Objective To investigate diagnostic value of low-tension computed tomography(CT) and magnetic resonance imaging(MRI) on carcinoma around Vater’s ampulla.Methods The data of CT and MRI of 30 patients with carcinoma around Vater’s ampulla confirmed by pathology were analysed retrospectively.Results 30 patients all had different degree obstruction of low part of biliary tract. CT or MRI showed the location, size and relationship with abjacent tissue of carcinoma in 26 patients, and the finger-stall sign of the descending part of the duodenum in 18 patients among them. Space occupying lesion of carcinoma was found dimly in 4 patients, no space occupying lesion of carcinoma was found in 3 patients.Conclusion The finger-stall sign of the descending part of the duodenum and finding of mass of ampulla are characteristic findings of carcinoma around Vaterys ampulla, low-tension CT and MRI are valuable methods of diagnosis of carcinoma around Vatery’s ampulla.

Objective To study the effects of N,P,and K fertilizers on the growth and accumulation of secondary metabolites,to reveal the accumulation relationship between the biomass and the secondary metabolites in medicinal plants in the plantation,and to establish the basic theory of fertilization in medicinal plant culture.Methods Orthogonal design was used to study the effects of nine combinations of N,P, and K on the biomass and active constituents in three levels of three factors.While plants flowered,they were harvested,weighed,and smashed.Then contents of N,total caffee esters,and scutellarin were anaylzed.Results High amount of N,P,and K fertilizers was optimum to the accumulation of biomass, but low amount of N,P,and K fertilizers was optimum to the accumulation of total caffee esters and scutellarin.The N fertilizer significantly increased the biomass and decreased the content of total caffee esters and scutellarin in Erigeron breviscapus,but did not affect the active constituents yield.The effect of P on the accumulation of active constituents was higher than that of K,but its effect on the biomass accumulation was lower than that of K.The effect of K on the active constituents yield was the highest.Conclusion N,P,and K fertilizers could increase biomass and active constituents yield,nevertheless,decrease the contents of flavonoids in medicinal plants.

Objective To investigate the curative effect and safety of microinvasive percutaneous nephrolithotomy (MPCNL) and ureteroscope lithotripsy (URSL) in treatment of children′s (≤6 years old) middle and upper segment ureteral calculi. Methods Eighty children (≤6 years old) with middle and upper segment ureteral calculi were selected, and they were divided into observation group and control group according to random number table method with 40 cases each. The children of observation group were treated with MPCNL, and the children of control group were treated with URSL. The operation time, hospitalization time, calculi clearance rate of the first phase, decline situation of the postoperative hemoglobin and hematocrit and complication were compared between 2 groups. Results The operation time and hospitalization time in observation group were significantly shorter than those in control group:(45.43 ± 9.76) min vs. (68.32 ± 11.28) min and (8.12 ± 1.03) d vs. (13.45 ± 2.34) d, the calculi clearance rate of the first phase was significantly higher than that in control group: 100.0% (40/40) vs. 62.5%(25/40), the incidence of complication was significantly lower than that in control group:20.0%(8/40) vs. 60.0% (24/40), and there were statistical differences (P<0.05). There were no statistical differences in the decline situation of the postoperative hemoglobin and hematocrit between 2 groups (P>0.05). Conclusions The MPCNL in treatment of children′s middle and upper segment ureteral calculi has short operation time, high calculi clearance rate of the first phase, and low incidence of perioperative complication. Compared with URSL, the URSL is safe and efficient, and it is worthy of clinical application.

Objective To observe the short-term efficacy and toxicity of HEPP regimen in treatment of refractory Non-Hodgkin's Lymphoma. Methods HEPP regimen: HCPT 8 mg/m2 iv gtt d1~ d5, VP16 100 mg/d iv gtt d1~d5, PDD 20 mg/d iv gtt d1~d5, PDN 60 mg/m2 po d1~d14. The chemotherapy was repeated every 4 weeks as a cycle.The clinical effect was evaluated after 2 cycles and toxicity was observed during every cycle. Results 25 patients were eligible for toxicity evaluation and 22 patients for clinical response evaluation. The objective response rate was 60.0 %, including three cases complete remission and ten cases partial remission. Six cases achieved stable disease and three cases progressive disease. The major toxicity was bone marrow suppression, including 24.0 % grade Ⅲ/Ⅳ leukopenia and 12.0 % grade Ⅲ/Ⅳ thrombocytopenia. The incidence of nausea/vomiting, mucositis and hepatic toxicity was low. Conclusion HEPP regimen can achieve a satisfy result in the treatment of refractory Non-Hodgkin's Lymphoma. It is low toxic and well tolerated.

