Clinical study of warming needle moxibustion of Jiaji and TCM fumigation combined for acute inflammatory period of lumbar disc herniation / 国际中医中药杂志

Objective:To evaluate the clinical efficacy of lumbar spine warming needle moxibustion of Jiaji and Traditional Chinese Medicine (TCM) fumigation combined with conventional western medicine therapy on patients with acute inflammatory period of lumbar disc herniation (LDH).Methods:Randomized controlled trial. A total of 140 patients with acute inflammation of LDH in our hospital from December 2019 to December 2021 were selected as observational objects, and the patients meeting the inclusion criteria were divided into 2 groups with 70 patients in each group by random number table method. The control group was treated with conventional western medicine therapy, and the observational group was treated with warming needle moxibustion of Jiaji combined with TCM fumigation on the basis of control group treatment. Both groups received continuous treatment for 1 month. TCM syndrome scores were performed before and after treatment, the degree of lumbar pain was assessed by VAS, the degree of lumbar dysfunction was assessed by Japanese Orthopaedic Association Evaluation Treatment (JOA score), and serum CRP, IL-6 and TNF-α levels were measured by ELISA.Results:The total effective rate was 95.71% (67/70) in the observation group and 82.86% (58/70) in the control group, and there was significant difference between the two groups ( χ2=6.05, P=0.014). After treatment, TCM syndrome score [(4.45±1.09) vs. (10.67±2.82), t=16.85], VAS score [(1.54±0.43) vs. (3.28±1.04), t=12.94] lower than those in the control group ( P<0.01), subjective feeling [(7.54±2.87) vs. (6.24±1.76), t=5.72], physical signs [(6.76±2.00) vs. (4.34±1.67), t=7.77], limited daily activities [(9.56±3.27) vs. (7.89±2.97), t=3.16], bladder function score [(2.88±0.84) vs. (2.63±0.64), t=2.89] and the total score [(25.04±7.44) vs. (20.35±6.87), t=4.63] were higher than those in the control group ( P<0.01). After treatment, serum IL-6 [(18.12±4.23) μg/L vs. (26.46±4.58) μg/L, t=11.19], CRP [(18.87±6.07) mg/L vs. (25.89±5.72) mg/L, t=7.04] and TNF-α levels [(24.42±5.37) ng/L vs. (29.45±5.44) ng/L, t=5.51] were lower than those in the control group ( P<0.01). Conclusion:The warming needle moxibustion of Jiaji and TCM fumigation combined with conventional western medicine therapy can improve the lumbar pain of LDH patients in acute inflammatory stage, reduce the level of inflammatory factors, improve clinical efficacy.

Safety and efficacy of endoscopic resection for early primary non-ampullary duodenal cancer / 中华普通外科杂志

Objective:To evaluate the safety and efficacy of endoscopic resection in the treatment of patients with primary non-ampullary duodenal early cancer.Methods:A total of 20 cases with primary non-ampullary duodenal early cancer receiving endoscopic resection were collected from Jan 2015 to Dec 2019 at the Department of Endoscopy, the First Affiliated Hospital of Shandong First Medical University.Results:The size of lesions ranged from 0.3-2.5 cm (0.9±0.5)cm.The size of removed membrane samples ranged from 1.5-3.5 cm (2.5±0.7)cm. The edges were all negatiue pathologically. Duodenal perforation occurred in 2 cases, and all were successfully clipped by endoscopy. The follow-up time was from 4-42 months (20.4±11.4)m and no recurrence was found.Conclusion:Endoscopic resection is a safe and effective method for primary non-ampullary duodenal early cancer.

