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 explore the regulatory effects of hyd ro gen sulfide (H 2S) on hypoxic pulmonary hypertension and pulmonary vascular rem odeling in rats. Methods Twenty-four rats were divided into 3 groups: control group(n=8), hypoxia group(n=8), and hypoxia +NaHS group( n=8). After 21 days of hypoxia, the mean pulmonary artery pressure (mPAP) wa s measured. The weight ratio of right ventricle. left ventricle +septum (R/L+S r atio) was measured. The microstructure and ultrastrcture changes in pulmonary sm all arteries were examined. The contents of proliferating cell nuclear antigen (PCNA) and Bc l-2 protein expressions were detected by immunohistochemical assay.Resu lts Compared with rats in the control group, the mPAP increased by 45.6 % (P

Objective To observed the impact of selenium supplementation therapy on the thyroid perioxidase antibody(TPO-Ab) levels and serum oxidative stress[malondialdehyde(MDA, glutathione peroxidase(GPx), and superoxide dismutase(SOD)] in patients with Hashimoto′s thyroiditis. Methods 79 patients with Hashimoto′s thyroiditis were randomly divided into trial group(n=44) and placebo group(n=35) .The double-blind treatment was for 24 weeks. The thyroid hormone levels, serum TPO-Ab levels, and oxidative stress indexes(MDA, GPx, and SOD) of both groups were detected before and after treatment. Results (1)There was no change of thyroid hormone levels either before or after treatments of both groups(P>0.05). (2)TPO-Ab of the trial group decreased significantly after the treatment(P<0.05). While the placebo group has little change. Group with TPO-Ab≤200 IU/ml and the course≤1 year manifested the most obvious declines by 29.98% and 26.63% respectively. (3)The oxidative stress level of trial group significantly decreased after 24 weeks. There was significantly positive correlation between the oxidative stress indexes and TPO-Ab. However the placebo group was with little change. Conclusion Selenium supplementation may reduce the level of TPO-Ab titers and oxidative stress in patients with Hashimoto′s thyroiditis, especially for those with lower antibody titers and short course.

Autophagy is a common phenomenon which widely ex-ists in eukaryotic cells. Researches have shown that autophagy plays a critical role in maintaining cellular hemostasis, cell com-ponents update and keeping a normal physiological state. In re-cent years, the study has found that autophagy is closely related to the growth, the development of cardiovascular diseases and tumors. Further studies show that in different pathological condi-tions, autophagy could both promote angiogenesis and inhibit the formation of blood vessels. Therefore, it is particularly critical to elucidate the mechanisms of autophagy in the regulation of angio-genesis in different pathological conditions. The role of autophagy in cardiovascular diseases especially in the regulation of angio-genesis is discussed in this paper. Besides, the paper also in-cludes the discussion about the mechanisms of autophagy in the regulation angiogenesis, which may provide references for follow-up research and clinical treatment.

ObjectiveTo investigate the therapeutic effectiveness of low-power laser on myofascial pain syndrome. Methods73 self-controlled patients with myofascial pain syndrome were irradiated on myofascial trigger points with Nd:YAG laser in wavelength 830nm, power 500mW, 20 minutes per day for 5 times. At pre-and post-treatment,pain intensity and pressure pain of myofascial trigger points were checked. ResultsAfter treatment, score of pain intensity was reduced signficantly from (7.24±2.41) to (2.21±1.22) (P<0.001). The pressure pain of myofascial trigger points were improved . Conclusions Low-power laser can reduce the pain intensity and increase the pressure pain threshold of myoficial trigger points.

Objective To investigate the changes of hydrogen sulfide (H_2S) level in plasma in order to explore the role of H_2S in the development of pulmonary hypertension (PH) secondary to congenital heart disease (CHD).Methods There were 9 CHD patients and 9 normal children in this study. The plasma concentration of H_2S and pulmonary artery pressure (PAP) of each child were measured. Meanwhile, the relationship between H_2S level and PAP was analyzed.Results The plasma level of H_2S in the group of CHD significantly decreased compared with control group (32.13?2.25) ?mol/L vs [(43.69?2.05)?mol/L, P

OBJECTIVETo study the influence of percutaneous microwave ablation (PMA) and surgical resection for patients with small primary hepatocellular carcinoma (PHC) on dissemination of tumor cells in peripheral blood determined by AFP mRNA.

