ABSTRACT
Objective To investigate the serum superoxide dismutase( SOD) ,malondialdehyde ( MDA) , and nitric oxide( NO) level in generalized anxiety disorder ( GAD) patients for exploring the importance of oxida?tive stress in etiology of GAD. Methods 42 cases of first episode patients with GAD ( GAD group) and 42 cases of health ( control group) matched with age and gender were included . Serum levels of SOD,MDA ,and NO were tested to analyze for a control study.Results GAD patients had significantly higher levels of SOD,MAD and NO than health controls ((858.09±137.32)×102 U/L vs (745.40±119.19) ×102 U/L;(10.92±3.42)mmol/L vs (7.52±2.32)mmol/L;(74.32±12.34) μmol/L vs(65.22±14.29) μmol/L), t=4.036,5.368,3.297;P=0.000, 0.000,0.003) . A positive relationship between SOD and total score of Hamilton Anxiety Scale( HAMA ) ,psychotic anxiety factor of HAMA,or somatic anxiety factor of HAMA was found in GAD group ( r=0.331,0.370,0.318;P=0.029,0.016,0.040).The level of MAD correlated with total score or psychotic anxiety factor of HAMA( r=0.311, 0.320;P=0.042,0.039).Conclusion It is suggested that the dysfunction of oxidative stress may play a role in pathogenesis of generalized anxiety disorder.
ABSTRACT
Objective To explore the method and evaluate the effect of locking compression plate (LCP)fixation of intraarticular unstable distal radial fractures.Methods Thirty patients with intraarficular unstable distal radial fractures were treated with LCP.According to AO/ASIF classification,there were 6 cases of type B2 fractures,7 cases of type B3,7 cases of type C1,8 cases of type C2,2 cases of type C3.Results After 6 to 24 months(average 12 months)following up,there were 15 cases graded as excellent,10 eases as good,3 cases as fair,and 2 cases as poor,according to X ray and wrist function assessment.The overall satisfaction rate was 83.3％.Conclusion Volar LCP fixation is a safe and effective treatment for intraarticular unstable distal radial fractures.It could effectively prevent loss of reduction,avoid tendon irritation and other complications if selecting implant angle for locking screw according to the specific intraoperative circumstances.
ABSTRACT
ObjectiveTo review the management and prevention of stenosis after hepaticojejunostomy. MethodsWe retrospectively analyzed 133 patients who developed stenosis after hepaticojejunostomy carried out for iatrogenic bile duct injuries. ResultThrough our active reoperative protocol, we were able to achieve satisfactory results in 131 patients, although the results were still unsatisfactory in 2 patients. ConclusionsStenosis after hepaticojejunostomy is a severe complication which should actively be prevented. Once it happens, doctors should apply active, appropriate and effective measures to correct the stenosis.
ABSTRACT
Objective To explore methods for the treatment and prevention of residual gallbladder.Methods Clinical data of 56 patients with residual gallbladder were retrospectively analyzed.Results All 56 cases were diagnosed through clinical imaging examination and cured by selective operation of residual gallbladder resection.Conclusion The residual gallbladder can be diagnosed by repeated biliary symptoms in patients with a history of cholecystectomy and imaging examination.Residual gallbladder resection is an effective therapy for the treatment of residual gallbladder.
ABSTRACT
Objective To pay close attention to and reverse the increasing trend about missed diagnosis and misdiagnosis of carcinoma of gallbladder and bile duct in laparoscopic cholecystectomy(LC). Methods By using retrospective analysis of 17 cases of missed diagnosis and misdiagnosis of carcinoma of gallbladder and bile duct in LC, their Clinical features and proposing protective measures were summarized. Results Seventeen patients including 14 with carcinoma of gallbladder and 3 with carcinoma of bile duct received various therapeutic measures according to their own conditions or aspirations. Conclusion Rapid intraoperative frozen section diagnosis is required for the cases with suspected carcinoma in LC and second operation is performed for those who are pathologically diagnosed with malignant tumor after the first one. No pathological diagnosis is strictly prohibited.
