Child ; Critical Care ; Humans ; Intensive Care Units, Pediatric ; Medical Records ; Severity of Illness Index

Gallbladder cancer (GBC) is the most common cancer of the biliary tract,constituting 80％-95％ of malignant biliary tract tumors.Surgical resection is currently regarded as the sole curative treatment for GBC.Hepatopancreatoduodenectomy (HPD) has been adopted to remove the advanced gallbladder tumor together with the infiltrated parts within the liver,lower biliary tract and the peripancreatic region of GBC patients.However,patients who underwent HPD were reported to have a distinctly higher postoperative morbidity (71.4％,ranging from 30.8％ to 100％) and mortality (13.2％,ranging from 2.4％ to 46.9％) than those given pancreatoduodenectomy (PD) alone.We present two patients with advanced GBC who underwent a modified surgical approach ofHPD:PD with microwave ablation (MWA) of adjacent liver tissues and the technique of intraductal cooling of major bile ducts.No serious complications like bile leakage,pancreatic fistula,hemorrhage and organ dysfunction,etc.occurred in the two patients.They had a rapid recovery with postoperative hospital stay being 14 days.Application of this approach effectively eliminated tumor-infiltrated adjacent tissues,and maximally reduced the postoperative morbidity and mortality.This modified surgical method is secure and efficacious for the treatment of locally advanced GBC.

OBJECTIVETo observe the therapeutic effect of Xinfeng Capsule (XFC) in treating adjuvant arthritis of rats and its effect on fas, fasL and bcl-2 expression in synovial membrane.

METHODSRats were randomly divided into the normal group, the model group, the model group, the methotrexate (MTX) group, the TPT group and the XFC group. Except for the rats in the normal group, animals were modelled to adjuvant arthritis with Freund's complete adjuvant, and the latter three groups were treated with MTX, Tripterygium wilfordii polysaccharide (TPT) and XFC respectively. The arthritis index (AI), change of body weight (BW) of rats were recorded, and the expressions of fas, fasL and bcl-2 in rats' synovial membrane were determined.

RESULTSCompared with before treatment, the AI in the three treated groups was lowered significantly (P < 0.01, P < 0.05). The BW increment in the XFC group after treatment was insignificantly different to that in the normal group (P > 0.05), while it was significantly lower in the other two treated groups than that in the normal group and the XFC group (P < 0.01). Compared with the model group, fasL expression was increased in the XFC group significantly (P < 0.05), but bcl-2 expression decreased, fas expression showed insignificant difference (P > 0.05). Comparison of the three gene expressions between the three treated groups showed no significant difference (P > 0.05).

CONCLUSIONXFC could decrease AI in rats with adjuvant arthritis in the same way as MTX and TPT, it effected better in increasing BW than the latter two. The effect of XFC might be performed by its action in enhancing fasL expression, inhibiting bcl-2 expression and promoting apoptosis of proliferated synovial membranous cell so as to restrain hyperplasia of synovial membrane.

Animals ; Apoptosis ; Arthritis, Experimental ; drug therapy ; metabolism ; Capsules ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Fas Ligand Protein ; Hyperplasia ; Membrane Glycoproteins ; biosynthesis ; genetics ; Phytotherapy ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Wistar ; Synovial Membrane ; metabolism ; pathology ; fas Receptor ; biosynthesis ; genetics

The degradation of chlorinated organic compounds by zerovalent iron is an effective technique which is popular in recent years.In the present paper,the recent researches on the technique were reviewed including the reductive dechlorination of chlorinated organic compounds by using the zerovalent iron and the factors which affect the degradation,especially the influence of DO,Cl~- and Fe~(2+),and the perspective of application of the technique was presented.

To evaluate the effects of different antagonists on the release of cytochrome c from mitochondria to cytosol and the expression of Bcl-2 in mitochondria in rat hippocampus after ischemia, we examined Bcl-2 and cytochrome c expression by immunoblotting using 4-vessel occlusion (4-VO) as brain ischemia model. The results showed that after 24 h ischemia/reperfusion (I/R) cytochrome c decreased markedly in mitochondria, which was correspondingly increased in the cytosolic fraction. Bcl-2 expression was time-dependent, reaching its peak level after 6 h I/R. In all those samples, there were no alterations in the subcellular distribution of cytochrome oxidase, a mitochondrial respiratory chain protein. The decreases in Bcl-2 and cytochrome c in mitochondria were restored by pretreatment with non-competitive NMDA receptor antagonist ketamine or L-type voltage-gated Ca(2+) channel (L-VGCC) antagonist nifedipine at 20 min prior to ischemia. The results demonstrate that the release of cytochrome c from mitochondria to cytosol and the up-regulation of Bcl-2 are possibly mediated by NMDA receptors or L-VGCC following brain ischemia. Cytochrome c release may be injurious while Bcl-2 up-regulation may be protective to ischemic hippocampus.
Animals ; Brain Ischemia ; metabolism ; Calcium Channel Blockers ; pharmacology ; Calcium Channels, L-Type ; drug effects ; Cytochromes c ; metabolism ; Cytosol ; Hippocampus ; metabolism ; Ketamine ; pharmacology ; Male ; Mitochondria ; metabolism ; Nifedipine ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; genetics ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; antagonists & inhibitors ; Up-Regulation

OBJECTIVETo investigate the clinical value of lower medial leg fasciocutaneous flap for the repair of soft tissue defects at root of tongue.

