Background and purpose:How to predict the survival length for terminally cancer patients is very important, it will help families and physicians to make decisions. This study aimed to reveal the factors related to the survival time of terminally ill cancer patients who received palliative care in our hospital. Methods:The clinical data of 271 dead patients treated in the Department of Palliative Care, Fudan University Shanghai Cancer Center from Mar. 2007 to Mar. 2012 were analyzed. The Kaplan-Meier method and the log-rank test were used to determine the corresponding factors with survival. Cox regression model was used to examine the independent prognostic factors. Different survival length of groups divided by different prognostic indexes was compared by log-rank test. Results:Seven factors were found to be related with the survival according to univariate analysis. The related factors were Karnofsky performance score (P<0.001), dyspnea (P=0.037), delirium (P=0.015), high white blood cell count (P=0.012), low lymphocyte percentage (P=0.030), high lactate dehydrogenase (P<0.001) and low serum albumin (P=0.001). The multivariate analysis selected four independent factors:Karnofsky performance score<30, high lactate dehydrogenase, low serum albumin and delirium.Conclusion:The study shows the clinical survival prognostics with Chinese characteristics. The combination of the seven factors may be useful but more studies in this area deserve further investigated.

Objective To compare the orthodontic efficacy of the self-locking appliance and the ordinary straight wire appliance.Methods A total of 144 patients from March 2010 to March 2012 at the Department of Stomatology Orthodontic Surgery,Zhejiang Dongyang City People's Hospital were divided into observation group (n =72) and control group (n =72) according to the random number table.The observation group were treated with the self-locking appliance,and the control group were treated with the ordinary straight wire appliance.Results (1) The number of referral unconventional visits had no statistically significant difference between two groups (U =-1.65,P =0.0990).The number of routine visits of observation group was significantly less than that of the control group (U =-2.80,P =0.0052).(2) The VAS score of observation group was significantly lower than that of the control group (U =-8.47,P =0.0000).Conclusions The orthodontic efficacy of the self-locking appliance is obviously better than the ordinary straight wire appliance,and the former-caused pain is lighter.Therefore,the self-locking appliance is more suitable for orthodontic surgery.

砄bjective:To study the effects of superlong pedicled latissimus dorsi muscle transplantation (SPLDMT) in the treatment of facial paralysis.Method: 16 cases of unilateral long standing facial paralysis were treated with SPLDMT in 1991～1998;follow up was conducted and the effects were analysed. Results:After operation satisfied movement recovery of the facial muscles was observed in 12 and improvenent in 3 of the 16 patients,no change was found in only 1 case. Conclusion: SPLDMT is effective in the treatment of unilateral long standing facial paralysis.

Colorectal Neoplasms ; pathology ; Humans ; Neoplasm Staging

Adaptor Proteins, Signal Transducing ; chemistry ; metabolism ; Animals ; Apoptosis ; Cell Differentiation ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Neoplasms ; pathology ; Phosphorylation ; Protein Isoforms ; RNA-Binding Proteins ; chemistry ; metabolism ; Transcription Factors ; antagonists & inhibitors

BACKGROUND:In recent years,bone defect caused by tumor,trauma,infection and so on is always the troublesome problem in the orthopaedics field. Many kinds of bone graft substitute have been exploited to conquer this problem.OsteoSet,a new substitute for bone graft,with the advantage of excellent biocompatibility,degradation,bone conduction and induction of ossification,is an ideal product.OBJECTIVE:To investigate the effect of OsteoSet in repairing bone defects due to tumor.DESIGN:Retrospective study and case analysis.SETTING:Department of Orthopaedics,First Hospital of Jilin University.PARTICIPANTS: Twenty-two patients with bone defect caused by bone tumor who received operation in the Department of Orthopaedics,First Hospital, Jilin University between June 2004 and September 2006.The involved patients,14 male and 8 female,averaged 23 years old ranging from 5 to 68 years.Inclusive criteria:① Diagnosed as benign tumor in bone according to the bone tumor classification criteria instituted in China in 1983.②Had the indications of tumorectomy and bone grafting with OsteoSet substitute.③Informed consent was obtained.The position of tumor was described as 6 in shaft of humerus,2 in neck of femur, 9 in inferior segment of femor, 4 in superior segment of tibia and 1 in celcaneus respectively.METHODS:①Operation procedure:After the effective anesthesia,the tumor was exposed as usual.Then the tumor was resected as thoroughly as we could.When OsteoSet substitute in the bone defect was filled carefully in order to avoid crushing into pieces.At last the substitute should be covered with periosteum or soft tissue.②Postoperative evaluation: The area of substitute absorption was observed by X-ray examination in 4, 8, 12 and 24 weeks after oporation.Postoperatively.incision healing,pain and complications of paients were observed at 6,7,8 and 9 months.MAIN OUTCOME MEASURES: OsteoSet substitute absorption rate and new bone formation rate as well as postoperative follow-up results.RESULTS:Twenty-two patients were involved in the final analysis.①OsteoSet substitute absorption rate and new bone formation rate:The evident absorption of OsteoSet substitute could be found in the X-ray film 4 weeks after operation.At the same time,the slender bone trabecula formed and bone density ncreased.At the end of 12 weeks after operation,about 97.1 percent OsteoSet substitute was absorbed and approximate 95.3 percent new bone infiltrated the defect area. In the 6 months, the substitute absorption rate and the new bone formation rate were 99.1 percent and 98.6 percent respectively. Stable bone trabecula formed in the bone defect area and the new bone connected with the surrounding health bone naturally by remolding.②Follow-up results:All the operative incisions healed well and there were no pain and discomfort in the duration of hospital stay; All the patients had no fever, erythra or other allergic responses during the follow up;The OsteoSet substitute were absorbed well and new bone also formed well in all the cases;All the patients were satisfied with the recovery of limb function.CONCLUSION:The substitute absorption was accordance with the new bone formation.For its good absorption and new bone reconstruction,OsteoSet is an ideal substitute for bone defect caused by tumor.

