Objective To investigate the clinical outcome of laparoscopic and open total mesorectal excision in the treatment of patients combined with rectal cancer and COPD. Methods From January 2011 to December 2014, clinical data of 74 patients combined with rectal cancer and COPD were analyzed retrospectively, including 42 cases in laparoscopic group and 32 cases in laparotomy group. Statistical analysis were performed by using SPSS 19.0 software. Measurement data, such as intraoperative indicators, PIP and PaCO2 were expressed as ±s, and were examined by using independent t test. Count data such as complications were examined by chi square test. A P value <0.05 was considered as statistically significant difference. Results Compared with the laparotomy group, the laparoscopic group had higher peak airway pressure(21.8±1.7cmH and partial pressure of carbon dioxide (PaCO2), the value of peak airway pressure(PIP) and partial pressure of carbon dioxide (PaCO2) in the laparoscopic group were higher than those of the laparotomy group[(21.8±1.7) cmH2O vs. (13.7±1.6) cmH2O (t=21.093, P=0.000)]; [(52.8±4.4) mmHg vs. (35.6±3.2) mmHg (t=19.239, P=0.000)] respectively. Compared with the laparotomy group, laparoscopic group has less intraoperative bleeding volume (280±64 ml vs. 130±60 P 0.05). In addition, there were no significant difference of postoperative pulmonary complications between two groups, while the other complications in the laparoscopy group is less than those in laparotomy group. Conclusion To our knowledge, the pneumoperitoneum in laparoscopy for rectal cancer might have an adverse effect on the respiratory function of patients with COPD, however the minimal invasion could also be achieved in laparoscopic surgery, which could promote the recovery of postoperative pulmonary function, with better short-term clinical outcome. There are similar 2-year survival rate in both laparoscopic and laparotomy group. Key words: Rectal Neoplasms; Pulmonary Disease, Chronic Obstructive; Mesentery; Laparoscopy; Postoperative Complications

Objective To investigate the safety, feasibility and clinical outcome of laparoscopic radical resection of low rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions.Methods From Mar 2010 to Dec 2017,102 patients with low rectal cancers,including 43 males and 59 females with an average age of 59.6 years(ranging from 36 to 81 years)underwent laparoscopic radical resection of low rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions.The distance between the anus and inferior margin of the tumor ranged from 5 cm to 7 cm(85 cases)and 4 cm(23 cases).TNM staging showed that 79 patients had cT1N0M0staging, 23 had cT2N0M0staging.Through the middle approach,the sigmoid mesentery was freed at the root with an ultrasonic scalpel, and the inferior mesenteric artery and vein was clamped and cut.Following the total mesorectal excision(TME)principle,the rectum was dissected to the anorectal ring and 3-5 cm from the distal end of the tumor.The electric knife was used to cut open the mucosa 1.5-2.0 cm above the dentate line.Sharp dissection was performed along the rectal mucosa, upwards, to peel off the rectal mucosa for 2-4 cm,to reach the levator ani muscles, and the rectum was cut circularly.The rectal tumor and distal sigmoid colon were removed from the anus together, then telescopic anastomosis of proximal sigmoid colon and the distal colon and rectal muscle sheath were performed. Results All of 102 patients received successful laparoscopic surgery without conversion.The average operation time was 179 min and the average harvested lymph nodes was 13.There were 3 cases(2.9%)of stoma leakage,who were cured by temporary colostomy and closure of the stoma 3 months later.The postoperative follow-up ranged from 6 to 84 months (average of 45 months), with 2 cases(1.9%)of stoma stenosis who received expansion treatment. Postoperative pathological results showed that 49 patients had pT1-2N0M0staging,53 had pT2N1M0staging. Twelve months after surgery,94.1% patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal.There were 4 cases(3.9%)of local recurrence within 3 years after surgery,with 100% 3-years-survival. Conclusion Laparoscopic radical resection of low rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions is safe, reliable and mini-invasive,without incision and scar on the abdominal wall with satisfactory clinical outcome.

