Objective To explore the occurrence and prevention and the principle of management of chylous fistula after neck dissection. Methods Retrospective research on 1750 cases of neck dissection in Henan Tumor Hospital from January 1983 to January 2005. There were 48 cases chylous fistula and 1 case chylothorax. The incidence was 2.8 %. 5 cases on the right, 44 cases on the left. 18 cases had completed radiotherapy or chemotherapy before operation. Conservative methods and surgical methods were used in the treatment. Low fat food was supplied to the patients with chylous fistula. The conservative methods was local pressure, the surgical methods was applied while maximal production of chylous exceeding 500 ml a day. Results All the patients were cured finally. The conservative method was 12.6(5~34) days, the surgical method 7.5(3~10)day. Conclusion The key to prevent chylous fistula was to band the rupture of thoracis or lymphatic duct during operation. The conservative methods could be used in patients with slight and middle chylous, when the chylous exceed 500 ml a day or the conservative methods was unavailable, the surgical methods was appropriate, it could shorten the time of tube draw.

Subcutaneous insulin resistance is a condition in which glucose is insensitive to insulin from the subcutaneous tissue,but sensitive to that by intravenous injection.The mechanism of subcutaneous insulin resistance is mainly associated with skin obstruction or delayed entry of insulin into blood circulation.The treatment of the problem involves Aprotinin,anticoagulant and intramuscular injection of insulin.This paper offers an overview of the advances in the researches of subcutaneous insulin resistance.

Objective To investigate the clinical effect of 153 Sm-EDTMP treatment on pain palliation in the patients with bone metastasis of lung cancer, breast cancer or prostate cancer. Methods 166 patients with bone metastasis of cancers were intravenously injected 18.5～37 MBq/kg (0.5～1.0 mCi/kg ) body weight of 153 Sm-EDTMP, once a month or two months. Results The effective rate of pain palliation of 153 Sm-EDTMP treating bone metastasis of lung cancer, preast cancer and prostate cancer were 68.5%, 89.3% and 100%, respectively. The efficacious rate of pain palliation in breast and prostate cancers was significantly higher than that in lung cancer (P

Recent in vitro and in vivo experiments have revealed that ellagic acid and its metabolites can inhibit the growth of digestive system malignant tumor cells by inhibiting tumor cell proliferation,inducing apoptosis,breaking DNA binding to carcinogens,blocking virus infection,disturbing inflammation,angiogenesis and drug-resistance processes required for tumor metastasis.Ellagic acid and its metabolites are potential chemoprevention and therapeutic drugs against human cancers.

Objective:To investigate the expression of Toll-like receptors(TLRs)signaling pathway in chronic rhinosinusitis(CRS)with nasal polyps.Method:Gene microarray analysis was used to detect the expression of TLRs signaling pathway in CRS with nasal polyps.Result:Of 19 differentially expressed(two-fold changes),4genes were upregulated and 15 genes were downregulated.Conclusion:The differentially expressed genes in TLRs signaling pathway may exert its effect in the pathogenesis of CRS.In addition,the roles of TLR9 and its agonists need further study.

V-P and MR tests were done at the same time using white porcelain board.The results showed that the white porcelain method was simple and convenient compared to the traditional method.

Objective To investigate the efficacy and safety of statins in primary and secondary stroke prevention.Methods We search in PubMed(1966—2006),Cochrane library(issue 1,2006),CNKI(1979—2006)and VIP(1989—2006)to get systematic reviews(SRs),meta-analyses and randomized controlled trials(RCTs)about statins for stroke prevention.Results We found 4 meta-analyses,8 RCTs about the primary stroke prevention and 1 Cochrane systematic review and an ongoing RCT about secondary stroke prevention.Conclusion Statins therapy can reduce the incidence of stroke,especially in high-risk patients with coronary heart disease,hypertension and diabetes.Statins have positive effect for primary stroke prevention and do not increase the incidence of hemorrhagic stroke and tumor.The clinical evidence about the effect of statins in secondary stroke prevention is insufficient.An ongoing stroke trial will provide important evidence for secondary stroke prevention.

