Purpose:To evaluate the effects of intraoperative radiotherapy for adenocarcinoma gastric cardia.Meth- ods:From Jan.1992 to Dec.2000 a trial on intraoperative radiotherapy for AGC was carried out in 38 patients.Whose age was younger than 75 years,at least on semiliquid diet and no contraindication of surgery.6MV or 9MV-E photon was used for the intraoperative radiation therapy to the cardia,lower segment of the esophagus,fundus,lesser curvature and hepato- gastric ligament.Results:Average follow up 65 months.The 5 year survival rates were 39.4%.Conclusions:Intraoperative radiation therapy is able to improve the results of surgery for adenocarcinoma of the gastric cardia.

Child ; Child Behavior Disorders ; etiology ; Child, Preschool ; Encephalitis ; complications ; metabolism ; virology ; Enterovirus ; Female ; Humans ; Infant ; Male ; Nerve Growth Factors ; metabolism ; S100 Calcium Binding Protein beta Subunit ; S100 Proteins ; metabolism

Objective: To apply the NRS2002 to screen the nutritional status of preoperative patients and investigate the nutrition support in the perioperation and clinical outcomes. Methods: 127 selective operational cases(including general surgery,thoracic surgery,gynecology and orthopedic) were recruited to adopte the NRS2002 which issued by CESPN in 2006,and the nutrition support,energy and nutriment in the perioperation,complications,length of stay and drug costs were investigated. Result: 30.7% patients needed nutrition support,with general surgery(28.3%) being higher than thoracic surgery(2.4 %),gynecology(0%) and orthopedic(0%).The nutritional risk in elderly,carcinoma,abdominal operation patients were 18.1%,19.7% and 18.1% seperately,which was higher than others(P

Objective To select valuable biomarkers for diagnosis and predicting outcome of sepsis-related acute respiratory distress syndrome(ARDS) from D-dimmer (DD),yon Willebrand factor (vWF),platelet (PLT),N terminal-pro brain natriuretic peptide (NT-ProBNP),interleukin-6 (IL-6),interleukin-8 (IL-8) and surfactant protein D (SP-D).Methods A total of 48 sepsis accompanied with ARDS patients and 40 sepsis patients were prospectively studied with comparison.The clinical characteristics of all the patients were recorded in detail.The blood samples were obtained within 24 hours of ICU admission.The concentration or activity of the seven biomarkers was quantitatively assayed and the results were recorded.To select the most valuable biomarkers as clinical indices,diagnosis model and death predictive model were constructed by Logistic regression.Results Among the seven candidate biomarkers,SP-D,vWF and IL-8 showed the most value.Their area under the receiver operator characteristic curve (ROC) were 0.758 (P ＜ 0.01),0.783 (P ＜ 0.01) and 0.747 (P ＜ 0.01) respectively,and raised to 0.847 (P ＜ 0.001) when the three biomarkers were combined.IL-8,age greater than or equal to 60 years and APACHE Ⅱ score greater than or equal to 20 were related to ARDS death with 12.138(lnIL-8)(P=0.022),6.157(P=0.040) and7.415(P=0.014) of OR values respectively.Conclusion SP-D,vWF,IL-8 should be valuable for early prediction of sepsis-induced ARDS and the diagnostic accuracy raised through combined utilization.IL-8 may be predictable for prognosis of sepsis related ARDS and the comprehensive evaluation combining clinical indices with IL-8 should be suggested in clinical practice.

The concentrations of berberine (BBR) and 8-cetylberberine (8-BBR-C16) in rat plasma and tissue were determined by RP-HPLC. Both the plasma pharmacokinetics characteristic and tissue distribution differences of BBR and 8-BBR-C16 were compared to provide experimental data for the mechanism research and further drug development. After the oral administrations of BBR and 8-BBR-C16 at the dose of 80 mg x kg(-1) for rats, the pharmacokinetics result showed that compared with BBR, the C(max) and AUC(0-t), of 8-BBR-C16 increased by 2.8 times and 12.9 times respectively, t1/2 extended from 3.61 h to 11.90 h. The tissue distribution result showed that compared with BBR, the concentration of 8-BBR-C16 in various organizations increased and the retention time extended remarkably. The maximum concentration was achieved in lung and the highest concentration in it was 3 731.82 ng x g(-1). After being derived, the C(max) in plasma and bioavailability of 8-BBR-C16 increased remarkably and the circulation time in vivo extended. The drug concentration in tissue increased remarkably, and the distribution ratio changed too, with strong targeting selection in lung.
Administration, Oral ; Animals ; Berberine ; analogs & derivatives ; pharmacokinetics ; Biological Availability ; Chromatography, High Pressure Liquid ; Rats ; Tissue Distribution