Associations between Mycobacterium tuberculosis Beijing genotype and drug resistance to four first-line drugs: a survey in China / 医学前沿

Investigations on the genetic diversity of Mycobacterium tuberculosis in China have shown that Beijing genotype strains play a dominant role. To study the association between the M. tuberculosis Beijing genotype and the drug-resistance phenotype, 1286 M. tuberculosis clinical isolates together with epidemiological and clinical information of patients were collected from the center for tuberculosis (TB) prevention and control or TB hospitals in Beijing municipality and nine provinces or autonomous regions in China. Drug resistance testing was conducted on all the isolates to the four first-line anti-TB drugs (isoniazid, rifampicin, streptomycin, and ethambutol). A total of 585 strains were found to be resistant to at least one of the four anti-TB drugs. The Beijing family strains consisted of 499 (53.20%) drug-sensitive strains and 439 (46.80%) drug-resistant strains, whereas the non-Beijing family strains comprised 202 (58.05%) drug-sensitive strains and 146 (41.95%) drug-resistant strains. No significant difference was observed in prevalence (χ= 2.41, P > 0.05) between the drug-resistant and drugsensitive strains among the Beijing family strains. Analysis of monoresistance, multidrug-resistant TB, and geographic distribution of drug resistance did not find any relationships between the M. tuberculosis Beijing genotype and drug-resistance phenotype in China. Results confirmed that the Beijing genotype, the predominant M. tuberculosis genotype in China, was not associated with drug resistance.

Role of tumor-derived exosomes in tumor metastasis / 国际肿瘤学杂志

Tumor-derived exosomes (TEXs) are small membrane vesicles secreted by tumor cells.They contain various proteins and RNA which make they serve as functional mediators in cell interaction.TEXs can alter the components of extracellular matrix and induces epithelial-mesenchymal transition of tumor cells,which enhance the invasiveness of tumor cells.TEXs regulate immunity through multiple pathways,allowing circulating tumor cells to escape immune surveillance.TEXs promote pre-metastatic microenvironment in target organ before metastasis and induce angiogenesis after circulating tumor cells colonization.Understanding the role and mechanism of TEXs in this process can effectively block relevant signaling pathways which may provide new targeted therapies for clinic.

Relationship between interleukin-6 and serum polyunsaturated fatty acids in patients with metabolic syndrome / 中华临床营养杂志

Objective To investigate the relationship between serum phospholipid polyunsaturated fatty acids (PUFA) and interleukin-6 (IL-6) in patients with metabolic syndrome.Methods Serum phospholipid PUFA profiles of 61 patients with metabolic syndrome and 55 healthy controls was analyzed with high performance gas chromatography.Enzyme-linked immunosorbent assay was used to measure serum IL-6 levels.Results The IL-6 concentration was significantly higher in the MS group than in the control group [(16.0 ± 4.7) pg/ml vs.(9.2 ± 2.6) pg/ml,P =0.000].The total PUFA percentage was lower in the MS group than in the control group [(47.2±2.4)％ vs.(50.8 ±2.5)％,P=0.001].The serum IL-6 concentration was negatively correlated with n-3 PUFA,n-6 PUFA,and total PUFA (r =-0.51,P ＜0.01;r=-0.27,P＜0.01;r=-0.38,P＜0.01).Conclusions Serum PUFA in patients with metabolic syndrome is lower than in healthy people.Serum IL-6 concentration may be negatively correlated with total PUFA concentration.

A propensity score matching analysis of prophylactic pancreatic stent and rectal NSAIDs for preven-tion of post-ERCP pancreatitis / 中华消化内镜杂志

Objective To investigate the efficacy of prophylactic pancreatic stent placement and nonsteroidal antiinflammatory drugs( NSAIDs) for the prevention of post?endoscopic retrograde cholangiopan?creatography(ERCP) pancreatitis(PEP). Methods A total of 623 patients with high risk factors for PEP were treated with prophylactic pancreatic stent placement ( 145 patients, group A) or rectal NSAIDs( 478 pa?tients, group B) for PEP prevention by using the propensity score matching( PSM) analysis. Incidence of PEP, moderate and severe PEP were investigated. According to risk factors of PEP, indications of prophy?lactic pancreatic stent placement were analysed. Results Of 623 patients with high risk factors, 145 pairs were generated after PSM.Pancreatitis occurred in 32 patients,10 (6?9%) in group A and 22 (15?2%) in group B( P<0?05 ) . Moderate?to?severe pancreatitis developed in 5 ( 3?4%) patients in group A and 14 (9?7%) patients in group B(P<0?05).Risk factors of post?ERCP PEP were cannulation attempts duration longer than 10 minutes, precut sphincterotomy, more than one pancreatic guidewire passages and history of ampullectomy. Conclusion Although the NSAIDs represent an easy, inexpensive treatment, prophylactic pancreatic stent placement is still a better prevention strategy for PEP.Prophylactic pancreatic stents should be recommended to those with risk factors including cannulation attempts duration longer than 10 minutes, precut sphincterotomy, more than one pancreatic guidewire passages and ampullectomy.

