Objective To evaluate the clinical effect of Tiaoxie Wan(Chinese medicine for regulating the metabolic functions)on the metabolic syndrome.Methods Under the condition without changing their original treatment,the 62 metabolic syndrome patients were administered Tiaoxie Wan for oral taking in succession for 2 months.The blood lipid,glycolated hemoglobin(HbA1C),fasting insulin(FINS),insulin action index(IAI),body mass index(BMI),and the clinical effect of main symptoms were observed.Results After treatment,the symptoms such as dizziness,dry mouth,constipation,abdominal distention,and hot temper with irritability were significantly relieved,the total effective rate was all above 85%.The BMI,blood lipid,and HbA1C were significantly decreased,while the FINS and IAI were significantly increased(P

Primary carcinoma of the gallbladder(PCG) is the most common malignant tumor in biliary system and its morbility has been rising year by year in our country.Because there is no specific clinical manifestation,patients diagnosed finally as PCG have mostly been in intermediate or advanced stage,thus losing the chance of radical resection of gallbladder carcinoma and having a poor prognosis.In this article we analyze the high risk factors,diagnosis of imageology,study of molecular biology,therapeutic progression and existent problems about PCG,by reviewing the related literature about diagnosis and treatment of PCG and the clinical data of 945 patients with PCG who were treated in our hospital in recent fifty years.We realize that early diagnosis of PCG is still difficult nowadays,it is very significant for secondary prevention of PCG to continue to carry out the foundamental and clinical study of PCG.Combined therapy that mainly includes surgical operation remains cardinal therapeutic management,and gene therapy has gradually developed to become a new therapy and displays favourable prospect of application.

Objective To discuss the efficacy and safety of transurethral plasmakinetic resection of the prostate(PKRP) for benign prostatic hyperplasia(BPH).Methods A British made Bipolar plasmakinetic resection system(Gyrus) was employed in this series.Started from the 6 o’clock point,the middle lobe of the prostate was resected,followed by the left and right lobes,which were resected down to the prostate capsule.And then the bladder neck was cut down.The apical tissues were resected to the anterior border of the seminal colliculus.After the operation,a F22 three-channel catheter was indwelled for 3 to 5 days after the operation,and a balloon was place in the bladder neck.Results The procedure was completed successfully in all of the cases with a mean operation time of(85.0?12.0) min,and a median blood loss 115.0 ml(30 to 650).Ten patients received blood transfusion during the operation(200 to 400 ml).No case showed transurethral resection syndrome or obturator nerve reflex.Fourteen patients developed inflammatory stricture of the anterior ureter and was then cured by dilating the urinary tract;15 cases showed transient urinary incontinence and was cured after pelvic floor muscle training for 1 to 3 weeks.Follow-up was available in the patients for 1 to 6 months,during which the mean Qmax of the patients significantly increased compared to that preoperation [from(7.6?2.4) ml/s to(22.6?3.4) ml/s,t=13.582,P=0.000),and the IPSS and life quality score markedly decreased [from 27.3?1.5 and 4.3?0.4 to 7.0?1.2 and 2.1?0.8;t=16.394 and 9.761,P=0.000 and 0.005,respectively] Conclusion PKRP is an effective and safe treatment for BPH.

Using immunoblotting analysis and salt-split skin indirect immunofluorescence, we studied sera from 5 patients with bullous systemic lupus erythematosus (BSLE) and 55 control subjects,including 20 cases of SLE, 20 cases of bullous pemphigoid (BP),5 cases of epidermolysis bullosa acquisita (EBA) and 10 normal volunteers. The results showed that the sera from 3 of 5 BSLE patients combined with dermal side of saltsplit skin and 290 000 antigen of dermal extracts in human skin. Sera from 2 BSLE patients which reacted with 290 000 antigen also combined with 165 000 antigen of epidermal extracts. Sera from SLE patients did not combined with both 290 000 and 165 000 antigens. The results suggest that there are EBA antibody and BP antibody in BSLE. We consider that EBA antigen and BP antigen may be the related antigens of skin basement membrane zone in BSLE.

ve To investigate the possible role of platelet endothelial cell adhesion molecule-1 (PECAM-1) in the lung injury induced by mechanical ventilation. Methods Twenty-four healthy small pigs of either sex, weighing (17.5?2.5) kg were randomly divided into four groups according to the tida volume of mechanical ventilation: control group without mechanical ventilation; low tidal volume group (A) VT=6 ml?kg-1; normal tidal volume group (B) VT=12ml?kg-1; high tidal volume group (C) VT =25ml?kg-1. The animals were anesthetized with intramuscular ketamine 15-20mg?kg-1 and diazepam 1.5-2.0mg?kg-1 and intubated and mechanically ventilated. Anesthesia was maintained with infusion of ketamine, procaine and succinylcholine. Respiratory rate was set at 18 bpm, I:E=1:2 and FiO2=35% , Femoral artery and vein were cannulated for intra-arterial pressure monitoring, blood sampling and infusion of fluid and anesthetics. ECG, rectal temperature and urine output were monitored. Venous blood samples and lung tissue from right lower lobe were obtained on 1st, 3rd and 7th day of mechanical ventilation for determination of serum and lung myeloperoxidase (MPO) activities, expression of PECAM-1 protein on pulmonary vascular endothelium cells and electron microscopic examination. Results The serum and lung MPO activities were higher in group A, B and C than those in control group (P

