Research advances in central nervous system changes in patients with primary biliary cholangitis / 临床肝胆病杂志

Primary biliary cholangitis (PBC) is an autoimmune liver disease manifesting as cholestasis and is often observed in the middle-aged and elderly women. About 50% of the patients have fatigue and itching, and 20% have depression or mood changes. In recent years, a number of studies have shown that the non-specific symptoms of patients with primary biliary cholangitis (PBC), such as fatigue, itching, and cognitive changes, are associated with the structural and functional changes of the central nervous system. Early identification of preclinical PBC patients through brain imaging changes may be one of the ways for the early diagnosis of this disease.

Research advances in central nervous system changes in patients with primary biliary cholangitis / 临床肝胆病杂志

Primary biliary cholangitis (PBC) is an autoimmune liver disease manifesting as cholestasis and is often observed in the middle-aged and elderly women. About 50% of the patients have fatigue and itching, and 20% have depression or mood changes. In recent years, a number of studies have shown that the non-specific symptoms of patients with primary biliary cholangitis (PBC), such as fatigue, itching, and cognitive changes, are associated with the structural and functional changes of the central nervous system. Early identification of preclinical PBC patients through brain imaging changes may be one of the ways for the early diagnosis of this disease.

Survival condition and predictive model in a large data of esophageal squamous cell carcinoma / 中华胸心血管外科杂志

Objective The survival and prognosis factors of thoracic esophageal squamous cell carcinoma patients after radical resection was investigated.Methods 1923 patients of thoracic esophageal squamous cell carcinoma after radical resection were included in our study from January 1th 2000 to January 1th 2010 in Zhejiang Cancer Hospital,1 670 male and 253 female.the age in the majority with 40 to 59 years old(1 076/1 923,56.0％).Eighteen prognosis factors were collected.A multivariate analysis of these selected variables was performed using Cox proportional model and prognosis index.We used life table for accumulated survival rate.Results The accumulated survival rate for all patients were 82％,48％ and 35％ in 1 year,3 years and 5 years,respectively.Median survival time was 35.42 months.The significant prognosis factors included body mass index,length of tumor,depth of invasion,differentiation degree,lymph node metastatic degree and region,complication of surgery.Conclusion The prognosis of thoracic esophageal squamous cell carcinoma was affected by multi-factors and prognosis index can predict survival condition.

Analysis of outcomes and prognostic factors after Ivor Lewis esophagectomy / 中国基层医药

Objective To explore the outcomes and prognostic effects of Ivor Lewis esophagectomy and evalue the N staging.Methods Participants comprised 1145 patients with ESCC from Jan.2004 to Dec.2013,who under-went Ivor Lewis esophagectomy.The clinicopathologic data were analyzed.Kaplan -Meier and Cox regression methods were used for survival analysis.Results The morbidity of postoperative complication was 9.15% and with 1.83% of motality.The 1 -,3 - and 5 -year survival rates were 84.2%,58.4%,47.9% respectively.The median survival time was 55 months and average survival time was (70.16 ±2.086)months.Cox model multivariate analysis was used for those of P <0.05 in single variate analysis.Univariate analysis revealed that gender(P =0.003),smoking history (P =0.013),alcohol history(P =0.017),tumor location(P =0.001),body mass index(P =0.008),tumor length (P =0.000),differentiation degree(P =0.000),numbers of metastic zones(P =0.000)of lymph node metastasis (P =0.000),depth of invasion (P =0.000),pathological staging(P =0.000),vascular tumor thrombus (P =0.000),nerve involvement(P =0.000)and postoperative adjuvant therapy(P =0.000)were influencing prognosis factors.And multivariate analysis revealed that differentiation degree(P =0.000),depth of invasion(P =0.000), numbers of metastic zones (P =0.013 )of lymph node metastasis (P =0.000)were independent risk factors. Conclusion Ivor Lewis esophagectomy was a safe and effective treatment,and tumor differentiation degree,depth of invasion,numbers and zones of lymph node metastasis were important prognostic factors.

