Comparison of over-the-scope clip and traditional through-the-scope clip in the treatment of peptic ulcer bleeding / 中国内镜杂志

Objective?To compare the difference between endoscopic hemostasis with over-the-scope clip and conventional endoscopic hemostasis with through-the-scope clip for treatment of peptic ulcer bleeding.?Methods?Using the method of retrospective study, 22 cases of peptic ulcer bleeding patients treated by endoscopic hemostasis with over-the-scope clip and 24 cases recently completed by endoscopic hemostasis with through-the-scope clip before the application of endoscopic hemostasis with over-the-scope clip as the research object, then evaluate the efficacy and safety of endoscopic hemostasis with over-the-scope clip by comparing immediate hemostasis success (rate), the total number of clips used for operation, first successful hemostasis (rate), postoperative recurrence (rate), hemostasis success (rate), rebleeding (rate), two endoscopic treatment (rate), permanent hemostasis (rate), complication (rate), postoperative hospital stay (d), mortality (rate).?Results?Immediate hemostasis success (rate) of peptic ulcer bleeding patients treated by endoscopic hemostasis with over-the-scope clip was 20/22 (90.9%) and the total number of clips used for operation was 22, the first successful hemostasis (rate) was 20/22 (90.9%), postoperative recurrence (rate) was 1/20 (5.0%), successful hemostasis (rate) was19/22 (86.4%), rebleeding (rate) was 1/20 (5.0%), two endoscopic treatment (rate) was 3/22 (13.6%), permanent hemostasis (rate) was 18/22 (81.8%), complications (rate) was 0/22 (0.0%), postoperative hospital stay time (d) was (8.95 ± 0.96) d, death (rate) was 0/22 (0.0%). Immediate hemostasis success (rate) of peptic ulcer bleeding patients treated by hemostasis therapy with through-the-scope clip was 13/24 (54.2%) and the total number of clips used for operation was 56, the first successful hemostasis (rate) was 13/24 (54.2%), postoperative recurrence (rate) was 0/13 (0.0%), successful hemostasis (rate) was 13/24 (54.2%), rebleeding (rate) was 0/13 (0.0%), two endoscopic treatment (rate) was 11/24 (45.8%), permanent hemostasis (rate) was 13/24 (54.2%), complications (rate) was 0/24 (0.0%), hospitalization time after operation (d) was (8.54 ± 0.53) d, death (rate) was 1/24 (4.2%). Immediate hemostasis success (rate), first successful hemostasis (rate), hemostasis success (rate), and permanent hemostasis (rate) were higher in the OTSC group than in the TTSC group. However, two endoscopic treatment (rate) was lower in the OTSC group than in the TTSC group (P < 0.05).?Conclusion?Endoscopic hemostasis with over-the-scope clip is safe and effective on the treatment of peptic ulcer bleeding,it can be used as the first choice for the treatment of complicated and refractory peptic ulcer bleeding due to rupture of blood vessel with the larger diameter or other causes.

Oral malignant acanthosis nigricans associated with endometrial adenocarcinoma / 国际口腔科学杂志·英文版

We report a 59-year-old patient with malignant acanthosis nigricans associated with metastasis of endometrial carcinoma. The patient presented papillomatosis lesions that appeared to be benign on multiple skins of body folds, particularly on lips. The lesions in lips and axilla had histological characteristic appearances of acanthosis nigricans, while the masses in abdomen and pelvis were metastasis endometrial adenocarcinoma. The article highlights the importance of biopsy and histopathological diagnosis in presumed benign lesions and the role of doctors in screening for body internal tumors.

