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Intraductal papillary neoplasm of the bile duct (IPNB) is a rare type of bile duct tumors with different classification criteria and has a better prognosis than cholangiocarcinoma. Clinicians lack the awareness of this disease due to its low incidence rate. This article reviews recent research advances in the etiology and pathogenesis, pathological characteristics, clinical features, differential diagnosis, treatment and prognosis of IPNB, in order to improve the clinical diagnosis and treatment of IPNB.
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Objective: To assess therapeutic effect of alprostadil on improving myocardial microcirculatory disturbance and hemorheological disorder in patients with coronary heart disease (CHD).Methods: A total of 164 CHD patients treated in our hospital were selected.According to random number table method, they were randomly and equally divided into routine treatment group and alprostadil group (received alprostadil injection based on routine treatment group), both groups were treated for two weeks.Serum levels of nitric oxide (NO), vascular endothelial growth factor (VEGF), thromboxan β2 (TXβ2) and hemorheological indexes were measured and compared between two groups after treatment;TIMI grade and TIMI myocardial perfusion grading (TMPG) of CAG were compared between two groups after treatment.Results: Compared with routine treatment group after treatment, there were significant rise in serum levels of NO[(64.9±10.3) mmol/L vs.(98.8±13.2) mmol/L]and VEGF[(1.62±0.53) mg/L vs.(3.31±0.68) mg/L], and significant reduction in serum TXβ2 level[(180.4±22.8) pg/ml vs.(78.9±9.6) pg/ml], P<0.05 or<0.01;significant reductions in whole blood high shear viscosity[(5.84±0.72) mPa·s vs.(4.25±0.31) mPa·s], whole blood low shear viscosity[(8.42±0.93) mPa s vs.(5.31±0.68) mPa s], plasma viscosity[(2.73±0.34) mPa s vs.(1.61±0.29) mPa s], fibrinogen level[(4.09±0.55) g/L vs.(3.13±0.55) g/L], erythrocyte aggregation index[(3.85±0.47) vs.(2.24±0.31)]and maximum platelet aggregation rate[(67.4±5.3)% vs.(48.0±3.6)%]in alprostadil group, P<0.05 all.Among those patients undergoing second CAG, compared with routine treatment group, there were significant reductions in percentages of TIMI and TMPG grade II and grade III, and significant rise in percentages of TIMI and TMPG grade 0 and grade I in alprostadil group, P<0.05 or <0.01.Conclusion: Alprostadil can significantly improve myocardial microcirculatory disturbance and hemorheological disorder in patients with coronary heart disease, which is worth extending.
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Objective To research the effects of establishing core system key risk index in reducing adverse events. Methods Analyzed the causes of the 147 adverse events in 2014. Including the core system implementation of the reasons for the end of the adverse events caused, the data of fundamental reasons in adverse events and the high risk link that because nurses don′t practice the core system. In 2015, randomly checked the 29 nursing units, including 27 wards and emergency outpatient transfusion room, ICU. Contains the implement rates of the core system in transfusion treatment, day and night shifts, doctors′ advice and patients′ identification. In order to quarterly analysis the index and pertinently improve the results, assessors of quality administration council, head nurse in endemic area and attendant watch keeper are chosen to gather index data. Results After one year of management, the key aspects of the core system execution qualified rate has reached 95%, the check of the implementation of the system, the total pass rate compared with before had increased 6.94%, orders execution system implementation of a qualified rate had increased 9.33%, patient identification system implementation of qualified rate had increased 4.29%, the qualified rate of change of comparison the differences were statistically significant (P<0.05). After the establishment of the core system key risk index management, the adverse events had decreased 11.06%(P < 0.05). Conclusion The establishment of the core system key risk index management can effectively improve the implement rates and reduce the nurse adverse events.
