Small cell carcinoma of cervix (SCCC) is a rare and high malignant neuroendocrine tumor.Because of its strong invasion,metastasis in early stage and easy recurrence,the prognosis is poor.Its diagnosis is based on pathomorphology,and immune-histochemistry biomarkers can improve its diagnosis.Combined therapy is recommended.Postoperative platinum/etoposide (PE),vincristine/adriamycin/cyclophosphamide (VAC) or taxel/carboplatin(TP) chemotherapy can improve the prognosis.

Background and purpose:To evaluate the treatment regimens used for patients with yolk sac tumors of the ovary and prognostic factors in our hospital. Methods:Clinical data for the patients with yolk sac tumors of the ovary were analyzed retrospectively. Patients were divided into four groups: patients in A group received nonsparing surgery and platinum-based chemotherapy; in B group received nonsparing surgery and non-platinum-based chemotherapy; in C group received fertility-sparing surgery and platinum-based chemotherapy; in D group received fertility-sparing surgery and non-platinum-based chemotherapy. 5-year survival rate and prognostic factors were analyzed.Results:The overall 5- year survival rate was 69.2 %. The 5- years survival rates were 81.8 %, 40.0 %, 82.6% and 50.0% for A, B, C and D group, respectively. Platinum-based chemotherapy achieved significant survival benefit (82.4% vs. 44.4%, P0.05). Clinical stage, the size of residual tumor and Platinum-based chemotherapy were the mainly prognostic factors in multianalysis.Conclusions:Fertility-sparing surgery with a postoperative plainum-based chemotherapy should be the ideal modality for the treatment of yolk sac tumors of the ovary. Staging and tumor-reductive surgery were most associated with the prognosis of the patients.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Humans ; Male ; Pancreatic Neoplasms ; therapy

Objective To discuss the clinicopathologic characteristics and risk factors for lung metastasis of early-stage cervical cancer after radical hysterectomy. Methods The complete clinicopathologic data of patients with lung metastasis of cervical cancer after radical surgery from January 2008 to December 2013 admitted in Zhejiang Cancer Hospital were retrospectively analyzed by univariate and multivariate analysis. Results (1)There were 38 cases of early cervical cancer suffered from lung metastasis after radical hysterectomy during the period. The median age at diagnosis of cervical cancer was 46 years, the average lung metastasis time was 13 months after operation, 50.0%(19/38) cases occurred in the first year. Thirty-one cases were squamous cell carcinoma and 7 cases were non-squamous cell carcinoma.(2)Univariate analysis showed that age,clinical stage, manner of tumor growth, tumor grade, perineuronal invasion, para-aortic lymph node metastasis were not significant effect on postoperative lung metastasis(all P>0.05). But tumor size, histologic types, depth of stromal invasion, uterine body infiltration, lympho-vascular space invasion,pelvic lymph node metastasis, positive margin and abnormal tumor markers were significantly correlated with postoperative lung metastasis(all P<0.05). Multivariate analysis showed that only tumor size, histologic types and pelvic lymph node metastasis were independent risk factors for lung metastasis of cervical cancer(P<0.05). Conclusions Patients of early-stage cervical cancer with lung metastasis mostly occurs within 1 year after radical hysterectomy. Local large tumor lesions (tumor size>4 cm), non-squamous cell carcinoma and pelvic lymph node metastasis were more likely to have lung metastasis.

Objective To investigate the clinicopathologic features,the complications of splenectomy and the survival of epithelial ovarian cancer patients with splenic metastasis.Methods A retrospective study was performed of 32 pailents with epithelial ovarian cancer who underwent splenectomy for tumor cytoreduction at Zhejiang Cancer Hospital between Jan 1998 and Jun 2006.Results Of 32 patients,23 patients(72%)were serous adenocarcinoma and 9 were non-serous adenocarcinoma.According to pathological grade,none was of G1,11 were of G2,21 were of G3.Postoperatively,20 patients were left with no residual tumor.7 were with≤2 cm and 5 were with＞2 cm residual tumor.Postoperative complications developed in 8 patients(25%),including subphrenic abscess,wound infection,gastric perforation,gastrorrhagia,phlebothrombosis,and bowel obstruction.The median follow up was 38 months,estimated 2-year and 5-year overall survival were 70%and 36%.Univariate analysis revealed that histological grade,residual tumor and courses of chemotherapy were influencing factors of the survival(P＜0.05),but multivariate analysis indicated that only residual tumor and courses of chemotherapy independently influenced survival(P＜0.05).Conclusions In epithelial ovarian cancer patients with splenic metastasis,low grade serous adenocarcinoma is most common.Splenectomy as part of cytoreductive surgery is associated with modest morbidity and mortality.Residual tumor and courses of chemotherapy are independent factors associated with the prognosis of the patients.