Application of CAD/CAM technique in three-dimensional reconstruction of zygomatic complex defect / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the efficacy of computer-aided design and computer-aided manufacturing (CAD/CAM) technique in reconstruction of zygomatic complex defect.</p><p><b>METHODS</b>Three-dimensional computed tomography (3D-CT) and rapid prototyping (RP) techniques were applied to produce facsimile models in 13 patients with zygomatic complex defects resulted from trauma or tumor ablation. The zygomatic complex defect was reconstructed using a mirroring technique by CAD/CAM. Titanium mesh was prefabricated on individual facsimile models and combined with autologous bone graft and pedicled buccal fat pad flap for reconstruction.</p><p><b>RESULTS</b>The measuring data of zygomatic complex defect between facsimile model and intraoperative findings was extremely consistent. The prefabrication of reconstructive titanium mesh was matched with zygomatic complex defect in the surgery. The postoperative 3D-CT image demonstrated the symmetry of reconstructed zygomatic complex. The functional recovery and facial contours were satisfactory in all cases.</p><p><b>CONCLUSION</b>The application of CAD/CAM technique can simulate the surgery procedures accurately, which contributes to shorten the actual operative time. RP techniques can reconstruct the facial contours symmetry and recover the function of zygomatic complex defect.</p>

Preoperative evaluation of the 64-slice spiral CT three dimensional angiography for vascular invasion in gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the preoperative diagnosis value of 64-slice spiral CT three dimensional angiography (3D CTA) for the vascular invasion in gastric cancer.</p><p><b>METHODS</b>CT images of 40 patients diagnosed as gastric cancer by endoscope,who proceeded to surgical exploration from August 2006 to December 2007,were collected. These images were rebuilt by 3D CTA to judge vascular invasion by gastric cancer in comparison with the surgical finding as standard reference.</p><p><b>RESULTS</b>Successful 3D CTA reconstructions were performed for all these 40 patient images. Out of 40 cases, 14 cases presented vascular invasion in the 3D CTA, and 12 of 14 cases were proved to have vascular invasion in the surgery. For assessing vascular invasion with CTA, the sensitivity was 98.1% and the specificity was 96.4% respectively (Chi Square chi(2)=0.0099,P>0.05). There was no significant differences regarding vascular invasion in gastric cancer between preoperative 3D CTA assessment and surgical finding.</p><p><b>CONCLUSION</b>Sixty-four-slice spiral CT 3D angiography is effective in assessing vascular invasion in gastric cancer and is also valuable in clinical application.</p>

Application of parasymphyseal mandible osteotomy combined with set-back tongue flap in treatment of tongue base carcinoma / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the efficacy of the approach of parasymphyseal mandible osteotomy combined with set-back tongue flap in treatment of tongue base carcinoma.</p><p><b>METHODS</b>In total 18 patients with cancer of tongue base, 13 were males and 5 females aged of 30 to 65 y (average 52.9 y). Eighteen patients were treated by parasymphyseal mandible osteotomy combined with set-back tongue flap in our hospital from June 2001 to June 2006.</p><p><b>RESULT</b>The range of follow-up period was 2 to 5 years. All patients had satisfactory speech, swallowing and taste function.</p><p><b>CONCLUSION</b>Parasymphyseal mandible osteotomy provides good exposure, and set-back tongue flap to reconstruction of the base of tongue can partially restore the function of tongue.</p>

Deep lingual arterial chemoembolization of tongue carcinoma with microcapsuled anticancer drug / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>Microcapsule chemoembolism is a promising treatment of tumors. We describe a deep lingual arterial embolization of tongue carcinoma with microcapsuled carboplatinum.</p><p><b>METHODS</b>Lingual artery cast specimens from cadavers were microscopically examined, and 78 patients with tongue cancer were recruited and treated with the deep lingual arterial embolization therapy.</p><p><b>RESULTS</b>Microcapsule embolism occurred approximately at the fifth or sixth level of the deep lingual artery branches. The five-year survival rate was 88.5% (69 out of 78), and the ten-year survival rate 52.6% (41 out of 78).</p><p><b>CONCLUSION</b>The deep lingual arterial embolization of tongue carcinoma with microcapsuled carboplatinum is an effective therapy to treat carcinoma in mid-margin or mid-body of the tongue.</p>

