Objective To systematically evaluate the safety of laparoscopic distal pancreatectomy (LDP) compared with open distal pancreatectomy (ODP).Methods Databases including Cochrane library,MEDLINE,EMbase,Google Scholar and Chinese National Knowledge Infrastructure were searched to enroll randomized clinical trials (RCT),controlled clinical trials (CCT) or retrospective case-control studies to compare LDP with ODP.All articles received quality assessment according to the inclusion and exclusion criteria,then the selected indices were analyzed using the Review Manager Version 5.0 software (The Cochrane Collaboration,Oxford,United Kingdom).Results 21 manuscripts with a total of 2 797 patients were enrolled.1 150 patients underwent LDP and the remaining 1 647 patients underwent ODP.In 20 studies (n =2 597),the total postoperative complication rates were 33.90％ for the LDP group versus 46.80％ for the ODP group [RR =0.76,95％ CI(0.69 ～ 0.84),P ＜ 0.01].In 8 studies (n =1 869) there was no significant difference [RR =0.51,95％ CI(0.21 ～ 1.24),P ＞0.05] in the perioperative mortality between LDP (4/703) and ODP (18/1 166).In 20 studies (n =2 757) there was no significant difference [RR =0.89,95％ CI(0.75 ～ 1.06),P ＞ 0.05] in the pancreatic fistula rate between LDP (168/1 132) and ODP (281/1 625).In 11 studies (n =1 840) the wound infection rate of LDP (3.24％) was significantly lower than ODP (10.85％) [RR =0.34,95％ CI(0.23 ～ 0.52),P ＜ 0.01].No significance was found between the two groups in the rates of pulmonary complications,peritoneal infection,urinary tract infection,postoperative bleeding,pseudocyst formation,intestinal obstruction and ascites formation between LDP and ODP.Conclusions When compared with the traditional open procedure,LDP has the advantages of significantlylower rates of postoperative complication and wound infection.There were no significant differences in postoperative mortality,and pancreatic fistula rate between LDP and ODP.This meta-analysis suggests that LDP is a safe and feasible operative method.

512?g/mL; MIC of 16 VIE to vancomycin were 16?g/mL; MIC of 8 VIE to vancomycin were 8?g/mL. It is a risk factor for hospital infection that VRE carriage of inpatients in intestinal tract is high. There is 100% agreement be-tween phenotypes and genotypes in 46 vancomycin resistance enterococci. VRE are multiresistant. Part iso-lates have high homology.

Objective To investigate the efficacy of electromyographic biofeedback therapy (EMGBFT) in treating dysphagia after stroke.Methods Patients diagnosed with dysphagia after stroke were recruited and randomly divided into a control group (n =22),an electrostimulation group (ES,n =25) and an EMGBFT group (n =23).The control group received conventional treatment,while the patients in the other groups additionally received Vitalstim ES or EMGBFT 5 times per week for 3 weeks.Before and after the trial,deglutition function was evaluated through surface electromyography (sEMG) and using a standardized swallowing assessment (SSA).Results After 3 weeks of treatment,the mean sEMG amplitude,deglutition duration and SSA score and improved significantly in comparison to the baseline in all three groups.All were also significantly better in the two treatment groups than in the control group.Importantly,the mean sEMG amplitude,deglutition duration and SSA score were all significantly better in the EMGBFT group than in the ES group.Conclusion EMGBFT can promote better deglutition among patients with dysphagia after stroke more effectively than ES or conventional treatment.

10.3969/j.issn.1000-3606.2013.06.016

Adult ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Infant ; Keratins ; metabolism ; Male ; Mandibular Neoplasms ; metabolism ; pathology ; surgery ; Melanoma ; metabolism ; pathology ; Neuroblastoma ; metabolism ; pathology ; Neuroectodermal Tumor, Melanotic ; metabolism ; pathology ; surgery ; Rhabdomyosarcoma, Embryonal ; metabolism ; pathology ; Synaptophysin ; metabolism

Adult ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Radiation, Ionizing ; Radiology Department, Hospital ; Serum ; metabolism ; radiation effects ; Testosterone ; blood ; Thyroid Hormones ; blood

Objective To evaluate the performance of Mindray TSH chemiluminescence immunoassay ,including imprecision , limit of detection ,functional sensitivity ,interference ,cross-reaction ,and calibration consistency .The purpose was to confirm Mind-ray TSH assay meets the criteria of IFCC standardization and harmonization of thyroid functional tests .Methods The CLSI guide-lines defined in EP documents have been followed to measure the limit of detection ,functional sensitivity ,specificity ,imprecision and calibration consistency of Mindray TSH immunoassay on CL2000i system .Results Limit of detection was 0 .001 5 μIU/mL ,func-tional sensitivity was 0 .013 μIU/mL ,the correlation coefficient of linearity was 0 .999 in the range of 0-98 .95 μIU/mL .Mindray TSH calibrator C0 spiked with luteinizing hormone (LH) up to 500 mIU/mL ,follicle stimulating hormone (FSH) up to 500 mIU/mL ,or human chorionic gonadotropin (HCG) up to 200 000 mIU/mL detected no cross reactivity (detected TSH was less than 0 .2μIU/mL) .Hemoglobin up to 500 mg/dL ,bilirubin up to 10 mg/dL ,triglycerides up to 1 800 mg/dL ,and protein up to 10 g/dL showed -6 .91% ~8 .60% bias in TSH measurement .The total imprecision of two controls (high and low levels) and three serum specimens were in the range of 3 .24% and 5 .34% .Calibration consistency which had been demonstrated with high and low controls were measured between -6 .58% and 5 .26% .Conclusion The performance of Mindray thyroid-stimulating hormone assay meets the criteria for IFCC standardization and harmonization of thyroid function tests .

