BACKGROUND: Many studies thought that predegenerated nerve graft (PNG) is superior to fresh nerve graft (FNG).OBJECTIVE: To observe the effect of predegeneration on nerve functional recovery from histological,immunocytochemical,electrophysiological and microstructural aspects based on predegenerated nerve graft to common peroneal nerve at different time periods.DESIGN: Grouping and controlled experiment SETTING: General Center of Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University of Chinese PLA MATERIALS: Totally 42 rabbits, with body mass ranged from 2.3 to 2.6 kg,of either gender, were used in this experiment METHODS: This experiment was conducted at the General Center of Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University of Chinese PLA in 1996. Totally 42 rabbits were divided into 7experiment groups A, B, C, D, E, F, G for nerve grafts of different predegenerated periods. In groups A, B, C, D, E, F, both side of the rabbits peroneal nerves were allowed to undergo predegeneration for 0, 4, 7, 14,21, 28 days; common peroneal nerve of the rabbits in the Groups B, C, D,E and F were cut off; The skin of the animals in Group A was cut open,exposed but the nerve was not cut off. Only the right common peroneal nerve in Group G was cut off. The cut nerve in Groups B, C, D, E and F were re-exposed respectively at 4,7,14,21 and 28 days after operation. 1.5 cm-length degenerated distal nerve segment was chosen for transplantation and reparation contrafateral nerve. Two sides were transplanted mutually. Common peroneal nerve in Group A was re-exposed 2 weeks later, 1.5 cm-length nerve segment was cut in the same way for mutual transplantation. In Group G, the predegenerated nerve segment of the right side was transplanted to the fresh receptor of the left side 2weeks later. The fresh nerve segment of left segment was transplanted to degenerated receptor of the right side.Histological observation, passing rate of axon counting shortened significantly the initial delay period of axonal regeneration (from 3.04 to 0.04 day), accelerated the axonal growing rate (1.73-2.59 mm/d)as compared with FNG; Electrophysiological study showed that N-MCV in the Groups D, C and B was the fastest, followed by Group A and Group E,Group F was the slowest; there was no significant difference in passing rate appeared in the animals of Group D after operation, middle-quantity of myelin sheaths appeared in the Group C and few myelin sheaths in the Groups A, B, and F.CONCLUSION: PNG excels FNG at decreasing initial delay period of axonal regeneration, promoting regeneration velocity of axon, boosting up passing rate of axon and enhancing N-MCV. Nerve grafting for predegenerated for 14 days can enhance significantly nerve regeneration than fresh nerve grafts, then grafts degenerated for 7 days. Grafts degenerated for 4 and 21 days can also enhance axonal regeneration lightly.

Objective To investigate the clinical effects, the therapy reactions,the living qualities of three treatments in advanced nasopharyngeal carcinoma. Methods From Jan 2001 to Jun 2002, 120 patients pathologically confirmed NPC who firstly underwent radiotherapy were divided into two groups: radiotherapy with concurrent chemotherapy group(RC, n = 60, 5 fractions per week, one time per day, 200 cGy per day to a total dose of 7 000 ～ 8 000 cGy. cisplatin and 5-Fu two cycles in the first and fourth week during radioation); radiotherapy with AiDi injection group(RAD, n = 60, radiotherapy was the same as that of RC. Continuously injecting AiDi for 10 days 50 ml per day was one cycle which was repeated 3 cycles every alternation of 7 days); another 60 patients who contemporaneity reciceved radiotherapy alone (radiotherapy was the same as that of RC) because of some reasons and were comparable in clilical materials were regarded as the third group (R) to compare with the above two groups. The life quality, 3-year survival rate, and acute or chronic radiation reactions in the three groups were observed. Results All patients were followed up for more than 3 years: the 3-year survival rate in RC (73.3%),which was homologous as that in RAD(65.0 %, P =0.347), was higher than that in R group(53.3%,P = 0.028), and the local recurrent was inverse(10.0%,26.7%,P = 0.033 6). The acute and chronic radiation reactions in RC was highest whereas that in RAD group is lowest(P

