Objective To investigate the clinical significance of external obturation with cotton ball in treatment of digestive tract lip shape fistula. Methods A prospevtive randomixed controllde study was conducted in 30 patients with digestive tract lip shape fistula admitted from January 2001 to November 2007,which were divided into experimental group ( 15 patienets) and control griup ( 15 patjients). The control group received traditional fistula mouth continuous drainage,with fastomg or part enteral nutrition and parenteral nutrition. The experimernal group received external obturatiion with cotton ball,with controling spills of oineteatinal fluid and resuming normal eating and activetes, The patients general information, fistuala mouth sixe, volume, weight, albumin, determinstic operation time, postoperative complications, hospital, signficantly reduced fistula, flow, postoperative compared between the two groups. Results Compared with the control group , significantly redced fistula, flow, postoperative complivations and cost, increased wdighe and albumin,as well as shortened operation time and hospital stay were found oin the experimetal grou. Conclusin External obturation with cotton ball is safe effective methde in treatment of digestive tract lip shape fistula, obviusly shortening the course of disease, redcing patients'cost and pain, and rapidly improving patients nutritional status.

OBJECTIVETo study the causes of orchiectomy in different age groups.

METHODSWe retrospectively reviewed the clinical data about 291 cases of orchiectomy performed between March 1993 and October 2014 and analyzed the causes of surgery and their distribution in different age groups.

RESULTSThe main causes of orchiectomy were testicular torsion (45.8%), cryptorchidism (32.5%) and testicular tumor (16.9%) in the patients aged 0-25 years, testicular tumor (42.4%), cryptorchidism (25.9%) and tuberculosis (10.6%) in those aged 26-50 years. Prostate cancer was the leading cause in those aged 51-75 years (77.6%) or older (84.0%)), and testicular tumor was another cause in the 51-75 years old men (10.2%). Prostate cancer, testicular tumor, cryptorchidism, and testicular torsion were the first four causes of orchiectomy between 1993 and 2009. From 2010 to 2014, however, testicular tumor rose to the top while prostate cancer dropped to the fourth place.

CONCLUSIONThe causes of orchiectomy vary in different age groups. The proportion of castration for prostate cancer patients significantly reduced in the past five years, which might be attributed to the improvement of comprehensive health care service.

Adolescent ; Adult ; Age Factors ; Aged ; Causality ; Child ; Child, Preschool ; Cryptorchidism ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Orchiectomy ; statistics & numerical data ; Prostatic Neoplasms ; surgery ; Retrospective Studies ; Spermatic Cord Torsion ; surgery ; Testicular Neoplasms ; surgery ; Tuberculosis, Male Genital ; surgery ; Young Adult

OBJECTIVETo study the pattern of the alterations of blood glucose, insulin and insulin sensitivity after traumatic brain injury in rats, and verify the occurrence of insulin resistance after the injury.

METHODSBased on Feeney's model of brain injury, the blood glucose and insulin concentration of the dogs measured 30 min before and at 6, 12, 24, 48, 72 and 120 h after injury. BG60-120, GIR60-120, and insulin sensitivity index (ISI) reflecting the insulin sensitivity were measured at 6, 24, 48, and 72 hours following severe traumatic brain injury using euglycemic-hyperinsulinemic clamp.

RESULTSBoth the blood glucose and insulin concentration increased markedly in rats following moderate and severe brain injury. BG60-120 increased markedly, and GIR60-120 and ISI decreased significantly 6, 24, 48, and 72 h after severe brain trauma as compared with those of the sham operation group. Blood glucose concentration of rats following severe injury was positively correlated with insulin concentration and BG60-120 at the corresponding time points, but negatively with GIR60-120 and ISI.

CONCLUSIONBoth the blood glucose and insulin concentration increase markedly in rats following severe brain injury. Increased blood glucose even in the presence of high-level insulin is due to acute insulin resistance occurring after traumatic brain injury.