Objective To evaluate the significance of myocardial bridge and find a reasonable diagnosis and treatment strategy.Methods Sixty-three myocardial bridge patients and sixty-three patients with negative results of coronary artery angiography were reviewed.The clinical data of symptoms,electrocardiogram,exercise tests,coronary artery angiography,therapeutics and the serum levels of C-reactive protein(CRP)were analyzed.Results The symptoms of chest distress and chest pain were found in myocardial bridge patients.Myocardial consumption of oxygen augmentation causes the symptoms of aggravation.Positive results of electrocardiogram and exercise tests in many of myocardial bridge patients were examined.There were no relationship with severity of myocardial bridge artery stenosis.Most of myocardial bridge were discovered in anterior descending branch.At present,the main treatment of myocardial bridge was drug therapeutics.After treatment,the serum levels of CRP was significantly decreased.Conclusion Myocardial bridge was anatomy abnormality with important clinical significance.The serum levels of CRP can be used to evalue the therapeutic efficacy of myocardial bridge.

OBJECTIVETo compare the differences in clinical efficacy on peripheral facial paralysis at acute stage between the opposing needling technique and routine acupuncture at the affected side so as to provide the evidence on the acupuncture treatment for peripheral facial paralysis at acute stage.

METHODSForty patients were rando- mized into an opposing needling technique group (19 cases) and an affected side needling technique group (21 cases). The basic medication was same in the two groups. The acupoints were Fengchi (GB 20), Yangbai (GB 14) to Yuyao (EX-HN 4) (penetrating needling method), Jingming (BL 1), Chengqi (ST 1), Xiaguan (ST 7), Jiache (ST 6) to Dicang (ST 4), Hegu (LI 4) and Zusanli (ST 36). In supplementation, in the opposing needling technique group, the acupoints were stimulated on the face of healthy side. In the affected side needling technique group, the acupoints were stimulated on the face of the affected side. The treatment was given three times a week, for 4 weeks. House-Brackmann (H-B) facial nerve function assessment was used to evaluate facial nerve function before and after treatment in the patients of the two groups. The efficacy was compared between the two groups.

RESULTSThe facial nerve function was recovered in the two groups and the total effective rate was 100.0% in the two groups (P>0.05). The curative rate was 68.4% (13/19) in the opposing needling technique group and better than 47.6% (10/21) in the affected side needling technique group (P<0.05). On the 7th and 14th day, scores of H-B in the opposing needling technique group were better than those in the affected side needling technique group (both P<0.05). The curative time in the opposing needling technique group was apparently shorter than that in the affected side needling technique group ((23.95 +/- 4.30) days vs. (29.14 +/- 5.43) days, P<0.01).

CONCLUSIONThe opposing needling technique accelerates the recovery of facial nerve function in peripheral facial paralysis at acute stage and apparently shortens the curative time. The efficacy is better than that in acupuncture on the affect- ed side of the face.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adolescent ; Adult ; Child ; Facial Paralysis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To evaluate the therapeutic effect of spironolactone on schistosomal pulmonary arterial hypertension(SPAH). Methods A total of 62 patients suffered from hepatosplenic schistosomiasis with pulmonary arterial hypertension were divided into the spironolactone group(n=31) and control group (n=31). All the patients underwent serial echocardiography and the clinical effect before and after the treatment was evaluated by assessing the mean pulmonary arterial pressure (mPAP) and pulmonary arterial diameter (PAD). At the same time, the varieties of the clinical symptoms, signs and the distance of the 6-minute walking test (6-MWT) were investigated. Results In spironolactone group, mPAP(-x±s) decreased from (31.8±7.1) mmHg to (21.2±2.1) mmHg, PAD(-x±s) decreased from (28.0±5.0) mm to (20.0±3.5) mm before and after the treatment respectively(P<0.01). There were significant differences in mPAP, PAD, the distance of 6-MWT and the heart function before and after the treatment in the spironolactone group. However, the data did not show the significant difference in the control group. Conclusion The therapeutic effect of spironolactone in the treatment of SPAH is satisfactory.