OBJECTIVE: To prepare a reduction-responsive nanoparticle (HID-NPs) for indomethacin (IND) and doxorubicin (DOX) delivering and investigate their effects on reversing multidrug resistance in breast cancer. METHODS: Hyaluronic acid-based amphiphilic substances (HA-SS-PA) were prepared by amidation reaction, and their structures were confirmed by NMR. HID-NPs were prepared by nano-precipitation method. The particle size measurement and morphology observation of the HID-NPs were measured by dynamic light scanning (DLS) and transmission electron microscopy (TEM), respectively. The reduction-responsive drug release behavior of HID-NPs was determined by dialysis method. Cell uptake HID-NPs on human breast cancer MCF-7/ADR cells were observed by laser confocal microscopy. The cytotoxicity of HID-NPs on human breast cancer MCF-7 and MCF-7/ADR cells was determined by MTT assay. RESULTS: 1H-NMR spectrum indicated that HA-SS-PA was successfully prepared. The results of DLS and TEM showed that HID-NPs were round and evenly distributed with an average particle size of (103±3.2) nm. Drug release assay indicates that HID-NPs have good reduction-responsiveness ability. Cell uptake experiments demonstrated that HID-NPs significantly increased DOX accumulation in MCF-7/ADR cells compared with free DOX; MTT assays showed that HID-NPs could significantly destroy MCF-7/ADR cells. CONCLUSION: HID-NPs shows good reduction-responsiveness and obvious reverse DOX resistance, which can be used for the treatment of multidrug resistance of breast tumors.

Objective To observe the therapeutic effect of electroacupuncture combined with rehabilitation exercises on swallowing function and cerebral perfusion in dysphagic stroke patients.Methods Sixty-two stroke pa- tients with dysphagia were randomly divided into a treatment group(n=32)and a control group(n=30).The treat- ment group received electroacupunture,rehabilitation exercise and conventional medical treatment,while the control group received only rehabilitation exercise and conventional medical treatment.They were treated once a day,6 times a week for 4 weeks.Water drinking test,stethocatharsis scores and swallowing fluorography were used to assess the swallowing function before and after treatment.Single photon emission computed tomography(SPECT)was also em- ployed to observe the status of cerebral perfusion before and after treatment.Results It was shown that the swallo- wing function and cerebral perfusion in the treatment group were significantly better than the control group after treat- ment.The effective rate in the treatment group was 96.88% while that of the control group was 66.67%.Conclu- sion Electroacupuncture combined with rehabilitation exercises is effective in treating the dysphagic stroke patients, and can significantly improve the brain perfusion of these patients.

Objective: To explore the treatment effect of sticking-needle acupuncture plus tendon-regulating manipulation on pain, swelling and joint dysfunction due to acute ankle sprain.Methods: A total of 80 patients with acute ankle sprain were recruited and divided into a control group and a treatment group according to the random number table method, with 40 patients in each group. Both groups received the same conventional interventions. The control group was treated with additional tendon-regulating manipulation, and the treatment group was treated with tendon-regulating manipulation plus sticking-needle acupuncture. The pain, swelling and joint dysfunction of the ankle were observed in both groups before and after 3 d, 7 d and 14 d of treatment. Results: Before treatment, there was no statistically significant difference in the visual analog scale (VAS) score of pain between the two groups (P>0.05). After treatment, the VAS scores of both groups showed a decreasing trend over time, and the differences within the groups were statistically significant (P<0.05). After 3 d, 7 d and 14 d of treatment, the VAS scores in the treatment group were lower than those in the control group, with statistically significant differences (P<0.05). Before treatment, there was no statistically significant difference in the degree of swelling between the two groups (P>0.05). After treatment, the degrees of swelling in both groups showed a decreasing trend over time, and the differences within the groups were statistically significant (P<0.05). After 3 d and 7 d of treatment, the degrees of swelling in the treatment group were lower than those in the control group, with statistically significant differences (P<0.05). There was no statistical difference in the degree of swelling between the two groups after 14 d of treatment (P>0.05). Before treatment, there was no statistically significant difference in the American Orthopedic Foot Ankle Society (AOFAS) ankle-hindfoot scale score between the two groups (P>0.05). After treatment, the AOFAS ankle-hindfoot scale scores of both groups showed an increasing trend over time, and all the differences within the groups were statistically significant (P<0.05). After 3 d, 7 d and 14 d of treatment, the AOFAS ankle-hindfoot scale scores in the treatment group were higher than those in the control group, with statistically significant differences (P<0.05). Conclusion: Based on the routine intervention, the addition of sticking-needle acupuncture and tendon-regulating manipulation was better in alleviating pain and swelling and improving joint function in patients with acute ankle sprain than the addition of tendon-regulating manipulation alone.