Objective To analyze the clinicopathologic factors related to the prognosis of gallbladder carcinoma.Methods A retrospective analysis was conducted on 61 cases of advanced gallbladder carcinoma who were operated on from 2001 to 2006 in Nanjing First Hospital.Results According to the 6th UICC/AJCC TNM classification and staging of gallbladder carcinoma,of the 61 patients,8 patients were stage IB,22 were IIA,11 were IIB,14 were III and 6 were IV.Palliative cholecystectomy and/or bile duct drainage procedures were performed in 24 patients;removal of gallbladder plus regional lymph nodes and fatty tissue dissections were performed in 14 cases;radical resection was performed in 7 patients;removal of gallbladder and part of liver in combination with resection of bile duct(radical operatian) was performed in 13 patients;1 patient had extensive radical operation including pancreaticoduodenectomy.In 37 patients,18 had positive lymph node metastasis.Fifty-two patients were followed up,41(67.2%) patients were alive at 6 months after operation,26(42.6%)were alive at 12 months,10(16.4%) were alive at 24 months,and 7 cases were alive at 36 months,1 patient is still alive 5 years after operation;51 patients died within 2 years after operation.The symptoms of recurrence in 31 patients included progressing jaundice(21 cases),metastasis in liver(14 cases),and refractory ascites(12 cases).Five patients died of non-bile duct disease.Conclusions The prognosis of gallbladder cancer has a close relationship with the clinical stage and method of resection.

Carcinoid tumors are relatively rare neuroendocrine malignancies most commonly originating from enterochromaffin cells in the gastrointestinal tract.Carcinoid syndrome occurs when tumor cells metastasize to the liver,as the vasoactive substances produced are able to reach the systemic circulation via the hepatic vein.The development of carcinoid heart disease (CHD) is thought to be related to the vasoactive substances secreted by the metastatic tumor cells in the liver,reaching the right heart.This is associated with deposition of fibrous tissue on the endocardial surfaces of the heart.Several series have reported CHD in up to 70% of cases of carcinoid syndrome.Somatostatin analogue use is a therapeutic cornerstone,effective in symptomatic control of the endocrine syndrome.In patients with severe cardiac involvement and well-controlled systemic disease,valve replacement surgery is an effective treatment modality that can relieve intractable symptoms and contribute to improved outcome.

Objective To study the relevant position of atlas pedicle to axis lateral mass, set up a technique of C1 pedicle screw placement with the lateral mass of axis as an anatomic landmark, and evaluate the reliability of the present screw placement technique by clinical practice. Methods 50 paired atlas and axis specimens were used to measure the distance from the sagittal midline to the medial border, the midpoint (the middle point of the mediolateral border) and the lateral border of C1 pedicle and C2 lateral mass. Furthermore, the distance between the medial border of C1 pedicle and that of C2 lateral mass, the distance between the midpoint of C1 pedicle and that of C2 lateral mass and the distance between the lateral border of C1 pedicle and that of C2 lateral were calculated respectively. The technique of C1 pedicle screw fixation was established. Using the present landmark technique, C1 pedicle screws were placed in 6 patients of atlantoaxial instability, including 5 males and 1 female averaged 41 years old, with os odontoideum in 1, odontoid hypoplasia in 3, and old odontoid fractures in 2. Results The medial border, the midpoint and lateral border of C1 pedicle was averaged (1.37?0.51) mm, (1.60?0.61) mm and (2.15?0.60) mm medial to C2 lateral mass, respectively. The entry point of C1 pedicle screw in present technique was defined as the method of making a vertical line through the midpoint of C2 lateral mass, and the entry point was 3 mm under the cross point of the superior rim of C1 posterior arch with the vertical line. 12 C1 pedicle screws were placed exactly in all 6 patients, and no neural or vascular injury was observed. The postoperative radiographs and CT scans verified all of C1 screws with a good position. Conclusion There is a steady anatomic relation between C1 pedicle and C2 lateral mass, the C2 lateral mass could be as a convenient anatomic landmark to determine the location of C1 pedicle and the position of C1 pedicle screw entry point.

Objective To investigate the changes and correlation between nuclear factor-?B (NF-?B) expression and brain water content (BWC) in perihematoma after experimental intracerebral hemorrhage (ICH) in rats. Methods Experimental ICH models of rat were made by injecting autologous blood using stereotaxic method. The expression of NF-?B in cerebral tissues was detected by immunohistochemistry technique. At the due time, BWC was measurement by day-wet method.Results NF-?B expression increased obviously at 6 h and peaked at 48 h in ICH group(P

HIFU treatment allows the destruction of a precise volume of tissue within an tumour without harming surrounding structures.The FEP-BY02 model is one of commercially available machines based on this technique,which is proved effectively in clinical practice.It's basic architecture,functional principle and some suggestions for safety use are introduced in this paper.

After introducing the predominance and status of remote maintenance,the paper lays emphasis on analyzing its application in medical equipment and problems to be solved in the development.Besides,the developing trend of remote maintenance is forecasted.Remote maintenance is one of the development directions for medical equipment maintenance support.

