Adult ; Histiocytosis, Sinus ; Humans ; Male ; Nasal Cavity ; Paranasal Sinuses

Objective:To explore the possibility and methods of surgical treatment(ST) for huge primary liver cancer(HPLC).Methods:The clinical data of 86 HPLC were analyzed retrospectively and the main challenges as well as their counter measures during ST are concluded.Results:Among the 86 cases,there were 10 cases which complicated with portal vein(PV),and 5 cases with IVC thrombus respectively;there were 76 cases with HBV cirrhosis,2 HCV cirrhosis,there were 60 and 26 cases of primary and secondary hepatectomy in which included regular right(9 cases),left hemihepatectomy(8 cases)and combined hepatectomy(69 cases).Six cases received PV embolism before surgery.There were 10 and 5 cases of cancer thrombus extraction from PV and IVC respectively.In this group,81 patients were cured,and the perioperative mortality was 5.8%(5/86).The postoperative one—year survival rate for the patients was 77.9%.Conclusions:ST for HPLC is safe and acceptable.Full of preoperative assessment,careful intraoperative exploration,and surgical skill played a key roles.

Objective:To investigate the clinical efficacy of intramedullary nailing combined with bone cement in repair of segmental bone defects after tumor resection.Methods:A retrospective analysis was conducted of the 5 patients with malignant bone tumor who had been treated at Department of Orthopaedics, Qiannan People's Hospital from April 2018 to September 2019 for remaining segmental bone defects following limb salvage surgery. They were 4 males and one female, aged from 11 to 55 years (average, 35.4 years). Their defects ranged from 6 to 21 cm (average, 12.3 cm) after tumor resection. By the Karnofsky performance score (KPS) for long-term quality of life, all of them scored less than 50 points. Of them, 3 were treated by interlocking intramedullary nails and bone cement filling, and 2 by elastic intramedullary nails and bone cement filling. In the 2 cases with defects of 21 cm and 13 cm, the fixation was assisted by a plate and an external fixator. Defect length after resection, operation time and intraoperative bleeding were recorded; the efficacy was evaluated by the Enneking functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system, visual analogue scale (VAS), and KPS.Results:All the 5 patients had uneventful surgery, with operation time ranging from 112 to 225 min (average, 154.2 min), intraoperative bleeding from 300 to 500 mL (average, 382 mL), and defect length after resection from 6 to 21 cm. The 5 patients were followed up for 6 to 28 months. Of them, 2 died of disease progression 6 and 7 months after surgery, respectively. According to the Enneking's evaluation, one patient scored 28 points, 2 patients 23 points and 2 patients 21 points, giving a high degree of satisfaction. Their VAS scores 6 months after surgery ranged from 1 to 6, averaging 3.6; their postoperative KPS scores ranged from 60 to 80, averaging 72.Conclusion:In repair of segmental bone defects after tumor resection, intramedullary nailing combined with bone cement filling can relieve pain of patients and lead to satisfactory short-term curative efficacy.

