Local recurrence and distant metastasis is the major factor of impacting long-term survival for patients with esophageal carcinoma after radical resection. Postoperative radiotherapy and chemotherapy is expected to reduce the rate of local recurrence and distant metastasis, but views for the value of postoperative radiochemotherapy were inconsistent in the past. In recent years, scholars have performed much more clinical studies on postoperative radiotherapy and chemotherapy and found that the combined postoperative radiotherapy and chemotherapy after surgery significantly reduces the recurrence rate and distant metastasis rate and can enhance the survival of the patients.

The authors reviewed the research and development of tissue engineered meniscus from three points (cell seeds, scaffolds, cell factors) and point out current questions and investigative direction in the future.

A 34-year-old male patient with suspected pheochromocytoma was referred to our department for paroxysmal hypertension. Pheochromocytoma was confirmed by very high plasma nor-metanephrine ( NMN ) and metanephrine ( MN ). Contrast CT of the adrenal disclosed a 3.0 cm x 3.0 cm mass in the left adrenal. 18 F-FDG-PET-CT showed high uptake only in the left adrenal. When the patient's blood pressure was well controlled with 4 mg/d doxazosin for 2 weeks, surgery was then performed under laparoscopy. A round solid left adrenal pheochromocytoma was resected. After surgery, plasma MN and NMN levels returned to normal, and the patient was free of clinical symptoms with normal blood pressure. This patient has been followed 3 years with normal blood pressure, MN, and NMN levels, without tumor recurrence shown hy adrenal CT.

Carcinoma ; pathology ; Carcinoma, Papillary ; Histiocytosis, Langerhans-Cell ; pathology ; Humans ; Thyroid Neoplasms ; pathology

Objective To report our experience with minimally invasive percutaneous nephrolithotomy (MPCNL) in treatment of renal calculi in solitary kidneys. Methods From August 2000 to August 2010, 242 patients with renal calculi in solitary kidneys were treated by MPCNL, the data were reviewed retrospectively. Results The mean operative time was 68 min, the clearance rates were 79.3% (192/242) after first session and 88. 0% (213/242) after second-look MPCNL and ESWL, respectively. Postoperative fever happened in 18 cases. Twenty-one cases required transfusion, 10 cases received angiography and embolization. One case experienced perirenal hematoma and 1 case had pneumatothorax. Conclusions MPCNL has the advantages of less bleeding, high clearance rate and short hospital stay. MPCNL is an effective and feasible treatment option for renal calculi in solitary kidneys and should be the first line choice.

Objective To review the safety and efficacy of upper-pole access percutaneous nephrolithotomy (PCNL). Methods From May 2008 to May 2010,237 cases ( 135 males and 102 females with mean age of 42 yrs) of renal or proximal ureteral calculi treated with upper-pole access PCNL were reviewed.The indications included calculus larger than 1.5 cm or impacted proximal ureteral calculi in 94 cases,calculus≥2 cm or impacted renal pelvic calculi in 26 cases,staghorn or multiple calculi in 68 cases,complex lower calyx calculi in 13 cases,upper calyx calculi not amenable to ESWL or URS in 12 cases,calculi within upper calyx diverticulum in 3 cases,combined UPJ obstruction or upper ureteral stenosis in 8 cases,morbidly obese patients in 3 cases,calculi within horseshoe kidneys in 6 cases,calculi within transplanted kidneys or ureters in 4 cases.Of the 237 cases,175 tracts (73.8％) were above the 12th rib,46were above the 11th rib,12 were below the 12th rib,4 were in the lower abdomen for renal transplant patients. Results The overall stone clearance rate with upper-pole access PCNL monotherapy was 74.3％.Additional punctures were required in 55 cases and combined ESWL in 6 cases.Total stone clearance rate at 3 months after operation was 88.2％.16 patients (6.8％) had a pleural injury.Thoracentesis was required in 8 patients,closed thoracic drainage in 5 patients,conservative treatment in 3 patients.After nephrostomy tube removed,pleural irritation symptom appeared in 12 cases (5.1％) who required symptomatic treatment.No patient had injury to the lung or other viscera.Significant bleeding requiring blood transfusion was olserved in 5 patients,while selective renal arterial embolization was required in 2 cases. Conclusions Upper-pole access offers optimal visibility,convenience for the movement of rigid nephroscope and high stone-free rate.It should be attempted in selected cages of upper ureteral calculi and complex renal calculi.

