Objective　To investigate the clinical significan ce of pelvic lymphadenectomy in advanced ovarian carcinoma. Methods　A total of 86 cases of advanced ovarian cancer with surgical treatment were assigned to 3 groups according to the size of residual focus and the performanc e of pelvic lymphadenectomy. Group A consisted of 42 cases with pelvic lymphaden ectomy and the diameter of residual focus smaller than 2 cm; Group B, 26 cases, underwent pelvic lymphadenectomy but with the residual focus larger than 2 cm; Group C con sisted of 18 cases without pelvic lymphadenectomy and the diameter of residual f ocus larger than 2 cm. All patients received CAP chemotherapy for 6 to 8 course of treatment and were in similar clinical stages and pathological grading. Results　The 5 year survival rate was 30.1% (13/42) in Group A, and 11.5% (3/26) in Group B with significant difference (P<0.05). Group C's 5 year survival rate was 11.1%(2/18). No significant difference was found betwee n Group B and C. Conclusion　Application of pelvic lymphadenecto my on those with residual focus less than 2 cm can apparently improve the patien ts' survival rate. But when the diameter of the focus is larger than 2 cm, pelvi c lymphadenectomy is not necessary.

Objective: To observe the mechanism and characteristics of new bone formation and remodeling process during distraction osteogenesis (DO) in the reconstruction of bone defect in cleft palate (CP). Methods: Sagittal palatal osteoectomy were performed in 12 cats to establish the CP model. The CP defects were reconstructed by intraoral distractors at the rate and rhythm of 0.4 mm?2/day till the transport disc (TD) reached the opposite edge across the defect region. Tetrachloride fluorescent labeling was administered 6 days before euthanasia specimen retrieval at 2, 4, 6, 8, 12 weeks through fixation period. Histological and fluoroscopical study were performed; control groups (2 animals in each group) were set for comparison. Results: The bone defect of CP was successfully reconstructed by DO. Exclusively intramembranous de novo osteogenesis were observed. Soft tissues attaching to TD were elongated simultaneously. No spontaneous repair was observed in control animals. Conclusion: With effective distraction and steady fixation, CP bone and soft tissue defect can be reconstructed by active intramembranous bone formation and remodeling following the applicaion of DO.

OBJECTIVEThe purpose of this study was to observe the roentgenographic characters of distraction osteogenesis (DO) correction of cleft palate (CP), to study the expression of BMP proportional to fixation period time intervals, and to explore the new bone formation mechanism in Cleft Palate bone shelf.

METHODS12 cats were used to establish the CP animal model surgically, and then were assigned randomly to (1) Experimental group (12 cats): CP defects were DO repaired at the rate and rhythm of 0.4 mm x 2/day. Specimen retrieval at 2, 4, 6, 8, 12 weeks after completion of distraction, roentgenography and Anti-BMP immunohistochemistry studies were performed; (2) Experimental control group (2 cats): CP defects without any treatment procedures, and (3) Empty control group of 2 cats.

RESULTSAnti-BMP immunohistochemistry study showed positive DAB dye in early 2 weeks and most extensively positive expression of BMP in 4 to 6 weeks. The expression of BMP wore off gradually through 8 to 12 weeks. The roentgenography showed that the newly mineralized bone was developed from the cut bone edges bilaterally to the central transparent zone, and the newly formed bone bridged the defect area completely at the end of the study. The CP bone defect was reconstructed and the distraction gap was filled with de nove osteogenesis. No new bone formation was observed in experimental control group.

CONCLUSIONThe process of new bone formation in the distraction area is dynamic. Being stimulated primarily, the process was kept highly active till quiescence phase finally. The X-ray examination shows that there is distinctively low roentgenopeque. Nevertheless, roentgenography is so far a very effective and convenient method to evaluate and monitor the DO correction efficiency.

Animals ; Bone Morphogenetic Proteins ; biosynthesis ; metabolism ; Bone Regeneration ; Cats ; Cleft Palate ; diagnostic imaging ; metabolism ; surgery ; Osteogenesis ; Osteogenesis, Distraction ; Palate, Hard ; diagnostic imaging ; metabolism ; surgery ; Radiography ; X-Ray Film

The blood reserve bank for preparedness against war,as a store of blood products and a base of blood supply,bears the responsibility of wartime emergency blood supply.Site selection is the basis of the construction of the blood reserve bank and directly related with its capacity of blood supply in both peace and wartime.The decision-making process concerning site selection is complicated and multi-aimed with various factors mutually related and conditioned.This paper proposes some basic principles of selecting the site of the blood reserve bank for preparedness against war,which are hoped to be beneficial for the demonstration of its site selection.

