Expression of miRNA-34b in non-small cell lung cancer tissues and its effect on proliferation and invasion of A549 cells / 肿瘤研究与临床

Objective:To investigate the expression of miRNA-34b (miR-34b) in non-small cell lung cancer (NSCLC) tissues and its effect on proliferation and invasion of human NSCLC A549 cells in vitro.Methods:The specimens of cancer tissues and paracancerous normal epithelial tissues (more than 5 cm from the edge of the tumor) were collected from 40 NSCLC patients in Shanxi Province Cancer Hospital from June 2015 to March 2017. A549 cells were transfected with miR-34b mimics (experimental group) and irrelevant sequences (negative control group), respectively. The expression of miR-34b in tissues and each group of A549 cells was detected by reverse transcription real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). The proliferation activity of A549 cells in the experimental group and the negative control group was detected by methyl thiazolyl tetrazolium (MTT) assay, and the invasion ability of A549 cells in the two groups was detected by Transwell assay.Results:The relative expression of miR-34b in NSCLC tissues was lower than that in paracancerous normal epithelial tissues (0.52±0.06 vs. 1.05±0.17), and the difference was statistically significant ( P < 0.001). The relative expression of miR-34b in A549 cells of the experimental group was higher than that in the negative control group, and the difference was statistically significant ( P < 0.05). MTT assay showed that the cell proliferation ability (absorbance value) of A549 cells in the experimental group was lower than that in the negative control group after cultured for 24 and 48 hours (both P < 0.01). Transwell assay showed that the number of invaded A549 cells in the experimental group was less than that in the negative control group [(49.53±5.03) cells vs. (121.00±12.06) cells, P < 0.01]. Conclusions:The expression of miR-34b is low in NSCLC tissues, and the up-regulation of miR-34b expression can inhibit the proliferation and invasion of NSCLC A549 cells.

The association of abnormal thyroid stimulating hormone levels with elevated blood pressure among females of child-bearing potential / 中华内分泌代谢杂志

Objective:To explore the association between abnormal thyroid stimulating hormone (TSH) and elevated blood pressure among females of child-bearing potential.Methods:A total of 294 674 females of child-bearing age who participated in pre-pregnancy health examination in Shenzhen from 2013 to 2019 were selected. Demographic characteristics, blood pressure, TSH, fasting blood glucose and other indexes were collected. Multivariate logistic regression model was used to analyze the association between abnormal TSH levels and elevated blood pressure (including prehypertension and hypertension).Results:This study showed that females of child-bearing potential with prehypertension and hypertension accounted for 21.77% and 2.41%, respectively. Compared with females of child-bearing potential with normal TSH, the risk of prehypertension and hypertension increased by 34.0% ( OR=1.340, 95% CI 1.248-1.438) and 59.6% ( OR=1.596, 95% CI 1.301-1.938) among those with decreased TSH, respectively, whereas the risk of prehypertension and hypertension increased by 13.6% ( OR=1.136, 95% CI 1.076-1.198) and 38.0% ( OR=1.380, 95% CI 1.198-1.581) among those with elevated TSH, respectively. Subgroup analysis showed that abnormal TSH levels in most subgroups, such as age, ethnicity, educational level, occupation, spouse smoking, alcohol drinking, body mass index, and fasting blood glucose, were associated with the risk of elevated blood pressure. Heterogeneity test showed that the association between decreased TSH and elevated blood pressure was higher in females with high school and below or alcohol drinking, and the association between elevated TSH and elevated blood pressure was higher in females with college/bachelor′s degree and above or non-smoking spouse. Conclusion:There is a significant association between abnormal TSH levels and the risk of prehypertension and hypertension in females of child-bearing potential, and the association should be explored with stratified educational level, alcohol drinking, and spouse smoking status.

