Objective: To search for the indications of broncho-angioplastic pulmonary resection by comparing it with pnumonectomy and lobectomy in patients with non-small cell lung cancer. Methods: Sixty-four patients with non-small cell lung cancer (TNM classification: T0 21, N1 28 and N2 15) underwent broncho-angioplastic pulmonary resection in our hospital from 1980 to 2000. The experience on the operative method and perioperative managements were summarized and the postoperative mortalities were compared between patients with different TNM classifications. Meanwhile, 64 non-small cell lung cancer patients receiving pneumonectomy and 64 receiving lobectomy during the same period were also included in this study, and their postoperative mortalities and complications were compared with those of broncho-angioplastic pulmonary resection. Results: The 3, 5 and 10-year survival rates of patients receiving broncho-angioplastic pulmonary resection were 58%, 42% and 19%, respectively, with a medium survival time of 45.76 months. The 3, 5 and 10-year survival rates of 21 N0 patients were 82%, 56% and 29%, respectively; of 28 N1 patients were 56%, 39% and 27%, respectively; and of 18 N2 patients were 21%, 12% and 0, respectively. Significant difference was found between each TNM classification group in survival rates (P<0.01). The postoperative mortalities and complications in patients receiving broncho-angioplastic pulmonary resection were similitar with those of pneumonectomy, but significantly higher than those of lobectomy (P<0.01). Conclusion: Broncho-angioplastic pulmonary resection expands the indication spectrum of the lung cancer and improves the post-operation life quality of patients. Broncho-angioplastic pulmonary resection is suitable for patients with lung cancer of N0 or N1 status, but not recommendable for N2 status.

Humans ; Infant ; Male ; Radius ; abnormalities ; Syndrome ; Thrombocytopenia ; complications

Objective:To investigate the diagnostic value of spiral CT head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.Methods:A total of 60 patients with acute cerebral infarction(ACI),who were treated in Affiliated Hospital of Yan'an University from January 2014 to January 2016,were selected as observation group,and 60 patients with non-acute cerebral infarction,as control group.The two groups of patients underwent spiral CT head and neck angiography.The degrees of carotid artery stenosis and the distribution of vascular plaques were compared between the two groups.The diagnostic value of spiral CT head and neck angiography in the diagnosis of carotid artery stenosis of the patients with ACI was evaluated.Results:The detection rates of mild and moderate stenosis in the observation group were significantly higher than those in the control group (P＜0.05),while the detection rates of severe stenosis and occlusion had no significant difference compared with the control group (P＞0.05).The total detection rate of stenosis in the observation group was higher than that in the control group (P＜0.05).There were plaques detected in the carotid bifurcation,common carotid artery,internal carotid artery and external carotid artery in the two groups.The total detection rate (69.4％) of the observation group was significantly higher than that (41.2％) of the control group (P＜0.05).Conclusion:Application of 128-slice spiral CT can effectively assess the head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.This method has a higher detection rate from mild to moderate stenosis and bilateral carotid artery plaques in the patients with ACI,and it has application value in the clinical diagnosis and prognosis.

