Objective To observe the effect of cures of keloids by operation and closely following X-ray therapy. Methods X-ray therapy was taken in no more than 24 hours after the keloids removing operations on 63 subjects, partly irradiating incision with 100～140kv X-ray,which was continued in the next three days,once for each day,till the total amount reached DT 1600～2000cGY. Results All postoperative incision healed in one-stage,all cases were followed up for 6～12 months, the new hyperplastic scar didn' t appeare on the incision of 57 subjects, while this happened on those of the other six with some improvement after operation than before operation. Rate of healing reached 90. 5% .Conclusion Cure of keloid by operation and closely following X-ray therapy can reach low recurrence and aesthetic effection,and it is worth popularizing in the clinic.

Objective To study the difference in clinical characteristics and experimental profiles of primary Sj gren's syndrome(pSS)with a different onset age.Methods The clinical and laboratory data of 136 pSS patients were retrospectively analyzed.Results The prevalence of anti-SSA and anti-SSB antibodies de- clined with later onset.As compared with patients with disease onset older than 45,patients with disease onset younger than 45 had higher rheumatoid factor,circulating immune complex and lower C3.The prevalence of parotitis was higher in patients with disease onset younger than 45 than those with disease onset older than 45. The two groups had similar extra-glandular involvement.Conclusion The younger onset pSS patients have more abnomlalities in inmmnological parameters,and more parotiditis,implying that young onset pSS have more strong immune responses.

Objective To explore the Chinese medical students′attitudes towards communication skills learning .And their communication skills are assessed by themselves in this study .Methods The cross-sectional survey of 127 undergraduates was completed in Sichuan University .Students were evaluated using Communication Skills Attitude Scale(CSAS) and Scale of medical student′s doctor-patient communication behavior which had been published at home or abroad .Results The mean PAS score of 127 students was 51 .43 ,which was 18 .50 points higher statistically significant than the mean NAS score 32 .94 .And there were no difference between undergraduates and eight-year medical students ,also between female and male .95 .28% students agree that“learning the doctor-patient communication skills and learning clinical skills are equally important” .Concerning Scale of medical student′s doctor-patient communication behavior ,the mean score for 127 students was 104 .93(total score is 150) .The mean scores for male was higher than male(P=0 .008) ,but the mean score for undergraduates and eight-year students had no statistic differ-ences .Conclusion Medical students have positive attitudes towards communication skills and have low self-assessments ,and we should enhance the communication skills training .

ObjectiveTo investigate the managements of complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA).MethodsData of 119 EA patients who underwent POEM from October 2010 to July 2011 were collected.Complications during and after POEM and during follow-up were analyzed.Results Complications during operation included bleeding in 19 patients ( 16.0％ ),mucosa rupture in 9 (7.6％),mediastinal and subcutaneous emphysema in 27 (22.7％ ) and pneumothorax in 3 (2.5％ ).Complications occurred at the night of procedure included pain in 43 (36.1％ ) patients and pneumothorax in 7 ( 5.9％ ).Postoperative complications included asymptomatic pneumothorax in 23 patients (19.3％),delayed hemorrhage in 1(0.8％),pleural effusion in 58 (48.7％ ),minor pulmonary inflammation or segmental atelectasis in 59 (49.6％),emphysema of mediasti-na and subcutaneous tissue in 76 (63.9％ ),and gas under diaphragm or aeroperitoneum in 47 (39.5％ ).Complications during follow-up included one case of dysphagia caused by stricture of mucosa and one case of dehiscence at the tunnel entry with food retention.No POEM-correlated death occurred.All the complications were cured by conservative treatments.No additional surgery was needed.ConclusionMain complications as emphysema of mediastina and subcutaneous tissue,pneumothorax,aeroperitoneum and bleeding during and after POEM can be treated timely and effectively with conservative treatment.