Effect of laparoscopic radical operation on colorectal cancer patients and its impact on inflammatory response and stress response / 中国医师进修杂志

Objective:To investigate the effect of laparoscopic radical operation on patients with colorectal cancer and its impact on inflammatory factors and stress response.Methods:The clinical data of 72 patients with colorectal cancer treated in Jiande First People′s Hospital from March 2018 to March 2020 were analyzed. The patients were divided into the observation group (36 cases) and the control group (36 cases) according to different surgical methods. The observation group received laparoscopic radical operation, while the control group underwent open radical operation. The postoperative complications, gastrointestinal function recovery, and perioperative indexes and the changes of inflammatory reaction indexes C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6), and stress response indexes noradrenaline (NE), cortisol (Cor) before operation and 3 d after operation were compared between the two groups.Results:The postoperative complications rate in the observation group was lower than that in the control group: 11.11%(4/36) vs. 33.33%(12/36), and the difference was statistically significant ( χ2 = 5.143, P<0.05). The time to start eating, exhaust time and recovery time of bowel sounds in the observation group were shorter than those in the control group: (2.15 ± 0.38) d vs. (3.89 ± 0.56) d, (2.39 ± 0.34) d vs. (3.58 ± 0.62) d, (2.56 ± 0.43) d vs. (3.81 ± 0.57) d, and the differences were statistically significant ( t = 15.427, 10.098, 10.504, P<0.05). The hospitalization time in the observation group was shorter than that in the control group [(12.38 ± 3.29) d vs. (18.74 ± 4.15) d], the intraoperative blood loss was less than that in the control group [(93.17 ± 16.52) ml vs. (158.93 ± 21.09) ml], the operation time was longer than that in the control group [(185.63 ± 23.14) min vs. (129.90 ± 18.76) min ], and the differences were statistically significant ( t = 7.206, 14.728, 11.225, P<0.05). Three days after operation, the levels of CRP , TNF-α and IL-6 in the observation group were lower than those in the control group: (17.84 ± 3.87) mg/L vs. (32.16 ± 5.64) mg/L, (307.12 ± 15.64) ng/L vs. (369.84 ± 21.25) ng/L , 84.62 ± 5.89) ng/L vs. (98.93 ± 7.74) ng/L, and the differences were statistically significant ( t = 12.561, 14.263, 8.828, P<0.05). Three days after operation, the levels of NE and Cor in the observation group were lower than those in the control group: (187.34 ± 14.62) ng/L vs. (235.27 ± 19.83) ng/L, (103.24 ± 12.09) μg/L vs. (147.86 ± 20.12) μg/L, and the differences were statistically significant ( t = 11.673, 11.405, P<0.05). Conclusions:Laparoscopic radical operation has obvious effect on patients with colorectal cancer. It can shorter the recovery time of bowel function, and has less postoperative complications, little influence on inflammatory reaction and stress response.

Preliminary study of the relationship between novel coronavirus pneumonia and liver function damage: a multicenter study / 中华肝脏病杂志

Objective@#To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage.@*Methods@#Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate.@*Results@#32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively.@*Conclusion@#The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

Prediction of infection following internal fixation of closed fractures by serum inflammatory factors / 中华创伤骨科杂志

Objective To explore the role of serum inflammatory factors in prediction of infection following internal fixation of closed fractures and its significance for surgical timing and infection prophylaxis.Methods A retrospective study was conducted of the 100 patients who had been treated by internal fixation for closed fracture from January 2014 through July 2016.They were 52 men and 48 women,aged from 24 to 76 years (average,45 years).There were 14 femoral fractures,19 tibial plateau fractures,25 patella fractures,8 pilon fractures,22 tibiofibular shaft fractures,and 12 calcaneal fractures.Of them,21 were inflicted by wound infection.The preoperative and postoperative infection indexes,CRP,ESR,PCT and leukocyte count,were recorded.Logistic regression analysis was conducted to test the correlation between the infection indexes and postoperative infection.The optimal cut-off value was determined by the receiver operating characteristic curve.Results CRP showed a significant correlation with postoperative infection while other indexes did not.The optimal cut-off value was 25 mg/L at one day before operation.Conclusions Preoperative determination of CRP may predict the risk of postoperative infection.CRP ＞ 25 mg/L at one day before operation may indicate the following day is not suitable for surgery and active infection prophylaxis should be conducted after surgery.

