Objective To investigate the feasibility of a new clinical staging of primary liver cancer (PLC). Methods 1*!038 PLC cases were surgically treated in our hospital from January 1990 to December 1998. Of those, 504 patients receiving liver resection were classified with the TNM staging and new clinical staging. Both staging systems were correlated with survival rates. Results In TNM staging, 24 cases (4 8%) were in stage Ⅰ, 66 cases (13 1%) in Ⅱ, 385 cases (76 4%) in Ⅲ, and 29 cases (5 8%) in Ⅳa. The 5 year survival rates were 79 2%, 62 1%, 32 2% and 0, respectively. As with the new clinical staging, 27 cases (5 4%) were in stage Ⅰa, 81 cases (16 1%) in Ⅰb, 224 cases (44 4%) in Ⅱa, 141 cases (27 9%) in Ⅱb, and 31 cases (6 2%) in Ⅲa. The 5 year survival rates were 70 3%,53 1%,40 2%, 22 7% and 0 respectively. Conclusion While both the TNM staging and new clinical staging have significant correlation with the selection of treatment and evaluation of prognosis, the new staging is more useful in clinical practice.

Objective To explore whether there is enough clinical evidence to confirm that hyperbaric oxygen (HBO) does more good than other treatments in treating patients with diabetic peripheral neuropathy. Methods Published clinical trials on hyperbaric oxygen treatment for diabetic peripheral neuropathy were collected through electronic searches of PubMed, the Cochrane Central Register of Controlled Trials, EMbase, Science Citation Index Expanded, the China Biological Medicine Database (CBM-disc), the Chinese National Knowledge Infrastructure (CNKI) and the VIP Database for Chinese Technical Periodicals (from the date of establishment of the databases to July 2010). The bibliographies of the retrieved articles were also checked. Results A total of 7 trials involving 446 patients with diabetic peripheral neuropathy were included. All studies reported positive results regarding the effects,but the quality of the studies was generally poor. The main problem was that most trials were reported as randomized and controlled, but with no description of the methods of randomization, concealment and blinding. Conclusions HBO in the treatment of diabetic peripheral neuropathy is promising based on present evidence. However at present,definite conclusions cannot be drawn about whether hyperbaric oxygen treatment is superior to the alternatives for patients with diabetic peripheral neuropathy. Higher quality randomized and controlled trials are required.

Adult ; Aged ; Female ; Humans ; Lymphoma, Follicular ; diagnosis ; Male ; Middle Aged ; Prognosis ; Young Adult

?AlM: To compare clinical efficacy between Ahmed glaucoma valve implantation and trabeculectomy in patients with primary open angle glaucoma ( POAG) .
?METHODS: This retrospective study included 58 eyes from 45 patients with primary open angle glaucoma. And 32 eyes underwent penetrating trabeculectomy ( group A), while 26 eyes were performed Ahmed glaucoma valve implantation ( group B) . lntraocular pressure ( lOP) , best-corrected visual acuity ( BCVA ) , visual field and post-operative complications were observed between these two groups.
?RESULTS:(1) lOP:the lOP of post-operation in group A were (13. 56±4. 91), (14. 47±4. 03), (17. 56±5. 74), (18. 25±5. 49), (18. 13±4. 24), (19. 68±4. 55) mm Hg at 2d, 1, and 2wk, 1, 3 and 6mo respectively; and that were (13.58±4. 16), (16. 00±4. 83), (18. 00±5. 05), (19. 42±5. 41), (18. 42±3. 37), (20. 00±5. 37) mm Hg in group B. There was no statistically significant difference in lOP between the two groups ( P> 0. 05 ). ( 2 ) BCVA: the number of visual acuity decreased eyes, with 6mo follow-up, was 7 (22%) in group A; and that was 5 in group B (19%). There was no statistically significant difference in vision loss postoperatively between the two groups (χ2=0. 061, P>0. 05). (3) Visual field: with 6mo follow-up, there were 13 eyes ( 41%) which had constricted visual field in group A, while those were 10 eyes (38%) in group B; the difference of visual field loss between the two groups was not statistically significant (χ2 = 0. 028, P>0. 05 ) . ( 4 ) Complications: six-month follow-up after operation, there were 4 eyes with shallow anterior chamber, 4 eyes with complicated cataract and 1 eyes with Descemet’s membrane detachment in group A, while that was 1 eyes with shallow anterior chamber and 1 eyes with complicated cataract in group B; there was statistically significant difference in the rate of complications between the two groups (χ2 = 4. 144, P<0. 05 ) . ( 5 ) Surgical success rate: six month after operation, the completed success rate was 37% (12 eyes) in group A, and that was 35% (9 eyes) in group B. The partial success rate was 19% (6 eyes) and 15% (4 eyes) in group A and group B respectively. The difference of success rates between the two groups was not statistically significant (χ2=0. 225, P>0. 05).
? CONCLUSlON: Both Ahmed glaucoma valve implantation and trabeculectomy are effective methods for the treatment of POAG. The clinical efficacy was no difference between the two methods. However, compared with trabeculectomy, Ahmed glaucoma valve implantation was safer and had fewer complications.

