Objective To evaluate the clinical outcomes of consecutive unselected patients treated with coronary artery bypass graft surgery or percutaneous coronary intervention with bare mental stents or sirolimus eluting stents for left main artery disease。Methods From 1995 to 2005,415 patients with left main artery disease received revascularization therapies in which 196 subjects received CABG procedure,and 97 subjects received BMS therapies from October,1995 to August,2003,and 122 subjects received SES therapies from September,2003 to May,2005.Results Rate of diabetes mellitus cormorbidity in CABG group was higher than that in BMS group and SES group,but the cormorbidity rates of renal insufficiency,stroke and pulmonary insufficiency in CABG group were lower than those in BMS group and SES group.The 30-day major adverse cardiac and cerebrovascular events in BMS group,SES group and CABG group was 3.09%,4.01% and 10.71% respectively(P

0 05) While patients′ satisfactory rate was significantly higher in electrical stimulation group than in medical group( P

CD5 Antigens ; metabolism ; Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 14 ; Chromosomes, Human, Pair 18 ; Cyclin D1 ; metabolism ; Diagnosis, Differential ; Humans ; Ki-67 Antigen ; metabolism ; Lymphoma, B-Cell, Marginal Zone ; genetics ; metabolism ; pathology ; Lymphoma, Follicular ; genetics ; metabolism ; pathology ; radiotherapy ; Lymphoma, Mantle-Cell ; genetics ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Pseudolymphoma ; metabolism ; pathology ; Translocation, Genetic

Gallbladder cancer (GBC) is the most common malignancy of the biliary tract.Most patients are diagnosed at the advanced stage,missing the optimal chance for curative surgery,thus leading to the fact that GBC is usually associated with poor prognosis.It is very crucial to strengthen the basic research on GBC,which may further improve the diagnosis and treatment.The research updates on the related genes in the initiation and progression,molecular mechanism of lymphatic metastasis,and tumor microenvironment of GBC in recent years were reviewed in this paper.

BackgroundThe morphological examination of macular disease is very important information for the early diagnosis.Spectral domain optical coherence tomography (SD-OCT) is a gold criteria in the diagnosis of macular diseases,but its clinical application is limited in the eyes with refractive medium opacity.The resolution ratio of conventional B-scan sonography is unsatisfactory.20 MHz B-scan sonography may be a new approach to maculopathy.ObjectiveThis study was to evaluate the clinical value of 20 MHz B-scan ultrasound by comparing morphological changes of different maculopathies observed by 20 MHz ultrasound and spectral-domain OCT.MethodsA prospective study was designed.51 eyes of 51 patients with macular diseases who were determined by Tianjin Medical University Eye Center were enrolled in this study.Spectral-domain OCT was used to image the macular area,and then the 20 MHz B-scan ultrasound was used to examine the same eye to assess the value of 20 MHz B-scan ultrasound diagnosis.The macular diseases were typed according to the OCT manifestation.The characteristics of 20 MHz ultrasound for the same maculopathy were analyzed.All the patients subscribe the informed consent before the study.ResultsIn 10 eyes with macular hole determined by spectral-domain OCT,shallow dome-shaped lesion with central hollow was exhibited on the ultrasound image.The macular edema,retinal neuroepithelium layer detachment and retinoschisis were found in 16 eyes,6 eyes and 4 eyes by spectral-domain OCT,but the 20 M Hz B-Scan ultrasound presented with the focal belt-shaped elevation with non-echo zone below.In contrast,in 15 eyes of retinal pigment epithelium detachment in OCT,spectral-domain OCT showed stronger and thicker belt-shaped echo.Conclusions20 MHz B-scan ultrasound has certain value in the diagnosis and differentiation for several common maculopathies.Although it is not accurate as OCT in recognizing diseases,it could play an important role in refractive media opacity eye.

Objective To explore the effect of spinal decompression system on lumbar disc herniation. Methods 83 patients of lumbar disc herniation were divided into observation group (n=42) and control group (n=41). Both groups received massage therapy, while the observation group was treated with spinal decompression system in addition. The effect was evaluated with Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) assessment of low back pain. Results The VAS score decreased and the JOA score increased in both groups after treatment (P<0.05), and it was better in the observation group than in the control group (P<0.01). Conclusion Spinal decompression system could improve the therapeutic effect on lumbar disc herniation.

