Treatment of esophageal rupture or perforation

<正>Esophageal rupture or perforation is a serious emergent disease.Without accurate diagnosis and effective treatment in time,it’s life-threatening.Esophageal rupture or perforation can be caused by:iatrogenic endoscopy examination and treatment,ligation and sclerotherapy of esophageal variceal,dilation of esophageal stricture,operative injury and so on; Spontaneous perforations; foreign body ingestion; trauma; tumor; calculus and ulcer of esophagus and so on.The key-point for the treatment of this disease lies in early diagnosis and accurate effective treatment.     

Development and Clinical Evaluation of a Newly Developed Forceps to Remove Intrauterine Foreign Bodies

Clinical use of a new forceps for foreign body removal (Intrauterine forceps) is introduced in this paper. The forceps can fit in uterine cavity during operation. A total of 310 foreign bodies in uterus, including IUD breakage, IUD embedment and remained fetal bone were removed satisfactorily by the new forceps. Two case failed.The two failed cases were not diagnosed before operation. One was a broken stainlesss teel ring and embedded into myometrium deeply. It was difficult to remove the IUD and the patient was advised to undergo a hysteroscopy diagnosis. Another one was a stainless steel V-shaped Cu IUD, which was broken into several pieces and removed by the forceps, but a small piece remained and was removed with aid of hysteroscopy.The new type of foeceps was proved to be effective and should be popularized.     

膝部枪击伤后子弹移行至心脏：1例报告

Migration of a bullet to a distant part of the body after a gunshot is rarely observed in the clinical setting, and migration to the heart is even rarer.There are usually no clear symptoms or signs from migration of a bullet.The bullet can be easily missed and sometimes identified in a review examination.A case of bullet migration to the heart 2 months after a gunshot to the left knee was reported.     

Foreign body embolus to ophthalmic artery following penetrating trauma of the neck

Migration of metallic foreign body into the cerebral circulation is rarely seen. Most of the cases reported were due to gunshot wounds and shotgun wounds to the neck and face. When the foreign body is near the great vessel, it must be removed immediately or will cause complications. This study reported a case of delayed metallic foreign body embolus to the ophthalmic artery resulting from an injury to the right neck, which arose from the presence of metallic emboli to the cerebral circulation.

     

A forgotten swab in bronchus for 19 years

To the editor:Airway foreign body (AFB) is a common condition which may be easily misdiagnosed when specific symptoms are lacking.Flexible bronchoscopy can accurately identify and locate foreign bodies within the airway,and is generally the first-line for the removal of AFB.1 We report a successful application of bronchoscopy for AFB in a patient which was misdiagnosed for 19 years.     

Treatment of 60 Cases of Hiccup by Puncturing Points Lateral to Haiquan

Hiccup is a commonly encountered diseaseclinically,but difficult to control.The attack is oftenaccidental.If it is mild,the patient can recoverwithout receiving any treatment.But,in case theattack lasts long,the patient suffers a lot,and needsto be treated in time.In recent years,the author hastreated 60 cases of hiccup by puncturing points     

Placement of a Long Intestinal Tube in Patients with Early Postoperative Small Bowel Obstruction under Fluoroscopic Guidance

Objective To investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO). Methods Fifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time, the radiation exposure time, and the incidence of complications were evaluated. Results The long tubes passed into the jejunum on initial insertion for all patients, so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4±8.6 minutes, and the mean radiation exposure time 18.9±6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention. Conclusions Using the wire-exchange technique, it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.     

Medical Foreign Bodies in Urinary Bladder:a Case Report

RETAINED foreign bodies in the urinary tract after surgical or diagnostic procedure, named iatrogenic foreign bodies, are rarely reported, though the estimated incidence was as high as 1/1500 cases.1 Prompt and proper retrieval is required due to potential complications. We report a case of iatrogenic foreign body into the bladder.     

Novel gelatin-adriamycin sustained drug release system for intravesical therapy of bladder cancer

In recent years,progress has been made in sus-tained and controlled drug release system,and manybiodegradable high molecular materials have beenused in human body.Asa drug cancer,the sustainedand controlled drug release system must be able toentrap drug in its molecularnetwork,and once intro-duced into human body,it can be degraded by pro-teinase,resulting in sustained release of drug.Gelatin is such a high molecule with good histocom-patibility.In this study,we impregnated adriamycininto a 2 …     

A convenient fluorescent-labeled assay for in vitro measurement of DNA mismatch repair activity

