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Objective To explore the clinical application of a new laryngeal mask in implantation of tracheal stent.Methods The new laryngeal masks were implanted under general anesthesia for 20 patients with tracheal or primary bronchus stenosis.The oxygen was continuously supplied from its side hole,and the stents were subsequently implanted from the tail hole.Results By using the new laryngeal masks under general anesthesia,all of 20 patients were successfully and leisurely implanted the tracheal stent.After the operation,the dyspnea symptoms were significantly improved,and there was no complication.Conclusion Stent implantation by using the new laryngeal mask under general anesthesia will provide a safe and effective treatment for tracheal stenosis.
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Objective To explore the clinical application of a new laryngeal mask in implantation of tracheal stent.Methods The new laryngeal masks were implanted under general anesthesia for 20 patients with tracheal or primary bronchus stenosis.The oxygen was continuously supplied from its side hole,and the stents were subsequently implanted from the tail hole.Results By using the new laryngeal masks under general anesthesia,all of 20 patients were successfully and leisurely implanted the tracheal stent.After the operation,the dyspnea symptoms were significantly improved,and there was no complication.Conclusion Stent implantation by using the new laryngeal mask under general anesthesia will provide a safe and effective treatment for tracheal stenosis.
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Objective To explore the therapeutic effects of pure collagenase injection and collagenase combined with herniation injection of ozone on the treatment of lumbar disc herniation(LDH).Methods According to the principle of randomized controlled double blind, 100 patients with LDH were divided into 2 groups:pure collagenase group and combined treatment group.Changes of NRS value and Macnab score were observed and recorded at multiple time points after operation.The difference of the effect of the two kinds of operation was analyzed.Results Among the 50 patients in the simple treatment group,3 patients were lost to follow-up.Among the 50 patients in the combined treatment group,2 patients were lost to follow-up,and open surgery in 2 patients because of poor efficacy after the injection of 3 months and 6 months respectively.By analyzing the change of NRS value and Macnab score of 2 groups patients,there was no significant difference in the short-term and long-term efficacy between the 2 groups(P>0.05);The symptoms of the 2 groups were improved after operation.The curative effect was positively correlated with the recovery time, and the difference was statistically significant (P<0.05).Conclusion The curative effect of pure collagenase injection and the combined with herniation injection of ozone are both significant, and there is no significant difference in the clinical efficacy between the 2 kinds of operations.
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Objective To analyze the clinical curative effect of inferior vena cava filter placement and catheter direct thrombolytic therapy combined with anticoagulant therapy with Rivaroxaban for deep venous thrombus (DVT) of the lower extremity.Methods 40 patients with acute lower extremity DVT were collected,after the inferior vena cava filter placement,thrombolytic catheter were placed in femoral and iliac vein occlusion,and urokinase was continuously infused through the catheter 24 h.Anticoagulant therapy with Rivaroxaban tablets started when the patient was diagnosed with the disease.We evaluated the short-term and long-term efficacy of the treatment from the iliac femoral vein patency,limb circumference and complications.Results 40 patients were successfully implanted the filter,38 patients were successfully removed the filter after 21 days.The clinical symptoms were relieved after 7 days of treatment,and the iliac femoral vein blood flow was basically recovered.Before and after treatment,the limb circumference was significantly reduced (P＜0.05).No serious complications occurred during the treatment period.Following up in 6 months,the rate of iliac vein occlusion and pigmentation were 2.5 ％ (1/40)and 2.5 ％ (1/40)respectively.Following up in 12 months,the rate of iliac vein occlusion and pigmentation were 7.5 ％ (3/40) and 5.0 ％ (2/40)respectively.Conclusion For treatment of acute DVT of the lower extremity,inferior vena cava filter placement and catheter direct thrombolytic therapy combined with anticoagulant therapy with Rivaroxaban can achieve satisfactory clinical curative effect,which is clinically safe and feasible.