Objective The aim of this study was to investigate the efficacy of lesion-oriented whole-liver computed tomography (CT) perfusion for predicting transarterial chemoembolization early treatment response in patients with hepatocellular carcinoma (HCC). Methods Volume helical shuttle CT perfusion imaging on the whole liver was prospectively performed on 39 patients with 46 independent HCC lesions before target-selected chemoembolization. The therapeutic effects were assessed: responder group included lesions with a complete and partial response, whereas the nonresponder group contained stable and progressive disease. The perfusion parameter value comparison between 2 groups and receiver operating characteristic analyses were performed. Results The responders demonstrated higher hepatic arterial perfusion (HAP) and hepatic arterial perfusion index (HAPI) and lower hepatic portal perfusion (HPP) compared with the nonresponders among the 34 lesions without Vp3 or Vp4 portal vein thrombosis. In addition, HAP and HAPI had good prognostic values. Conclusions Whole-liver CT perfusion allows for hemodynamic evaluation of HCC lesions. The HAP, HAPI, and hepatic portal perfusion values may be useful predictors of short-term therapeutic response after transarterial chemoembolization.

Objective To summarize and analyze the clinical features and etiologies in hospitalized patients with syndrome of inappropriate antidiuretics (SIAD) during the past 25 years.Methods All data of 128 patients with SIAD admitted to Chinese PLA General Hospital since January 1991 to January 2016 were collected.SIAD was diagnosed based on the 1957 criterion.Results (1) The most frequent causes of increased inappropriate secretion of vasopressin were malignant tumors , lung diseases ( e.g.pneumonia ) , and central nervous system diseases , in which malignant tumors accounted for 38.28% of the SIAD.(2) During the past 25 years, the proportion of malignant diseases declined from 4/7 to 35.29%, while, the proportion of pulmonary infection increased from 1/7 to 35.29% ( P<0.05 ) .( 3 ) The patients with malignant tumors had the lowest serum sodium and serum osmolality among all SIAD patients .(4) CT scan had a high diagnostic value for chest and brain detection .( 5 ) Among three SIAD subjects with unknown reasons at onset , two were diagnosed with small cell lung cancer and one with gastric cancer during follow -up.Conclusion The etiology of SIAD is complex and it could be attributed to multifarious etiological factors.Malignant tumors account for the largest proportion of all patients , and pulmonary infection was ranked in second place .Cautions on tumors have to be taken when serum sodium of a SIAD patient is below 118.1 mmol/L.

Objective To investigate the safety , feasibility and clinical outcome of laparoscopic abdominal peritoneal resection ( APR ) and colostomy by using stapler without abdominal incision for low rectal cancer. Methods From Jan 2010 to Dec 2016, 106 patients with low or ultralow rectal cancers , including 59 males and 47 females with an average age of 60.7 years ( ranging from 34 to 87 years ) underwent laparoscopic APR and colostomy by using stapler without abdominal incision . The distance between the anus and inferior margin of the tumor ranged from 2 cm to 5 cm.TNM staging showed that 65 patients had cT1-2 N0 M0 staging, 41 had cT2 N1-2 M0 staging.Clinical data of 106 patients were analyzed retrospectively. Results All of 106 patients received successful laparoscopic surgery without conversion . The average operation time was 149 min.The average intraoperative blood loss was 50 ml.Bowel movement recovered 2-3 days after surgery .The first postoperative ambulation ranged from 3 to 4 days.Average postoperative hospital stay was 12 days.Postoperative pathological results showed that 27 patients had pT1-2 N0 M0 staging, 79 had pT2-3 N1-3 M0 staging.There were no postoperative complication such as delayed incision heal, stoma necrosis or retraction .There were 2 cases (1.8%) of early postoperative inflammatory small bowel obstruction , who were cured by gastrointestinal decompression and traditional Chinese medicine treatment.The postoperative follow-up ranged from 3 to 73 months, with 3 cases (2.8%) of stoma stenosis who received reconstructive surgery .There were 4 cases (3.7%) of local recurrence within 3 years after surgery. Conclusion Laparoscopic abdominal peritoneal resection (APR) and colostomy by using stapler without abdominal incision for low rectal cancer is safe , reliable and mini-invasive, without incision and scar on the abdominal wall with satisfactory clinical outcome .

