Objective To explore skills and values of needle-knife in difficult papillosphincterotomy.Methods 222 cases underwent needle-like fenestration(NKF),and other 194 cases directly underwent needle-knife papillotomy(NKP) using needle-knife.Results The success rate of operation in the NKF Group and NKP Group was 75.2%(167/222) and 97.9%(190/194) respectively,with total success rate 85.8%(357/416).Infections of biliary tract occurred in 5 cases(1.2%) after operation,in which 3 cases were treated by surgical biliary tract drainage,2 cases were placed drainage tubes under endoscope once again and administrated antibiotics for controlling infection.Pancreatitis occurred in 24 cases(5.8%) postoperatively,in which 1 case of acute severe pancreatitis was cured with abdominal paracentesis drainage in 3 sites,other 23 cases were given medical conservative treatment.1 cases had massive bleeding of incision and was cured by injecting sclerosing agent under endoscope.Conclusions Using niddle-knife can make papillotomy successful in most of standard EST or pre-cut failure.The success rate of NKP is significantly higher than that of NKF,and re-NKP can improve the success rate without increasing severe complications and death mortality,but NKP should be restricted to duodenal hypo-papilla and stenotic terminal of common bile duct.

Transient receptor potential vanilloid 1 (TRPV1) is a non-selective positive ion channel that is mainly expressed in sensory neurons and a member of transient receptor potential (TRP) family. The receptor could be activated by mechanical irritation, chemical irritation or endogenous ligand to mediate pains and cause injury to body functions. Traditional Chinese medicine believes that the mechanism of pain is that "stagnation leads to pain". Specifically, both of the contracture and tautness caused by cold and the blood stasis could result in blood impassability and pain. Most of traditional Chinese medicines for clearing heat and removing toxicity have the anti-inflammatory effect, while those for warming interior, and promoting blood circulation to remove blood stasis have the effect in smoothening blood vessels. Therefore, either with the anti-inflammatory effect or the effect in smoothening blood vessels, traditional Chinese medicines for clearing heat and removing toxicity, warming interior, and promoting blood circulation have the analgesic effect In this paper, the authors summarize the analgesic effect of the above three traditional Chinese medicines, with TRPV1 as the target.
Analgesics ; administration & dosage ; Animals ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Pain ; drug therapy ; genetics ; metabolism ; TRPV Cation Channels ; antagonists & inhibitors ; genetics ; metabolism

0.05).Conclusions Neither the new nor old SIRS diagnostic criteria had a high conforning rate with neonatal critical illnesses;There was no significant difference between them in each clinical item.It shows that the new SIRS diagnostic criteria is not superior to the old one,therefore we should improve the neonatal SIRS diagnostic criteria in the future.

Objective To explore the effects of the autoantibody against the second extracellular loop of ?3-adrenoceptor(?3AR)from children with heart failure on isolated cardiomyocytes of adult rats.Methods The synthetic peptide corresponding to the sequence of the se-cond extracellular loop(176-202 amino acid residues)of the human ?3AR was used as the antigen to screen the anti-?3AR autoantibodies from the sera of the 50 children with heart failure and 50 healthy children by enzyme linked immunosorbent assay(ELISA);IgG in the children with heart failure of positive autoantibodies sera was purified.The effects of purified IgG per each group on contractile response of isolated cardiomyocytes of adult rats were observed using motion-edge detection system and double-provocation fluorescence photomultiplier system.Results Among the 50 children with heart failure,the anti-?3AR autoantibodies positive rate was 30%(15/50 cases),and ob-viously higher than that of healthy children[12%(6/50)cases,P

Objective To explore for the methede and effect of endoscopic treatment on biliary leakage and biliary duct damage. Methods All patients with biliary damage such as biliary leakage and biliary duct stricture were treated by endoscopic sphincoterotomy and endoscopic nasobiliary drainage (ENBD) during abdominal cavity drainage ENBD was removd when biliary leakage healed and abdominal cavity drainage ceased for 1～2 weeks were confirmed. Plastic stents were implanted to distend the biliary duct stricture for 2-3 months. Results Twenty-six patients with biliary leakage were cured 3-4 weeks after ENBD. Fourteen out of 17 patients implanted with plastic stent were recovered uneventfully after stent removed, and 4 patients also recovered after installation of double-stents for 3 months, while another case with calculus and stricture of left hepatic duct in spite of implantation of simple-stent suffered repeatedly from biliary tract infection and one case developed hepatic abscess after repeatedly infection for one year before he had the hepatic lobectomy. Conclution Endoscopic therapy is the first choice in treating biliary leakage or secondary duct stricture.