ObjectiveTo evaluate magnesium sulfate and compound polyethylene glycol electrolyte in bowel preparation before capsule endoscopy.MethodsA total of 81 patients were randomly divided into two groups.Group A (n =41 ) received compound polyethylene glycol electrolyte,and group B (n =40) received magnesium sulfate combined with compound polyethylene glycol electrolyte. Positive detection rate,intestinal preparation score,the incidence of capsule retention and solution quality,liver and kidney function were compared between those two groups.ResultsThe positive detection rates of capsule endoscopy were 65.9％ (27/41) in group A and 62.5％ (25/40) in group B,which were nonsignificantly different (x2 =0.099,P ＞ 0.05).The intestinal preparation scores of 19 patients in group A were ≤4 and those of 22 patients were ≥6,while those of 28 patients in group B were ≤4 and of 12 patients were ≥6,which were significantly different (x2 =4.653,P ＜ 0.05). The rates of capsule retention of group A and B were 2.4％( 1/41 ) and 5.0％ (2/40) respectively,which were not significantly different (x2 =0.372,P ＞ 0.05 ).Obvious abdominal pain,nausea or vomitting occurred in no patients of the two groups.There was no difference in electrolyte level or liver and kidney function between those two groups (P ＞ 0.05 ).ConclusionMagnesium sulfate combined with compound polyethylene glycol electrolyte is applicable for the bowel preparation before capsule endoscopy.

Objective To explore the prevalence,subtype,distribution characteristics and risk factors of IBS met ROME Ⅲ criteria in local adult residents of Shanghai Songjiang area.Methods With multi-stage,stratified cluster random sampling method,from April to May in 2010,residents of45 shanghai Songjiang communities were interviewed by questionnaire survey.IBS diagnosis was based on Rome Ⅲ criteria,and the subtypes were according to Bristol stool scale.Self-rating anxiety scale (SAS),self-rating depression scale (SDS) and Athens insomnia scale (AIS) were also simultaneously finished. Results There were 7648 individuals who completed the survey with qualified questionnaires; the efficient rate was 90％. The sample size accounted about 1.62％ of total population in Shanghai Songjiang area.Total 970 patients were detected,who met the Rome Ⅲ criteria,of those 492 males and 478 females.The adjusted prevalence of IBS was 13.1％,13.8％ in males and 12.7％ in females.The ratio of male to female was 1 ∶ 0.92.There was no significant difference in detection rate between males and females (P＞0.05).The prevalence was highest in the 18 to 29 years age group (18.2％,P=0.000).IBS unsubtyped (IBS-U) was the most common type in patients who met the Rome Ⅲ criteria (45.3 ％),IBS with diarrhea (IBS-D) type was more common in male (27.0％) and IBS with constipation (IBS-C) was more common in female (19.5％).The IBS prevalence of obesity group (x2 =4.046,P=0.044),higher education group (x2=31.210,P=0.000),mental group (x2 =8.409,P =0.015),unmarried group(x2 =26.933,P =0.000) and no abdominal surgery history group(x2 =5.894,P=0.015) was higher than that of control group.The risk of IBS prevalence in those who had the history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics increased by 5.105,3.388,2.949 and 2.811 times respectively(P=0.000).Multivariate analysis indicated that the risk of IBS prevalence was increased by 1.69 times if took more spicy food,however high-protein diet was a protective factor (OR=0.900,P=0.000).Anxiety (OR=2.452,P=0.000) and insomnia (OR=1.923,P=0.000) were also risk factors of IBS.Conclusion IBS is a common and frequently occurring disease in Shanghai Songjiang community.The history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics,intake of more spicy food,anxiety and insomnia may be risk factors of IBS.