Esophageal and Gastric Varices ; complications ; prevention & control ; surgery ; Gastrointestinal Hemorrhage ; complications ; prevention & control ; surgery ; Humans

Adult ; Antibodies, Monoclonal, Murine-Derived ; administration & dosage ; therapeutic use ; Female ; Hemophilia A ; drug therapy ; Humans ; Rituximab

Objective To study X-ray and clinical diagnosis of multiple myeloma(M M).Methods X-ray findings in 16 cases with M M were retrospectively analyzed.Results The main manifestations on X-ray were:normal in 3;osteoporosis in 8;osteolytic destrucion in 12;osteosclerosis in 1 and mass of soft tissue in 6.Conclusion The diagnosis of M M is mainly depended on clinical and X-ray findings,puncture of bone marrow is of diagnostic value,the differential diagnosis is still necessary.

Objective To summarize the clinical experience of endovascular intervention for intra-cranial aneurysms, especially in the respect of the technique and management of intra-operative complications. Method The clinical data of 60 patients with intra-cranial aneurysms treated with endovascular intervention in the past 3 years were analyzed. The relevant literature especially with regard to the practical technique described was reviewed so as to potentiall minimize and properly manage the intra-operative complications. Results A total of 69 sacciform aneurysms and one dissecting aneurysm located at left vertebral artery (VA) were detected by using digital subtraction angiography (DSA) in 60 patients. There were 65 saccular aneurysms obliterated with constructive approach, and five of them treated with stent-assisted technique and four of them treated with ballon-assisted technique. The VA dissecting aneurysm was obliterated with coils by deconstructive approach with complete occlusion of its parent vessel. There were a total of 53 complete occlusions of aneurysms accounted for 76.81% of 69 sacciform aneurysms in 51 patients ( 85 % ) and eight subtotal occlusion of aneurysms (95 % ～ 99 % occlusion) accounted for 13.56% of total sacciform aneurysms in five patients (8.47%) and four incomplete occlusion of aneurysms ( ＜ 95% occlusion) accounted for 6.78% of total sacciform aneurysms in three patients (5.08%), and one was failure in operation. The rupture of aneurysms occurred during operation in4 patients (6.78%). Two senile patients suffered from intra-opeartive symptomatic thromboembolisn. One patient had stent shifting and spring coil dislocated and moved into the M3 segment of the ipsilateral MCA. Vasospasm occurred in 15 patients during operation, and most of them received endovascular intervention 3 days after the initial ictus. The rate of good recovery was 93.3% at discharge from hospital (the modified Rankin Scales, mRS＜ 2). There were 55 patients followed up for up 24 months after discharge, and excellent recovery rate was found in 51 patients ( mRS ＜ 2), and 3 died.During the follow-up period, no aneurismal recanalization or rupture was noticed in all patients. Conclusions The endovascular intervention is a safe and effective approach to the intra = cranial aneurysms. Advances in the skill of technique and proper management will decrease the complications during operation and improve the prognosis of patients.

Endoscopy ; Equipment Failure ; Female ; Foreign Bodies ; surgery ; Humans ; Intubation, Intratracheal ; instrumentation ; Middle Aged ; Trachea

