Cardiomyopathy, Dilated ; etiology ; genetics ; Humans

Objective To discuss the technical points and clinical effects of thoracic reconstruction after resection of the sternal tumnors with autogenous rib graft and pedicle oinental flap. Method A retrospective study was made on 12 patients,who underwent resection of sternal tumors and thoracic reconstruction with autogenous rib graft and pedicle omental flap between January 2004 and March 2010. The tumor involved the manubrium in 4 patients and the sternal body in 8 patients. Results All operations of 12 patients were succeed with no perioperative mortality or severe complications. Incisions healed by primary intention healing,and no paradoxical breathing was found. The postoperative period was uneventful.Conclusion It's an effective way to treat sternal tumors by the resection and thoracic reconstruction with autogenous rib graft and pedicle omental flap.

ObjectiveTo compare the diagnostic efficiency of 18F- FDG coincidence SPECT/CT and 99Tcm- MDP whole body bone scan (WBBS) in detecting malignancy.MethodsA total of 71 cases (male 45,female 26,mean age 59.2 ± 15.4 years) with clinically confirmed malignancy underwent both 99TcmMDP WBBS and 18F-FDG coincidence imaging within three weeks.The sensitivity,specificity,accuracy,positive and negative prediction value of these two imaging methods in detecting bone metastases were compared based on the results from pathology or clinical follow-up.x2test was used for data analysis.ResultsA total of 350 lesions (including primary,second malignancy and benign disease) in 71 patients were eval-uated.81.7％ (286/350) malignant lesions were identified by either 99Tcm-MDP WBBS (209/350,59.7％ ) or 18F-FDG coincidence imaging ( 141/350,40.3％ ) (x2 =25.65,P ＜ 0.01 ).The imaging findings of osteoblastic,osteolytic,mixed types of bone metastases by99Tcm-MDP WBBS and 18F-FDG coincidence imaging were significantly different (x2 =20.78,2.89 and 9.94,all P ＜ 0.05 ).The sensitivity,specificity,accuracy,false-positive,false-negative,positive and negative predictive values for detecting bone metastases by 18 F-FDG coincidence study and 99Tcm-MDP WBBS were as follows:11.72％ ( 15/128),91.67％(22/24),24.34％ (37/152),8.33％ (2/24),88.28％ (113/128),88.24％ (15/17),16.30％ (22/135) ; and 53.91％ (69/128),75.00％ ( 18/24),57.24％ (87/152),25.00％ (6/24),46.09％ (59/128),92.00％ (69/75),23.38％ ( 18/77 ).The sensitivity,accuracy,false-negative,positive-predicting value of the two methods had been significant different (x2 =32.70- 46.21,all P ＜ 0.01 ).When two methods were combined,the diagnostic efficiency could been improved.ConclusionThe 99Tcm-MDP WBBS and 18F-FDG coincidence imaging has a complementary role in detecting bone metastases.

Objective To investigate clinical distribution and drug sensitivity of infectious pathogens in our wards for hematology malignancies. Methods Drug sensitivity tests of bacteria were performed by Kirby-Bauer method, 56 strains of pathogens were isolated from all detected samples. Results The results showed that the composition ratio of Gram-negtive bacteria, Gram-positive bacteria was 69.64%, 30.36%. In decreasing frequency, Escherichia coli (37.50%), Klebsiella pneumoniae (10.71%). All of staphylococcies were resistant to meticillin, and sensitive to vancomycin. Conclusion This study indicates that Gramnegative bacteria remain the predominant pathogens in microorganisms causing bloodstream infections for hematological malignancies at Huashan Hospital. The incidence of Escherichia coli is the highest. All of staphylococcies were resistant to meticillin.