Topical application of sodium hyaluronate for preventing perivascular adhesion of the vein grafts in rabbits: An experimental study / 解放军医学杂志

Objective To explore the effect of topical application of sodium hyaluronate on preventing perivascular adhesion of the vein grafts in rabbits. Methods Thirty-six male New Zealand white rabbits, aged 5 months, were randomly and equally divided into 2 groups: groups A and B. Arterial defect model was established by cutting about 1cm artery from the middle part of the dissected left common carotid artery. A section about 3cm was cut from the right external jugular vein, and the harvested vein was inverted and anastomosed end-to-end to the artery defect. After the anastomosis, the adventitia and two anastomoses of the grafted veins in group A were coated locally with 0.2ml sodium hyaluronate. The grafted veins were obtained 1, 2 and 4 weeks after the operation, with the perivascular adhesion of the vein grafts being examined macroscopically before the resection. HE staining and Masson staining were preformed for histological changes of grafted vein wall and the perivascular adhesion of the vein grafts. At 2, 4 weeks postoperation, the perivascular adhesions of the vein grafts were graded by the grading criteria of adhesion in macroscopic evaluation and histological evaluation. Result At 1, 2 and 4 weeks postoperatively, the macroscopic and histological observation found that the perivascular adhesions in group A were looser than those in group B. The macroscopic grade and histological grade were lower in group A than in group B, there was a significant difference between the two groups at 2 and 4 weeks postoperation (P<0.05). Conclusion Topical application of sodium hyaluronate can reduce the perivascular adhesion and is an ideal treatment strategy for preventing perivascular adhesion of vein grafts.

Comparison of thin sectional anatomy based on the Chinese Visible Human with MRI of biceps reflection pulley / 局解手术学杂志

Objective To explore the morphologic features of the biceps reflection pulley through the comparative study of the thin sec -tional anatomy based on the Chinese Visible Human ( CVH) and MRI sectional anatomy of the biceps reflection pulley ,and to provide ima-ging anatomic data for the diagnosis of lesions .Methods The thin slices of sagittal oblique plane and coronal oblique plane by visualization -al reconstruction based on 5 data set of the Chinese visible human ( CVH) were compared with the corresponding MR images from 20 shoulder joints of the normal volunteer individuals with routine MRI ,5 shoulders without abnormalities with MR arthrography .The detailed sectional a-natomy structure of the the biceps reflection pulley was marked from the CVH ,routine MRI and MR arthrography one by one with Photoshop CS2 software.Results The main three components of the biceps reflection pulley including the coracohumeral ligament (CHL),the superior glenohumeral ligament ( SGHL) ,and the long head of the biceps tendon ( LBT) were markedly displayed on the CVH and MRI .The CHL was markedly displayed on the sagittal oblique , using plain MRI .The SGHL was markedly displayed on the CVH , especially in the transverse plane.The LBT was markedly displayed on the CVH ,especially in the coronal oblique plane parallel to the LBT .The biceps reflection pulley was markedly displayed on the sagittal oblique plane with CVH and MR arthrography .The SGHL was perpendicular to the CHL , with T-shaped link anterior to the LBT on the sagittal oblique plane .Conclusion It is complementary for MRI and CVH displaying the components of the biceps reflection pulley .The sagittal oblique plane is the best position for displaying the components and adjacent structures of the bi -ceps reflection pulley ,which provide helpful position mark for the diagnosis of the lesions in the rotator interval .

