Objective To evaluate the treatment of acute cholecystitis patients through laparoscopic cholecystectomy (LC). Methods 387 cases of acute cholecystitis patients who underwent LC were studied retrospectively . Results Of the 387 cases, there were 359 cases of calculus incarcerated cholecystitis , 152 cases of cholecystitis with acute inflammatory symptoms for 72 h or more, 10 cases were converted to Laparotomy (2.6%).The operations lasted for 30~200 min(63.09 ±26.62 min on average),with blood loss about 10~500 mL(51.41 ±32.41 mL on average),and drainage was adopted in 183 cases.No complications developed fol-lowing the surgeries in 3 to 24 months, indicating a 100% cure rate. Conclusion If with good command of rules and techniques during LC operations , It is both safe and feasible to treat acute cholecystitis patients through LC operations .

AlM: To investigate the effect of endocapsular phacoemulsification cataract extraction and intraocular lens (lOL) implantation with a 1. 8mm or 3. 0mm clear corneal incision on total root mean square ( RMS ) value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film.
METHODS:ln a prospective study, 156 age- related patients ( 196 eyes ) were randomly distributed into two groups. 1. 8mm-group comprised 94 eyes that had a silicone lOL inserted through a 1. 8mm sutureless clear corneal incision, while, 3. 0mm- group comprised 102 eyes through a 3. 0mm clear corneal incision. Postoperatively, the changes in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film at 1wk, 1 and 3mo were determined respectively.
RESULTS:ln both groups, postoperatively at 1wk,there were statistically significant differences ( P<0. 05 ) in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film, while, there were statistically minimal differences ( P< 0. 05 ) between 1. 8mm-group and 3. 0mm-group at 1mo, but were not statistically significantly different ( P > 0. 05 ) between two groups at 3mo postoperative.
CONCLUSlON:This study confirms that incision size has strong impact on the corneal higher-order aberrations, especially, 3. 0mm incision caused significant differences in the total RMS value of cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film compared with 1. 8mm micro-incision, therefore, micro-incision is very beneficial for clinical use in phacoemulsification.

OBJECTIVETo investigate the prevalence of erectile dysfunction (ED) in men with high-normal blood pressure (HNBP).

METHODSThis study included 120 men with HNBP and another 120 with normal blood pressure (NBP) as controls. We analyzed the scores of the two groups on the International Index of Erectile Dysfunction 5 (IIEF-5).

RESULTSThe ED prevalence in the men with HNBP was 25.8%. After controlling for age, nationality, occupation, education, income, smoking, alcohol consumption, exercise, obesity, fatty liver, blood lipids, blood glucose, and blood uric acid, the incidence of ED was 25.8% in the HNBP group, significantly higher than 14.2% in the NBP group (P<0.05).

CONCLUSIONThe prevalence of ED is higher in men with HNBP than in those with NBP.

Adult ; Blood Pressure ; Erectile Dysfunction ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo study the correlation between Apnea Graph (AG) analysis of airway obstruction and cephalometric assessment of the posterior airway space in the diagnosis of obstructive level in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), so as to improve the preoperative diagnostic accuracy and the therapeutic outcome.

METHODSThirty patients (28 males and two females) who were diagnosed with severe OSAHS (mean AHI 58.6) by overnight polysomnography in recent 3 months were enrolled. The ages of the patients ranged from 35 to 59 years old with the median age of 41.5 years old. The mean body mass index (BMI, x(-) ± s) was (28.8 ± 4.1) kg/m(2). Mean apnea-hypopnea index (AHI) was (58.6 ± 16.4)/h. The lowest oxygen saturation was averaged to 0.69 ± 0.09. All patients underwent AG study as well as cephalometric analysis preoperatively. A correlation analysis was performed between the percentage of lower level obstructions measured by AG and the posterior airway space (PAS) evaluated by cephalometric analysis.