Cell Line ; Cyclin-Dependent Kinase 5 ; metabolism ; Humans ; Lipopolysaccharides ; Microglia ; cytology ; drug effects ; metabolism ; Stilbenes ; pharmacology

Objective To observe the therapeutic efficacy of eight nape needle therapy in treating mild cognitive impairment (MCI) after cerebral stroke. Method By following a randomized controlled trial design, 200 eligible patients were randomized into an eight nape needle group and a medication group by the random number table, with 100 cases in each group. The patients all received basic medications, while the eight nape needle group was additionally intervened by acupuncture at the eight nape acupoints including Fengchi (GB20), Fengfu (GV16), Dazhui (GV14) and Xiangsihua points (Extra), and the medication group additionally received oral administration of nimodipine. The intervention lasted eight weeks, followed by a three-month follow-up. Before and after treatment, the two groups of patients were evaluated by Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Barthel Index (BI). Result Respectively at four-week and eight-week treatment and the follow-up, the scores of MMSE, MoCA and BI showed improvements compared with the corresponding baseline (P<0.01, P<0.05);compared with the medication group, the eight nape needle group was superior to the medication group comparing the MMSE score at each time point after treatment (P<0.01, P<0.05); there were no significant differences in the MoCA and BI scores between the two groups at four-week treatment (P>0.05), but the differences were significant at eight-week treatment and the follow-up (P<0.01). Conclusion Eight nape needle therapy can effectively improve the cognitive function in patients with MCI after cerebral stroke.

OBJECTIVE: To investigate the potential risk factors and management of excessive epistaxis after endoscopic endonasal surgery (EES). METHOD: Six hundred and forty-one patients who underwent EES in our hospital from December 2011 to December 2012 were reviewed retrospectively. Factors which potentially affect the incidence of excessive epistaxis after EES were analyzed with univariate and multivariate logistic regression model. RESULT: The incidence rate of excessive epistaxis after EES was 8.4% in our study. Multivariate logistic regression analysis revealed that history of previous EES, along with other four factors, correlated significantly with the occurrence of excessive epistaxis after EES. CONCLUSIONS Previous EES, along with other three factors, may increase the chance of excessive epistaxis after EES, while pre-operative corticosteroid therapy may reduce the risk to some extent.
Adolescent ; Adult ; Aged ; Child ; Endoscopy ; adverse effects ; Epistaxis ; etiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Nasal Surgical Procedures ; adverse effects ; Nose ; surgery ; Postoperative Complications ; etiology ; Retrospective Studies ; Risk Factors ; Young Adult

Objective:To investigate the efficacy of systemic glucocorticoid treatment and its related factors in progressive vitiligo patients with vitiligo disease activity (VIDA) scores ≥ 2 points.Methods:A total of 272 progressive vitiligo patients with VIDA scores ≥ 2 points and skin lesion area < 1% of body surface area, who received no systemic glucocorticoid treatment, were collected from Department of Dermatology, the Third People′s Hospital of Hangzhou from June 2018 to June 2019. The area and type of skin lesions, VIDA scores, predisposing factors and special clinical markers (trichrome vitiligo, confetti-like depigmentation, Koebner phenomenon and inflammatory vitiligo) were analyzed. These patients were randomly divided into 3 groups by a random number table: topical glucocorticoid group (62 cases) , oral prednisone + topical glucocorticoid group (76 cases) and compound betamethasone injection + topical glucocorticoid group (134 cases) , and the latter two groups were also called as the systemic and topical glucocorticoid group. The patients in the topical glucocorticoid group were treated with halometasone cream or 0.05% clobetasol propionate cream once a day; during the oral prednisone treatment, the dose was adjusted once every 7 days, and gradually reduced from 30 mg/d to 20, 15, 10 and 5 mg/d, and the treatment lasted 35 days; during the treatment with compound betamethasone injection, intramuscular injection was performed once every 20 days at a dose of 1 ml for 2 sessions. The stable disease rate (defined as the proportion of patients experiencing no progression during the study among the analyzed patients) was calculated in these groups after 3 months of treatment, and changes in vitiligo types were evaluated after 1 year of follow-up. Statistical analysis was carried out by using Kruskal-Wallis H test, χ2 test and Fisher′s exact test. Results:After 3-month treatment, there was a significant difference in the expansion rate of skin lesion area among the 3 groups ( H = 12.468, P < 0.001) , and the expansion rate of skin lesion area was significantly lower in the oral prednisone + topical glucocorticoid group and compound betamethasone injection + topical glucocorticoid group than in the topical glucocorticoid group ( P < 0.001, = 0.005, respectively, α = 0.016 7) ; among the patients with slowly progressive vitiligo (VIDA scores = 2 or 3 points) , the stable disease rate was significantly higher in the systemic and topical glucocorticoid group than in the topical glucocorticoid group ( χ2 = 23.973, 11.877, respectively, both P < 0.001) ; the stable disease rate also significantly differed among the patients with different VIDA scores (VIDA scores = 2, 3 or 4 points) in the systemic and topical glucocorticoid group ( χ2 = 17.122, P < 0.001) . After 3-month treatment, the patients with predisposing factors or special clinical markers showed significantly decreased stable disease rate (47.3% [35/74], 41.2% [47/114], respectively) compared with those without predisposing factors or special clinical markers (70.6% [96/136], 87.5% [84/96]; χ2 = 11.098, 47.548, respectively, both P < 0.001) . After 1 year of follow-up, the proportion of patients with localized vitiligo converted into non-localized vitiligo was significantly higher in the topical glucocorticoid group (41.9%, 26/62) than in the systemic and topical glucocorticoid group (21.9%, 46/210; χ2 = 10.328, P = 0.006) , and higher in the group with predisposing factors or special clinical markers than in that without predisposing factors or special clinical markers respectively (both P < 0.01) . Conclusions:Early systemic glucocorticoid treatment should be performed in the progressive vitiligo patients with high VIDA scores, predisposing factors and special clinical markers.

