Objective To evaluate the changes in the epidemiology and clinical characteristics of cervical carcinoma over the past 50 years, and to explore the equitable treatment corresponding to these changes. Methods The clinical and pathological data of 1557 patients with invasive cervical carcinoma from January 1955 to December 2004 were retrospectively analyzed. Results (1) The average age of cervical carcinoma onset gradually decreased over the past 50 years, from 56.27?8.45 in years 1955~1964 to 43.81?8.9 in years 1995~2004. At the same time, the radio of clinically early (stages Ⅰ-Ⅱ) and non-squamous cancer also steadily increased. (2) Young patients (≤35 year old) had higher ratios of non-squamous, poorly differentiated and late stage (Ⅲ-Ⅳ) cancers, with a higher rate of lymphatic metastasis compared with other ages. (3) Because of the changes in epidemiology and clinical characteristics of cervical carcinoma, it′s necessary to alter the traditional model of treatment and to explore equitable therapy corresponding to these changes. Conclusions The average age of cervical carcinoma onset gradually decreased and simultaneously the ratio of clinically early (stages Ⅰ-Ⅱ) and non-squamous cancer also steadily increased over the last 50 years. Patients aged 35 and younger of cervical carcinoma had some obvious clinical characteristics compared with that of older patients. Preservation of reproductive endocrine function ought to be deliberated on in cervical carcinoma treatment of women with fecundity. Neoadjuvant intraarterial chemotherapy (NAIC) is an useful method for cervical carcinoma at present

OBJECTIVETo investigate the clinical application of pedicled superficial circumflex iliac artery (SCIA) flaps in Burns and Plastic Surgery.

METHODS19 cases with skin and soft tissue defects were repaired with the Superficial circumflex iliac artery flaps. The defects located in the hand and forearm, the lower abdomen and perineal area, the radicle area of thigh, etc. Before the SCIA flaps were transfered to the recipient areas, 15 cases with different kinds of wounds were debrided thoroughly, 3 cases with scar were removed directly. The size of the flaps ranged from 3.0 cm x 4.5 cm to 26.0 cm x 22.0 cm, and the pedical was 5 cm to 7 cm in length.

RESULTSThe flaps in the 18 cases survived completely. Skin necrosis in the distal end of the flap appeared in 1 case, and the wound healed after the second repair. The follow-up period rang from 3 to 18 months. The apperance and function of the hand or foot was satisfactory.

CONCLUSIONSBecause the pedicled SCIA flaps can be obtain conveniently and contain sufficient blood-supply, so the flap is easy to survive and the flap can be designed in a large size. We believe it is an ideal method to use this flap to repair skin and soft tissue defects located in hands, forearms, the lower abdomen and perineal areas, the radicle area of thigh and so on.

Burns ; surgery ; Forearm ; Graft Survival ; Hand ; Humans ; Iliac Artery ; Necrosis ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; pathology ; transplantation ; Thigh ; Wound Healing

Ten glucosyloxybenzyl 2-isobutylmalates and one benzyl alcohol glycoside were isolated from the dry tuber of Pleione bulbocodioides, which is a specie of Orchidaceae family and its dry tuber is one of the main sources of traditional Chinese medicine "shanci-gu", by a combination of various column chromatographic methods, including ODS, macroporous adsorbent resin, Sepheadex LH-20, and preparative HPLC. Their structures were identified on the basis of chemical evidences and spectroscopic analysis asloroglossin (1), grammatophylloside A (2), cronupapine (3), (-)-(2R, 3S)-1-(4-β-D-glucopyranosyloxybenzyl)-4-methyl-2-isobutyltartrate (4), vandateroside II (5), grammatophylloside B (6), bis [4-(β-D-glucopyranosyloxy) -benzyl] (S) -2-isopropylmalate (7), gymnoside I (8), militarine (9), dactylorhin A (10), gastrodin (11). Compounds 1-7 were isolated from this genus for the firt time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Malates ; chemistry ; isolation & purification ; Molecular Structure ; Orchidaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

This study was to investigate the chemical constituents from pseudobulbs of Pleione yunnanensis, one of the source of traditional Chinese medicine "Shancigu". The chemical constituents were isolated by various chromatography methods, including silica gel, ODS, Sephadex LH-20, and semi-preparative HPLC. Fourteen compounds were isolated and identified from the EtOAc fraction of 90% ethanol extract, including five dihydrophenanthrenes, four bibenzyls, two triterpenoids, and three phenylacrylic acids. Their structures were identified on the basis of the spectral data as 4, 7-dihydroxy-2-methoxy-9,10-dihydrophenanthrene (1), 4, 7-dihydroxy-1-(p-hydroxybenzyl)-2-methoxy-9,10-dihydrophenanthrene (2), (2,3-trans)-2-(4-hydroxy-3-methoxyphenyl) -3-hydroxymethyl-10-methoxy-2,3,4,5-tetrahydro-phenanthro[2,1-b]furan-7-ol (3), pleionesin B (4), blestriarene A (5), batatasin III (6), 3, 3'-dihydroxy-2-(p-hydroxybenzyl) -5-methoxybibenzyl (7), 3', 5-dihydroxy-2-(p-hydroxybenzyl) -3-methoxybibenzyl (8), 3,3'-dihydroxy-2,6-bis(4-hydroxybenzyl) -5-methoxybibenzyl (9), triphyllol (10), pholidotin (11), (E) -p-hydroxycinnamic acid (12), (E)-ferulic acid (13), and (E)-ferulic acid hexacosyl ester (14). Compounds 5,10-14 were separated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Orchidaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective Based on the published articles,this paper aims to study the pattern and probability of lymph nodes metastasis in nasopharyngeal carcinoma (NPC) and establish a radiotherapy standard for selecting and delineation of clinical target volume of neck lymphatics for NPC patients with N0 or N1.Methods Clinical trials about NPC by MRI as the main or only diagnostic imaging way were collected and extracted from database,such as WanFang,CBM,PubMed,Cochrane Library.Statistical analyses were performed using Stata software,version 12.0.Results Twenty-one clinical trials from 963 original articles were included in this analysis.The most commonly involved regions included retropharyngeal (67％) and level Ⅱ lymph nodes (71％).The overall probability of levels Ⅲ,Ⅳ and Ⅴnodal involvement were 37％,14％ and 21％,respectively.Low-risk node groups included levels ⅠA,ⅠB,Ⅵ nodes,and the rates of lymph node metastasis were 0,2％,2％ and 1％,respectively.Nodal metastases followed an orderly pattern of top-down,and the probability of skip metastasis between levels varied between 0.5％ ～7.9％.Conclusion Lymph node metastasis in NPC follows a predictable and orderly pattern.The rarity of metastasis in certain nodal groups andskip metastasis suggest that reduced treatment volume is feasible in conformal radiotherapy for NPC patients with No or N1.