Objective To observe the different expressions of androgen and estrogen receptor in nucleus membrane of human prostate stromal cells under anoxic or normoxic conditions.Methods Human prostate stromal cell line WPMY-1 was cultured in vitro.At 4,8,12,24,48 h after cellswere seeded,the mRNA and protein expression of androgen receptor (AR) and estrogen receptor (ER) in prostate stromal cells were tested by RT-PCR and immunohistochemistry method,respectively.Results The exprcssions of AR and ER were significantly increased in prostate stromal cells under anoxic conditions compared with under normoxic conditions.The relative expression of AR mRNA was 0.35±0.01 in anoxic prostate stromal cells at 4 h,and increased to 1.40±0.02 at 48 h,which was higher than in normoxic prostate epithelial cells [0.27 ± 0.01 and0.36± 0.01] synchronously (t=28.182,both P ＜ 0.001).Immunohistochemistry showed significantly increased AR-positive cells under anoxic conditions as compared with under-normoxiccondition from 12 h synchronously [(33.72±4.19) per 200 cells,(23.84±1.31) per 200 cells,t=3.902,P=0.018].The expression of ER mRNA was 0.39±0.01 in prostate stromal cells at 4 h,and increased to 0.59±0.01 at 48 h under anoxic conditions,which were higher than under normoxic conditions (0.31±0.01 and 0.46±0.13) synchronously (both P＜0.001).Immunohistochemistry showed the significantly increased ER-positive cells under anoxic conditions as compared with under normoxic condition from 4 h to 48 h synchronously [(13.42±0.80) per 200 cells and (55.16±0.41) per 200 cells； (9.68±0.63) per 200 cells and (22.95±0.55) per 200 cells,t=81.130,P＜0.001].Conclusions The expression of androgen and estrogen receptors is upregulated in human prostatestromal cells under anoxic conditions.

Objective To investigate the role of endoscopic sphincterotomy(EST)and endoscopic nasobiliary drainage(ENBD)in the treatment of non-biliary severe acute pancreatitis(SAP).Methods 73 patients were randomly divided into the endoscopic treatment group(35 cases)and control group(38 cases).The patients in control group received non-surgical treatment.EST plus ENBD were performed in patients in the endoscopic treatment group 72h within hospitalization.Serum levels of amylase before EST and 1d,3 d,7 d after EST were measured;the ease of pain and recovery of bowel function were documented;the mortality rate,complication rate,surgery rote and hospital stay were also observed.Results The successful cannulation rate in the EST group was 94.3%(33/35),and there was no procedure related complication.Serum levels of amylase before EST and 1d,3 d,7 d after EST were(1376±131)U/L,(675±49)U/L,(238±49)U/L,(75±13)U/L,the serum levels of amylase before EST and 1d after EST in the EST group were not significantly different from those in the control group,but the corresponding values at 3 d,7 d were significantly lower than those in the control group(P＜0.01).The apparent effective rate and total effective rate of pain relief was 37.1%and 48.6%.which was significantly higher than those in the control group (26.3%and 28.9%,P＜0.05).There was no mortality in both groups.The complication rate in the EST group within 30 d was 14.3%,which was signiilcanfly higher than that in the control group(44.7%,P＜0.01).The gurgery rate in EST group was 2.86%,which was significantly lower than that in the control group (21.1%,P＜0.05).The hospital stay in EST group was(27.6±4.0)d,which was significantly shorter than that in the control group[(41.7±5.9)d,P＜0.05].Conclusions EST and ENBD treatment for non-biliary SAP was superior to non-surgical treatment within 72 h of symptom onset with excellent safety and feasibility profile.

Objective To evaluate the effectiveness of the treatment of slight and moderate benign prostatic hyperplasia(BPH)with large doses of cemilton by urodynamie test.Methods A systematic review of using large doses of cernihon only for 80 patients with BPH with 7 grade ＜ International Prostate Symptom Score(IPSS)≤20 grade.All cases with cemilton had been administered in a dosage of 750 mg,three times a day for one year.All were respectively given IPSS,postvoiding residual urine(PVR),maximum flow rate(Qmax)and pressure-flow(A-G)test in order to assess the effectiveness at pre-treatment and 3,6,12 months after treatment.Results All patients had followed up for(1.2±1.6)years,additionally 26 of those were removed and others had received complete follow-up.Before the treatment IPSS was(20.5±4.5)grade,PVR was(42.5±8.2)ml,Qmax was(10.2±2.3)ml/s,A-G was 56.5±12.8,PQmax was (54.8±13.7)mm Hg(1 mm Hg = 0.133 kPa),and 12 months later,IPSS was(11.0±3.3)grade,PVR was (15.9±7.4)ml,Qmax was(15.7±2.5)ml/s,A-G was 49.2±13.6,PQmax was(43.6±14.9)mm Hg.There were significantly difference between pre-treatment and post-treatment data of the urodynamics(P ＜ 0.05).Conclusions The effectiveness of the treatment of slight and moderate benign prostatic hyperplasia with large doses of cemihon are relatively satisfactory.Main post-treatment urodynamic parameters obviously improves than that of the pre-treatment.

