Objective To review the research advancement of multimodal therapy for advanced gastric carcinoma.Methods The literatures on multimodal therapy for advanced gastric carcinoma in recent years were collected and reviewed.Results The multimodal therapy,such as preoperative chemotherapy,preoperative adjuvant chemoradiotherapy,preoperative interventional chemoradiotherapy for advanced gastric carcinoma was effective because it could increase the rate of R0 resection for the patients with advanced gastric carcinoma.And it can decrease the mortality rate after operation,extend the overall survival time and improve patients' life quality.Conclusion Multimodal therapy is a promising method for the treatment of advanced gastric carcinoma and it should be further developed.

Objective To evaluate T2WI sequence and liver acquisition with volume acceleration (LAVA) technique in the diagnosis of early endometrial carcinoma on 3.0 T MR scanner. Methods Twenty-seven patients with endometrial carcinoma confirmed by pathology were retrospectively analyzed. MRI sequences included axial T1WI and sagittal T2WI with fat saturation, axial and sagittal LAVA scanning including four phases: early arterial phase, late arteral phase, parenchymal phase and delayed phase. The tumor location, signal features, and myometrial infiltration by tumor were recorded and preoperative staging was compared with pathologic results. The sensitivity, specificity, accuracy of T2WI and LAVA in diagnosing endometrial carcinoma was assessed. The accuracy of the evaluation of the deep myometrium infiltration was compared between the two sequences using Fisher's exact test. Results According to Federation International of Gynecologie and Obstetrigue (FIGO) standard, 27 patients with endometrial carcinoma were classified as: stage Ⅰ in 22 cases, stage Ⅱ in 5 cases. The sensitivity, specificity, positive and negative predictive values in assessing deep myometrium infiltration were 70.0% (7/10), 94. 1% (16/17), 87. 5% (7/8), 84. 2% (16/19) respectively for T2WI sequence. Its accuracy in assessing myometrium invasion was 85.2% (23/27). The sensitivity, specificity, positive and negative predictive values were 80. 0% (8/10), 94. 1% ( 16/17 ), 88. 9% (8/9), 88. 9% ( 16/18 ) respectively for LAVA sequence, and the accuracy was 88.9% (24/27). There was no statistical difference of accuracy between two techniques( P = 1.00). Conclusion 3.0 T MR T2WI sequence has important role in diagnosing early endometrial carcinoma, and LAVA technique is highly valued in preoperative diagnosis and staging in early endometrial carcinoma for myometrium infiltration.

Compression Bandages ; Cysts ; surgery ; Humans ; Sutures

OBJECTIVE To explore the expression of Maspin in invasive fungal rhinosinusitis (IFRS) and the value of Maspin in the diagnosis of IFRS. METHODS Forty two cases of fungal rhinosinusitis (FRS) were set as the experimental group, which included 12 cases of IFRS and 30 cases of noninvasive fungal rhino-sinusitis (NIFRS). At the same time, 30 cases of chronic rhino-sinusitis were set as control group. Immunohistochemistry (IHC) was used to detect the expression of Maspin. RESULTS Compared with the control group, the expression of Maspin in FRS group decreased statistically (t=-3.367, P<0.05). The IFRS group, compared with other two groups, had the lowest expression of Maspin (t=-3.390, P<0.05; t=-4.143, P<0.05). By using Maspin score of 5.70 as the cut-off point, the sensitivity and specificity for the diagnosis of IFRS was 91.7% and 88.3% respectively. CONCLUSION The expression of Maspin is very low in IFRS group. Down-regulation of Maspin expression may be a potential indicator for diagnosis of IFRS.

