Objective To investigate the safety and efficacy of CO2 fractional laser combined with 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (ALA-PDT) for the treatment of refractory flat wart.Methods The 80 patients with facial flat wart were randomly divided into observation group (40 cases) and control group (40 cases).The observation group was treated with CO2 fractional laser combined with 5-ALA-PDT,and the control group was treated with 5-ALA-PDT only.Those with residual lesions after the first treatment were treated with the second or third times.The interval duration between treatments was 2 weeks.The efficacy and the adverse reaction were evaluated after the 2-week,4-week and 6-month after the last treatment.Results Compared with prior treatment,the facial lesions achieved complete response and improvement.The total effective rate of the observation group were 90.0％ (36/40) and 72.5％ (29/40) for the control group,the difference was statistically significant (P＜0.05).There were 2 cases of pigmentation occurred in observation group and 3 cases in control group.The complications including infection and hypertrophic scar were seldom occurred in the two groups.Conclusions The safety and efficacy of CO2 fractional laser combined with ALA-PDT are better than that with ALA-PDT only in the treatment of refractory flat wart.

Objective To evaluate how functional endoscopic sinus surgery(FESS)modifies patients symptom profiles and the quality of life and analyze the influential factors.Methods During 2010 to 2012,90 cases were investigated to evaluate the quality of life of different age groups to use SNOT-20.Results The quality of life after the surgery of different age groups were significantly higher than it before the surgery(P<0.05).The juvenile group:first dimension(nasal congestion,70%),the second dimension (memory,30%),the third dimension(worried about the condition,30%)and the fourth dimension(social influence,40%).The young aged group:first dimension(nasal congestion,73.3%),the fourth dimension(social influence,43.3%),second dimension (quality of sleep,20.0%)and the third dimension(irritability,16.7%).The middle and old aged group:first dimension(nasal con-gestion,66.7%),the third dimension(trepidation,20%),the second dimension(quality of sleep,20.0%)and the fourth dimension (financial burden,40.0%).Preoperative QOL related factors:complications,age,gender,disease duration and urban-rural;Postop-erative QOL related factors:complications,disease duration,age,perioperative management,gender and urban-rural.Conclusion The quality of life of different ages after FESS is improved in different aspects.To increase the level of perioperative compliance can improve the quality of life.

Objective: To observe the effect of Mo-Rubbing abdomen manipulation on glucose metabolism and inflammatory factors in rats with type 2 diabetes mellitus (T2DM). Methods: Sixty Sprague-Dawley rats were randomly divided into a normal group (n=10) and a group for modeling (n=50) using the random number table method. Rats in the group for modeling were induced to form T2DM models by a high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin. Thirty successfully modeled rats were randomly divided into a model group, a Mo-Rubbing abdomen group, and a metformin group, with 10 rats in each group. Rats in the normal group and the model group received no intervention, those in the Mo-Rubbing abdomen group received Mo-Rubbing abdomen manipulation, and those in the metformin group received metformin by gavage. After 8-week intervention, fasting insulin (FINS), fasting plasma glucose (FPG), homeostasis model assessment for insulin resistance (HOMA-IR) and area under the curve at the oral glucose tolerance test (AUC-OGTT), as well as serum inflammatory factors interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α were detected, and the morphological changes of the pancreas were also observed. Results: After the 8-week intervention, the levels of FINS, FPG, HOMA-IR, and AUC-OGTT of rats in the Mo-Rubbing abdomen group were significantly lower than those in the model group (P<0.05); the pancreatic injury degree in the Mo-Rubbing abdomen group and the metformin group was lower than that in the model group. Compared with the model group, the serum IL-1β, IL-6, and TNF-α levels of rats in the Mo-Rubbing abdomen group were significantly decreased (P<0.05), and the serum IL-1β and TNF-α levels of the metformin group showed a downward trend; the serum IL-6 and TNF-α levels in the Mo-Rubbing abdomen group were significantly lower than those in the metformin group (P<0.01). There was a significant positive correlation between FPG with IL-1β, IL-6, and TNF-α in the T2DM rats (P<0.01). Conclusion: Mo-Rubbing abdomen manipulation reduces the inflammatory response and improves the morphological changes of the pancreas in T2DM rats, thereby achieving the effect of lowering blood glucose.

Objective To observe the efficacy and safety of topical 2％ propranolol cream for strawberry hemangiomas in proliferative phase.Methods Sixty infants with strawberry hemangiomas in proliferative phase were included in this study.There were 18 males and 42 females aged 30 days to 12 months.The lesions were located in head and neck (n=30),trunk (n=19) and extremities (n =11).All the infants received the 2％ propranolol cream treatment three times per day.The infants were required a regular return visit every month.The changes of tumor size,texture and color were monitored and recorded.The adverse effects after medication were observed and managed accordingly.The short-term results were evaluated using a 4-grade system.Results All the infants were followed up for 12 months.Among 60 infants,the Ⅰ,Ⅱ,Ⅲ and Ⅳ grade curative effects were 2,17,33 and 8 cases,respectively.All the infants had no drug adverse reaction.Conclusions The effect of topical 2％ propranolol cream for strawberry hemangiomas in proliferative phase is reliable,with little side effects.It will be popularized in clinical application.

