Objective To evaluate selective retention of the great saphenous vein (GSV) belowknee in the prevention of saphenous nerve injury during varicose veins surgery.Methods From January 2009 to January 2012,280 consecutive patients with incompetence of the GSV resulting in varicose veins were prospectively randomized into 2 groups.Patients in the experimental group underwent stripping restricted to the below knee level,patients in control group underwent GSV stripping to the ankle level Patients in the two groups were treated with transilluminated powered phlebectomy,and foam sclerotherapy.Primary end points were postoperative pain,saphenous nerve injury,quality of life and recurrence rate.Results After one month follow-up:5.71％ patients had symptoms of nervous system in the observation group,14.29％ patients had symptoms of nervous system in the control group (P =0.02).After 1 year follow-up,1.47％ patients had symptoms of nervous system in the observation group,7.14％ patients had symptoms of nervous system in the control group (P =0.02).Conclusions Selective retention of great saphenous vein below-knee decreases saphenous nerve injury.

Objective To compare the outcome and early patency rate of revascularization treatment for patients with iliac artery occlusion or stenosis.Methods Retrospective analysis was made on 105 cases of iliac artery occlusion or stenosis from January 2009 to April 2014.49 were with iliac artery occlusion and 56 with iliac artery stenosis.Results The demographics,and comorbidities were not statistically different between the 2 groups.The occlusion group had more critical limb ischemia and the ankle-brachial index was lower than the stenosis group.The occlusion group underwent more hybrid surgery and used more covered stents in the operation.The peri-operative complication was higher in the occlusion group,but the difference was not statistically different.The ABI improved significantly for all patients after surgery.The early patency rate was similar in the 2 groups.Conclusions Revascularization treatment for patients with iliac artery occlusion and stenosis was safe and effective,with similar early patency rate and peri-operative complications between the two groups.

Objective To study the clinical outcome of endoscopic vessel harvesting system (EVH) for the treatment of lower limbs varicose veins.Methods Patients (n =41) with varicose veins admitted from Jan 2011 to May 2013 were randomly divided into EVH group (n =20) and stripping group (n =21).Indexes as postoperative VAPS (48 hours and 1 week),subcutaneous ecchymosis (1 week),hematoma(1 week),skin numbness (1 week),CEAP classification (3 months),surgery effect and satisfaction scores(3 months) were compared between the two groups.Results 48 hours and 1 week VAPS was lower in EVH group(P ＜0.01).After EVH there was less subcutaneous ecchymosis (1 week),hematoma(1 week) and skin numbness (1 week) (all P ＜ 0.01).Postoperative CEAP classification improved significantly in both groups (P ＜ 0.01),while surgery effect and satisfaction scores (3 months) were better in EVH group (P ＜ 0.05).Conclusions EVH is a safe and minimally invasive technique in treatment of varicose veins of the lower limbs.

Objective To study the intraoperative and postoperative complications of autologous liver transplantation (ALT),and their prevention and treatment.Methods From October 2005 to December 2011,our center carried out 36 cases of ALT for malignant (n=23) and benign diseases (n=13).Intraoperative and postoperative complications and treatment methods were analysed.Results Of the 36 patients,2 patients developed small liver syndrome in the perioperative period.Allogeneic liver transplantation was carried out for 1 of these two patients for acute liver failure.Another patient died of lung infection 16 days after the surgery.Among 36 ALT recipients and 23 patients suffering from malignant tumor,1,2,3-year survival rates were.75％,71％,68％ and 65％,59％,54％ respectively.Conclusions With adequate preoperative assessment,the incidence of serious complications after ALT should be low.Prompt prevention and treatment of intraoperative and postoperative serious complications could cut down perioperative mortality,and provide long-term survival after ALT.