Objective To evaluate the characteristics of glucose metabolism and the possible mechanisms of glucose metabolism disorder in patients with Klinefelter's syndrome (KS). Methods This was a retrospective clinical research. The following data were collected and analyzed:the general condition, gonadotropic and gonadal hormone levels, lipid and glucose profiles, glucose and insulin levels after a 75 g oral glucose tolerance test, and homeostasis model assessment of insulin resistance (HOMA-IR) in 19 patients with KS alone, 9 patients with both KS and DM, 18 DM patients without KS;all were hospitalized in PLA General Hospital since 1990. Independent sample t test was used for comparison betneen two groups. Results (1)The incidence of DM in KS patients was 32.1% (9/28); in patients with 47,XXY karyotype and 48,XXYY karyotype the incidence were 30.7%(8/26) and 50%(1/2), respectively;(2)Compared with simple KS patients, patients with both KS and DM was significantly older, while the testosterone (T) level was significantly lower[(28 ± 8)vs (22 ± 4) year,(2.0 ± 1.3) vs (5.4 ± 4.3) nmol/L,t=3.044,-2.249;all P<0.05];Although they had similiar fasting insulin level and area under the curve of insulin, KS patients complicated with DM presented a much higher insulin resistance index(6.5 ± 3.4 vs 1.2 ± 2.1,t=3.234,P<0.05);(3)KS patients complicated with DM were much higher and heavier than simple DM patients[(178±12)vs(170±6) cm,(91 ± 23)vs(80 ± 14)kg,t=0.750,3.866;P<0.05]. The low-density lipoprotein concentration in patients with both KS and DM were lower than that of the patients with KS alone [(2.13±0.93)vs(2.85±0.50) mmol/L, t=-2.681;P<0.05],but their glucose and insulin levels during an oral glucose load were not different between two groups;(4)The estradiol-to-testosterone ratio of KS patients complicated with DM was significantly higher than that of simple KS patients as well as simple DM patients(t=2.302,2.748;P<0.05). Conclusions (1)KS patients tend to develop late-onset DM;(2)The possible risk factors of glucose metabolism disorder in KS patients are age, testosterone level, insulin resistance, high estradiol-to-testosterone ratio and abnormalities of X chromosome.

Objective To investigate the safety, feasiblity and clinical efficacy of laparoscopic resection of rectal cancer by using double-stapling anastomosis method. Methods From Jan 2009 to Dec 2015, 103 patients including 59 men and 44 women, aged 32-85 years (mean age of 61.6 years) underwent laparoscopic resection of rectal cancer by using double-stapling anastomosis method in Department of general surgery , General hospital of PLA Army.The tumors were 7-12 cm away from the anal margin.In preoperative assessment, there were 26 cases of T1 N0 M0 and 77 cases of T2-4 N1-3 M0 .Clinical data were analyzed retrospectively, including laparoscopic operation time, intraoperative blood loss, number of harvested lymph nodes, postoperative evacuating time, hospital stay, incidence of complications, anal function.Follow-up were lasted to April 2015 by using clinic service or telephone. Results For the present cohort of 103 cases, all of whom received successful operation, with an average of 12 lymph nodes detected, including 12 cases of preventive diverting stoma of transverse colon or ileum and closure operation 3 months later.Postoperative evacuating time were 3-5 days with average hospital stay of 11 days.The postoperative pathology showed T1-T2 N0 M0 in 15 cases, T2-4 N1-3 M0 in 82 cases and T2-4 N1-3 M1 in 6 cases.The patients were followed up for 3-50 months, with an average of 26 months.Three case (2.9%) of postoperative anastomotic leak was observed, 2 cases requiring temporary colostomy, which was closed and recovered 3 months later, 1 case received conservative treatment and were cured 1 month later.Two cases (1.9%) of stoma stenosis were observed, and were cured by dilatation.There was 4 cases of local recurrence&nbsp;(3.8%) . Conclusion Laparoscopic resection of rectal cancer by using double-stapling anastomosis method is mini-invasive , safe and feasible with satisfactory clinical efficacy .

