Objective:To study the risk factors and treatment of lymphatic fistulas after the radical operation of gastric cancer.Methods:Observed the clinical data of 631 cases after the radical operation of gastric cancer that had been received in our hospital from February 1998 to February 2008.Multiple factor analysis with logistic regression was performed for the risk factors.Results:The level of post-operative serum albumin on the first day and Ultrasonically activated shears are protective facrors against lymphatic fistulas(P

Objective: To observe the effect of Anrou-pressing and kneading Hegu (LI 4) and Sanyinjiao (SP 6) on uterine inertia during painless parturition. Methods: A total of 100 cases of patients with uterine inertia during painless parturition were randomized into an acupoint group and a medicine group by the SPSS programming, with 50 cases in each group. Patients in the acupoint group received the treatment of Anrou-pressing and kneading bilateral Hegu (LI 4) and Sanyinjiao (SP 6), while patients in the medicine group received intravenous oxytocin. The labor time and maternal-child safety were evaluated, and the labor stage was compared. Results: The latent and active phases in the 1st labor stage and the 2nd labor stage in the acupoint group were substantially shorter than those in the medicine group, and the between-group comparisons showed statistical significance (all P<0.05). The between-group comparison of the 3rd labor stage showed no statistical significance (P>0.05). The postpartum hemorrhage amount in both groups was within the safe range, and the between-group comparison showed no statistical significance (P>0.05). The newborn 1 min Apgar score was ranged 8-10 points, and the between-group comparison showed no statistical significance (P>0.05). The between-group comparison of the labor stage efficacy showed statistical significance (P<0.01), with a better progression in the acupoint group. Conclusion: Anrou-pressing and kneading Hegu (LI 4) and Sanyinjiao (SP 6) is both effective and safe for uterine inertia during painless parturition.

Objective To observe the efficacy and safety of implantation of tissue expanders for large hyperplastic scar on scalp.Methods Between June 2011 and April 2013,a total of 23 patients with large hyperplastic scar received treatment with 31 tissue expanders.The scar size varied from 5.5 cm × 4.0 cm to 17.5 cm ×9.5 cm.The capacity was 50-400 ml for expanders,with the shape of kidney or ellipse.After tissue expansion for 6 to 8 weeks,the expander was removed and hyperplastic scars were resected,followed by the repair of defect with expanded flaps.Further more,the patients received postoperative superficial isotope irradiation after the surgery.Follow-up varied from 6 to 12 months.Results Thirty expanders,except l expander pocket that was removed ahead of time due to infection,were implanted successfully during the whole course of treatment.The main complication was expander exposure in 4 patients,which showed no significant influence on secondary surgery.Twenty patients reported relief of symptoms and achieved satisfactory outcomes,while 3 patients showed great suture tension and experienced delayed stitch removal,followed by the recurrence of hyperplastic scar after the operation.Conclusions The implantation of tissue expanders under the scalp skin is an ideal treatment option for large hyperplastic scar on scalp.Regional suture tension is a direct contributor to the recurrence of hyperplastic scar formation after surgical excision.

In recent years,the effects of ultrasound combined with microbubble contrast agent in treatment of tumors has been become a new research hot point,which may have great potential in tumor treatment.Low-power ultrasound radiating microbubble embolization angiogenesis therapeutics has been widely used in tumor treatment.Among them the following foundation research aspects can make great breakthrough,such as : target drug delivery,target gene therapy,increasing high-intensity focused ultrosound therapy efficiency etc.

Objective:To evaluate the efficacy of the resection of nasal inverted papilloma (NIP) under endoscope.Methods: A total of 100 patients with NIP from April 2008 to December 2013 in our hospital were randomly divided into endoscopic surgery group (endoscopic group) and conventional surgery group (conventional group), each with 50 cases. All patients were followed up for 2 years, whose recurrence, complications and satisfaction were observed. Results: The patients were followed up for 2 years, and the recurrence rate between the two groups was not statistically significant (x2=0.96,P>0.05). The traditional group had a higher incidence of complications than the endoscopic group, and the difference was statistically significant (x2=4.16,P<0.05). Endoscopic patients’ satisfaction was higher, and the difference was statistically significant (x2=5.02,P<0.05).Conclusion: The resection of (NIP) under endoscope can reduce the incidence of complication, improve patient satisfaction, and will not increase the recurrence rate, which is an effective means of treatment to the NIP.