Reconstruction of maxillary defect by prefabricated titanium mesh combined with pedicled buccal fat pad flap and bone autograft / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce individualized 3-dimensional (3-D) reconstruction of maxillary defect by prefabricated titanium mesh combined with pedicled buccal fat pad flap (PBFPF) and bone autograft.</p><p><b>METHODS</b>Since May, 2001, 16 patients with maxillary defect resulted from tumor or trauma were treated. The 3-D models were created through 3-D CT and rapid prototype technique. The maxilla on the unaffected side was copied to the affected side by CAD/CAM. Then the titanium mesh was prefabricated accurately on the 3-D model. The PBFPF served as lining of the titanium mesh and the autogenous bone graft was used to reconstruct the shape and function of maxilla.</p><p><b>RESULTS</b>The duration of follow-up was 6 to 36 months. All the wounds healed primarily with good facial symmetry. No food reflux to nasal cavity was observed. The dentitions in 8 of 16 cases were restored with good function by removable partial denture. They could have normal diet and were articulate. Nasopharyngoscopy showed normal tissue lining of the titanium mesh 5-12 months after operation in 3 cases.</p><p><b>CONCLUSIONS</b>Satisfactory aesthetic and functional result can be achieved with this 3-D reconstruction method for maxilla defect. The PBFPF was insert better titanium mesh and mucous of maxilla sinus to avoid exposure of titanium mesh. The fat pad flap with blood supply promotes wound healing and helps partially restoring the function of the maxillary sinus.</p>

The effect of artificial bone implantation in cleft palate on the development of maxilla / 中华整形外科杂志

<p><b>OBJECTIVE</b>To research the influence of palate bone implantation to the growth of maxilla in three dimensional direction.</p><p><b>METHODS</b>40 patients of congenital cleft palate type II with palate board damage were stochastically divide into the comparison group and bone planted group. In bone planted group, HA-Bone cement was used to repair palate tabular damage. All patients are 16 full year old, cephalometric radiograph and tooth cast model were measured and contrast analysis was applied.</p><p><b>RESULTS</b>Planted bone group and the comparison group does not have the significance difference in both the maxilla length and maxilla hightness( P > 0.05); But there was significance difference in the width of post-part of the maxilla (P < 0.05).</p><p><b>CONCLUSIONS</b>It could promote the growth of maxilla width in use of bone implantation, that advocated the bone repair in the sequence treatment process in cases of the hard palate bone damage.</p>

Relative quantification of cytokeratin 19 transcription in oral squamous cell carcinoma tissues by fluorescent quantitive real-time RT-PCR / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the relative quantification of cytokeratin 19 transcription in oral squamous cell carcinoma tissues by fluorescent quantitive real-time reverse transcription-polymerase chain reaction ((RT-PCR).</p><p><b>METHODS</b>CK19mRNA level was detected by fluorescent quantitive real-time RT-PCR in cancerous and para-cancerous tissues from 31 oral squamous cell carcinoma patients. According to the 2(-DeltaDeltaCt) equation, the relative quantification fold of CK19mRNA level was calculated in cancerous tissues compared with para-cancerous tissues.</p><p><b>RESULTS</b>CK19mRNA levels in cancerous tissues were 2.21 folds higher than those in para-cancerous tissues, and the amplicon was specific. CK19mRNA level in cancerous tissue correlated significantly with pathological differentiation degree, the poorer the differentiation was, the higher the CK19mRNA level became.</p><p><b>CONCLUSIONS</b>Fluorescent quantitive real-time RT-PCR is accurate and reliable in the detection of relative quantification of CK19 transcription in oral squamous cell carcinoma tissues.</p>