Animals ; Blood Glucose ; metabolism ; Brain Injuries ; blood ; complications ; physiopathology ; Hyperglycemia ; etiology ; Insulin ; blood ; Insulin Resistance ; Male ; Rats ; Rats, Wistar

Objective To provide the skin vessels morphologie basis for perforating flap of the antero- lateral thigh(ALT).Methods Six sides lower limbs of adult fresh cadaver specimens perfused with lead oxide-gelatine mixture were used.Observe the peraforators of anterolateral thigh by dissection.The elevated tissue was radiographed by X-ray and MSCT-scanning.Computer techniques was used for the detection and 3D-reconstruction of the regions of each perforators of ALT flap.Results The three-dimensional recostruct- ed digitized visible models perfectly displayed the anatomic structures of arteries on the anterolateral thigh, and,the morphology and distribution of the vascular territory of each perforator from descending branch of LCFA was displayed in the images of 3D-visualization,their effective morphology and distribution were same, and they accord with vascular territory of radiograph.On the 2D-image of X-ray,The margins of the anatomical distribution of each perforator from descending branch of the lateral circumflex femoral artery were determined, their total areas was about 25cm?24cm.Conclusion Since the digitized image of perforator territory can accord with the morphology of anatomy,and can off vascular structure insights into cutaneous perforator anato- my,their 3D visualizative models can be applied in pre-operative designing and virtual operation procedures, and can be helped for study of perforator flap.

Objective To analyze the registration of pulmonary tuberculosis (PTB)among students in Hunan Province,understand the epidemiological characteristics,provide evidence for improving tuberculosis control strate-gy in schools in Hunan Province.Methods Registration rate and epidemiological characteristics of students with tu-berculosis in Hunan Province were analyzed through data registered in China Tuberculosis Information Management System between 2012 and 2017.Results From 2012 to 2017,7 940 students with PTB were found in Hunan Prov-ince,the registered incidence was 13.23/1 00 000,2 203 cases were smear positive for PTB,registered incidence was 3.67/1 00 000.Registered incidence of active PTB students in 2012－2017 was significantly different (χ2＝80.079,P＜0.001);registered incidence of smear positive PTB students in 2012－2017 was significantly different (χ2＝112.213,P＜0.001).The number of registered PTB students in the second quarter was the largest (32.2%), mainly male (60.8%)and students aged 15－19 years (61.8%).There was a significant difference in the registra-tion of PTB students in different cities from 2012 to 2017 (χ2＝320.432,P＜0.001).The top three regions of the total number of registrations were Changsha,Xiangxi and Hengyang.From 2012 to 2017,the registered PTB students were mainly referral (38.8%),99.8% of the patients received anti-tuberculosis treatment,diagnosis and treatment were mainly for smear-negative,non-severe,non-drug-resistant,and newly treated patients,accounting for 67.9%,95.2%,99.5%,and 99.3% respectively.Conclusion It is necessary to strengthen the prevention and control of tuberculosis in schools,screen tuberculosis among freshmen in high schools and universities,publicize tu-berculosis knowledge,and improve awareness of tuberculosis prevention and control in schools.

OBJECTIVETo further study the characteristics of drugs with neutral property in two-way application and conditioned dominance by observing the action characteristic of 10 traditional Chinese medicines with neutral property in hemorheological indicators of heat stagnation and blood stasis syndrome and cold stagnation and blood stasis syndrome rats.

METHODThe model of heat stagnation and blood stasis syndrome rats was established by injecting carrageenan and dry yeast, while the model of cold stagnation and blood stasis syndrome rats was established by body freezing. Subsequently, 10 traditional Chinese medicines with neutral property, 5 traditional Chinese medicines with heat property and 5 traditional Chinese medicines with cold property were selected for intervention to observe the changes in such indicators as whole blood viscosity, plasma viscosity and hematocrit and analyze the action characteristics of drugs with neutral property.