Objective To study the effect of fluoride on the expression of bcl-2 and Bax in chondrocyte in vitro, and investigate the mechanism of action of chondrocyte apoptosis induced by fluoride. Methods Articular chondrocytes of neonate rat were cultured in vitro and treated with 0(control),5,20,40 mg/L of fluoride,respectively, for 10 days. Then observed the u]trastructure of chondrocytes under eletronicmicroscope, and tested the expression of bcl-2 and Bax in chondrocyte in different groups by Western blotting. Results Abundant rough endoplasmic reticulums (RERs) and complete structure of mitochondria membranes were presented in globular chondrocytes in the control group and 5 mg/L group; but more lipid droplets and vacuoles were seen in the cytoplasm, and the structure of intracellular membranes became incomplete, and some shrieked chromatin and pyknosis were seen in the chondrocytes of the 20,40 mg/L groups. The expression of bcl-2 markedly decreased in 20 mg/L group(0.626 ± 0.042) and 40 mg/L group(0.531± 0.039) compared to the control group(0.876 ± 0.035,all P ＜ 0.01 ). And the expression of Bax significantly increased in 20 mg/L group(0.966 ± 0.047) and 40 mg/Lgroup ( 1 .289 ± 0.156) compared to the control group(0.642 ± 0.050, all P ＜ 0.01). But there was no statistical significant difference of the expression of bcl-2 or Bax between 5 mg/L group(0.885 ± 0.065,0.657 ± 0.045) and control group (all P ＞ 0.05 ). However there were statistical differences of expressions of bcl-2 and Bax between 20 and 40 mg/L groups(all P ＜ 0.01 ). Conclusions Twenty and 40 mg/L fluoride can cause damage to the ultrastructure of chondrocyte, and fluoride possibly promotes chondrocyte apoptosis by reducing the expression of antiapoptotic factor bcl-2 and increasing the expression of Bax.

Objective To systematically evaluate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in the investigation of bile duct anatomy of liver transplantation living donors.Methods A search in Cochrane library,MEDLINE,EMBASE,CBMdisc (China Biology Medicine disc) was performed to identify relevant English and Chinese-language abstracts,supplemented by Springer,OVID,Sciencedirect full text database,etc.Criteria for inclusion were based on validity criteria for diagnostic research published by the Cochrane collaboration.With Meta analysis package for Stata10.1,heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity and specificity,positive likelihood ratio,negative likelihood ratio. Summary receiver operating characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally,sensitivity analysis was performed.Results Seventeen articles with 34 studies were included.Heterogeneity analysis revealed heterogeneity between studies and the source was MRCP imaging methods spotted by meta-regression analysis. Subgroup analysis according to MRCP imaging methods showed homogeneity within subgroups.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odd ratio of breath-holding thick slice MRCP,3D MRCP,the combination of the prior two methods,contrast enhance MRCP were 0.89,0.78,4.1,0.14,29; 0.92,0.80,4.5,0.10,45;0.95,0.82,5.2,0.06,85; and 1.00,0.76,4.1,0,1228,respectively with fixed effect model analysis.The area under the SROC curve was 0.83,0.92,0.96 and 0.99 respectively.Conclusion The combination of thick slice and 3D MRCP is a practical and effective method with good sensitivity and specificity to investigate bile duct anatomy of living liver transplantation donors,which fully meets the requirements of the preoperative assessment of bile duct structure.

Objective To systemically evaluate the accuracy of CT and MR estimating whole liver volume with evidence based medicine methods.Method Published papers about whole liver volume estimation with CT or MR modality were searched in Cochrane library,MEDLINE,EMBASE,CMBdisc(China biology medicine disc) for English and Chinese abstracts.Inclusion criteria were formulated according to validity criteria for diagnostic research published by the Cochrane collaboration.Heterogeneity test of extracted data of Eligible papers was performed first to determine the appropriate statistical model used to pool the result.Finally,sensitivity and publish bias analysis was performed.Result Seventeen articles with 37 studies including 351 patients met the inclusion criteria.There was no heterogeneity between included studies (I2 =0％,Q =5.85,P =1).Fixed effect model was selected for the meta analysis and there was no statistically significant difference between true and radiological estimated whole liver volume (WMD =21.61 mL,95％ confidence interval:-6.33-49.57 mL,z =1.51,P =0.13).Sensitivity analysis revealed the result was robust which was not affected by excluding any of the included studies.Funnel plot and publish bias analysis showed no publish bias (t =-1.55,P=0.13).Conclusion CT and MR volume estimation is accurate for liver volume measurement,which provides important information for preoperative evaluation,postoperative monitoring and follow-up studies of other hepatic pathologies.aximum benefit to patients.

