Disinfectants ; analysis ; Disinfection ; Drinking Water ; analysis ; Environmental Monitoring ; methods

BACKGROUND AND OBJECTIVEAlthough there are many randomized clinical trials of late course accelerated hyperfractionated radiotherapy (LCAHFR) combined with FP chemotherapy for esophageal cancer, the efficacy and toxicity are controversial. This study was to evaluate the efficacy and toxicity of LCAHFR combined with FP chemotherapy in treating esophageal cancer.

METHODSReports of randomized clinical trials on LCAHFR combined with FP chemotherapy for esophageal cancer published between January 1999 and January 2009 were researched through Wanfang, CNKI, and PubMed databases. RevMan4.2 software was used for Meta-analysis.

RESULTSTwenty-one reports, including 2030 patients, were included in the meta-analysis. Of the 2030 patients, 1006 underwent LCAHFR (LCAHFR group), and 1024 underwent LCAHFR combined with FP chemotherapy (combination group). Compared with those of the LCAHFR group, the 1-, 2-, 3-, 5-years survival rates and 1-, 2-, 3-year local control rates of the combination group were significant increased, and the acute toxicity was also increased, but chronic toxicity showed no significant difference.

CONCLUSIONSLCAHFR combined with FP chemotherapy can improve the survival rate and the local control rate of the patients with esophageal cancer. The increased acute toxicity need to be concerned, whereas the chronic toxicity needs a long-term observation.

Adenocarcinoma ; drug therapy ; radiotherapy ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bronchitis ; etiology ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; Cisplatin ; therapeutic use ; Combined Modality Therapy ; Dose Fractionation ; Esophageal Neoplasms ; drug therapy ; radiotherapy ; Esophageal Stenosis ; etiology ; Esophagitis ; etiology ; Humans ; Leukopenia ; etiology ; Nausea ; etiology ; Pulmonary Fibrosis ; etiology ; Randomized Controlled Trials as Topic ; Survival Rate ; Tegafur ; therapeutic use ; Uracil ; therapeutic use

Objective To observe the injury of high intensity focused ultrasound combined with radiotherapy (RT) to the pancreas,the unintended abdominal tissues and organs of swine in vivo.MethodsAccording to the criterion to grade the gross and histological injury of the pancreas and the unintended tissue,the scores of injury between the groups to get the data of safety and feasibility of high intensity focused ultrasound(HIFU)combined with RT were compared.Results There was a better tolerance in each group and no fatal complication was observed.For the pancreas there was significant difference for the combined group compared with the other groups.For the unintended target tissue there was no significance difference except the control group with the other groups.Conclusion HIFU combined with RT can increase the injury to the pancreas of the swine compared with HIFU alone; while there was no increase for the injury to the unintended target tissue.The main toxicity of combination treatment is the toxicity of RT and can be tolerated by the animals.If the HIFU treatment is strictly controlled,the combination of HIFU and RT is safe and feasible.

OBJECTIVETo compare the clinical results of early and delayed intramedullary nailing and locked plating for the treatment of multi-segments tibial fractures of type AO/ASIF-42C2.

METHODSBetween January 2010 and January 2013,45 patients with multi-segments closed tibial fractures of AO/ASIF-42C2 were treated by early primary intramedullary nailing and locked plating in 20 cases as early group and delayed in 25 cases as delayed group. In early group,20 cases included 13 males and 7 females with an average age of (37.9±14.3) years old ranging from 20 to 56 years;according to soft tissue injury Tscherne classification, 8 fractures were frade I,12 were grade II. In delayed group, 25 cases included 17 males and 8 females with an average age of (38.7±17.2) years old ranging from 24 to 55 years,4 fractures were grade I ,19 were grade II ,2 were grade III. The operative time, blood loss, hospital stay,fracture healing time and complications were recorded. At final follow-up, the Johner-Wruhs score were used to evaluate functional efficacy, and the posterior-anterior and lateral X-ray to evaluate fracture reduction and alignment.

RESULTSAll the patients were followed up for (12.5±2.5) months in early group and (13.2±2.8) months in delayed group (P>0.05). No wounds infections were happened. At the last follow-up, the mean range of knee joint was 10°-0°-120°. According to Johner-Wruhs scoring,there were 15 cases in excellent,3 in good,fair in 2 in early group; 21 in excellent,2 in good,2 in fair. The average operative time,blood loss had no significant differences between two groups (P>0.05), but hospital stay in early group was significantly shorter than those in delayed group(P<0.05). Average fracture healing time of early group and delayed group were (5.3±2.6) months and (6.0±2.9) months, respectively (P>0.05).

CONCLUSIONFor multi-segments tibial fractures of type AO/ASIF-42C2 with preoperative minor soft tissue injuries lighter of Tscherne grade I or II, early primary intramedullary nailing and locked plating does not significantly increase the postoperative incidence of soft tissue complications for patients. The early and delayed primary intramedullary nailing and locked plating for treatment of AO/ASIF-42C2 proximal third tibial fractures can get similar curative effect.