OBJECTIVETo examine the effects of continuous and intermittent exercises on obesity and fatty liver in rats fed with high-fat diet.

METHODSWistar rats were randomly assigned into routine diet (R) and high-fat diet (H) groups, and each group were subdivided into sedentary group (S), continuous exercise (CE) group, and intermittent exercise (IE) group (n=8). In the CE group, the rats were forced to swim continuously for 90 min once daily, and those in the IE group swam for 30 min for 3 times (at a 4-h interval) daily. Both the CE and IE groups exercised for 5 days a week for 8 consecutive weeks. After the experiment, the retroperitoneal, epididymal, and visceral white and brown adipose tissues, the liver, and the gastrocnemius muscle of the rats were weighed. The lipogenesis rate was determined by incorporation of (3)H(2)0 into saponified lipids, and the blood lipid profiles were analyzed. The body weight and food intake of the rats were recorded daily.

RESULTSIE appeared to be more efficient than CE in reducing the adverse effects of high-fat diet and sedentarism. Compared with CE, IE resulted in an improved lipid profile with reduced food intake, body weight gain, visceral and central adiposity, and fatty liver. The effect of high-fat diet and different exercises on weight gain, adiposity, fatty liver, and lipid profile in rats was associated to the manner of exercise, time of each session, age, gender, and length of observation period.

CONCLUSIONIntermittent exercise is an important nonpharmacological strategy to control obesity and the related complications.

Animals ; Diet, High-Fat ; Fatty Liver ; etiology ; therapy ; Male ; Obesity ; etiology ; therapy ; Physical Conditioning, Animal ; methods ; Rats ; Rats, Wistar

Objective To assess the efficiency and methods of the interventional management in acute mesenteric venous thrombosis (AMVT). Methods Fifteen patients with AMVT who diagnosed by imageology were treated by interventional procedures. Eight patients were treated by transcatheter superior mesenteric artery thrombolysis with urokinase, 5 cases by percutaneous transhepatic treatment, 2 cases by transjugular intrahepatic portosystemic shunt approach. Results The technical success was achieved in all the 15 cases without complications. The majority of the thrombus was cleared by interventional procedures and flow restorated on the angiograms. All the patients with follow-up from 10 to 22 months showed no recurrence. Conclusion The minimally invasive interventional techniques are safe and effective in the treatment of mesenteric venous thrombosis without necrosis.

Objective:To observe the effects and explore the mechanism of Tuina(Chinese therapeutic massage)static training on vascular endothelial cell dysfunction and adiponectin(APN)in obese rats. Methods:Eight of 40 Sprague-Dawley rats were randomly selected as a normal group to be fed a common diet.The remaining rats were fed a high-fat diet to induce obesity models and randomly divided into a model group,an aerobic exercise group,and a static training group after successful modeling,with 8 rats in each group.During the entire experiment,rats in the normal group were fed a common diet without intervention.Rats in the model group were fed a high-fat diet without intervention.Rats in the aerobic exercise group were given moderate-intensity running exercises.Rats in the static training group were given 6-day/week static training for 8 weeks.The body mass and length of rats were recorded throughout the experiment,and the Lee's index was calculated.After the intervention,the perirenal and peri-epididymal fat weights of rats were measured,and the fat/body mass ratio was calculated.Four items of blood lipids were detected by biochemical methods[triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL),and high-density lipoprotein(HDL)];serum nitric oxide(NO),endothelin-1(ET-1),soluble thrombomodulin(sTM),and APN were detected by enzyme-linked immunosorbent assay.The morphological changes of the aorta in each group were observed under the microscope. Results:Compared with the normal group,the body mass,body length,Lee's index,perirenal fat mass,peri-epididymal fat mass,fat/body mass ratio,TG,TC,LDL,ET-1,and sTM in the model group were significantly increased(P<0.05),while the HDL,NO,and APN were significantly reduced(P<0.01).Compared with the model group,the body mass,Lee's index,perirenal fat mass,peri-epididymal mass,fat/body mass ratio,TC,LDL,ET-1,and sTM in the aerobic exercise group and the static training group were significantly reduced(P<0.05 or P<0.01),while the HDL,NO,and APN were significantly increased(P<0.05 or P<0.01).Compared with the aerobic exercise group,NO in the static training group was significantly higher(P<0.05).APN was positively correlated with NO(P<0.01),while APN was negatively correlated with ET-1 or sTM(P<0.01).Aortic morphological observation showed that the degree of endothelial injury in the aerobic exercise group and the static training group was less significant than that in the model group,and the improvement of endothelial cell morphology in the static training group was more notable than that in the aerobic exercise group. Conclusion:Tuina static training and aerobic exercise improved the aortic endothelial injury in obese rats,and the effect of Tuina static training was more significant.The mechanism of action may be related to regulating lipid metabolism and promoting APN secretion.