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Objective The use of targeting therapy for the treatment of gastric glandular cancer has been a hot topic in recent years. This study aims to clarify that through what ways the histone deacetylase inhibitor MS-275 completes its selectively killing effect on gastric glandular cancer cell line SGC-7901. Methods SGC-7901 cells and GES-1 cells were respectively cultured for 24h, with(10-100) μmol/L concentrations of MS-275. (1) The survival rate of SGC-7901 cells, GES-1 cells and the normal cells were analyzed by WST-1; (2) The change of the mitochondrial membrane potential in SGC-7901 was estimated by flow cytometry;(3) The expression levels of p21, p27, p57, cyclinB1, cyclinD1 were determined by Western blot and PCR methods. Results (1) MS-275 could decrease the survival rate of SGC-7901 cells, the effect was significantly enhanced with the increasing of the concentration (P<0.05), but MS-275 showed no obvious effect on normal gastric mucosa epithelial cells GES-1; (2) MS-275 treatment could decreased the mitochondrial membrane potential of SGC-7901 cells (P<0.05); (3) MS-275 treatment could increase the relative contents of p21, p27, p57 genes and their protein and, at the same time, decrease the relative contents of CyclinB1 and CyclinD1 (P<0.05). Conclusion MS-275 treatment can selectively kill gastric glandular cancer cells SGC-7901 through several possible ways, such as inducing mitochondrial apoptosis and regulating the expression levels of cell cycle-related genes and proteins.
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Objective To evaluate the clinical efficacy and safety of two kinds of uterine artery perfusion chemotherapy plus embolization (UACE) in treating ectopic pregnancy (EP). Methods A single center, randomized, double-blind, controlled clinical trial was carried out at authors hospital. A total of 50 cases of EP patients were randomly and equally divided into the study group (perfusion chemotherapy of MTX and 5-FU plus embolization therapy) and the control group (perfusion chemotherapy of pure MTX plus embolization therapy). After UACE, the serumβ-HCG value, the clinical healing time and the tubal patency rate were determined at different time, and the adverse events were recorded. The results were statistically analyzed by using t test, and χ2 test, and the data were compared between the two groups. Results One patient in both groups was excluded from the study. In the remaining 48 patients, one patient of the control group failed to respond the treatment, so the overall cure rate was 97.9%. The differences in the main effect of treatment method and the time interaction of the serum β-HCG values between the two groups were not statistically significant (P > 0.05), while the difference in the time effect between the two groups was statistically significant (P 0.05). The tubal patency rate of the study group and the control group was 76.2%and 78.9%respectively, and no statistically significant difference existed between the two groups (P > 0.05). The adverse events in both groups were mild, and the occurrence of the adverse events in the study group and the control group was 58.3% and 26.1% respectively, and the difference between the two groups was statistically significant (P <0.05). Conclusion Two kinds of interventional methods have the same clinical curative effect. However, the incidence of adverse events in the control group is lower than that in the study group. Therefore, in treating ectopic pregnancy perfusion chemotherapy with MTX only is recommend.
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For recent two decades,radiofrequency ablation technology(RFA)has made great progress in the field of the treatment for diseases for its distinguishing characteristic of microtrauma,targeted,effective and almost having no side-effect.At the very beginning,radiofrequency ablation was adopted in treating solid tumors,and since then it has been gradually practiced in treating benign diseases of solid organs such as hypersplenism,prostatic hyperplasia and widely used in almost every system of the body.Here,we review its therapic principle,types and clinical application.
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Objective To investigate the apoptosis of gastric carcinoma SGC-7901 cell induced by histone deacetylase inhibitor(TSA)and to clarify its mechanisms.Methods The apoptosis-inducing role of TSA on gastric carcinoma SGC-7901 cell was investigated with the help of cell proliferation assay,Annexin V stain,cell flow analyzer and Tunel assay.Western blot,gene chips,real time PCR were employed to study the influence and mechanisms of TSA on the expression of gastric carcinoma cell SGC-7901 p53,bax,etc.Results TSA could induce the apoptosis of gastric carcinoma SGC-7901 cells,increase the expression of p53 and bax,and decrease the expression of bcl-2.survivin and easpase in gastric carcinoma SGC-7901 cells.TSA could transfer AIF and EndoG from mitochondria to nucleus.The apoptosis induced by TSA was brought about through the regulation of multiple apoptosis-related genes,and the apoptosis pathway induced by TSA was caspase-independent.Conclusion TSA can induce caspase-independent apoptosis in gastric carcinoma SGC-7901 cell through the regulation of multiple apoptosis-related genes.