Objective To investigate the efficacy and safety of posaconazole in the prophylaxis or salvage treatment of invasive fungal disease (IFD) in patients with hematological diseases.Methods 25 patients with hematological diseases receiving posaconazole treatment from Feb 2014 to Feb 2015 were analyzed retrospectively.The patients' average age was 32.6 years old (16-64 years old).18 patients received posaconazole for IFD prophylaxis, and 7 patients for IFD salvage treatment.Results 18 patients receiving posaconazole for IFD prophylaxis had no clinical manifestation of IFD (that is no case of breakthrough fungal infection) during treatment or in the 12 weeks after treatment, and the average prophylaxis period was 21 d (14-35 d).Among 7 patients receiving posaconazole for IFD salvage treatment, 6 patients were effective, including 4 cases cured and 2 cases effective.There were no obviously side effects of posaconazole in these patients.Conclusion Posaconazole has good clinical response for IFD in the hematologic diseases patients whether in prophylaxis or in salvage treatment.

Objective To study the value of echoeardiography for diagnosis of juxtaposition of atrial appendage(JAA) and to discuss its features. Methods Eehocardiographic characteristics of JAA in nine cases were compared with results of cardiac catheterization and operation. The diagnostic features of echocardiography were summarized. Results Seven cases had juxtaposition of left atrial appendage and two had juxtaposition of right atrial appendage. The nine cases were all associated with severe congenital heart disease and the most frequent malformations observed with JAA were double outlet right ventricle, transposition of great artery, single ventricle and so on. Direct visualization of the JAA in the parasternal short-axis view at the base of the heart and visualization of an unusual transverse orientation of the atrial septum were the most features of JAA. Echocardiographie characteristics of JAA cases were correspondent to the results of cardiac catheterization and operation. Conclusions There is high accuracy by echocardiography to diagnosis JAA. JAA should be alerted in severe congenital heart disease.

OBJECTIVETo evaluate the renal function in treatment-naive patients with hepatitis B virus (HBV) related cirrhosis and to identify the risk factors for renal impairment.

METHODSWe collected the data of 860 HBV-related cirrhosis patients hospitalized in our unit between Jan 1, 2011 and Dec 31, 2011. Liver function of the patients was assessed with Child-Pugh score system, and the renal function with estimated glomerular filtration rate (eGFR) calculated by Modification of Diet in Renal Disease (MDRD) equation recommended by Kidney Disease Outcomes Quality Initiative (K/DOQI). We investigated the prevalence of renal impairment (eGFR>60 ml/min/1.73 m(2)) among these patients and explored the risk factors for renal impairment.

RESULTSOf the 860 patients, 296 had complete clinical data and were included in our analysis. The overall incidence of renal impairment among the enrolled patients was 8.45% (25/296). Patients with Child-Pugh stage C showed a significantly higher incidence of renal impairment than those with stages B and A (17.17% [17/99] vs 6.67%[7/105] vs 1.09% [1/92], P<0.001). Age, history of hyperuricemia, and Child-Pugh score were identified as the risk factors for renal impairment in these patients.

CONCLUSIONIn patients with HBV-related liver cirrhosis, the incidence of renal impairment increases significantly with deterioration of the liver function, and renal function should be regularly monitored in these patients for appropriate antiviral treatment.

Adult ; Female ; Glomerular Filtration Rate ; Hepatitis B virus ; Hepatitis B, Chronic ; physiopathology ; Humans ; Incidence ; Kidney ; physiopathology ; Liver Cirrhosis ; physiopathology ; virology ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

Objective To investigate the reliability and validity of the medical outcomes by applying short form-36 (SF-36) in evaluating gout patients’ health related quality of life (HRQOL).Methods Gout patientswere enrolled between March 2016 and June 2016 in Foshan Hospital of Traditional Chinese Medicine.Patients completed the SF-36 questionnaire.Summary scores,physical component summary (PCS) and mental component summary (MCS) were calculated by summing factor-weighted scores across all 8 subscales,with factor weights derived from general population.The indicators of reliability and validity included internal consistency,test-retest reliability,structural and discriminant validity,ceiling and floor effect.Results Totally 306 patients were enrolled.The internal consistency test showed that the Cronbach α coefficients ranged from 0.782 to 0.822,and the test-retest reliability coefficients ranged from 0.720 to 0.986 (P＜0.01).Structural validity analysis showed that there were two items whose eigenvalues were greater than one with the cumulative contribution rate of 66.1％.The discriminant validity analysis found that patients with more numbers of tophi,higher frequency of flare,multi-arthrosis involved and more complications had less scores of PCS and MCS (P＜0.05).There was a high ceiling effect on physiological function and a higher ceiling and floor effect on role limitation and emotional function caused hy impaired physical health.Conclusion The SF-36 can be used for the assessment of HRQOL in Chinese gout patients but disease specific questionnaire are warranted.