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Objective To establish a qualitative and quantitative determination of glyphosate in serum using ultraviolet spectro-photometry(UV) to provide basis for clinical diagnosing and treating glyphosate poisoning .Methods The mixture of 0 .5 mL serum and 0 .2 mL 10% methanol solution of perchloric acid was shocked and centrifuged with 10 000 r/min for 5 min .A nitrosyla-tion reaction conducted on supernatant and 50 μL serum nitrosylation liquid was detected by UV scanning .Results The results of serum theophylline absorption maxima was(243 ± l) nm and the concentration of 10 .0-60 .0 μg/mL range linear regression equa-tion was Y=0 .0173 8X+0 .036 3(r= 0 .999 8) .The recovery rate was from 85 .5% to 102 .4% and the relative standard deviation (RSD) was from 3 .50% to 4 .90% .The intra-day and inter-day RSD were 3 .79% -5 .10% and 3 .88% -4 .55% .The minimum de-tectable concentration was 5μg/mL .Conclusion This method is simple ,rapid and accurate results for detecting glyphosate poison-ing .
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Objective To compare the curative effect of anatomical plate and locking plate in treatment of calcaneous intraarticular fracture. Methods 67 petiants with calcaneous intraarticular fracture were randomly divided into anatomical plate group (n=33) and locking plate group (n=34) . The Bo..hler angle, the Gissane angle, the length of calcaneal axis, the width and height of calcaneous and the Maryland grade were compared at 1 week and 6 month after operation. Results (1) week after operation, the Bo..hler angle, the Gissane angle, the height and width of calcaneous, the length of calcaneal axis, the Maryland grade had no significant difference between 2 groups . 6 months after operation, the Bo..hler angle, the Gissane angle, the height of calcaneous had significant differe nce between 2 groups. There was no significant difference in the length of calcaneal axis and the grade of Maryland between 2 groups. Conclusions The locking plate group is better than anatomical plate group in major anatomical measure indicators in 6 months follow up. The therapy of locking plate is worth of clinical promotion.
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0.05). The percents of high to 35 ℃ and of low to 10 ℃ of day average temperatures did not possess significance. There were significant differences among the temperatures in spring, summer and autumn. As for the relative humidity and rainfall amount from 2000 to 2005, those in 2000 were the maximum and the former was significant(P
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Objective To investigate the expression of multidrug resistance gene 1 product P-glycoprotein(P-gp) when nuclear factor kappa B is induced or inhibited.Methods Ovarian cancer cells SKOV-3 were treated with Docetaxel or combinded with pyrrolidine dithiocarbamate(PDTC),the inhibitor of NF-?B.Western blot assay、 flow cytometry assay and MTT assay were used to measure P65 protein,P-gp,apoptosis of cancer cells,and the survival rate respectively.Results Docetaxel increased P65 protein and P-gp expression,while combind use of PDTC reversed this function.Both Docetaxel(≥(1 ?g/mL))and PDTC(≥(10 ?mol/L)) significantly inhibited the growth of SKOV-3 cells,and caused apoptosis.The combined use of Docetaxel and PDTC at low concentrations significantly inhibited the growth of cancer cells and caused apoptosis as compared with those treated with Docetaxel only.Conclusion The expression of P-gp may be ralated to the activation of NF-?B;Inhibition of NF-?B can enhance the chemosensitivity of ovarian cancer cells to Docetaxel.
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Objective To evaluate the cumulative irritative effect of topical retinoic acid preparations on normal skin.Methods A randomlized,doubled blind,placebo-controlled clinical trial was carried out with7groups for6tested preparations.All subjects were patch tested with each preparation for24hours on Monday to Thursday,and for72hours on Friday.The patch tests were performed for3consecutive weeks.Results The minimal cumulative irritative effects were found in Group G treated with0.1%adapalene gel,with a cumulative irritative index of0.09?0.11in20days.The cumulative irritative index was significantly lower in Group G than that in Group B treated with0.1%retinoic acid(Diweishuang誖)(0.59?0.24),or in0.025%retinoic acid(Diweishuang誖)(0.41?0.22),or in0.05%retinoic acid(VITAMIN誖Cream)(0.25?0.22).Conclusion Adapalene,the third generation of retinoic acid,is characterized by lower irritative ef-fects in comparison to the first generation of topical retinoic acid agents.