Twenty-six patients with stenosis of the thoracic spinal canal and myelopathy caused by ossification of the ligamentum flavum were treated from 1983 to June 1991. There were 21 patients with spastic paraplegia and 5 with flaccid paraplegia in the series. The findings on radiograms, CT scans, myelograms and MRI were described. Total laminectomy was performed in all of the patients which resulted in an effective rate of 91.6% and exellent and good results in 83.3%. The mechanism of the disease our experience in diagnosis and surgical treatment, causes of misdiagnosis and surgical techniques are discussed.

Objective To evaluate the efficacy and toxicity of induction chemotherapy with nedaplatin and docetaxel plus concurrent intensity?modulated radiotherapy ( IMRT) with nedaplatin or cisplatin in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 223 patients with pathologically diagnosed locally advanced NPC in five treatment centers from 2011 to 2012 were randomly divided into two groups. In the test group, one hundred and thirteen patients received two cycles of induction chemotherapy with docetaxel (65 mg/ m2 on day 1) and nedaplatin (80 mg/ m2 on day 1) plus concurrent IMRT with nedaplatin (40 mg/ m2 on day 1). In the control group, 110 patients received two cycles of induction chemotherapy with the same regimens plus concurrent IMRT with cisplatin (40 mg/ m2 on day 1). The survival rates were calculated with the Kaplan?Meier method and the differences in the survival rates between the two groups were analyzed using the log?rank test. Comparison of the incidence rates of adverse reactions between the two groups was made by the chi?square test. Results The follow?up rate was 99?? 1%.The response rates at 3 months after treatment in the two groups were both 100%. The 2?year local recurrence?free, regional recurrence?free, distant metastasis?free, and overall survival rates were 94?? 0%, 94?? 2%, 88?? 2%, and 90?? 3%, respectively, in the test group, versus 93?? 4%, 94?? 1%, 86?? 7%, and 87?? 3% in the control group ( P= 0?? 757、 0?? 478、 0?? 509、 0?? 413). The incidence rates and severity of leucopenia, neutropenia, and thrombocytopenia were significantly higher in the test group than in the control group ( P= 0?? 027 , 0?? 028 , 0?? 035 ) . The incidence rates and severity of hemoglobin reduction and nausea /vomiting were significantly lower in the test group than in the control group (P= 0?? 000,0?? 023). There were no significant differences in the incidence rates of mucositis and xerostomia between the two groups ( P=0?? 483,0?? 781). Conclusions The short?term efficacy of induction chemotherapy with nedaplatin and docetaxel plus concurrent IMRT with nedaplatin is similar to that with cisplatin in the treatment of locally advanced NPC. The mild gastrointestinal reactions can be tolerated by patients. However, the severe myelosuppression should be closely monitored during the treatment.

Background and purpose:Bladder cancer is the most common urological tumor, and its pathogen-esis is still not fully understood. The study was aimed to observe the expressions of key genes in many tumor-associated signaling pathways in normal bladder tissue and bladder carcinoma, and to provide further evidence for the subsequent study of bladder cancer recurrence and metastasis.Methods:Twenty-seven cases of bladder cancer specimens were col-lected, and normal bladder tissues and bladder cancer tissues were distinguished by frozen section. Then, the expressions of 84 genes of cancer-related signaling pathways in bladder cancer tissues and normal bladder tissues were screened by Cancer Pathway Finder PCR Array produced by QIAGEN company.Results:Compared with the normal bladder tissues, the bladder carcinoma tissues had 8 up-regulated genes and 19 down-regulated genes. In this study, the impact of epithe-lial-mesenchymal transition (EMT) signaling pathway was selected as a research direction in which theGSC,KRT14,DSP were up-regulated,SNAI2,SNAI3 were down-regulated. ThereforeGSC,KRT14,DSP,SNAI2 andSNAI3 were chosen as target genes, and verified by qRT-PCR in many examples. The result showed that the expressions ofGSC gene in bladder cancer tissues were up-regulated, but with no statistical significance;KRT14,DSP expressions in bladder cancer were higher than those in normal bladder tissues (P<0.05);SNAI2,SNAI3 expressions in bladder cancer were lower than those in normal bladder tissues (P<0.05), andSNAI3 showed the most obvious expression differences.Conclusion:KRT14,DSP andSNAI3 may play an important role in bladder cancer’s occurrence, development and metastasis.