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Objective To evaluate the effectiveness and safety of interventional thermochemotherapy for VX2 transplanted hepatic tumor model in experimental rabbits.Methods The hepatic tumor model was established in 20 New Zealand rabbits by implanting VX2 tumor cells into the right hepatic lobes of the rabbits.The rabbits were randomly and equally divided into two groups with 10 rabbits in each group:group A (study group)and group B(control group).Via the femoral access,the catheter was placed into the tumorfeeding artery,which was confirmed by DSA.The rabbits in group A received an infusion of 100 ml 5% glucose plus 5-Fu(20 mg/kg)at 60℃ temperature,while the rabbits in group B received an infusion of 100 ml 5% glucose plus 5-Fu(20 mg/kg)at normal room temperature(22-25℃).Before and after the procedure,the tumor size was measured by means of B ultrasonography and the serum ALT was estimated to assess the liver function.The results were statistically compared between two groups.Results After the treatment,the tumor size in group A(study group)became much smaller than that in group B(control group),with P＜0.05.And no significant difference in the serum ALT level existed between group A and group B.Conclusion The interventional thermochemotherapy is superior to interventional chemotherapy in inhibiting VX2 transplanted hepatic tumor in experimental rabbits.
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Objective To observe the clinical effects and safety of radiofrequency thermocoagulation in treating the lumbar intervertebral disc protrusion.Methods Thirty patients with lumbar intervertebral disc protrusion,whose diagnoses were confirmed by clinical manifestations and CT findings,were involved in this study.The needle was punctured to the target point of the diseased intervertebral space under C-arm fluoroscopic guidance.After the testing of sensory nerve,motor nerve and temperature was made,the target needles were heated until the nerve radiofrequency temperature meter reached the point of 92℃.This point of temperature was held for 100 seconds and the procedure was repeated for four cycles.Results Six months after the treatment,all patients showed an obvious improvement in VAS,which decreased from 7.83±0.33before operation to 2.37±0.48 after treatment(P＜0.05).According to the modified Macnab therapeutic evaluation criteria,excellent result was seen in 9,good result in 12,fair result in 5 and poor result in 4cases,with a total effective rate of 86.7%.No serious complications occurred in all patients.Conclusion Radiofrequency thermocoagulation is an effective and safe method for the treatment of lumbar intervertebral disc protrusion.
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Objective To evaluate the efficacy of the combination of percutaneous transhepatic embolization of gastroesophageal varices (PEGV) and partial splenic embolization(PSE) for the treatment of variceal bleeding. Methods Fifty patients with cirrhosis who fit in with the requirements of the study were randomly divided into dual-interventional group and surgical group. The patients in dual-interventional group were treated with PEGV together with PSE, and the patients in surgery group were treated with Hassab's operation. After the procedure all the patients in two groups were followed up periodically. The endoscopy, B ultrasonography, liver function tests and hematologic examinations were performed 24 months after the therapy, and the results were statistically analyzed. Results Fifty patients were enrolled in this study. The procedures of embolization and surgery were successful in all patients. In dual-interventional group, the whit eblood cell and platelet counts were (2.33±0.65) 10~9/L and (3.63±1.05) ×10~9/L respectively before the treatment and were (7.98±3.0) ×10~9/L and (163±91)× 10~9/L respectively 24 months after the treatment (P<0.05). The diameter of theportal vein was (1.47±0.25) cm before the treatment and was(1.31±0.23) cm 24 months after the treatment (P<0.05). The severity of esophageal varices decreased from grade Ⅲ to lower grade Ⅱ in 11 patients, and from grade Ⅱ to lower grade Ⅰ in 6 patients 24 months after procedure. Portal thrombosis occurred in 1 case. The recurrent bleeding rate was 16% (4/25) 24 months after treatment. Three patients died of the recurrent bleeding, one patient died of hepatic failure. In surgical group, the white blood cell and platelet counts were (2.2±0.60) ×10~9/L and (41±12.5) ×109/L before treatment, and were (9.3±2.56)×10~9/L and (321±12.5)×10~9/L 24 months after treatment (P<0.05). The diameter of the portal vein was (1.43±0.22) cm before the treatment and was (1.28±0.18) cm after the treatment (P<0.05). The severity of esophageal varices decreased from grade Ⅲ to lower grade Ⅱ in 13 patients, and from grade Ⅱ to lower grade Ⅰ in 7 patients. Four patients developed portal thrombosis after the procedure. The recurrent bleeding rate was 20%(5/25), 2 patients died of hepatic failure after the surgery, 2 died of recurrent bleeding. Conclusion In treating patients with cirrhosis, the combination of PGEV and PSE, regarded as dual-interventional therapy, is very effective, especially in controlling recurrent bleeding and in improving white blood cell and platelet counts.