Objective The assay of DNA mismatch repair （MMR） activity can be used as a biomarker for environmental condition detection and human disease diagnosis. Radioactive 32p-endlabeled DNA containing mismatch is extensively used as the substrate for MMR activity analyses. The aim of the present study is to develop a simple non-radioactive, but equally specific and sensitive method for the MMR activity assay. Methods A fluorescent label was chosen to replace the radioactive isotope label. Sensitive evaluation of the fluorescent label was carried out for the first time, and then the fluorescent label was compared with the isotope label in the MMR activity and DNA binding assays. Result LOD （limit of detection） of the fluorescent label was about 0.1 fmol and the relative signal strength displayed a pretty good linear relationship. Moreover, the fluorescent label method has equivalent sensitivity and performance as compared with the classical radioactive method in experiments. Conclusion In light of the sensitivity, reproducibility, safety, rapidity and long lifespan of the fluorescent label, this improved method can be applied to evaluation of biologic and toxic effects of environmental pollutants on man and other forms of life.     

Feasibility on Systemic Delivery of Asialoorosomucoid Complex to Hepatic Origin Cells Mediated by Asialoglycoprotein Receptor

Receptor mediated gene delivery is a new gene transfer strategy. Asialoglycoprotein receptor (ASGP R), the receptor of asialoorosomueoid (Asor), is specially expressed on the surface of hepatoeyte. In this paper, the nuclide ^131I was combined with Asor to form a kind of soluble nuclide-protein complex, which can be specifically endoeytosed into hepatoeyte by ASGP-R. After intravenous injection of the complex into experimental animals, the deposition of Asor in vivo and the targeting quality of hepatoeyte was detected by ECT. This research testified the feasibility of targeting Asor complex delivery to hepatoeyte mediated by ASGPR in vivo, and provided foundation for the genetic diagnosis and gene therapy of hepatic cell related diseases.     

Vitreoretinal surgery combined with C-arm fluoroscopic-guided removal of intraorbital foreign body following ocular perforating injury

Perforating ocular trauma with retained intraorbital foreign body (IOrFB) is a severe injury with a poor prognosis.The injury involves the posterior segment of the eye,and foreign bodies are mostly lodged posterior to the globe.Vitreoretinal surgery and IOrFB removal are always performed separately in patients with ocular perforating injury and IOrFBs.Obviously,separate procedures increase the cost and patient discomfort.Intraoperative fluoroscopy,used to localize the foreign body during surgery,1 facilitates the treatment of ocular perforating injuries and plays a valuable role in aiding the removal of radio-opaque orbital foreign bodies.     

Surgical Treatment of Bile Duct Cancer at Hepatic Hilum:A Clinical Analysis of 60 Cases

The incidence of bile duct cancer at hepatic hilum has a tendency toincrease in recent years.This paper is to report 60 cases during a10-year-period from 1975 to 1985.The cancer at the hepatic hilum(60 cases)made up 73％ of all extrahepatic bile duct cancers(82 cases),and accounted for1.65％ of 3626 biliary operations done at the same period.The clintcalmanifestations of the patients could be categorized into three types,the presentingsymptoms were obstructive jaundice in 29 cases,of which 25 had beenmisdiagnosed as infectious hepatitis;the symptoms of acute cholangitis were foundin 12 cases;and in 14 cases,various symptoms and signs of biliary diseases hadbeen found for a long time before the diagnosis was established as cancer.In theremaining 5 cases,miscellaneous manifestaions were revealed.The patients wereexamined with B- US(19 cases),ERCP(10 cases)and PTC(39 cases).The finaldiagnosis was established according to the findings of PTC and/or ERCP,surgical exploration,or histopathological examination.Surgery was performed on56 cases.Only 6 out of the 56 received radical resection of the cancer withhemi-hepatectomy;palliative internal drainage of the bile duct was done on 15cases,external drainage on 23 cases,and other palliative measures on 12 cases.The average survival time after operation was 24.5 months in 6 cases with radicalresection,8.7 months in 48 cases with palliative measures,and only 5 months in 4cases without surgical intervention.Early diagnosis is imperative if successfultherapy is expected.It is suggested that a patient over 40 years of age,sufferingfrom“infectious hepatitis”or obstructive jaundice,be watched out for thepossibility of hilum cancer,and appropriate examinations such as B-US,CT,ERCP or PTC be carried out.It is emphasized that PTC plays an important rolein the diagnosis of hilum cancer.In severe cases,the intrahepatic bile ducts couldbe examined with PTC of the two sides at one time.Exploratory laparotomyshould be performed on suspected cases.     