Objective To investigate the value of DWI imaging combined with T2WI imaging and CT image fusion technology and explore the role of DWI imaging in the determination of target areas in radiotherapy for advanced esophageal cancer.Methods Twenty-three patients with locally advanced esophageal cancer were included in this study.All the patients were fixed by a heat plastic device.Each patient was examined by CT,T2WI and DWI scan in the same position as the radiotherapy treatment.Images obtained from the three sequences were transmitted to the Eclipse 11.0 treatment planning system.All images were registered at Eclipse workstation as to normalized mutual information registration.The target areas were delineated by the clinical radiation physicians in the CT imaging,and CT and DWI fusion images.The target areas of the two kinds of image were evaluated using fusion function and statistical function of the treatment planning system.Results Target parameters differed significantly between CT base and CT/MRI fusion base.The results of the target volume outline closer by CT and MRI fusion image base in the three groups of clinicians.Conclusion The target volume between the groups is closer by using CT and DWI fusion image.DWI image has a good assisting effect in determining the target area of locally advanced esophageal cancer.

Objective Short-segment fixation is one of the most commonly used methods for the management of thoracolumbar vertebral fractures.In this study, we compared the clinical effects of short-segment fixation via and across the injured vertebrae in the treatment of thoracolumbar vertebral fractures . Methods We retrospectively analyzed 75 cases of thoracolumbar vertebral fractures treated by short-segment fixation, 39 via the injured vertebrae (group A) and 36 across the injured vertebrae (group B).We obtained the pre-and post-operative anterior vertebral body height ratio (AVBHr) and sagittal Cobb angle, operation time, and intraoperative blood loss, and compared them between the two groups of patients . Results Compared with the baseline, the AVBHr and the sagittal Cobb angle were significantly restored after surgery in both groups A ([56.32 ±12.53] vs [85.76 ±11.48]%and [20.41 ±5.73] vs [8.72 ±5.34]°, P<0.05) and B ([57.67 ±13.81] vs [83.51 ±12.54]%and [19.87 ±5.76] vs [9.18 ±5.42]°, P<0.05).The last follow -up examinations showed the AVBHr and Cobb angle to be (81.74 ±10.38)% and (10.93 ±6.32)°in group A and (76.82 ±11.06)%and (15.42 ±6.14)°in group B (P<0.05), with statistically significant differences from the postoperative parame-ters in group B (P<0.05).However, no remarkable differences were found between the two groups in the operation time or intraopera-tive blood loss (P>0.05).The losses of the AVBHr and Cobb angle were (3.78 ±1.24)%and (2.25 ±1.06)°in group A, signifi-cantly lower than (6.69 ±2.52)% and (6.31 ±2.18)°in group B (P<0.05). Conclusion For thoracolumbar fractures, short-segment fixation either via or across the injured vertebrae can effective-ly improve the vertebral height and Cobb angle , but fixation via the injured vertebrae may achieve a better maintenance of correction .

The rates of chronic obstructive pulmonary disease ( COPD) and lung cancer morbidity in Xuanwei city of Yunnan province are among the highest nationwide , and COPD is an major risk factor for lung cancer .The concur-rence of COPD and lung cancer is a common disease .There are common causative environmental risk factors and pathogenic processes between the two diseases , which provides new ideas for the research , prevention and treatment of both diseases .Additionally the discussion of the relationship between COPD and lung cancer can provide refer -ences for further studies of both diseases .

Objective To investigate the security and validity of transabdominal preperitoneal prosthetic (TAPP) in treatment of incarcerated hernia.Methods One hundred and twenty-four patients with incarcerated hernia were divided into 2 groups by random pair method:observation group with treatment of laparoscopic reposition and TAPP (56 cases) and control group with treatment of open reduction and tension-free hernioplasty (68 cases).The operative time,hospital stay,bed time,hospital costs,recurrence rate and complication were compared between the 2 groups.Results All patients in observation group were received laparoscopic surgery successfully.The operation time,hospital stay,bed time in observation group were significandy shorter than those in control group [(37.52 ± 7.78) min vs.(44.23 ± 11.32) min,(4.53 ± 0.89) d vs.(6.85 ± 2.03) d,(9.30 ± 2.65) h vs.(12.63 ± 3.97) h],there were statistical differences (P ＜0.05).The hospital costs in observation group was significandy higher than that in control group [(9 324 ± 599) yuan vs.(7 203 ± 507) yuan],there was statistical difference (P ＜ 0.05).There was no statistical difference in complication rate between the 2 groups (P ＞ 0.05).Follow-up 1 year,there was no recurrence patient in observation group and 1 patient was recurrence in control group,there was no statistical difference between the 2 groups (P ＞ 0.05).Conclusions TAPP is safe and effective with advantages of mini-invasion,quicker recovery but more hospital costs in treatment of incarcerated hernia.The recurrence rate of TAPP is similar to tension-free hernioplasty.