Objective To observe the results and reality of transurethral resection of bladder tumor(TUR-Bt) with upside down loop and plsamakinetic in the prevention of obturator nerve reflex.Methods A total of 211 patients with lumbar anesthesia received TUR-Bt.Firstly,the tumor tower above bladder wall was cut with the traditional way.When intraoperative findings were obturator nerve reflex,or to the obturator nerve mapping area,operation should be changed to superimpulse plasma column electrode vaporization to cut off residual tumor tissue,then after flipping the loop,the residual tumour was resected with upside-down loop from the tumour side wall.Results In 211 cases,192 cases had a little obturator nerve reflex,but the movement of body was not obvious,which did not influence the operation.The serious complication,such as perforation of bladder and injury of nerve and vessel,did not occur.Conclusions The lateral resection of bladder side wall tumour with upside-down loop can effectively avoid strong obturator nerve reflex,which is safe,uncomplicated,and efficacious and it does not increase the additional outlay and hurt.

In this paper, three spoilage organisms were separated from five transmutative soy milks, and all the three spoilage bacteria could survive condition of both 1?105Pa,30min and 300mg/kg Nisin. Morpha character, physiological and biochemical characteristics, and a phylogenetic analysis based on 16S rDNA gene sequences reveal that these three strains are Bacillus licheniformis, Bacillus pumilus and Brevibacillus borstelensis respectively. GenBank accessions for these three strains are EF439666-EF439668。

Objective The purpose of this study was to evaluate the safety and clinical oulcomes of aortic valve replacement (AVR) performed with minimally invasive technique.Methods From June 2010 to October 2011,20 cases of minimally invasive AVR were performed.The mean age was (47.60±12.28) ;12 males and 8 females.All patients are ventilated with a double-lumen endotracheal tube,through the 3nd anterior intercostals space with a 5 -6cmskin incision,right femoral artery and vein cannulation are used to establish CPB,direct aortic cross-clamped by Chitwood sliding clamp through the right 4th intercostals space,and completed the aortic valve replacement.Results Mean length of incision was (4.73±0.54)cm.Mean duration of cardiopulmonary bypass was (124±39.83)min,crossclamp time was (97.21±33.17) min.Median intubation time was (13.55±3.87)hours.Median duration of intensive care and postoperative hospital stay was (16.34±3.82)hours and (6.63±1.45) days,respectively.Hospital mortality was 0.There was no perivalvular leakage,Conclusion Minimally invasive aortic replacement with a modified Port-Access approach is feasible,small incisions,more cosmetic,shorter length of bospital stay and less need for blood transfusion are attainable.

OBJECTIVETo observe the clinical effect of Huikangling Tablet (HT, extracted from Scabrous Patrinia root) on peripheral blood micrometastasis of differentiated thyroid carcinoma (DTC) patients.

METHODSTotally 87 DTC patients with positive micrometastasis were randomly assigned to the treatment group (45 cases) and the control group (42 cases). DTC endocrine inhibition treatment standards were executed in all patients. They all took levothyroxine sodium (50 microg/tablet, from low dose, 25 microg each time, once per day, 0.5 h before breakfast), and its dosage was gradually added one week later. The dosage was adjusted according to tested results of TSH combined recurrence risk stratification and endocrine suppression induced adverse reactions risk stratification. Patients in the treatment group took HT (0.4 g per tablet, 3 tablets each time, three times per day for a total of 12 weeks) combined TSH suppression therapy, while those in the control group only received TSH suppression therapy. Peripheral micrometastatic cytokeratin 19 (CK19) and polymorphic epithelial mucin1 (MUC1) were detected by FCM at week 4 and 12. Meanwhile, distant metastasis and adverse reactions were observed.

RESULTSAfter 4-week treatment positive micrometastasis was shown in 18 cases (40%) of the treatment group and 29 cases (69%) in the control group with statistical difference (chi2 = 5.68, P < 0.05). After 12-week treatment positive micrometastasis was shown in 7 cases (15.6%) of the treatment group and 17 cases (44.7%) in the control group with statistical difference (chi2 = 8.49, P < 0.01). Pulmonary metastasis occurred in 2 cases and bone metastasis in 1 case of the control group at follow-ups. Cervical lymph node metastasis without accompanied recurrence of thyroid cancer occurred in one case of the treatment group. No obvious liver or renal abnormalities occurred.

CONCLUSIONHT inhibited peripheral blood micrometastasis of DTC patients and its mechanism needed to be further studied.

Antineoplastic Agents ; pharmacology ; therapeutic use ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Neoplasm Micrometastasis ; drug therapy ; Neoplasm Recurrence, Local ; Tablets ; Thyroid Neoplasms ; drug therapy

Diagnostic Techniques and Procedures ; standards ; Fatigue Syndrome, Chronic ; diagnosis ; Humans ; Reference Standards

OBJECTIVETo observe the pinching action to the nerve root by the lumbar disc herniation and facet or lamina (ligamentum flavum) and evaluate its clinical meaning.

METHODSSeventy-one patients were divided into 3 groups according to the size of distance between protrusion of nuclear and facet or lamina (ligamentum flavum). The degree of the straight leg raising of the affected side (SLR) and the sagittal index (SI) of lumbar disk herniation were measured and analyzed among them.

RESULTSThere was no corelation between the affected degree of SLR and sex, age and SI of patient (P > 0.05). The coefficient between distance group and the affected degree of SLR is-0.878 7 (P < 0.01).

CONCLUSIONThe degree of the surrounding compression by the protrusion of nuclear and facet or lamina (ligamentum flavum) reflects the injuried severity of the nerve root.

Adolescent ; Adult ; Female ; Humans ; Intervertebral Disc Displacement ; complications ; diagnostic imaging ; pathology ; Ligamentum Flavum ; pathology ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nerve Compression Syndromes ; etiology ; Spinal Nerve Roots ; injuries ; Tomography, X-Ray Computed

Objective To study the risk factors of hyperthyroid heart diseases(HHD) by analyzing clinical features of patients in order to provide a scientific basis for prevention and treatment of HHD. Methods Nine hundred and eighty two cases were selected as objective from in-patient data of Thyroid Disease Treatment Centre of Shandong Province. The cases were divided into hyperthyroidism group and HHD group. The variables of etiology,sex, age, duration of disease, TSH, FT3, FT4 and TRAb were analyzed by comparative analysis. The risk factors were analyzed by logistic regression. Results The prevalence of hyperthyroidism complicated hyperthyroid heart disease was 7.7%(76/982), age, duration of diseases, FT3, TRAb in the HHD group were [(51.4 ± 11.5), (6.3 ±2.1) years, 21.6 pmol/L, 71.6 U/L], in hyperthyroidism group were [(37.9 ± 9.8), (2.6 ± 1.3) years, 14.9pmol/L, 49.6 U/L]. The differences were statistically significant(u = 9.93,15.23, T = 44954,48792.5, P ＜ 0.05)between the two groups. The factors of the older, higher FT3 and TRAb, longer duration, Graves disease (OR =1.751,1.470,1.483,1.445,1.234) increased the risk of HHD. Conclusions Graves disease, longer duration, old age, higher FT3 and TRAb are the risk factors of HHD. Timely prevention and control of risk factors is necessary to reduce the incidence of HHD.

OBJECTIVETo study chemical constituents from Cynanchum auriculatum.

METHODThe chemical components were isolated and purified by silca gel, sephedex-LH-20 and ODS column chromatography. The chemical structures were elucidated on the basis of physicochemical properties and spectral data.

RESULTThirteen compounds were isolated and identified as: caudatin (1), metaplexigenin (2), cynauricuoside A (3), succinic acid (4), azelaic acid (5), wilforibiose (6), sucrose (7), 1-O-hexadecanolenin (8), beta-amyrin acetate (9), cynanchone A (10), acetylquinol (11), beta-sitosterol (12), daucosterol (13).

CONCLUSIONCompounds 4-9 were obtained from this plant for the first time.

Cynanchum ; chemistry ; Dicarboxylic Acids ; chemistry ; isolation & purification ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Plant Tubers ; chemistry ; Plants, Medicinal ; chemistry ; Succinic Acid ; chemistry ; isolation & purification

Objective To investigate the effects of nursing intervention on the treatment of children with acute bronchitis in the outpatient department.Methods 120 cases of children diagnosed with acute bronchitis in the outpatient department were randomly selected and divided into intervention group and control group. Both groups received routine therapy and nursing. Intervention group was treated with nursing intervention including treatment,prevention,health care,and cognition.Clinical manifestations and treatment effects were evaluated for two groups.Results Treatment effects for the intervention group was 51.67％ and significantly higher than the control group (33.33％ ); The total efficacy for the intervention group is significantly higher than that for the control group (81.67％ vs 71.67％ respectively; x2 =4.19,P ＜0.05).In terms of clinical manifestations,significant more patients had disappeared coughing,Wheezy phlegm,wet rales,less days for body temperature return to normal in the intervention group than in the control group (P＜0.05).Conclusions Nursing intervention for acute bronchitis pediatric outpatients enhances treatment effect,relief the symptoms,shorten the duration of the disease and improves the cure rate. It is worth of clinical promotion.

OBJECTIVETo evaluate the clinical effect of the treatment for sequestered type lumbar disk herniation (SLDH) with FENG's spinal manipulation.

METHODSForty-one patients (27 male, 14 female) were treated by FENG's spinal manipulation. The clinical results were measured by the Japanese and FENG's lumbar treatment standard and evaluated by scoring system for assessment of treatment for low back pain between pre- and post-treatment. To measure MRI sagittal index (SI) of lumbar disc herniation between pre- and post-treatment.

RESULTSThe score of subjective symptoms and clinical signs increased obviously after treatment. There was no statistical difference of SI between pre- and post-treatment (P<0.05). The outcome of treatment was satisfying.

CONCLUSIONThe major pathologic change of SLDH is the single/multiple vertebral subluxation. FENG's spinal manipulation can correct the vertebral subluxation which leading to the series of clinical manifestations. The good clinical outcome may due to the alleviation of distortion and tension of dura and nerve root with the recovery of the spinal column's stability.

Adult ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Male ; Manipulation, Spinal ; methods ; Middle Aged