Bile Duct Neoplasms ; pathology ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; pathology ; surgery ; Hepatectomy ; methods ; Hepatic Artery ; pathology ; surgery ; Humans ; Lymph Node Excision ; methods ; Portal Vein ; pathology ; surgery

Objective To evaluate the clinical effect of the enteral nutrient(Pediasure) on making improvements in nutritional status of children with anorexia.Methods Thirty children were treated with pediasure for 2 months, twice a day, and height(Ht),weight(Wt),AG,TSF,SSF,ASF,RBC,Hb were measured before and after treatment and their appetites,alimentary canal reactions were recorded.Results Compared with the effects after 2 months, the average Ht,Wt,AG,SF all increased, and there was significant difference between pretreatment and after treatment(P0.05). All of the 30 children had no adverse reactions during treatment.Twenty-two children (73.33%) had better appetites and increased the amount of eating after treatment.Conclusion The study suggests that pediasure may be safely used in the treatment of children′s anorexia and effectively improve patients′ nutrition without adverse reactions.

Bile Duct Neoplasms ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; surgery ; Humans

Objective To investigate the anticoagultive effectiveness and specialty of sodium citrate comparing with hep- arin in continuous venovenous hemodiafiltration (CVVHDF).Methods 50 multiple organ disorder patients undergoing CWHDF were randomly divided into two groups:group A(sodium citrate)27 cases,group B(heparin)23 cases,blood e- lectrolyte,acid-alkali degree,cruor index changes,the blood coagulation of tube path way and blood filter were recor- ded.As the same time,side effects were observed in theraphy.Results The patients of two groups were kept stable vital signs,serum electrolyte and blood gas markers during the therapeutic periods.Moreover,ideal serum creatinine and urea clearance rate and uhrafiltration rate were obtained in all patients.The coagulation and longevity of blood filter of Group A are better than Group B,Group A without sigaificantly prolonged cruor index inside body,the dosage of calcium gluco- nate in Group A are greater than Group B.Conclusion Out body anticongulation of sodium citrate is more effective and reliable than regular heparin anticoagulation.

Background Many studies and clinical trials of pharmacologic vitreolysis are already under way to try to improve vitreo-retinal surgery and to liquefy and detach the vitreous from the retina ultimately, including chondroitinase,hyaluronidase,dispase and plasmin. However, there has not been any report on purification of human plasminogen from cord blood plasma and inducing posterior vitreous detachment of the animal eye at present.Objective This study was designed to isolate and purify the production of human plasminogen (Plg) from cord blood plasma with ethanol precipitation and evaluate the efficacy of Plg in inducing posterior vitreous detachment (PVD).Methods Human Plg was Separated and purified from cord blood plasma by ethanol precipitation method. The protein band corresponding to Plg with molecular mass of 92 000 was revealed in SDS-PAGE and confirmed by MALDI-TOF and Mascot database. Anion-exchange chromatography and plasminogen activity assay kit were used to obtain purified Plg with biological activity. Twenty-five fresh pig eyes were enucleated and assigned to 5 groups and 5 eyes for each group. The normal eyes were used as control group. Balanced salt solution(BSS)of 0.1 ml was intravitreally group and standard substance group. All of the eyes were then incubatedfor 60 minutes under the 37 ℃. Retinal histopathology and ultrastructure were examined under the light microscopy, scanning electron microscopy ( SEM ) and transmission electron microscopy (TEM). Results The Plg with potential fibrinolytic activity was successfully extracted and purified from cord blood plasma by ethanol precipitation method. No posterior vitreous detachment (PVD) was seen in normal control group, BSS group and r-SK group following the intravitreal injection under the sem. However,PVD was demonstrated in r-SK+ Plg group and standard substance group under the SEM. The inner limiting membrane ( ILM ) and the retina were well preserved in all of the experimental eyes. No retinal morphology and ultrastructural abnormality were found under the light and SEM and TEM. Conclusion Ethanol precipitation is a feasible way to isolate and purify Plg from human cord blood plasma. Extracted Plg shows potential fibrinolytic intravitreal injection of Plg.

AIM: To observe the effects of scleral buckling surgery for retinal detachment under microscope and under indirect ophthalmoscope.
METHODS: Forty - six patients ( 46 eyes ) with rhegmatogenous retinal detachment were retrospectively analyzed. Twenty-six patients received surgeries under microscope was retrospectively analyzed and compared to that of 20 patients who received surgeries under indirect ophthalmoscope by the same operator.
RESULTS: No statistical difference was found in patients' operation method choice, including condensation reaction reattachment situation and the retina reset operation at a time ( P> 0. 05 ). The best corrected visual acuity of microscopic group after 1mo of operation was better than before operation, and the improving rate of vision after operation was higher than that of the traditional group (P<0. 05).
CONCLUSION:The curative effect of external approach microsurgery has the similar efficacy with the conventional external approach surgery, and gets better visual acuity.