Objective To explore the expressions of LAT and VEGF, and the relationship between them in hepatocellular carcinoma (HCC). Methods The expressions of LAT protein and VEGF protein in SO HCC, 30cirrhosis and 10 normal tissues were assessed by immunohistochemical method. Results The expressions of LAT and VEGF in cancer tissues, cirrhosis tissues, normal tissues were significantly different. The expression of LAT in HCC tissues was stronger than that in cirrhosis, but the expression of VEGF in cirrhosis was stronger than that in HCC tissues. Conclusion The expression of LAT was not closely associated with the expression of VEGF in HCC. The abnormal expressions of LAT and VEGF were closely associated with the development of HCC. They may play important roles in development of HCC.

Objective The biological half-life in vivo of local anesthesia is short, high concentration in local tissue is in-clined to cause central nerve and cardiovascular toxicity due to the drug absorption into blood by blood vessels.The research was to pre-pare the poly ( lactide-co-glycolide) nanoparticle loaded with ropivacaine ( RVC-PLGA-NPS) , optimize its process, and determine its characteristics in vitro. Methods An oil-in-water emulsion solvent evaporation technique was adopted to prepare the RVC-PLGA-NPS.The formulation was optimized by central composite design/response surface method(CCD-RSM), with the encapsulation effi-ciency( EE) , drug loading( DL) and particle size as the indexes.Research was also made on itsin vitro release by fitting different model equations. Results The acquired nanoparticals were smooth, with the mean particle size (331.21±2.11) nm, DL (13.81±1.35)%and EE (74.82±2.53)%.The accumulative release rate of the nanoparticals was about 73%in 96 h, which showed that Higuchi func-tion fitted the release curve. Conclusion The RVC-PLGA-NPS made by emulsion solvent evaporation technique have obvious drug-release behaviour in vitro.

Objective To investigate the effect of early nursing intervention on severe complication of radical cystectomy and orthotopic ileal neobladder.Methods A total of 30 patients undergoing radical cystectomy with orthotopic ileal neobladder were randomly divided into the intervention group and the control group with 15 cases in each group,the control group received routine nursing,while the intervention group received psychological counseling,health education,sufficient preoperative preparation,postoperative strict tube care,nutritional support according to the serious complications after operation.The postoperative complications,indwelling time of tubes,hospitalization days between two groups were compared.Results Serious complications rate after surgery of the intervention group was lower than that in the control group.The indwelling time of tubes,length of stay in the intervention group were less than those of the control group,the two groups had significant difference.Conclusions Early predictive nursing intervention can reduce compli-cations rate after radical cystectomy and ileal neobladder,shorten the hospitalization time and improve the success rate of operation.

Objective To explore the influence of alimentary tract reconstruction after gastrectomy on the blood glucose level in patients with gastric cancers combined with type 2 diabetes mellitus. Methods From January 2004 to December 2009, the level of blood glucose and body weight before operation and 1,3,6 months after operation in 87 gastric cancer combined with type 2 diabetes mellims patients were retrospectively analyzed. These patients underwent different alimentary tract reconstructions,including 48 patients for Billroth I after distal subtotal gastrectomy (group A), 39 patients for esophageal Roux-en-Y jejunostomy after total gastrectomy (group B). Fasting blood glucose (FBG) level and body weight of these patients were compared. Results In group A, change of FBG before and after operation were not significant (P ＞ 0.05 ). The levels of FBG in group B were significantly lower in 1,3,6 months after operation [(6.7 ±0.8), (6.6 ±0.6), (6.8 ±0.7) mmol/L] than that before operation [(9.7 ± 1.4) mmol/L](P＜0.05). The lower value average difference of FBG at 1,3,6 months was significant between group A and group B (P＜0.05 ). In group B, 6 months after operation's total effective rate was 87.2% (34/39). Changes of body weight before and after operation in group A and group B were significant (P ＜ 0.05 ). But between two groups, the changes of body weight between 1,3,6 months and before operation were not significant (P ＞0.05).Conclusions Esophageal Roux-en-Y jejunostomy after total gastrectomy has obvious influence on FBG level in patients with gastric cancers combined with type 2 diabetes mellitus. It takes about 1 month to reveal the effect of operation and has nothing to do with weight loss.