Objective To explore the influence of earlier nasal continuous positive airway pressure(NCPAP) applying on pulmonary function,and evaluate the clinical results of the early application of NCPAP.Methods Ninety newborn infants with pulmonary dynspnea treated with face mask from Jan.2000 to Nov.2002 were selected as control group.One hundred and ten patients treated with NCPAP from Dec.2002 to Dec.2006 were selected as treatment group.Treatment group applied KD-300 CPAP oxygen therapy equipment NCPAP delivering oxygen.Setting up and adjusting parameter: the beginning flow volume 6-8 L/min,the oxygen therapy bulk(FiO2)30%-50%,the NCPAP pressure was 0.195-0.488 kPa,parameter was adjusted according to the sickness and detecting the transcutancous oxygen saturation(TcSO2).If nasal cannulae Oxygen therapy couldn′t keep the TcSO2 in 85%-93%,the patients in control group were used face mask,small face mask,the oxygen flow vo-lume was 6 L/min,three holes,average FiO2 was 59%.The artery blood oxygen partial pressure [pa(O2)],artery blood carbon dioxide partial pressure [pa(CO2)],oxygenation index(OI),respiration rate(RR) of 2 groups after therapy 4,24 and 72 h were observed,also the difference of recovery rate between the 2 groups were analyzed.Results Compared with the control group,pa(O2) and OI after the application of NCPAP in treatment group were obviously improved(Pa

Monocytes,Kupffer cells,spleen macrophages,lung and peritoneal macrophageswere isolated from same rat simultaneously.The effector cells from diverse anato-mical sites were checked for their tumor cytostatic properties using an in vitro tar-get cell growth inhibition assay through measuring (~3H)-TdR incorporation intotumor cell DNA.All of them expressed spontaneous cytostatic activity against hu- man SMMC-7721 hepatoma and mouse YAC-1 lymphoma cells.The effector cells,except monocytes,were shown to exert inhibition on various target cells with diffe-rences in their susceptibility.The cytostasis against either tumor cell lines variedwith five types of effector cells.The most effective cells for inhibiting the growthof lymphoma were monocytes,and Kupffer cells for heptoma,The effector cellsstimulated by Corynebacterium parvum (CP) in vitro were shown that their cytostaticactivity against YAC-1 was increased up to 140-408%,but to heptoma,it wasdecreased to 48-64%.Furthermore,the efficiency of CP stimulation varied withdifferent effector cells also.It is concluded that monocytes and macrophages withsuch natural selective tumor cytostatic capacity were thus everywhere readily availa-ble for activation.CP may enhance or inhibit the cytostatic effect of monocytes andmacrophages on diverse tumor cell lines.It might suggest that the use of CP in thetumor immunotherapy should be considered with different type of tumors.

Objective To evaluate the effectiveness of mild hypothermia and the intra-aortic balloon pump (IABP) in postcardiac surgical patients with severe heart failure. Methods Twelve patients took combination therapy of IABP and mild hypothermia after cardiac surgery, which did not improve the low cardiac output with massive doses of catecholamine, were included in this study. The values of cardiac index (CI), mixed venous oxygen saturation (SvO2), urine volume and creati-nine (Cr) were measured before and after treatment. Results After combination therapy of IABP and mild hypothermia, the value of CI was improved obviously [L/(min·m2):2.4±0.5 vs 1.6±0.2], the value of SvO2 increased (0.65±0.07 vs 0.52±0.05 ), urine output increased obviously [mL/(kg·h):2.9±1.9 vs 1.2±0.9 ] and the value of Cr decreased obviously (mmol/L:95±10 vs 282±25 ). Conclusion The combination therapy of mild hypothermia and IABP is an effective and simple procedure for the postcardiac surgical patients with severe heart failure.

Objective To investigate the feasibility of total hip arthroplasty through a small anterolateral incision. Methods Total hip arthroplasty through a small anterolateral incision was performed in 53 cases (58 hip joints) from February 2003 to December 2003, including 5 cases of simultaneous replacement of bilateral joints, 6 cases of total hip revision, and 4 cases of hip joint rigidity. The surgical modification features were as follows: the patient was placed in recumbent position, with the involved buttock region slightly hanging over the side of the surgical bed and normally drooping; the involved leg was placed in 10? of adduction, which was helpful to the exposure of the greater trochanter; after the exposure of the neck of the femur and the greater trochanter, osteotomy was performed firstly, then the femoral head was dislocated and removed. Results The length of incision was 7~12 cm (mean, 8.5 cm). The operation time was 70~140 min (mean, 88 min). The blood loss was 250~660 ml (mean, 470 ml). No severe complications occurred. Postoperatively, weight-bearing and mobilization exercise were begun in 6~14 days. All the cases were followed for 4~40 weeks (mean, 28 weeks). The Harris hip scores showed excellent outcomes in 37 cases, good in 12, fair in 4, with a rate of excellent or good results of 92.5% (49/53). Conclusions Total hip arthroplasty through a small anterolateral incision is a feasible procedure that is characterized with minimal invasion, less blood loss and quick recovery. It can be applied in total hip replacement for artificial hip joint revision, hip joint rigidity, or congenital dislocation of hip joint.