Radiotherapy is one of the main treatment for esophageal cancer. With the development of radiotherapy techniques, prognostic outcomes of esophageal cancer have been gradually improved and radiation-induced heart disease (RIHD) has captivated increasing attention. Radiation-induced heart complications mainly encompass pericardial disease, cardiomyopathy, coronary artery atherosclerosis, valvular heart disease, and arrhythmias, etc. The use of modern radiotherapy techniques is expected to mitigate heart injury and reduce the risk of RIHD. Research progress on the incidence and risk factors of RIHD in esophageal cancer were described as follows.

Objective:To evaluate the efficacy and safety of 192Ir brachytherapy combined with external beam radiation for the treatment of unresectable hilar cholangiocarcinoma. Methods:The clinical data of 26 patients with unresectable hilar cholangiocarcinoma admitted to Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine from February 2016 to July 2018 were retrospectively analyzed. All patients received 192Ir brachytherapy combined with external beam radiation. First, percutaneous hepatobiliary stent implantation was given, followed by external beam radiotherapy (radiotherapy dose 45 Gy, 25 times), and then 192Ir brachytherapy (radiotherapy dose 20 Gy, 4 times), a total of 4 to 6 cycles of chemotherapy. The short-term and long-term efficacy were evaluated, and the Karnofsky performance status (KPS) score, CA19-9, total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST) level changes and percutaneous transhepatic biliary drainage (PTCD) tube indwelling time were analyzed. Adverse reactions were recorded according to the Radiation Therapy Oncology Group (RTOG) injury classification standard. Results:Three months after the end of treatment, 4 cases (15.4%) were completely remitted, 20 cases (76.9%) were partially remitted, 2 cases (7.7%) were stable, and there was no disease progression. The objective remission rate was 92.3% (24/26). The 1-year and 2-year local control rates were 75.0% and 62.5% respectively, and the 1-year and 2-year overall survival rates were 57.7% and 26.9% respectively. The KPS score was 70.39±10.76 one month after the treatment, which was significantly higher than the 60.00±10.58 before treatment ( t=-27.00, P<0.001). The levels of CA19-9 before treatment and 1 month, 2 months and 3 months after treatment were (390.88±202.62) U/ml, (322.45±204.06) U/ml, (254.00±160.49) U/ml, (182.85±124.05) U/ml, which showed a gradual decrease trend, and there was a statistically significant difference ( F=126.94, P<0.001). TBIL [(250.88±80.83) μmol/L, (153.98±61.74) μmol/L, (93.45±38.12) μmol/L, (53.82±26.75) μmol/L], DBIL [(205.82±66.68) μmol/L, (133.23±58.53) μmol/L, (64.31±36.25) μmol/L, (40.55±26.16) μmol/L], ALT [(163.92±54.12) U/L, (68.23±28.86) U/L, (45.73±21.94) U/L, (32.66±12.88) U/L], AST [(177.69±58.68) U/L, (79.23±32.87) U/L, (49.77±25.45) U/L, (35.54±16.10) U/L] showed progressive decline, with statistically significant differences ( F=315.60, P<0.001; F=385.30, P<0.001; F=284.24, P<0.001; F=311.80, P<0.001), and liver function was improved. The PTCD tube was removed after treatment in all patients, with a median time of 54 days (49-96 days). During the treatment, bone marrow suppression, nausea and vomiting, abdominal pain and biliary tract infection occurred. All of them improved after symptomatic treatment. No serious complications such as bile leakage and biliary hemorrhage occurred. Conclusion:192Ir brachytherapy combined with external beam radiation has a reliable curative effect in the treatment of unresectable hilar cholangiocarcinoma. It can improve the quality of life of patients, and the adverse reactions can be tolerated. It provides a feasible and safe treatment method for the clinic.

Pelvic insufficiency fracture (PIF) is a late complication which is not fully understood after radiotherapy and chemotherapy for cervical cancer and is easily misdiagnosed as bone metastasis. Previous clinical trials focused on the incidence, time and location of PIF, while the analysis of potential risk factors mainly emphasized the clinical characteristics of patients. There were few studies analyzing the correlation between treatment factors and the incidence. The damage of pelvis bone, especially the sacrum, after radiotherapy is mainly related to irradiation mode and dose. In this article, the radiotherapy technology, the formulation of bone-conserving radiotherapy plan, the dose-volume parameters of external irradiation and intracavitary brachytherapy, and the correlation between chemotherapy and this disease were reviewed. In the future, according to the advantages of precision radiotherapy technology, it is necessary to optimize the bone preservation plan, reduce the irradiation range and dose of sacrum and pelvis, and then reduce the incidence of PIF, which needs further clinical trials and practice to verify.