Objective To observe the symptoms,short and long term effects of body gama-knife in treatment of obstructive jaundice caused by cholangiocarcinoma.Methods 76 patients with obstructive jaundice caused by cholangiocarcinoma were treated with OUR-QGD body gamma-knife.The single therapeutic dose was 3.0-4.0 Gy,isodose curves was 50.0 ％-65.0 ％,the total treatment time was 10-12 times.The liver function,blood routine and adverse effects were monitored.Results Among 76 patients,the jaundice symptoms of 69 cases were significantly reduced,the TBIL and ALT levels were significantly lower than that before treatment (P ＜ 0.05),the ORR was 88.16 ％ (67/76),DCR was 90.79 ％ (69/76).The median TTP was 8.8 months and the median OS was 13.4 months.Conclusions Body gamma-knife treatment for obstructive jaundice caused by cholangiocarcinoma can significantly improve symptoms of patients,and improve their life quality.This treatment has less adverse effects and satisfaction short-time and long-term effects.

Objective: To establish a white noise-induced stress ulcer model in rats and to assess the changes of gastric parietal cell configuration and acid secretion under noise stress. Methods: Rats were randomly divided into 3 groups: NS 4 h,8 h and control groups. The rat NS model was induced by white noise. The pH values of gastric juice were measured by the pH/mV pH meter and the gastric ulcer index (UI) was evaluated. The stomach tissue was processed for immunofluorescence detection and the β subunit of H+, K+-ATPase was immunostained. The gastric parietal cell configuration was observed with conventional microscopy and confocal laser scanning microscope. Results: (1)The pH value of NS 4 h group (2.22±0.05) was significantly lower than that of control group (2.59±0.21, P<0.05), but higher than that of NS 8 h group (1.31±0.06, P<0.01). (2) The UI of NS 4 h group (10.5±1.29) was significantly higher than that of the control group (P<0.05), but significantly lower than that of NS 8 h group (34.36 ± 2.22, P < 0.01). (3) The reticular pattern parietal cells in NS 4 h group (55.5±3.42)/100 was significantly higher than that in control group (42.5±3.70/100, P<0.01), but lower than that in NS 8 h groups (62.0±3.46/100, P<0.05). (4) The pH was negatively related with both UI (r=-0.85, P<0.05) and the number of reticular parietal cells (r=-0.89, P<0.05). Conclusion: A white noise-induced stress ulcer model has been successfully established in rats. NS rats develop gastric mucosal lesions with increased acid secretion, which is closely related with the oxyntic function of parietal cells.

3D printing technology has become the focus of the study on rapid proyotyping technology in recent years. This paper introduced the principle, material and equipments of 3D printing, as well as the foot orthosis. This paper also summarized the application of 3D printing in custom-made foot orthosis, and the differences between 3D printing and traditional technology from the aspect of structure design, material, and clinical application, etc., and discussed the problems and future development of 3D printing.

Objective To evaluate the role of intercellular gap junction in lung injury induced by hemorrhagic shock and resuscitation in rabbits. Methods Twenty-four healthy rabbits of both sexes weighing 1.5-2.2 kg were used in this study. The animals were anesthetized with iv 3% pentobarbital 30 mg/kg,tracheostomized and mechanically ventilated. Femoral artery was cannulated for MAP monitoring, blood-letting.Right external jugular vein was cannulated for fluid infusion. Hemorrhagic shock was induced according to the method described by Wiggers. MAP was maintained at 35-40 mm Hg for 60 min. The animals were then randomly divided into 2 groups (n = 12 each):traditional treatment group (group A) and octanol group (group B). Both groups received rapid iv infusion of lactated Ringer's solution (LR solution) 1.5 ml·kg-1 ·min-1 for 30 min (T3 ).In group B 99.5% octanol (a specific gap junction inhibitor) 5 mmol/kg was injected intraperitoneally (IP) in addition to iv LR solution infusion. Thirty minutes later the animals were resuscitated with infusion of the blood withdrawn and LR solution (the volume was equal to the volume of blood loss). Then LR solution was infused iv at 2.5 ml· kg-1 · h-1 for 150 min ( T4 ). Left ventricular systolic pressure (LVSP) and HR were recorded before blood letting (T1), immediately after successful establishment of the model (T2), and at T3 and T4. The mortality during resuscitation was calculated. The animals were killed at T4. Blood samples were taken from femoral artery for determination of the serum protein concentration. The lungs were removed. The left lower lobe was lavnged. The protein concentration in broncho-alveolar lavage fluid (BALF) was measured. Lung permeability index (LPI) was calculated (LPI = protein concentration in BALF protein concentration in serum). Na+-K+-ATPase and Ca2+-ATPase activities and W/D lung weight ratio were determined and microscopic examination was performed. Results HR was significantly lower at T3 and T4 and LVSP higher at T4 in group B than in group A. The pulmonary permeability index, W/D lung weight ratio and mortality were significantly lower and the activities of Ns+-K+-ATPase and Ca2+ -ATPase were significantly higher in group B than in group A. The lung tissue danage was significantly ameliorated in group B. Conclusion Intercellular gap junction is involved in the development of lung injury induced by hemorrhagic shock and resuscitation in rabbits.