ABSTRACT
Clinical data of 50 patients with gastric injury after blunt abdominal trauma(gastric rupture in 20 and gastric laceration in 30)were retrospectively analyzed.All the patients with gastric rupture had a satiate stomach.which was not found in the patient with gastric laceration.Forty-nine patients experienced combinant injury.The most common combinant injury of gastric laceration was liver and pancreatic injury(15/30 and 10/30),and the most frequent combinant injury of gastric rupture was spleen injury(11/20).Forty-eight patients recovered while 2 died after the treatment with gastric prosthesis.The mortality rate was 4%.Surgical operation,or prosthesis,could be the main treahnent of choice.The management of combinant injuries and complications should be imprta.
ABSTRACT
Objective To explore the emergency management and prevention of iatrogenic injury of in-ferior vena cava. Methods A retrospective study was undertaken to investigate the operative procedure and post-operative outcome of 7 patients suffering from iatrogenic injury of inferior vena cava in the course of three nephrectomy, one fight adrenal gland tumor resection, one fight surgical kidney, one right upper retro-peritoneal tumor and one pancreaticoduodenectomy. The gross hemorrhage was controlled by local pressure. Then, abdominal incision was done. Firm pressure on the inferior vena cava was performed to right side for temporary control of hemorrhage. The bleeding part could be found when the hematocele was cleaned. And continuous suture should be done with 3-0 silk or absorbable suture after the crevasse was clamped. Results In these 7 cases, 1 died of hemorrhagic shock and the other 6 had significant effect postoperatively. The asso-ciated injuries were healed well except 1 case of slight edema of lower extremity. Conclusion Iatrogenic inju-ry of inferior vena cava can be treated successfully with correct procedure. Furthermore, the injury could be avoided with exactitude intraoperative procedure.
ABSTRACT
Objective: To observe the protective effect of BushenHuoxueFang on renal interstitial fibrosis in rats and try to explore the mechanism. Methods: The renal obstruction model of rats was established by unilateralureteral obstruction ,and then they were divided into four groups randomly, including sham-opration group,model group,Lotensin group, BushenHuoxueFang high-dose and low dose group.The morphological changes of kidney tissue were observed,the level of PDGF-BB was detected by Western-blot on the third,seventh,fourteenth and twenty first,twenty eighth day Results: Compared with the sham-operation group, there were different degrees of kidney lesions in UUO group and the treatment groups. The level of PDGF-BB in UUO group was significantly higher than that in sham-operation group from the third day(P
ABSTRACT
Objective: To investigate the protective influence and mechanism of Yishen Huayu Formula on the expression of connective tissue growth factor (CTGF)in the rat with renal interstitial fibrosis. Methods: 150 rats were randomly divided into sham-opration group, model group, Lotensin treatment group, Yishen Huayu high low dose treatment groups. The rat models with renal interstitial fibrosis were induced by unilateral ureteral obstruction. The expressions of CTGF in the kidneys were observed on 3rd, 7th, 14th, 21st, 28th day. The alterations of renal the expressions of CTGF in the kidneys were observed with the ?-actin as intrinsic control. Results: Compared with the control group,the expression of CTGF increased signifi cantly in model group(P
ABSTRACT
Objective To explore the diagnostic and therapeutic methods for male breast cancer. Methods Clinical data of 11 cases of male breast cancer treated in our hospital from 1992 were analyzed (retrospectively). Results 2 patients were diagnosed at advanced stage and survived 6 and 8 months (respectively) after biopsy. The other 9 patients received radical mastectomy. 3 were lost to follow-up, 1 was found to have pulmonary metastasis after 5 years and combined treatment of traditional Chinese medicine and western medicine was given. Nodules were found under the axillary fossa in another patient at five years after surgery and the nodules were recurrent carcinoma as confirmed by biopsy. The patient has survived for 7 years with radiotherapy and chemotherapy. The other 4 cases have survived 0.5 to 7 years respectively, and are undergoing treatment. Conclusions Early diagnosis of male breast cancer should be emphasized. Aggressive surgery combined with other auxiliary treatments are effective.