RESULTANOVA showed that among six of the 10 traditional Chinese medicines with neutral property, including Typhae Pollen, Sarcandrae Herba and Sappan lignum, could obviously increase the hemorheological indicators of both heat stagnation and blood stasis syndrome and cold stagnation and blood stasis syndrome rats; five traditional Chinese medicines with cold property, such as Salviae Miltiorrhizae Radix et Rhizoma, Leonuri Herba, Rhei Radix et Rhizoma, could significantly ameliorate the hemorheological indicators of heat stagnation and blood stasis syndrome rats (P < 0.01 or P < 0.05), and Salvia Miltiorrhiza Radix et Rhizoma alone could ameliorate the hemorheological indicators of cold stagnation and blood stasis syndrome rats (P < 0.05); all of the five traditional Chinese medicines with heat property could significantly ameliorate the hemorheological indicators of cold stagnation and blood stasis syndrome rats (P < 0.01), among which Carthami Flos and Notoginseng Radix et Rhizoma could significantly ameliorate the hemorheological indicators of cold stagnation and blood stasis syndrome rats. According to the average high-shear blood viscosity analysis, drugs with neutral property showed similar action characteristics to those with cold property in ameliorating hemorheology indicators of heat stagnation and blood stasis syndrome rat and better effect than those with heat property in reducing whole blood viscosity; and traditional Chinese medicines with neutral property have the similar action characteristics to those with heat property in improving the hemorheology indicators of cold stagnation and blood stasis syndrome rat and better effect than those with heat property in reducing whole blood viscosity.

CONCLUSIONUnder the condition of heat stagnation and blood stasis syndrome, traditional Chinese medicines with neutral property show the similar action characteristics to those with cold property; but under the condition of cold stagnation and blood stasis syndrome, traditional Chinese medicines with neutral property show the similar action characteristics to those with heat property. This indicates that traditional Chinese medicines with neutral property show both heat and cold properties under he conditions of heat stagnation and blood stasis syndrome and cold stagnation and blood stasis syndrome.

Analysis of Variance ; Animals ; Blood Circulation ; drug effects ; physiology ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Hemorheology ; drug effects ; Homeostasis ; drug effects ; Male ; Medicine, Chinese Traditional ; methods ; Rats ; Rats, Sprague-Dawley ; Thrombosis ; drug therapy ; physiopathology

OBJECTIVETo clarify three-grade criteria of curative resection for primary liver cancer (PLC) and evaluate their clinical significance.

METHODSCriteria of curative resection of PLC were summed up to three grades. Grade I: complete removal of all gross tumors with no residual tumor at the excision margin. Grade II: on the basis of Grade I, there was no extrahepatic metastasis, no hilar lymph node metastasis, no tumor thrombus in the main trunks and their primary tributaries of the portal vein, common hepatic duct, hepatic vein and vena cava inferior, and the tumor was not more than two in number. Grade III: in addition to the above criteria, AFP dropped to normal level (in patients with elevated AFP before surgery) within 2 months after operation, and no residual tumor upon diagnostic imaging. A total of 354 cases with PLC who had their liver resected was reviewed. Patients in each grade were divided into two portions depending on whether the treatment was curative or palliative.

RESULTSThe survival of patients receiving curative treatment was better than those receiving palliative treatment (P < 0.01). This was true for patients whose treatment belonged to anyone of the three-grade criteria. The survival was improved along with the promotion of curative criteria used. The 5-year survival rate of Grade I, II and III patients undergone curative resection was 43.2%, 51.2% and 64.4%, respectively (P < 0.01).

CONCLUSION1. The three-grade criteria may be used for judging the radicality of tumor resection for PLC. 2. The more stringent the criteria used, the better the survival would be. 3. Adopting high-grade criteria to select cases, to guide operation and postoperative follow-up would improve the results of liver resection for PLC.