The effect of triptolide on proliferation and apoptosis of human multiple myeloma RPMI-8226 cells in vitro, as well as the roles of nuclear factor-kappa B (NF-κB) and IκBα was investigated. The effect of tritptolide on the growth of RPMI-8226 cells was studied by MTT assay. Apoptosis was detected by Hoechest 33258 staining and Annexin V/PI double staining assay. The expression of NF-κB and IκBα was observed by Western blot and confocal microscopy. The results showed that triptolide inactivated NF-κB apoptotic pathway in human multiple myeloma RPMI-8226 cells. Triptolide at nM range induced proliferation inhibition in a dose- and time-dependent manner and apoptosis in a dose-dependent fashion in RPMI-8226 cells. Besides, we observed the inhibition of NF-κB /p65 in the nuclear fraction was correlated with the increase in the protein expression of IκBα in the cytosol. These results suggested that triptolide might exhibit its strong anti-tumor effects via inactivation of NF-κB/p65 and IκBα.

Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiac conduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed, such as difficulty of sinus electrode implantation, coronary sinus injury and bleeding, still one third CRT cases remain unchanged cardiac function.Recently the epicardial lead CRT therapy by the cardiac surgeons appears promising to provide better clinic resynchronization.The aim of this research is to explore the clinical value of surgical epicardial lead CRT for the cardiomyopathy heart failure with micro-invasive thoracoscopy techniques. Methods During April 2007 to Sep 2009 eleven patients were diagnosed as advanced heart failure with cardiac dysynchronization proven by the ECG and tissue Doppler echo examination. The dysynchronization parameters of tissue Doppler echo includes left ventricle maximize delay time , the left dysynchronization index (Ts-SD), the inter-ventricle mechanical delay time (IVMD), left ventricle end-dilation diameters (LVEDD) and the left ventricle ejection fraction (LVEF). All the patients got the consent agreement before the surgery. In the hybrid operation room the right atrial and ventricle endocardial electrodes were placed firs guided by X ray under the general anesthesia and double lumnen incubation. Then the thoracoscope techniques were used to explore the left ventricle lateral wall. The right atrial and ventricle electrodes were connected into the three chamber pacemaker. The Tissue Doppler Echo TEE technique was used to check which part of the left ventricle lateral wall is suitable for the idea CRT therapy. Usually the latest activated part of the left ventricle wall is the goal place. Then the epicardial electrode was fixed with 4-0 prolene suture at the idea place. All the cases were performed by the same surgeons group in the same medical center. The resynchronization features were examined after surgery and during the follow up. Results The endocardial and epicardial electrodes were implanted successfully without any serious complication. All patients were weaned and discharged without any adverse cardiac episodes. There is no mortality during the follow up period. All the patients received the β-blokers, diuretics, ACEI/ARB and other traditional medicine for the heart failure.The Tissue Doppler showed the E peak wave separated form the A peak which means the good resynchronization between the atrium and the ventricle. After surgery during the follow up the left ventricle maximize delay time decreased from (393.4 ±40.2 ) ms to ( 102.1 ± 34.6) ms, the left dysynchronization index (Ts-SD) decreased from (145.2±29.3)ms to(51.0±21.4) ms, the inter-ventricle mechanical delay time (IVMD) decreased from (59.1 ±23.4) ms to (31.2 ± 11.5 ) ms, left ventricle end-dilation diameters increased from (73.1 ± 13.4) mm to (63.2 ± 6.7) mn and the left ventricle ejection fraction increased from 0.32 ±0.04 to 0.41 ±0.07. Conclusion The micro-invasive surgical synchronization therapy could get good CRT result for the cardiomyopathy heart failure patients. Some patients traditionally in the waiting list for the heart transplant could be considered for the CRT therapy candidates.