Objective To study the curative efficacy and safety of single-unit umbilical cord blood transplantation (sUCBT) for malignant hematologic diseases,which is provided by China's public cord blood bank.Methods We retrospectively analyzed 409 cases of malignant hematologic diseases who accepted myeloablative single-unit unrelated donor UCBT without ATG at our center between May 2008 and December 2016.A comparative analysis was made on the total nuclear cells (TNC) of the umbilical cord blood before freezing and after thawing,the cells of CD34+,the recovery rate of cells and the clinical effect of UCBT.Result 409 units of umbilical cord blood used in UCBT respectively came from eight China's public cord blood banks.The average TNC of 409 units of umbilical cord blood before freezing and after the tubular recovery were respectively 18.5 × 108 and 16.34 × 108 (p =0.000).The average recovery rate of the tubular recovery was 88.5％,and there was significant difference among cord blood banks (P =0.000).The average TNC of umbilical cord blood before freezing and transfusion were respectively 18.5 × 108 and 15.86 × 108 (p =0.000).The average recovery rate of umbilical cord blood transfusion was 85.9％,with the difference being significant among cord blood banks (P =0.000).The average number of CD34+ cells before freezing and after the tubular recovery was 11.18 × 106and 8.68 × 106 (p =0.000).The average recovery rate of CD34+ cells after the tubular recovery was 80.75 ％,with the difference being significant among the cord blood banks (P =0.000).At 42nd day after UCBT,the cumulative incidence of neutrophil engraftment was 95.4％,and the median time of the engraftment was 17 days (11-38 days).The cumulative incidence of platelet engraftment at 120th day was 84.6％,and the median time of the engraftment was 36 days (14-93 days).The cumulative incidence of erythrocyte engraftment at 60th day was 92％,and the median time of engraftment was 22 days (9d-60 days).After the umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of engraftment.The P values for cumulative incidence of neutrophil,platelet and erythrocyte engraftment were respectively 0.004,0.01 and 0.000 2,with the differences being statistically significant.At 100th day after UCBT,the cumulative incidence of Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees of acute graft-versus-host disease (aGVHD) was respectively 28.63％ and 15.7％.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of aGVHD.There was no significant difference between Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees (P =0.809 and 0.68 respectively).At 3rd year after UCBT,the cumulative incidence of relapse was 15.89％.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the cumulative incidence of relapse (P =0.898).At 3rd year after UCBT,the overall survival (OS) rate and disease free survival (DFS) rate were respectively 66.7％ and 59％.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in OS and DFS.There was no significant difference in OS and DFS (P =0.566 and 0.703 respectively).At 3rd year after sUCBT,the rate of graft-versus-host diseases/relapse-free survival (GRFS) was 54.3％.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the rate of GRFS (P =0.449).Conclusion The umbilical cord blood provided by China's public cord blood bank was used in UCBT.It has a high safety and good efficacy in treating malignant hematologic diseases.But it needs to set up the standardized and normalized quality-control system of umbilical cord blood for China's public cord blood bank.

Objective To analyze the epidemiologic and clinical features of post-engraftment blood stream infection (pePSI) after unrelated cord blood transplant (UCBT) in our hospital,and provide the basis for empiric antibacterial treatment.Methods 484 patients with hematological malignancies who received single-unit high intensity myeloablative UCBT in our hospital between April 2011 and November 2017 were enrolled.The incidence,etiology of BSI and associated mortality,drug resistance rate in the post-engraftment phase were investigated.Results Totally 25 episodes of BSI among 22 patients in the post-engraftment phase were documented,and the incidence of peBSI was 5 ％.Gram-negative organisms predominated over Gram positive,with Escherichia coli being the most frequent Gram-negative organism isolated (31.5％).Among Gram positive organisms,methicillin resistant Staphylococcus (MRS) was the most frequent species isolated (66％).Nearly 33％ of Escherichia coli isolates and 60％ Klebsiella pneumonia isolates were carbapenem-resistant.All Grampositive bacteria were sensitive to vaneomyein and linezolid.Among the 22 patients,14 patients were cured and survived (63％) eventually.Conclusion The most frequent causative agents of the peBSI after UCBT were Escherichia coli,Klebsiella pneumonia and MRS,etc.Combined antibacterial treatment including a carbapenem or beta lactamase inhibitor can be used for patients suffering fever in the post-engraftment phase as empiric antibacterial therapy.Vaneomyein and linezolid can be used as the first-line therapy for Gram-positive bacteria.