Objective To evaluate the therapeutic effectiveness and safety of combining chemoembolization using microspheres with iodized oil in the treatment of patients with hepatocellular cancer.Methods According to the inclusion and exclusion criteria,two reviewers independently completed the whole process of data search,selection,collection and quality assessment.The Medline,Cancer Lit,PUBMED,EMBASE,Cochrane Library,CNKI,CBM,VIP,Wanfang Data and Grey literature were searched for randomized controlled trails (RCTs) on combining chemoembolization using microspheres with iodized oil in the treatment of liver cancer.The search was from January 2005 to December 2012.The software package Rev Man 5.1 (the Cochrane collaboration) was used to conduct the Meta-analysis and to analyze the data.Results Of the 159 trials selected out from January 2005 and December 2012 for review,only five RCT involving 471 patients were finally included into the analysis.When compared with chemoembolization by iodized oil alone,the combination treatment significantly improved the therapeutic effectiveness (CR + PR).However,there was no obvious difference between the two methods of treatment in the incidence of adverse reaction.Conclusions Combining chemoembolization using microspheres with iodized oil for patients with hepatocellular cancer was effective in controlling liver cancer progression.There is still a need to reduce the incidence of adverse reaction in future.

Objective:To analyze the high risk behaviors of HIV/AIDS and its influencing factors in men who have sex with man(MSM)in a city,so as to provide evidence for the targeted intervention.Methods:Between July 2006 and October 2006,1000 MSM were sampled by snowball sampling and had a face to face interview by well trained investigators with informed consent.Questions on age,education background,and sex orientation were designated and 3 ml blood samples were obtained for examination of HIV and syphilis.?2 test and logistic regression analysis were used for statistical analysis.Results:The average age of the 1 000 MSM was 27.8?9.1 years old.In the past 6 months,43.6% of them had 3 or more male sex partners,53.6% had unprotected anal intercourse with men,8.0% had commercial sex with men,and 24.3% had sex with women.Elder subjects had a higher ratio of unprotected anal intercourse and male-female sex;subjects with lower educational background had more sex partners and male-female sex.Subjects working in the bathhouse had a higher ratio of commercial sex and male-female sex.Subjects with a male-female sex orientation or undetermined sex orientation had a higher ratio of commercial sex.Syphilis was detected in 93(9.3%)subjects and HIV was detected in 104(10.4%)subjects;among them 18 subjects had both syphilis and HIV.Multivariate logistic regression analysis showed that the aged(OR=3.5,95%CI 1.7-7.1),the number of male sex partners(OR=3.8,95%CI 1.9-7.6),the behavior of unprotected anal intercourse(OR=1.9,95%CI 1.0-3.5)and the infection of syphilis(OR=2.1,95%CI 1.4-3.4)were independently associated with the risk of HIV/AIDS prevalence;the knowledge of AIDS was the protective factor of HIV/AIDS prevalence(OR=0.5,95%CI 0.3-0.7).Conclusion:High risk behaviors of HIV exist in MSM population in the researched city;there is local epidemic of HIV.Interventions should be given according to age,educational background,sex orientation,etc.

Objective To find out nutrient support drug utilization in cancer patients in our hospital. Methods An analysis was made by means of drug utilization research into the structure and rationality of nutrient support drug utilization in our hospital through an investigation into the detailed records of the dispensary from 1999 to 2002 and into 1 014 medical records from 2002. Results The variety, quantity, and cost of nutrient support drug utilization in the four years rose respectively by 58.82%, 71.66% and 28.16%. 49.30% of the cancer patients whose medical records were surveyed used such drugs. The quantity and person time ratio of PN and EN drug utilization was respectively 14∶1 and 13∶1, with malnourished patients accounting for 19.80%. Of the PN drugs whose DDD value could be determined, most had a DUI value that was greater than 1 whereas most of the EN drugs had a DUI value which was smaller than 1. Conclusion The variety, quantity, and cost of nutrient support drug utilization in the four years rose rapidly. The quantity and person time of PN drug utilization were much higher than those of EN drug utilization. Doubts could be cast in the handling of indications for nutrient support drug utilization in some patients and the doses of some nutrient support drugs prescribed were not so rational. Further explorations need to be made into the rational application of nutrient support treatment.