Objective To evaluate the treatment efficacy,toxicities and prognostic factors of nasopharyngeal carcinoma ( NPC ) treated with intensity modulated radiation oncology ( IMRT ).Methods Between January 2006 and August 2008,300 patients with pathologically diagnosed NPC from 6 center received IMRT.The number of patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳa+b disease (UICC/AJCC 2002 staging system) were 6,45,141 and 108,respectively.The prescription doses were as follows:70-74 Gy/30f toplanning target volume of primary nasopharynx tumor ( PTVRλ),68-70 Gy/30f to planning target volume of positive lymphnode (ptvnd),60-64 Gy/30f to higher risk region (PTV1),50-54 Gy/30f to lower risk region (PTV2).Patients with stage Ⅲ and Ⅳa+b disease also received cisplatin-based chemotherapy.Cox method was used for Multivariate analysis.ResultsThe follow-up rate was 99.7％.The 4-year rate of local control,regional control,metastasis-free survival (DMFS),disease-free survival (DFS) and overall survival (OS) was 94.0％,95.5％,87.4％,80.8％,86.1％,respectively.Mucositis was the most severe acute toxicity,with 18.0％grade 1,48.7％grade 2,33.3％grade 3.No patient suffered from grade 4mucositis.Xerostomia was the most common late toxicity,with 12.0％ grade 0,75.7％ grade 1,12.3％grade 2.No grade 3-4 xerostomia was observed.There were 18,15 and 42 patients failed in local,regional and distant metastasis,respectively.Multivariate analysis showed that N stage was the only prognostic factor for OS (x2 =5.17,P=0.023),DMFS (x2 =6.91,P=0.009) and DFS (x2 =8.15,P=0.004) in these patients.ConclusionsIMRT can improve the treatment efficacy of NPC.The acute and late toxicities were tolerated.Distant metastasis becomes the main treatment failure.N stage is a significant prognostic factors.

Objective To evaluate the safety of cetuximab combined with intensity-modulated radiotherapy (IMRT) plus concurrent cisplatin chemotherapy in locoregionally advanced nasopharyngeal carcinoma (NPC) in a Chinese multicenter clinical study.MethodsFrom July 2008 to April 2009,100Patients with primary stage Ⅲ- Ⅳb non-keratinizing NPC were enrolled.The planned dose of IMRT to gross tumor volume and positive cervical lymph nodes was 66.0-75.9 Gy and 60-70 Gy in 30-33 fractions.Cisplatin (80 mg/m2,q3 week (w)) and cetuximab (400 mg/m2 one w before radiation,and then 250mg/m2 per w) were given concurrently.The adverse events (AEs) were graded according to common terminology criteria for adverse events v3.0.ResultsThe compliance of the entire group of patient was satisfactory.Actual median dose to gross tumor volume was 69.96 Gy,and the median dose to positive cervical lymph nodes was 68 Gy.Median dose of cisplatin was 133 mg,median first-dose of cetuximab was 690 mg,and median weekly dose was 410 mg.AEs were well tolerated and manageable,mainly consisting of acneiform skin eruptions,dermatitis and mucositis.Grade 4 mucositis was observed in 2％ of the patients and no other grade 4 AEs were observed.ConclusionsThe combined treatment modality of IMRT +concurrent chemotherapy + cetuximab in loco-regionally advanced NPC is well tolerated.

