Objective To investigate the effect of left lateral segmentectomy combined with fiber choledochoscope for hepatobiliary calculus.Methods Eighty-seven patients with hepatobiliary calculus who underwent hepatectomy from December,1998 to December,2008 were reviewed retrospectively.Forty-six patients underwent the section of common bile duct to remove calculus combined with left lateral segmentectomy and fiber choledochoscope( Group A),41 patients underwent left hepatectomy and section of common bile duct to remove calculus( Group B).The postoperative stone residual rate,complications and long-term outcome were compared between the two groups.Results The postoperative stone residual rate of either group was zero.Intraoperative bleeding ( 401.1 ± 180.4ml) ,operative times ( 202.5 ±36.6 rmin) of group A were significantly lower than those of the group B (515.9 ± 200.6ml and 257.3 ± 42.9min) ( P ＜ 0.001 and 0.01,respectively) .Hospital stays of group A was lower than that of group B,but this is no statistical significance ( P ＞ 0.05 ) .The incidence of postoperative complications were similar in the two groups( 15.2% v.s.24.4% ,P ＞ 0.05 ).The effective rates of the two groups were similar (91.3 % VS 92.7 %,P ＞ 0.05 ).Conclusions The long-term and short-term outcome of left lateral segmentectomy combined with fiber choledochoscope for hepatobiliary calculus is similar to that of left hepatectomy ,and can successfully shorten the hospital stay and reduce the hospital fee.

Objective To explore the relationship between the expression of CD44v6,P16 protein and the invasion and metastasis in gastric carcinoma and to investigate the correlation between the expression of CD44v6 and P16 protein.Methods Immunohistochemical methods were used to detect the expression of CD44v6 and P16 protein in 110 cases of gastric carcinoma.Results In 110 cases of gastric carcinoma,the expression of CD44v6 and P16 protein were 72.7%(80/110)and 47.3%(52/110)respectively. The high level expression of CD44v6 protein and low level expression of P16 protein were positively correlated with the TNM staging,serosa infiltration,lympho node and liver metastasis of gastric carcinoma(P

Objective To evaluate the clinical therapeutic effect of Shenfu injection (参附注射液) on patients with chronic obstructive pulmonary disease at acute exacerbation stage (AECOPD) and approach its therapeutic mechanism. Methods Fifty-eight patients with AECOPD were divided into a Shenfu group (30 cases) and a control group(28 cases); the Shenfu group received 50 ml Shenfu injection and 5% glucose 250 ml intravenous drip once a day at the base of conventional therapy,while the control group received conventional therapy only. The therapeutic course of both groups was 14 days. The clinical therapeutic effects of both groups were observed, the serum levels of tumor necrosis factor-? (TNF-?), interleukin-2 (IL-2) were measured by enzyme-labeled immunosorbent assay (ELISA), and the lung function of both groups was measured before and after the treatment. Results The total effective rates was 93.3% (28/30) and 85.7% (24/28) in the treatment group and the control group, respectively. In the comparison before and after treatment, the levels of TNF-? in both groups were decreased obviously (both P0.05). Conclusion Shenfu injection has a definite clinical curative effect in the treatment of AECOPD, it may decrease obviously the serum level of TNF-?, increase the level of IL-2 and improve the lung function in the patients with AECOPD.

Double-blind randomized controlled trial design is the most recognized scheme of therapeutic experimental design.On the assessment of the efficacy of traditional medicine, randomized controlled clinical trial design also has the same value.Only when using the research method towards epidemiology to perform the rigorous design on the clinical trial of traditional medicine and make the objective evaluation of its effect, can it get the real understanding and approval from modern medicine.When making the therapeutic clinical trial under the traditional medicine, due to the characteristics of the subject, therapeutic measures usually need to be changed so they cannot be standardized, and the modification may result in the share of multiple intervention components, which leads to the inaccurateness of results under the effect of confounding bias.According to the characteristics of traditional medicine, a new method was proposed for therapeutic clinical trial.Firstly do the randomization with the inclusion criteria made by the same symptom arise in a certain stage of disease, secondly adopt the standardized intervention measures for processing.Eventually confirm whether there is significant statistical difference.The symptom directing standardized interventions have provided the experimental design of the traditional medical clinical therapy with a feasible scheme, which can solve several problems existing in this design.

