OBJECTIVETo compare the therapeutic effects of peripheral facial paralysis in acute stage by different interventions and explore the better treatments of peripheral facial paralysis.

METHODSOne hundred and thirty one cases of Bell's facial paralysis were randomly divided into three groups. In acupuncture group (44 cases), Dicang (ST 4), Jiache (ST 6), Hegu (LI 4), Yangbai (GB 14) and Taiyang (EX-HN 5), etc. were applied; in electroacupuncture group (45 cases), the selection of acupoints and needling method were same as those in acupuncture group, and the electroacupuncture therapy was applied on Dicang (ST 4), Xiaguan (ST 7), Yangbai (GB 14) and Taiyang (EX-HN 5) in acute stage; in medication and acupuncture group (42 cases), Prednisone and Acyclovir were taken by oral administration, Vitamin B1 and Vitamin B12, were applied by intramuscular injection in acute stage, and acupuncture was applied by the way which was same as that in acupuncture group during quiescent and recovery stages. The curative effects were evaluated by House-Brackmann Grading Scale, and the failed rates were observed by follow-up after one and three months.

RESULTSThe cured and markedly effective rates were 79.6% (35/44), 93.4% (42/45) and 78.6% (33/42) respectively in acupuncture group, electroacupuncture group and medication and acupuncture group, and the result in electroacupuncture group was superior to those in acupuncture group and medication and acupuncture group (P < 0.05). The cured rates above tympanichord were 54.2% (13/24), 85.2% (23/27) and 48.0% (12/25) in acupuncture group, electroacupuncture group and medication and acupuncture group, and the result in electroacupuncture group was superior to those in acupuncture group and medication and acupuncture group (P < 0.01). There was no significant differences of cured rates below tympanichord among three groups (P > 0.05); and the failed rate in electroacupuncture group was much lower than those in acupuncture group and medication and acupuncture group by follow-up after one and three months (all P < 0.01).

CONCLUSIONThe peripheral facial paralysis is effectively treated by electroacupuncture in acute stage, and it suggests that electroacupuncture should be applied early during the acupuncture treatment of peripheral facial paralysis.

Acupuncture Points ; Acupuncture Therapy ; Acyclovir ; administration & dosage ; Adolescent ; Adult ; Aged ; Electroacupuncture ; Facial Paralysis ; drug therapy ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Prednisone ; administration & dosage ; Treatment Outcome ; Young Adult

The most appropriate time to introduce androgen deprivation therapy for prostate cancer remains controversial. Our aim was to evaluate the effects of early versus delayed surgical castration on prostate cancer progression and survival in the transgenic adenocarcinoma of the mouse prostate (TRAMP) model. TRAMP mice were randomly divided into three groups: the early castration group (on which castration was performed at the age of 4 weeks), the delayed castration group (on which castration was performed when abdominal tumours could be palpated), and the sham-castrated group. Mice were monitored daily throughout their lives until cancer-related death or the development of an obviously moribund appearance, at which time the individual mouse was killed. Androgen receptor expression in prostate tumours was also evaluated. The results shows that the average lifespan in early castration, delayed castration and sham-castrated groups were 54.1 weeks, 59.9 weeks and 39.1 weeks, respectively. Both early castration and delayed castration conferred a statistically significant survival advantage when compared with the sham-castrated group (P<0.001). However, the difference in lifespan between the early castration group and the delayed castration group was not statistically significant (P=0.85). The increase in lifespan in the TRAMP mice that received either early or delayed castration correlated with lower G/B value (genitourinary tract weight/body weight) at death than the sham-castrated mice. In conclusion, early and delayed castrations in TRAMP mice prolonged survival to a similar extent. This finding may provide a guide for clinical practice in prostate cancer therapy.
Adenocarcinoma ; mortality ; pathology ; surgery ; Animals ; Body Weight ; Disease Models, Animal ; Kaplan-Meier Estimate ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Orchiectomy ; Organ Size ; Prostate ; metabolism ; pathology ; surgery ; Prostatic Neoplasms ; mortality ; pathology ; surgery ; Receptors, Androgen ; metabolism ; Time Factors ; Transgenes ; genetics

Objective To explore the approach and early effects of endovascular stent-graft deployment in the treatment of portal stenosis of cancerous thrombus.Methods Six cases with portal vein stenosis of cancerous thrombus,which caused by primary hepatic carcinoma(5 cases)and eholangiocarcinoma(1 case)and the severity of stenosis showed on contrast enhanced CT were more than 75% or occluded,were performed percutaneous transhepatie or transsplenic portography.FLUENCY~(TM) endovascular stent-graft(10 mm diameter)was placed at the position of stenosis after gastroesophageal varices embolization.Portal pressure was measured pre-and post-deployment.Results Stents were successfully placed in all patients.The average portal pressure decreased from 50.7 cm H_2O(1 cm H_2O = 0.098 kPa)to 41.3 cm H_2O after endovascular stent-graft deployment.The restenosis were found in 2 cases after one month.Haematemesis and refractory aseites appeared in one case respectively,the other 4 cases showed no significant symptoms above caused by portal hypertension.Conclusion It is safe and feasible for endovaseular stent-graft deployment in the treatment of portal stenosis of cancerous thrombus.Selecting the suitable indications,the symptoms of portal hypertension can be controlled effectively.

