Complementarity of Mental Observables

The aim of this note is to complete the discussion on the possibility of creation of quantum‐like (QL) representation for the question order effect which was presented by Wang and Busemeyer (2013). We analyze the role of a fundamental feature of mental operators (given, e.g., by questions), namely, their complementarity.     

临床路径变异调查与分析

目的分析临床路径变异，以提高临床路径的管理水平。方法以大隐静脉曲张高位结扎剥脱术为例，按照疾病转归、医护、患者、医院和退出路径5方面的因素对临床路径变异进行回顾性调查和统计分析。结果主要的变异因素中患者方面的占36．46％，主要是患者提前出院；医护方面的占31．31％，主要是提前安排手术。结论临床路径变异主要是人的因素，加强变异管理，才能更好的实施临床路径。     

Double cystic duct,a review of literature with report of a new case

IntroductionAlthough cystic duct variation is quite common, duplication of cystic duct is an extreme rare variant. We report a case of double cystic duct with literature review. A 33-year old female presented with right upper quadrant pain of three day duration, associated with nausea and poor appetite. The patient reported previous three attacks of right upper quadrant pain within the last two years. On examination: Murphy's sign was positive and the right upper quadrant was tender. Abdominal ultrasound showed multiple gall stones. Oesophago-gastro- duodenoscopy was normal. Under general anesthesia, four port formal laparoscopy was done, double cystic duct was found. Histopathological examination showed features of chronic cholecystitis.Conclusiondouble cystic duct is a very rare variant of the cystic duct anomaly. Identification pre or intraoperatively is very important to prevent ductal injury.     

新鲜周期单囊胚移植314例临床结局

目的 探讨新鲜周期单囊胚移植(single blastocyst transfer,SBT)的可行性。方法 回顾性分析314个新鲜周期行SBT患者的临床资料,从年龄、囊胚分级等方面比较分析临床结局。结果 妊娠组患者的年龄显著低于未妊娠组(P0.001);选择性SBT(elective SBT,eSBT)组的临床妊娠率显著高于非选择性SBT(non-elective SBT,non-eSBT)组(P0.05);年龄≤35岁的患者,eSBT组的临床妊娠率与双囊胚移植(double blastocyst transfer,DBT)组无统计学差异,但多胎妊娠率显著降低(P0.001);而35岁的患者,eSBT组的临床妊娠率低于DBT组(P0.05),组间的多胎妊娠率无统计学差异(P0.05);囊胚扩张和孵化的程度与临床妊娠率显著相关,优质囊胚可获得更好的妊娠结局。结论 妊娠结局与囊胚的质量及患者的年龄显著相关,对于年龄≤35岁,有优质囊胚的患者,可以进行SBT。     

Heart-hand syndrome

Heart–hand syndromes show substantial clinical and genetic heterogeneity. The unusual case of a patient with a heart–hand syndrome consisting of preaxial polydactylia, postaxial syndactylia, parachute mitral valve, mild subaortic stenosis, and double outlet right ventricle is presented and discussed. The importance of distinguishing Holt–Oram syndrome from its phenocopies and other heart–hand syndromes is underlined.     

Detection of K-<Emphasis Type="Italic">ras</Emphasis> mutations in the plasma DNA of pancreatic cancer patients

Background In pancreatic cancers, K-ras mutations have been found frequently (80%–100%), and they could be a good marker to detect tumor DNA in the plasma. Several studies have indicated that polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) analysis of K-ras mutation was a useful method for the detection of hepatic and lymph node metastasis of pancreatic cancer. However, this method sometimes exhibited false-positive results, and the rate of K-ras mutation might thus be overestimated in these tissues. To diagnose pancreatic cancer correctly at an early stage, we attempted to detect tumor DNA in the plasma of pancreatic cancer patients using a more sensitive and specific method.Methods We examined 28 pancreatic cancer patients using a sensitive mutation-specific mismatch ligation assay for K-ras gene mutations in primary tumors and paired plasma samples.Results K-ras gene mutations were detected in 26 of the 28 (93%) pancreatic cancers. We also found the same mutations in 9 of these 26 (35%) patients in their plasma DNA. This mutation was found even in the plasma of patients with TNM stage II cancer.Conclusions Genetic alterations present in the tumors of pancreatic cancer patients can be detected in their plasma, and this approach is potentially applicable for cancer screening and the monitoring of this deadly disease.     

