Objective To evaluate the clinical curative effect of multiple interventional techniques with skilled manipulation in treating common bile duct stones. Methods The clinical data of 36 patients with common bile duct stones, who were treated with percutaneous transhepatic puncture of intrahepatic bile duct and multiple interventional techniques, were retrospectively analyzed. Before operation, according to CT or MRI findings the optimal puncture path was selected to perform cholangiography so as to reconfirm the position, number and size of the stones. Depending on the size of the stone, the corresponding sized lithotripsy basket and balloon were selected. The duodenal papilla was dilated by balloon, and the stone was pushed into the duodenum with a balloon. After complete removal of stones, the internal and external biliary drainage tubes were routinely implanted and remained there for two weeks. Results The operation was successfully accomplished in 35 patients, the success rate was 97.2％. Successful removal of stones with single procedure was accomplished in 32 patients, and in 3 patients the complete removal of stones was achieved by secondary procedure. No serious complications were observed during the operation. Early postoperative complications included hyperamylasemia (n=2), bile peritonitis (n=2), small amount of bloody bile (n=3) . No biliary perforation occurred. Conclusion In treating common bile duct stones, the combination use of multiple interventional techniques with skilled manipulation has high success rate, low risk and less complications, therefore, it is an effective therapeutic method

Objective: To determine the morbidity of cervical intraepithelial neoplasia 2+ (CIN2+ ) and CIN3+ of different human papillomavirus(HPV) subtype infection combined with different cytology status. Methods: The Shenzhen Cervical Cancer Screening Trial Ⅰ & Ⅱ (SHENCCASTⅠ&Ⅱ) are population-based cross-sectional cervical cancer screening studis conducted in Shenzhen and surrounding area from 2008 to 2010. A total of 12 097 women who aged 25-59 years were included in the analysis. All of these women were detected by liquid-based cytology test and several high-risk HPV-DNA tests. The ones with HPV positive or atypical squamous cells of undetermined sign (ASC-US) were sequentially conducted by cervical biopsy vaginoscopy. Finally, 10 805 samples with complete data of hybrid capture 2(HC2), the polymerase chain reaction-based matrix-assisted laser desorption/ionization time-of-flight assay (MALDI-TOF), HPV genotyping detection, cytology and pathology results were analyzed. Results: The top 6 infection rates of HR-HPV in CIN2+ and CIN3+ were HPV16, HPV52, HPV58, HPV33, HPV31, HPV18. The highest constituent ratio of cytology in CIN2+ and CIN3+ was high grade squamous intraepithelial lesion(HSIL). The morbidities of CIN2+ of patients infected with HPV16, HPV31, HPV58, HPV33, HPV18, HPV52 were 41.3%, 31.5%, 30.6%, 28.7%, 28.2%, 17.7%, respectively, while the morbidities of CIN3+ of those were 33.5%, 20.5%, 19.4%, 15.7%, 19.2%, 8.3%, respectively.The morbidities of CIN2+ in negative intraepithelial lesion or malignancy (NILM), ASC-US, low grade squamous intraepithelial lesion (LSIL), atypical squamous cell cannot exclude high-grade squamous intraepithelial lesion (ASC-H), high grade squamous intraepithelial lesion (HSIL), atypical glandular cell (AGC) samples were 0.4%, 6.9%, 11.1%, 36.4%, 82.0%, 16.7%, respectively, while the morbidities of CIN3+ of those were 0.2%, 3.1%, 4.2%, 22.7%, 64.8%, 0.0%, respectively. The morbidities of CIN2+ in NILM combined with HPV16, HPV18, HPV31, HPV33 infection were 12.6%, 13.3%, 15.8% and 11.5%, respectively, while the morbidities of CIN3+ of those were 10.3%, 11.1%, 7.9% and 7.7%, respectively.The morbidities of CIN2+ and CIN3+ in ASC-US combining with hrHPV infection were high, and the top 6 subtypes associated with high risk of CIN2+ were HPV31 (35.7%), HPV33 (26.9%), HPV16 (26.5%), HPV58 (22.4%), HPV52 (18.6%), HPV68 (15.4%), while those associated with high risk of CIN3+ were HPV16 (20.4%), HPV31 (14.3%), HPV33 (11.5%), HPV58 (8.6%), HPV68 (7.7%), HPV52 (5.8%). Conclusions Cytology combined with HPV genotyping detection can more effectively estimate the morbidity risks of CIN2+ and CIN3+ . Both high prevalence rates and high risks associated with CIN2+ and CIN3+ of HPV31, HPV33, HPV52 and HPV58 are observed. NILM and ASC-US status combined with these subtypes mentioned above are advised to be conducted by colposcopy.