METHODS4 cases of soft tissue defects at root of tongue were underwent surgery with lower medial leg fasciocutaneous flaps. This paper describes in detail the anatomy of the flap, technique of make up the flap, advantages and disadvantages, and its clinical applications.

RESULTSAll the 4 flaps were got successfully one stage repair. A satisfied reconstruction were attained, the transplanted skin grafts on the defect regions of lower medial leg survived without necrosis.

CONCLUSIONSThe lower medial leg fasciocutaneous flaps is a good method for the repair of the defect reconstruction at the root of tongue. The soft tissue defects at root of tongue can be used the flap combined with partial soleus. The flaps not only has thin fat and soft quality, but also is far away from the region of head and neck. The donor site is blanket with less damage.

Adult ; Aged ; Female ; Humans ; Leg ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Tongue Neoplasms ; surgery

Objective To analyze the safety and effectiveness of photoselective green-light laser vaporization of the prostate(PVP)in treatment of large prostate with volume more than 80 ml. Methods Retrospective analysis was performed in 25 benign prostatic hypertrophy patients undergoing the PVP treatment,whose prostate volume was more than 80 ml.Results Twenty-five patients with prostate mean volume of 151.8(84.0-270.0)ml were treated by PVP and 23 cases were finished successfully.One operation was suspended because of bleeding and the other because of damaging orifice.No blood transfusion was needed and no“transurethral resection(TUR)syndrome”happened.Five cases had acute retention and 2 of them needed second PVP.In a mean of 7.9(3.0- 12.0)months follow-up,maximal urinary flow rate(Qmax),international prostate symptom score (IPSS),quality of life score(QOL),and prostate-specific antigen(PSA)level were improved significantly.The volume of prostate reduced after PVP than before PVP but no significant difference was found.Conclusions PVP is feasible in treating large prostate even the volume is more than 80 ml,although it needs better skill.Catheterization for some time is helpful in reducing the incidence of early postoperative acute urinary retention.

Objective To analyze retrospectively the clinico-pathological features that influencing the occurrence of anastomotie leakage after low anterior resection of rectal cancer, as well as its management and outcome of patients. Methods The data of 513 patients underwent anterior resection for low rectal cancer from june 1999 to June 2007 were reviewed. Results The incidence of anastomotic leakage was 4.5 %(23/ 513). 20 patients underwent conservative therapy,while 3 patients underwent reoperation, all patients were cured without ileostomy or colostomy.Conclusion The occurrence rate of anastomotie leakage is closely re- lated to the type of operation,the Dukes staging,Diabetes Mellitus and Diarrhea. Local irrigation via the drainage tube is the main strategic point to manage the leakage.

Objective To establish a small intestinal organoid culture system as an in vitro study model of intesti-nal epithelial cells, and to explore the relevant pathological detection techniques and provide a convenient platform for in vitro study of various intestinal diseases. Methods The mouse intestinal epithelium was isolated and cultured into or-ganoids to simulate the growth and development of intestinal epithelium in vitro. The proliferation and differentiation signals were detected by immunohistochemistry and three-dimensional immunofluorescence technique. Results The culture system of the mouse small intestine epithelium was established. Immunohistochemical staining and three-dimensional immunofluo-rescence technique were successfully used to detect the growth and development of small intestinal organoids. Conclusions The successfully established mouse small intestinal organoid culture system and application of immunoassay technology will gradually become a most favorable technical means for studies of various intestinal diseases.

Objective To study the conventional MRI and dittusion weighted imaging(DWI) features of Japanese encephalitis(JE)in children.Methods Sixteen patients with JE were included. Conventional MRI and DWI sequences were performed in all patients.Seven patients received MRI within 10 days of onset and 9 after 10 days.The appearances on DWI and T_2 WI were recorded.The ADC values of lesions were calculated,and then were correlated with the corresponding time interval between onset of neurological symptoms and MRI scanning.Results The lesions of JE mainly showed long T_1 and long T_2 signal intensity on MRI.The thalami were the most frequently involved areas,and 15 out of 16 showed thalamic involvement and 6 patients only showed thalamic abnormalities without other lesions.Seven patients within 10 days of onset showed lesions with high signal intensity on both DWI and T_2WI,but whole or partial lesions showed clearer on DWI than on T_2WI,and 2 patients showed extra lesions that were invisible on T_2WI.As for the other 9 patients after 10 days of onset,the lesions showed clearer on T_2WI than on DWI. There was a direct correlations between thalamic ADC values and the disease duration (r=0.84,P