ObjectiveTo explore linkage relationship between polymorphisms of (AC)n (AT)xTy and mutations in the β-globin gene in patients with mild β-thalassemia.MethodsThe subjects were 89 mild β-thalassemia patients with known mutations and 110 healthy subjects from People's Hospital of Baoan District of Shenzhen from February 2009 to July 2010.Genomic DNA was extracted from peripheral leukocytes.Sequence of the BP1 binding site upstream of the β-globin gene was amplified by polymerase chain reaction,polymorphisms of (AC)n (AT)xTy were determined by DNA sequencing.Allelic frequencies of (AC)n (AT)xTy between mild β-thalassemia patients and healthy subjects were compared using x2 test.Mutation rates between two groups were also compared using x2 test for subjects carrying same haplotype. Linkage relationship was conducted according to allelic frequencies and mutations. Results Analysis of the (AC)n(AT) xTy polymorphisms of the BP1 binding site upstream of the β-globin gene showed 9 different genotypes: (AC)2( AT)7T7,( AC)2( AT)8T5,( AC)3( AT)7T5,( AC)2( AT)9T5,( AC)2(AT)8T9,(AC)3(AT)8T5,(AC)2(AT)10T3,(AC)2(AT)7T5 and (AC)2(AT)11T3.The (AC)2(AT)7T7 and (AC)2 (AT)8T5 genotypes were common for patients with mild β-thalassemia.Allele frequencies of (AC)2(AT)7T7,(AC)3 ( AT)7T5 and ( AC)2( AT)8T9 were 38.8％ (69/178),11.8％(21/178),9.0％ ( 16/178 ) for mild β-thalassemia patients,and 24.1％ ( 53/220),5.4％ ( 12/220),3.2％(7/220)for healthy subjects, respectively, there were significant differences between mild β-thalassemia patients and healthy subjects (x2 =9.966,4.371,6.093,P ＜ 0.05 ).Allele frequency of (AC)2(AT)9T5 was 10.1％ (18/178) and 33.2％ (73/220) for mild β-thalassemia patients and healthy subjects,frequency of (AC)2 (AT)9T5 was significandy lower in mild β-thalassemia patients than in healthy subjects (x2 =29.691,P ＜0.01 ).Allele frequency of (AC)2(AT)8T5 was 25.3％ (45/178) and 29.1％(64/220) for mild β-thalassemia patients and healthy subjects,there wasn't significant difference between patients and healthy subjects (x2 =0.718,P ＞0.05).The mutation rates of codon41/42(-TTCT) and IVSⅡ-654(C→T) were 59％ (10/17) and 29％ (5/17) for mild β-thalassemia patients carrying (AC)2(AT)7T7 allele,and 29％ (4/14) and 57％ (8/14) for patients carrying ( AC)2 (AT)8T5 allele.There were not significant differences between codon41/42(-TTCT) mutation rate and IVS-Ⅱ-654(C→T) mutation rate (x2 =2.982,2.333,P ＞ 0.05 ) for mild β-thalassemia patients carrying ( AC)2 ( AT)7T7 and ( AC)2(AT)8T5 allele.ConclusionsAllele of (AC)2(AT)7T7,(AC)3(AT)7T5 and (AC)2(AT)8T9 are in linkage disequilibrium with β-thalassemia.Most mild β-thalassemia patients carrying (AC)2 (AT)7T7 allele are caused by codon41/42 (-TTCT) mutation in the β-globin gene,and IVS-Ⅱ-654 (C→T) is a major mutation for patients carrying (AC)2(AT)8T5 allele.

Objective To retrospectively analyze the anesthesia management of applying minimally invasive percutaneous neplrolithotripsy for treating hepatolithiasis.Methods The anaesthesia method,anesthetic effect,the time of resuscitation after anesthesia and side -effect of anesthesia in 86 patients who were underwent minimally invasive percutaneous neplrolithotripsy for hepatolithiasis were analyzed.Results All 86 patients were satisfied with anesthetic effect and completed surgery successfully.Among them,48 patients underwent operation with epidural anesthesia,31 patients with general anesthesia and 7 patients with the management of anesthesia monitoring(MAC) plus with local anesthesia.The time of resuscitation after anesthesia in general anesthesia patients was longer than those of epidural anesthesia and MAC.6 patients were delayed recovery and hypothermia after general anesthesia, 4 cases of epidural anesthesia and 1 case of MAC appeared cholecyst -heart reflection,and 2 cases of epidural anesthesia vomiting intraoperation.Conclusion The rational anesthesia method for patients underwent minimally invasive percutaneous neplrolithotripsy for treating hepatolithiasis should consider reasonably heart and lung function, maintain hemodynamics and respiratory stably,pay attention to insulation intraoperation,prevent cholecyst -heart reflection and shorten the operation time,which can reduce the side -effect of anesthesia and were favor for recovery after operation.

