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Objective To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with gabapentin for treatment of recurrent pain after trigeminal radiofrequency thermocoagulation.Methods Forty patients of both sexes suffering from recurrent pain after trigeminal radiofrequency thermocoagulation,who refused surgical treatment,aged 45-80 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with visual analog scale score ≥4,with the course of recurrent pain 0.5-17.0 months,were randomized into 2 groups (n =20 each) using a random number table:gabapentin group (group A) and gabapentin plus rTMS group (group B).The patients were treated with 2 courses of rTMS in total (5 days for 1 course,1 time per day) and with the second course at a 2-day interval in group B.Effective analgesia and pain relief were recorded within 6 months after treatment,and the therapeutic efficacy was evaluated according to the modified Macnab criteria.The daily consumption of gabapentin and development of rTMS-and gabapentin-related adverse reactions were recorded.Results No rTMS-related adverse reactions were found in group B.Compared with group A,the rates of effective analgesia and pain relief were significantly increased,the therapeutic efficacy was enhanced,the daily consumption of gabapentin was decreased,and the incidence of gabapentin-related adverse reactions was decreased in group B (P＜0.05).Conclusion Combination of rTMS and gabapentin produces better efficacy than gabapentin alone when used to treat the recurrent pain after trigeminal radiofrequency thermocoagulation,and the safety is good.
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Objective To explore the extrahepatic bile duct stones after reoperation cause analysis and coun-termeasures.Methods Clinical data of 150 patients with liver surgery gallstone surgery again were retrospectively analyzed,according to the first reason for liver from gallstone surgery will be divided into the three groups:group hepa-tolithiasis ( group A,100 cases) ,gallstones group ( group B,30 patients) ,common bile duct stones group ( group C, 20 cases) .The reasons for reoperation were analyzed.Results In intrahepatic bile duct stones reoperation patients, the recurrence of liver gallstones was 98 cases(65.3%),common bile duct cysts and Caroli disease was 35 cases (23.3%),anastomotic stenosis in 17 cases(11.3%);The postoperative complication rate of group A(44.0%) was significantly higher than that of group B(13.3%) and group C(15.0%)(χ2 =9.32,5.88,all P<0.05);The sec-ondary and post-operative inflammation stone recurrence within 5 years of group A was 32.0%,which was significant-ly higher than 6.7%of group B and 10.0%of group C(χ2 =7.67,3.97,all P<0.05).Conclusion The intrahe-patic bile duct stones are the main types of reoperation after liver gallstones,gallstones and liver recurrence is the main cause of its secondary surgery.It should be make clear the disease cause of preoperation, take a different surgical options for patients with different types of stones,prevention,and avoid the occurrence of postoperative complications, which can effectively reduce the risk of secondary surgery to alleviate the suffering of patients.
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Objective To investigate the effects of changes in protein bile sugar chain structure for differen-tiating benign and malignant biliary tract disease .Methods 100 patients with biliary tract diseases who were treated in Department of General Surgery ,Qingdao Haici Medical Group were selected in this study .According to benign or malignant biliary disease ,the patients were divided into control group ( benign biliary tract disease ) and observation group ( cholangiocarcinoma ) ,50 cases in each group .Two groups of patients with bile drops on the nitrocellulose mem-brane,through the comparison of wheat germ agglutinin (WGA),Datura stramonium agglutinin (DSA),lentil lectin (LCA),concanavalin A(CONA) positive rate of test,to explore the relationship between sugar chain of glycoprotein in bile and bile duct benign and malignant diseases .Results In control group,the positive rates of WGA,DSA,LCA, CONA agglutinin test were 22.0%,14.0%,2.0%,76.0%,those in the observation group were 76.0%,66.0%, 76.0%,82.0% respectively.No statistically significant difference between the two groups of CONA agglutinin test positive rate was observed(P>0.05).The WGA,LCA,DSA agglutination test positive rates in observation group were significantly higher than those in the control group ,the differences were statistically significant (χ2 =29.17,28.17, 57.55,all P<0.05).Conclusion Changes in bile glycoprotein chain structure are closely related to benign and ma -lignant biliary tract disease ,positive rates of WGA ,LCA,DSA agglutination test can be used to determine the benign and malignant biliary disease ,it should be popularized in clinical practice .