Objective To investigate the related risk factors,clinical features and prognosis of hospital-acquired acute kidney injury (AKI) in intensive care unit (ICU).Methods We retrospectively analyzed 48 patients with both acute kidney injury and multiple organ dysfunction syndrome (MODS),who received renal replacement therapy from October 2006 to February 2011 in our ICU.According to whether the occurrence time of AKI was 48 hours after admission,they were divided into hospital-acquired AKI (HA-AKI) group and community-acquired AKI (CA-AKI) group,with 13 and 35 cases respectively.We compared the differences between these two groups in gender,age,acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ),primary diseases,days of mechanical ventilation,times of renal replacement therapy,number and indicators of organ failure,prognosis,renal function recovery,length of stay in ICU and hospital.Results The mean age of HA-AKI group is ( 64.5 ± 21.4) years,which is older than that in CA-AKI group ( 50.2 ± 17.5 ) years (P=0.022).The top three primary diseases in CA-AKI group are severe infection(42.8％ ),chronic kidney disease (CKD) concurrency of AKI ( 11.4％ ) and multiple trauma without head injury ( 8.6％ ).However severe infection still occupies the first in HA-AKI group ( 30.8％ ),followed by stroke (23.1％,P=0.024),multiple trauma with head injury( 15.4％,P=0.018 ) and gastrointestinal bleeding( 15.4％ ) ;Patients in HA-AKI group with more than four organ failures account for 84.6％,significantly higher than 65.7％ in CA-AKI group (P=0.000).On the first day,the levels of serum sodium ( P =0.036 ) and bicarbonate ( P=0.001 ) in HA-AKI group are higher than that in CA-AKI group,and the urinary volume is more(P =0.046).In HA-AKI group,the level of urea nitrogen on the seven day increases so progressively that it becomes significantly higher than that on the first day(P=0.015),but in CA-AKI group,there is no significant change in the levels of serum creatinine and urea nitrogen after AKI,while the levels of seruum sodium ( P=0.023 ) and bicarbonate ( P=0.030) increase significantly;APACHE Ⅲ score in HA-AKI group after admission 24 hours is significandy lower than that in CA-AKI group(53.2 ±22.8) point vs (89.1±25.7) point,P=0.000),and the length of stay in ICU and hospital and days of mechanical ventilation in HA-AKI group are significantly longer than that in CA-AKI group,but there are no significant differences in times of RRT therapy,prognosis and recovery of renal function.Conclusion APACHE Ⅲ score after 24 hours of admission does not accurately reflect the prognosis of patients with MODS and HA-AKI.There are great differences in age,primary diseases,organ function changes and other aspects of HA-AKI when compared with CA-AKI.

AIM: To investigate the expression of ICAM-1 mRNA in hepatic sinusoidal cells (HSCs) during liver ischemia-reperfusion injury and its effects. METHODS: Three groups of rabbit livers experiencing ischemia for 15, 30 and 60 minutes respectively, and reperfusion for 60 minutes were conducted. The hepatic ICAM-1 mRNA expression was observed and leukocytes in hepatic sinus were counted. RESULTS: The lower expression of ICAM-1 mRNA showed in HSCs before reperfusion. Besides, leukocyte counts could no change. However, the more expression of ICAM-1 mRNA was found at the point of 60 minutes reperfusion. Furthermore, the higher expression of ICAM-1 mRNA showed in the more prolonged ischemic liver. Meanwhile, there was significant positive correlation between ICAM-1 mRNA contents and leukocyte counts. CONCLUSION: The high ICAM-1 mRNA expression induced by hepatic ischemia in HSCs increased adherence of HSCs and sequestrated more leukocytes in liver.

Objective　To investigate the protective effects of alcoholic extracts of Ganoderma lucidum (GL) and its combination with Rad ix Salviae Miltiorrhizae (RSM), Radix Bupleuri (RB), and Fructus Schisandrae Chi nensis (FSC) respectively on experimental hepatic injuries. Methods　Hepatic injury models were established with the injections of carbon tetrac hloride (CCl4) or D-galactosamine(D-GlaN) into mouse, and then the therapeut ic agents at same dose were given respectively. The activity of cholinesterase(C hE) and alaline aminotransferase(ALT) in the serum and hepatic homogenate, the c ontents of malonyl dialdehyde (MDA), alkaline phosphatase (ALP) and reduced glut athione (GSH) in hepatic homogenate from all mouse were determined. The morpholo gic changes of the livers were also observed with VG staining. Results 　In CCl4 treated mice, serum ALT activity was increased markedly wh ile ChE acti vity decreased significantly. GL and GL+RB, GL +FSC could relieve these changes ; GL combined with all other agents could inhibit the GSH accumulation, but only GL+FSC had a suppressive effect on MDA increase and made it return to normal. For D-GlaN treated mice, all agent groups had little effect on the activity of ChE; Only GL dramatically reduced the increased activity of ALT; GL +RSM could e liminate the GSH, but not significant; GL and all GL combinations could decrease the increased MDA (P<0.01). Pathological observation showed that hepatocyte damage in GL group and GL+FSC group incline d to recover. Conclusion　The results indicate that Ganoderma lucidum is an effective agent against hepatic injuries, especially combined wi th F ructus Schisandrae Chinensis, which may be associated with its anti-hepatocyte oxidation.