Objective To determ inate triptolide and wilforlide A in biological sam ples by liquid chrom atog-raphy-tandemmass spectrom etry (LC-M S/MS)method and to verify themethod. Methods A fter 0.4mLblood, urine or 0.4 g hepatic tissues with internal standard were extracted by ethyl acetate, they were separated on a A llure PFP Propyl (100mm ×2.1mm , 5μm ) with amobile phase ofmethanol-20mm ol/Lammonium acetate using gradient elution. Formass spectrom etric detection, electrospray ionization (E SI+) in positivemode was elected and the data was collected usingmultiple-reactionmonitoring (M R M ). Results The linearity was good (r>0.995 0) and the lim it of detection was 2 ng/m Lor 2 ng/g for triptolide and wilforlide A . The recovery was 61.08% -102.98% . The intra-day and inter-day precision was less than 12.58% for each biological sam ple, and the accuracy was 90.61%-105.80%. Conclusion Thismethod is sim ple, convenient and good selective, and could be applied to analysis of triptolide and wilforlide A in different biological sam ples. A nd themethodmay provide technical support for forensicmedicine identification, clinical diagnosis and treatm ent of tripterygium wilfordii Hook. f. poisoning.

The static balance test and training equipment has been used over ten years in our country. Because balance function of patients can be assessed objectively and quantitively and pertinent taining can be performed with balance equipment, this instrument has a abroad domestic application. The application of balance equipment in clinical rehabilitation is sumarized in this article.

OBJECTIVE: To determinate triptolide and wilforlide A in biological samples by liquid chromatography-tandem mass spectrometry (LC-MS/MS) method and to verify the method. METHODS: After 0.4 mL blood, urine or 0.4 g hepatic tissues with internal standard were extracted by ethyl acetate, they were separated on a Allure PFP Propyl (100 mm x 2.1 mm, 5 µm) with a mobile phase of methanol-20 mmol/L ammonium acetate using gradient elution. For mass spectrometric detection, electrospray ionization (ESI⁺) in positive mode was elected and the data was collected using multiple-reaction monitoring (MRM). RESULTS: The linearity was good (r > 0.995 0) and the limit of detection was 2 ng/mL or 2 ng/g for triptolide and wilforlide A. The recovery was 61.08%-102.98%. The intra-day and inter-day precision was less than 12.58% for each biological sample, and the accuracy was 90.61%-105.80%. CONCLUSION This method is simple, convenient and good selective, and could be applied to analysis of triptolide and wilforlide A in different biological samples. And the method may provide technical support for forensic medicine identification, clinical diagnosis and treatment of tripterygium wilfordii Hook. f. poisoning.
Chromatography, High Pressure Liquid ; Diterpenes/urine* ; Epoxy Compounds/urine* ; Humans ; Oleanolic Acid/urine* ; Phenanthrenes/urine* ; Sensitivity and Specificity ; Tandem Mass Spectrometry

Objective To investigate the clinical value and effect of peripherally inserted central eatheter(PICC) in patients with tuberculous meningitis. Methods 56 patients with tuberculous meningi-tis were randomly divided into the treatment group and the control group with 28 cases in each group. The treatment group was medicated by PICC, while the patients of the control group were medicated through pe-ripheral superficial vein. The curing rate, degree of anxiety, infusion response, satisfaction with nursing and related expense were recorded. Results The curing rate and satisfaction with nursing of the treatment group were higher than those of the control group. The anxiety degree, infusion response and related ex-pense of the treatment group were lower than those of the control group.Their difference had statistical sig-nificance. Conclusions PICC has clinical value in patients with tuberculous meningitis,which is worth promoting.

Objective: To observe the effect of tolvaptan on treating the patients with intractable heart failure (HF) combining hyponatremia for their clinical conditions and improvements. Methods: A total of 100 relevant patients treated in our hospital from 2014-01 to 2015-01 were studied. Based on conventional treatment as cardiac stimulant, dieresis and correction of electrolyte disturbance, the patients were randomly divided into 2 groups: Tolvaptan group, the patients received tolvaptan15 mg/d for 5 days and Control group, the patients had no tolvaptan administration.n=50 in each group. The improvement of clinical symptoms, changes of cardiac, renal functions and blood levels of electrolyte were compared between 2 groups after treatment. Results:① Compared with Control group, Tolvaptan group had significantly improved dyspnea, reduced lung moist rale and low limb edemaP<0.01; Tolvaptan group showed increased 24 h urine volume (2416.0±771.6 vs 1124.6±215.7) ml,P<0.01, decreased plasma levels of NT-proBNP (2678.04 ± 537.09) pg/ml vs (4051.34 ± 306.07) pg/ml,P<0.01 and increased blood levels of sodium (139.08 ± 6.18) mmol/L vs (129.44 ± 2.20) mmol/L,P<0.01. ②In Tolvaptan group, the above improvements were found in 38 patients, and with 1 day tolvaptan therapy, their blood nitrogen dropped from (10.39 ± 1.23) mmol/L to (7.28 ± 1.53) mmol/L,P<0.01; the other 12 patients had no such effect, and with 1 day tolvaptan therapy, their blood nitrogen elevated from (10.39±1.23) mmol/L to (13.38 ± 0.66) mmol/L,P<0.01. Conclusion: Tolvaptan could effectively improve clinical symptom and cardiac function in patients with intractable HF, it is helpful to increase blood sodium level; the efifcacy of tolvaptan might be evaluated by the changes of blood nitrogen at the early stage of treatment.