Objective To investigate the features of lymph node metastasis and its effects on the prognosis of patients after radical operation for thoracic esophageal squamous cell cancer, and investigate the reasonable postoperative adjuvant protocol. Methods Multivariate analysis of the clinical data of 204 patients was carried out by Spearman correlation analysis, Cox model and Kaplan-Meier method. Results The lymph node metastasis rate was 40.2% (82/204), and 166 out of 2193 dissected lymph nodes had metastasis with the rate of 7.57%. The analysis of related factors revealed that the invasion depth, tumor length and differentiation grade were significantly associated with the postoperative lymph node metastasis (χ2 = 17.466, 11.494, 6.767, P <0.05), while age, tumor site were not significantly correlated with the postoperative lymph node metastasis (χ2=1.086, 3.897, P > 0.05). Kaplan-Meier analysis showed that the 1-, 3-, 5-year survival rates of patients with < 4 lymph nodes metastasis were significantly higher than those with ≥4 lymph nodes metastasis (χ2=4.493, 4.494, 4.450, P < 0.05). The recurrence and metastasis were more often occurred in patients with lymph node metastasis compared with those without lymph node metastasis (r=-2.060, -4.296, P <0.05). Multivariate analysis confirmed that the pathological stage, tumor differentiation grade, and the postoperative adjuvant treatment were the independent prognostic factors. Conclusions The invasion depth, tumor length and differentiation grade are significantly associated with the postoperative lymph node metastasis. The lymph node metastasis state and the number of involved lymph nodes affect the prognosis of patients. Oral administration of 5-FU is benefit to the patients without lymph node metastasis.

Objective:To evaluate the effect of surgery on 47 patients with moyamoya disease by retrospective analysis.Methods:A total of 47 patients with moyamoya disease were enrolled from August,2010 to According to the improved treatment in August,2013,all cases were divided into two groups:a pre-improved group and a post-improved group.According to different surgical methods,they were divided into two subgroups:an indirect revascularization subgroup and a combined revascularization subgroup.Results:The cerebral ischemia in 77.4％ of patients was relieved after the surgery.There was significant difference in outcomes of patients between the pre-improved group and the post-improved group (P＜0.05),while there was no significant difference between the pre-improved indirect revascularization subgroup and the pre-improved combined revascularization subgroup.There was also no significant difference between the post-improved indirect revascularization subgroup and the post-improved combined revascularization subgroups (P＞0.05).Conclusion:Surgical treatment can improve the outcomes of patients with moyamoya disease,but there is no significant difference in surgical effects between indirect and combined revascularization.

Objective To explore the effects and mechanism of hydrogen sulfide on myocardial ischemia reperfusion in rats. Methods With sodium hydrogen sulfide (NaHS) as a donor of hydrogen sulfide ( H2S), we established myocardial ischemia-reperfusion injury model in rats. The SD rats were randomly divided into control group,myocardial ischemia reperfusion group (I/R group), H2S group,and H2S and glibenclamide (H2S + GLI)group. We monitored the hemodynamics index of rats, including heart rate, arterial pressure, left ventricular pressure. The rate of ventrical arrhythmia was also observed in each group. Results H2 S significantly reduced the ventricular arrhythmia (VA) occurrence (H2S group 66.5% vs I/R group 33.5% (P ＜0.05) and score in myocardial ischemia reperfusion rats (H2S group 2. 6 ±0. 7 vs I/R group 4. 5 ±0. 8(P＜0.05). The KATP channel blocker,glibenclamide,could weaken the antiarrhythmic effects of H2S ( H2S group 2. 6 ±0. 7 vs. H2S + GLI group 4. 0 ± 0. 6, P ＜ 0.05 ). Conclusions H2S has the protective effect against myocardial ischemia reperfusion damage. This function may be associated with the KATP signal transduction pathway in cells.