The assessment of curative effect after total mesorectal excision with autonomic nerve preservation for rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the impact on sexual function, local recurrence and survival after total mesorectal excision (TME) with autonomic nerve preservation (PANP) of rectal cancer.</p><p><b>METHODS</b>One hundred and five patients after TME with PANP were followed by means of questionnaire on postoperative genital function [TME + PANP(+) group], and the results of 110 patients after TME without PANP [TME + PANP(-) group] were compared with, also their local recurrence and 5-year survival were retrospectively analyzed.</p><p><b>RESULTS</b>TME + PANP(+) group was compared to TME + PANP(-) group: the erection dysfunction, 33.3% vs 63.2%; the ejaculation dysfunction, 43.8% vs 70.0% (P < 0.01), there were significant differences between two groups, but no difference in local recurrent rate and 5-year survival rate (7.6% vs 5.5%; 63.4% vs 59.7%, P > 0.05).</p><p><b>CONCLUSION</b>The TME with PANP of rectal surgery ensure the radical cure of rectal cancer, at the same time reasonably save the postoperative sexual function and obtain satisfactory postoperative survival.</p>

Effects of fluvastatin on blood levels of inflammatory cytokines in patients with unstable angina undergoing percutaneous coronary intervention / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effect of fluvastatin on blood levels of c-reactive protein (CRP), tumor necrosis factor alpha (TNFalpha) and cardiac troponin I (cTnI) in patients with unstable angina undergoing percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Sixty patients who underwent PCI from July 2002 to April 2004 in our hospital were randomized into two groups: control group; fluvastatin group (40 mg/d). Serum levels of CRP, TNFalpha and cTnI were measured before and after two weeks treatment (in the early morning of the procedure) and at 24 hours after the procedure.</p><p><b>RESULTS</b>The serum levels of CRP, TNFalpha and cTnI in fluvastatin group were distinctly lower than those in control group before (P < 0.01) and after the procedure (P < 0.01), respectively.</p><p><b>CONCLUSION</b>The result suggested that PCI could lead to a detectable increase in serum levels of CRP, TNFalpha and cTnI in patients with coronary heart disease; Fluvastatin could significantly decrease the serum levels of CRP, TNFalpha and cTnI in patients with coronary heart disease; Fluvastatin could also decrease the serum levels of CRP, TNFalpha and cTnI in patients with PCI.</p>

Subciliary incision and lateral cantholysis in rigid internal fixation of zygomatic complex fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures.</p><p><b>METHODS</b>The subciliary incision and lateral cantholysis combined with tri-dimension reduction and rigid internal fixation of zygomatic complex fractures with titanium microplates were applied in 56 patients with zygomatic complex fractures. Another lateral eyebrow incision or sublabial incision was used to simplify the operation.</p><p><b>RESULTS</b>The postoperative follow-up period ranged from 6 months to 5 years. During the follow-up period, all the patients had satisfying postoperative results. All clinical symptoms disappeared except the numbness in the infraorbital region in 2 patients. In 94.6% patients no complications such as obvious scar, ectropion, entropion or blepharoedema were found, only 5.4% of the patients had slight ectropion 6 months after operation.</p><p><b>CONCLUSIONS</b>The subciliary incision and lateral cantholysis have many advantages such as invisible scar, sufficient exposure, minimal injury, and few complications and combined with rigid internal fixation with titanium microplates this technique could be used as one of the routine operation methods to treat zygomatic complex fractures.</p>

Immediate maxillary reconstruction after tumor excision by using lined buccal-fat-pad flap with bone graft technique / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the role of buccal-fat-pad flap in the lined coverage of the maxillary bone graft for the maxillary reconstruction after the tumor excision.</p><p><b>METHODS</b>Based on the cadaver anatomical observation of the buccal-fat-pad, 38 patients with the maxillary tumors were undertaking the treatment in this paper. Under general anesthesia, the buccal-fat-pad flap was elevated and transferred to the anterior or nasal cavities as a line of the sinus after the tumor was immediately excised through an intro-oral or external approach. The bone from the ribs was then grafted in the place for the maxillary support.</p><p><b>RESULTS</b>After the anatomical evaluation, 38 patients were carried out the operation successfully. All of the grafted bones were well covered without bone exposure. The aesthetic appearance was achieved.</p><p><b>CONCLUSION</b>Bone graft lined by the pedicled buccal fat pad flap may be a safe and good method for reconstruction of the maxilla with a lower rate of re-absorption and sequestration.</p>