Objective To analyze the clinical effect of ostimeatal complex surgery on chronic sinusitis under nasal endoscope.Methods A total of 270 patients with chronic sinusitis treated in Huzhou Central Hospital from March 2014 to May 2017 were selected.The patients were randomly divided into control group and observation group according to the digital table,with 135 cases in each group.The observation group received ostimeatal complex surgery under nasal endoscope.The control group was treated with local excision,local glucocorticoid injection,and maxillary sinus puncture and irrigation. The patients were followed up for 6 months after surgery, the clinical effect was observed.The life quality of patients was evaluated with 36-items short form health survey (SF-36) and sino-nasal outcome test-20 (SNOT-20).Results At the last follow-up,the cure rate of the observation group was 84.4% , the improvement rate was 13.3% , the cure rate of the control group was 45.2% , and the improvement rate was 20.0%.The clinical efficacy of the observation group was significantly better than that of the control group ( Z =7.291,P<0.001).Three months after treatment,the physiological role score[(69.5 ± 14.1) points] and general health score [(62.9 ± 11.4) points], the total score of 20 items [( 15.5 ± 3.4 ) points] and 5 items [( 8.1 ± 3.7)points] of SNOT-20 scale in the observation group were significantly improved (t=4.881,5.102,20.283, 14.360,all P<0.05).The scores of physiological function,physiological role,body pain,vigor,social function,emotional role,mental health and general health in the observation group were (86.8 ± 11.5) points,(81.0 ± 12.1) points, (82.8 ± 12.7)points,(70.4 ± 11.0)points,(84.5 ± 13.0) points,(73.4 ± 11.6) points,(87.0 ± 12.4)points and (68.7 ± 16.4)points,which were significantly better than those in the control group [(83.8 ± 11.4)points,(69.5 ± 12.4)points,(78.5 ± 13.1) points,(68.4 ± 11.9) points,(74.4 ± 11.7) points,(67.4 ± 11.9) points,(78.9 ± 12.3)points and (64.3 ± 12.9) points],the differences were statistically significant (t =2.153,7.712,2.738, 2.012,6.710,4.195,5.388,2.450,all P<0.05).There were no statistically significant differences in the score of 20 general items and the score of 5 items compared with those at 3 months (all P>0.05).Conclusion The clinical effect of ostimeatal complex surgery on chronic sinusitis under nasal endoscope is satisfactory.The overall symptoms and quality of life of the patients returned to normal,but the 5 major problems such as nasal mucus,mucus nose,bad sleep at night,nasal discharge backstreaming and inattention have not been solved thoroughly.

