Antineoplastic Agents ; therapeutic use ; Humans ; Neoplasms ; drug therapy ; Precision Medicine ; methods

Cholangiocarcinoma is a malignancy of biliary tract and its incidence has been increasing in recent years all over the world.Meanwhile,there have been advances in techniques for its diagnosis and treatment.Some new methods such as PET,endoscopic ultrasonography and scopic CT can promote the diagnostic rate in the early stage and they have been used for diagnosis and staging of tumors.For those patients with large cholangiocarcinoma in the liver,photodynamic therapy is an effective neoadjuvant treatment.For those patients with unresectable cholangiocarcinoma,organ transplantation might be employed. Classification of cholangiocarcinoma and study on its diagnosis are important for disease evaluation in patients with the disease.

The development of the international spread of Chinese medicine facing the serious challenge of the global competition with the tentacles of Chinese medica;communication in the world are spreading even wider.How to make countermeasures.seize an opportunity and receive the challenge to improve international competitiveness effectively and promote sound and rapid development of the internationalization of Chinese medicine have become the focus of common attention.In this paper,I'll discuss some problems in the development of the international communication of the culture of Chinese medicine such as the main task and the principles.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Musculoskeletal Manipulations ; Snoring ; therapy ; Young Adult

Objective To investigate the effect of bundle strategy of diagnosis and treatment on preventing hospital acquired pneumonia in intensive cancer patients.Methods Two hundred and sixty-five patients as control group were treated by regular preventive measures,and 292 cases as intervention group were treated by bundle strategy including the control application of antibiotics,hand hygiene,oral care,isolation of multi-drug resistant,elevation of bedside,management of respiratory tract and appropriate sedation and analgesia et al.Compare the hospital acquired pneumonia incidence,attribution mortality,duration of mechanical ventilation,stay-time in ICU,hospital acquired pneumonia antibiotics defined daily doses system and positive rate of multi-drug resistant infection between two groups.Results With the bundle treatment,the decreases of the hospital acquired pneumonia Incidence,duration of mechanical ventilation,stay-time in ICU and hospital acquired pneumonia Antibiotics daily doses system were significant(P＜ 0.01),and the positive rate of hospital acquired pneumonia attribution mortality and MDR infection were no statistical significance (P ＞ 0.05).Conclusion The bundle strategy of diagnosis and treatment could reduce the hospital acquired pneumonia incidence and the length-time in hospital.

Objective To evaluate and compare the clinical effects of forward and reverse anterior cruciate ligament (ACL) reconstruction through the arthroscopy. Methods From April 2008 to August 2009,97 cases with simple ACL injures were treated with eight strands of hamstring tendons in way of two-bundle and four-tunnel reconstruction. The patients were randomly divided into two groups according to the number of hospital admissions: odd numbers (A group, 47 cases) were treated with forward double-bundle reconstruction and even (B group,50 cases) were treated with reverse. The grafts were fixed with a suspension technique by mini-plates and mini-buttons. Mean follow-up exceeded one year. The function of knee joint were assessed by the IKDC, Lysholm and Tegner rating scale. Results Mean follow-up was 13.71 months.At the last follow-up, 2 patients in A group had a 10°extension deformity and 5 had a less than 15° flexion limitation. All patients in B group showed normal knee extension, and 4 had a 5° flexion limitation. According to Lachman test, there were one case with one plus positive and one with two plus positive in A group,and one with two plus in B. KT-1000 examination (30° flexion and 30 N) showed the side to side mean difference of anterior knee laxity was (1.04±1.11) mm in A group and (0.86±1.12)mm in B. According to objective IKDC evaluation, the results were graded as normal or nearly normal in 46 patients in A group and 48in B. There were no statistical differences in the IKDC, Lysholm, and Teguer scores between two groups.Conclusion Forward or reverse ACL double-bundle reconstruction with eight strands of hamstring tendons can both restore knee stability, and there is no significant deviation between the two techniques.

