Objective To evaluate the centralization of the distal stem of hip femoral prosthesis after total hip replacement with CT imaging. Methods T he 4th zone of the femoral stem of hip prosthesis in 18 cases was scanned with c omputerized tomography; the affected limb was fixed, the window level was 1 500 to 2 000. The rectangular coordinat was established, its origin was the center o f femoral medullary cavity, and the line parallel with the connecting line betwe en the posterior borders of femoral medial lateral condyles was X axis. The foll owed variables were recorded on CT imaging: 1)the distance of the centers(the me dullary cavity center and femoral prosthetic center); 2) medullary cavity radius ; 3) the distance of the centers/medullary cavity radius; 4) the relationship of the prosthetic hip and quadrant; 5) metal pseudo imagines.The distal femoral st em of hip prosthesis could be measured and analyzed. Results Through CT scan, th e location of the distal stem in femoral medullary cavity could be accurately sh own and viewed directly. The distances between the femoral stem tips and the cen ters of medullary cavity, the radius of femoral medullary cavity, and the quadra nt which the stem tips are located at, could be considered as quantitative indic es on the centralization of the femoral distal stem of hip prosthesis. Conclusio n The centralized status of the distal stem of hip prosthesis can be observed wi th CT imaging. CT imaging is a kind of accurate and quantitative analysis method . It not only can guide the doctor to study and improve the surgical techniques, but also offer a reliable basis for correlative research. [

Objective To explore cell suspension and level of IL-17 in bronchoalveolar lavage fluid (BALF) of children with labor pneumonia combined with mycoplasma pneumonia and its clinical significance. Methods 87 children with labor pneumonia who had been done BAL were divided into CPIS ≥ 6 group and CPIS < 6 group ac-cording to the clinical pneumonia infection score (CPIS). Meanwhile, according to the results of MP-DNA, we grouped the children above into combined with mycoplasma pneumonia infection group and no mycoplasma pneumo-nia infection group, then combined with mycoplasma pneumonia infection group into group of MP-DNA:103~106 and group of MP-DNA: 106~. ELISA method was used to detect IL-17 level, HE staining and microscopy to sort cells, PCR detect MP-DNA. Results The percentage of neutrophils and lymphocytes in BALF are not related to that in blood ( > 0.05). The percentage of columnar epithelial cells in CPIS < 6 group were higher than CPIS ≥ 6, how-ever, macrophagocyte was lower ( < 0.05). The percentage of neutrophils are related with both MP-DNA ( = 0.48,= 0.000) and IL-17 ( =0.49, =0.000). Conclusions The composition of BALF is more appropriate to react the circumstance of lobar pneumonia. When lobar pneumonia occurs, columnar epithelial cells are damaged, macrophagocyte gathered to participate in the inflammatory response. In Mycoplasma pneumonia infection group, IL-17 raises neutrophils to resist infection, NE%in BALF can indirectly reflect the mycoplasma infection degree.

ObjectiveTo evaluate the technique and implications of No.12 lymph node dissection for advanced gastric cancer with D2 lymphadenectomy.MethodsIn this study 102 advanced gastric cancer patients undergoing D2 lymphadenectomy from January 2010 to January 2011were retrospectively analysed. ResultsThe average number of No.12 lymph node dissected was 4.3.The metastatic rate of No.12 lymph node was 21.6％.Postoperative pancreatic fistula developed in 4 cases,and lymphatic fistula in 6.There was no anastomotic leakage,lymphatic duct leakage,biliary leakage,post-operative jaundice and bleeding.ConclusionsNo.12 lymph node dissection for advanced gastric cancer is safe and necessary.