RESULTSAll of the 30 patients had the obvious narrow PAS of 4.4 - 10.8 mm, with the average of (7.6 ± 2.1) mm. Their constituent ratios of lower level obstruction ranged from 2 to 87 percent with the median ratio of 15.5% [9.0%; 35.8%]. Among all the patients, only 2 cases had more than 50 percent obstruction of the airway at lower level, 8 cases had 30 to 40 percent obstruction, and 6 cases had the narrow PAS less than 6 mm. The constituent ratio of lower level obstructions had a negative rectilinear correlation with the data of PAS (r = -0.6511, P < 0.01), which meant the patient with a higher percentage of lower obstruction had the tendency to have a corresponding narrower PAS. Two cases whose constituent ratios of lower level obstructions were not compatible with the rectilinear tendency due to tonsillar hypertrophy were reported.

CONCLUSIONSAG analysis of airway obstruction and cephalometric assessment of the PAS could provide comparable and consistent results for the diagnosis of obstructive level in OSAHS. However, the tonsillar hypertrophy should be considered when using AG to identify the airway obstruction.

Adult ; Airway Obstruction ; diagnosis ; diagnostic imaging ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Sleep Apnea, Obstructive ; diagnosis ; diagnostic imaging ; physiopathology ; Tongue ; diagnostic imaging ; Transducers, Pressure

OBJECTIVETo analyze the surgical treatment result and clinical characteristics of hilar cholangiocarcinoma in order to improve the rate of early diagnosis and radical resection.

METHODSBetween 1986 and 2004,84 hilar cholangiocarcinoma patients underwent surgery, and their data were retrospectively reviewed.

RESULTSAccording to the Bismuth-Corlette staging system, 7 were type I, 18 type II, 22 type II a, 12 type IlI b, 20 type IV and 5 unclassified. 32 patients (38.1%) had had the history of operation for cholelithiasis before or were found to have cholelithiasis simultaneously at the time of diagnosis. The rate of making correct diagnosis by ultrasound, CT and MRCP was 71.4% , 84.0% and 91.4% , respectively. Of these 84 patients, 24 (28.6%) underwent radical resection, 14 (16.7%) palliative resection and 30 (35.7%) only internal or external drainage, while 16 patients was found to have contraindication for any further surgical intervention. The overall operation rate was 81.0% (68/84) with a radical resection rate of 35.3% (24/68). The 1-, 3- and 5-year survival rates was 70.8%, 50.0% and 20.8% in the radical resection group, and 50.0%, 21.4% and 0 in the palliative resection group, respectively. There was a statistically significant difference in the survival between two groups. Whereas in the internal or external drainage group, the 1-, 3- and 5-year survival rates was 20.0% ,10.0% and 0. All of the patients who did not undergo surgical intervention died within one year.

CONCLUSIONCholelithiasis may play an important role in the pathogenesis of hilar cholangiocarcinoma. Early diagnosis and radical resection are two important factors to improve the prognosis of hilar cholangiocarcinoma. Skeletonization of hepatoduodenal ligament with partial liver resection can improve the rate of radical resection for hilar cholangiocarcinoma.

Adenocarcinoma ; diagnosis ; surgery ; Adenocarcinoma, Mucinous ; diagnosis ; surgery ; Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; diagnosis ; surgery ; Bile Ducts, Intrahepatic ; Biliary Tract Surgical Procedures ; methods ; Cholangiocarcinoma ; diagnosis ; surgery ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Survival Analysis

OBJECTIVETo study the therapeutic effect of agonistic CD40 monoclonal antibody combined with tumor specific cytotoxic T lymphocyte (CTL) on B lymphoma.