Objective:To analyze the influence factors of postoperative pregnancy in patients of endometriosis associated infertility after laparoscopy combined with hysteroscopy treatment.Methods:340 patients with endometriosis associated infertility who underwent laparoscopy combined with hysteroscopy treatment in Maternal and Child Health Care Hospital of Xiamen from April in 2012 to April in 2014 were followed up for 18 ～ 42 months to assess fertility outcomes.The relative factors of postoperative pregnancy rate were analyzed.Results:85.88％ (292/340) of patients were followed up,and the overall postoperative pregnancy rate was 56.51％.Among which the postoperative pregnancy caseswere 115 cases (39.38％),40 cases (13.70％),8 cases (2.74％),2 cases (0.68％) in the 1 ～ 6 months,7 ～ 12 months,13 ～ 24 months,25 ～ 42 months,respectively.There were significant differences among the four groups(x 2 =11.76,P ＜ 0.05).The multy-factors analysis showed that age ≥35,infertility time ≥3,r-AFS stage relatively high were risk factors of postoperative pregnancy(OR =10.45,3.03,3.74,P ＜0.05),and secondary infertility,applying ovarian stimulation treatment were the protective factors of postoperative pregnancy(OR =0.23,0.33,P ＜ 0.05).Conclusions:Laparoscopy combined with hysteroscopy treatment can increase postoperative pregnancy rate,and the best time to pregnancy is the first one year after treatment.The age ≥35,infertility time≥3,r-AFS stage relatively high are the important causes for the postoperative infertility,while applying ovarian stimulation treatment can promote pregnancy rate.

Objective:To evaluate efficacy and safety of multiple-dose tropisetron plus dexamethasone (DXM) versus palonosetron plus DXM for chemotherapy-induced nausea and vomiting. (CINV) in patients received multiple day-based highly emetogenic chemotherapy. Methods:Cancer patients who were receiving multiday-based highly emetogenic chemotherapy were randomly assigned to AB or BA groups. A randomized, cross self-control ed method was applied. Patients in AB group received palonosetron (0.25 mg) 30 min before chemotherapy on day 1 and 3 or additional day 5 in the first cycle;and with tropisetron (5 mg) 30 min before chemotherapy on day 1, 2, and 3, or sup-plementary days (day 4 and 5) in the second cycle. Patients in BA group were treated with tropisetron in the first cycle and with palonosetron in the second cycle. Tropisetron and palonosetron were administered with DXM (10 mg) on day 1, followed by additional doses (5 mg) on days 2 to 5. Palonosetron group comprised patients in the AB group in the first cycle and BA group in the second cycle, whereas tropisetron group included patients in the AB group in the second cycle and BA group in the first cycle. Efficacy and safety of tropisetron versus palonosetron in preventing CINV were evaluated. Results:Ninety-one patients were included in analyses. At day 3, 4, and 5, incidence rates of nausea in the palonosetron group reached 28.6%, 30.8%, and 24.2%, respectively, and those of the tropisetron group totaled 42.8%, 47.3%, and 39.6%, respectively (P<0.05). At day 4, 5, and 6, incidence rates of vomiting in the palonosetron group measured 28.6%, 18.7%, and 5.5%, respectively, and those of the tropisetron group reached 42.9%, 34.1%, and 14.3%, respectively (P<0.05). From day 4 to day 5, day 6 to day 7, and day 1 to day 7, the palonosetron group yielded significantly lower incidence rates of nausea and vomiting than tropisetron group (P<0.05). Rate of rescue treatment in the palonosetron group was lower than that in tropisetron group (13.2%vs. 24.2%, P=0.057). No statistical difference in toxicities was observed between the two groups. Conclusion:Palonosetron plus DXM features better efficacy than that of tropisetron plus DXM against delayed CINV induced by multiple day-based highly emetogenic chemotherapy, which was well tolerated in the two treatments.