OBJECTIVETo report 2 cases of prostatic abscess and review the current characteristics of prostatic abscess in China.

METHODSTwo cases of prostatic abscess were reported, and a meta-analysis was made of the literature from the Chinese National Knowledge Infrastructure database and Wanfang Data in recent 10 years.

RESULTSBoth the cases had a high glucose level, and one of them had received instrumental examination of the lower urinary tract prior to the problem, both with difficult defecation, severe perineal pain and high fever, with normal peripheral white blood cell count and negative urine routine. One case of abscess was confirmed by MRI, ruptured into urethra and cured by antibiotics. The other case was confirmed by transrectal ultrasound and CT and cured by transrectal ultrasound guided needle aspiration. Meta-analysis showed that the predisposed factors were diabetes mellitus, the indwelling catheter and instrumentation of the lower urinary tract. Major pathogens were staphylococci aureus and Escherichia coli. For most patients, the diagnosis was mainly established by ultrasonography and the treatment included needle aspiration or surgery.

CONCLUSIONThe clinical symptoms of prostatic abscess are not typically presented and the differential diagnosis may be difficult. Imaging investigation is helpful, and transrectal ultrasonography can be used for both diagnosis and treatment.

Abscess ; diagnosis ; Adult ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Prostatic Diseases ; diagnosis

BACKGROUNDUterine arterial embolization (UAE) is a safe and effective therapy for symptomatic uterine leiomyoma. This study was to assess the effectiveness and the feasibility of pingyangmycin-lipiodol emulsion (PLE) for the management of symptomatic uterine leiomyoma.

METHODSOne hundred consecutive patients (aged 21 - 53 years, with 38 in average) with symptomatic uterine leiomyoma underwent superselective UAE with PLE. Clinical symptoms of the patients (including menorrhagia, bulk-related symptoms, and postprocedure-related abdominal pain) and the changes in uterine volume and tumor size after the embolization were analyzed. The patients were followed up for 8 - 21 months (mean, 15 months).

RESULTSNinety-nine patients (99%, 99/100) were interviewed in their first menses circle after embolization, showing improvements in their abnormal bleeding and bulk-related symptoms to some extent. Imagiological results during follow-up showed a mean of 48% reduction in uterine volume at 6 months and a mean of 75% reduction in tumor size at 9 months. Eighty-three percent of the patients reported complete resolution of postprocedure pain within 7 days.

CONCLUSIONSPLE is effective in the management of uterine leiomyoma, having superiority in alleviating postprocedure-related pain.

Adult ; Antibiotics, Antineoplastic ; administration & dosage ; Bleomycin ; administration & dosage ; analogs & derivatives ; Contrast Media ; administration & dosage ; Embolization, Therapeutic ; methods ; Emulsions ; Female ; Follow-Up Studies ; Humans ; Iodized Oil ; administration & dosage ; Leiomyoma ; therapy ; Middle Aged ; Uterine Neoplasms ; therapy ; Uterus ; blood supply

OBJECTIVETo evaluate the efficacy and complications of radiofrequency ablation (RFA) with or without transcatheter arterial chemoembolization (TACE) for management of hepatocellular carcinoma (HCC).

METHODSA retrospective analysis was conducted for 62 small HCC cases undergoing RFA with or without TACE, and in each case, the tumors were not more than 3 with a diameter below 5 cm. Nineteen cases were managed with RFA alone (RFA group) while the other 27 underwent RFA combined with TACE (TACE+RFA group). Percutaneous RFA (RITA 1500) procedure was performed under CT guidance 1-3 weeks after TACE in TACE+RFA group.

RESULTSThe complete tumor necrosis rate was 77.8% (21/27) in TACE+RFA group, significantly higher than that in RFA group [57.9% (11/19), P<0.01], and the former group had a significantly lower local recurrence rate than the latter [22.2% (6/27) vs 42.1% (8/19), P<0.01]. Postoperative fever, local pain and temporary hepatic function abnormality were the common complications that were relieved after proper interventions, and mortality did not occur in these cases.

CONCLUSIONThe combination of TACE and RFA significantly increases the complete tumor necrosis rate and decreases the recurrence rate of small HCC. CT-guided percutaneous RFA can be a safe and effective therapy for small HCC.

Adult ; Aged ; Carcinoma, Hepatocellular ; therapy ; Catheter Ablation ; methods ; Chemoembolization, Therapeutic ; methods ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVESTo evaluate the feasibility and effectiveness of stent placement in treating hepatic artery stenosis after orthotopic liver transplantation (OLT).

METHODSFrom November 2003 to September 2005, 14 patients who had hepatic artery stenosis after OLT underwent stent placement in their narrowed hepatic arteries. This included early interventional treatment in 10 patients and delayed interventional treatment in 4 patients. The technical results, clinical outcomes, and the hepatic artery patencies were reviewed.