Objective To investigate the value of ~1H-MRS in the diagnosis and prognosis of diffuse axonal injury(DAI).Methods A prospective imaging study was performed in 63 patients with craniocerebral injury admitted from October 2002 to April 2004.Sixty-three patients were divided into DAI group(27 cases)and Non-DAI group(36 cases)according to the result of the MRI.Then,the ratio of NAA/Cr,Cho/Cr,mINs/Cr,and GIx/Cr at basal ganglia and genu and splenium of corpus callosum was quantified using ~1H-MRS and compared between DAI group and Non-DAI group.Twenty healthy persons were served as control group.The relation between ~1H-MRS indexes and period of primary uneonciousness post-injury was analyzed.Results The results of NAA/Cr and Cho/Cr at genu and splenium of corpus callosum and basal ganglia of control group were 1.19?0.18,1.21?0.24;1.89?0.17,1.84?0.14; 1.57?0.16,1.85?0.25,which of DAI group were 0.83?0.24,2.92?0.78;1.25?0.35,2.54? 0.42;1.33?0.17,2.38?0.44,and those of Non-DAI group were 1.11?0.23,1.61?0.33;1.61? 0.22,1.93?0.26;1.49?0.23,1.89?0.29.The differences between them were statistically significant (P

OBJECTIVE: To investigate the clinical application and efficacy of ¹²⁵Ⅰ radioactive seeds implantation in the treatment of recurrent salivary gland carcinoma after external radiotherapy. METHODS: From July 2004 to July 2016, 43 cases of recurrent salivary gland carcinoma of the neck after external radiotherapy or surgery combined with external radiotherapy were treated. According to the conventional segmentation radiotherapy for head and neck cancer (once a day, 1.8-2.0 Gy each time, 5 days per week), the cumulative radiation dose of the patients in this group was calculated. In the study, 26 patients received 50-60 Gy, 7 patients received less than 50 Gy, 4 patients received 60-70 Gy, and 6 patients received more than 80 Gy (range: 80-120 Gy). The interval between the last external irradiation and local recurrence was 4-204 months, and the median interval was 48 months. Among them, 25 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation only and 18 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation after operation. The prescription dose was 100-140 Gy. The control rate, survival rate and disease-free survival rate were recorded to evaluate the side effects. RESULTS: The median follow-up time was 27 months (ranging from 2.5 to 149.0 months). Among them, the median follow-up time of adenoid cystic carcinoma patients was 31 months (range: 2.5-112.0 months), and the median follow-up time of mucoepidermoid carcinoma patients was 18 months (range: 5-149 months). The local control rates for 1, 3 and 5 years were 66.5%, 48.8% and 42.7%, respectively. The 1-, 3- and 5- year survival rates were 88.0%, 56.7% and 45.8%, respectively. The disease-free survival rates of 1, 3 and 5 years were 58.3%, 45.4% and 38.1%, respectively. There was no statistically significant difference in local control rate, survival rate, and disease-free survival between the radioactive seeds implantation group and the radioactive seeds implantation group after surgical resection. There were 2 cases of acute radiation reaction Ⅰ/Ⅱ and 3 cases of reaction Ⅲ or above. In the late stage of radiotherapy, there were 8 cases with Ⅰ/Ⅱ grade reaction and 3 cases with Ⅲ grade or above reaction. The incidence of radiation reactions of Grade Ⅲ and above was 7%. CONCLUSION ¹²⁵Ⅰ radioactive seeds implantation provides an alternative method for the treatment of recurrent salivary gland carcinoma after external radiotherapy. The local control rate and survival rate are improved on the premise of low incidence of side effects.
Brachytherapy/adverse effects* ; Humans ; Iodine Radioisotopes/therapeutic use* ; Neoplasm Recurrence, Local/radiotherapy* ; Salivary Gland Neoplasms/radiotherapy* ; Salivary Glands