Brucella spondylitis and spinal tuberculosis are two common specific infectious diseases in spine surgery. They have many similar manifestations in clinical manifestations and imaging features. Clinically, there are symptoms such as pain, fever, hyperhidrosis, and anorexia. When inflammation involves the intervertebral space, intervertebral disc, or epidural abscess, it can cause nerve compression, resulting in pain, numbness, sensory disturbances, and decreased muscle strength in the corresponding innervated areas. And even in severe cases it can cause paralysis. The early imaging of both showed bone destruction of the involved vertebral body, narrowing or disappearance of the intervertebral space, and the formation of paravertebral abscesses. Therefore, it is very easy to cause misdiagnosis. This article compares and summarizes the diagnosis of brucellosis spondylitis and spinal tuberculosis from four aspects: clinical manifestations, imaging characteristics, and laboratory examinations and histopathological examinations. Based on the above, the treatment principles and surgical indications of the two diseases were summarized and discussed from the aspects of drug treatment and surgical treatment, with an aim to further improve the clinical diagnosis and treatment of the two diseases.

Background Permethrin is a commonly used pyrethroid insecticide and has been found to be potentially neurotoxic. Microglia are innate immune cells in the central nervous system and are involved in the development of a range of neurodegenerative diseases. Objective To observe possible toxic effects of permethrin on human microglia clone 3 (HMC3) in vitro and explore associated mechanism. Methods HMC3 were treated with 0, 10, 25, and 55 μmol·L⁻¹ permethrin for 72 h. Cell cycle and apoptosis were measured using flow cytometry. Cyclin-dependent kinase 1 (CDK1), cyclin-dependent kinase inhibitor 1A (CDKN1A), cyclin B2 (CCNB2), cellular tumor antigen p53 (p53), factor-related apoptosis (FAS), caspase 3 (CASP3), and H2A histone family member X (H2AX) were detected by quantitative real-time PCR (qPCR). The differential genes and enrichment pathways of HMC3 after 0 and 25 μmol·L⁻¹ permethrin treatment was analyzed by RNA sequencing. HMC3 was treated by 0, 10, 25, and 55 μmol· L⁻¹ permethrin for 72 h. The content of nitric oxide (NO) in the supernatant was detected using Griess reagent. The secretion level of interleukin-6 (IL-6) was detected by enzyme linked immunosorbent assay (ELISA). The mRNA expression levels of mitogen-activated protein kinase (MAPK) pathway (including MAPK1, MAPK8, and MAPK14), interleukin-1β (IL-1β), IL-6, and matrix metalloproteinase (MMP) families (including MMP1, MMP2, MMP3, and MMP9) were detected by qPCR. The protein expressions of phosphorylated p38 mitogen-activated protein kinase (p-p38), phosphorylated extracellular signal-regulated kinase (p-ERK), IL-1β, IL-6, and MMP1 were detected by Western blot. Results HMC3 was arrested in G2/M phase after 0, 10, 25, and 55 μmol·L⁻¹ permethrin treatment for 72 h, of which there was a statistically significant difference between the 55 μmol·L⁻¹ permethrin treatment group and the control group (P<0.01), and the mRNA expression of CDKN1A was up-regulated according to the qPCR (P<0.05). There was no statistically significant difference in the proportions of apoptosis between the groups (P＞0.05). The RNA sequencing showed that the differential genes were enriched in the MAPK pathway, and the mRNA expressions of MAPK1, MAPK8, and MAPK14 were up-regulated after the permethrin treatment at 55 μmol·L⁻¹ compared to the control group by qPCR (P<0.05). The Western blot revealed that, compared to the control group, the levels of p-p38 and p-ERK were increased after the 10 μmol·L⁻¹ permetrin treatment (P<0.05), the p-ERK level was increased after the 25 μmol·L⁻¹ permetrin treatment (P<0.05), and the p-p38 level was up-regulated after the 55 μmol·L⁻¹ permetrin treatment (P<0.05). The secretion of NO in the supernatant of HMC3 increased after permetrin treatment compared to the control group (P<0.05), the mRNA and protein expressions and the secretion of IL-6 showed an upward trend, the mRNA and protein expressions of IL-1β were up-regulated (P<0.05), and the mRNA and protein expressions of MMP1 were up-regulated in the 25 and 55 μmol·L⁻¹ permethrin groups (P<0.05). Conclusion Permethrin inhibits HMC3 cell proliferation in vitro, induces cell cycle arrest, activates MAPK pathway, and promotes the expression of inflammatory factors IL-1β and MMP1, which may be one of the mechanism of neurotoxicity induced by permethrin.