OBJECTIVE: To determine the effect of Parkinson's disease-weight bearing exercise for better balance (PD-WEBB) exercise on balance impairment and falls in people with Parkinson's disease (PD). METHODS: A single-blind, randomized controlled clinical trial was conducted. The falls efficacy scale score, unified Parkinson disease rating scale (UPDRS) score and Mini-BESTest score were measured and compared between a PD-WEBB group and a control group. RESULTS: The falls efficacy scale score, UPDRS-2 score, UPDRS-3 score and Mini-BESTest score were improved in the PD-WEBB group compared with the control group (P<0.05), with no significant change in UPDRS-1 score between the two groups. CONCLUSION PD-WEBB training can significantly improve the balance impairment and quality of life to prevent falls. PD-WEBB training is suitable for PD patients in China, and is a reasonable, effective and sustainable training of family and community assessment model.
Accidental Falls ; prevention & control ; China ; Humans ; Parkinson Disease ; therapy ; Postural Balance ; Quality of Life ; Resistance Training ; Single-Blind Method

Objective:To investigate the reliability of gene detection results using pleural effusion from patients with lung adenocarcinoma, and evaluate the clinical application value of pleural effusion supernatant in gene detection of lung adenocarcinoma.Methods:A total of 145 patients with lung adenocarcinoma pathologically confirmed from February 2015 to December 2019 were included, including 129 patients from Peking University Cancer Hospital & Institute and 16 patients from the First Hospital of Fangshan District. In this study, 55 pleural effusion supernatant samples, 52 plasma samples, and 48 tumor tissue samples were selected to targeted next-generation sequencing (NGS) of 1, 021 cancer-related genes, and the ability of gene detection of pleural effusion supernatant, tumor tissue, and plasma were compared.Results:The mutation rate of pleural effusion supernatant was 100.00%, the median maximum somatic allele frequency (MSAF) was 16.40%, and the chromosomal copy number detection (CNV) was 45.45%, showed no statistically significant difference compared with the tumor tissue samples (95.56%, 26.55% and 45.83%, respectively, P>0.05); However, it showed many advantages compared with plasma samples (90.38%, 2.50% and 9.62%). Among the drug-related driver genes, the percentage of EGFR mutation carrier in pleural effusion supernatant, tumor tissue and plasma were 61.82%, 58.33% and 38.46% respectively, the percentagein pleural effusion was higher than that in plasma ( P<0.05), but had no statistical difference compared with the tissue ( P>0.05). Conclusions:Pleural effusion supernatant has high reliability and effectiveness in detecting gene mutation. When lung adenocarcinoma patients are difficult to obtain tumor tissue clinically, it can be used as a substitute sample for genetic testing.

Objective:To investigate the reliability of gene detection results using pleural effusion from patients with lung adenocarcinoma, and evaluate the clinical application value of pleural effusion supernatant in gene detection of lung adenocarcinoma.Methods:A total of 145 patients with lung adenocarcinoma pathologically confirmed from February 2015 to December 2019 were included, including 129 patients from Peking University Cancer Hospital & Institute and 16 patients from the First Hospital of Fangshan District. In this study, 55 pleural effusion supernatant samples, 52 plasma samples, and 48 tumor tissue samples were selected to targeted next-generation sequencing (NGS) of 1, 021 cancer-related genes, and the ability of gene detection of pleural effusion supernatant, tumor tissue, and plasma were compared.Results:The mutation rate of pleural effusion supernatant was 100.00%, the median maximum somatic allele frequency (MSAF) was 16.40%, and the chromosomal copy number detection (CNV) was 45.45%, showed no statistically significant difference compared with the tumor tissue samples (95.56%, 26.55% and 45.83%, respectively, P>0.05); However, it showed many advantages compared with plasma samples (90.38%, 2.50% and 9.62%). Among the drug-related driver genes, the percentage of EGFR mutation carrier in pleural effusion supernatant, tumor tissue and plasma were 61.82%, 58.33% and 38.46% respectively, the percentagein pleural effusion was higher than that in plasma ( P<0.05), but had no statistical difference compared with the tissue ( P>0.05). Conclusions:Pleural effusion supernatant has high reliability and effectiveness in detecting gene mutation. When lung adenocarcinoma patients are difficult to obtain tumor tissue clinically, it can be used as a substitute sample for genetic testing.