Objective:To explore the clinical application values of contrast-enhanced ultrasound in the diagnosis and classification of portal vein tumor thrombosis (PVTT)by comparing with enhanced CT.Methods:43 patients with PVTT confirmed by clinic and pathology were selected, and the accuracy rates of the diagnosis and clinic classification of contrast-enhanced ultrasound and enhanced CT were compared. Results:The characteristic of PVTT in contrast-enhanced ultrasound was“quick in fast out”;88.4% (38/43)of PVTT were hyper-enhancement in the arterial phase, 81.4% (35/43 ) of PVTT were hypo-enhancement in the vein phase, and all tumor thrombosis showed hypo-enhancement in the delay phase. The diagnostic accuracy rate of contrast-enhanced ultrasound in PVTT was 100%,and the accuracy rate of enhanced CT was 97.7% (42/43).The classification accuracy rate of contrast-enhanced ultrasonic was 95.3% (41/43),and the accuracy rate of enhanced CT was 93.0% (40/43 );there was no statistically significant difference between two methods (P > 0.05 ). Conclusion:Dynamiccontrast-enhanced ultrasonography can display the blood perfusion characteristics of PVTT, and displays the actual infiltrating tumor thrombosis. Ultrasonic imaging and enhanced CT in the qualitative diagnosis of PVTT and clinical classification have a good consistency.Contrast-enhanced ultrasound can be used as an important imaging method to evaluate the PVTT before treatment.

Objective To analyze the impact of age on the detection rate,grade and stage of prostate cancer in patients with prostate specific antigen (PSA) 4-10 μg/L.Methods A retrospective analysis was made in 426 patients with PSA 4-10 μg/L who underwent prostate biopsy and divided into 4 group according to their age less than 60 (n=33),60-69 (n=163),70-79 (n=202) and more than 80 (n=28) to compare the correlation between age and the cancer detective rate.Among them,115 patients,diagnosed as prostate cancer,were further divided into 4 group according to their age less than 60 (n =3),60-69 (n=32),70-79 (n=69) and more than 80 (n=11).The correlation between age and the Gleason score or clinical stage was analyzed in 115 prostate cancer patients.Results The detective rate in each group was 9.1％ (3/33),19.6％ (32/163),34.2％ (69/202) and 39.3％ (11/28).There was significant difference in prostate cancer detective rate among those groups.The cancer detective rate became significantly higher as the age increased (P＜0.001).In the patients with prostate cancer,the number of patients with Gleason score more than 7 in each group was 1 (50.0％),11 (37.9％),30 (44.8％),7 (63.6％).No significant correlation was found between age and grade (P=0.292 4).And each group had cases with localized prostate cancer was 2 (100.0％),14 (60.9％),39 (78.0％),4 (66.7％),with locally advanced prostate cancer 0,5 (21.7％),7 (14.0％),1 (16.7％),with metastatic prostate cancer 0,4 (17.4％),4(8.0％),1 (16.7％).No significant difference was found between each group and clinical stage (P =0.101 6,P=0.285 2,P=0.349 1).Conclusions The prostate cancer detective rate significantly increases with the age increasing.There is no significant correlation between age and grade or clinical stage in the patients with PSA 4-10 μg/L.

OBJECTIVETo investigate the protective effect of sesamin against cadmium chloride (CdCl2)-induced cardiotoxicity in rats.

METHODSFifty male Wistar rats were randomly assigned to five groups: control group, CdCl2 group, and low-, middle-, and high-dose sesamin groups. The control group was given normal saline. The CdCl2 group and sesamin groups were intraperitoneally injected with CdCl2 (5 mg/kg×2 d), and the low-, middle-, and high-dose sesamin groups were given 20, 40, and 80 mg/kg sesamin, respectively. All treatments lasted for four weeks. ECG was measured by a physiological recorder, and serum myocardial enzyme levels were determined by biochemical assay. The heart was weighed, and heart tissues were used in histopathological examination and determination of malondialdehyde (MDA) level.

RESULTSCompared with the control group, the CdCl2 group showed significantly higher levels of serum CK and CK-MB, an increased heart coefficient, significant ST-segment elevation, and higher level of MDA in myocardial tissue (P < 0.05). Histopathological analysis showed edema of myocardial tissues and cells, myocardial fibers disorder, karyopyknosis, and uneven or deep staining of nuclear chromatin. Different doses of sesamin relieved the myocardial pathological changes induced by CdCl2, and high-dose sesamin was the most effective. The middle- and high-dose sesamin groups showed significantly reduced serum CK and CK-MB levels compared with the CdCl2 group (P < 0.05). The heart coefficient of the high-dose sesamin group (0.19±0.01%) was significantly lower than that of the CdCl2 group (0.21±0.01%) (P < 0.05). Myocardial MDA levels of the three sesamin groups (42.32±4.65, 36.71±5.34, and 33.12±4.62 nmol/mg pro, respectively) were all significantly lower than that of the CdCl2 group (55.87±3.65 nmol/mg pro) (P < 0.05).