Objective To analyze the clinical methods of type Ⅲ Pilon fracture internal fixation. Methods The internal fixation with steel plate were performed in 36 cases with Ruedi-AllgoWer type, Ⅲ Pilon fracture and all patients had early post-operative rehabilitation functional exercise. Results Thirty-six cases were followed up for an average period of 16 months. The fracture healed completely in all cases and the successful rates of good function reached 88.9% (32/36) according to YU Guang-rong's evaluation standard. Conclusion For Ruedi-AUgower type Ⅲ Pilon fracture, appropriate surgical time combined with internal fixation with steel plate and early post-operative function exercise showed satisfactory therapeutic effect.

Objective To compare clinical outcomes of minimally invasive plating osteosynthesis (MIPO) and intramedullary nail stabilization in treatment of acute humeral shaft fractures. Methods From March 2007 to January 2009, 52 patients were treated in our department for acute fractures of middle and lower humeral shaft. Twenty-seven were treated with MIPO technique (group A) and 25 with intramedullary nail (group B) . In group A, there were 15 men and 12 women, aged from 18 to 65 years (average, 36. 7 years); in group B, there were 16 men and 9 women, aged from 25 to 63 years (average,39. 4 years). Operation time, amount of blood transfusion, hospital stay, time for union, complications, Mayo scores of the elbow and Constant scores of the shoulder were recorded in both groups and compared statistically. Results The mean follow-up time was 17. 8 months (range, 16 to 36 months) . There were no significant differences between the 2 groups in operation time, amount of blood transfusion, hospital stay, time for union, and Mayo scores of the elbow ( P > 0. 05) . There was no case of postoperative iatrogenic radial nerve palsy or non-union in group A, but there were 4 cases of non-union, 2 cases of iatrogenic radial nerve palsy and one case of varus malunion in group B. Compared with group B, group A showed significant advantages in rate of postoperative non-union and Constant scores of the shoulder functional recovery ( P < 0. 05) . Conclusion In treatment of humeral shaft fractures, MIPO technique has advantages of less operative invasion, quick bone union, satisfactory shoulder functional recovery and low risk of postoperative palsy of the iatrogenic radial nerve.

Objective To detect the fluctuations of homoeysteine(Hcy),endothelin(ET),mononitrogen monoxide(NO),folic acid(FA) and vitamine Bi2 (VitB_(12)) in the plasma of patients suffered from acute cerebral infarction and to investigate the clinical significance.Methods 140 blood specimens from cerebral infarction patients and 61 specimens from healthy individuals were obtained in this study and a series of items of Hey,ET,NO,FA and VitB_(12) were detected.Results The Hey [(17.15±4.63) μmol/L]and ET [(32.62±18.76) μmol/L]were increased in acute cerebral infarction(ACI) group compared with that in control group[(10.12±2.62) μmol/L,(20.08±13.38) μmol/L respectively]and the difference was significant (P＜0.01).The levels of NO [(39.82±7.26) μmol/L],FA [(7.54±4.01) ng/ml]and VitB_(12) [(247.70±119.85) pg/ml]were decreased compared with control group [(60.22±6.28) μmol/L,(10.08±3.86) ng/ml,(411.52±194.58) pg/ml respectively]and the differences significant (P＜0.01).Gender and hypertension affected the values of Hey.Conclusions Hcy and ET were increased while NO,FA and VitB_(12) were decreased in acute cerebral infarction.Hcy had positive correlation with ET and negative correlation with FA and VitB_(12).

Vascular endothelial growth factor(VEGF)is a major angiogenic factor that regulates multiple endothelial cell functions. After cerebral ischemia, VEGF not only promotes vascular endothelial proliferation and migration. involving in angiogenesis and increasing vascular permeability, but also plays important roles in both neuroprotection and neurogenesis. This article reviews the roles of VEGF in ischemic cerebral injury.