[Objective]To develop an animal pulmonary cement embolism model,by which the effect of polymethylmethacrylate(PMMA),calcium phosphate cement(CPC) and silk fibroin/calcium phosphate cement composite(SF/CPC) on the hemodynamic change,respiratory function and the antithrombin activity were measured after the pulmonary embolism caused by cement injection.The efficiency of SF reducing the risk of cardiovascular complication was evaluated.[Method]Twenty-four pigs were assigned to 3 groups randomly,with 8 pigs in each group.After general anesthesia,animals were endotracheal intubated and mechanically ventilated by a respirator.The pulmonary trunk was exposed via sternotomy and each kind of cement was injected into the main pulmonary artery.Hemodynamic parameters were continuously monitored.Blood samples were drawn at certain time points for blood gases analyzing and measurement of AT Ⅲ.Postmortem lungs were subject to computer tomography(CT) examination along with three-dimensional reconstructions of cement casts.[Result]The injection of CPC caused severe pulmonary hypertension and arterial hypotension,with a maximum elevation of 20.93?5.04 mmHg in PAP(20 min post-injection) and a maximum decrease of-26.59?6.8 mmHg in MABP(50 min post-injection).The changes in SF/CPC group were relatively slighter,which is similar with PMMA group,having a statistically significant difference from CPC groups(P

Objective To survey the high risk behavior and infection of HIV/AIDS among men who have sex with men(MSM)and provide scientific evidence for HIV/AIDS prevention and control.Methods MSM were sampled by snowball sampling method and were interviewed by well trained investigators face to face under the informed consent.Their venous blood samples were collected for HIV seropositivity rate.Results A total of 1000 MSM,averagely aged(27.8?9.1)years,were interviewed,among whom 43.9% perceive AIDS knowledge.78.6% had anal intercourse with male partners,31.8% of whom always used condom in the past 6 months.8.0% participants had commercial sex with men in the past 6 months.The prevalence of HIV in the surveyed subjects was 10.4%.Conclusion Potential risk of HIV epidemic threatens local MSM who spread the risk to general population.High risk behavior is ubiquitous among MSM.It is imperative to carry out targeted interventions among MSM.

Professor Y ang Y ufe i is the director and founder of the Oncology Department of X iyuan Hospital of China Academy of Chinese Medical Sciences. Professor Y ang Y ufei thinks highly of the treatment of breast cancer with harmonizing and dredging principle combining traditional Chinese medicine (TCM) and western medicine. She regards the basic pathogenesis of breast cancer is not only on traditional liver-kidney yin deficiency and liver-qi stagnation with spleen deficiency, but also three mechanisms which are breakdown of the normal physiological coordination be-tween the liver and kidney, heart and the kidney and Shaoyang. Professor Y ang gradually formed Tri-Traffic Dredg-ing Liver And Nourishing Kidney Formula base on tonification and purgation in combination. Y ang Y ufei thinks highly of combining treatment of TCM and western medicine, especially combined with endocrine therapy. Professor Y ang also pays much attention on immune function of patients and health education.

Objective To investigate the pre-emptive analgesia effects of hydromorphone on stress reaction in patients undergoing gynecological laparoscopic surgery.Methods Forty ASA Ⅰ or Ⅱ patients [age:45-58 years,body mass index:18-24 kg· (m2)-1] undergoing gynecological laparoscopic surgery were randomly divided into 2 groups (n =20 for each group):treatment group and control group.Hydromorphone (1 mg) was intravenously injected before anesthesia in treatment group.In the two groups,after routine induction and incubation,remifentanil (0.2 μg· min-1 · kg-1) and propofol (0.1 mg· min-1· kg-1) were injected with micro perfusion pump,cisatracurium was injected intermittently.Injection of remifentanil and propofol was stopped when skin suture started.The concentrations of epinephrine(E) and norepinephrine(NE) were obtained before induction (t1),pneumoperitoneum (t2),1 h after pneumoperitoneum (t3) and extubation (t4),respectively.The heart rate,blood pressure and the time of operation to extubation of the patients were recorded.Results There were no significant changes in extubation time after operation among the groups.Heart rate and systolic blood pressure were significantly lower in the treatment group than in the control group (P ＜ 0.05).Plasma E and NE levels at t1 were significantly lower than those at t2,t3 and t4.Plasma E and NE were significantly lower in treatment group than that of control group at t2,t3 and t4 (P ＜ 0.05).Conclusion Pre-emptive analgesia of hydromorphone can significantly decrease the release of epinephrine and norepinephrine during and after laparoscopic surgery,restrain the increase of heart rate and systolic blood pressure during extubation,without influence of revival time.