The effects of Bushen-Gufeigao and breathing movements on the patients with COPD of ;lung and kidney yang deficiency TCM pattern / 国际中医中药杂志

Objective Evaluating the effects of Bushen-Gufeigao and breathing movements on the patients with chronic obstructive pulmonary disease of Lung and kidney deficiency TCM pattern. Methods The patients with chronic obstructive pulmonary disease of lung and kidney deficiency TCM pattern were recruited and randomly divided into two groups the treatment group (32 cases) and the control group (34 cases). The control group was treated with the conventional medicine, and the treatment group were added Bufei-Gushengao and breathing movements based on the treatment of control group. Both groups were treated for 1 month. The changes of the clinical symptoms, lung function and frequency of attack and duration of each attack in 10 months after treatment were observed. Results After the treatment, compared with the control group, the TCM patterns scores (5.32 ± 2.67 vs. 9.12 ± 4.11, t=4.424) of the treatment group significantly decreased, while the FVC (3.00 ± 0.49 L vs. 2.71 ± 0.47 L, t=2.408), FEV1 (2.27 ± 0.44 L vs. 1.85 ± 0.54 L, t=3.496), and the percentage of FEV1%(75.62 ± 6.84 vs. 66.86 ± 9.32, t=4.333) increased significantly. In the 10 mouths after the treatment, the treatment group showed significantly fewer patients who had attacked more than 6 times than that in the control group, and the duration of attacks showed significantly fewer minutes in the treatment group than the control group (5.56 ± 1.45 d vs. 8.06 ± 1.80 d, t=6.190). Conclusion Bushen-Gufeigao and breathing movements can effectively improve patient's lung function and symptoms.

Comparison of the effect of ultrashort and short -acting insulin after subcutaneous insulin infusion pump un-der glucose monitoring in treatment of diabetes / 中国基层医药

Objective To investigate the efficacy of ultrashort and short-acting insulin after subcutaneous insulin infusion pump under glucose monitoring in treatment of diabetes.Methods 110 cases with type 2 diabetes were selected,they were randomly divided into two groups with a random number table:the study group and the control group,55 cases in each group.The study group was treated with short -acting insulin after subcutaneous injection of insulin pump,the control group was treated with short -acting subcutaneous insulin infusion by insulin pump therapy, glucose monitoring system was used to monitor glucose during treatment of the two groups.The clinical efficacy after a month of treatment was observed.Results Before treatment,fasting blood glucose(FPG),postprandial 2 h blood glucose(2h PG),bedtime blood glucose of the two groups had no statistically significant differences.After treatment, FPG and 2hPG,bedtime blood glucose in the study group were (6.01 ±1.06)mmol/L,(7.90 ±0.50)mmol/L, (7.13 ±0.95)mmol/L respectively,which of the control group were (5.98 ±1.04)mmol/L,(7.91 ±0.48)mmol/L, (7.14 ±0.94)mmol/L,which were significantly lower than before treatment (t =9.843,23.669,13.569,9.683, 22.881,13.710,P 0.05).The blood glucose time and insulin dosage in the study group were (5.59 ±1.30)d,(39.98 ±11.01)u/d,which of the control group were (6.98 ±1.40)d,(51.89 ±11.97)u/d,and there were significant differences between the two groups(t =1.825,5.431,P <0.05).The mean blood glucose,blood glucose standard deviation,time percentage of blood glucose≥10 mmol/L,time percentage of blood glucose≤3.9 mmol/L in the study group were (5.95 ±0.61 )mmol/L, (1.28 ±0.25)mmol/L,(14.16 ±2.13)%,(6.35 ±1.45)%,which in the control group were (6.59 ±0.94)mmol/L, (1.54 ±0.29)mmol/L,(15.15 ±2.14)%,(7.96 ±1.42)% respectively,and the differences were statistically significant between the two groups(t =4.236,503.6,2.432,5.883,P <0.05).Conclusion Glucose monitoring system in monitoring blood glucose is accurate and reliable,ultra -short -acting insulin after subcutaneous insulin pump infusion in treatment of diabetes is better than short -acting insulin.