Objective To investigate the reproducibility of magnetic resonance intravoxel incoherent motion in body diffusionG weighted imaging (IVIMGDWI)for normal lumbar disc scanning.Methods 50 healthy volunteers were enrolled with informed consent,30 males and 20 females,2 5.20±2.04 years old.Using 3.0T MR on the lumbar spine,the sagittal T1 WI,the sagittal,axial T2 WI and sagittal IVIMGDWI sequences were scanned once,then the second sagittal IVIMGDWI sequence was scanned after 4 hours.The IVIMGDWI sequence used 10 b values (0,10,20,40,60,80,100,200,400,600 s/mm2 ).The discs were graded according to the Pfirrmann grading standard.The ADCfast ,ADCslow ,and f values of each intervertebral disc were measured by two doctors at the postGprocessing workstation.Paired tGtest was used to analyze whether there was a difference between the two scans.The intraGgroup correlation coefficient (ICC)was used to analyze the consistency of the ADCfast ,ADCslow ,and f values of the two acquisitions (P＜0.05)and the consistency of the ADCfast ,ADCslow,and f values between the different doctors (P＜0.05).The IVIMGDWI imaging was evaluated to measure the repeatability of normal lumbar discs. Results Of the 50 healthy volunteers,230 intervertebral discs matched the criteria(Pfirrmann gradeⅠandⅡ).The ADCslowvalue between the two scans was significantly different (t＝2.460,P＜0.05),and the differences in ADCfast and f values were not significant (t＝－0.418,1.273,P＞0.05). The consistency of ADCfast ,ADCslow ,and f values for the two scans were generally (ICC＝0.478,0.306,0.316,P＜0.05 ).Different observers had good consistency in the measurement of interverG tebral disc ADCfast ,ADCslow,and f values (ICC＝0.929,0.909, 0.9 1 1 ,P＜0.05).Conclusion The IVIMGDWI imaging has good consistency in the measurement of normal lumbar disc between different observers.The consistency of IVIMGDWI in two scans of normal lumbar intervertebral discs is general,which may be due to the time interval between the two scans.Because ADCslow represents the diffusion of water molecules in tissues,the microenvironment in the lumbar intervertebral disc has changed,resulting in the difference of ADCslow value.As for the problem that different scanning time may lead to the change of IVIMGDWI data,we will study it further.

BACKGROUND:Kinesio taping has been widely used as a means of sports protection,but its role as a means to correct abnormal biomechanical changes of the lower limbs during side-step cutting remains unclear. OBJECTIVE:To analyze and compare the changes in lower limb kinematics and dynamics when the subjects complete the side-step cutting of the knee joint under the conditions of kinesio taping,placebo taping and blank control. METHODS:Thirty-nine male college students majoring in basketball were recruited as subjects.Each subject was tested with kinesio taping,placebo taping or no taping.The mechanical correction method was used to patch the dominant knee joint of each subject.The run-up speed of 4.5-5.5 m/s was selected to complete the 45° side-step cutting motion,and the kinematics and kinetics data were collected synchronously by the three-dimensional dynamic capture system and the force measuring platform.The kinematics and kinetics parameters at the moment of initial touchdown and peak ground reaction force were selected for data analysis.SPSS 27.0 software was used for statistical analysis of the test data. RESULTS AND CONCLUSION:Kinematic indexes:compared with no taping and placebo taping,the hip abduction and knee valgus angles at the initial touchdown moment were significantly decreased when kinesio taping was used(P<0.05);at the moment of peak lateral ground reaction force,the angles of hip abduction,knee valgus and ankle plantar flexion decreased significantly(P<0.05),and the knee flexion angle was significantly increased(P<0.05).Kinetic indexes:Compared with no taping,both kinesio taping and placebo taping significantly reduced hip abduction and external rotation torque,knee valgus and external rotation torque at the moment of initial touchdown(P<0.05),and significantly reduced peak vertical ground reaction force and peak horizontal backward ground reaction force(P<0.05);in addition,kinesio taping significantly reduced peak lateral ground reaction force compared with no taping and placebo taping(P<0.05).These results indicate that kinesio taping of the knee joint may improve some kinematic and kinetic indexes associated with lower limb injury risk factors during the completion of the side-step cutting in basketball specialized college students to some extent,and may have a positive effect on the prevention of injury during the side-step cutting.In addition,the trends in the effects of placebo taping and kinesio taping on the knee joint are more consistent in terms of changes in some indexes,suggesting that there may be a placebo effect on the mechanism of action of kinesio taping.