The effects of Haimaichong Nutrient on the contents of Lipo peroxide(LPO),Lipofuscin(LPF)and the activities of the old rats were investigated.After Haimaichong(HMC) was given 60 day,the results showed that the contents of LPO in blood and liver were significantly decreased (P

Objective: To study the effects of hydrolysed casein in different doses on plasma and liver antioxidant capacities in mice. Methods: Fifty mice were divided into 5 groups: control group, vitamin E group (VE), low dose of hydrolysed casein group (CH1), medium dose of hydrolysed casein group(CH2)and high dose of hydrolysed casein group(CH3). The mice were supplemented with 0.25ml normal saline,7.2 mg/ml Vitamin E,4,12 and 20 mg/ml hydrolysed casein respectively by gavage one time a day. The mice were euthanatized after ten days. The activities of SOD, GSH-PX and the level of MDA were determined. Results: Hydrolysed casein in different dosese vidently increased the activities of SOD and GSH-Px in serum, and reduced the level of MDA in serum and liver of mice; group CH3 significantly increased the activities of GSH-Px in liver. Conclusion: Different doses of hydrolysed casein could raise plasma and liver antioxidant capacities in mice, especially the high dose of hydrolysed casein.

Objective To explore the diagnostic value of hysteroscopy and transvaginal B-type ultrasound in endometrial polyps.Methods Eighty cases of endometrial polyps in our hospital from August 2015 to August 2016 were selected as the research subjects.Firstly,the patients were performed the transvaginal B-type ultrasound examination and then the hysteroscopic examination was conducted.The examination results of the two methods were observed.Results After hysteroscopic examination,75 cases were diagnosed as endometrial polyps,5 cases were misdiagnosed as other diseases.In the transvaginal B-type ultrasound examination,52 cases were diagnosed as endometrial polyps and 6 cases were misdiagnosed as other diseases.The detection rate had statistically significant difference between hysteroscopy and B-type ultrasound examination (P<0.05);the minimum was at least 1 endometrial polyp and the maximum were 4 endometrial polyps, including 21 cases of 1 endometrial polyp,36 cases of 2 endometrial polyps,14 cases of 3 endometrial polyps and 9 cases of 4 endometrial polyps.The hysteroscopic examination accurately detected 21 case(100.00%) of 1 endometrial polyp,34 cases (94.44%) of 2 endometrial polyps,12 cases (85.71%) of 3 endometrial polyps and 8 cases (88.89%) of 4 endometrial polyps;the transvaginal B-type ultrasound accurately detected 13 cases (61.90%) of 1 endometrial polyp, 17 cases (47.22%) of 3 endometrial polyps,11 cases (78.57%) of 3 endometrial polyp and 5 cases (55.56%) of 4 endometrial polyps,there were statistically significant differences in the distribution between the two examination methods (P<0.05),moreover hysteroscopy had higher accuracy.Conclusion The diagnosis efficiency of hysteroscopy in diagnosing endometrial polyps is significantly better than that of B-type ultrasound.

Objective To investigate the pathological features,diagnosis and treatment of primary malignant melanoma in esophagus (PMME).Methods The clinical data of 3 patients with PMME who were admitted to the Beijing Friendship Hospital from January 2008 to June 2009 were retrospectively analyzed.All the patients received esophageal barium radiography,electronic fiberesophagoscopy,esophageal endoscopic ultrasonography,computed tomography,and underwent surgery.Adjuvant therapy and immunotherapy were applied postoperatively.Results The results of barium radiography showed irregular filling defect presentation in the distal esophagus.The results of endoscopy showed a purple black tumor with a length of 3-8 cm in the esophagus.The results of endoscopic ultrasonography showed that the tumor was derived from the mucosal layer with low echo density.The results of computed tomography showed thickness of the lower segment of the esophagus.All the 3 patients received left thoracic approach esophagectomy and esophagogastrostomy.Histopathology and immunohistochemistry confirmed malignant melanoma.The expressions of Mart-1,HMB-45 and S-100 antigen were positive.The survival time of 2 patients was longer than 3 years,and 1 patient died of metastasis 6 months after operation.Conclusions PMME is a kind of rare and malignant tumor with dismal prognosis.Surgical management is the first choice,adjuvant chemotherapy and immunotherapy are hopeful to increase the survival time of the patients.