Objective To analyze the factors influencing the prognosis of patients with bile duct carcinoma after resection. Methods The clinical data of 120 patients with bile duct carcinoma receiving resection in our hospital from 1980 to 2004 were collected retrospectively and clinicopathologic factors that might influence survival were analysed. A multiple factor analysis was performed through Cox proportional hazard model. Results The overall 1-year, 3-year and 5-year survival rates were 71.7%, 32.5% and 19.2% respectively. The single factor analysis showed that the major significant factors influencing survival of these patients were histological type of the lesions, lymph node metastasis, pancreatic infiltration, duodenal infiltration, resected surgical margin, perineural infiltration, peripheral vascular infiltration and depth of tumor infiltration (P

Gallbladder volvulus is defined as the rotation of the gallbladder on its mesentery along the axis of the cystic duct and cystic artery. It is an unusual and rare occurrence with a predilection for women in their sixth or eighth decades of life. Only about 400 cases have been reported in the literature. The etiology of gallbladder volvulus remains speculative; however, the presence of a redundant mesentery is a prerequisite for torsion. Clinical symptoms are non-specific. Some form of right upper quadrant abdominal pain is nearly always present. Although recent advances in radiographic studies have aided in the diagnosis of many diseases,radiographic studies remain nonspecific in diagnosing gallbladder torsion. Laboratory evaluations are often nonspecific. An elevated white blood cell count is a frequent finding.Liver function tests are commonly normal. Gallbladder volvulus leads to gangrene or perforation because of occlusive obstruction of biliary drainage and blood flow. With early diagnosis and surgical intervention, the disease maintains a low mortality. Here, we present a review of the literature about gallbladder volvulus in order to enhance recognition of gallbladder volvulus.

To discuss the status quo of gallbladder cancer in China,88 articles published in China were collected and the clinical data of 7882 patients who were suffering from gallbladder cancer was analyzed.The requirements for the literature were:domestic articles published from 1980.1 to 2008.6,the gallbladder cancer cases must exceed 50,the cases must come from the same domestic hospital,and if the cases were reduplicative,the maximum were selected.Analysis of the data showed that primary carcinoma of the gallbladder was the most common malignant tumor in the biliary tract,with a higher incidence in females than males.The cancer's pathologic characteristics of undiscoverable growth and poor differentiation led to its clinical significance of difficult early stage diagnosis,high degree of malignancy,poor prognosis,and adenocarcinoma formation.Although the technique of surgical operation has constantly progressed over time,gallbladder cancer surgery possesses a lower rate of radical resection.Every biliary surgeon should brainstorm and deliberate about how to face the status quo of gallbladder cancer in China.This article participates in that discussion by identifying several noticeable problems in the diagnosis and treatment of gallbladder cancer.

Objective To evaluate the advances in minimally invasive surgery treatment for hepatolithiasis. Methods Literatures about the advances in minimally invasive surgery treatment for hepatolithiasis were collected and reviewed. Results Hepatectomy and bile duct exploration using laparoscopy can get better effect. Fibrocholedochoscopy play an important role in the course of operation and after operation for hepatolithiasis. Conclusion The individualization treatment program should be used for hepatolithiasis. Association application of multipathway minimally invasive operation, such as laparoscopy, fibrocholedochoscopy and so on, can increase the cure rate of hepatolithiasis.

Objective To study the significance of expression of VEGF in the hepatocellular carcinoma tissue(HCT) and the expression of AFPmRNA in the peripheral vein blood in hepatocellular carcinoma patients(HCC) with metastasis. Methods AFPmRNA was detected in peripheral blood before operation and the expression of VEGF in HCC tissue was analyzed by immunohistochemistry after operation in 20 patients. The relations between the expression of VEGF protein and AFPmRNA with clinicpathological parameters were analyzed statistically. Results (1)Among the 20 patients with HCC, 10 were positive expression of VEGF protein, which had no relation with the clinicopathological parameters. (2)Of the 20 patients, positive expression of AFPmRNA were detected in the peripheral blood in 15 patients, and AFP≥200?g/L were found in 13 patients.(3) AFPmRNA in the peripheral blood vein was detected in 9 of 10 patients with VEGF positive expression. Conclusions (1)Either VEGF protein expressed in HCC tissue or AFPmRNA detected in the peripheral blood could be as a guide line to judge the tendency of the metastasis of HCC,however former is simpler and the later is more sensitive . (2)The detection of AFPmRNA in the peripheral blood is more sensitive than the detection of serum AFP lever for surveillance of the high risk patients and postoperative follow up of the patients with HCC.