RESULTSTechnical and immediate success was 100%. After a mean follow-up of 146 days (range, 9-345 days), all patients' hepatic arteries were patent, except that hepatic arterious restenosis occurred in 2 patients at 26 and 45 days after the stent placement. Of the 10 patients who received early treatment, 8 survived with normal results of liver function test and 2 patients died of septic multiple-organ failure at 9 and 30 days after the stent procedure. One patient received a retransplantation because of refractory biliary infection. Of the 4 patients who received a delayed interventional treatment, 1 patient survived for 345 days but with abnormal liver functional test results, the other 3 patients died of septic multiple-organ failure resulting from liver abscesses biliary infection.

CONCLUSIONHepatic artery stenosis after OLT can successfully be treated with stent placement and an early interventional treatment is the key for a good clinical outcome.

Adult ; Constriction, Pathologic ; therapy ; Female ; Graft Occlusion, Vascular ; etiology ; therapy ; Hepatic Artery ; surgery ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Stents ; Vascular Diseases ; etiology ; therapy

BACKGROUND: Acute liver failure (ALF) caused by viral and non-viral hepatitis is often accompanied with severe metabolic disorders, the accumulation of toxic substances and continuous release and accumulation of a large number of endogenous toxins and inflammatory mediators. The present study aimed to investigate the effects of various combined non-biological artificial liver treatments for patients with acute liver failure (ALF) complicated by multiple organ dysfunction syndrome (MODS). METHODS: Thirty-one patients with mid- or late-stage liver failure complicated by MODS (score 4) were randomly divided into three treatment groups: plasmapheresis (PE) combined with hemoperfusion (HP) and continuous venovenous hemodiafiltration (CVVHDF), PE+CVVHDF, and HP+CVVHDF, respectively. Heart rate (HR) before and after treatment, mean arterial pressure (MAP), respiratory index (PaO2/FiO2), hepatic function, platelet count, and blood coagulation were determined. RESULTS: Signifi cant improvement was observed in HR, MAP, PaO2/FiO2, total bilirubin (TBIL) and alanine aminotransferase (ALT) levels after treatment (P<0.05). TBIL and ALT decreased more signifi cantly after treatment in the PE+CVVHDF and PE+HP+CVVHDF groups (P<0.01). Prothrombin time (PT) and albumin were signifi cantly improved only in the PE+CVVHDF and PE+HP+CVVHDF groups (P<0.05). TBIL decreased more significantly in the PE+HP+CVVHDF group than in the HP+CVVHDF and PE+CVVHDF groups (P<0.05). The survival rate of the patients was 58.1％ (18/31), viral survival rate 36.4％ (4/11), and non-viral survival rate 70％ (14/20). CONCLUSION: Liver function was relatively improved after treatment, but PE+HP+CVVHDF was more efficient for the removal of toxic metabolites, especially bilirubin. The survival rate was significantly higher in the patients with non-viral liver failure than in those with viral liver failure.

Objective To evaluate the clinical outcome of transvenous embolization withdetachable coils and N-butyl cyanoacrylate (n-BCA) for management of dural carotid-cavernous sinusfistulas (dCCFs). Methods Six patients with angiographically confirmed spontaneous dCCF wereinvolved in this study, including two with concurrent ipsilateral internal jugular vein occlusion. All thepatients received surgeries for transvenous embolization through the superior ophthalmic vein (2 cases) orthe inferior petrosal sinus (4 cases), using detachable coils (2 cases) or detachable coils combined withn-BCA (4 cases). Results The vascular murmur, exophthalmos and conjunctival congestiondisappeared in 4 patients shortly after the total embolization of the fistulas, while eyeball movementdisorder, diplopia and visual deterioration persisted for at least 1 month and gradually recovered 3 monthsafter the surgery. The fistulas failed to be completely embolized in two patients, and in one of the patients,the symptoms resolved after intermittent carotid artery compression for one week; in the other patient,exophthalmos recurred and worsened 1 month after embolization, and was successfully managed withtransarteriai embolization of the fistula. No symptomatic complications were found in these 6 patientsafter transvenous embolization in spite of the presence of a few small n-BCA granules in the lungs of twopatients. Conclusion Transvenous embolization is safe and effective for management of dCCF, andcombined use of detachable coils and n-BCA may enhance the success rate of total fistula embolization.

Objective To study the prevention and foreseeing nursing of the complications of interventional therapy for carotid cavernous fistula (CCF). Methods The foreseeing nursing and reasons for the complications of interventional therapy for CCF were analyzed in the 16 patients. Results 16 patients were embolized successfully.Exophthalmos and vascular murmur were relieved. The most common complications were bleeding of the puncture,cerebral vasospasm, cerebral hemorrhage, cerebral embolism and hyperperfusion syndrome. 1 patient was reembolized for the rupture of balloon. Vascular vasospasm was relieved after treatment in 2 patients. Hyperperfusion syndrome was relieved after lower blood pressure in 1 patient. Conclusions Interventional embolization was an effective treatment for CCF. Foreseeing nursing was the key to ensure the treatment effect.