Objective To investigate the change in body weight over time in rectal cancer patients receiving radiotherapy and the correlation between setup errors and weight loss,and to establish the image-guided radiotherapy regimens in different periods of treatment.Methods A total of 24 postoperative patients with rectal cancer admitted to our hospital in 2016 were selected.Before each fraction of radiotherapy,the body weight was recorded,and the patients underwent cone-beam computed tomography (CBCT) with different frequencies in every week.The planning CT was matched with CBCT to obtain setup errors.The paired t test was used for difference analysis;the Pearson method was used to analyze the correlation between setup errors and weight loss.Results Body weight was measured 456 times in the 24 patients,and these patients underwent CBCT scans and image registration 456 times.Two patients were excluded because of treatment discontinuance.In the first and second weeks,there was no significant change in body weight.In the third week,the mean weight loss was 1.53 kg.In the fourth week,the mean weight loss was 2.48 kg.In the fifth week,the mean weight loss was 3.24 kg.The setup errors obtained by CBCT image registration in the superior-inferior (SI),anterior-posterior (AP),and left-right (LR) directions were 0.19 cm,0.20 cm,and 0.18 cm,respectively,in the first week,0.18 cm,0.17 cm,and 0.15 cm,respectively,in the second week,0.20 cm,0.22 cm,and 0.21 cm,respectively,in the third week,0.19 cm,0.25 cm,0.24 cm,respectively,in the fourth week,and 0.34 cm,0.33 cm,and 0.31 cm,respectively,in the fifth week.The Pearson correlation analysis showed that weight loss increased the setup errors,with P values of 0.140,0.046,and 0.044 in the SI,AP,and LR directions,respectively.Conclusions For rectal cancer patients receiving radiotherapy,the body weight decreases significantly in the late period (especially in the fifth week),which influences the setup errors.Therefore,in the fourth and fifth weeks of radiotherapy for rectal cancer,the weight loss should be closely monitored,and the number of CBCT scans can be increased before the treatment fraction to ensure the accuracy and optimization of treatment.

OBJECTIVETo probe into a better therapy for primary trigeminal neuralgia.

METHODSEighty-six cases were randomly divided into an observation group (n = 46) and a control group (n = 40). The observation group were treated with the three-combination needling method, i. e. acupuncture, acupoint-injection and fire-needle therapy, and the control group with acupuncture and acupoint-injection. After treatment of 2 courses, their therapeutic effects were assessed.

RESULTSThe total effective rate of 93.5% and the cured rate of 60.9% in the observation group were better than 65.0% and 22.5% in the control group, with significant differences (both P < 0.01).

CONCLUSIONThe three-combination needling method has obvious clinical therapeutic effect on primary trigeminal neuralgia.

Acupuncture Therapy ; methods ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Trigeminal Neuralgia ; diagnosis ; therapy

In order to compare the differences of 35 Menthae Herba samples collected on the market and at producing areas, the contents of six total terpenoids, the essential oil and chromatographic fingerprints were analyzed, which provided evidences for drawing up the commodity specifications and grading criteria of Menthae Herba. GC-MS method was used to analyze the chemical constituents of 35 different samples. The chromatographic fingerprints obtained by using GC were then evaluated by similarity analysis, hierarchical clustering analysis and principal component analysis. The relativity between the content of six terpenoids and the essential oil were studied. In this study, the chemical profiles of 35 samples from different producing areas had significant disparity. All samples collected in the report could be categorized into four chemical types, L-menthol, pulegone, carvone and L-menthone, but the chemical profiles had no relationship with the areas. The chromatographic fingerprints of the samples from different types were dissimilar, while the different producing areas were difficult to be separated. It was indicated that the content of volatile oil was positively correlated with the content of L-menthol and the sum of six total terpenoids. The content of the essential oil, L-menthol and the sum of six total terpenoids of Menthae Herba were considered as one of the commercial specifications and grading criteria. These results in the research could be helpful to draw up the commercial specification and grading criteria of Menthae Herba from a view of chemical information.
Cluster Analysis ; Gas Chromatography-Mass Spectrometry ; Mentha ; chemistry ; Oils, Volatile ; analysis ; Principal Component Analysis ; Terpenes ; analysis

OBJECTIVETo detect the expression of the glucocorticoid receptor-alpha/beta (GR-alpha/beta) mRNA in nasal polyp and normal nasal mucosa and investigate the significance of receptor-alpha/beta in GC-insensitive and GC-sensitive patients.

METHODSThe expression of GR-alpha/beta mRNA in 40 samples of nasal polyp and 30 normal nasal mucosa was examined by using Fluorescent quantitative PCR.

