ObjectiveTo summarize the curative effect of l aparoscopic cholecys tectomy (LC) combined with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) for cholelithiasis concurrent with choledoc holithiasis.MethodsERCP and EST were applied in 210 patients suspected for c holedocholithiasis before (164 cases) or after (46 cases)LC.Results ERCP dis closed choledocholithiasis in 69 patients before LC, and then stones were comple tely removed by EST in 63 patients, with a clearance rate of 91 3% (63/69); ERC P revealed residual cholelith in 9 patients after LC, and 8 of them were cured by EST, with a clearance rate of 88 9% (8/9).ConclusionsLC co mbined with ERCP and EST for cholelithiasis concurrent with choledocholithiasis is safe and effec tive, keeping patients free from open surgery.

China ; Clinical Trials as Topic ; methods ; Humans ; Organizational Policy ; Publishing ; standards ; Registries

Objective To estimate the effect of glycoprotein (transmembrane) nonmetastatic melanoma protein B (GPNMB) on the proliferation and migration of as well as melanogenesis in melanoma cells.Methods The expression of GPNMB was detected by immunofluorescence assay in two melanoma cell lines M14 and G-361,as well as in primary human melanocytes.Then,the three kinds of cells each were classified into three groups:experimental group treated with small interfering RNA targeting GPNMB (GPNMB-siRNA),negative control group treated with the negative control siRNA,blank control group remaining untreated.Methyl thiazolyl tetrazolium (MTT) assay,transwell invasion assay and spectrophotometry were performed to evaluate cell proliferation activity,invasion potential and melanin levels,respectively.Statistical analysis was done using Student's t test.Results GPNMB was expressed in both melanoma cells and melanocytes.The transfection with GPNMB-siRNA down-regulated the mRNA and protein expressions of GPNMB in,and markedly suppressed the proliferation and migration of,melanoma cells.In detail,the proliferative activity (expressed as the absorbence value at 570 nm) of M14 and G361 cells was reduced by 35％ and 40％ respectively,the migration activity of M14 and G361 cells by 49％ and 51％ respectively,and the melanin levels in melanocytes,M14 cells and G361 cells by 73％,82％ and 69％ respectively,in the experiment group compared with those in the blank control group.Conclusions The siRNA-mediated silencing of GPNMB could effectively inhibit the proliferation of,invasion of and melanogenesis in melanoma cells,which suggests that GPNMB plays critical roles in the initiation and progression of melanoma.

Acupuncture Therapy ; Adult ; Heat Stroke ; complications ; therapy ; Humans ; Male

Adult ; Carcinoma, Embryonal ; drug therapy ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Endodermal Sinus Tumor ; drug therapy ; metabolism ; pathology ; surgery ; Humans ; Keratin-19 ; metabolism ; Ki-1 Antigen ; metabolism ; Male ; Orchiectomy ; methods ; Testicular Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; alpha-Fetoproteins ; metabolism

Objective To investigate changes of brainstem auditory evoked potential (BAEP)and somatosensory evoked potential (SEP) in patients with acute cerebral infarction,and discuss their relation with prognosis of the patients.Methods The study involved 60 patients with acute cerebral infarction.Changes of BAEP and SEP in each patient were detected and recorded continuously.Prognosis evaluation was performed by using GCS.Another 60 age-matched and gender-matched healthy human beings were enrolled as controls.Results Incubation period of BAEP wave Ⅰ had no significant difference between the cerebral infarction and control groups (P ＞ 0.05).However,interspike intervals of other BAEP waves in cerebral infarction group were different from those in control group (P ＜ 0.05).A series of waves of SEP (P14-N60) were all significantly prolonged in cerebral infarction group (P ＜0.05).Conclusion BAEP and SEP can effectively reflect function of brain stem in patients with acute cerebral infarction and have some values in determining their prognosis.

BACKGROUND: BuCy2 composed of large-dose oral busulfanum and cyclophosphamide has been one of the main conditioning regimens before transplantation, but oral busulfanum can result in many side effects.OBJECTIVE: To evaluate the efficacy and safety of the conditioning regimen with intravenous busulfanum (Ⅳ Bu) in hematopoietic stem cell transplantation (HSCT) for malignant hematopathy.DESIGN: Case observation.SETTING: Department of Hematology, Union Hospital,Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: A total of 13 patients with chronic myelogenous leukemia (CML) and 6 patients with acute leukemia,who received allogeneic HSCT with the conditioning therapy of modified BuCy2, were enrolled at Institute of Hematopathy, Union Hospital, Huazhong University of Science and Technology from May to December 2006. There were 12 males and 7 females aged 14-50 years with an average of 33 years, and there were 9 cases of related transplantation and 10 cases of unrelated transplantation. Hematopoietic stem cells (HSCs) were harvested from peripheral blood of 18 subjects and bone marrow of 1 subject. All patients and their family members signed the informed consent.METHODS: All patients were treated with allogeneic HSCT with the conditioning therapy of intravenous BuCy2.All patients received the modified combination of busulfanum and cyclophosphamide that was commonly utilized currently.Hydroxycarbamide 40 mg/kg was orally taken ten days before transplantation. Arabinosylcytosin (Ara-C) 2 g/m2 was injected via vein nine days before transplantation. Busulfanum ampule 0.8 mg/kg (equal to 1 mg/kg oral administration)was given by central venous cannula eight, seven and six days before transplantation. The injection was performed over 2 hours controlled by infusion pump, once every 6 hours, totally 12 times. Busulfanum was diluted by saline or 5% glucose to about 0.5 g/L (about 10 times) before Ⅳ Bu. Cyclophosphamide 1.8 g/m2 was intravenously injected every day from five and four days before transplantation. Methyl-CCNU 250 mg/m2 was taken orally three days before transplantation. Occurrence of hepatic vano-occlusive disease (HVOD) and its side effects were determined. Follow-up was performed at month 6.5 after operation to observe disease recurrence and patient survival.MAIN OUTCOME MEASURES: Occurrence and side effects of HVOD 100 days after transplantation, and results of follow-up.RESULTS: Totally 19 patients were involved in the result analysis. In 13 days after transplantation, blood conversion,chromosome karyotype and DNA polymorphism tests verified that reconstruction of hematopoietic function was obtained and two patients got recurrence, of which one patient got complete remission after receiving fludarabine plus cytarabine plus granulocyte colony-stimulating factor (G-CSF) and HSCs from peripheral blood. DNA polymorhism test verified that re-engraftment was obtained. Another patient received chemotherapy. Other patients lived well.