METHODSHuman B lymphoma cell line, Daudi cells, were cultured with CD40 mAb (5C11) for 24 and 48 hours, respectively. Annexin V/PI-binding assay was employed to analyze apoptosis, and FCM to analyze Fas (CD95) expression. Human peripheral monocyte-derived DC were loaded with apoptotic Daudi cells and stimulated by SC11 for further maturation. Tumor specific CTL were generated in vitro by co-culture of mature DC with autologous T lymphocytes. DNA fragmentations of Daudi cells treated with 5C11, CTL or 5C11 combined with CTL were determined by JAM assay. To establish the B lymphoma model, Daudi cells were subcutaneously injected into humanized SCID mice (hu-SCID). 1 or 3 weeks after tumor transfer. tumor-bearing mice were respectively treated with SC11, CTL, 5C11 combined with CTL by intraperitoneal injection. Tumor volume in differently treated mice was measured every week after therapy, and the survival of tumor-bearing mice was recorded.

RESULTS5C11 significantly up-regulated FAS expression in Daudi cells, but had no significant effect on apoptosis rate of Daudi cells. Tumor-specific CTL could effectively kill Daudi cells. Fragmentation of Daudi cells co-cultured with CTL was remarkably enhanced by combination with SC11. Tumor growth in hu-SCID mice was apparently delayed by treatment with SC11, CTL, or SC11 combined with CTL. Moreover, minimal tumor burden mice got 30.0% or 70.0% complete remission (CR), respectively, when received CTL treatment or combination treatment of SC11 with CTL, and the lifespan of tumor bearing mice was also prolonged significantly.

CONCLUSIONSC11 may enhance the sensitivity of Daudi cells to apoptosis by up-regulation of Fas expression and promote cytotoxicity of CTL in vitro and therapeutic effect in vivo.

Animals ; Antibodies, Monoclonal ; immunology ; therapeutic use ; Apoptosis ; immunology ; CD40 Antigens ; immunology ; Cell Line, Tumor ; Coculture Techniques ; Female ; Flow Cytometry ; Humans ; Immunotherapy, Adoptive ; methods ; Lymphoma, B-Cell ; immunology ; pathology ; therapy ; Mice ; Mice, SCID ; Remission Induction ; Survival Analysis ; T-Lymphocytes, Cytotoxic ; cytology ; immunology ; Xenograft Model Antitumor Assays ; fas Receptor ; immunology

OBJECTIVETo study the effect of inhibiting the expression of endothelial-overexpressed lipopolysaccharide-associated factor 1 (EOLA1) on proliferation of human umbilical vein endothelial cell line ECV304.

METHODSAfter constructing and transfecting EGFP-EOLA1 fusion protein expressive vector into ECV304 cells, the transfected cells was cultured in M199 containing G418 for 5 weeks to screen the cell line stable expression EGFP-EOLA1 fusion protein. Oligonucleotides targeting EOLA1 at different sites were synthesized and inserted into pSinencer3.1/H1 vector. Then, the recombinant vector was transfected into the cultured ECV304 cells and the inhibiting effect to target gene EOLA1 was investigated by observing the green fluorescence in transfected cells under inverted fluorescent microscope and by Western blot assay. The proliferation of ECV304 cells was numbered when the expression of EOLA1 in ECV304 cells was inhibited by RNA interference.

RESULTSThe ECV304 cell line stably expressing EGFP-EOLA1 fusion protein was constructed and the siEOLA1 interfere vectors can knock down EOLA1 gene expression specially. When blocking the expression of EOLA1 in ECV304 cells,the proliferation of cells slowed down.

CONCLUSIONEOLA1 maybe has a role on the proliferation of cells.