RESULTSForty cases were screened from the 80 cases after follow-up, including 26 cases of GC-sensitive and 14 cases of GC-insensitive. the levels of GR-beta mRNA in group of GC-insensitive [(5.72 +/- 0.58) x 10(2) copy/microg] were significantly higher than that of GC-sensitive [(4.82 +/- 0.28) x 10(2) copy/microg, t = -6.65, P < 0.01] and normal nasal mucosa [(4.44 +/- 0.35) x 10(2) copy/microg, t = -9.19, P < 0.01]. There was difference between group of GC-insensitive and other two groups of GC-sensitive and normal nasal mucosa (P < 0.01). The ratio of GR-alpha/GR-beta showed significant difference between the group of GC-sensitive (829.42 +/- 67.36) and that of GC-insensitive (535.70 +/- 89. 00, t = 11.74, P < 0.01).

CONCLUSIONSThe high expression of GR-beta mRNA and low expression of GR-alpha mRNA in nasal polyp show the status of "insensitive" in chronic sinusitis and nasal polyp. The GR-beta may play an important role in evaluating the effect of glucocorticoid in chronic sinusitis and nasal polyps.

Adult ; Case-Control Studies ; Chronic Disease ; Female ; Humans ; Male ; Nasal Mucosa ; metabolism ; Nasal Polyps ; metabolism ; RNA, Messenger ; genetics ; Receptors, Glucocorticoid ; metabolism ; Sinusitis ; metabolism

[Objective]To investigate the effect of GRACE scores on prediction of 30-day cardiovascular adverse events in acute chest pain patients.[Methods]A prospective,observational analysis was conducted in the patients with acute chest pain in Emergency Department(ED)from January 1,2016 through April 1,2016.Data including characteris-tics and GRACE scores were collected.All causes leading to MACE were followed up at 30th day after the onset of acute chest pain.[Results]Among a total of 209 patients presenting with acute chest pain enrolled in this study,110 were male (52.63%)and 99 were female(47.37%).The range of age was 20-98years old,and mean age was(65.28±16.85)years old.During follow-up period,12 patients had MACE,2 patients died in ED,3 patients died in hospital,6 patients died out of hospital,and 1 person was diagnosed with myocardial infarction. When compared with non-MACE group,factors including age,BMI,hospitalized patient number,and number of patients admitted in CCU as well as GRACE scores, were significantly higher in MACE group(P<0.05). The predictive ROC curve area of GRACE scores in 30-day MACE was 0.819(0.735 to 0.902). The optimal sensitivity and specificity were 0.92 and 0.65,respectively. The probability of 30-day cardiovascular adverse events in various GRACE score risk stratification was 0.95%(low-risk),6.67%(medi-um-risk),and 18.92%(high-risk),respectively.[Conclusion]The GRACE score was a useful predictor to the occur-rence of 30-day cardiovascular adverse events in acute chest pain patients.

OBJECTIVETo evaluate the clinical effectiveness of three localization methods, including methylene blue, metal clips and intraoperative colonoscopy in laparoscopic colorectal surgery.

METHODSA retrospective analysis was performed to review the clinical data of 64 patients who underwent the laparoscopic colorectal operations in Cancer Hospital of Fudan University from December 2009 to June 2012. Three methods of tumor localization were used perioperatively, including 23 cases of methylene blue, 20 of metal clips and 21 of colonoscopy.

RESULTSOperations were successfully performed in this cohort and there were no deaths or complications. In methylene blue group, intraoperative colonoscopy was performed in two cases because of the inability to visualize blue dye on the serosal surface of the intestinal wall, another 2 cases were converted to open operation because of methylene blue diffusion and inability to identify resection margin. Intraoperative colonoscopic localization was required for 3 cases of sigmoid colon or upper rectal tumor because of inaccurate tumor localization by metal clips. Poor operative exposure due to obvious bowel distension prompted the conversion to open surgery in 2 cases of colonoscopy localization group, and the accurate position of the lesion was not found in another 2 cases due to long pedunculated adenoma.

CONCLUSIONSColorectal tumor can be localized effectively by endoscopic methylene blue tattooing at a maximum of 2 tumors before operation and the method of 4-point positioning can significantly improve the accuracy of colorectal tumor localization. Tumor localization preoperatively on the day of surgery by metal clip is accurate for the right or left colon cancer. Intraoperative colonoscopy can localize tumor accurately and rapidly for rectosigmoid or descending tumor, and the incidence of bowel distension can be significantly reduced. Localization method should be considered according to the tumor location and surgical procedure.

Adult ; Aged ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome