1.Hyperthermia Combined with Chemotherapy for Ovarian Cancer:A Meta-analysis
Xiao GU ; Shunchao YAN ; Wusheng LI ; Li ZHAO ; Huawei ZOU
Journal of China Medical University 2015;(6):489-493
Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy(HCT)compared with chemotherapy (CT)for ovarian cancer. Methods Related literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,CNKI and CBM.Then the meta?analysis was performed by using RevMan 5.3 software. Results A total of 10 RCTs involving 546 patients were included. The results of Meta?analysis showed that the HCT group was superior to the CT group in the effective rate,tumor control rate,effective rate of CA125,ascites control rate and PD,with significant differences(P<0.05). There was no significant difference in the improvement rate of life quality and the incidences of myelosuppression,severe myelosuppression,severe nausea and vomiting,severe constipation and diarrhea,liver and renal damage(P>0.05). Conclusion Compared with CT,HCT can significantly increase short?term curative effect,ameliorate the quality of life,and it does not increase the incidence of adverse reactions. HCT is worthy of clinical applica?tion.
2.Expression of c-Met and c-Src in non-small cell lung cancer and its relationship with prognosis
Cheng SUN ; Yonggang TAN ; Shunchao YAN ; Huawei ZOU
Chinese Journal of Postgraduates of Medicine 2019;42(1):31-36
Objective To explore the expressions of c-Met and c-Src in non-small cell lung cancer (NSCLC), and its relationship with clinical pathological characters and prognosis. Methods The c-Met and c-Src expressions were detected by immunohistochemistry in 88 patients with NSCLC from April 2011 to January 2013. The relationship between the expressions of c-Met and c-Src and clinical pathological features and prognosis were analyzed. Results The c-Met and c-Src were all significantly expressed in NSCLC tissues, and no expression showed in interstitial and normal lung tissues. The expressions of c-Met and c-Src in patients with NSCLC were associated with sex, differentiation, pathology type, T staging and TNM staging (P<0.05 or <0.01); and the expression of c-Met was associated with lymph node metastasis (P<0.01). The expressions of c-Met and c-Src in patients with NSCLC were not associated with age, and the expression of c-Src was not associated with lymph node metastasis (P>0.05). Pearson correlation analysis result showed that the expressions of c-Met and c-Src in lung cancer tissues was positive correlation (r=0.662, P<0.01). Kaplan-Meier survival curve analysis result showed that the disease free survival time (DFS) and overall survival time (OS) in c-Met high expression patients (51 cases) were significantly shorter than those in c-Met low expression patients (37 cases): (18.08 ± 1.34) months vs. (23.76 ± 1.79) months and (33.63 ± 1.95) months vs. (42.24 ± 2.68) months, the DFS and OS in c-Src high expression patients (25 cases) were significantly shorter than those in c-Src low expression patients (63 cases): (16.96 ± 2.56) months vs. (21.86 ± 1.15) months and (27.84 ± 2.89) months vs. (40.98 ± 1.81) months, the DFS and OS in both c-Met and c-Src high expression patients (25 cases) were significantly shorter than those in both c-Met and c-Src low expression patients (37 cases): (16.96 ± 2.56) months vs. (23.76 ± 1.79) months and (27.84 ± 2.89) months vs. (42.24 ± 2.68) months, and there were statistical differences (P<0.05). Cox multiplicity result showed that T staging (RR=2.174, 95%CI 1.354 to 3.490, P=0.001) and high expressions of c-Met and c-Src (RR=1.447, 95%CI 1.114 to 1.880, P=0.006) were the independent risk factors of DFS in patients with NSCLC;pathology type (RR=0.610, 95%CI 0.377 to 0.986, P=0.044), T staging (RR=2.215, 95%CI 1.357 to 3.616, P=0.001) and high expressions of c-Met and c-Src (RR=1.979, 95%CI 1.455 to 2.692, P = 0.000) were the independent risk factors of OS in patients with NSCLC. Conclusions The c-Met and c-Src are involved in the development of NSCLC and affect the prognosis of patients with NSCLC.
