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

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.

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

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 investigate cranial decompression under temporal muscle in very-low position with large bone flap combined with mild hypothermia for severe cranial trauma.Methods 88 severe brain injury patients (GCS ≤ 8 ) were randomly divided into two groups,mild hypothermia group( n =48) and non-mild hypothermia group ( n =40),both presented with cranial decompression under temporal muscle in very-low position with large bone flap.Data of patients,GCS increment,rate of brain cistern display,rate of pupil shrink and therapeutic effect were ananlyzed.Results The treatment group showed better effect compared with the oontrol group(P＜0.05).Condusion The therapy of cranial decompression under teniporal muscle in very-low position with large bone flap combined with mild hypothennia showed the advantage of depressing intracranial pressure,reducing crerebral edema and improving the therapeutic effect of severe brain injury patients.

Objective To investigate the distribution of Human Papillomavirus 16 (HPV16) infection and its mixed infection with other HPV subtypes in the Yunnan region. Methods 16 166 cases of women were tested using flow fluorescence Luminex technology. Results (1) HPV16 infection rate and mixed infection rate was 2.2%and 28.0%, respectively; (2) The most common type of HPV16 mixed infection was HPV52, followed by HPV33. The two kinds of mixed infection accounted for 39.8% of the total infection rate; (3) There was a significant difference between each age group of HPV16 mixed infection (Chi=26.39, <0.01) . Conclusion The HPV16 infection was mainly HPV infection in Yunnan region. HPV16 mixed infection merged mainly with HPV52 and HPV33. HPV16 mixed infection was associated with age.

Objective To investigate the the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute non-ST-segment elevation myocardial infarction patients with heart failure.Methods 80 patients with heart failure caused by acute non-ST-segment elevation myocardial infarction were chosen,they were divided into the observation group and control group based on a random number table,each group included 40 patients.The observation group were treated with intravenous injection of recombinant human brain natriuretic peptide,the control group were treated with intravenous nitroglycerin.vital signs,dyspnea,brain natriuretic peptide (BNP),associated hemodynamic changes and adverse reactions of two groups were compared before and after treatment.Results The total effective rate in observation group was 87.5％ (35/40),which were significantly higher than 50.0％ (20/40) of the control group,there were significant difference (x2 =13.09,P ＜ 0.05).In the observation group,after treatment,the left ventricular ejection fraction (LVEF) and average hourly urine output were significantly higher than those of before treatment (t =26.40,3.22,all P ＜ 0.05),and the brain natriuretic peptide (BNP) concentration levels were significantly lower than those of before treatment (t =14.11,all P ＜ 0.05).The control group before and after treatment LVEF,BNP and changes in urine levels were not significantly.Conclusion In the treatment of heart failure caused by acute non-ST-segment elevation myocardial infarction,the recombinant human brain natriuretic peptide (rhBNP) has significant effect,feasible and safe with few side effects,which has a high clinical value.

Objective To explore the mechanism of immunologic injury in patients with Tourette's syndrome(TS). Methods The serum level of anti-brain antibody ( ABAb) , antinuclear antibody ( ANAb) , soluble IL-6 receptor (sIL-6R) and soluble gpl30(sgp130) in patients with TS were analyzed by commercially available ELISA kits,and the titer of anti-streptolysin O ( ASO) in TS and in control was examined with latex enhanced immunoturbidimetry. Results The level of sIL-6R and sgpl30 was significantly elevated in TS compared with control group [(44. 1 ± 15.8)ng/mL vs (30. 3 ± 9. 0) ng/mL and (69. 0 ±24. 6)ng/mL vs (47. 3 ±14. l)ng/mL,P <0. 01 respectively]. ASO titer(250 U/mL) was found higher in TS than that in control(P <0. 01). The positive rates of anti-brain an-tibody and antinuclear antibody in TS were higher than that in control group (66% vs 4% and 53% vs 25% , P <0. 01 respectively). The level of ABAb negatively correlated with sgpl30 concentration( r = 0. 375, P <0. 05 ). Conclusion IL-6 signal transduction might be involved in Tourette's syndrome to lead the function enhancementand start cascade of feedback inhibition, because of elevated levels of slL-6R, sgp130, ANAb and ABAb in serum.Autoimmune-related injuries may potentially explain the pathogenesis of the disease.

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.