ABSTRACT
Objective In order to discuss the surgical treatment of iatrogenic bile duct injury.Methods 156 cases of iatrogenic bile duct injury during recent 20 years were reviewed and analyzed in this paper.Results The total re-operation rate was 85.71% (126/147), the re-operation rate of LC, OC, OC plus exploration of common bile duct were 95.24%, 87.27%, 62.50% respectively (P
ABSTRACT
Objective To investigate the relationship between canceration and primary operation mode for congenital choledochal cysts(CCC). Methods The clinical data of 21 patients with CCC treated in the last 30 years were analysed retrospectively. Results In this series, the incidence of carcinoma was 14.8%; the canceration rate after internal drainage operation was significantly higher than that after resection of the cyst(P<0.001); the age of canceration after internal drainage was younger than that of resection of the cyst(P<0.01) and patients without operation(P<0.01); the interval time of canceration after internal drainage operation was significantly less than that of resection of the cyst(P<0.01); the age of carcinoma would be 15.4 years younger in internal drainage operation patients than that in patients without operation. Conclusions Internal drainage, which could accelerate the occurrence of canceration of CCC, should be abandoned; resection of the cyst is recommended as the therapy of the first choice.
ABSTRACT
Objective To screen down regulated genes and find down regulated novel genes in gastric cancer. Methods Genes mRNA expression were detected between gastric cancer and normal gastric mucous membrane of five patients using cDNA microarray. Genes mRNA expression signals on hybridization membranes were analysized with computer software. Down regulated genes in gastric cancer were screened. cDNA suppression subtraction library was established by counterpart normal gastric mucous membrane mRNA(Tester) subtracting gastric cancer tissues mRNA(Driver) of five patients. After identification of the subtraction library, positive clones choosen randomly were sequenced , and down regulated novel genes in gastric cancer were screened. Some of the genes were identified by RT PCR.Results Down regulated genes in gastric cancer consist of 60 genes including tumor suppressing genes, apoptosis related genes, DNA replication and transcript or translate related genes, cell cycle related genes, cell migration related genes, etc. Two unknown gene fragments in gastric cancer were cloned. Conclusions Sixty down regulated genes in gastric cancer are confirmed. They are involved in gastric tumorigenicity and metastasis. cDNA subtraction library of gastric cancer was constructed successfully. Two down regulated novel gene fragments in gastric cancer was found.
ABSTRACT
Objective To study the early diagnosis and the prognosis of carcinoma of the head of pancreas(CHP) and to determine the sensitivity of various detecting methods. Methods Data of preoperative diagnosis and prognosis in 22 patients with early stage of CHP and 168 patients with advanced CHP treated in our department in recent 15 years were retrospectively analyzed and compared. Results The early stage of CHP revealed no specific symptom. In early stage of CHP,the diagnlstic rate was 88.9%, detecting rate of cancer cells in pancreatic juice with ERCP was 88.4%, The sensitivity of needling cytologic examination during operation was 91.7%,the resection rate was 90.9%, 3years survival rate was 36.4%.Those were significantly higher than those in advanced CHP. Conclusions B mode ultrasonography and CT are the first choice of diagnosis for early stage of CHP. ERCP and selective celiac artery angiography can promote diagnostic rate. Searching carcinoma cells in pancreatic juice collected by ERCP and needling cytologic examination during operation can further improve the early diagnostic rate.In patients with early stage of CHP,the resection rate and post operation cure rate are significantly higher than those in patients with advanced CHP.
ABSTRACT
From 1978 to 1985, 14 patients with accidental injury of extrahepatic bile ducts at cholecystecto-my were reported. The incidence was 0.12%. The injury caused suffering, severe after effects for the patients.In the analysis of the causes, half of the cases occurred due to over-confidence and negligence of operating surgeons. Other causes were as unsatisfactory anesthesia, improper operative incision, blind clamping for control of hemorrhage in the area of the bile ducts, difficult dissection of the Calot's triangle because of anatomical anomaly, fibrosis, inflammation or adhesion. The methods of the prevention were discussed.According to various types of injury, different therapy should be taken. Early intervention, Roux-Y jejunal reconstruction, judicious use of Y tube and prolonged dilatation of hilar strictures will improve the outlook. No mortality and malfunction occurred.