3.Effectiveness of rotational filling of an inferolaterally pedicled tongue-shaped parenchymal flap via a double periareolar incision on breast ptosis
Kaili YAN ; Chongxu QIAO ; Shunchao YAN ; Zai SHI ; Jingyi XU ; Yuming QU ; Shu WANG ; Wensong SHANGGUAN ; Guoping WU
Chinese Journal of Medical Aesthetics and Cosmetology 2024;30(6):582-587
Objective:To evaluate the effectiveness of correcting breast ptosis using the rotational filling of an inferolaterally pedicled tongue-shaped parenchymal flap via a double periareolar incision.Methods:A retrospective study was conducted on 34 female patients (68 breasts) with breast ptosis treated at the Department of Plastic Surgery at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2016 to June 2023. The patients' ages ranged from 23 to 53 years, with an average of (37.4±7.9) years. All patients underwent correction of breast ptosis using an inferolaterally pedicled tongue-shaped parenchymal flap via a double periareolar incision. Pre-operative and post-operative measurements were taken to assess the corrective outcomes, including mammary base width (MBW), areola diameter (AD), nipple-to-nipple distance (NN), suprasternal notch-to-nipple distance (SSN-N), nipple-to-inframammary fold distance (N-IMF), and thoracic circumference at the nipple level (TN). Patients' satisfaction was assessed using the BREAST-questionnaire (BREAST-Q) module.Results:Postoperative first-stage wound healing was achieved in all 34 patients without complications such as hematoma, infection, or nipple necrosis. The follow-up period ranged from 6 to 60 months, with a median of 12 months. Early postoperative observations showed periareolar folds, which disappeared within 3 to 6 months in 31 cases, while mild periareolar folds, persisted for up to 12 months in 3 cases. Four patients reported reduced nipple sensation postoperatively. Measurements showed a statistically significant increase in TN and a reduction in NN, SSN-N, AD, N-IMF, and MBW compared to preoperative values (all P<0.001). BREAST-Q scores indicated significant improvements in satisfaction with breasts, psychosocial well-being and physical well-being, with preoperative scores of (21.6±8.9), (42.4±11.9) and (49.7±12.9) scores increasing to (82.3±8.5), (81.9±8.1) and (81.2±8.3) scores, respectively (all P<0.001). Conclusions:The double periareolar incision technique with rotational filling of an inferolaterally pedicled tongue-shaped glandular flap is a safe and effective method for correcting breast ptosis.
4.Contralateral mandibular outer cortex "sandwich" bone grafting for correcting lower facial asymmetry with normal occlusal relationship
Guoping WU ; Tong LU ; Yuming QU ; Sheng GAO ; Zhiyang XIE ; Kaili YAN ; Chongxu QIAO ; Shunchao YAN ; Shu WANG ; Wensong SHANGGUAN
Chinese Journal of Plastic Surgery 2024;40(10):1049-1058
Objective:To investigate the clinical outcomes of using autologous mandibular outer cortex "sandwich" grafting to augment mandible for correcting lower facial asymmetry with normal occlusal relationships.Methods:A retrospective analysis was conducted on the clinical data of patients with lower facial asymmetry treated at the Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, from January 2016 to December 2019. Preoperative cone-beam CT (CBCT) scans of the maxillofacial region were obtained to acquire three-dimensional data of the maxillofacial skeleton. Computer-aided design was used to determine the osteotomy range of the mandibular outer cortex and design osteotomy guide template. The outer cortex of the larger mandibular side (donor site) was harvested according to the osteotomy guide template and sectioned. The segmented mandibular outer cortex was then contoured to match the arc of the recipient side’s mandibular outer cortex and fixed to the inner side of the recipient mandibular outer cortex, thus increasing the width and thickness of the expanded mandible. Follow-up was conducted at 7th day and 6 months postoperatively, CBCT scan was performed to measure the changes in ramus height (Co-Go), mandibular body length (Go-Me), and mandibular outer cortex thickness, and volume, and the patient satisfaction with facial appearance (1 to 5 points, with higher scores indicating higher satisfaction), were assessed to evaluate surgical outcomes. Statistical analysis was performed using SPSS 12.0 software. Paired t-tests were used to compare patient satisfaction scores preoperatively and six months postoperatively. Repeated measurement ANOVA was used to compare Co-Go and Go-Me measurements preoperatively, 7th day, and 6 months postoperatively. If a statistically significant difference is found, further analysis using post-hoc testing(Tukey’s HSD test) will be conducted to examine the data. Results:Sixteen patients with lower facial asymmetry were included, comprising of 5 males and 11 females, aged 18 to 40 years, with an average age of 25.2 years. Surgical method included contralateral mandibular outer cortex "sandwich" grafting to the expanded mandible in 9 cases and simultaneous genioplasty in 7 cases. Follow-up ranged from 6 months to 5 years, with an average follow-up of 18.6 months. All patients experienced numbness of the lower lip postoperatively, which resolved within six months, and no severe complications occurred. The symmetry of lower facial contour improved significantly and remained stable. Patient satisfaction score for facial appearance increased from (1.63±0.62) points preoperatively to (4.19±0.75) points six months postoperatively( P<0.01). The differences in Co-Go on the donor side and Go-Me on the recipient side across the three time points(preoperatively, 7th day and 6 months postoperatively) were not statistically significant(all P>0.05). However, the differences in Go-Me on the donor side and Co-Go on the recipient side across the three time points were statistically significant(all P<0.05). On the donor side, the mandibular outer cortex thickness decreased by a maximum of 6 mm on 7th day postoperatively and increased by a maximum of 2 mm at 6 months postoperatively compared to 7th day. On the recipient side, mandibular outer cortex thickness increased by a maximum of 6 mm on 7th day postoperatively and decreased by a maximum of 2 mm at six months postoperatively compared to 7th day. The volume of the mandibular outer cortex on the recipient side increased by (4 415.94±1 017.21)mm 3 at 7th day postoperatively compared to preoperatively, and decreased by (202.63±300.85)mm 3 at 6 months postoperatively. Conclusion:For lower facial asymmetrical with normal occlusal relationships and no occlusal plane deviation, contralateral mandibular outer cortex "sandwich" bone grafting can effectively increase the width and volume of the mandible on the grafted side, achieving favorable clinical outcomes.