Female ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; mortality ; surgery ; Male ; Middle Aged ; Survival Rate

OBJECTIVETo investigate the effect of different operation time to percutaneous balloon pulmonic valvuloplasty (PBPV) to critical pulmonary valve stenosis (CPS).

METHODTwenty-one infants (age ≤ 60 days at operating day) suffered from CPS, diagnosed by fetal echocardiogram and confirmed by echocardiography after birth, were enrolled in this case-control-study with written informed consent during April 2007 to December 2011. Of the 21 cases, 7 had prenatal diagnosis in our prenatal diagnosis center (prenatal group, Pre) and 14 were referred from other hospitals, who were divided into postpartum group A (Post A, referred within 28 days after birth) and postpartum group B (Post B, referred 29 to 60 days after birth). To Pre-group, the integrative interventional protocol was cautiously made by the consultative specialists, including intrauterine diagnosis, perinatal care and urgent PBPV soon after birth. To Post-group, emergency PBPV was preformed after the referral. Tei index of right ventricular and pressure-gradient (PG) between right ventricular and pulmonary artery were measured before and at different time points one year after PBPV.

RESULTThe values of SpO2 in Pre-group ranged from 82%-92% (86.57% ± 5.34%) under the state of continuous intravenous infusion of alprostadil. PBPV was successfully preformed within 3-6 days after birth. The values of SpO2 increased to 97.33% ± 1.15% post procedure. The values of PG pre- and post- procedure were (86.34 ± 11.77) mm Hg and (31.43 ± 8.46) mm Hg respectively. Preoperative RV Tei-index was 0.68 ± 0.05, it decreased rapidly after procedure, and recovered to normal one month after procedure. Only one case showed restenosis seven months after procedure and repeated PBPV. Fourteen referral cases (6 cases in Post A group and 8 cases in Post B group, accompanied in 1 and 3 cases with heart failure), the values of SpO2 ranged from 83%-91% under state of continuous intravenous infusion of alprostadil. And the operating time was 10-57 days after birth. The values of SpO2 recovered to normal post procedure, and heart failure alleviated. Increased preoperative RV pressure obviously decreased significantly post-procedure. And increased Tei-index declined gradually, at one-year follow-up, the value of Tei-index in Post A group recovered to normal, whereas that of Post B was (0.51 ± 0.06), compared to Pre and Post A groups, the difference was significant (P < 0.05) . One case showed restenosis nine months after procedure and repeated PBPV was performed. The hypoxic exposure durations were (4.43 ± 0.68) , (16.33 ± 4.46) , (41.25 ± 9.19) , respectively, and the difference among the three groups was significant (P < 0.05).

CONCLUSIONTo the fetuses with definite prenatal diagnosis of critical pulmonary valve stenosis, preoperative general condition can be adjusted to more suitable for emergency operation. Early PBPV can achieve shorter hypoxic exposure and better recovery of right ventricular function post procedure. Perinatal integrated intervention for CPS can significantly improve the prognosis and quality of life in this patient population.

Catheterization ; instrumentation ; methods ; Dilatation ; methods ; Echocardiography ; Female ; Humans ; Infant ; Infant, Newborn ; Pregnancy ; Prenatal Diagnosis ; methods ; Pulmonary Artery ; physiopathology ; surgery ; Pulmonary Valve Stenosis ; congenital ; diagnosis ; physiopathology ; surgery ; Time Factors ; Treatment Outcome ; Ventricular Function, Right

OBJECTIVETo investigate whether hepatitis B e antigen (HBeAg) can modulate the ability of dendritic cells (DCs) to produce inflammatory cytokines (IL-12/IL-6) upon stimulation in vitro.

