (2) For Schirmer I test, at the moment of the 1st treatment, the result in the SHI's manipulation group and the artificial tears group was improved significantly as compared with that before treatment (both P < 0.05). In 3 weeks of treatment, the result in the acupuncture group and the SHI's manipulation group group was improved significantly as compared with that before treatment (both P < 0.05). At the moment of the 1st treatment, the result in the artificial tears group was improved significantly as compared with the acupuncture group and the SHI's manipulation group (both P < 0.05). In 3 weeks of treatment, the result in the acupuncture group and the SHI's manipulation group was better than that in the artifi-cial tears group separately (both P < 0.05). (3) For BUT, the result in the acupuncture group and the SHI's manipulation group was prolonged significantly as compared with that before treatment and was prolonged apparently as compared with that in the artificial tears group (both P < 0.05) in 3 weeks of treatment.

CONCLUSIONThe intervention of SHI's acupuncture manipulation relieves the subjective symptoms of xerosis conjunctivitis of liver and kidney yin deficiency and achieves the same efficacy as the common acupuncture and artificial tears treatment. It does not present the apparent advantages as the common acupuncture in the short term for promoting the tear secretion and tears film repair.

Acupuncture Therapy ; Adolescent ; Adult ; Conjunctivitis ; physiopathology ; therapy ; Dry Eye Syndromes ; physiopathology ; therapy ; Female ; Humans ; Kidney ; physiopathology ; Liver ; physiopathology ; Male ; Middle Aged ; Treatment Outcome ; Yin Deficiency ; physiopathology ; therapy ; Young Adult

Actins ; metabolism ; Adenocarcinoma, Clear Cell ; metabolism ; pathology ; Adult ; Carcinoma, Renal Cell ; metabolism ; pathology ; Desmin ; metabolism ; Diagnosis, Differential ; Endometrial Stromal Tumors ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Leiomyoma, Epithelioid ; metabolism ; pathology ; Melanoma ; metabolism ; pathology ; Melanoma-Specific Antigens ; metabolism ; Perivascular Epithelioid Cell Neoplasms ; metabolism ; pathology ; surgery ; Receptors, Progesterone ; metabolism ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Adenocarcinoma, Papillary ; metabolism ; pathology ; Adult ; Calbindin 2 ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Keratin-5 ; metabolism ; Leiomyoma ; metabolism ; pathology ; surgery ; Mesothelioma ; metabolism ; pathology ; surgery ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Omentum ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; Peritoneal Neoplasms ; metabolism ; pathology ; surgery ; S100 Calcium Binding Protein G ; metabolism ; Teratoma ; metabolism ; pathology ; surgery ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To explore the diagnosis and treatment strategy of mammary duct ectasia.Methods The clinical data of 59 cases with mammary duct ectasia from January 2006 to December 2013 were analyzed retrospectively.Results The main clinical manifestations of mammary duct ectasia were mammary inflammatory mass in 46 cases,nipple discharge in 21 cases,nipple retraction in 18 cases,mammary abscess and mammary fistula in 8 cases.Definite diagnosis of mammary duct ectasia depended on pathology.All the patients were treated by operation,followed up for 3 months to 6 years,and none of them had recurrence.Conclusions Operation is the main method of curing mammary duct ectasia.To select proper operation time and method according to disease type,lesion size,location and scope.Thorough resection,repeat rinsing,wound clearance and immediate breast shape can not only cure disease,but also reserve breast configuration as possible.Therapeutic effect is satisfactory.

The clinical and experimental publish literatures of the traditional acupuncture treatment for xerophthalmia were review and selected, and the acupoints and outcomes index were analyzed. The clinical studies demonstrated that acupoints around eyes, head and face were mainly coordinated with Zangfu organs and meridians; and the experimental studies showed the effect of acupuncture work through stimulation of the lacrimal gland secretion, repairing lacrimal gland structure, inhibition of apoptosis to increase the flow of tears, extending the breakup time of lacrimal film, and relieving eye related symptoms.

OBJECTIVETo investigate the effect of baicalin on insulinoma cell line and the molecular mechanism involved.

METHODSLight microscope, MTT assay, flow cytometry, gene analysis and Western Blot were applied to investigate the effects of baicalin on the cell proliferation, the cell cycle and the involved molecular mechanism.

RESULTSAfter treatment with baicalin, the number of cells in mitotic stage and the survival rate of cells obviously decreased, and cell proliferation was inhibited in a drug concentration- and acting time-dependent manner, with the appearance of apoptotic insulinoma cells. During the apoptotic process, the activity of caspase-3 was elevated by baicalin in a time-dependent manner; with the increase of the concentration of baicalin, the number of cells in S-phase obviously decreased from 38.2% to 9.4%, while the percentage of cells in G0/G1 phase increased from 56.4% to 85.9%, indicating cells were arrested in G1-phase. Meanwhile, the activity of cyclin gene promoter obviously declined, and the expression of cyclin reduced remarkably.

CONCLUSIONBaicalin could induce apoptosis of insulinoma cells, which might be correlated with the activity of caspase-3, and inhibiting proliferation of insulinoma cells in a concentration- and time-dependent manner, in which the action of baicalin in down-regulating the gene transcription and expression of cyclin may play an important role.

Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Blotting, Western ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Dose-Response Relationship, Drug ; Flavonoids ; pharmacology ; Flow Cytometry ; Insulinoma ; metabolism ; pathology ; Rats

OBJECTIVETo evaluate the bone refilling in the interface between the trabecular metal (TM) acetabular shell and the bone surface according to consecutive X film measuring after surgery.

METHODSFrom July 2006 to July 2007, 35 patients (40 hips) accepted total hip replacement using trabecular metal monoblock acetabular cup system (TM). The cup was made of a ellipse shaped press fit Tantalum shell and high cross-linked PE liner (Longevity) with 28 mm inner diameter. The patients demography was: 16 male (20 hips), 19 female (20 hips), 5 bilateral hip replacements, age from 41 - 71 (mean 53), including 18 avascular necrosis hips, 16 osteoarthritis hips (including those secondary to a dysplasia hip), 4 avascular necrosis hips after femoral neck fracture, 2 Ankylosis Spondylitis. All the 40 total hip replacements used posterior approach, using hemispherical acetabular reamer and 2 mm press fit of final metal shell without screw fixation. The consecutive X film was taken at the end time of surgery and 2, 6, 12, 24 weeks, and 12 months. The clinical results was evaluate according to Harris scoring system, and the standard pelvis AP X film was measured at the interface between metal shell and the acetabular bone surface, witch was divided into five regions (A, B, C, D, E).

RESULTSTotally 32 patients (37 hips) were followed with average 8.7 months (7 - 12 months). The Harris before surgery was 50.5 (32 - 85), promoted to 91.0 (72 - 100), including 29 excellent, 6 good, 2 fair, and the total excellent and good rate was 94.6%. Complications include 4 patients leg length discrepancy from 1 - 2 cm, 3 patients moderate thigh pain and released after conservative therapy. No infection and dislocation was found. Twenty-one patients (23 hips) were found lucent line at the bone-metal interface from 1 - 5 mm, most common in B region and BC boundary than C, D, and CD boundary. All the patients followed was found the lucent line disappeared and refilled with bone at X film 24 weeks after surgery, however, no patients was found osteolysis and cup migration.

CONCLUSIONThe trabecular metal has strong capacity of bone conductive and bone inducement.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Bone Regeneration ; Female ; Follow-Up Studies ; Hip ; diagnostic imaging ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Radiography ; X-Rays

OBJECTIVETo investigate the expression of JAK, ERK and Cyclin D proteins in squamous-cell carcinoma of tongue.

METHODSThe expression of JAK, ERK and Cyclin D1 proteins was determined with SP immunohistochemical method in 30 cases of lingual Squamous cell carcinoma, 20 of normal lingual mucosa, 10 of mild epithelial dysplasia and 20 of severe epithelial dysplasia.

RESULTSThe expression of pJAK in lingual squamous-cell carcinoma and epithelial dysplasia was stronger than that of normal lingual mucosa (chi2=37.54, P<0.01), and the expression of pJAK in lingual squamous-cell carcinoma was significantly higher than that of the epithelial dysplasia (chi2=6.83, P<0.05). pJAK expression in squamous-cell carcinoma of low-middle differentiation was stronger than that of high differentiation. There was no significant difference in pERK expression among lingual squamous-cell carcinoma, normal lingual mucosa and epithelial dysplasia. There was a significantly positive correlation between pJAK and Cyclin D1 expression in SCC (r=0.619, P<0.05). There was no significant correlation between the expression of pERK and Cyclin D1 (r=0.231, P>0.05).

CONCLUSIONOver-expression of pJAK and Cyclin D1 may be associated with the occurrence and development of squamous-cell carcinoma of the tongue.

Carcinoma, Squamous Cell ; metabolism ; pathology ; Cyclin D1 ; metabolism ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; Immunohistochemistry ; Janus Kinases ; metabolism ; Phosphorylation ; Tongue Neoplasms ; metabolism ; pathology

Objective:To retrospectively analyze the data of patients undergoing extracorporeal membrane oxygenation (ECMO) during perioperative period of cardiac transplantation and provide objective and reliable evidence for further clinical promotion.Methods:Collect the clinical data of patients undergoing heart transplantation and ECMO support in Fuwai Hospital, analyze the duration of ECMO support, combined use of aortic balloon counterpulsation (IABP), and complications during the supporting period. All statistical analyses were processed by SPSS 23.0 software. Independent sample Student's test was employed for normal distribution and Mann-Whitney U test for abormal distribution. χ2 or Fisher exact test was utilized for comparinge the classification data between groups. Results:All ECMO support models were intravenous-arterial ECMO (V-A ECMO). Eight patients successfully bridging heart transplantation through VA-ECMO. Sixty-one patients (89.7%) who had undergone cardiac transplantation were successfully weaned from ECMO while 48 patients (70.5%) survived and discharged. The most common complications during circulation support are bleeding, acute renal insufficiency, and pulmonary infection. Patients with ECMO support in the operating room had a better rate of survival and weaning off(95.6%, 84.4%) than those with ECMO at the bedside of ICU(72.2%, 27.8%).Conclusions:ECMO can provide adequate circulation and respiratory function support for heart transplant patients, and it is an indispensable treatment for patients to go through the perioperative period of heart transplant surgery smoothly. It is advocated to use IABP combined with ECMO in the early stage and at the same time to increase the perfusion of vital organs, improve the prognosis of patients and obtain good outcomes.