OBJECTIVEGlucocorticoid can induce apoptosis by regulating some genes' expression, but its effect on the pro-apoptotic protein Puma in leukemia remains unclear. This study was designed to investigate the effect of glucocorticoid on the expression of Puma in glucocorticoid-induced apoptosis of acute lymphoblastic leukemia cells in vitro.

METHODSLeukemia cells from acute lymphoblastic leukemia patients were transplanted into the immunodeficient mice. The transplanted leukemia cells were collected and then were treated with dexamethasone at the final concentration of 1 microM. The expression of Puma protein and mRNA in leukemia cells after dexamethasone treatment was detected by Western Blot and real-time quantitative PCR. A drug sensitive test was performed by MTT assay.

RESULTSThe leukemia cells which came from the patients who had good clinical outcomes were sensitive to dexamethasone, while the ones from the patients who had poor clinical outcomes were resistant to dexamethasone in vitro. The sensitivity to dexamethasone in vitro between the resistant and sensitive leukemia cells was significantly different (P < 0.05). No upregulation of Puma protein and mRNA was detected in resistant and sensitive leukemia cells after dexamethasone treatment.

CONCLUSIONSGlucocorticoid can not upregulate the expression of Puma in glucocorticoid-induced apoptosis of acute lymphoblastic leukemia cells in vitro.

Animals ; Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; analysis ; genetics ; Dexamethasone ; pharmacology ; Gene Expression Regulation, Leukemic ; drug effects ; Humans ; Mice ; Neoplasm Transplantation ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; pathology ; Proto-Oncogene Proteins ; analysis ; genetics ; RNA, Messenger ; analysis ; Transplantation, Heterologous

Objective To study the effect of magnetic nanoparticles on human cholangiocarcinoma xenograft in nude mice, and compared with otherchemotherapy drugs Methods We established human cholangiocarcinoma xenograft in nude mice with QBC939 cell line.The nude mice were devided into 4 groups randomly.Saline,5-FU, Gemcitabine and magnetic nanoparticles were given to nude mice through tail vein on 20d after implanting QBC939 cell line. Calculations were done at different time after treatment in order to compare tumor volume,inhibition ratio of tumor and tumor growth curve of each group. The nude mice were killed on 35d after treatment to harvest tissue for electron microscopic examination to observe ultra-structural changes. Results The tumor volume of control, 5-FU, magnetic nanoparticles and Gemcitabine groups was (2256.1?267.1) mm3, (2096.5?237.9)mm3,(1392.2?189)mm3, and (1534.9?115 )mm3 respectively.The last two groups have significant difference compared to the first two groups(P