The prevalence of obesity is rising year by year. The disease can lead to multiple organ systems, and cause male infertility, female infertility and reproductive system tumor, etc. Its prevalence is increasing every year. Gonad hypofunction can also lead to obesity, both influence each other. Most obese are induced by bad personal lifestyle. Gonad axis dysfunction associated with obesity is reversed after the intervention of obesity. Gonad hypofunction causes obesity mainly by the lack of sex hormones and gonad hypofunction because obesity is mainly caused by the lack of sex hormones (testosterone and estrogen), showed as abdominal obesity, high blood sugar, blood lipid disorder and insulin resistance and other metabolic disorders. Giving corresponding sex hormone treatment, weight can drop, and metabolic disorders can be corrected to a certain extent.

AIM:To assess laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions.METHODS:From March 2010 to June 2014, 30 patients (14 men and 16 women, aged 36-78 years, mean age 59.8 years) underwent laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through anus-preserving transanal resection. The tumors were 5-7 cm away from the anal margin in 24 cases, and 4 cm in six cases. In preoperative assessment, there were 21 cases of T1N0M0 and nine of T2N0M0. Through the middle approach, the sigmoid mesentery was freed at the root with an ultrasonic scalpel and the roots of the inferior mesenteric artery and vein were dissected, clamped and cut. Following the total mesorectal excision principle, the rectum was separated until the anorectal ring reached 3-5 cm from the distal end of the tumor. For perineal surgery, a ring incision was made 2 cm above the dentate line, and sharp dissection was performed submucosally towards the superior direction, until the plane of the levator ani muscle, to transect the rectum. The rectum and distal sigmoid colon were removed together from the anus, followed by a telescopic anastomosis between the full thickness of the proximal colon and the mucosa and submucosal tissue of the rectum.RESULTS:For the present cohort of 30 cases, the mean operative time was 178 min, with an average of 13 positive lymph nodes detected. One case of postoperative anastomotic leak was observed, requiring temporary colostomy, which was closed and recovered 3 mo later. The postoperative pathology showed T1-T2N0M0 in 19 cases and T2N1M0 in 11 cases. Twelve months after surgery, 94.4% patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. The patients were followed up for 1-36 mo, with an average of 23 mo. There was no local recurrence, and 17 patients survived for > 3 years (with a survival rate of 100%).CONCLUSION:Laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions is safe and feasible.

Objective To assess the safety, feasibility and clinical outcome of laparoscopic radical resection of right hemicolon cancer. Methods Thirty patients with right hemicolon cancers underwent laparoscopic right hemicolectomy From January 2013 to September 2014 in the Department of General Surgery, General Hospital of PLA Beijing Military Command.Preoperative diagnosis was confirmed by biopsy under coloscopic examination in 13 cases of ileocecal junction cancer, 11 cases of ascending colon cancer and 6 cases of hepatic flexure of colon cancer.Preoperative TNM staging was performed using CT or MRI in 6 cases of stageⅠ, 18 cases of stageⅡ and 6 cases of stage Ⅲ.Clinical data of the 30 patients were all collected and analyzed. Results In the 30 patients, laparoscopic surgery was performed successfully without conversion.The mean operative time was 126 minutes.The average blood loss was 36 ml, and a total of 13 lymph nodes were harvested.Bowel movement was recovered 3 days after the operation and the postoperative hospital stay was 9 days without complications.Postoperative pathological assessment showed stageⅠin 4 cases, stageⅡin 18 cases and stageⅢin 8 cases.All the 30 patients were followed up for 3-20 months, with an average of 10 months.There was no local recurrence and all the patients survived. Conclusions Laparoscopic radical resection of right hemicolon cancer by a median approach is safe and feasible with satisfactory clinical outcome.