Objective To investigate the application of endoscopic retrograde cholangiopancreatography (ERCP) in pancreatic duct injury. Methods Fourteen patients with pancreatic duct injury who were diagnosed and treated with ERCP in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between August 2006 and February 2014 were retrospectively analyzed. Among them, 9 were males and 6 were females, aged 6-77 years old with a median age of 58 years old. Six patients were diagnosed with closed pancreatic injury. Eight cases were complicated with pancreatic fistula after surgery, 3 of whom underwent distal pancreatectomy and 5 underwent distal pancreatectomy combined with splenectomy. The informed consents of all patients were obtained and the local ethical committee approval was received. Patients diagnosed with closed pancreatic injury underwent ERCP. According to the imaging result and American Association for the Surgery of Trauma (AAST) classification, therapeutic measures such as endoscopic retrograde pancreatic drainage (ERPD), and endoscopic retrograde biliary drainage (ERBD) + ERPD were performed. Patients with pancreatic fistula after surgery received ERCP for diagnosis and drainage therapy. The recovery status and incidence of ERCP-related complications after ERCP diagnosis and treatment were observed. Results Six cases were confirmed with closed pancreatic injury by ERCP. According to the AAST classification, 4 cases with grade Ⅲ injury underwent ERPD, and 2 with grade IV injury underwent ERBD + ERPD. Eight cases with pancreatic fistula after surgery were all found with pancreatic duct injury by ERCP and then underwent ERPD. The median healing time of pancreatic fistula after surgery was 16(12-25)d. No severe complication was observed during the treatment of ERCP. All patients were recovered and discharged after ERCP treatment. Biliary and pancreatic duct stents were removed 3 months after discharge. Conclusions ERCP has the advantages of safty and minimally invasion for the diagnosis and treatment of pancreatic duct injury.

OBJECTIVETo prepare cisPLLAtin-loaded polylactic acid/cnts, and to study the anti-tumor effect of 5-FU-PLLA-CNTs on human gastric carcinoma cell lines(MGC803 and MNK45).

METHODS5-FU-PLLA-CNTs were prepared with ultrasound emulsification. The morphology of 5-FU-PLLA-CNTs was determined by scanning electron microscope(SEM), and its drug loading and drug release curve in vitro were detected by UV-Vis-NIR spectrophotometer. Cells were divided into experiment, positive control and negative control groups. CCK8 method was used to test the cytotoxic effect of 5-FU-PLLA-CNTs in different concentrations on MGC803 and MNK45 cell proliferation. Flow cytometry was employed to measure the apoptotic rate of MGC803 and MNK45 cells before and after the intervention of 5-FU-PLLA-CNTs.

RESULTSDeep layer film of 5-FU-PLLA-CNTs was successfully established, whose drug-load rate was(4.54±0.43)%, entrapment rate was(21.56±2.36)%. In vitro release test showed release rate within 24 h of 5-FU-PLLA-CNTs was 23.9% in a as lowly increasing manner, and accumulating release rate was 85.3% at day 31. CCk8 experiment revealed, as compared to control group, 5-FU-PLLA-CNTs significantly inhibited the proliferation of two cell lines in dose-dependent and time-dependent manner. The best 5-FU-PLLA-CNTs concentration of inhibition for human gastric cancer cell lines was 1 mg/well. Flow cytometry indicated the apoptotic rate of MGC803 and MNK45 cells in experiment group treated by 1 mg/well 5-FU-PLLA-CNTs significantly increased as compared to negative control group (P<0.05), while the difference was not significant as compared to positive control group (P>0.05).

CONCLUSIONThe 5-FU-PLLA-CNTs has good drug sustained-release capacity, and can significantly kill and inhibit the proliferation of MGC803 and MNK45 cell lines.