Adult ; Bone Plates ; Female ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

Objective To investigate the expression of Th17/Th1cells in peripheral blood and its relationship with rapid virologic response (RVR) to the therapy with pegylated interferon (PEG-IFN)combined with rib(a)ivirin (RBV) in patients with chronic hepatitis C (CHC).Methods Thirty one CHC patients treated with PEG-IFN combined with RBV were enrolled,and the demographic and clinical data including age,gender,body mass index (BMI),results of biochemical parameters in serum and the peripheral blood samples at baseline were collected. Eleven healthy volunteers were enrolled as control group.The RVR in 4th week were observed by prospective experimental research method. The ratio of CD3 +,CD8 -,IL-17 +,Th17 and CD3 +,CD8-,IFN-γ+,Th1in peripheral blood mononuclear cells (PBMCs) were detected at baseline by flow cytometry.Results Compared to the healthy control group,the level of Th1cells was decreased and the level of Th17 cells was increased in patients with CHC.In non-RVR group of CHC,compared to the healthy control group,the level of Th1cells was decreased significantly,and the level of Th17 cells was increased significantly ( P ＜ 0.05 ). Conclusions There was Th1/Th17 subgroups imbalance in no-RVR CHC patients treated with PEG-IFN combined with RBV,the level of Th1cells was reduced,and the level of Th17 cells was increased.The high level of TH17 cells and low level of Th1cells at baseline may not be conducive to the RVR.

Background Our previous studies have indicated that the beneficial effects of grafting neural stem cells (NSCs) overexpressing glial cell line-derived neurotrophic factor (GDNF) in rats after stroke.However,the underlying mechanisms are highly debatable.In this study,we investigated whether neurogenesis,Akt,and extracellular signalregulated kinase 1/2 (Erk1/2) signaling were involved in this process.Methods Transient ischemic stroke were induced by occluding middle cerebral artery for 2 hours and reperfusion.At 3 days after reperfusion,GDNF/NSCs,NSCs,and vehicle were administered.Immunohistochemical staining was used to evaluate neurogenesis by nestin antibody; phosphorylation of Akt and Erk1/2 was investigated by Western blotting analysis.Results Transplantation of GDNF/NSCs and NSCs significantly increased nestin-positive cells compared to control group (vehicle) from 1 to 7 weeks after reperfusion,and GDNF/NSCs showed stronger effect than NSCs at 2 and 3 weeks after reperfusion.Meanwhile,enhanced phosphorylation level of Erk1/2 was observed in the GDNF/NSCs and NSCs groups compared with control group,and phosphorylation level of Erk1/2 in GDNF/NSCs group was remarkably higher than that of NSCs group at any given time.In contrast,expression of mitogen-activated protein kinase phosphatase-1 (MKP-1),known as inhibitor of Erk1/2 signaling,was significantly decreased in the GDNF/NSCs and NSCs groups compared with the control group.Moreover,much enhanced and prolonged phosphorylation level of Akt of GDNF/NSCs group was detected compared with control and NSCs group.Conclusion Grafting GDNF/NSCs enhances neurogenesis and activates Akt and Erk1/2 signaling,that may provide the potential for GDNF/NSCs in stroke treatment.

Objective To investigate the clinical features, laboratory findings, chest CT findings and treatment of patients with COVID-19, and to analyze their relationship with prognosis. Methods From January to February 2020, the clinical data on the 42 patients with COVID-19 admitted to the Wenzhou Sixth People′s Hospital were analyzed retrospectively. Results The clinical symptoms of the 42 cases included fever (35 cases), cough (26 cases), fatigue (14 cases), aspiration (9 cases), sore throat (4 cases), muscle ache (5 cases), headache (2 cases), nausea (4 cases), diarrhea (6 cases) and abdominal pain (1 case).The absolute number of blood lymphocyte decreased to different degrees in 22 cases.Fourteen cases had lactate dehydrogenase obviously, with no obvious change in procalcitonin.The imaging manifestations were cloud-like and ground-glass-like high density shadows scattered outside the lungs, small flaky consolidation and bronchus inflating sign were seen locally.A few images showed diffuse high density, most of the lesions showed consolidation or striate change, and local fibrosis was formed in the lower lobes of both lungs. Conclusion Fever and cough are the first symptoms of COVID-19, and a few cases are associated with shortness of breath and diarrhea, accompanied by different degrees of systemic symptoms, but most of the patients improve their conditions after active antivirus, anti-infection, systematic symptoms improvement and supportive treatment.The disease is highly infectious and its condition changes rapidly.Therefore, early detection, early diagnosis and comprehensive treatment of the whole body as soon as possible are the keys to treatment.

OBJECTIVETo investigate the clinical outcome and effect of interferon treatment on patients with chronic hepatitis C.

METHODS136 cases of patients with chronic hepatitis C were followed up by methods of retrospective survey combined with prospective study. SPSS16. 0 was used to perform chi-square test and multiple logistic regression.