Diagnosis of frozen shoulder with the coracohumeral ligament on the coronal oblique plane by MRI / 局解手术学杂志

Objective To evaluate the diagnosis of frozen shoulder with the coracohumeral ligament on the coronal oblique plane with MRI.Methods There were 60 patients(120 shoulder joints)in control group,with 30 males and 30 females,the mean age was 50.5 years old.There were 72 shoulder joints in 72 patients of frozen shoulder group(50 femles and 22 males with a mean age of 53.5 years)with clini-cal evidence and MR imaging evidence of frozen shoulder.These were prospectively analyzed to identify the CHL visualization rate and meas-ure the maximum thickness of the CHL.Results The CHL visualization rate on the coronal oblique plane in the control group was 86.7%(104 /120),and the frozen shoulder group was 87.5%(63 /72),the difference was not significant(P >0.05).The CHL visualization rate on the axial view in the frozen shoulder group was 19.4%(14 /72)and the control group was 24.2%(29 /120),the difference was not signifi-cant(P >0.05).The CHL thickness on the coronal oblique plane (n =63)in the patients with frozen shoulder was (4.37 ±1.71)mm, which was significantly greater than (2.84 ±0.79)mm ofpatients in the control group(n =104),the difference was significant(P <0.001). The CHL thickness on the axial plane(n =14)in the patients with frozen shoulder was (3.93 ±1.49)mm,which was significantly greater than (2.29 ±0.65)mm of patients in the control group(n =29),the difference was significant(P <0.001).Conclusion A thickened CHL is highly suggestive of frozen shoulder,which is 4.37 mm on the coronal oblique plane.

A prospective study on indwelling suture in preventing re-adhesion of fallopian tube after interventional recanalization / 中华放射学杂志

Objective To explore the clinical efficacy of indwelling suture in preventing re-adhesion of fallopian tube after fallopian tube recanalization(FTR). Methods Screen 93 patients with fallopian tube obstruction and FTR indications of prospective, the patients without other interference factors of infertility, they were randomized with random sampling into two groups (treatment group 50 and control group 43)and treated by FTR,then the treatment group with indwelling sutures in fallopian tube for 3 days, the control group were infused lipiodol into the tube and with a intrauterine cavity perfusion in 3 days. The two groups received followed up examination at 2,6 months after operation ( a treatment was repeated with the case of re-obstruction) . Follow-up for 12 months to appraise the pregnancy rate and the influence of pregnancy competence of tube with indwelling suture(6 months after operation, to collect and compare the pregnancy rate and ectopic pregnancy rate of patent tube in two groups). Results The tubal patency rate were 89.8%(53/59),89.5%(51/57)of treatment group at 2,6 months after operation and the control group were75.9%(44/58),75.0%(39/52), there was a significant difference between the two groups(2 m:χ2=4.027, P months after operation, the pregnancy rate and ectopic pregnancy rate of patent tube in treatment group were 21.6%(11/51),2/11, the control group were15.4%(6/39),1/6, there was no significant difference between them(pregnancy rate:χ2=0.552,P>0.05). Conclusions The indwelling suture of fallopian tube can prevent re-adhesion better after FTR, then improve the long-term recanalization rate and the pregnancy rate. There is no change on the pregnancy competence of fallopian tube.

Angiographic diagnosis and therapeutic embolization of Dieulafoy disease / 中华放射学杂志

Objective To evaluate the clinical efficacy of interventional techniques in the diagnosis and therapy of Dieulafoy disease. Methods A retrospective study was performed, including 17 patients with massive upper gastrointestinal hemorrhage (patients without peptic ulcer and portal hypertension or diagnosed with Dieulafoy disease by endoscopic examination). All patients had both DSA and interventional embolization treatment, and were followed for 12 months to appraise the clinical effectiveness. Results Sixteen patients were diagnosed as Dieulafoy disease by using DSA. Fifteen of the 16 patients were treated with embolization successfully withoutserious complications. One patient received subtotal gastrectomy because of upper gastrointestinal hemorrhage recurrence. Nine patients with irregular upper abdominal pain and burning sensation had complete remission after symptomatic management. Fifteen patients who had embolization showed no serious complications during the follow-up period of 12 months, there was no hematemesis and melena for the 15 cases with successful embolization. Conclusion The angiography and embolization are safe and efficacious in the diagnosis and therapy of Dieulafoy disease.