? AlM: To analyze the reason of corneal epithelial implantation and ingrowth after laser in situ keratomileusis ( LASlK ) , and summarize the treatment experiences.
?METHODS: The clinical data of postoperative corneal epithelial ingrowth on 18 cases (30 eyes) from 1 256 cases (2 256 eyes) after LASlK were retrospectively analyzed in our hospital from January 2008 to December 2012. After the treatment of all eyes, patients’ general visual quality scores before and after treatment were analyzed.
?RESULTS:There were 18 cases ( 30 eyes ) with corneal epithelial implantation and ingrowth after LASlK, and the incidence rate was 1. 3%. ln the 18 cases (30 eyes), there were 12 eyes corneal flap epithelial ingrowth caused by postoperative trauma, 12 eyes caused by multiple corneal flap flush, 2 eyes caused by intraoperative irregular corneal flap, and nothing special for 4 eyes. The classification of corneal epithelial ingrowth of 30 eyes:grade I, 11 cases (18 eyes);gradeII, 4 cases (8 eyes);grade Ⅲ, 3 cases ( 4 eyes ) . Grade I-II were treated with TobraDex eye drops and intraocular pressure lowering drug. Grade Ⅲ firstly were treated by drugs, otherwise by surgery if it didn’t improve. After treatment, 8 cases (13 eyes) epithelial ingrowth disappeared from 11 cases ( 18 eyes ) , 3 cases ( 5 eyes ) implanted epithelial tumor shrank in grade l;epithelial implantation of 2 cases (4 eyes) in grade II disappeared, implantation degree of 2 cases (4 eyes) reduced to grade I;2 cases (2 eyes) in grade Ⅲ had 0. 5 ~ 1mm wide flap edge shallow gray ribbon 1 mm inside the limbus, visual acuity was 0. 8 ~1. 2, 1 case ( 2 eyes ) treated with curettage corneal epithelial implantation and endophytic epithelium hadn’t relapsed in the follow-up. After the treatment, 18 cases of corneal epithelial ingrowth got lower visual quality scores than those before therapy (Hc=10. 511, P<0. 01).
?CONCLUSlON: Operation standardized, postoperative early detection and aggressive treatment are important for prevention and treatment of complications after LASlK.

Adolescent ; Humans ; Male ; Neurofibromatosis 1 ; Neurofibromatosis 2

Objective To assess the clinical features and treatment of children with long QT syndrome (LQTS)and syncope.Methods Eleven cases of children with LQTS and syncope between January 2009 and July 2014 in Hunan Children′s Hospital were retrospectively analyzed for clinical features,treatment and long term follow -up.Results There were 11 cases of children with LQTS aged 4.0 -14.5(9.16 ±2.71)years,8 male and 3 female, with syncope more than once.The range of QTc was 460 -521(483.72 ±22.90)ms.For 3 cases of acquired LQTS,1 case was parathyroid hypothyroidism causing hypocalcemia,1 case was myocarditis complicated with third degree atrio-ventricular block,and 1 case showed atrial flutter receiving amiodarone post congenital cardiac surgery.All patients re-covered after the inducement removed and primary illness cured.For 8 cases of congenital LQTS,3 cases of LQTS un-derwent genetic test (1 case of KCNQ1 gene mutation,2 cases of KCNH2 gene mutation).One case died after frequent torsade de pointes (Tdp)and ventricular fibrillation during hospitalization,the remaining 7 patients were given oral pro-pranolol,potassium chloride sustained -release tablets after discharge.Follow -up time was 8 to 75 months,an average of (45.73 ±24.42)months.One case died suddenly at home after 25 months of follow -up.The remaining 6 cases of children with congenital LQTS could withstand general activities without syncope,in which 4 cases had normal QTc by electrocardiography(ECG),and the findings in 2 cases did not change compared with those previously.The QTc re-turned to normal in children with acquired LQTS in the follow -up review.Conclusions Children with congenital LQTS should receive early genetic screening and genotyping for rational use of drugs.For children with higher risk of sudden death,drug therapy combined with implantable cardioverter defibrillator should be considered.For acquired LQTS,it should be better to remove the inducement and treat primary disease actively.