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ObjectiveTo explore the role of activation and expression of absent in melanoma 2 (AIM2) in pathogenesis of hepatitis B virus (HBV) associated glomerulonephritis (HBV-GN).MethodsFifty-four patients with HBV-GN were recruited into the investigational group,and 25 patients with chronic glomerulonephritis (CGN) and 6 patients with chronic hepatitis B (CHB) were included as negative control group and positive control group,respectively.Immunohistochemistry was used to detect AIM2,Caspase-1 and interleukin (IL)-1β expressions in both kidney tissues from the investigational group and negative control group and liver tissues from positive control group.The differences between groups were compared by chi-square test,and the correlation analysis was conducted by Spearman correlation test.ResultsThe positive expression rates of AIM2 in 54 patients of HBV-GN group and 25 of CGN group were 81.4 ％ and 4.0％,respectively (x2 =38.746,P＜ 0.01).AIM2 was found to be expressed in all 6 CHB patients.In HBV-GN group,the expression of AIM2 was positively correlated with Caspase-1 (rs =0.444,P＜0.01),and the expression of IL-1β was also positively correlated with Caspase-1 (rs =0.515,P＜0.01 ).In HBV-GN group,the expression of AIM2 in patients with HBV DNA≥1 ×105 copy/mL was significantly higher than that in those with HBV DNA＜1 × 105 copy/mL (x2 =6.097,P＜0.05).ConclusionThe activation of AIM2 may play a role in the pathogenesis of HBV-GN through Caspase-1 activation and inflammatory factor IL-1β release.
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Objective To study the hemodynamic change and the machanism of anomalous enhancement of hepatic peripheral area in arterial phase in patients with tumor embolismus in portal vein.Methods The imaging data in 30 cases of hepatic carcinoma (hepatic cell carcinoma in 28 cases and metastatic carcinoma in 2 cases)with tumor embolismus in portal vein confirmed by CT and angiography were reviewed and analysed.Results The tumor embolism were formed in portal stem vein is 3 cases,portal stem vein right and left branches in 18 cases,and right and left branches in 9 cases.The cavernous transformation of portal vein was in 26 cases.The blood vessel grouped and thickened in hepatic portal,the fissure of liver and fossa of gallblader were showed on CT.The hepatic peripheral area was enhanced in arterial phase in 10 cases.Conclusion The collateral branch underwent cavernous transformation after formation of tumor embolism in portal vein the liver blood supply is still maintain.The hepatic peripheral area in arterial phase are anomalously enhanced,it is suggested that the portal vein blood supply is reduction and the arterial blood supply is complemently increased.
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The absorption of 59 Fe incorporated into yeast was studied in rats. Yeast was cultured in a nutrient solution to which radioactive 59Fe was added as an intrinsic tag. The 59Fe-enriched yeast was separated from the solution by centrifuge and given to rats by a stomach tube. The rats of the control groups were given the radioactive " Fe together -with ordina-ly yeast plus ferrous sulfate or only with ferrous sulfate separately.All feces were collected until less than 0.5 per cent of the administered dose was present in a 24-hour specimen of feces. The radioactivity in the feces was then measured daily for three successive days. The absorption of iron was calculated by the difference between intake and fecal loss.The result revealed that the absorption of iron in "Fe-enriched yeast (38.7%) was similar to that of ferrous sulfate (38.3%). It indicated that the iron incorporated into yeast was easily to be absorbed.This study afforded the scientific data for researching and popularizing fortified food with iron-enriched yeast.