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Objective To explore the effect of the position of the biliary stents on the short?term and long?term effects of the patients with low malignant obstructive jaundice after treatment.Methods Seventy?eight patients with low?grade malignant obstructive jaundice diagnosed in Jiangyin Hospital Affiliated to Medical College of Southeast University who underwent biliary stenting were enrolled as the study object.According to the placement of the biliary stents,the stents were divided into the spanning group and the non?crossing group.The baseline data and related serological indexes were recorded,and the changes of jaundice between the two groups were compared by repeated measurements.All patients were followed up for 48 weeks.Multivariate Cox regression analysis was applied on the risk factors that might affect the prognosis of patients, and the degree of influence of various factors on the prognosis of patients was further evaluated.Results Repeated measures analysis showed that the biochemical indicators of the spanning group and the non?crossing group showed a significant downward trend and the difference was statistically significant (TBil: Fintra?group＝9.392,Pintra?group＝0.000; DBil: Fintra?group＝7.581,Pintra?group＝0.001).Among them,the total bilirubin (TBil) (Preoperative: (318.69±101.13) μmol／L,1 week after surgery: (135.98 ±63.61) μmol／L,2 weeks after surgery: (60.21±24.81) μmol／L) was lower than the non?crossing group preoperative: (309.07±109.97) μmol／L,1 week after surgery: (158.87±66.92) μmol／L,2 weeks after surgery: (75.91 ± 20.46) μmol／L), and the difference was statistically significant ( Finter?group ＝3.362, Pinter?group＝0.041).The direct bilirubin ( DBil) ( Preoperative: (171.93 ± 73.01) μmol／L,1 week after surgery: (90.38± 57.33) μmol／L,2 weeks after surgery:(36.64± 18.95) μmol／L) was lower than the non?crossing group ( Preoperative: ( 174.53 ± 82.74) μmol／L,1 week after surgery: ( 107.85 ± 49.07) μmol／L,2 weeks after surgery: ( 37.87 ± 14.55 ) μmol／L.The difference was statistically significant (Finter?group＝6.284,Pinter?group＝0.003).There was an interaction between the treatment regimen and treatment time (1 week after surgery and 2 weeks after surgery) (TBil: Finteraction＝12.262,Pinteraction＝0.000; DBil:Finteraction＝10.254,Pinteraction＝0.000).The results of the multi factor Cox proportional hazard model of the spanning group and the non?crossing group showed that the ALP, DBil, TBil and lymphatic metastasis of malignant tumor were the two independent risk factors that affect the prognosis.However, the pancreatic cancer,ALT and age in the spanning group across the ampulla also have a certain effect on the prognosis of the patients.Conclusion The effect of the placement of biliary stents across the Vater ampullary was more obvious in the short term on the decline of bilirubin.But in the long term,there was no significant difference in the prognosis of patients with biliary stenting position.ALP,TBil,DBil,and disease classification were all important risk factors affecting the prognosis of two groups of patients
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In the process of MPH graduates education in medical universities , there are three problems such as lack of initiative subjective of postgraduate, uneven level of tutors and monitoring defi-ciency of education. The main reasons are the low quality of MPH graduates, lack of quality consciousness for graduates education and graduates’ value tending to be utilitarian. Facing the problems, we suggest establishing guarantee mechanism for MPH graduate education quality, strengthening the tutors’ construc-tion and framing an eliminating system.
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Objective To evaluate the clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) and pcrcutaneous transhcpatic insertion of biliary stent (PTIBS) for malignant biliary obstruction.Methods PTBD or PTIBS were performed in 56 patients with malignant biliary obstruction, which were aused by hepatic carcinoma (n = 14), biliary duct carcinoma (n = 11), gallbladder carcinoma (n = 5),stomach carcinoma accompanied with metastasis of lymph node (n = 14), carcinoma of ampulla (n = 1 ) or carcinoma of pancreatic head (n = 11 ). The diagnosis was confirmed by ultrasonography, CT or MRI in all patients. The obstructed site was well identified, including high obstruction in 19 patients and lower obstruction in 37 patients. Based on the imaging findings, suitable interventional procedure was employed.Results PTBD or PTIBS were performed successfully in all 56 patients, of them PTBD was adopted in 11,PTIBS in 40 and both PTBD and PTIBS in 5. The serum total bilirubin decreased from (295.65±152.86)μmol/L before the procedure to (151.05 ± 107.36) μmol/L after the procedure, (P < 0.01 ). Postoperative infection could affect the fading of jaundice (P < 0.01 ), but the location of the obstruction carried no relationship with the fading of jaundice (P = 0.063). Conclusion Both PTBD and PTIBS are safe and effective palliative therapies for malignant biliary obstruction, which can markedly relieve patient of jaundice,improve the quality of life and elongate the survival period.