Protective effects of oxymatrine injection on renal function of rats with endotoxic shock / 天津医药

Objective To evaluate the protective effects of oxymatrine injection on rats with endotoxic shock. Methods Wistar rat model of endotoxic shock was produced in this study. Twenty-four Wistar rats were randomly divided into normal control group (n=8), endotoxic shock group (n=8) and oxymatrine injection treatment group (n=8). Fifteen min?utes after the infusion of LPS (15 mg/kg) from femoral vein, oxymatrine was injected from femoral vein in treatment group, then we observed the mean arterial pressure (MAP) for six hours. At the end of experiment blood samples were harvested for measurement of urea and creatinine (Cr), which reflect renal function. Also contents of IL-6, IL-10, TNF-αin the renal ho?mogenate were detected. Results Oxymatrine can prevent progressive decrease of MAP in endotoxin shock treatment group. The contents of plasma urea and Cr were significantly higher in endotoxin shock group than those of control group. The contents of IL-6, IL-10 and TNF-αin renal homogenate increased obviously, but after the injection of oxymatrine, the contents of urea and Cr significantly decreased in treatment group, also IL-6 and TNF-α were significantly declined. Conclusion Oxymatrine provides protection at renal function after endotoxin shock, and its mechanism may be related to inhibit the releasing of inflammatory cytokines in kidney.

Modified laparoscopic combined with gastroscopic surgery for the gastric stromal tumors from the muscularis propria / 中华消化外科杂志

Objective To explore the clinical effects of laparoscopic combined with gastroscopic surgery for the gastric stromal tumors (GSTs) from the muscularis propria.Methods The clinical data of 25 patients with GSTs from the muscularis propria who were admitted to the Qianfoshan Hospital Affiliated to Shandong University between January 2011 and January 2014 were retrospectively analyzed.Patients received the general anaesthesia by endotracheal intubation.The pneumoperitoneum was done by an arc incision of 0.5 cm above margin of the umbilical cord and then laparoscopy was placed for exposing and gastroscopy was placed for confirming the location of the tumor.A laparoscope was placed in the cavity via the trocar at the navel,and the other two trocars penetrated both the abdominal and stomach walls.With gastroscopic monitoring,the operation was carried out in the gastric lumen using laparoscopic instruments and the tumor was resected.The tumor tissue was removed orally using a gastroscopic basket,and puncture holes and perforations were sutured using titanium clips.The proton pump inhibitor and antibiotics were used as the conventional therapy for 3 days,while adjuvant therapy with a usage of imatinib was applied to patients who were confirmed with the high-risk GSTs by pathological examination after tumors resection,and the other patients did not receive adjuvant therapy.Gastroscopic reexamination was done every 3 months within postoperative 1 year and then every 6 months after 1 year.Abdominal CT reexamination was done every 6 months within postoperative 1 year and then every 1 year after 1 year.The followup was done till December 2014.Results All the 25 patients received successfully modified laparoscopic combined with gastroscopic surgery without conversion to open surgery and postoperative complication.The operation time,volume of intraoperative blood loss,diameter of tumor,duration of postoperative abdominal pain and duration of hospital stay were (79 ± 4) minutes,(28 ± 3) mL,(2.6 ± 0.3) cm,(2.8 ± 0.3) days and (6.3 ± 0.3) days,respectively.GSTs were confirmed by postoperative pathological examination.The mitotic count was (3.3 ± 0.3) /50 HPF and reached R0 resection.Extremely low risk was detected in 3 patients,low risk in 19 patients,intermediate risk in 3 patients and no high risk was detected.Two of 3 patients with intermediate risk took the medicines following instructions without the adverse drug reaction,and 1 of 3 patients refused to take the medicines due to low income.All the patients were followed up for 12-36 months without the recurrence or metastasis of tumors.Conclusion Modified laparoscopic combined with gastroscopic surgery is feasible and effective for the treatment of gastric stromal tumors (GSTs) from the muscularis propria.