5.Contralateral mandibular outer cortex "sandwich" bone grafting for correcting lower facial asymmetry with normal occlusal relationship
Guoping WU ; Tong LU ; Yuming QU ; Sheng GAO ; Zhiyang XIE ; Kaili YAN ; Chongxu QIAO ; Shunchao YAN ; Shu WANG ; Wensong SHANGGUAN
Chinese Journal of Plastic Surgery 2024;40(10):1049-1058
Objective:To investigate the clinical outcomes of using autologous mandibular outer cortex "sandwich" grafting to augment mandible for correcting lower facial asymmetry with normal occlusal relationships.Methods:A retrospective analysis was conducted on the clinical data of patients with lower facial asymmetry treated at the Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, from January 2016 to December 2019. Preoperative cone-beam CT (CBCT) scans of the maxillofacial region were obtained to acquire three-dimensional data of the maxillofacial skeleton. Computer-aided design was used to determine the osteotomy range of the mandibular outer cortex and design osteotomy guide template. The outer cortex of the larger mandibular side (donor site) was harvested according to the osteotomy guide template and sectioned. The segmented mandibular outer cortex was then contoured to match the arc of the recipient side’s mandibular outer cortex and fixed to the inner side of the recipient mandibular outer cortex, thus increasing the width and thickness of the expanded mandible. Follow-up was conducted at 7th day and 6 months postoperatively, CBCT scan was performed to measure the changes in ramus height (Co-Go), mandibular body length (Go-Me), and mandibular outer cortex thickness, and volume, and the patient satisfaction with facial appearance (1 to 5 points, with higher scores indicating higher satisfaction), were assessed to evaluate surgical outcomes. Statistical analysis was performed using SPSS 12.0 software. Paired t-tests were used to compare patient satisfaction scores preoperatively and six months postoperatively. Repeated measurement ANOVA was used to compare Co-Go and Go-Me measurements preoperatively, 7th day, and 6 months postoperatively. If a statistically significant difference is found, further analysis using post-hoc testing(Tukey’s HSD test) will be conducted to examine the data. Results:Sixteen patients with lower facial asymmetry were included, comprising of 5 males and 11 females, aged 18 to 40 years, with an average age of 25.2 years. Surgical method included contralateral mandibular outer cortex "sandwich" grafting to the expanded mandible in 9 cases and simultaneous genioplasty in 7 cases. Follow-up ranged from 6 months to 5 years, with an average follow-up of 18.6 months. All patients experienced numbness of the lower lip postoperatively, which resolved within six months, and no severe complications occurred. The symmetry of lower facial contour improved significantly and remained stable. Patient satisfaction score for facial appearance increased from (1.63±0.62) points preoperatively to (4.19±0.75) points six months postoperatively( P<0.01). The differences in Co-Go on the donor side and Go-Me on the recipient side across the three time points(preoperatively, 7th day and 6 months postoperatively) were not statistically significant(all P>0.05). However, the differences in Go-Me on the donor side and Co-Go on the recipient side across the three time points were statistically significant(all P<0.05). On the donor side, the mandibular outer cortex thickness decreased by a maximum of 6 mm on 7th day postoperatively and increased by a maximum of 2 mm at 6 months postoperatively compared to 7th day. On the recipient side, mandibular outer cortex thickness increased by a maximum of 6 mm on 7th day postoperatively and decreased by a maximum of 2 mm at six months postoperatively compared to 7th day. The volume of the mandibular outer cortex on the recipient side increased by (4 415.94±1 017.21)mm 3 at 7th day postoperatively compared to preoperatively, and decreased by (202.63±300.85)mm 3 at 6 months postoperatively. Conclusion:For lower facial asymmetrical with normal occlusal relationships and no occlusal plane deviation, contralateral mandibular outer cortex "sandwich" bone grafting can effectively increase the width and volume of the mandible on the grafted side, achieving favorable clinical outcomes.