Objective To explore the diagnostic value of endoscopic retrograde cholangio-pancreatiography (ERCP),ultrasonography (US) and CT scanning on cholagio-pancreatic diseases caused by clonorchis sinensis infection.Methods The results of US,CF and ERCP examination in 65 cases of obstructive jaundice caused by clonorchiasis and confirmed by presence of imagoes or eggs in feces or bile juice were analyzed and compared retrospectively.Results US examination was the simplest and most convenient which was characterized by diffuse even dilatation,thickening of walls,strengthened echo with the shape of“equal sign”intrahepatic bile ducts.The characteristic findings of CT included saccular dilatation of bile ducts of the periphery of the liver,thickening of the walls of bile ducts.Under duodenoscopy,32.3% (21/65) of cases presented as abnormal papilla such as small opening,mucosa outward turned,trapping or stiffness.Alterations in ERCP were characterized by shm or oval filling defect,diffuse saccular dilatation of terminal intrahepatic bile ducts.The most common complications included cholangiolithiasis (40%,26/65),carcinoma of bile duct on papilla (9.8%,6/65),and pancreatitis (1.5%,1/ 65).Conclusions Three methods were all useful for diagnosis of cholangio-pancreatic diseases caused by clonorchis sinensis infection,which were identically characterized by diffuse saccular dilatation of terminal intrahepatic bile ducts.The gold standard of diagnosis was the presence of imagoes or eggs in bile juice aspirated by the route of ERCP.Endoscopic sphincterectomy with postoperative vermifugal was the first choice of the treatment.

Objective To investigate the therapeutic effects of Smad7 and urokinase-type plas- minogen activator(uPA)co expression on CCl_4-induced rat liver fibrosis.Methods Forty SD rats were subcutaneously injectied of 40% CCl_4 every three days for 8 weeks.The rats were then divided into model group,AdSmad7/uPA group(injected with AdSmad7/uPA via tail vein),AdSmad7 group(injec- ted with AdSmad7 via tail vein)or AdGFP group(injected with AdGFP via tail vein).Ten healthy rats were served as control.The serum levels of procollagenⅢ(PCⅢ)and laminin(LN)were determined by radioimmunoassay,and the hydroxyproline level in liver tissues were examined by alkaline hydrolysis. The expressions of Smad7 and uPA in tissue were examined by immunohistochemistry and fibrosis area was stained with Sirius red.Results The expressions of Smad7 and uPA protein were significantly higher in AdSmad7/uPA group than that in AdGFP group after 3 days.Serum levels of ALT,AST,PCⅢand LN were significantly decreased in AdSmad7/uPA group compared to Smad7 and AdGFP groups (all P value

?AIM:To investigate the measurement of central anterior chamber depth ( ACD ) in patients with acute primary angle - closure glaucoma ( APACG ) with A - scan ultrasound, Pentacam and ultrasonic biological microscope ( UBM) .?METHODS: Thirty-five patients (35 eyes) with APACG were selected, of whom central ACD were measured with A-scan ultrasound, Pentacam and UBM.?RESULTS: The measurement values of ACD with A-scan ultrasound, UBM and Pentacam were 1. 5633±0. 2089, 1. 5783 ± 0. 2067, 1. 6275 ± 0. 2296mm, which was equal variance tested by the homogeneity of variance, and was significant different by multiple comparision (F=4. 074, P=0. 026). The difference of ACD between the two groups of A-scan ultrasound and UBM, A-scan ultrasound and Pentacam, UBM and Pentacam were statistically significant ( P = 0. 032, 0. 023, 0. 012 ). Altman- Bland analysis showed that the three methods were not consistent with each other.?CONCLUSION: The ACD value of the APACG with the three methods is the largest using Pentacam, followed by UBM and A - scan ultrasound. In clinical the three methods with different advantages can complement each other, but cannot be replaced. In order to obtain more accurate results, we should combine the advantage and make comprehensive analysis.

Objective To observe the changes of serum ferritin (SF)in neonates with mechanical ventilation and its clinical significance in the ventilation-induced lung injury (VILI). Methods The study was carried out in 36 neonates with mechanical ventilation and 31 neonates without mechanical ventilation in neonate intensive care unit(NICU).SF level in venous blood was measured on 1,24,48,72 hours after mechanical ventilation and 24 hours after mechanical ventilation removal by radioimmunoassay (RIA ).SF level of non-mechanical ventilation group were determined at the same time. Results SF levels in mechanical ventilation groups were significantly higher than those of control group (P