A bite of parasite,experiences of application of documentaries into parasi-tology class teaching / 中国血吸虫病防治杂志

Medical parasitology education has been facing some difficulties because it is a course of wide range lacking clini?cal cases and concerned specimens of parasites currently. In addition its relationship with life is not closely enough. All these reasons may impact the effect of class education negatively. Therefore it is important to increase the vitality of parasitology edu?cation and diversify the instructional mode by using the resources from Internet. In recent years the Discovery Channel has up?loaded a documentary Monsters Inside Me online. This documentary is high professional and closely linked with parasitology. It maintains numbers of clinical cases about parasitic diseases. Each episode is about 3 minutes and shortly enough to be intro?duced into class teaching. However this resource has not been fully used in domestic temporally. We found that direct introduc?tion of the documentary into class teaching can enrich teaching forms to attract learning interest of students and finally improve the teaching effect of class. Above that another popular documentary A Bite of China involves many related knowledge points of parasitology. The appropriate usage of the knowledge can build up close linkage between book and life which is extremely help?ful to give students a deep impression of parasitology. In brief it is our strong recommendation to introduce the documentary Monsters Inside Me into class.

Characteristics of serum free fatty acid and high-sensitivity C-reactive protein in patients with type 2 diabetes mellitus and metabolic syndrome / 中华临床营养杂志

Objective To investigate characteristics of free fatty acid (FFA) and high-sensitivity Creactive protein (hs-CRP) in patients with type 2 diabetes mellitus and metabolic syndrome (MS) compared to those with type 2 diabetes mellitus without MS.Methods Totally 120 patients with type 2 diabetes mellitus who received blood glucose control in Shaoxing People's Hospital from January to June 2013 were recruited and divided into MS group (n =56) and non-MS group (n =64).The serum FFA profile of the patients was measured by enzymatic assay, and the serum hs-CRP level measured by particle-enhanced immuno-precipitation assay.Results The level of FFA was higher in the MS group than that in the non-MS group [(0.60 ±0.25) mmoL/L vs.(0.45 ±0.21) mmol/L, P =0.033].The level of hs-CRP was higher in the MS group than that in the non-MS group [5.29 (4.69-5.82) mg/L vs.0.73 (0.42-1.26) mg/L, P =0.000].The level of hs-CRP was higher in the patients with central obesity than that in those without central obesity [4.34 (0.91-5.46) mg/L vs.1.80 (0.82-3.27) mg/L, P=0.014], also higher in hypertensive patients than in non-hypertensive patients [5.21 (3.18-5.96) mg/L vs.2.93 (0.89-4.98) mg/L, P =0.012].Conclusions Serum FFA and hs-CRP concentrations may be significantly higher in type 2 diabetes mellitus patients with MS.The increased levels of FFA and hs-CRP may play an important role in the pathogenesis of type 2 diabetes mellitus and MS.

Application of Internet Drug Supply Chain Coordination Platform in Hospital Drugstore / 中国药师

Objective:To improve the logistics management automation in hospital drugstore using internet drug supply chain coor-dination platform. Methods: According to the correspondent relationship between drug information and drug bar code, drug accept-ance, accurate location and batch input were achieved using bar code technique. Results: The platform could not only enhance the efficiency but also ensure the accuracy of drug information input. Conclusion:The platform provides a practical solution for developing modern pharmaceutical logistics and improving the efficiency of pharmaceutical distribution.