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@#Objective To observe the effect of 2450 MHz microwave on the white blood cells (WBC) and haematogenous of granulocytic series of mice.Methods The whole body of BALB/c mice were exposure to 2450 MHz power density (10 mW/cm2) microwave, and the mice were killed at different times after exposure, to determine the changes of spleen/body ratio, peripheral blood WBC, number of marrow nucleus cells, cell cycle and form ability of GM-CFU (granule and macrophage-clone forming unit).Results The number of peripheral blood WBC increased at first and then reduced with the exposure time prolonged. Number of marrow nucleus cells kept decreasing after microwave exposure, otherwise, form ability of GM-CFU of marrow cells increased. Exposure to 2450 MHz 10 mV/cm2microwave might speed up marrow nucleus cell passed from G1 period to G2 and S periods.Conclusion Low frequency of 2450 MHz microwave exposure has significant stimulate function on granule cell system, but with the time prolong, number of nucleus cells decreased.
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@#ObjectiveTo explore the changes of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malondialdehyde (MDA) in the brain of mice after irradiated by electromagnetic radiation (EMR) and therapeutic effect of curcumin.Methods40 mice were divided randomly into the bare control group, simply EMR group, EMR+curcumin low dose, middle dose and high dose groups total 5 groups with 8 animals in each group. The mice except the bare control group received EMR irradiation and those in the EMR+curcumin groups were given various doses of curcumin at the same time. Five days later, EMR irradiation and medication stopped, and the levels of SOD, GSH-Px and MDA in the brain of mice were tested.ResultsCompared with the bare control group, the activities of GSH-Px and SOD, and level of MDA all increased in the mice irradiated by EMR ( P<0.05). Compared with the simply EMR group, the activities of GSH-Px and SOD, and level of MDA all decreased in the mice of EMR +curcumin groups ( P<0.05).ConclusionEMR irradiation can induce changes of GSH-Px and SOD and peroxidation of mice brain, curcumin can lighten these damages by its anti-oxidation with a dose-dependent effect.
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ObjectiveTo investigate the protection of extract form earthworm a traditional Chinese medicine in auricle microcirculation disturbance in mice. MethodThe microcirculation disturbance in mice was brought by rapid injection of high molecule dextran. Observe the microvascular diameter,the blood flow speed,the blood fluid state and crossing net patency quantity of micrangium in mice before injection and after injection 10min,20min,30min with WX-9 microcirculation microscope and analytical system. ResultHigh and low dose of extract form earthworm could expend the diameter of the vein and artery of micrangium, quicken the blood flow speed,improve the blood fluid state,increase micrangium crossing net patefaction numbers. To compare with the control group, threr’s significant difference (P
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Objective To investigate the influences of blast wave overpressure created by explosion on rat's blood-brain barrier (BBB),and to provide an experimental evidence for further elucidating the mechanism of craniocerebral blast injury,to help direct the clini- cal therapeutic strategy.Methods Twenty male Sprague-Dawley rats were randomly divided into four groups:15min,12h and 24h post- explosion groups and normal control group with five rats for each group.Rats were injured with blast wave produced by explosion.Evan 's blue(EB)was intravenously injected into the injured rats,and the overpressure-induced leakage of BBB was examined under the fluores- cence microscope and by quantitative observation with opacimeter.Results Extensive impairment of BBB could be seen all over the brain 15 min after the overpressure explosion,and bright red EB fluorescent patches appeared as a method distributing along the capillary vessels. These patches were more distinct near the cerebral cortex,and with the lapse of time,their number decreased gradually from the inner to the outer areas.The changes in EB contents in brain tissue matched with that of the BBB.The EB contents in brain tissues in 15min group were(330.4?53.6)?g/g,and it was much higher compared with that of other groups(P