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Background and purpose:The morbidity of the elderly patients with hepatic portal cholangiocarcinoma is rising. Due to the characteristics of pathology,physiology and anatomy of the disease, most of the patients with cancer are not resectable, the main treatment consists of the diverting drainage and postoperative chemoradiation.We studied the clinical features and the effective therapeutic method for the elderly patients with hepatic portal cholangiocarcinoma. Methods:A retrospective analysis was performed in 28 cases of the elderly patients with hepatic portal cholangiocarcinoma who were treated between January 1995 and December 2005 in our hospital.Results:3 cases received surgery, 2 of them survived for over three years, another 3 cases were given operative exploration with 14 months of medium survival time. 22 cases were given internal or external drainage and received radiotherapy after operation, their survival time ranged from 5 months to 40 months.Conclusions:Surgery is the primary therapeutic method for elderly patients with hepatic portal cholangiocarcinoma. Internal or external drainage and radiotherapy could prolong survival time of the patients with unresectabke disease.

Objective To facilitate standing and walking after rehabilitation training by designing and using individualized ischial weight bearing orthosis for patients with various conditions of the lower limbs. Methods An orthosis with ischial support was ordered and tailored according to the condition of the patient's affected lower limb. Adaptive standing and walking training were administered daily. The functional recovery after the assembly of the orthosis was observed. Results The patients' standing and walking ability improved significantly after the training with the ischial weight bearing orthosis. The standing time was significantly longer than without the orthosis, and the walking distance was notably increased. Conclusion An ischial weight bearing orthosis has a significant effect on the recovery of standing and walking capability.

The characteristics and developing trends of electrical system for medical vehicles are introduced.Key techniques in electrical system design are put forward.Emphasis is put on application of new technologies to electrical system for medical vehicles.By using some new techniques in design of medical vehicles,the performance of vehicles is improved in a certain extent.

This paper introduces the application of motor medical equipment independently developed by ourselves in combined medical succor action between China and Gabon.Problems about equipment using are summarized,and the corresponding resolvent to every different problem is listed,which will help to provide some references to the evolution,demonstration and development of medical equipment in the future.

Objective: To explore the effect of caveolin-1 ( Cav-1 ) on lipopolysaccharide ( LPS )-induced airway mucous hypersecretion.Methods:16HBE human airway epithelial cells with Toll-like receptor 4(TLR4) inhibitor,nuclear factor-kappa B(NF-κB) inhibitor,Cav-1 siRNA or plasmid pr-treated,further stimulated with LPS.The cells were divided into 8 groups:the control group, the LPS group,the LPS+Cav-1 expression group,the LPS+Cav-1 siRNA group,the LPS +negative siRNA group,the LPS +empty vector group,the LPS +E5564 group, the LPS +PDTC group.Cell survival rate was detected by MTT assay.Transcription level of mucin(MUC)5AC was evaluated with RT-PCR.The level of MUC5AC protein was measured by ELISA.The expression of TLR4,Cav-1 and phosphorylated IκBα( p-IκBα) were measured by Western blot.MUC5AC protein changes were observed by immunofluorescence and confocal laser technology.Results:LPS remarkably increased MUC5AC,as well as TLR4,p-IκBα(P<0.05).These effects were prevented by E5564 and PDTC.We found that the overexpression of Cav-1 further enhanced the expression of TLR4, p-IκBαand MUC5AC.However,downregulation of Cav-1 inhibited the expression of TLR4,p-IκBα,MUC5AC.Conclusion: Cav-1 enhances LPS-induced MUC5AC hypersecretion through TLR4/NF-κB signaling pathway.

Objective To analyze the anatomical relationship between Zuckerkandl's tubercle (ZT) and the recurrent laryngeal nerve(RLN),to reduce the incidence of RLN injury risk.Methods 280 patients undergoing total thyroidectomy from Jan.2008 to Jan.2013 were included in our study.A meticulous technipue of excapsular dissection was used to dissect thyroid.ZT's size,classification,and its relationship with RLN were studied and classified.Results A total of 280 thyroid gland lobes were dissected.ZT identified in the left was 94.1％(128/136),right 96.4％(160/166),and bilateral 72.8％(220/302).ZT grades were as the following:Grade 0,left 11.8％(16/136) and right 11.4％(19/166);Grade I,left 30.1％(41/136) and right 25.3％(42/166);Grade II,left 44.1％(60/136) and right 43.4％(72/166);Grade III,left 8.1％(11/136) and right 16.3％(27/166).There was no significant difference on ZT classification between the left side and right side.For ZT with grade I or above,112 cases were at the left side,among which type A was 90.2％(101/112),type B 0.9％(1/112),type C 7.1％(8/112),and type D 1.8％(2/112),and 141 cases were at the right side,among which type A was 92.9 ％ (131/141),type B 0.7％(1/141),type C 5.0％(7/141),and type D 1.4％(2/141).There was no significant difference between the left side and the right side in terms of type.Type A of ZT was the most common type.Conclusion As an important anatomic landmark,ZT is essential for locating and dissecting RLN during thyroid surgery,however,due to its complex anatomical relationship with adjacent organs and the variability of RLN and its branches here,from which to reveal RLN has the possibility of increasing the injury risk.