The effects of pentoxifylline on liver regeneration after portal vein ligation in rats.

AIM: To determine the effects of pentoxifylline, a methyl xanthine derivative on hepatic cell production of uninterferred lobe after portal vein branch ligation. METHODS: Sixty-six rats were randomly allocated into 9 groups with 8 rats in PVL groups and 6 rats in sham operation groups. The portal branches of the median and the lateral liver lobes, corresponding to approximately 70% of the liver volume were ligated in the PVL groups. The control group received 0.9% NaCl solution. The rats in the treatment groups received pentoxifylline at the dose of 50 mg/kg/dy. After 1, 2, 4 days of portal vein ligation in both PVL and PVNL lobes the levels of adenine nucleotides were determined and flowcytometric analysis of cell cycles were performed. RESULTS: On the first day of portal branch ligation energy charge was significantly lower, in pentoxifylline treated group comparing to pentoxifylline untreated group, both in PVL and PVNL lobes (P<0.05). Proliferative indexes were 0.38 and 0.29 in pentoxifylline treated and pentoxifylline untreated PVNL lobes respectively (P<0.05). CONCLUSION: Pentoxifylline treatment resulted in an increase of percentage of calls entering mitosis phase on the first day after PVL, somehow accelerating the regeneration process.     

Treatment of gastrointestinal bleeding in left ventricular assist devices: A comprehensive review

Left ventricular assist devices(LVAD) are increasingly become common as life prolonging therapy in patients with advanced heart failure. Current devices are now used as definitive treatment in some patients given the improved durability of continuous flow pumps. Unfortunately, continuous flow LVADs are fraught with complications such as gastrointestinal(GI) bleeding that are primarily attributed to the formation of arteriovenous malformations. With frequent GI bleeding, antiplatelet and anticoagulation therapies are usually discontinued increasing the risk of life-threatening events. Small bowel bleeds account for 15%as the source and patients often undergo multiple endoscopic procedures.Treatment strategies include resuscitative measures and endoscopic therapies.Medical treatment is with octreotide. Novel treatment options include thalidomide, angiotensin converting enzyme inhibitors/angiotensin Ⅱ receptor blockers, estrogen-based hormonal therapies, doxycycline, desmopressin and bevacizumab. Current research has explored the mechanism of frequent GI bleeds in this population, including destruction of von Willebrand factor,upregulation of tissue factor, vascular endothelial growth factor, tumor necrosis factor-α, tumor growth factor-β, and angiopoetin-2, and downregulation of angiopoetin-1. In addition, healthcare resource utilization is only increasing in this patient population with higher admissions, readmissions, blood product utilization, and endoscopy. While some of the novel endoscopic and medical therapies for LVAD bleeds are still in their development stages, these tools will yet be crucial as the number of LVAD placements will likely only increase in the coming years.     

两种微创手术治疗小儿腹股沟斜疝的对比

目的：对采用两种微创手术治疗小儿腹股沟斜疝的临床疗效进行对比。方法回顾性分析该院于2013年1月—2014年3月收治的采用两种微创手术进行治疗的小儿腹股沟斜疝患者90例的临床资料,并随机分为两组,即下腹横纹小切口疝囊高位结扎术(开放手术组)40例,腹腔镜疝囊高位结扎术(腹腔镜组)50例,对比两组患者的手术时间、住院时间、住院费用、并发症、复发率。结果开放手术组手术时间（40.1±4.2）min,住院时间（4.2±0.7）d,住院费用（3280.64±40.21）元,无并发症,无一例复发;腹腔镜组手术时间（40.0±3.1）min,住院时间（4.1±0.2）d,住院费用（5431.25±46.58）元,无并发症,且无一例复发。开放手术组住院费用明显少于腹腔镜组,差异有统计学意义（P<0.05）,而两组手术时间、住院时间、并发症方面差异无统计学意义（P>0.05）。结论下腹横纹小切口疝囊高位结扎术比腹腔镜手术更值得在基层医院推荐。