Objective To evaluate the effect of cytokine-induced killer cells (CIKs) as an adoptive immunotherapy option for treatment of leukemia relapse after allo-hematopoietic stem cell transplantation (allo-HSCT).Methods Two cases of infusion of donor CIKs in patients with leukemia relapse after allo-HSCT were retrospectively analyzed.Patient one relapsed 986 days (+986d) after HLA-matched unrelated donor allo-HSCT.Applications of chemotherapy only resulted in short term remission,but allo-CIKs were successfully expanded from the patient's peripheral blood mononuclear cells of donor origin.Totally five cycles of CIKs infusion were infused as an alternative of adoptive immunotherapy.Patient two had recurrent in the + 158d after HLA-matched sibling alloHSCT.At + 204d and + 294d,two cycles of CIKs which were expanded from donor peripheral blood mononuclear cells were infused.Results One cycle of CIKs was given to patient one after the application of chemotherapy to reduce the tumor burden,and the patient successively achieved complete remission.Again after additional four cycles of CIKs infusion,consistent remission was maintained during the following seven months.Patient two who had relapsed disease posttransplantation,achieved cytological complete remission after withdrawal of immunosuppressants and undergoing chemotherapy combined with G-CSF mobilized stem cell infusion.However,at + 187d,the patient suffered from side-effect of acute graft versus host disease and extramedullary infiltration.The symptoms were alleviated markedly after one cycle of CIKs infusion at + 204d.Moreover,the pain disappeared after an additional infusion at + 294d.And up to the present,the bone marrow aspiration showed complete remission while the extramedullary disease vanished.Conclusion The use of CIKs in the treatment of leukemia relapse after allogeneic bone marrow transplantation can be feasible and well tolerated.

Objective To investigate early and midterm outcomes after minimally invasive1-stop or 2-stage MICSCABG and PCI hybrid surgery.Methods Between June 2011 and February 2015, 28 patients(19 males and 9 females) with multiple coronary artery disease underwent MICS-CABG and PCI hybrid surgery, 4 cases of which were1-stop hybrid surgery and 24 cases were 2-stage.All patients were followed up to major adverse events(recurrent angina, secondary myocardial infarction, congestive heart failure, serious arrhythmias, secondary bypass graft) as the end point event.Results All patients were no perioperative deaths, shock, infection and myocardial infarction.ICU stay time was(22.9 ± 12.5) h, hospital stay time was(6.75 ±2.10) days, intubation time was(21.1 ± 17.7) h.Perioperative1-stop and2-stages hybrid surgery had significant statistical differences in ICU stay time and intubation time[(41.8 ±32.9) h vs.(16.5 ± 8.5) h;(40.0 ± 34.2) h vs.(18.8 ± 8.5) h;P ＜ 0.05].Patients were followed up for 1-44 months, averaged (17.9 ± 12.8) months.The postoperative major adverse event rate was 7.14％, one patient died of cerebral hemorrhage after 6 months, and one patient underwent coronary angiography because angina.Conclusion l-stop or 2-stage MICS-CABG and PCI hybrid surgery provides a safe,effective and cosmetic revascularized method to patients with multiple coronary artery disease.Meanwhile,the procedure does not destroy the way of re-operation.The perioperative and early results of follow-up are satisfactory.

BACKGROUND:There is little attention focused on the effect of isokinetic testing about the variation of angular velocity on pain and muscle strength in the evaluation of curative effect of McConnel taping. OBJECTIVE: To evaluate the changes of quadriceps muscle strength and perceived pain levels in patients with patelofemoral pain syndrome before and after corrective McConnel taping in isokinetic testing. METHODS:A total of 34 patients with patelofemoral pain syndrome were evaluated in isokinetic testing for concentric contraction muscular strength, including the maximum torque, the total work, and the average work in 60 (°)/s and 180 (°)/s angular velocity, before and after the interventions of McConnel taping. The visual analogue scale scores were recorded. RESULTS AND CONCLUSION: The visual analogue scale scores were slightly decreased in angular velocity of 60 (°)/s after obturation when compared to before obturation (P > 0.05), while the scores were significantly decreased in angular velocity of 180 (°)/s (P < 0.05). The maximum torque, the total work, and the average work were slightly increased after obturation, but showed no significant difference in angular velocity of 60 (°)/s (P > 0.05), while significantly increased in 180 (°)/s angular velocity (P < 0.05). McConnel taping significantly improves the curative effect in patients with patelofemoral pain syndrome under low load joint movement.