ObjectiveTo study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis (TA). MethodsThe clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. ResultsThere were 136 female and 37 male patients in this study. The mean age at onset was(26±11 ) years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6％, 41.1％, 28.7％ of patients, respectively. The distribution of arterial involvement were 64.7％in aorta, 9.8％ in pulmonary artery, 19.1％ in innominate artery, 65.9％ in common carotid arteries, 65.3％in the subclavian artery, 36.2％ in the renal artery, 12.1％ in the vertebral artery, and 5.8％ in coeliac axis.Elevated erythrocyte sedimentation rate(ESR) was found in 61.0％ patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients(26.0％). Ten patients(5.8％) were hepatitis B virus carriers.Among 105 followed-up patients, 98 patients(94.2％) achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. ConclusionCorticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.

Objective To compare the mid-term results of video-assisted pulmonary veins isolation and box-lesion for lone atrial fibrillation.Methods Between June 2010 to November 2012,80 lone atrial fibrillation(LAF) patients underwent minimally invasive surgical ablation in Beijing Anzhen Hospital,and all of them received left atrial appendage excision and Marshall ligament break in the surgery.Among them,37 cases were performed two epicardial ablation lines in order to created box-lesion based on PVI(14 paroxysmal AF and 23 persistent AF).Follow-up was finished after discharge.Results Mean follow-up was(18.8 ± 7.4) months,and 2 patients were died with non-cardiac disease.The success rate is 78.8％ (Paroxysmal AF 87.9％;Persistent AF 72.3％).In the paroxysmal AF patients,the success rate for PVI and Box lesion treatment was 84.6％ (11/13) and 92.9％ (13/14),P =0.45;in the persistent AF patients,the success rate for PVI and Box-lesion was 58.3％ (14/24) and 87.5％ (14/16),P =0.04.Conclusion Addition of epicedial ablation lines might increase the cure rate for lone AF therapy,especially for persistent AF.

Objective To summarize the experience in hepatic artery reconstruction in adult-to-adult living donor liver transplantation(ALDLT).Methods Fifty patients underwent ALDLT in our hospital from January 2002 to July 2006.All the hepatic a~ery reconstructions were done under surgical microscope.ResultsTwo patients(4%)presented with hepatic artery thrombosis.All the patients were followed up for 2 to 52 months (median,9 months),and no hepatic artery stenosis nor hepatic artery pseudoaneurysm occurred.The 1-year survival rate was 92%(46/50).Conclusions Systematic evaluation of hepatic artery reconstruction and use of microsurgical technique are key to the reduction of complications of hepatic artery reconstruction in ALDLT.

Objective To investigate the clinical results of extracorporeal membrane oxygenation (ECMO) technique during the peri-operative heart transplantation. Methods The clinical data of heart transplantations supported by the ECMO were retrospectively analyzed, including during the bridge to transplant, working as routine bypass in the operation room, and supporting the heart failure after surgery. Results Three 3 cases were supported with ECMO to extend the waiting time: 2cases died of multi organ failure during the waiting, and the third one received the heart transplant and the ECMO was successfully removed. Totally 12 cases of heart transplantation received the modified open style ECMO techniques replacing the routine bypass. The ECMO was removed after assistance for (38 ± 14) h. All the recipients except one death recovered well without right ventricular failure or obvious tricuspid regurgitation which was common after heart transplantation. Ten cases received ECMO support for the heart failure after the transplant. The initial application time ranged from 2 h to 2 days and lasted 43～176 h. One died of infection and two died of multi organ failure nothing to do with ECMO application and other 7 discharged with NYHA Ⅰ/Ⅱ cardiac function. Conclusion Early use of ECMO could safely bridge the heart failure patients to the transplant. Replacing the routine with ECMO techniques in the heart transplantation could get good myocardial protection results even with long cold ischemic time and improve the cardiac function recovery. For the heart failure patients after the surgery the ECMO could afford good support effect.