Diagnostic Errors ; Encephalocele ; diagnosis ; Female ; Humans ; Meningocele ; diagnosis ; Middle Aged ; Mucocele ; diagnosis ; Sphenoid Sinus ; pathology

Objective To investigate the clinical outcomes of three kinds oi internal fixations via posterior approach for treating adjacent two-segment thoracic and lumbar vertebral fractures.Methods A retrospective analysis was done on data of 34 patients with adjacent two-segment thoracic and lumbar vertebral fractures treated between 2003 and 2010.The treatments included three different pedicle screw fixations via posterior approach,ie,fixation with four verlebrae and four screws (Group Ⅰ,n ＝ 14),fixation with four vertebrae and six screws ( Group Ⅱ,n ＝ 11 ),fixation with four vertebrae and eight screws ( Group Ⅲ,n ＝ 9).The changes of spinal Cobb' s angle before and after operation and at the last final follow-up were statistically analyzed.Oswestry disability index (ODI) score,Denis pain scale and Denis work scale at the final follow-up were evaluated.Also,the recovery of neurological function was observed.Results The duration of follow-up was average 24 months (range,10-48 months).The neurological function of all the patients recovered to some degree.Two patients had pedicle screw breakage and one had spontaneous fusion of the collaprsed vertebra in Group Ⅰ.The Cobb' s angles of the three groups were decreased immediately after operation,but all obtained some degree of enhancement at the final follow-up.In Group Ⅰ,the mean Cobb's angle was (7.5 ±3.0)° postoperatively and then improved to ( 13.7 ±5.1 )°at the final follow-up,with correction loss of (6.2 ±2.1)°.In Group Ⅱ,the average Cobb's angle was( 1.4 ± 1.5) ° postoperatively and later increased to (4.5 ± 2.4)° at the final follow-up,with correction loss of (3.1 ± 1.1 )°.In Group Ⅲ,the mean Cobb' s angle was ( 0.0 ± 1.1 )° postoperatively but was increased to ( 1.3 ± 1.2 )° at the last follow -up,with correction loss of ( 1.3 ± 0.0 1 )°.The three groups showed statistical difference regarding the correction loss of Cobb' s angle ( P ＜ 0.05 ).Group Ⅱ and Group Ⅲ showed no significant differences in aspects of ODI score and Denis work and pain scale at the final follow-up,but the differences were significant when Group Ⅰ was compared with Group Ⅱ and Group Ⅲ (P ＜ 0.05 ).Conclusions The posterior transvertebral pedicle screw fixation with 4 vertebrae and 8 screws for adjacent two-segment thoracic and lumbar vertebral fractures is beneficial to gaining well reduction and fixation,maintaining deformity correction,preserving motion segment and releasing pain.The operation,a simple and convenient technique,has the prospect of clinical application.

protrusion measured by ultrasound for diagnosing bladder outlet obstruction.Methods A literature search of medline (1966.1-2011.6),embase(1984.1-2011.6),CNKI (1994.1-2011.6) and WEIPU Data (1989.1-2011.6) from 1999 to 2009 was performed by two reviewers independently.QUADAS items was applicated to assess trial quality.Golden standard was BOOI measured by urodynamics (BOOI more than 40 indicates bladder outlet obstruction).Heterogenous studies and meta-analysis were conducted by Meta-Disc 1.4 software.Results Totally 6 studies was included at last,involving 682 subjects.No threshold effect was found,but there was heterogeneity due to other factors.The meta-analysis showed that the sensitivity was 70.8 ％,specificity was 87.6 ％,positive LR was 5.132,negative LR was 0.303,the diagnostic OR was 22.18,the area under SROC curve was 0.8723 and Q index was 0.8028.Conclusions Intravesical prostatic protrusion measured by ultrasound is a good index for diagnosing bladder outlet obstruction in patients with benign prostate hyperplasia when intravesical prostatic protrusion is equal or more than 10mm.