Humans ; Sleep Initiation and Maintenance Disorders ; classification ; diagnosis ; therapy

Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Methylprednisolone ; therapeutic use ; Mucocutaneous Lymph Node Syndrome ; diagnosis ; drug therapy ; gamma-Globulins ; therapeutic use

Objective To study the correlation between normal level of thyroid hormone and gensini coronary scor-ing system. Methods Coronary heart disease patient who were treated with Cardio-angiography (CAG) (n=231) were divid-ed into 4 groups based on gensini coronary score. All the patients were examined with indexes include total triiodothyronine (TT3), total thyronine(TT4), free thyronine(FT4), free triiodothyronine (FT3), thyroid stimulating hormone (TSH). And correla-tion between thyroid hormone level and gensini coronary scoring system was studied by Spearman correlation analysis and Multiple regression analysis. Results No significant difference was found in the levels of TT3, TT4, FT4, Cholesterol(CHO) and Triglyceride(TG) between the all 4 groups (P>0.05). FT3 and HDL-C decreased with the increase of extent of coronary artery lesions(P<0.01), and AGE and LDL-C raised with the coronary artery lesions extent (P<0.05). Gensini coronary scoring system was linearly negatively correlated with FT3, HDL-C and positively correlated with age and LDL-C. Age, FT3,HDL-C,LDL-C was independently correlated to Gensini score. Conclusion The lower level of FT3 is an indepen-dent risk factor for CHD.

Objective:The paper aims to evaluate the impacts of the urban residents’ basic medical insurance on the medical treatment and preventive care services utilization through quantitative evaluation. Methods:The China Health and Nutrition Surveys ( CHNS) Data collected from 2006 to 2011 were used to compare the difference between medical treatment and preventive care services utilization adopting the difference-in-difference method and the Probit model. The control group urban residents did not participate in the basic medical insurance while their treatment group participated. Results:The medical treatment and preventive care services utilization were more for the treat-ment group than they were for the control one. The age, education level, annual per capita income and hypertension influenced the medical services utilization, and the annual per capita income was a protective factor. The age and ed-ucation level also influenced the preventive care services utilization. Conclusion: The urban resident basic medical insurance plays an important role in the medical treatment and preventive care services utilization. Meanwhile, this factor continuously enhanced the coverage and the per capita income protection for medical services.

Objective To retrospectively study the character, surgical interventions of chordomas in the cervical spine. Methods All the clinical data of 8 cases of chordoma arising in the cervical spine which under went surgical treatment in our department from 1989 to 2006 were retrospectively reviewed, which including 5 males and 3 females. The patients ranged from 34 to 72 years at diagnosis, with an average age of 53.8 years. Surgical interventions were defined according to WBB criteria. 3 patients underwent subtotal centrum or total centrum resection, 2 patients underwent sagital resection and 2 patients received subtotal or total spondylectomy. Extracapsular excision was performed in a intradural invasion case. Autogenic iliac blocks were used as bone graft in 5 cases and titanium mesh with bone cement filling-in for anterior pedestal in 2 cases for reconstructing the stability of spine. Radiation therapy was given as an adjuvant treatment after surgery. Results Symptom of nerve root irritation disappeared or relieved prominently and the patients suffering spinal cord compression symptom got well recovery with at least 1 or 2 levels after operation. The typical “Physaliphorous cell” could be found in the oncologic examination in all those cases. Follow-up average 43.5 months, ranged from 3 to 120 months. All the internal fixation got well fusion and the rate of fusion for the bone graft was 100%. There were 4 cases in which the postoperative local recurrence of the tumor can be seen, with one patient dead of complications of high paralysis, but no local recurrence was observed in the cases which received total spondylectomy. No evidence of distant metastasis was observed in 7 cases for our series except the special intradural case which had the operation history for “sacral chordoma” before. So we consider it as a intradural metastasis case of the primary sacral chordoma. Conclusion Chordomas are rarely seen in the cervical spine and the typical clinical manifestation is rare in pristine cases. So we should think highly of the CT and MR examination for diagnosis. Total spondylectomy with postoperative radiation therapy could lower the rate of local recurrence.

Objective To analyze the effect of different medical insurance payments on medical expenses so as to provide some suggestions for Guangdong Provincial Department of Offsite Medical Insurance Administration in its future policy-making.Methods An statistic analysis was conducted of medical expenses among patients who chose different medical insurance payments and their average length of stay.Results Medical expenses and average length of stay were statistically different among patients who chose different payments.Conclusion The medicare reimbursement′s inclusion of prevention and diagnosis should be recommended to establish a flexible referral system, reinforce the payments reform and increase the efficiency of social security funds.