METHODSPurified adherent mononuclear cells isolated by Ficoll-hypaque density gradient centrifugation were cultured in complete medium containing granulocyte macrophage colony-stimulating factor plus interleukin (IL)-4 to generate immature (i)DCs. Microscopic analysis and flow cytometry were performed to define the phenotypic characteristics of the iDCs. Then, different concentrations (1, 2 and 5 mug/ml) of HBeAg were added to the culture medium and for 24 hrs of incubation. To induce iDCs' maturation, the various groups of cells were incubated for 24 hrs in differentiation culture with lipopolysaccharide (LPS). Effects on secreted inflammatory cytokines were determined by enzyme-linked immunosorbent assay of the cells' supernatants.

RESULTSAll concentrations of HBeAg led to significant reductions in IL-6 (all P less than 0.05). Similar significant reduction trends were seen for IL-12 at the HBeAg concentrations of 2 and 5 mug/ml (both P less than 0.05), but not at the 1 mug/ml concentration.

CONCLUSIONHBeAg may suppress the production of cytokines from DCs; this mechanism may contribute to the immune escape of HBV that supports persistent infection.

Cells, Cultured ; Dendritic Cells ; immunology ; metabolism ; Hepatitis B e Antigens ; immunology ; Humans ; Interleukin-12 ; metabolism ; Interleukin-6 ; metabolism ; Lipopolysaccharides ; adverse effects

OBJECTIVETo investigate the role of absent ductular reaction (DR) at hepatocellular-stromal boundaries in early stage hepatocellular carcinoma (HCC) with cirrhosis in patients with chronic hepatitis B.

METHODSCytokeratin (CK)7 and CK19 expression was detected by the SP immunohistochemistry method in 112 hepatic nodules taken from 20 cases of early HCC, 26 cases of HCC with nodules more than 3 cm, 20 cases of high-grade dysplastic nodule (HGDN), 26 cases of low-grade dysplastic nodule (LGDN), and 20 cases of cirrhosis (CIR). DR/CK7 and DR/CK19 were assessed separately on a semi-quantitative scale and statistically analyzed.

RESULTSThe mean age of the patients in the study was 53.71 years-old, and the study population consisted of 73 males and 39 females. The follow-up time ranged from 3 to 90 months. Positive CK7 and CK19 staining was detected in the cytoplasm of DR-positive hepatobiliary cells, interlobular bile duct, and a portion of hepatic cells. All of the DR/CK7- and DR/CK19-positive cells were localized around the non-invasive nodules. Specimens with focal or diffuse DR/CK7- and DR/CK19-loss had more robust stromal invasion. Specimens from early HCC cases showed greater DR/CK19 loss than specimens from HGDN cases, LGDN cases and CIR cases (all P less than 0.01). DR/CK7 loss of early HCC was less than HCC with nodules more than 3 cm (P less than 0.05), and more than LGDN cases and CIR cases (both P less than 0.01).The area under the receiver operating characteristic curve of DR/CK7 was very similar to that of DR/CK19 (P more than 0.05). Pearson's correlation analysis indicated that DR/CK7 and DR/CK19 were positively correlated with tumor-free time (P less than 0.01) and negatively correlated with early recurrence time as well as death rate (both P less than 0.01). Furthermore, cases showing DR/CK7 or DR/CK19 loss had lower overall survival rate and tumor-free survival rate (P less than 0.01) and higher early recurrence rate (P less than 0.01).

CONCLUSIONDR/CK7 and DR/CK19 immunostaining may help to distinguish non-invasive HGDNs from both minimally-invasive and overtly-invasive HCCs by identifying small foci of invasion and predicting increased risk of invasiveness.

Adult ; Aged ; Aged, 80 and over ; Bile Ducts, Intrahepatic ; pathology ; Carcinoma, Hepatocellular ; diagnosis ; pathology ; virology ; Early Diagnosis ; Female ; Hepatitis B, Chronic ; pathology ; Humans ; Immunohistochemistry ; Keratin-19 ; metabolism ; Keratin-7 ; metabolism ; Liver Neoplasms ; diagnosis ; pathology ; virology ; Male ; Middle Aged