Construction and expression of eukaryotic expression vector of PEA-15 / 肿瘤研究与临床

Objective To construct the eukaryotic expression vector of pcDNA3.1-PEA-15 and express it in the human esophageal cancer (EC-109) cells,and to explore the effect of PEA-15 on EC-109 cells.Methods The PEA-15 gene was amplified from EC-109 by reverse transcriptase polymerase chain reaction (RT-PCR) and ligated to eukaryotic expression vector pcDNA3.1.After confirmation of recombinant plasmid was correctly by endonuc]eases digestion and DNA sequencing,the construct was transfected it into EC-109 through liposome inducing.The expression of PEA-15 in transfected EC-109 was detected by RT-PCR and Western blot.The cell growth inhibition ratio was evaluated by MTT assay.Results RT-PCR indicated that PEA-15 was highly expressed in EC-109 cells.The amplified fragment by RT-PCR was coincident with hypothesis enzyme digestion analysis and DNA sequencing confirmed that the pcDNA3.1-PEA-15 was constructed successfully.The expression of PEA-15 gene was increased obviously in the transfected EC-109 detected by RT-PCR and Western blot respectively (t =4.078,5.269,P ＜ 0.05).The cell growth inhibition ratio in the group which transfected pcDNA3.1-PEA-15 was significantly lower compared with the pcDNA3.1 transfect group after 72 hours (t =6.163,P ＜ 0.05).Conclusions The recombinant eukaryotic expression vector pcDNA3.1-PEA-15 is constructed successfully,and it can be expressed in EC-109.It also shows that PEA-15 has the function on cell growth which suggests that PEA-15 can inhibit the apoptosis of EC-109 cells and its expression involved in esophageal cancer development.

Expression of PED/PEA-15 mRNA and protein in esophageal carcinoma / 肿瘤研究与临床

Objective To investigate the expression of PED/PEA-15 mRNA and protein in esophageal carcinoma tissue and their clinical significances.Methods The expression of PED/PEA-15 mRNA was detected by RT-PCR,and the expression of PED/PEA-15 protein was measured by immunohistochemistry in 50 cases of esophageal carcinoma,50 cases of corresponding paracarcinoma tissue,and 50 cases of corresponding normal esophageal tissue.Results The expression of PED/PEA-15 mRNA was 1.14±0.49 in esophageal carcinoma,which was significantly higher than that in para-carcinoma tissue (0.59±0.31) and normal esophageal carcinoma tissue (0.53±0.22) (F =44.085,P ＜ 0.001).The immunohistochemistry results showed that PED/PEA-15 protein expression was significantly higher than that in para-carcinoma tissue and normal esophageal tissue (x2 =36.967,P ＜ 0.001; x2 =26.272,P ＜ 0.001).The expression of PED/PEA-15 mRNA and protein were significantly associated with pathological grade,clinical stage of esophageal carcinoma (P ＜ 0.05),but were not significantly correlated to the age of onset,gender,pathological types (P ＞ 0.05).Conclusion The expression of PED/PEA-15 mRNA and protein are increased in esophageal carcinoma,which may play an important role in the occurrence and development of esophageal carcinoma.

Comparative study of cerebrospinal fluid flow in the cerebral aqueduct between empty sella syndrome and normal volunteer / 中国医师进修杂志