Objective To analyze the diagnosis and prognosis value of abdominal CT scans in patients with acute pancreatitis complications.Methods 151 cases with acute pancreatitis were selected.The relationship between abdominal CT performances and the common complications and death in patients was analyzed.The prognosis of patients with different Balthazar CT severity index (CTSI) grade was compared.Results The complication rate of patients with CT signs of fatty liver, pleural effusion, liver gap effusion, adrenal gland involvement (AGI), penirenal space involvement (PSI) and gastric bare area involvement (GBAI) was significantly higher than that of patients with negative CT findings above (P<0.05).With CTSI grading increasing, the patient''s fasting time, heating time, hospital stay, recovery time of blood amylase were extended, and the incidence of pseudo cyst, transit surgery, organ failure and death was gradually increasing (P<0.05).Conclusion Severe fatty liver, AGI, GBAI, PSI and liver gap effusion are risk factors for acute complications and death in patients with pancreatitis.

OBJECTIVETo compare therapeutic effects of acupuncture therapy and Motilium on diabetic gastroparesis.

METHODSSixty cases were randomly divided into a needling method group and a medication group, 30 cases in each group. The needling method group were treated with turtle probing the cave (a kind of needling manipulation) as main, with pair-acupoints, Zhongwan (CV 12) and Zusanli (ST 36), Neiguan (PC 6) and Sanyinjiao (SP 6) selected, once a day, two weeks constituting one course. The medication group were treated with oral administration of 10 mg Motilium, thrice each day, 30 minutes before meals, two weeks constituting one course. The therapeutic effects were observed after 2 courses.

RESULTSThe total effective rate was 93.3% in the needling method group and 73.3% in the medication group, with a significant difference between the two groups (P<0.05). The needling method group in improvement of epigastric distention and pain, eructation, nausea and vomiting was better than the medication group.

CONCLUSIONThe therapeutic effect of turtle probing the cave needling method on diabetic gastroparesis is significantly better than that of Mutilium.

Acupuncture Therapy ; methods ; Adult ; Diabetes Complications ; therapy ; Female ; Gastroparesis ; therapy ; Humans ; Male ; Middle Aged

Objective To investigate the difference of amplitude of low-frequency fluctuation (ALFF) and fraction of amplitude of low-frequency fluctuation(fALFF) between Alzheimer's disease (AD)patients and normal aging (NA) controls by voxel-based analysis.Methods Thirty-one AD patients and 44 NA controls were enrolled in the study.Blood oxygen level dependent functional (BOLD) EPI data were obtained during resting-state by using 32-channel head coil.Data were realigned,normalized and then smoothed with 8 mm FWHM kernel.Resting-state fMRI toolkit(version 1.6) was used to generate ALFF and fALFF images.Independent two sample t-test was performed with SPM5 to compare ALFF and fALFF of AD and NA controls.Pearson correlation analysis was performed to examine the relationship between MMSE score and ALFF,fALFF parameters.The significance level was set to be uncorrected O.001 on the voxel level and 0.05 on the cluster level.Results AD patients showed increased ALFF in left temporal lobe (0.492 ±0.119) and right cingulated cortex (0.434 ± 0.093) of AD patients,which were 0.443 ± 0.068 and 0.380 ±0.081 in NA controls (t =2.658,2.227,P ＜ 0.05).Decreased fALFF was found in bilateral posterior cingulate cortices (1.167 ± 0.203) and increased fALFF was found in bilateral temporal lobes (left 1.226 ±0.127,right 1.146 ±0.214) with left side dominance,which were 1.453 ±0.269,1.134 ±0.088,1.014 ± O.132 in NA controls (t =5.001,3.695,3.285,P ＜ 0.05).Bilateral temporal ALFF and fALFF correlated with MMSE positively (r =0.768—0.909,P ＜ 0.05) with left dominance.Conclusion AD patients showed increased resting-state functional MRI changes correlated with MMSE score in the temporal lobes with left dominance,which indicated left temporal lobe may be the best location for the observation of disease progression in AD patients.

Animals ; Calcium ; metabolism ; Cell Line ; Cricetinae ; Cricetulus ; Dose-Response Relationship, Drug ; Fibroblasts ; drug effects ; metabolism ; Vehicle Emissions