ObjectiveTo evaluate a second endoscopy for prevention of delayed bleeding after ESD.MethodsData of 67 patients with gastric epithelial neoplasms undergoing ESD from May to November 2011 were reviewed.The median age was 63 ( 31 ～ 84) years.All patients were followed up by endoscopy on the first and the third day after ESD.ResultsOf 67 lesions,5 were located at cardia,6 at gastric body,3 at fundus,35 at antrum,16 at gastric angle,and 2 at residual stomach.The mean maximum diameter of the lesions was 3.73±4 1.24 (2.0 ～ 7.0) cm.There were no intraoperative complications.Post-ESD delayed bleeding was detected by endoscopy in 6 (9.0％ ) patients,with 5 on the third day and 1 on the fourth day.Forrest grading showed 2 cases of Ⅰ b,and 4 of Ⅱ b.All 6 cases were cured by endoscopy.The incidence of postoperative bleeding was far more than that evaluated based on the patients' clinical manifestations only.But therapeutic effect and saffety were the same according to the follow-up results.ConclusionIncidence of post-ESD bleeding is high,but there are no symptoms or severe consequences,so a second endoscopy after gastric ESD may contribute little to the prevention of delayed bleeding.

Objective To analyze the risk factors for postoperative stricture after endoscopic submucosal dissection (ESD) for early stage esophageal cancer.Methods The data of 362 patients with early esophageal cancer treated by ESD from January 2007 to February 2012 were reviewed to investigate the risk factors of postoperative stricture.Results Esophageal stricture after ESD occurred in 42 patients (11.6％)with a mean time from ESD to stricture of (58.5 ± 12.3) days.The rates of mild,median and severe stricture were 16.7％ (7/42),38.1％ (16/42) and 45.2％ (19/42),respectively.Multivariate analysis revealed that lesion range ＞ 3/4 esophageal circumference (odds ration [OR]:44.2 ; 95％ confidence interval [CI]:4.4-443.6) and tumor invasion beyond m2 (OR:14.2; 95 ％ CI:2.7-74.2) were independent risk factors.Stricture level was related to lesion's circumferential extension (relational coefficient (φ) =0.47,P ＜ 0.05) and tumor invasion depth (relational coefficient (φ) =0.647,P ＜ 0.05).Conclusion Circumferential extension and invasion depth of early esophageal cancer were independent risk factors for post-ESD esophageal stricture and related with the degree of stricture.

To establish a method for the determination of cucurbitacin in plasma samples, in order to study the in vivo pharmacokinetic characteristics of cucurbitacin in rats. Rats were intravenously injected with cucurbitacin. With diphenhydramine as the internal standard (IS), the plasma concentrations of cucurbitacin in rat plasma at different time points were determined by liquid chromatography tandem mass spectrometry (LC-MS/MS). With electrospray ionization source, the positive ion detection in the multiple reaction monitoring mode was conducted to determine the ion-pairs for target compound and IS were m/z 503.2/113.1 and m/z 256.0/167.2, respectively. Agilent ZOBAX SB-C18 column (2.1 mm x 50 mm, 1.8 microm) was adopted and eluted with methanol and 0.1% formic acid (55:45), and the flow rate was 0.2 mL x min(-1). DAS 2.0 software was applied to fit the blood concentration and calculate corresponding pharmacokinetic parameters. The rats were intravenously injected with cucurbitacin at the concentration of 3.0 mg x kg(-1). The target blood quality concentration show good linear relations within the range of 10.5-3 150 microg x L(-1) (R2 = 0.996), the lower limit of the standard curve was 10.5 microg x L(-1), and the signal to noise ratio S/N = 12. Intra- and inter-day precisions RSD was less than 6.9% and 14%, respectively; The accuracy RE ranged between 0.20% and 3.7%; The extraction recoveries ranged between 92.7% and 97.1%. Regarding the pharmacokinetic parameters of tail intravenous injection of cucurbitacin, AUC (0-t) was (811.615 +/- 111.578) microg x h x L(-1), (t1/2) was (1.285 +/- 1.390) h, CL was (3.627 +/- 0.487) L x h x kg(-1), and V(d) was (6.721 +/- 7.429) L x kg(-1). In this study, researchers established a simple, accurate, sensitive and highly specific method for determining the blood concentration of cucurbitacin, and reported the in vivo pharmacokinetic characteristics of cucurbitacin in rats for the first time.
Administration, Oral ; Animals ; Cucurbitaceae ; chemistry ; Cucurbitacins ; administration & dosage ; blood ; pharmacokinetics ; Drugs, Chinese Herbal ; administration & dosage ; pharmacokinetics ; Male ; Rats ; Rats, Wistar

OBJECTIVETo assess the treatment method and outcome of mesially or horizontally impacted mandibular molars.