Emergency treatment of aortic dissection and clinical pathway discussion / 中华急诊医学杂志

Objective To investigate the clinical features of aortic dissection (AD) and emergency treatments. Methods Data from 784 patients with aortic dissection were collected in the Department of Emergency from January 2000 through December 2009. A retrospective analysis was carried out to determine the survival rate, mortality rate and treatment efficiency. Results Pain was the most common onset symptom (77.7% , 609/784). The majority of patients (86.5%) had essential hypertension (678/784). All the patients with preoperative diagnosis of aortic dissection underwent emergency medical intervention by internists resulting in 81.5% survival rate (639/784) and 18.5% mortality rate (145/784). There were 157 patients without improvement (20.0% ) and the total efficiency rate was (83. 1% ). The efficiency rate of conventional treatment was 76.4% , while the efficiency rate of triple four-procedure treatment was 89. 8% (P<0.05). Of them, 139 patients (17. 7% ) died in the hospital. Among them,. 26 patients died within 24 hours (18.4% ) and 47 cases died within 48 hours (33. 8% ) and 66 patients died within 72 hours (47.2% ). There were 92 patients who refused treatments after diagnosis, and among them, 81 patients died within 72 hours (88.04% ). The difference in mortality rate between two groups was significant (P<0.05). Conclusions The diagnosis of aortic dissection depends on detailed history, physical examination and CT or MRI imaging. Analgesia, sedation and control of blood pressure are essential for emergency treatments. Early diagnosis and effective emergency treatments are the critical strategy for the early surgical intervention and time window for further treatment to improve the survival rate of AD.

Management of the recalcitrant bronchopleural fistula using the transsternal transpericardial approach / 中华胸心血管外科杂志

Objective To review the experience of closure of recalcitrant bronchopleural fistula using the transsternal transpericardial approach. Methods 3 patients with recalcitrant bronchopleural fistula underwent transsternal transpericardial closure of a bronchopleural fistula and drainage by open thoracostomy. Results All patients were survived and there was no recurrence of bronchopleural fistula. Conclusion Transsternal transpericardial approach seems to be a safe and effective method in cases of bronchopleural fistula complicated with empyema. It has the added advantage of less recurrent fistula formation.

Clinical Comparative Study of Myocardial Protection of Valve Surgery Patients with Cold Blood Cardioplegia and Crystalloid Cardioplegia / 中国医师杂志

Objective To compare myocardial protection between cold blood and crystalloid cardioplegia in short aortic cross-clamping(

Applicaton of PGE_1 in Heart-Lung Transplantation / 中国医师杂志

Objective To observe the role of PGE 1 in heart-lung transplantation. Methods PGE 1 combined with modified LPD solution as the lung flush solution of the donor was applied in heart-lung transplantation. Results PGE 1 combinded with modified LPD solution provided the excellent effect of lung pretection. The patient survived over one year after heart-lung transplantation, and never occurred severe infection, lung disfunction and severe graft rejection. Conclusion The combination use of PGE 1 and modified LPD solution as the lung flush solution in heart-lung transplantation possessed a excellent protective effect for lung.

Experiment on pharmadynamics and acute toxicity of Sanyuzhitong Pills / 中成药

Objective: To study the pharmadynanics and acute-toxicity of Sanyuzhitongjiegu Pills Methods: Hot plate, body-twisted, in flammation caused by dimethyl benzene, cotton ball method, fracture-healed hare and hemorrheology were applied. Results: Sanyuzhitongjiegu Pills could markedly reduce the twisting times of mice and prolong the initiate of pain caused by heat irritation, inhibit mice's ear swelling caused by dimethyl benzene, diminish the weight of rat's myoidem, promote the healing of experimental fracture, reduce the sticky property of whole blood and improve hemorrheology. The maximum of dosage for mice is 10g?kg -1 , all of them survived for 7 day. Conclusion: Shayuzhitong Pills have effect on pain-killing, anti-inflammation, promotion of fracture healing, regulation of blood, remove of stagnant, The Pills have little toxicity.