Objective To evaluate the efficacy and adverse reactions of Navelbine(NVB)in the treatment of recurrent and metastatic breast cancer.Methods 34 patients with recurrent and metastatic breast cancer were treated with Navelbine in this clinical study,and 16 patients were treated by the NP(DDP+NVB)regimen,12 patients by the NA(ADM+NVB)regimen,6 patient by single-agent NVB.34 patients received above regimens for two cycles(3～4 week a cycle).Result The overall response rate(CR+PR)was 35.3%,clinical benefit rate(CR+PR+SD≥6 months)44.1%,disease contrrol rate(CP+PR+SD)58.8%,the median time to failure 3.4 months(range:0.7～11 months),the median time to progression(TTP)3 months(range:0.8～11 months),and the median duration of response(CP+PR)5 months(range:2～11 months).The main side effect of the therapies is bone marrow depression,and the grade Ⅲ～Ⅳ leucopenia is 35.3%.Conclusion Single Navelbine and Navelbine plus DDP(or ADM)are effective and well tolerated treatments in patients with recurrent and metastatic breast cancer.

Background: Basic principles of clinical trials of nonpharmacologic treatment are similar to those of pharmacologic treatment, but its some special characteristics should be discussed. Objective: To explore the design characteristics of clinical surgery trial through the example of tunnel thread-drawing therapy for simple anal fistula. Design, setting, participants and interventions: The clinical trial was designed as a prospective, controlled, randomized multicenter trial. The patients came from Longhua Hospital, Yueyang Hospital of Integrated Traditional Chinese and Western medicine, and Affiliated Hospital of Jianxi University of Traditional Chinese Medicine. Stratified random was performed according to the subtype of anal fistula including low and high anal fistula. Full analysis set was applied to analyze the baseline data, and per protocol set was used in efficacy and safety analysis. The intervention was tunnel thread-drawing method. Classical therapy of thread-drawing method was employed as positive control. Main outcome measures: The primary outcomes were course of recovery and cure rate. Quality of life score was used as secondary outcome and anal maximum constriction pressure was considered as safety outcome. Results: Optimal efficiency testing method was used to estimate sample size. A total of 244 subjects were recruited and 236 subjects completed the trial. There was no significant difference in the cure rate of the low and high anal fistula between the treatment group and control group. There was a significant difference in the course of recovery in the patients with low and high anal fistula between treatment group and control group (P<0.01). To the patients with low anal fistula, the course of recovery in the treatment group was (22.26+/-8.67) d, and the course of recovery in the control group was (31.41+/-11.39) d. To the patients with high anal fistula, the course of recovery in the treatment group was (24.73+/-8.15) d, and the course of recovery in the control group was (32.20+/-12.60) d. There was no significant difference in the scores of quality of life in the patients with low anal fistula between the treatment group and control group (P>0.05). The trial showed that the tunnel thread-drawing therapy was significantly more effective than classical method for improving the anal sphincter function and patient satisfaction with treatment in the patients with high anal fistula. However the other items of quality of life in the two groups did not show significant difference. There was no any adverse event report in each group. There was no significant difference in the anal maximum constriction pressure in the treatment group before and after the operation. Conclusion: The trial shows that the tunnel thread-drawing therapy for simple anal fistula can shorten the course of recovery and improve the patients' quality of life. The training about surgical intervention and clinical implementation program is important in clinical surgery trial. Blind is absolutely difficult to implement and placebo cannot be used in this kind of trial.

Objective To prepare 3D printed tracheal graft and investigate its cellular biocompatibility and biomechanical properties.Methods Bone marrow was isolated from tibial plateau of young New Zealand white rabbit,and bone mesenchymal stem cells (BMSCs) were obtained by whole bone marrow culture method and adherent purification method.Biomechanical test was performed for 3D printed trachea graft.After co-cultured of 3D printed trachea graft and BMSCs,cell morphology was observed and the proliferation index of the cells on 3D printed trachea graft was quantified using sulforhodamine B (SRB) assay.Results 3D printed trachea graft showed excellent biomechanical properties.Cell morphology was normal and cells grew well after co-culture with 3D printed trachea graft.The SRB assay indicated good proliferation of BMSCs on 3D printed trachea graft.Conclusions 3D printed trachea graft shows favorable cellular biocompatibility and biomechanical properties,and therefore can be used as a scaffold material for tissue-engineered trachea.

Tissue engineering can regenerate damaged tissues and restore the biological functions by cell or tissue reconstruction,and is becoming a promising method for trachea replacement.Seed cells,cell growth factors and tracheal scaffolds are the three major elements of tissue engineering trachea,as a result researchers have paid a lot of attention to find ideal seed cells.Mesenchymal stem cells (MSCs) are a kind of stem cells with high self-renewal ability and muhi-directional differentiation potential.MSCs are widely distributed in bone marrow,umbilical cord,adipose tissue,myocardial tissue,brain,muscle and skin,and can differentiate into a variety of cells,including osteocytes,chondrocytes,adipocytes and neurocytes.MSCs have the characteristics of high proliferation ability,wide differentiation range and immunomodulatory function,which can be used to repair damaged tissue.These advantages make the MSCs an ideal candidate of seed cells for tissue engineering trachea.This review mainly summarized the application of MSCs in tissue engineering trachea.