BACKGROUND: Many experiments indicate that the angiogenesis of tissue engineered bone graft plays a key role in the osteogenesis.OBJECTIVE: An experimental pattern was set up designed to prepare a kind of vascularized engineered-bone graft for repairing rhesus tibia defects and analyze the relation of angiogenesis and osteogenesis in vivo by rontgenographic and morphological approaches.DESIGN: Random controlled animal experiment.SETTING: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University.MATERIALS: The composite graft was constructed by seeding the induced bone marrow stem cells (BMSCs) on to a beta-tricalcium phosphate(3-TCP) scaffold in vitro, a circular cylinder (20 mm × 8 mm diameter) with a slit (width 2 mm and length 3 mm ) open to both ends and slot. Porosity 60% and pore diameter 100-150 μm. Twenty-nine healthy rhesuses aged 4-5 years and weighted 3.5-5 kg were adopted without gender limitation.METHODS: The experiment was conducted in the Department of Orthopaedics and Traumatology, Nanfan Hospital, Southern Medical University from October 2003 to July 2005. ①Bone-periosteum defect of 20 mm was made in the middle part of right tibia of the 27 rhesuses, and randomly divided into 3 groups equally. ②The defect gaps in fascia-blood vessel group (A) were plugged with in vitro engineered composites constructed by bone marrow stem cells and 3-TCP scaffold, which were totally hugged by a sheet of pedicled deep fascia and additionally a corresponding portion of saphenous artery and veins. The gaps in fascia group (B) and control group(C), however, were inserted with fascia-coated tissue engineered bone and tissue engineered bone only, respectively. Furthermore, two rhesuses without filling materials on the defect were picked up as blanks fixed by steel pins. ③The angiogenesis and osteogenesis for each treatment was assessed by radioactive imaging, roentgenographic analyses, blocking density and vaso-area image analysis at time intervals of 4, 8 and 12 weeks postoperative.MAIN OUTCOME MEASURE: The score of radioactive imaging,roentgenographic, morphological and vaso-area image analyses RESULTS: Totally 29 rhesuses were involved in the result analysis.① General observation of samples: In group A, all the surfaces of the implanted material and the central part were wholly wrapped up or replaced by bonelike tissues which were hard and could not be broken. And 2/3 materials had been absorbed; In group B and C, partial materials of the medial surface and the front were not coated or replaced by bonelike tissues, which could be broken with force, and 1/3 material had been absorbed.②Histological observation of scaffolds: With time passing, the scaffold materials were absorbed to different degrees in group A, B and C, among which, group A was most significant; Under the microscope, the implanted materials at 12 weeks were completely coated with the bonelike tissues, while the blood vessels structures in the materials were mostly alveoli alike and multi-braches. In group B, most of the materials at 12 weeks were wrapped up by the new bone, and few blood vessels could be seen in the center of the materials. In group C, the implanted materials at 12 weeks were slightly absorbed. The new bone and the vascular structures were both increased a little, but still very few.③Analyses of vaso-area: The vaso-areas of both central and peripheral parts in group A were significantly bigger than those of group B and C (P ＜ 0.05). Furthermore, it tended to increase with the time.④X-rays observation: At 12 weeks, group A's images presented obviously decreased density which was lower than that of the normal bone in individual areas and the continual bony callus manifested. Whereas group B and C's images showed slightly decreased density and the continual bony callus appeared on the sections. ⑤The roentgenographic scores of bone defects: The results indicates that the scores of group A was better than those of group B and C at 4, 8 and 12 weeks, respectively (P ＜ 0.05).CONCLUSION: ①This study shows that a feasible and effective angiogenesis approach of tissue engineered bone can accelerate osteogenesis in vivo. ②The absorption level is positively related to local angiogenesis.