Objective To assess the clinical outcome of double-loop anastomosis of gastrointestinal reconstruction in laparoscopic radical resection of gastric cancer. Methods The clinical data of 18 patients with gastric cancer who had been treated from March 2008 to December 2014 were analyzed retrospectively. These patients underwent a double-loop anastomosis of gastrointestinal reconstruction in laparoscopic resection of gastric cancer, including total gastrectomy for 8 patients and distal subtotal gastrectomy for 10 patients. Their clinical data included operation time, intraoperative blood loss, number of harvested lymph nodes, recovery of bowel movement, hospital stay, postoperative complications, gastrointestinal function and 3-year local recurrence rate.The patients were followed up at the out-patient clinic or by telephone until March 2015. Results The 18 patients were operated upon successfully, with an average of 238 minutes for total gastrectomy and 217 minutes for distal subtotal gastrectomy.The average intraoperative blood loss was 180 ml and a total of 16 positive lymph nodes were detected.Postoperative gastric emptying dysfunction in 3 patients was treated conservatively.No positive resection margin and perioperative death were found and their hospital stay was 12.6 days. Conclusion Laparoscopic radical resection of gastric cancer by double-loop anastomosis of gastrointestinal reconstruction is feasible, with rapid recovery, less complications and satisfactory short-term clinical outcome.The Long-term clinical outcome of this procedure needs further investigation.

Objective To investigate the clinical efficacy of laparoscopic radical resection for rectal cancer using transanal telescopic anastomosis.Methods The clinical data of 52 patients with low rectal cancer who underwent laparoscopic radical resection using transanal telescopic anastomosis at the General Hospital of Beijing Military Command from March 2010 to December 2014 were retrospectively analyzed.Patients with T2N1 stage received the routine chemotherapy after operation.The evaluating indexes of clinical efficacy included operation time, volume of intraoperative blood loss, number of lymph nodes dissection, time to anal exsufflation, pelvic drainage-tube removal time, duration of hospital stay, postoperative complications, marginal states, postoperative anal defecation function and local recurrence of tumors.Patients were followed up by outpatient and inpatient examinations and telephone interview up to March 2015, and follow-up included the occurrence of complications, postoperative anal defecation function and local recurrence of tumors.Measurement data with normal distribution were presented as-x ± s, and measurement data with skew distribution were described as M (range).Results Fifth-two patients underwent transanal laparoscopic sphincter-preserving radical resection using telescopic anastomosis successfully.The operation time, volume of intraoperative blood loss, number of lymph nodes dissection, time to anal exsufflation, pelvic drainage-tube removal time and duration of hospital stay were (150 ±36) minutes, (16 ± 9) mL, 12 ± 9, (2.0 ± 1.5) days, (5.0 ± 2.0) days and (9.0 ± 2.5) days, respectively.One patient with anastomotic fistula was cured by transverse colostomy, with a stoma healing 3 months later.The postoperative pathological examination showed there were 46 patients with high-and moderate-differentiated adenocarcinomas and 6 patients with poor-differentiated adenocarcinomas, and T1-2N0M0 stage was detected in 29 patients and T2N1-2M0 stage in 23 patients.The distal and circumferential resection margins of tumors were negative.The defecation of 6-9 times/day in 52 patients after postoperative early food intake was reduced to 3-6 times/day after taking orally compound diphenoxylate tablets 2 pills each time and 3 times a day for 2-3 days.Twenty-three patients with T2N1 stage or above underwent postoperative routine chemotherapy.Fifth-two patients were followed up for a median time of 29.7 months (range, 3.0-51.0 months).The defecation control was improved remarkably at 2-3 months after operation.There was 94.2％ (49/52) of patients with Kirwan grade lof anal defecation function at postoperative month 12, and anal defecation function had basically returned to normal.There were 3 patients with Kirwan grade 2 of anal defecation function.One patient complicated with anastomotic stenosis had remission by anal expansion treatment during follow-up.Patients had no local recurrence of tumor with good quality of life.Conclusion Laparoscopic radical resection for low rectal cancer using transanal telescopic anastomosis is safe and feasible without abdominal incision, with a good cosmetic effect and satisfactory short-term outcome.

Objective To assess the safety, feasibility and clinical outcome of laparoscopic radical resection for low rectal cancer with telescopic anastomosis or with colostomy by stapler through transanal resection without abdominal incisions. Methods From January 2010 to September 2014, 37 patients underwent laparoscopic radical resection for low rectal cancer through transanal resection without abdominal incisions. The tumors were 4-7 cm above the anal verge. On preoperative assessment , 26 cases were T1N0M0 and 11 were T2N0M0. Results For all cases, successful surgery was performed. In telescopic anastomosis group, the mean operative time was (178±21) min, with average blood loss of (76±11) ml and (13±7) lymph nodes harvested. Return of bowel function was (3.0±1.2) d and the hospital stay was (12.0±4.2) d without postoperative complications. Patients were followed up for 3-45 months. Twelve months after surgery, 94.6%(35/37) patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. Conclusions Laparoscopic radical resection for low rectal cancer with telescopic anastomosis or colostomy by stapler through transanal resection without abdominal incisions is safe and feasible. Satisfactory clinical outcome can be achieved mini-invasively.