Objective:To explore the diagnosis, treatment and prognostic of pediatric intracranial atypical teratoid/rhabdoid tumor(AT/RT).Methods:A total of 15 pediatric patients with intracranial AT/RT were treated between January 2012 and June 2019 at the First Affiliated Hospital of Zhengzhou University.The clinical data were retrospectively analyzed.Overall survival (OS) rate and progression free survival (PFS) rate were calculated by adopting Kaplan- Meier method.The differences between the 2 groups were tested by performing Log- rank method, and the prognostic factors were analyzed by COX regression. Results:There were 12 males and 3 females, with the median age of 5.5 years (ranging from 8 months to 17.1 years). All patients underwent surgical resection.Gross-total resection (GTR) was achieved in 10 cases and subtotal resection (STR) was carried out in 5 patients.The conducted treatments were as follows: surgery+ radiotherapy+ chemotherapy+ intrathecal injection in 6 cases, surgery+ chemotherapy+ intrathecal injection in 4 cases, surgery+ radiotherapy in 2 cases, and surgery alone in 3 cases.Until January 2020, the median survival time of all the 15 patients was 18 months (ranged 1-27 months), and the survival rate was 33.3%.The 1-year OS rate and PFS rate for all 15 cases were 71.5% and 49.7%, respectively.The 2-year OS rate and PFS rate were 17.9% and 0, respectively. Log- rank analyses revealed that the 1-year OS rates of children less than 3 years old and those older than 3 years were 87.5% and 57.1%, respectively ( χ2=6.057, P=0.014). The 1-year OS rates of children with GTR and those with STR were 90.0% and 40.0%, respectively ( χ2=6.057, P=0.014). The 1-year OS rates of children with tumor dissemination and those without tumor dissemination were 100.0% and 33.3%, respectively( χ2=9.865, P=0.002). The 1-year OS rates of children in the standard-risk group and those in the high-risk group were 88.9% and 41.7%, respectively ( χ2=5.111, P=0.024). COX regression analyses proved that age, the extent of tumor resection, tumor dissemination and risk stratification are independent risk factors for prognosis [hazard radio( HR)=3.411, 3.795, 5.245, 3.397; P=0.025, 0.011, 0.001, 0.017]. Conclusions:Pediatric intracranial AT/RT is rare.The preliminary diagnosis and prognosis are difficult and poor, respectively.The complete resection of tumors with maximal safety remains the primary treatment.Age, the extent of tumor resection, tumor dissemination and risk stratification are independent prognostic factors for AT/RT children.

OBJECTIVE: To explore the microsurgical techniques for insular glioma without damaging its surrounding normal structures. METHODS: We retrospectively analyzed 54 patients with insular gliomas who underwent microsurgical operation by trans-syvian fissure approach between May, 2003 and August, 2008 in Xiangya Hospital. We discussed the techniques in the operation and summarized how to protect the key blood vessels, distinguish and protect the surrounding normal structures. RESULTS: There were 36 complete removals,14 secondary complete removals, and 4 partial removals.Six patients had complications after the craniotomy who had temporal speech disorder (aphasia mostly began to recover about 10 days after the craniotomy),4 patients had opposite side paralysis worsening (3 recovered normally and 1 improved after 6 months),4 had light paralysis, and another 3 had paralysis and speech disorder. CONCLUSION The microsurgery by means of trans-syvian fissure approach can well expose the anatomical relation between tumor and its surrounding structures,so that we can remove the tumor and protect the surrounding normal tissues as much as we can.
Adolescent ; Adult ; Brain Neoplasms ; pathology ; surgery ; Cerebral Cortex ; pathology ; surgery ; Female ; Glioma ; pathology ; surgery ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Neurosurgical Procedures ; methods ; Retrospective Studies ; Young Adult

OBJECTIVE To evaluate the impact of sublingual immunotherapy(SLIT)on the balance of Treg/Th17 cells and related cytokines in preschool children aged 3-6 years with allergic rhinitis(AR).METHODS Seventy preschool children aged 3-6 years with AR were divided into the SLIT group and the medication group,and their clinical data were retrospectively analyzed.The medication group received symptomatic treatment alone,while the SLIT group received a combined treatment of SLIT and symptomatic medication,with a 3-year follow-up period.The Treg/Th17 cell balance,serum levels of TGF-β,IL-10,IL-17,IL-21,as well as the total nasal symptom score(TNSS),total medication score(TMS),and visual analog scale(VAS)scores were compared before and after treatment between the two groups.RESULTS After 3 years of treatment,both groups showed significant improvements(P<0.05)in the percentages of CD4+CD25+Foxp3+Treg and CD4+IL-17+Th17 cells among CD4+T cells,percentages of Treg and Th17 cells,serum levels of TGF-β,IL-10,IL-17,IL-21,TNSS,TMS,and VAS scores.Moreover,the SLIT group exhibited significantly better outcomes compared to the medication group(P<0.05).CONCLUSION SLIT can modulate the balance of Treg/Th17 cells and improve serum levels of TGF-β,IL-10,IL-17,and IL-21.