Objective To determine the value of MR in the diagnosis of the medial and lateral meniscal posterior root tears.Methods One hundred and twenty one patients underwent arthroscopy and MR of knee examinations were retrospectively reviewed,and all of them did not have the history of knee surgery before the MR examination.MR images were double-blinded,independently,retrospectively scored by radiology residency (doctor 1) and attending radiologist (doctor 2).The likelihood of the meniscus posterior root tear was scored on basis of arthroscopic findings constituted the gold standard.Sensitivity,specificity and accuracy of MR diagnosis of the lateral and medial meniscus posterior root tear by two physicians were calculated,and the consistency of diagnosis results by two physicians was evaluated using the Kappa statistics.Reasons leading to misdiagnosis or missed diagnosis were discussed.Results Thirty three of the 121 patients were diagnosed with meniscus posterior root tears by arthroscopy,including 14 cases of lateral tears and 19 cases of medial tears.The sensitivity,specificity and accuracy in the diagnosis of posterior lateral meniscus root tears (PLMRT) for doctor 1 were 71.4％ (10/14),82.2％ (88/107) and 81.0％ (98/121),respectively,and for doctor 2 were 71.4％ (10/14),86.0％ (92/107) and 84.3％ (102/121).The sensitivity,specificity and accuracy in the diagnosis of posterior medial meniscus root tears (PMMRT) for doctor 1 were 100.0％ (19/19),88.2％ (90/102) and 90.1％ (109/121),respectively,and for doctor 2 were 100.0％ (19/19),95.1％ (97/102) and 95.9％ (116/121),respectively.The Kappa statistics for PLMRT and PMMRT were 0.67 and 0.81,respectively,demonstrating a good interobserver agreement (P＜0.05).The misdiagnosed cases of the PMMRT were 12 for doctor 1 and 5 for doctor 2.There were 4 cases being commonly misdiagnosed by the two doctors,and there were no any missed cases in this study.For the PLMRT,the misdiagnosed cases were 19 for doctor 1 and 15 for doctor 2.Eleven cases were misdiagnosed and 4 were missed by the two physicians.Conclusion MR is a reliable diagnostic tool for detecting posterior root tears of the medial and lateral meniscus.

pFH23. These studies provide the possibility of further research on the expression of recombinant antigenic genes, the immunity of their expressed products and the protection of animals.

Objective To explore whether hypermethylation in the promoter of p16 gene and protein of p16 were associated with development and clinicopathological characteristics of colorectal cancer. Methods Methylation-specific PCR ( MSP) and immunohistochemistry SP were used to detected hypermethylation of p16 gene and p16 protein in tumor tissues from 32 patients with colorectal cancer. Results The hypermethylation of p16 gene was detected in 40. 6% of tumor tissues. The protein of p16 promoter was detected in 75% of tumor tissues. The hypermethylation of p16 gene was detected in 63% in Dukes stages of C and D tumors. The protein of p16 promoter was detected in 69% of tumor tissues. The hypermethylation of p16 gene was detected in 25% in the stages of A and B tumors. The protein of p16 promoter was detected in 81% of tumor tissues. The hpermethylation of p16 gene was detected in 100% in low differentiated carcinomas. The protein of p16 promoter was detected in 20% , the hypermethylation of p16 gene was detected in 30% , in the high and mediate differentiated carcinomas, the protein of p16 promoter was detected in 85%. Furthermore, the hypermethylation of p16 gene was detected in 63% in the lymph node metastasis and 25% in without lymph node metastasis. The protein of p16 promoter was detected in 65% in rectum and 100% in colon. Conclusions Our study demonstrated that p16 hypermethylation and protein were associated with the development of colorectal cancer and could be used as a putative prognostic indicator for this malignancy.

OBJECTIVE To explore the features,developing trend and factors of hospital infection in patients with iatrogenic injury.METHODS Retrospective surveys of hospital infections in 750 cases with iatrogenic injury were carried out in hospital between 2000 and 2007.RESULTS The incidence of hospital infection in patients with iatrogenic injury was 87.39%.Among them,hospital wound infection was the highest(87.39%),the second one was cavity infection(8.98%).The leading causative microorganisms were Gram-negative bacteria.CONCLUSIONS It is imperative to make effort to decvease the morbidity of hospital infections.We hope that the iatrogenic injury can be brought into the category of public health as soon as possible to enhance the medical care service and secure safty and health of the patients.

Through the experiments of producing spherical steel-bullet (4.763mm in caliber and 0,44gm in weight) wound on the hind legs of 17 dogs, the authors re- ported that there was a definite linear relationship between the reactions of the serum creatine kinase and the amount of kintic energy from the high speed of the bullets absorbed by the tissues and also with the weight of dead tissue removed around the bullet-path, Within the first 6 hours after injury, the activity of SCK increased with the rise of the biologic effect values of the amount of the kinetic energy absorbed and the weight of the dead tissue removed.