Objectives To investigate the safety,feasibility and clinical outcome of laparoscopic anus-preserving anterior resection via telescopic colorectal mucosal anastomosis (TCMA) for low rectal cancer.Methods 23 patients with low rectal cancers,including 11 males and 12 females with an average age of 59.8 years underwent laparoscopic transabdominal and transanal anterior resection,followed by TCMA.The distance between the anus and inferior margin of the tumor ranged from 5 cm to 7 cm in 20 patients,and 4 cm in 3 patients.16 patients were on cT1N0M0 stage,7 on cT2N0M0 stage.Surgery was performed according to the TME principles,with dissection of mesocolon,high ligation of the inferior mesenteric artery and dissection to the levator ani.The rectum was mobilized 3-5 cm distal to the tumor to facilitate the perianal approach.A circumferential incision of the mucosa was made at 1 cm above the dentate line.Dissection was performed by mobilizing the rectum through the mucosal plane to approximately 2-4 cm and then the distal margin of the rectum was clamped and cut,with preservation of the entire muscular sheath of the rectum.The distal end of the colon was pulled through the anus,and TCMA of the sero muscular layer and muscular sheath was performed.Results The average operation time was 183 min.Average harvested lymph nodes was 13.Anastomotic leakage developed in one,cured by colostomy and subsequent closure.Pathology showed that 14 patients were of pT1-2N0M0 stage,9 on pT2N1M0.Continence was good when scored on 6 months after resection.Postoperative follow-up ranged from 1 to 36 months with a median time of 23 months,without local recurrence.Conclusions Laparoscopic anus-preserving rectectomy via TCMA for patients with low rectal cancer is safe,reliable and mini-invasive,with satisfactory mid term continence.

SIADH是住院低钠血症患者的最常见原因之一，以稀释性低血钠、低血浆渗透压、尿钠和尿渗透压升高为主要表现。因患者致残、致死率高，故明确诊断至关重要。诊断为排他性，需与其他引起低钠血症的病因进行仔细鉴别。治疗方面包括病因治疗和对症治疗。对症治疗方面，目前国际指南推荐限水治疗为一线治疗措施，而抗利尿激素受体拮抗剂疗效确切，具有非常广阔的应用前景。

Colorectal cancer (CRC) remains one of the most common cancers worldwide. HS1-associated protein X-1 (HAX-1) has been highlighted as an important marker in many types of cancers. However, little is known about the role of HAX-1 in CRC. The aim of this study was to analyze the correlation of HAX-1 expression with the clinicopathological features of CRC. The protein and mRNA levels of HAX-1 were examined by immunohistochemistry (IHC) and real-time quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR) in CRC tissues and adjacent noncancerous tissues. Survival curves were made with follow-up data. The relations of the prognosis with clinical and pathological characteristics were analyzed. Using IHC and RT-qPCR, we showed that HAX-1 expression was significantly higher in CRC tissues than in adjacent noncancerous tissues (P < 0.05). High HAX-1 expression was significantly associated with lymph node metastasis (P = 0.034) and tumor (T) node (N) metastasis (M) stage (P = 0.028) of patients with CRC. The Kaplan-Meier survival curves indicated that overall survival was significantly worse in CRC patients with HAX-1 overexpression. Multivariate analysis showed that high HAX-1 expression was an independent predictor of overall survival. In conclusion, our data for the first time provide a basis for the concept that overexpression of HAX-1 may contribute to the malignant progression of CRC and predict poor prognosis for patients with this disease. HAX-1 might be an important marker for tumor progression and prognosis, as well as a potential therapeutic target of CRC.