Objective To study the changes in the level of serum IMA in patients with cardiac arrest followed by CPR,and explore the value of serum IMA in predicting prognosis of these patients after CPR.Methods (1) A total of 36 patients (25 men and 11 women) after CPR following cardiac arrest were recruited into experimental group (group C).Of them,15 cases (11 men and 4 women) and 21 cases (14men and 7 women) were assigned into resuscitation group (group R) and non resuscitation group (group NR),respectively,according to the presence or absence of ROSC.Meanwhile,another 60 healthy subjects (39 men and 21 women) matched for age and gender were recruited into healthy control group (group H).(2) The determination of the serum IMA level and comparisons of changes in serum IMA levels among groups were carried out.Results (1) The level of serum IMA in group C was higher than that in group H (P ＜ 0.05) ; The serum IMA level in group R was lower than that in group NR and higher than that in group H (P ＜0.05 for both).(2) The area under the ROC curve for serum IMA in predicting the prognosis of patients treated with CPR after cardiac arrest was 0.73.When the cut off value was 128.25 U/mL,the sensitivity and specificity were 57.1％ and 93.3％ respectively; the positive predictive value and negative predictive value were 92.3％ and 60.9％ ; positive likelihood ratio and negative likelihood ratio were 8.5 and 0.5 ; the correct diagnosis index was 72.2％,and Youden index was 50.5％.Conclusions Serum IMA has a certain value in prediction of prognosis in patients treated with CPR following cardiac arrest.

Adult ; Compliance ; Humans ; Male ; Occupational Exposure ; prevention & control ; Population Surveillance ; Quality Control ; Young Adult

Objective To compare the clinical efficiency between laparoscopic and open complete mesocolic excision for right-sided colon cancer.Methods Between January 2011 and August 2012,a total of 134 patients with right-sided colon cancer who underwent CME at Fuzhou General Hospital of Nanjing Military Command were divided into laparoscopic (71) and open (63) groups.The intraoperative parameters,pathology,postoperative course and short-term outcomes were compared between groups.The chi-test and the student t test were used for statistics.Result There were no significant differences in the length of distal (P=0.427) and proximal margin (P=0.515),tumor diameter (P =0.440) and number of lymph nodes dissected (P =0.377).Postoperatively patients were followed for up to 12 months,no significant differences were found in local regional recurrence rates (4.2％ vs 1.6％) (P =0.622) and distal metastasis rates (5.6％ vs 3.2％) (P =0.684) between the two groups.The mean operative time (P =0.134) and postoperative complication rate (P =0.977) were similar.The mean intraoperative blood loss was less (P =0.000),bowel flatus passed earlier (P =0.000) and hospital stay shorter (P =0.000) in laparoscopic than that in open group.Conclusions Laparoscopic CME has the same oncologic clearance effects and short-term follow-up result compared with open CME for right-sided colon cancer,and laparoscopic CME is minimally invasive,less bleeding,less pain and quick recovery.

Objective Pancreatic duodenal homeobox-1 ( PDX-1) plays an important role in the occurrence and development of diabetes.More importantly,its potential application in insulin resistance (IR) improvement is attracting further attention .Berberine has been shown to improve glucose metabolism and insulin resistance .In this study,rat models of type 2 diabetes mellitus ( T2DM) were established by combination of intraperitoneal injection of low -dose streptozotocin and highg-lucose-high-fat diet induction .The effect of berberine on fasting glucose , fasting serum insulin , homeostasis model assessment of insulin resistance ( HOMAI-R) , and ex-pression of PDX -1 of islet in T2DM rats were analyzed .The present study aimed to evaluate the anti-diabetic efficacy of berberine and study the mechanism of its preliminary therapeutic effects .Methods Twenty healthy adult male Sprague Dawley ( SD) rats were di-vided by random number table into the normal control group ( n =6) feeding with a standard diet ,and the experimental group ( n =14 ) given an intraperitoneal injection of streptozotocin .The rats with fasting blood glucose ( FBG) greater than 13.8 mmol/L were ran-domly divided into diabetes mellitus group feeding high sugar high fat diet for two weeks and then continuing with a standard diet , and the berberine group given berberine [180 mg /(kg· d)] every day.The normal control group and diabetes mellitus group were given physiological saline for every day 6 weeks.At the end of 6th week, the rats were executed , and the levels of fasting glucose, fasting se-rum insulin, HOMA-IR, and expression of PDX-1 in pancreas islet of each group were detected .The expression of PDX1-in pancreas islet was examined by immunohistochemistry .The image pro plus 6.0software was used to calculate the integrated optical density ( IOD) of positive expression .Results Compared with the normal control group , FBG, fasting insulin levels ( FINS) , and HOMA-IR of the diabetes mellitus group and berberine group were significantly increased ( P <0.05 ) .Compared with the diabetes mellitus group, FBG, FINS, and HOMA-IR of the berberine group were statistically significantly decreased [ ( 13.11 ±6.87 ) mmol/L vs (18.45 ±4.69) mmol L/, (2.58 ±0.34) μIU/ml vs (2.98 ±0.40) μIU/ml, 1.60 ±0.91 vs 2.75 ±0.28, P <0.05].Compared with the normal control group , the expression of PDX-1 of the islet in the diabetes mellitus group and berberine group was statistically significantly decreased ( P <0.05).After treatment with berberine, FBG, FINS, HOMA-IR, and IOD of PDX-1 in pancreas islet of berberine treatment rats were significantly increased compared with the diabetes mellitus group ( 9.14 ±1.51 vs 6.79 ±0.98 , P <0.01 ) .Conclusions The increases of PDX-1 in islet may be one of the mechanism in the improvement of hyperglycemia .