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Objective To evaluate the effects of domestic irbesartan on blood pressure and renal function in the aged with primary hypertension.Methods Renal function,plasma and urine β2 microglob ulin WBS measured and blood pressure was investigated by 24-hour ambulatory blood monitoring in 42 aged with primary hypertension who received domestic irbesartan(1 50 mg/d,followed up every 1-2 weeks.If the effect was not ideal,the dose could be added to 300 mg/d)in 8-week's treatment.Results After the treatment.24 hours recall systolic blood pressure,24-hour mean diastolic blood pressure,mean day systolic blood pressure,mean day diastolic blood pressure,mean night systolic blood pressure,mean night diastolic blood pressure were significantly reduced.At the same time,domestic irbesartan induced a remarkable reduction of plasma and urine β2 microglobulin [(5.9±3.3)μg/L vs(2.6±2.6)μg/L, (811.2±97.2) mmol/L vs(457.6±69.8)mmol/L,respectively].Conclusion The antihypertensive effects of domestic irbesartan can persist for 24-hour and Can reduce urinary protein.
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BACKGROUND: Negative pressure of limbs is a convenient, safe and unwound way to treat peripheral arterial occlusion and to relieve pain.Prostaglandin E1 can directly rellax vascular smooth muscles and relieve pain on nerve.OBJECTIVE: To observe the effect of negative pressure of limbs immunologic reaction positive nerve fiber of prostaglandin E1 in sensory nerve fiber of central nervous system of dogs with peripheral arterial occlusion.DESIGN: Randomized controlled animalstudy.SETTING: Tumor Center of Zhujiang Hospital affiliated to Southern Medical University, the Third General Surgery of Xijing Hospital affiliated to the Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Animal Laboratory of Xijing Hospital affiliated to the Fourth Military Medical University of Chinese PLA from April 2003 to May 2004. A total of 17 healthy adult hybrid dogs were randomly divided into three groups: treatment group (n=10),non-treatment group (n=5) and normal control group (n=2), according to randomly digital table.METHODS: Ischemic models of left hindlimb were established in treatment group and non-treatment group. Fourteen days later, dogs in treatment group were given negative pressure (-12kPa) treatment for 15 minutes. The negative pressure was done once a day for 10 successive days.However, negative pressure was not done in non-treatment group. Animals were not interfered in normal control group.MAIN OUTCOME MEASURES: Twenty-four days later, dogs in each group were anesthetized and sacrificed. L1-L5 spinal cord and ganglia of dorsal root were selected and stained with immunohistochemical method to detect average giay value of immunologic reaction positive nerve fiber of prostaglandin E 1.RESULTS: A total of 17 dogs were involved in the final analysis. Average gray values of immunologic reaction positive nerve fiber of prostaglandin E1 in spinal cord were 75.23±4.3 in non-treatment group, 43.22±3.7 in treatment group and 22.00±5.8 in normal control group; average gray values of immunologic reaction positive nerve fiber of prostaglandin E1 in ganglia of dorsal root were 67.12±2.3, 40.08±3.8, 27.64±2.7, respectively.There was no significant difference among the three groups (P＜0.01).CONCLUSION: After onset of peripheral arterial occlusion, amount of immunologic reaction positive nerve fiber of prostaglandin E1 in spinal cord and ganglia of dorsal root of distal limbs is increased remarkably, and this may be a kink of auto-protective mechanism of organism. Negative pressure can relieve pain of limbs and decrease damaged-stimulated transmission of peripheral arterial occlusion.