Objective To investigate molecular typing and drug resistance patterns of 98 Klebsiella pneumoniae (K.pneumoniae) isolated from type 2 diabetes patients complicated with maxillofacial infection,to research the virulence and resistance mechanisms.Methods The study was a prospective study that adopted the method of continuous sampling from fixed location,from March 2010 to October 2012.The maxillofacial surgery patients diagnosed with type 2 diabetes complicated with maxillofacial infection were chosen in 7 hospitals in Zhengzhou as the research object,and a total of 431 pus sample were collected continuously,in which 98 strains K.pneumoniae were isolated and identified.The Kirby-Bauer disk diffusion test was conducted in 98 strains to determine the resistance to 19 antibacterial agents.K.pneumoniae chromosomal DNA were digested by restriction endonuclease Xba Ⅰ and analyzed by pulsed-field gel electrophoresis (PFGE).PFGE patterns of K.pneumoniae strains were analyzed using Fingerprinting software.The relationship between the molecular types and resistance phenotype was observed.The extended spectrum β-1actamase-producing K.pneumoniae were screened out by the double disc synergy test (DDST)Polymerase chain reaction (PCR) was used to detect resistant genotypes,serotype and virulence genes.The purified PCR products of resistant genes were cloned and sequenced.Hypermucoviscosity phenotype of all strains were determined by string test.Results Much severer drug-resistance for K.pneumoniae was identified and the result of extended-spectrum beta-lactamase producing rate was 57.1 ％.Ninety-eight strains were dispatched into 13 groups by PFGE.No dominant bands and specific extended-spectrum beta-lactamase DNA bands were found.The results of PCR showed that among the 56 strains of extended spectrum β-lactamase-producing K.pneumoniae,40 were positive for blaSHV (accounting for 71.4％),28 positive for blaTEM (accounting for 50.5％),21 positive for blaCTX-M (accounting tor 37.5％).The sequencing results were as follows:TEM-1,CTX-M-3 and a variety of SHV.Serotype K1,K2,K3,K5,K20,K54 and K57 and 3 kinds of virulence genes were detected,but not in strong toxicity-based.Hypermucoviscosity positive rate was 31.6％ (31/98).Conclusion Much severer drug resistance of K.pneumoniae in this study was identified and resistant mechanism was complex,in which strong toxicity serotype and virulence geues exist,which need more attention from clinical.

ObjectiveTo compare the clinical effectiveness and adverse effects following low doses versus traditional doses of amphotericin B liposome (L-AmB) in the treatment of patients with invasive pulmonary fungal infections (IPFI) after renal transplantation.MethodsA total of 26 postrenal transplantation patients with IPFI between Jan. 2005 and Mar. 2011in Zhujiang hospital received L-AmB treatment identified low doses group (0.2-0.5 mg·kg-1·d-1,n =19) or traditional doses group (1-5 mg· kg-1,d-1,n =7) were reviewed.ResultsThe treatment duration in low doses group and traditional doses group was 20.3 +12.7 and19.3 ±13.2 days respectively (P＞0.05).The effective rate in low doses group and traditional doses group was 84.2％ and 57.1％ respectively (P＞0.05).The overall dosage was significantly less in the low doses group (414.7 ± 241.7 mg) than in the traditional doses group (1158.8 ± 928.0 mg) (P＜0.05).The incidence of adverse effect was significantly lower in the low doses group than in the traditional doses group (21.1％ vs.85.7％,P＜0.05).ConclusionThe effectiveness of low doses of L-AmB protocol in the treatment of IPFI postrenal transplantation patients was similar to that of traditional doses of L-AmB protocol,but the incidence of adverse effects in low doses of L-AmB protocol was significantly lower.