AIM:To compare the efficacy and tolerance of ilaprazole compared with other proton pump inhibitors(PPIs)in the treatment of duodenal ulcer.METHODS:An electronic database search of Medline,Embase,the Cochrane controlled trials register,Web of Science,PubMed,and the Chinese Biomedical Literature Database(updated to July 2013),and manual searches were conducted.A meta-analysis of randomized controlled trials comparing the efficacy and tolerance of ilaprazole and other PPIs in the treatment of duodenal ulcers was performed.RESULTS:Five articles involving 1481 patients were included.The meta-analysis showed no difference in the4-wk healing rate between ilaprazole and other PPIs[89.7%vs 87.0%;relative risk(RR)=1.02;95%CI:0.98-1.06;Z=1.00;P=0.32].The results did not change in the sensitivity analyses.The meta-analysis indicated that the adverse effect rate in the ilaprazole group was lower than that in the control group,but the difference was not significant(9.7%vs 13.0%;RR=0.81;95%CI:0.60-1.07;Z=1.47;P=0.14).CONCLUSION:Ilaprazole is a highly effective and safe PPI in the treatment of duodenal ulcers.Ilaprazole can be recommended as a therapy for acid-related disorders,especially in Asian populations.

AIM:To determine the clinical outcome of single-visit root canal therapy with GuttaFlow in mo-lar root canal therapy .METHODS:102 molars with 325 root canals were treated by single-visit filling with GuttaFlow (163 canals) and deep blue cataplasm(162 canals) respectivey.Quality of filling was assessed using radiograph .The pain intensity within 1 week after treatment and the therapeutic outcome were evaluated by 12-month follow-up. RESUTS:Radiographic scores of root filling quality of Gutteflow group were significantly better than those of control group (P<0.05).No significant difference was observed between the 2 groups at 1 year follow -up (P>0.05). CONCLUSION:Single-visit root canal therapy using GuttaFlow technique result in less postoperative reaction and may produce reliable therapeutic outcome in 1 year.

<正>1病例报告患者男,56岁。因左侧阵发性头痛1年余,加重1个月到我院就诊。患者起病初曾在当地县医院就诊,诊断为鼻窦炎,给予药物治疗未见好转。半年后症状渐加重,到多家医院神经内科就诊,建议口腔科会诊,经口腔专家会诊未发现异常情况,考虑头痛与牙病无关。先后行头颅CT和MRI等检查,均未发现异常,诊断为血管神经性头痛,建议观察治疗。此后,患者阵发

目的 观察连续性血液净化(CBP)救治慢性肺源性心脏病并重度低钠血症的疗效.方法 采用随机数字表法分为两组,对照组19例采用抗感染、改善通气、加强营养、必要时无创机械通气支持等常规方法治疗,并积极寻找病因,去除诱发因素,同时予以静脉补钠纠正低钠血症.CBP组19例在上述常规治疗基础上,联合CBP救治.比较CBP组患者治疗前和治疗后4、8、12、24、36、48 h的血钠及血浆渗透压检测结果；比较对照组和CBP组患者治疗前和治疗后第1、2、3天血钠及血浆渗透压的检测结果；比较对照组及CBP组患者治疗前和治疗后第1、2、3天的Glasgow评分及APACHE评分及两组患者的病死率.结果 CBP组治疗后4h与治疗前的血钠及血浆渗透压比较,有统计学差异(P＜0.05)；治疗后8、12、24、36、48 h与治疗前的血钠及血浆渗透压比较明显提高,差异有显著统计学意义(P＜0.01).CBP组患者治疗后24、48、72 h血钠及血浆渗透压与对照组相同时间的指标比较明显升高,有显著统计学差异(P＜0.01).两组患者治疗前的Glasgow评分与APACHE评分比较无统计学差异(P＞0.05)；与对照组比较,CBP组患者治疗后24 h及48 h Glasgow评分明显上升,而APACHE评分明显下降,差异均有统计学意义(P＜0.05)；对照组患者病死率明显高于CBP组,差异有显著统计学意义(P＜0.01).结论 CBP救治慢性肺源性心脏病伴重度低钠血症的疗效显著,耐受性好,不良反应低,比较安全,并可在床边进行治疗,便于对患者的观察及抢救,为临床提供了一种安全、有效的治疗方法.