Objective To compar the cerebrospinal fluid (CSF) flow between empty sella syndrome (ESS) and normal volunteer in the cerebral aqueduct with MRI in phase contrast cine mode. Methods Thirty-eight ESS patients (ESS group) and 38 normal volunteers (control group ) were involved in this study.The aqueduct CSF flow image was positioned perpendicularly to the midbrain aqueduct at the middle sagittal T1WI or T2WI image. The waveforms were analyzed for the flow direction, flow rate, flow volume rate and cardiac cycle. Results The CSF flow of the aqueduct in control group and ESS group had two directions which was downward flow during the systolic period and upward flow during the diastolic period of the cardiac cycle. The.systolic period downward peak flow rate, diastolic period upward peak flow rate, mean downward flow rate, mean upward flow rate and mean flow rate were (5.231 ± 0.262), (4.902 ± 0.281 ),(3.083 ± 0.191 ), (3.032 ± 0.151 ), (3.151 ± 0.162) cm/s in control group, and (6.244 ± 0.356), (6.091 ±0.430), (3.916 ± 0.196), (3.812 ± 0.273 ), (3.690 ± 0.291 ) cm/s in ESS group respectively,and there was no significant difference between the two groups ( P ＞ 0.05 ). The systolic period downward peak flow volume rate, diastolic period upward peak flow volume rate, mean downward flow volume rate,mean upward flow volume rate and mean flow volume rate were (0.050 ± 0.003 ), (0.050 ± 0.004), (0.030± 0.002), (0.031 ±0.002), (0.030 ± 0.003 ), ( 0.004 ± 0.001 )ml/s in control group, and (0.058 ± 0.003 ), (0.063 ± 0.005),(0.039 ±0.002), (0.038 ±0.003), (0.038 ±0.003), (0.004 ±0.001) ml/s in ESS group respectively,and there was no significant difference between the two groups(P ＞ 0.05 ). The correspond cardiac cycle of systolic period downward peak flow rate, correspond cardiac cycle of diastolic period upward peak flow rate, mean cardiac cycle were (40.890 ± 37.096), (501.026 ± 19.374), (719.511 ± 14.946) ms in control group,and (35.921 ±6.218), (531.553 ± 16.764), (770.700 ±21.579) ms in ESS group,and there was no significant difference between the two groups (P ＞ 0.05 ). Conclusion Part of CSF flows into the area of saddle in ESS patients, but it has no effect on CSF indexes in area of cerebral aqueduct.

Study of the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease by atorvastatin / 中国综合临床

Objective To evaluate the intervention effect of atorvastatin on the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease. Methods One hundred and eighteen patients who undertook intracavitary therapy (including Balloon dilation, Stent implantation and endarterectomy, Stent implantation and thrombectomy) in our hospital from January 2008 to January 2010 were divided into two groups randomly,60 cases into the control group,and 58 cases into the atorvastatin group whom were orally medicated with Atorvastatin 20 mg once daily. Blood lipid, C-reactive protein, Intima-media thickness and the patency rate of lower limb artery of two groups were observed and recorded before treatment and at 4 weeks, 12 weeks, 24 weeks after treatment. Results Success rates of intracavitary therapy were 98. 33% (59/60) and 100. 00% (58/58) in the control and atorvastatin group respectively. The patency rate decreased in different degree with time in both groups,which decreased more significantly in the control group but remained relatively stable in the atorvastatin group. By follow up we found that the patency rate in the control group was significantly lower than that of in the Atorvastatin group(77. 96% vs 94. 82% ,P ＜ 0. 01 )at 24 weeks. Blood lipid, C-reactive protein, Intima-media thickness and the patency rate of lower extremity artery of control group increased in different degrees, but with no statistical significance (P＞ 0. 05 ), while these indices began to decrease in atorvastatin group after 4 weeks of medication and were significantly lower than the control group ( P ＜ 0.01 ). Conclusions Atorvastatin has effect on preventing the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease.