Traumatic diaphragmatic hernia associated with pelvic fractures： a case report and literature review

Objective： To review the epidemiological feature, clinical, and diagnostic data of post-traumatic diaphragmatic hernia （TDH） associated with pelvic fractures patients reported in recent 10 years. Methods： One case of delayed presentation of TDH after pelvic fractures taken place one month later was present, with a review on the literature of this kind of patients in our country. Results： The incidence of TDH associated with pelvic fractures was relatively rare, and the diagnosis were often delayed or missed. Although the trans-thorax approach was preferred for surgical closure in the acute phase, its mortality was 8.51%. Conclusion： TDH associated with pelvic fractures is difficult to diagnose because of their varied clinical and radiological signs and the patients may not present with symptoms for a long time following the injury. In clinical, a high index of suspicion with appropriate examination is the mainstays of management, which can also increase the prognosis.     

A systematic analysis of the theory and practice of syndrome differentiation

Syndrome differentiation is a methodology unique to Chinese medicine.It threads the diagnosis process with clinical treatment into a holistic web of links to determine and regulate the patterns of dysfunctions in the human body.It is seen as the essence of Chinese medicine because it takes into account the theoretical principles,diagnostic methodologies and the modality of treatment holistically.In this process the progressive development and changes of syndromes are also considered by the physician.This paper is a systematic study of the methodology of syndrome differentiation in relation to its clinical applications in the treatment of diseases.To illustrate the efficacy of syndrome differentiation,the relationship between pattern identification and diseases is analysed to provide a guiding principle for integration between Chinese medicine and Western medicine. Diseases being selected include cancer,cardiovascular and metabolic syndromes.A study of renal and hepatic diseases related to lifestyle is also included to highlight the clinical efficacy of syndrome differentiation.The paper also includes an analytical summary of the theoretical advancements made in integrative differentiation methodology during the past five decades which links to the recent clinical thinking and practice.     

Letting minimally invasive surgery be safe and efficacious

The concept of minimally invasive surgery （MIS） is thought to minimize damage and possible reactions of the surgical site and the whole body in order to achieve the same outcome as that achieved from conventional surgery. It does not simply make the incision small, instead emphasizes the protection of the surgical part and its environmental conditions in an attempt to minimize or, if not, avoid body reaction to surgery. This would decrease the amount of complications and shorten the time of recovery. Patients could be benefited from MIS for the operation itself is not only safer, but the patients can recover more quickly. Obviously it is exactly the ultimate goal of MIS. In short, MIS aims to achieve the best outcome with minimal costs. Arthroscopy, a method developed in the middle of the last century, could be regarded as a typical paradigm.     

Non-invasive diagnostic screening of hepatic fibrosis in patients with chronic hepatitis B

Liver cirrhosis is usually associated with complications which can be effectively prevented. In the case of compensated cirrhosis, early diagnosis is essential. Liver biopsies are used as the primary method for the diagnosis of compensated cirrhosis. In clinical practice, the use of liver biopsies has several limitations including complications, which lead to a death rate of 0.015%, discomfort, and longer hospitalization. These limitations prevent the use of liver biopsies as a general screening procedure for cirrhosis.     

CLINICAL OBSERVATION OF THE WEIGHT-REDUCING EFFECT OF EAR ACUPUNCTURE IN 350 CASES OF OBESITY

When body weight is above the ideal by10%,the subject is generally considered to beobese,though some workers give a 20%allowance.Among the causes of obesity areendocrine disturbance,heredity and a caloricfood intake over and above the body's needs.All often result in the deposit of surplus adiposetissue in the body.Over consumption of caloriescauses what is called simple obesity,whichmay be subdivided into two categories:constitu-tional and acquired obesity.In both cases excesscalories cause fat cells to increase in size aswell as number.     

A Progress in Neurological Surgery

Current and Future Management of Brain Metastasis is a well-written book by Kim Dong Gyu and L.Dade Lunsford.It is interesting that the gradual increase of brain metastasis incidence rate is associated with the development of cancer diagnosis,the screening level of brain metastasis,the growth of cancer survivor population,and the prolongation of survival time.In the past,the survival period of brain     

Double-balloon enteroscopy in detecting small intestinal bleeding

Digestive tract hemorrhage is a common disease of the digestive system, but about 0.4%-5% intestinal bleeding can not be detected with gastroscope or colonscope.1 Since the intestine is long, tortuous, far away from both ends of the digestive tract and unfixed in position, clinical diagnosis of the bleeding is relatively difficult. Yamamoto and Sugano2 reported the clinical application of double-balloon enteroscope at American DDW in 2003. Since this new instrument can help to observe the…