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 calculate the health efficiency of government health expenditures in 1990 , 2000 and 2010 and analyze its determinants. Methods:To calculate the health efficiency of government health expenditures and analyze its determinants by using the DEA-Tobit model. Results:Health efficiency of government health expenditures has been increasing gradually;the same provinces are found to be on the productive frontier, but the provinces off the frontier are different;eastern provinces have a higher efficiency than those in the middle and western regions. Fiscal decentralization has a significant negative impact on health efficiency. Conclusion:The current Chinese fiscal decen-tralization system reform is important to improve the health efficiency of government health expenditures.

Objective To study the effect of Schwann cell enclosed by antibody of neural cell adhesion molecule L1 on injured spinal cord. Methods Over 98% of the purity of Schwann cells obtained from bilateral sciatic nerves of 2 days newborn SD rats, the concentration of Schwann cells was about 2.5?104 /?l. The Schwann cells were enclosed by the antibody of neural cell adhesion molecule L1 using co-culture. The adult SD rats (weight 200-250 g) were used to establish the model of spinal cord injury by hemi-transection at the left side of T10 level. The animals were divided into three groups; the SC group was transplanted with 20 ?l suspension Schwann cells; the anti-L1 group with 20 ?l Schwann cells enclosed by antibody of neural cell adhesion molecule L1; and the control group was injected solely with normal saline to the injured cord. Eight weeks later regenerated neural axons were investigated through horseradish peroxiase HRP retrograde trace immunohistochemistry of neurofilament and Western blot. Results Few regenerated neural axons appeared in the control group; some of regenerated neural axons could be observed in anti-L1 group; plentiful and bulky regenerated neural axons were found in SC group. The group with antibody had significant less HRP positive neurons and neural axons than the group without antibody. Western blot showed that the quantity of neurofilament in the anti-L1 group was only two thirds of the SC group. Conclusion Schwann cell-derived neural cell adhesion molecule L1 is able to enhance the neural axon regeneration of injured spinal cord.

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

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

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.