Objective:As a promising strategy,tumor vaccine is at the forefront of novel approaches to tumor treatment.Since tumor antigens derived from self proteins are often less immunogenic alone,they must be administered with a potent immunostimulatory adjuvant to induce robust T-cell response.IFA was widely used and considered to be one of the most effective adjuvant available for con-sistently producing high titer antibodies to diverse antigens.However,IFA-containing tumor vaccines do not produce positive results.The reasons are unclear.Methods:BALB/c mice were s.c.injected with one single dose of IFA.At indicated days, spleen cells were collected and detected for CD11b+cells.MTT method was used to analyze the effect of CD11b+cells on T cell proliferation.ELISA method was used to determine the influence of CD11b+cell on IFN-γ-secreting ability of T cells.Results:In the spleen of mice treated with IFA,the proportion of CD11b+cell was augmented.IFA-induced CD11b+cells inhibit the proliferation and tumor antigen-induced IFN-γ-secreting ability of T cells.Conclusion:This finding may help to understand the low therapeutic efficacy of cancer vaccines recently observed in some clinical trials using Freund′s adjuvant and underscores the necessity of adjuvant selection for active immuno-therapy.

The thread-dragging therapy, as a new external treatment of traditional Chinese medicine, could eliminate pathogenic factors and restore the vital qi by promoting qi and activating blood circulation to advance tissue repair in treating refractory sinus tracts or fistulae. This article reviewed its origin and development, and introduced its use in treating refractory sinus tracts or fistulae.

Objective To explore the relationship between bone mineral density(BMD) and body tat disrribution in the aged in Ningbo area of China. Methods The BMD of lumbar vertebra and total body bones as well as body composition were measured by dual-energy X-ray absorptiometry (DXA) in 61 aged males, and also in 63 aged females as control group. Results In the aged males, a negative correlation was found between BMD and age, while BMI, muscle, trunk fat were positively correlated with BMD. As for the aged female, age, BMI, muscle and fat were all positively correlated with BMD. Conclusions The correlation between body fat and BMD is closer in females than in males in the aged. There is a positive correlation between trunk fat and lumbar spine BMD, and it indicates that central obesity may have a protective effect on lumbar spine BMD.

OBJECTIVETo explore the clinical effect of the lobulated medial sural artery perforator flap in repairing soft tissue defect in hand or foot.

METHODSSince March 2012 to September 2014, 6 cases with soft tissue defects in hands or feet were treated by lobulated medial sural artery flaps pedicled with 1st musculo-cutaneous perforator and 2st musculo-cutaneous perforator of the medial sural artery. The size of the flaps ranged from 4.5 cm x 10.0 cm to 6.0 cm x 17.0 cm.

RESULTS5 cases of lobulated flap survived smoothly, only 1 lobulated flap had venous articulo, but this flap also survived after the articulo was removed by vascular exploration. All flaps had desirable appearance and sensation and the two-point discrimination was 6 mm in mean with 4 to 12 months follow-up (average, 7 months). Linear scar was left in donor sites in 3 cases and skin scar in 3 cases. There was no malfunction in donor sites.

CONCLUSIONSLobulated medial sural artery perforator flap is feasible and ideal method for the treatment of soft tissue defect in hand or foot with satisfactory effect.

Arteries ; Cicatrix ; Follow-Up Studies ; Foot Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Perforator Flap ; transplantation ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Time Factors ; Wound Healing

Objective:To analyze the clinical outcomes of tibial bone transport over an intramedullary nail in combination with antibiotic-loaded calcium sulphate for treatment of segmental bone defect.Methods:A retrospective analysis was conducted by enrolling 11 surgically treated patients with tibial segmental bone defect after the debridement for tibial infection or osteomyelitis who were admitted in Lower Limb Surgery Ward of Traumatic Orthopedic Department, Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from Jan. 2018 to Jan. 2020. The collected clinical materials and data included gender, age, injury mechanism, smoke or alcohol, comorbidities, intraoperative bleeding loss, bone defect length, resorption time of calcium sulphate, bone transport time, external fixation time, external fixation index, complications and Paley bone and functional criteria. SPSS 24.0 software was used to analyze the data.Results:Eleven patients were followed up for 8 to 31 months (average 23.2 months). All patients achieved bone healing and the infection was eradicated with no sign of recurrence. The mean length of defect was (8.1±1.6) cm, mean resorption time of calcium sulphate was (6.6±2.6) months, bone transport time was (11.4±2.8) weeks, external fixation time was (4.7±1.2) months, external fixation index was (0.58±0.07) month/cm and full weight bearing time was (6.1±1.4) months. The complication rate was 36.4% including deep vein thrombosis, delayed union of the docking site, pin tract infection and sterile draining of the wound. Paley bone evaluation results were excellent and good in 10 patients (90.9%) and functional results were excellent and good in 11 patients (100%).Conclusion:Tibial bone transport over an intramedullary nail in combination with antibiotic-loaded calcium sulphate is a safe, reliable and successful method for segmental bone defect and eradication of infection which reduces external fixation time and complication rate, allows patients perform weight bearing and return to daily life earlier.