Objective　To explore the levels of peripheral blood IL-33 and the difference of arteriovenous fistula glucose (Da-jvGlu) after giving Shenqi glucose injection in acute cerebral infarction patients.Methods　The levels of plasma IL-33 and Da-jvGlu were detected in 126 patients of acute cerebral infarction and 10 normal controls.The correlation between IL-33 and cerebral infarction was analyzed.Results　Compared with those in normal control group and the pretherapy groups,the levels of IL-33 in large volume were significantly higher (P<0.05).After giving Shenqi glucose injection,the level of IL-33 in mid volume and small volume were significantly higher between groups (P<0.05).Compared with those in normal control group and the pretherapy groups,the level of Da-jvGlu in large volume was significantly higher (P<0.05).After giving Shenqi glucose injection,there was no significant difference of Da-jvGlu in statics between groups (P>0.05).Conclusion　Shenqi glucose injection can affect the levels of IL-33 to protect nerve cells and stabilize blood glucose concentration.

Objective To evaluate the effects of nitrous oxide inhalation on conscious sedation of patients during colonoscopy and analyze its risk factors. Methods From October 2016 to July 2017, a total of 154 patients undergoing colonoscopy were included in the study. The comfort level was rated using Modified Gloucester Comfort Scale ( MGCS). Factors affecting comfort level were analyzed by univariate analysis and multivariate Logistic regression, and then a comfort stratification predicting model was created. Results All 154 patients finished colonoscopy. The mean time of ideal anesthesia state was 195. 15 s. Among the 154 cases, 115 ( 74. 7%) were identified as comfort ( grade of MGCS from 1 to 3) and 39 (25. 3%) were rated as discomfort ( grade of MGCS from 4 to 5). Multivariate regression indicated that age ≥60 years ( P＝0. 000, OR＝1. 074, 95%CI: 1. 036-1. 114) and mild anxiety ( P＝0. 018, OR＝3. 338, 95%CI: 1. 227-9. 079) were associated with comfort level during colonoscopy.The established model with the age (X1) and mild anxiety (X2) was P＝eY/(1+eY), Y＝－3. 812+0. 071X1+1. 205X2(no anxiety was assigned 1, mild anxiety was assigned 2), and the area under the receiver operating characteristics curve was 0. 746 (95%CI: 0. 661-0. 830), which showed moderate predictive power of the final model. The model reached the highest predictive accuracy when the Yoden Index was 0. 838 with sensitivity of 50. 4% and specificity of 89. 7% for predicting comfort level of patients in conscious sedation status induced by nitrous oxide inhalation during colonoscopy. Conclusion Nitrous oxide can ease pain during colonoscopy, especially for patients over 60 years old and with anxiety. We can use it as an option according to actual circumstance in practice.

In this study, we used next-generation sequencing methods to screen 300 individuals for BRCA1 and BRCA2. A novel mutation (c.849dupT) in BRCA2 was identified in a female patient and her unaffected brothers. This mutation leads to the truncation of BRCA2 functional domains. Moreover, BRCA2 mRNA expression levels in mutation carriers are significantly reduced compared to noncarriers. Immunofluorescence and western blot assays showed that this mutation resulted in reduced BRCA2 protein expression. Thus, we identified a novel mutation that damaged the function and expression of BRCA2 in a family with breast cancer history. The pedigree analysis suggested that this mutation is strongly associated with familial breast cancer. Genetic counsellors suggest that mutation carriers in this family undergo routine screening for breast cancer, as well as other malignancies, such as prostate and ovarian cancer. The effects of this BRCA2 mutation on drug resistance should be taken into consideration during treatment.
Blotting, Western ; BRCA2 Protein ; Breast Neoplasms* ; Breast* ; Drug Resistance ; Female ; Fluorescent Antibody Technique ; Genes, BRCA2 ; High-Throughput Nucleotide Sequencing ; Humans ; Mass Screening ; Nonsense Mediated mRNA Decay* ; Ovarian Neoplasms ; Pedigree ; Prostate ; RNA, Messenger ; Siblings