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Objective To study the efficacy of laparoscopic tumor resection combined with iodine-125 and radiofrequency ablation in the treatment of rectal carcinoma with synchronous hepatic metastasis. Methods There were 30 patients diagnosed as rectal carcinoma with synchronous hepatic metastasis detected by CT scan. Hepatic metastases were confirmed by needle biopsy under laparoscopy. Laparoscopic radical resection of rectal carcinoma and metastatic hepatic tumors was performed. Those metastatic tumors that could not be resected were managed by RAF. Iodine-125 was planted in the tumors' site. Results Seven new hepatic metastases were found by the laparoscopic ulstrasound during the operation. 8 hepatic metastatic lesions were removed, 25 tumors located in the right liver were managed by RAF. All patients were followed-up from 12 to 25 months(average 22. 3 months), Local recurrence was found in 6 patients, the 1-year survival rate was 73% (22/30). Conclusions Laparoscopic excision, Iodine-125 and radiofrequency ablation in the treatment of rectal carcinoma with synchronous hepatic metastasis is safe、effective、minimally invasive.
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Objective:To determine the promoting effect of pyrrolidine dithiocarbamate(PDTC),an inhibitor of NF-?B,on the sensitivity of human ovarian cancer cell line SKOV-3 to chemoagent cisplatin and the possible mechanisms.Methods:SKOV-3 cells were treated with various concentrations of cisplatin and PDTC combination for different periods.Then the growth inhibition of SKOV-3 cells were observed by MTT assay,expression of I-?B? and P65 protein by Western blotting assay,and apoptosis of cells by flow cytometry.Results:Separate application of both cisplatin(0.1-10 ?g/ml)and PDTC(10-40 ?mol/L L)significantly inhibited the growth of SKOV-3 cells and caused cell apoptosis(P
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Objective To evaluate the clinical efficacy and safety of adapalene0.1%gel with individ-ualized treatment regimen for acne vulgaris(ITRAV).Methods Eighty-one patients with acne vulgaris of mild to moderate severity were treated with adapalene0.1%gel topically1to3times daily for6to8weeks according to the severity of the disease.Clinical responses were recorded and photographed weekly in30pa-tients randomly selected from the81patients,and treatment regimens were adjusted accordingly.Results It was shown that cure rates were44.4%and73.4%,in81recruited cases and30selected cases,respectively.Seborrhea decreased remarkably(83.3%)in the treatment.Side effects took place in39.5%of patients with-out interruption of the treatment.Conclusions ITRAV with adapalene0.1%gel has been proved to have an excellent response.Reasonably increasing the daily dosage could improve the cure rates.The cutaneous tolera-bility of the drug was generally good.Seborrhea could be reduced considerably during the treatment
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Objective To study the change tendency of air pollutants in Shenzhen, China in 2002-2005, further, to explore the relationship between disease spectrum and air pollution. Methods The daily mean concentration of SO2, NO2 and PM10 in 2002-2005 in eight environmental monitoring sites were determined according to Ambient Air Quality Standard. Results Air concentrations of SO2, NO2 and PM10 increased yearly in 2002-2004, from 0.018 3 mg/m3 to 0.023 4 mg/m3, 0.050 1 mg/m3 to 0.072 5 mg/m3, 0.061 0 mg/m3 to 0.075 7 mg/m3, respectively, however, the concentrations of the three indexes decreased in 2005. In the past four yeas, average levels of SO2 were under the limit of grade 2 of GB3095-1996, as for PM10, under the limit of grade 2, and most of the concentrations of NO2 were under the limit of grade 3, but in the other two monitoring sites, the concentrations of NO2 in 2004 exceeded the limit of grade 3. The year average concentrations of SO2, NO2 and PM10 in 2002-2005 in the outer region were higher compared with those in the inner region of the special economic zone, except the level of NO2 in 2002. As for the quarter average concentrations of SO2, NO2 and PM10, 1st and 4th were higher compared with 2nd and 3rd. Conclusion The air quality in Shenzhen is better in China, however, more attention should be paid to the pollution of nitrogen oxides and inhalable particle matters.
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Intraductal papillary neoplasm of the bile duct (IPNB) is a rare type of bile duct tumors with different classification criteria and has a better prognosis than cholangiocarcinoma. Clinicians lack the awareness of this disease due to its low incidence rate. This article reviews recent research advances in the etiology and pathogenesis, pathological characteristics, clinical features, differential diagnosis, treatment and prognosis of IPNB, in order to improve the clinical diagnosis and treatment of IPNB.