METHODSForty patients with small PHC (The maximal diameter < or = 5 cm) confirmed histologically were included in this study. All the patients had single tumor nodule only without metastasis. Of the 40 patients, 19 were treated by PMA and 21 by surgical resection. Blood samples were collected and tested immediately before treatment, 30 min after the mass ablated/resected, 1 d and 7 d later by RTD-Nested-RT-PCR for AFP mRNA. The CD3, CD4, CD8 and CD4/CD8 in blood, and hepatic function were tested at the same time points as well.

RESULTSAfter treatment, ALT and AST in peripheral blood increased in both groups, but more intensely in the surgical group. The CD3, CD4 and CD4/CD8 in peripheral blood decreased at 30 min, 1 day and 7 days after surgical resection, and the lowest value was at 30 min after surgery. The immune function was kept at the same level as pre-treatment in the PMA group. AFP mRNA copies in blood could be detected in 27 of 40 patients (67.5%) in two groups before treatment, and the copy number was increased after treatment. There was no significant difference between the two groups. The patients were followed up for 1 - 16 months. AFP mRNA copies in blood could be detected persistently in the 4 patients with extrahepatic metastasis or liver recurrence.

CONCLUSIONSurgical resection and microwave ablation may cause PHC cells dissemination into the blood circulation in patients with small PHC, and there was no difference between the two treatment groups. The cellular immune function in peripheral blood is decreased after surgical resection, but is maintained at the same level as pre-treatment in the PMA group. The impairment of liver function is less severe after PMA treatment than surgical resection. PMA may provide certain value for clinical management of small hepatocellular carcinoma.

Adult ; Aged ; CD3 Complex ; blood ; CD4 Antigens ; blood ; CD4-CD8 Ratio ; CD8 Antigens ; blood ; Carcinoma, Hepatocellular ; blood ; surgery ; therapy ; Catheter Ablation ; methods ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver Neoplasms ; blood ; surgery ; therapy ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Neoplasm Recurrence, Local ; RNA, Messenger ; biosynthesis ; genetics ; alpha-Fetoproteins ; biosynthesis ; genetics

The clinical manifestations of five children with paroxysmal kinesigenic dyskinesia (PKD) were retrospectively analyzed and their gene mutations were analyzed by high-throughput sequencing and chromosome microarray. The 5 patients consisted of 4 males and 1 female and the age of onset was 6-9 years. Dyskinesia was induced by sudden turn movement, scare, mental stress, or other factors. These patients were conscious and had abnormal posture of unilateral or bilateral extremities, athetosis, facial muscle twitching, and abnormal body posture. The frequency of onset ranged from 3-5 times a month to 2-7 times a day, with a duration of <30 seconds every time. Electroencephalography showed no abnormality in these patients. Three patients had a family history of similar disease. The high-throughput sequencing results showed that a heterozygous mutation in the PRRT2 gene, c.649_650insC (p.R217PfsX8), was found in two patients; the mutation c.436C>T (p.P146S) was found in one patient; a splice site mutation, IVS2-1G>A, was found in one patient. The two mutations c.436C>T and IVS2-1G>A had not been reported previously. The chromosome microarray analysis was performed in one patient with negative results of gene detection, and the chromosome 16p11.2 deletion (0.55 Mb) was observed. Low-dose carbamazepine was effective for treatment of the 5 patients. PKD is a rare neurological disease. The detection of the PRRT2 gene by multiple genetic analysis can help the early diagnosis of PKD.
Carbamazepine ; therapeutic use ; Child ; Chromosome Deletion ; Chromosomes, Human, Pair 16 ; Dystonia ; complications ; diagnosis ; drug therapy ; genetics ; Electroencephalography ; Female ; Humans ; Male ; Membrane Proteins ; genetics ; Mutation ; Nerve Tissue Proteins ; genetics

Background Hyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inflammatory status, may impact uric acid (UA) metabolism. This study was to assess their potential relations to UA metabolism in heart failure. Methods We retrospectively assessed clinical characteristics, echocardiological, renal, metabolic and inflammatory variables selected on the basis of previous evidence of their involvement in cardiovascular diseases and UA metabolism in a large cohort of randomly selected adults with congestive heart failure (n = 553). By clustering of indices, those variables were explored using factor analysis. Results In factor analysis, serum uric acid (SUA) formed part of a principal cluster of renal functional variables which included serum creatinine (SCr) and blood urea nitrogen (BUN). Univariate correlation coefficients between variables of patients with congestive heart failure showed that the strongest correlations for SUA were with BUN (r = 0.48, P < 0.001) and SCr (r = 0.47, P < 0.001). Conclusions There was an inverse relationship between SUA levels and measures of renal function in patients with congestive heart failure. The strong correlation between SUA and SCr and BUN levels suggests that elevated SUA concentrations reflect an impairment of renal function in heart failure.