RESULTS136 cases of patients were infected with HCV virus mainly through blood and blood products transfusion. They were diagnosed mainly between 2000 and 2005. 98 cases of them had anti-viral treatment with interferon and ribavirin, while the rest did not; 12 new cases developed HCV-related cirrhosis or liver carcinoma in five years, which accounted for 8.8% of the total. Among 76 cases once treated with interferon, 46 cases (60.5%) relapsed in five years. For patients with age < 40, the rates of cirrhosis and liver cancer were 0, and patients with age ≥ 40 but < 60 years, the rates of cirrhosis and liver cancer were 12.5% (7/56 cases), while for those ≥ 60 years old the rates were 35.7% (10/28 cases). The difference was significant ( B = 0.111, Wald = 4.324, P = 0.038) as analysed by logistic regression. The rates of cirrhosis and liver cancer were zero for those with normal or within twice the upper normal AST limit in five years, 43.5% (10/23 cases) for those with AST ranging from 2 to 4 fold the upper normal limit, and 58.3% (7/12 cases) for those with AST higher than four times the upper normal limit. The difference was also significant ( B = 2.184, Wald = 5.443, P = 0.02) by logistic regression analysis. The rate of relapse was 29.7% (11/37 cases) for those using pegylated interferon and 89.7% (35/39 cases) for those using interferon. The difference was significant ( Result of logistic regression showed-B = -2.077, Wald = 4.352, P = 0.037). The rate of relapse was 100% (15/15 cases) for those with treatment less than 24 weeks, 76.2% (16/21 cases) for those with treatment more than 24 weeks but less than 48 weeks, and 37.5% (14/40 cases) for those with treatment more than 48 weeks. The difference was significant (Result of logistic regression showed-B = -1.632, Wald = 6.651, P = 0.01). 42 cases of the relapsed (91.3%) were administrated with interferon once again with ideal effect.

CONCLUSIONHepatitis C virus infection increases the risk of liver cirrhosis and liver cancer. Interferon combined with ribavirin therapy could effectively control the virus and improve outcomes. We can reduce the incidence of relapse by choosing the treatment of pegylated interferon instead of interferon and by completing the full treatment.

Adult ; Antiviral Agents ; therapeutic use ; Female ; Follow-Up Studies ; Hepatitis C ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Logistic Models ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies

OBJECTIVETo investigate the impact of pyloric stenosis on the prognosis after D2 radical resection for advanced distal gastric cancer.

METHODSClinical data of 284 patients with advanced distal gastric cancer who underwent D2 radical resection from January 1998 to December 2004 were analyzed retrospectively. Clinicopathologic variables, survival outcomes, and postoperative morbidity and mortality were compared between patients who developed pyloric stenosis (n=69) and those without pyloric stenosis (n=215).

RESULTSThe 5-year survival rate was 38.8% in patients with pyloric stenosis and 62.4% in those without pyloric stenosis, and the difference was statistically significant (P<0.05). Cox regression model showed that pyloric stenosis, tumor size, depth of invasion, and lymph node involvement were independent predictors for survival. There were no significant differences between the two groups in postoperative morbidity (13.0% vs. 10.2%, P>0.05) or mortality (2.9% vs. 1.4%, P>0.05).

CONCLUSIONSPyloric stenosis is associated with poor survival for patients undergoing D2 radical resection for advanced distal gastric cancer. However, pyloric stenosis does not increase postoperative morbidity and mortality related to surgery.

Aged ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Male ; Middle Aged ; Prognosis ; Pyloric Stenosis ; complications ; Retrospective Studies ; Stomach Neoplasms ; complications ; surgery ; Survival Rate

OBJECTIVETo investigate the hepatotoxic effects of accidental intravenous diethylene glycol (DEG.) poisoning in patients with liver disease.

METHODSClinical data and liver function results were obtained from 64 patients with liver diseases who had been accidentally treated with diethyl glycol-contaminated agent and 45 cases with hepatorenal failure. The hepatotoxic effects of diethylene glycol DEG on the patients with liver diseases were assessed by multivariable logistical regression analysis.

RESULTSOf the 64 cases with liver diseases, 15 cases (23.4%) developed toxic presentations following the accidental administration of DEG. All affected cases were male. Twelve of the 15 poisoned patients (80%), died within 7 days of exposure to DEG. The most common clinical manifestations included kidney damage, renal failure, metabolic acidosis, and nerve system disturbances. The intravenous administration of DEG resulted in only mild liver function impairment. In terms of risk factors, both gender (r = 4.266, P less than 0.05) and the severity of jaundice prior to DEG administration were related to the occurrence of toxin-induced renal failure (r = 7.640, P less than 0.01).

CONCLUSIONSDEG may worsen liver damage in patients with liver diseases.

Adolescent ; Adult ; Aged ; Chemical and Drug Induced Liver Injury ; etiology ; Child ; Child, Preschool ; Ethylene Glycols ; poisoning ; Female ; Humans ; Liver Diseases ; drug therapy ; physiopathology ; Logistic Models ; Male ; Medication Errors ; Middle Aged ; Young Adult