Analysis on genetic diversity of Mycobacterium tuberculosis isolates from Tibetan patients in Tibet by spacer oligonucleotide typing / 中华传染病杂志

Objective To detect the genetic diversity and prevalent strains of Mycobacterium tuberculosis isolates from Tibetan patients in Tibet and to analyze factors associated with prevalent strains.Methods A total of 577 Mycobacterium tuberculosis isolates were genotyped by spacen oligonucleotide typing (spoligotyping) and the results were analyzed with BioNumerics software (Version 5.0) and compared with the international spoligotype database of SITVIT2.Results Among the 577 cases of Tibet patients,329 were male and 248 were female.Based on spoligotyping,23 different spoligotypes were identified among 577 Mycobacterium tuberculosis isolates,with a genetic diversity of 3.99 ％.The majority (97.57％,563/577) of the isolates belonged to four known families,such as Beijing family,T family,CAS family and MANU2 family.The remaining 14 isolates had 11 novel spoligotypes.522 (90.47％)isolates belonging to Beijing family presented with 7 spoligotypes,resulting in the genetic diversity of Beijing family of 1.34％.With high similarity,Beijing family strains could be clustered into one genotype;among non-Beijing family strains,strains belonging to T family and MANU2 family were similar and could be clustered into one genotype.Changdu had the highest prevalence (97.83％) of Beijng family strains.In this study,the occurrence of Beijing family strains was not associated with age,sex,bacillus CalmetteGuerin vaccination or treatment history (P=1.00,0.36,0.83 and 1.00,respectively).Conclusions In this study,the genetic diversity of Tibetan Mycobacterium tuberculosis is low and Beijing family strains are highly prevent in Tibet,by classical spoligotyping.

Research Status of Objective Characteristics of TCM Digitized Tongue / 世界科学技术-中医药现代化

Computer science and technology has been used to promote the development of objectification of traditional Chinese medicine (TCM), which is also required for international development of TCM. In this paper, on the basis of current situation of Chinese medicine tongue objective research, the analysis was made on involved computer-related technology, relevant standards, and the future trend was discussed.

Clinical Observation of Warm Needling for Tinnitus / 上海针灸杂志

ObjectiveTo observe the clinical efficacy of acupuncture-moxibustion in treating tinnitus.MethodNinety-eight patients with tinnitus were divided into a warm-needling group (n=32), an acupuncture group (n=34), and a medication group (n=32), to observe thetherapeuticefficacies.ResultThe total effective rate was 83.3% in the warm-needling group, versus 78.8% in the acupuncture group and 60.0% in the medication group.ConclusionWarm needling and acupuncture plus TDP are both superior to the medication treatment in comparing the therapeutic efficacy.

Association of triglyceride with serum polyunsaturated fatty acid in patients with metabolic syndrome / 中华临床营养杂志

Objective To investigate the relationship between triglyceride and serum polyunsaturated fatty acid (PUFA) in patients with metabolic syndrome (MS).Methods Totally 74 MS patients (MS group) and 62 healthy subjects (normal control group,NC group) were recruited from June 2011 to June 2012 in Shaoxing People's Hospital.Serum phospholipid fatty acid profiles were analyzed with capillary gas chromatography.Serum lipids were measured by enzymatic assay.Results The triglyceride concentration was significantly higher in MS group than that in NC group [(2.0 ±0.8) mmol/L vs.(1.3 ±0.5) mmol/L,P=0.000].The levels of n-3 PUFA,n-6 PUFA,and PUFA were significantly lower in MS group than those in NC group (9.8％ ±2.2％ vs.11.1％ ±2.4％,P=0.002; 35.4％ ±6.7％ vs.39.5％ ±7.8％,P=0.009; 45.2％ ±8.9％ vs.50.6％ ±10.1％,P =0.000).Triglyceride concentration was inversely correlated with n-3 PUFA and PUFA levels (r =-0.42,P =0.008 ; r =-0.23,P =0.013).Conclusions n-3 PUFA,n-6 PUFA,and PUFA decrease in MS patients.Triglyceride concentration is inversely correlated with PUFA.