BACKGROUND:Transoral ventral release and posterior fusion have predominated in the treatment of irreducible atlantoaxial dislocation, but there is no consistent conclusion on the clinical efficacy.
OBJECTIVE:To explore the clinical outcomes of transoral ventral release and posterior fusion and screw/rod implantation in the treatment of irreducible atlantoaxial dislocation.
METHODS:A total of 32 patients with irreducible atlantoaxial dislocation undergoing thetransoral ventral release and posterior fusion were selected. After treatment, they received cervical anteroposterior and lateral digital DR and cervical MRI examinations to understand the conditions of nerve compression and bone fusion. The recovery of nerve function was evaluated using Japanese Orthopaedic Association before treatment, 6 months after treatment and during final fol ow-up.
RESULTS AND CONCLUSION:Post-treatment, 29 patients were fol owed-up for an average period of 12 months. (1) Al the patients obtained perfect atlantoaxial joint reduction and bone fusion. This achieved reduction and reconstruction of spinal column stability. (2) Spinal compression was obviously lessened after treatment in al patients, and nerve functions were improved to different degrees. Significant differences in Japanese Orthopaedic Association score were detected between 6 months post-treatment, final fol ow-up and pre-treatment (P<0.05). (3) There were no serious intraoperative complications such as spinal cord or vertebral artery injuries. Postoperative complications such as infection or burst were also not found. (4) Imaging evaluation revealed that transoral ventral release and posterior fusion is safe and effective for treatment of irreducible atlantoaxial dislocation.

Clinical data of 80 patients with renal failure due to under detected causes(from January 1998 to June 2007)were retrospectively analyzed.Of 66 patients with acute renal failure(ARF),rhabdomyolysis was found in 45,tumor in 15,anti-neutrophil cytoplasmic antibody(ANCA)related vasculitis in 2,infective endocarditis in 2,and hemolytic uremic syndrome in 2.Of 14 patients with chronic renal failure(CRF),primary hypothyroidism was seen in 3,multiple myeloma in 4,amyloidosis in 2,analgesic nephropathy in 3,and renal tuberculosis in 2.

Objective: To investigate the mechanism of curative effects of Guben Fangchuan capsule (固本防喘胶囊) on chronic obstructive pulmonary disease(COPD). Methods: Using double blind control method , 86 elderly COPD patients in in acute exacerbating stage were divided into treatment group and control group (n=43 in each group). The conventional treatment of the two groups was the same. Additionally, the patients in the treatment group were given Guben Fangchuan capsules orally. The levels of interleukinCD*28 (ILCD*28) and eotaxin in phlegm were detected by enzyme linked immunoadsorbent assay (ELISA). Chymase activity in phlegm was determined by spectrophotometry. They were compared before and after treatment. Results: ①The activity of chymase, the levels of ILCD*28, eotaxin, neutrophil (NEU) and eosinophil (EOS) in phlegm in patients with intermediate and severe COPD patients were lower after treatment in treatment group than those of the patients before treatment and control group (all P