Prevalence of vitamin A deficiency in children under six years of age in Tibet, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the prevalence of vitamin A deficiency (VAD) among children under six years of age in Tibet, China.</p><p><b>METHODS</b>Totally, 1 257 children under six years of age were selected from two cities, two farming counties, two semi-farming counties and two livestock farming counties with stratified cluster sampling to asses VAD status in Tibet. Family information, children's feeding and disease history in the previous two weeks were collected by questionnaire. Blood specimen was collected from each child and serum was separated for detection of vitamin A concentration with microfluorescent spectrophotometry.</p><p><b>RESULTS</b>Totally, 1 257 children under six years of age were surveyed, with 635 boys, 622 girls, 862 aged over two years, and 98.5% of Tibet nationality. Six cases of night blindness and two cases of xerophthalmia were detected from them, with prevalence of clinical VAD of 0.96%. Eighteen of 1071 mothers with children under six years of age were found suffering from night blindness, accounting for 1.7%. Clinical cases of VAD both in children and mothers came from all four sampling strata. Average serum concentration of vitamin A and prevalence of subclinical VAD (serum vitamin A lower than or equal to 0.70 micromol/L) was 1.15 micromol/L and 5.4% and 1.12 micromol/L and 4.7% in cities and livestock farming counties, respectively, significantly higher than those in farming (1.04 micromol/L and 11.0%) and semi-farming counties (1.05 micromol/L and 12.3%), respectively, as compared to average levels of 1.09 micromol/L and 8.4% in the autonomous region as a whole. Prevalence of subclinical VAD in children under six months and those aged six to eleven months were 22.2% and 13.3%, respectively, significantly higher than those in children aged one year (8.5%), two to three years (5.4%) and four to five years (7.9%), respectively. There was also significant difference in serum level of vitamin A between children at varied ages, but no significant difference both in serum level of vitamin A and prevalence of subclinical VAD between gender was found.</p><p><b>CONCLUSIONS</b>In general, status of VAD in children of Tibet was milder than that at national level. But, moderate subclinical VAD in some areas, such as farming and semi-farming counties, did exist, so vitamin A supplementation aiming to children, especially those under one year of age, in those areas should be urged.</p>

Relationship of expression of inducible nitric oxide synthase to microvessel density in oral squamous cell carcinomas / 浙江大学学报·医学版

OBJECTIVE: To study expression of inducible nitric oxide synthase (iNOS) in oral squamous cell carcinomas (OSCC) and its relations to microvessel density (MVD) and lymphatic metastasis. METHODS: With 9 cases of normal oral mucosa as control, the expression rate of iNOS in 41 cases of OSCC was evaluated by immunohistochemstry SP staining. With CD34 as label, MVDs of these cases were also detected. RESULTS: The iNOS expression rate of OSCC cases was 63.41%(26/41), while no positive expression was seen in 9 cases of normal oral mucosa. Anymore, the expression rate of N+ group was 85.00% while that of N group 42.90%, the rate between them was significantly different (P<0.01). There was correlation between MVD and lymphatic metastasis (rs=0.51, P<0.01). MVDs in groups of different iNOS expression( approximate, equals +++) were 29.667+/-6.945, 34.833+/-4.579, 46.357+/-6.687, 54.167+/-5.565, respectively, and were significantly different with each other (P<0.001). CONCLUSION: There is high expression rate of iNOS in OSCC, and it has close relation to lymphatic metastasis; angiogenesis may facilitate lymphatic metastasis of OSCC, and expression of iNOS has positive relation to MVD in OSCC.

Resources of medicinal plants in China

Four aspect dealts with in this paper are as follows: 1. environment of medicinal plants; 2. brief history on studies of medicinal plants; 3. species of medicinal plants; 4. studies on development and utilization of medicinal plant resources.