Objective To analyze the effect of adjustments of control strategy on epidemic trend of iodine deficiency disorders (IDD) in Shanxi Province after universal salt iodization (USI),and to provide basis for timely adopting targeted control countermeasure and scientifically adjusting intervention strategy.Methods A method of retrospective analysis was performed to collect data from IDD surveillance at national or province levels after 1995,and from iodized salt surveillance of the province after 2004.According to the statistics and analysis of children's goiter rate,median urinary,median and mean of salt iodine,coverage rate of iodized salt,qualified rate of iodized salt,consumption rate of qualified iodized salt and their relationship.Results Since 1995,the children's goiter rate by palpation and B-ultrasound showed a steady descending trend.The median salt iodine,mean salt iodine and children's median urinary iodine showed a trend of rise→decline→stable→decline.Namely:The three indicators began to rise year by year from 1995 (29.1 mg/kg,31.7 ± 15.0 mg/kg,199.3 μg/L),in 1999 (48.7 mg/kg,53.4 ± 29.4 mg/kg,407.5 μg/L) reached its climax; and then decreased,in 2001 (34.7 mg/kg,36.2 ± 11.9 mg/kg,282.1 μg/L)stoped; which were basically stable from 2001 to 2011; since 2013 (26.0 mg/kg,26.5 ± 6.3 mg/kg,192.0 μg/L),a significant decline began.The rate and edible rate of qualified iodized salt showed a trend of decline→rise→stable.Two indexes began to decline circuitously from 1995 (72.61％,68.25％),and dipped to a low point in 1999 (44.80％,43.67％); then began to rise,until 2002 (94.73％,91.80％) reached basic stability; and remained steady from 2002 to 2013.Conclusions Following the process of prevention and treatment of IDD for more than 30 years in Shanxi Province,with the depth understanding of the range of adequate iodine nutrition,according to the monitoringfeedback mechanism,the strategy of salt iodization has been adjusted several times,the target of continuous elimination of IDD has achieved since 2000 and the levels of iodine nutrition in population are more reasonable.Salt iodization strategy should continue to adhere to.

Objective:To study the expression and significance of transforming growth factor-β1 (TGF-β1) in nasal polyps.Method:Expression of TGF-β1 in nasal polyps from 34 patients and middle turbinates from 30 patients with deviation of nasal septum were prospectively studied with immunohistochemistry.Each tissue section was observed under optical microscope.Result:①The TGF-β1 positivity in extracellular matrix and in cells in the stroma was significantly higher in nasal polyps than in middle turbinates (P＜0.01).②The distribution and shape of TGF-β1 expressing cells in nasal polyps was similar to that of eosinophil,their positivities were significantly correlative (P＜0.05).③The positivity of TGF-β1 did not correlate with clinical type of nasal polyps (P＞0.05),eosinophil infiltration correlated significantly with clinical type of nasal polyps(P＜0.05).Conclusion:①The TGF-β1 may contribute to some of the pathologic changes observed in nasal polyps,such as thickening of the epithelial basement membrane and stromal fibrosis.②Eosinophils in nasal polyps represent a major source of TGF-β1.③Eosinophils infiltration may play a prominent role in the development and recurrence of nasal polyps.

OBJECTIVE To evaluate the association between the results of skin prick test (SPT) of dust mites and serum specific IgE (S-IgE). METHODS A total of 170 patients with allergic rhinitis received SPT and detection of S-IgE of Der p and Der f. The positive rates and grades of S-IgE to different diameters of skin reaction or skin index (SI) were compared. RESULTS The positive rates and grades of S-IgE showed significant differences among different diameters of skin reaction or skin index (SI) patients. The positive rates and grades of S-IgE increased significantly according to the diameters of skin reaction or SI. CONCLUSION There is a significant association between SPT of dust mites and S-IgE.