OBJECTIVE: To investigate the field planting of Bacillus bifidus and Bacillus acid lactic on mucosa membrane of gaster, jejunal, ileum, ascending colon, and descending colon in rats with renal failure, and to observe their decomposition of creatinine (Cr), urea nitrogen (UN),and uric acid (UA). METHODS: Forty SD rats were randomly divided into 4 groups. Group A was normal control group,and 10 of them were sham-operated. Thirty of them were operated with 5/6 nephrectomy. Group B was pathological control group. Group C were fed Bacillus bifidus and Group D were fed lactobacillus. After 1 week all rats were sacrificed as samples of blood, digestive juice and gastrointestinal mucosa were taken.Bacteria on the gastrointestinal mucosa were counted. The concentration of UN, Cr,and UA of blood and digestive juice was determined. RESULTS: The number of bacteria on the gastrointestinal mucosa of Group B was less than that of Group A (P<0.05), but that of Group C and D was more than that of Group A and B. The bacteria number on the gastric mucosa was least and that on the descending colon was most. There was significant difference in the bacteria number and concentration of Cr, UN,and UA in various sites of the gastrointestinal tract (P<0.05). The concentrations of Cr, UN, and UA in the digestive juice of various sites and serum in Group C and D were lower than those in Group B (P<0.05). Bacteria planting number in the digestive tract has obvious negative correlation with the concentration of Cr,UN, and UA in the blood and digestive tract. CONCLUSION Field planting of lactobacillns and Bacillus bifidus, and the concentration of low molecule urotoxin are different in various sites of the gastrointestinal tract. It can decrease the concentration of BUN,Cr,and UA in rats with renal failure by feeding lactobacillus and Bacillus bifidus.
Animals ; Bifidobacterium ; growth & development ; metabolism ; Blood Urea Nitrogen ; Creatinine ; metabolism ; Gastrointestinal Tract ; microbiology ; Kidney Failure, Chronic ; etiology ; metabolism ; microbiology ; Lactobacillus ; growth & development ; metabolism ; Male ; Nephrectomy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Uric Acid ; metabolism

Objective To characterize the viability and transgene expression of articular chon-drocytes cultured in 3-Dimensional scaffolds provided by four types of carriers.Methods Articular chondrocytes from rabbit knees were cultured and infected with adenovirus that could express green fluo-rescence protein (AdGFP) and GL3 luciferase (AdGL3-Luc).The viability and gene expression were determined with fluorescence microscopy and luciferase assays in four types of scaffolds;type I collagen sponge, fibrin glue, hyaluronan and open-cell polylactic acid (OPLA).Cartilage matrix production was assessed by Alcian blue staining.Results Articular chondrocytes of rabbits were effectively infected by AdGFP and exhibited sustained GFP expression.All the tested scaffolds supported the survival and gene expression of the infected chondrocytes.However, the highest transgene expression was observed in the OPLA carrier (P<0.01).Alcian blue-positive matrix materials were readily detected in OPLA cultures four weeks later.Conclusion OPLA supports the highest transgene expression and is the most conduc-tive scaffold for matrix production, suggesting that OPLA may be a suitable scaffold for cell-based gene therapy of articular cartilage repair.

Objective To summarize our experience and treatment results of nasopharyngeal carcinoma treated in a single institution. Methods From Jan. 2000 to Dec.2003,1837 patients with histologically proven nasopharyngeal carcinoma(NPC) were retrospectively analyzed. The disease was staged according to the Fuzhou stage classification. 885 patients received cisplatin (DDP) based chemotherapy. All patients received radiotherapy to the nasopharynx and neck. The dose was 30.6-74.0 Gy, 1.8-2.0 Gy per fraction over 3.5-8.0 weeks to the primary site with 60Co γ rays or 6 MV X-rays. The dose to lymph nodes was 60-68 Gy. The residual disease was boosted by 192Ir afterloading brachytherapy,small external beam fields, conformal radiotherapy,or X-knife. Results The median follow-up time was 54(3-90) months. The 5-year overall survival(OS), disease-free survival (DFS), relapse-free survival (RFS) and distant metastasis free survival(DMSF) rates were 67.42% ,63.25% ,86.47% and 80.31% ,respectively. Clinical stage was the most significant prognostic factor,and OS was 88% ,74.8% ,65.9% ,52.4% and 20% for stage Ⅰ ,stage Ⅱ,stage Ⅲ,stage ⅣA and stage ⅣB,respectively. Gender,T,N and TNM stage were the significant prognostic factors of OS in multivariate analysis. Conclusions For NPC patients,the 5-year OS of 67.4% is achieved by conventional radiotherapy technique in our institution. Both univariate and multivariate analysis shows that gender and clinical stage are the significant prognostic factors of OS.