Blotting, Western ; Cell Line ; Cell Proliferation ; Down-Regulation ; genetics ; Humans ; Membrane Proteins ; genetics ; Phenotype ; RNA Interference ; RNA, Small Interfering ; genetics ; metabolism ; Recombinant Proteins ; genetics

BACKGROUND: A series of basic researches have confirmed that,the olfactory ensheathing cell transplantation can promote spinal cord regeneration and recover some neurological functions of spinal cord in animal models of spinal cord injury.Some clinical trials also prove that transplantation of olfactory ensheathing cells can indeed improve neurological function in patients with spinal cord injury,and then improve their quality of life.OBJECTIVE: To verify the effectiveness and safety of olfactory ensheathing cell transplantation in repair of neurological function of spinal cord injury patients.METHODS: The aborted embryonic olfactory bulb was collected and digested into single olfactory ensheathing cells.After they were cultured and purified 2 weeks,olfactory ensheathing cell suspension was prepared.A total of 213 cases of spinal cord injury were selected.Under general anesthesia,the prepared olfactory ensheathing cell suspension was injected through several target sites surrounding the injured spinal cord.ASIA scale was used to assay the patients before transplantation,3 weeks to 2 months after transplantation,so as to evaluate spinal cord recovery.RESULTS AND CONCLUSION: The spinal cord nerve function in all patients altered to different degrees at 3 weeks postoperation.Spinal cord function score,the sensory and motor functions were significantly increased compared with preoperation(P < 0.001),and showed a trend of continuous improvement with time; the patients were visited as follow-up for no more than 5 years,and no impairment of the restored nervous function or transplant adverse reactions were observed.It is confirmed that olfactory ensheathing cell transplantation can promote the recovery of nerve function in patients with spinal cord injury,it can restore and improve some spinal cord functions,and the treatment is safe.

OBJECTIVE: To study the value of the pepsin in the sputum for diagnosing and evaluating the effectiveness of treatment of laryngopharyngeal reflux. METHOD: Thirty-six patients with the symptoms of dry pharynx, globus pharyngeus, excessive throat clearing, chronic cough and so on were divided into laryngopharyngeal reflux group and chronic laryngitis group by the results of therapeutic trial taking proton pump inhibitors for 3 months. The estimation of the reflux symptom index (RSI), the reflux finding score (RFS) and the detection of pepsin in the sputum were done before and after the treatment. The difference between two groups and the value of the pepsin were analyzed. RESULT: There were significant decreasing in RSI, RFS and pepsin level (P < 0.01) after the treatment in all patients. There were statistical differences between the laryngopharyngeal reflux group and the chronic laryngitis group in the changes of RSI and pepsin level (P < 0.01). CONCLUSION Pepsin level in the sputum might be used as a objective, effective method for diagnosing and evaluating the effectiveness in laryngopharyngeal reflux.
Adult ; Female ; Humans ; Laryngopharyngeal Reflux ; diagnosis ; therapy ; Male ; Middle Aged ; Pepsin A ; analysis ; Sputum ; chemistry ; Treatment Outcome ; Young Adult

BACKGROUNDSince being reclassified by WHO in 1996, solid pseudopapillary tumour (SPT) of pancreas has been recognized as the internationally accepted name. Clinicians are lacking in knowledge of this rare disease so the misdiagnosis and inappropriate therapy are hard to avoid. The clinic data on 22 patients were summarized to study the misdiagnosis and treatment of a sample of SPTs.

METHODSTwenty-two female patients with SPT were studied retrospectively and divided into two groups, the misdiagnosed group and the correctly diagnosed one. The analyses were performed with Fisher test with accurate probability for categorical data, and Kruskal-Wallis test for ranked data.

RESULTSThe rate of misdiagnosis in this sample was 45.5%. The misdiagnosed SPTs were apt to be the incomplete capsule ones (P = 0.020), which resulted in obvious difficulties during operation (P = 0.024). In the misdiagnosed SPT group, the medical expenses increased significantly (P = 0.042), and the number of days in hospital greater than in correctly diagnosed group (P = 0.041).

CONCLUSIONSAlthough SPT has low malignancy with excellent prognosis after surgical treatment in most patients, the misdiagnosis of SPT increases the social and economic burdens on patients. It is important to analyse the causes of misdiagnosis.

Adolescent ; Adult ; Carcinoma, Papillary ; diagnosis ; surgery ; Child ; Diagnostic Errors ; Female ; Humans ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; surgery