Small endoscopic sphincterotomy plus large balloon dilatation for common bile duct stones larger than 12mm: a randomized comparative study with endoscopic sphincterotomy / 中华消化内镜杂志

Objective To evaluate the efficacy and safety of small endoscopic sphincterotomy (EST) plus large balloon dilataion (EPLBD) for removal of common bile duct (CBD) stones larger than 12mm.Methods From June 2009 to December 2011,a total of 198 patients with CBD stones were randomly divided into two groups to receive EPLBD (n =100) or EST only (n =98).The rate of complete stone removal after the first session,the overall success rate of stone removal,the rate of using mechanical lithotripsy (ML),the rate of post procedure complication,procedure time and fluoroscopy time were compared between the two groups.Results The rate of complete stone removal after the first session in EPLBD group (89.0％) was significantly higher than that in EST group (71.4％,P ＜ 0.05).ML was required significantly more often in EST group (35.7％) compared to EPLBD group (12.0％,P ＜0.05).Total procedure time and total fluoroscopy time in EPLBD group (39.3 ± 15.8 min and 14.2 ±5.2 min) were significantly shorter than those of EST group (48.4 ± 19.3 min and 24.2 ±9.4 min,P ＜0.05).There was no significant difference between two groups in overall success rate of stone removal (97.0％ in EPLBD vs.93.9％in EST group,P ＞ 0.05) and the complications rate (8.0％ in EPLBD vs.13.3％ in ESTgroup,P ＞0.05).Conclusion EPLBD is as safe and effective as EST for common bile duct stones,larger than 12mm,and is more efficient in terms of procedure time,use of ML and success rate of stone removal.

A study on the combined use of small endoscopic sphincterotomy plus balloon dilation to replace endoscopic sphincterotomy in the removal of common duct stones / 中华肝胆外科杂志

Objective To evaluate whether small endoscopic sphincterotomy (EST) plus balloon dilation (EPBD) can replace endoscopic sphincterotomy (EST) alone for patients with common bile duct (CBD) stones.Methods From May 2008 to April 2011,462 patients with CBD stones were randomly divided into two groups.The success rate of complete stone removal after the first session,the rate of using mechanical lithotripsy (ML),the short-term complications,the procedure time and fluo roscopy time were compared between the two groups.Results Overall ductal clearance did not differ between the two groups (96.5％ vs 93.5％,P＞0.05).The complication rates at 24 hours were 6.9％ for the small EST plus EPBD group and 11.7％ for the EST group (P＞0.05).However,the rate of complete stone removal after the first session using small EST plus EPBD was significantly higher than EST alone (86.2％ vs 70.4％,P＜0.05).ML was required significantly more often in the EST group when compared with the small EST plus EPBD group (34.8％ vs 12.1％,P＜0.05).The total procedure time and total fluoroscopy time in the small EST plus EPBD group were significantly shorter than the EST group [(38.6±15.5) min vs (47.1±20.2) min,P＜0.05 and (17.3± 7.0) min vs (26.5±10.8) min,P＜0.05].Conclusions Compared with EST,small EST plus EPBD was safe and more efficacious for bile duct stones.In the future,small EST plus EPBD probably can replace EST to be the first treatment of choice for bile duct stones.

Value of doppler ultrasound hook-wire-guided suspicious node biopsy in early breast cancer / 中华内分泌外科杂志

Objective To explore ideal surgical axillary management of early breast cancer,and to determine the feasibility of reducing false negative rate of sentinel lymph node biopsy(SLNB)by combination of axillary suspicious lymph node biopsy and SLNB.Methods From Jan.2008 to Oct.2009,42 consecutive cases with early breast cancer were enrolled.All patients underwent suspicious node hook-wire location by doppler ultrasonography before operation.SLNB and suspicious lymph node biopsy were performed during operation.Complete axillary nodes dissection(ALND)or level II dissection would be conducted according to the biopsy result.The difference of node status prediction between SLNB and SLNB with axillary suspicious lymph node biopsy and was compared.Results All the 42 cases successfully underwent SLNB (100%).There were 2 false negatives occurred in SLNB,resulting in false negative rate of 11%,sensitivity of 88.9%and accuracy of 95.2%in predicting axillary nodes status.By contrast,SLNB with axillary suspicious node biopsy showed a false-negative rate of 0%,sensitivity of 100%,and accuracy of 100%.Conclusions Compared to SLNB in early breast cancer,combination of suspicious node biopsy and SLAB has a tendency of reducing false negative rate.However,Because of the limited samples,the difference has no statistical significance(P=0.2500).