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Objective To discuss the clinical application of percutaneous radiologic gastrostomy (PRG) in treating dysphagia associated with amyotrophic lateral sclerosis (ALS),and to evaluate its safety and improvement effect on patient's nutritional status in ALS patients with pulmonary insufficiency.Methods The clinical data of 51 ALS patients who received PRG were retrospectively analyzed.The success rate of surgery and postoperative complications were recorded.All patients were regularly followed up,and the longterm complications as well as the one-,3-and 6-month mortality rates after the surgery were documented.The improvement of patient's nutritional status was evaluated.Results PRG was successfully accomplished in all 51 patients,the technical success rate was 100％.Mild postoperative complications occurred in 7 patients (13.73％) and severe massive hemorrhage in one patient (2.0％).After PRG,no signs or symptoms of impaired respiratory function were observed.No death occurred in one month and in 3 months after PRG.Six months after PRG,three patients died(6.8 ％,3/44).One month after PRG,31 patients had an increase in body weight of more than 1 kg,and the mean BMI was increased from preoperative t8.60±2.14 to postoperative 19.27±1.81 (one month after PRG),19.17±1.93 (3 month after PRG) and 18.89±2.33 (6 month after PRG).Conclusion For the performance of PRG no gastroscopy or anesthesia is needed,thus,the risk of aspiration asphyxia can be reduced in ALS patients complicated by pulmonary insufficiency and the success rate as well as the safety can be improved.Therefore,this technique is an effective means to ensure that the ALS patients with pulmonary insufficiency can get adequate energy intake to improve their nutritional status.
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Objective To study the mechanical properties and degradation behavior of biodegradable silicon-covered magnesium alloy stent in vitro,to investigate the technical feasibility of its implantation into rabbit esophagus and to observe the tissue reaction in vivo.Methods The mechanical compression recovery properties and the degradation behavior of biodegradable silicon-covered magnesium alloy stent were tested in vitro.A total of 30 healthy Holland rabbits were randomly divided into silicon-covered magnesium alloy stent group (n=15) and control group (n=15).For rabbits in the silicon-covered magnesium alloy stent group fluoroscopy-guided insertion of the stent into the lower third segment of esophagus was conducted,while for rabbits in the control group no intervention was adopted.One,2 and 4 weeks after the implantation of the stent,esophagography was performed for all rabbits of both groups,and each time every 5 rabbits from both groups were sacrificed,the specimens were collected and sent for histological examinations.Results In vitro test indicated that biodegradable silicon-covered magnesium alloy stent had good flexibility and elasticity,and in phosphate-buffered saline with pH 4.0 or pH 7.4 it degraded more slowly than bare magnesium alloy stent.In vivo test showed that the stent implantation could be well tolerated by all experimental rabbits.Before stent insertion the esophageal diameter was(9.2±0.8) mm,and at one,2 and 4 weeks after stent insertion the esophageal diameters were (9.7±0.7) mm,(9.6±0.8) mm and (9.6±0.5) mm respectively (P＞0.05).In the silicon-covered magnesium alloy stent group,stent displacement occurred in 6 rabbits in one week (n=l),2weeks (n=1) and 4 weeks (n=4).After stent implantation,the tissue reactions such as esophageal wall injury,collagen deposition,etc.were not obviously different from those in the control group (P＞0.05).Conclusion It is technically feasible to insert silicon-covered magnesium alloy stent into the rabbit's esophagus,the stent can provide sufficient support for at least 2 weeks,the stent displacement rate is low and acceptable,and no severe esophageal wall injury and collagen deposition are observed.
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Objective:To determine the effects of Jinlong capsule combined with interventional therapy on the immune functions of primary hepatocellular carcinoma patients. Methods:Sixty randomly selected cases of clinically diagnosed primary hepatocellular carcinoma were divided into the observation group and the control group. Three days after operation, the observation group was given four Jinlong capsules three times a day for 30 days (one treatment). Meanwhile, the control group received interventional therapy after the operation. One to four days following one treatment, peripheral blood specimens were collected from the two groups to determine the cellular immune function indices. Results:The cell numbers (mean) of the peripheral blood components CD3, CD4, NK, SIL-2R, TSGF, and SIL-2R and the CD4/CD8 ratio in the observation group showed no significant difference before and after treatment. In the control group, these indices were significantly different before and after treatment. Conclusion:The Jinlong capsule facilitates the cellu-lar immunity recovery of patients with primary hepatocellular carcinoma after interventional therapy.
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Objective To explore the tumor markers for the diagnosis of primary liver carcinomas (PLC) by detecting the serum protein spectrum differently expressed between PLC patients and healthy controls. Methods We detected the serum protein spectrum in 50 PLC patients and 50 healthy controls using surface enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS) technique and find the significant protein peaks. The serum Alpha-fetoprotein (AFP) levels in all 100 serum samples were also measured by ELISA. Results The protein peaks, which could discriminate healthy individuals from PLC patients, were detected. Four protein molecules (3354.71, 8825.80, 4345.08, 13 715.01) had a significant difference between PLC patients and the normal controls (P <10-5), indicating that these protein molecules might be a potential marker for PLC. The specificity and sensitivity of SELDI-TOF-MS were 94% and 90% respectively. Sixteen PLC patients were AFP positive and the sensitivity was 54%(27/50). Conclusion With a high specificity and sensitivity, the detection of serum protein spectrum can be performed easily and quickly by SELDI-TOF-MS technique, which provides a serological way in identifying PLC and most likely to benefit from AFP strategies.