Cell Line, Tumor ; Cell Proliferation ; drug effects ; Delayed-Action Preparations ; Fluorouracil ; pharmacology ; Humans ; Lactic Acid ; pharmacology ; Nanotubes, Carbon ; Polyesters ; Polymers ; pharmacology ; Stomach Neoplasms ; pathology

Objective: To investigate the feasibility and effectiveness of endoscopicretrograde cholangio-pancreatography(ERCP)in the management of long-term complications after pancreaticoduodenectomy. Methods: From January 2009 to July 2018, the clinical data of 62 patients with biliary or pancreatic long-term complications after pancreatoduodenectomy were reviewed at Department of General Surgery, and the corresponding ERCP were carried out in the multi-disciplinary cooperation.There were 39 males and 24 females.The age was 56.5 years(aging from 13 to 76 years). The time of treatment was 3 months to 20 years after pancreatoduodenectomy.The long-term biliopancreatic complications after pancreatoduodenectomy included 51 cases of biliary calculi, 42 cases of bilioenteric anastomotic stenosis with proximal bile duct dilatation, and 11 cases of pancreaticointestinal anastomosis stenosis with distal pancreatic duct dilatation.All patients received conventional duodenoscopy or single-balloon enteroscopy assisted ERCP under general anesthesia. Results: A total of 95 ERCP were performed in 62 patients, averaging 1.5 times per case.The long-term complications of cholangiopancreatic after pancreatoduodenectomy(ERCP indications) included 56 times of bile duct stones(58.9%), 45 times of bilioenteric anastomatic stricture(47.4%), 11 times of recurrent pancreatitis(11.6%), 6 cases(6.3%) of bilioenteric anastomatic foreign body, 3 times of intrahepatic bile duct stenosis(3.2%). Among the 95 times, 82 times(86.3%) achieved endoscopic endoscopy, 76 times(80.0%) were diagnosed successfully, and 72 times(75.8%) were successfully treated with ERCP.Small intestinal perforation occurred in 1 patient undergoing duodenoscopy, and then healed by surgical repair. Conclusion Multi-disciplinary collaboration of ERCP is safe and effective in the treatment of long-term complications after pancreaticoduodenectomy, but the long-term effect still needs further clinical follow-up.

Background::Hepatopancreatoduodenectomy (HPD) has been considered the only curative treatment for metastatic cholangiocarcinoma and some locally advanced gallbladder cancers (GBCs). However, HPD has not yet been included in treatment guidelines as a standard surgical procedure in consideration of its morbidity and mortality rates. The aim of this study was to evaluate the safety and effectiveness of HPD in treating biliary malignancies.Methods::The medical records of 57 patients with advanced biliary cancer undergoing HPD from January 2009 to December 2019 were retrospectively retrieved. A case-control analysis was conducted at our department. Patients with advanced GBC who underwent HPD (HPD-GBC group) were compared with a control group (None-HPD-GBC group). Baseline characteristics, preoperative treatments, tumor pathologic features, operative results, and prognosis were assessed.Results::Thirteen patients with cholangiocarcinoma and 44 patients with GBC underwent HPD at our department. Significant postoperative complications (grade III or greater) and postoperative pancreatic fistula were observed in 24 (42.1%) and 15 (26.3%) patients, respectively. One postoperative death occurred in the present study. Overall survival (OS) was longer in patients with advanced cholangiocarcinoma than in those with GBC (median survival time [MST], 31 months vs. 11 months; P < 0.001). In the subgroup analysis of patients with advanced GBC, multivariate analysis demonstrated that T4 stage tumors ( P = 0.012), N2 tumors ( P = 0.001), and positive margin status ( P = 0.004) were independently associated with poorer OS. Patients with either one or more prognostic factors exhibited a shorter MST than patients without those prognostic factors ( P < 0.001). Conclusion::HPD could be performed with a relatively low mortality rate and an acceptable morbidity rate in an experienced high-volume center. For patients with advanced GBC without an N2 or T4 tumor, HPD can be a preferable treatment option.