CONCLUSIONSesamin can relieve myocardial injury induced by CdCl2, and one possible mechanism is the enhancement of antioxidant capacity of myocardial tissue.

Animals ; Cadmium Chloride ; toxicity ; Creatine Kinase, MB Form ; blood ; Dioxoles ; pharmacology ; Heart ; drug effects ; Lignans ; pharmacology ; Male ; Malondialdehyde ; metabolism ; Myocardium ; metabolism ; pathology ; Rats ; Rats, Wistar

OBJECTIVETo evaluate the survival rate and complications of endodontically treated residual crowns and roots restored directly or by glass fiber post and core or cast metal post and core.

METHODSIn this study, 96 patients with a total of 142 teeth were selected. All the teeth were undergone root canal therapy. And then, according to different situations, some of them were restored with glass fiber post and core, another with cast metal post and core, the rest were restored directly in the strict controlled indications.

RESULTSThe teeth (135) in 89 patients were divided into three groups. The first group contained 73 (54.1%) teeth restored with glass fiber post and composite resin core. The survival rate reached 97.3% in the average observation period of (5.7 +/- 1.9) years. The second group contained 40 teeth, restored with pure titanium casting post and core. The survival rate reached 87.5% in the average observation period of (6.2 +/- 2.2) years. The last group contained 22 teeth received no treatment. The survival rate reached 90.9% in the average observation period of (5.4 +/- 1.8) years. The success rate had no significant difference among the three groups. The most common complications after restored included root fracture (6.7%), retention loss (2.2%), secondary caries (1.5%) and periapical periodontitis (0.7%).

CONCLUSIONUnder the premise of high quality root canal treatment and standard restoration treatment, the abutment teeth, whether are restored by glass fiber post and core, cast metal post and core or without post, have a higher survival rate over 5 years of observation period and complications especially root fracture still should attract the necessary attention.

Composite Resins ; Crowns ; Dental Abutments ; Dental Stress Analysis ; Glass ; Humans ; Metals ; Post and Core Technique ; Root Canal Therapy ; Tooth Root ; Tooth, Nonvital

Objective To evaluate the influences of prostate-specific antigen (PSA) and digital rectal examination (DRE) to the detection rate,stage and Gleason grade of prostate cancer.Methods Retrospective analysis was performed on the prostate biopsy data of Beijing hospital from January 1997 to December 2010.The spearman rank correlation was applied to evaluate the relationship of PSA and DRE to the parameters related to the prostate cancer.Results The PSA had significant correlation with cancer detection rate,stage and Gleason grade (r =0.537,P ＜0.0001; r =0.365,P ＜0.0001; r=0.556,P ＜0.0001).However,DRE had only correlation with cancer detection rate and Gleason grade (r =0.212,P ＜0.0001 ; r =0.126,P =0.02).As the PSA increased,when divided into different groups,the cancer detection rate and the proportion of patients with Gleason 7-10 increased whereas the localized cancer rate decreased.DRE positive patients had higher cancer detection rate when PSA was in 10.0-19.9 μg/L and 20.0-99.9 μg/L groups.The DRE results had no influence to the stage or Gleason grade in same PSA group.Conclusions PSA has significant correlation with prostate cancer detection rate,stage and Gleason grade.However,the DRE results only affect cancer detection rate in some PSA level.

Objective To explore the classification and risk factors of nocturia in patients with benign prostatic hyperplasia (BPH). Methods The 120 males aged 60 years old and over were enrolled who were first diagnosed as BPH or had ceased the BPH medication for at least 3 months.The patients were divided into six groups according to the nocturnal voiding episodes estimated according to the international prostate symptom score (IPSS). All 120 males were inquired about general information and medical histories. The time and volume of intake and voided urine were recorded for 72 hours. The indexes of prostate and bladder function in all cases were also examined and recorded. Results The incidence of nocturia in our study was 79.2%, the incidence of nocturnal polyuria and overactive bladder were 3.3% and 10.8%, respectively. The quality of life was affected by the duration between the time of patients' going to bed and the first time getting up at night. After excluding the cases of nocturnal polyuria and overactive bladder, statistical analysis indicated that the age, and residual urine volume of the bladder were positively associated with nocturia frequencies (NF), the nocturnal voiding volume negatively with NF, while the prostate volume and peak flow rate were not associated with NF. Drinking volume in 24-hours affected the nocturia (P＜0. 01). Conclusions Nocturia is a common complaint in elderly males with BPH and significantly affects the quality of life. The age and the storing function of bladder are more important factors as compared with prostate hyperplasia itself.