METHODSEleven patients with mandibular impacted molars, including 9 horizontally impacted molars and 5 mesially impacted molars were treated with fixed appliance in conjunction with molar band soldered with pushing spring. Crowns of impacted molars were moved occlusally and distally.

RESULTSAll mesially or horizontally mandibular impacted molars were uprighted and brought into occlusion. Mean treatment period was 7.4 months (6 to 12 months).

CONCLUSIONSThis orthodontic molar uprighting technique was effective in uprighting and distalizing the impacted molars.

Adolescent ; Adult ; Female ; Humans ; Male ; Molar ; pathology ; physiology ; Orthodontic Appliances ; Orthodontics, Corrective ; methods ; Tooth, Impacted ; therapy ; Young Adult

To compare the pharmacokinetics of syringin, eleutheroside E and isofraxidin after intravenous administration of each monomer and Ciwujia injection. Twenty-four Sprague-Dawley rats were randomly divided into four groups and intravenously administrated with syringin, eleutheroside E, isofraxidin, and Ciwujia injection, respectively. The concentrations of the three components in rat plasma were determined by LC-MS/MS. DAS 2.0 software was applied to calculate the pharmacokinetic parameters while the SPSS 17.0 software was used for statistical analysis. Significant difference (P < 0.05) was found between each monomer and the injection on the main pharmacokinetic parameters such as AUC, CL and t1,/2. Compared with the injection, the group treated with the syringin has obvious decrease in AUC, and increase in CL while the group treated with eleutheroside E has obvious increase in AUC, and decrease in CL The t1/2 of isofraxidin was prolonged in Ciwujia injection. Pharmacokinetic characters of the ingredients in the injection varied greatly from the monomer. Other constituents in the injection may have an impact on the pharmacokinetic profiles of these three components.
Administration, Intravenous ; Animals ; Coumarins ; administration & dosage ; blood ; pharmacokinetics ; Drugs, Chinese Herbal ; administration & dosage ; pharmacokinetics ; Glucosides ; administration & dosage ; blood ; pharmacokinetics ; Lignans ; administration & dosage ; blood ; pharmacokinetics ; Male ; Phenylpropionates ; administration & dosage ; blood ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

Objective To explore the clinical value of endoscopic treatment by summarizing the experience of endoscopic treatment of duodenal submucosal tumor (SMT).Methods The data of SMT patients with endoscopic treatment from May 2006 to May 2011 at Endoscopy Center of Zhongshan Hospital Fudan University were studied retrospectively,including the lesions characters,the procedure of performance,complications and recurrence after the treatment.Results A total of 67patients received 69 times of endoscopic treatment,including 36 males and 31 females.The median agewas 55 years,and the average maximum diameter of the lesions was (1.34±0.50) cm.Of these 69lesions,38 lesions located at the bulb,12 at the ball and descending junction,and 19 at the descending part.All lesions were treated by endoscopic treatment successfully.Eleven leisions were treated by polypectomy,12 by endoscopic mucosal resection (EMR),45 by endoscopic submucosal dissection (ESD) and 1 by nylon rope.Complication rate was 14.5％ (10/69),including 1 case of active bleeding,2 cases of perforation,3 cases of delayed bleeding,3 cases of transient increase in amylase level and 1 case of delayed perforation.Total 67 cases were with pathological diagnosis,and brunner′s glands adenoma (36 cases) was the most common.Sixty patients in all were followed up,and the median follow-up time was 13 months.After ESD,one carciniod case was indicated tumor cells in vascular by the pathologic diagnosis and then received extended resection.One case of brunner′s glands adenoma recurred 1 year after EMR and improved after ESD.Conclusion Endoscopic treatment is safe,minimally invasive and effective,which may be used of duodenal SMT.