Fatal esophagogastric-arterial fistula following resection for carcinoma of the esophagus and cardia / 肿瘤研究与临床

Objective To study the pathogenesis, clinical symptoms, surgical treatment and preventive measures of esophagogastric-arterial fistula following resection for carcinoma of the esophagus and cardia. Methods The clinical data of 18 patients with esophagogastric-arterial fistula were retrospective analyzed. Results There were 14 patients of esophageal carcinoma and 4 patients of cardiac carcinoma.7 patients had supra-aortic esophagogastric anastomosis(2 near the apex of pleura) and 11 had anastomosis under the aortic arch. Fatal hemorrhage occurred postoperatively from 11 to 93 days. The interval between hemorrhage and death varied from being instant to 18 days.All patients died. Conclusion The surgical treatment provide an opportunity for those patients. Successful management is possible if early diagnosis is made and prompt surgical management is undertaken. Preventive measures of peptic ulcer and esophageal fistula can decrease occurrence of this complication.

Changes of intestinal barrier function and relationship with SIRS in patients with multiple injuries / 解放军医学杂志

Objective To investigate the changes of intestinal barrier function of patients with multiple injuries,and explore the relationship between the changes and Systemic Inflammatory Response Syndrome(SIRS).Methods Fifty two patients with multiple injury admitted to our hospital from Aug.2007 to May 2008 were divided into mild injury group(n=24,ISS0.05),while obvious increasing existed in moderate and severe groups at 1st day after trauma(P

Endoluminal therapy guading by ultrasonography or plus portosystemic shunts for Budd-Chiari syndrome: a report of 36 cases / 中国普通外科杂志

Objective To evaluate the effect of endoluminal treatment for Budd Chiari syndrome (BCS) .Methods In 36 patients with BCS were treated by inferior vena cava(IVC) dilation and endoluminal stent placement guaded by ultrasonography, including self expanding mental Giaturco stent placement in 33 patients and pure dilation in 3 patients. Portosystemic shunts(PSSs) were followed in 13 patients with hepatic venous occlusion a week after the endoluminal treatment, including splenorenal(S R) shunts in 5 cases,and mesocaval (M C) shunts in 8 cases. Results After endoluminal procedures ,slight heart dysfunction appeared in 3 cases . After shunting ,acute pancreatitis occurred in 1 case, and upper gastrointestinal hemorrhage occurred and finally resulted in death in another case on the 10th day after PSS.All the 36 patients were followed up for 1 month to 8 years. Restenosis of the distal part of stent was found in 1 case 2 years after the operation,hepatic vein occlusion occurred in 1 case 1 year after the treament, hepatoma occurred in 1case 3 years after the treatment,and 1 patient died of C type hepatitis a year later; and 2 cases with infertility had babies 1 year later. All patients had no stent migration or occlusion of shunts .Conclusions Endoluminal therapy guarding by ultrsonography is a convenient, safe and effective method for Budd Chiari syndrome. For patients with hepatic venous occlusions, a portosystemic shunt is recommended.The above mentioned methods provide a feasible and effective means for some kinds of Budd Chiari syndrome.

Treatment of lower extremity deep venous thrombosis with IVC filter placement ,embolectomy and thrombolytic therapy / 中国普通外科杂志

ObjectiveTo investigate the feasible and effective means for the lower extremity deep ve nous thrombosis(DVT).Methods The clincal data of 211cases of l ower extremity DVT treated in recent 9 years were analysed retrospectively .Antegrade infusion of high -dose urokinase was performed via the dorsalis pedi s vein of the involved lower limb in 179 patients.Of the 179 patients vena cava filters(VCF) was placed in 29 patients,including Tempofilter II VCF in 5pa tients, VenaTech TM LP VCF in 24patients.Other 32 cases underwent embol ectomy after IVC filter placement(Tempofilter II was placed in 6patients, VenaT echTM LP was placed in 26patients). Results 146 patients were followed up for 3-108 months with averge 54months .A total of 61 IVC filters w ere successfully expanded ,but 1 Tempofilter II VCF was migrated to proximal end of IVC.Tempofilter II VCF was taked out 2-4 week after the IVC filt er placement . VenaTechTM LP occlusion in one case 14 months after the IVC fil ter placement.In thrombolytic group,87were cured,86 improved,6 ineffective. In operative group, 28were cured,3 improved,1 ineffective . The cured rate in op erative group was better than that in thrombolytic group(P