[Summary] Sixty-one patients suffering from pituitary apoplexy( PA) were mainly diagnosed according to pathologic findings, and were collected from case record, pathology, and MRI databases. They were classified into 4 types according to the clinical condition: the insidious type was characterized with only positive pathological findings;the asymptomatic type had both positive pathologic and MRI findings; the subacute type had PA associated symptoms longer than 2 weeks; and the acute type had PA associated symptoms for 2 weeks or less. The latter 2 types had positive pathological and MRI findings additionally. The basic lesions, acute or chronic symptoms, endocrinopathies and MRI findings were compared among 4 types. Results showed as followed. In all patients, there were headache(60. 7% ), blurred vision(55. 7% ), vomiting(21. 3% ), and dizziness(14. 8% ). Apoplexy associated symptoms comprised severe headache (24. 6% ), rapid vision loss (29. 5% ), and blepharopotosis or diplopia (9. 83% ). Insidious, asymptomatic, subacute, and acute types were composed of 15 (24. 6% ), 9 (14. 8% ), 19 (31. 1% ), and 18 (29. 5% ) cases, respectively. Aging and intracranial space-occupying symptoms as first complaint showed increasing trend from mild to severe types(both P<0. 05), while in chronic course it showed decreasing trend(P<0. 05). Acute massive symptoms(P<0. 01), and non-functional tumor(P<0. 01) in the 2 clinical types were much more frequent than in the two mild types. Half or more pituitary-target glands showed impaired functions in each type, and the impairment showed increasing trend through mild to severe types(P<0. 01). The present study provided a brief typing system in order to expand PA concept to a wider span covering various conditions. Some differences in tumor composition and endocrinopathies existed among the four types.

This study was intended to assess the therapeutic effect and toxicity of Compound vincristine liposome on breast cancer in nude mice. The mammary cancer models of BALB/c nude mice were set up using MCF-7 cells, and were divided into seven groups: MTO-VCR-LP, MTO-VCR-Soln, VCR-LP, VCR-Soln, MTO-LP, MTO-Soln and 0.9% NaCl. After the first treatment in the same day of transplantation, different treatments were given respectively. According to the design, the BLAB/c nude mice were given the therapy, the weight of nude mice and tumor volume were measured, and the tumor growth inhibitory rate was calculated. Bone marrow smears and extravasation injury were observed. The tumor growth inhibitory rates were higher in MTO-VCR-LP and MTO-VCR-Soln groups than in other groups. MTO-VCR-Soln, VCR-Soln and MTO-Soln led to severe local extravasation injury. MTO-VCR-Soln cause serious bone marrow inhibition of nude mice. The average weight of nude mice in the three liposome groups was higher than that in the three solution groups. So the use of liposome as the carriers of the two anticancer drugs could improve the cure rate of cancer and decrease the side-effects. This work, which not only expanded the research field of liposome but also brought in new ideas and new methods to treat cancer. Furthermore, the findings in this research may have the potential for use in clinical practice.
Animals ; Drug Carriers ; Drug Synergism ; Female ; Liposomes ; administration & dosage ; Mammary Neoplasms, Experimental ; drug therapy ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Mitoxantrone ; administration & dosage ; adverse effects ; Neoplasm Transplantation ; Random Allocation ; Vincristine ; administration & dosage ; adverse effects

OBJECTIVE: This study was to explore the expression and clinicopathologic features of Tyrosine kinase receptors B (TrkB) and its ligand brain-derived neurotrophic factor (BDNF) in nasopharyngeal carcinoma (NPC). METHOD: Immunohistochemistry was adopted to detect the expression level of TrkB and BDNF in NPC patients. RESULT: Both TrkB and BDNF were expressed in NPC as well as in chronic inflammation. The active expression rate of TrkB in NPC was 82.5% (47/57) and BDNF was 52.6% (30/57), both of which were higher than those in chronic inflammation (P < 0.05). The degree of TrkB expression was more marked in T3 + T4, III + IV stage NPC than that in T1 +T2, I + II stage NPC (P < 0.05). TrkB abnormal expression rate of nasopharyngeal carcinoma with lymph node metastasis was higher than that of NPC without lymph node metastasis (P < 0.05). No statistical significance for degrees of TrkB expression in pathologic type grades was found (P > 0.05). There were no statistical significance for degrees of BDNF expression in T stage, clinical stage and lymph node metastasis in NPC (P > 0.05). The expression of TrkB was unrelated to the expression of BDNF (r = 0.049, P > 0.05). CONCLUSION The high expression rate of TrkB and BDNF maybe plays an important role in development of NPC. It is suggested that TrkB and its ligand BDNF may act as an important index for forecasting the development and metastasis of NPC.
Adolescent ; Adult ; Aged ; Brain-Derived Neurotrophic Factor ; metabolism ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Neoplasm Staging ; Receptor, trkB ; metabolism ; Young Adult