Objective To evaluate the effect of losecplatin combined with compound matrine in the intraperitoneal perfusion treatment of ovarian cancer with malignant ascites and its influence on the levle of serum tumor necrosis factor alpha(TNF-) of ovarian cancer marker.Methods 60 ovarian cancer patients with malignant ascites were divided into three groups:losecplatin combined with compound matrine perfusion group(combination group),single losecplatin perfusion group(losecplatin group) and single compound matrine perfusion group(compound matrine group),20 cases in each group.Before treatment,all the three groups were drained intraperitoneal fluid,then given the above-mentioned group of intraperitoneal perfusion therapy.The effects,side effects and serum TNF- levels of the three groups were compared.Results The patients of the three groups were successfully completed treatment,the effective rate of the combination group was 95%,which of the losecplatin group was 60%,which of the compound matrine group was 55%.The effective rate of the combination group was significantly higher than that of the single drug group(χ2=7.025,P<0.05),and the adverse reaction of the combination group was not significantly increased(χ2=1.026,P>0.05).The serum TNF- levels of the three groups after the perfusion treatment were significantly decreased(t=15.40,13.82,8.90,all P<0.05),TNF- level of the combination group was significantly lower,the difference was statistically significant(F=9.719,P<0.05).Conclusion Losecplatin combined with compound matrine in the intraperitoneal perfusion is a more effective method for the treatment of ovarian cancer with malignant ascites,which is worthy of promotion.

To investigate the chemical constituents of the roots of Andrographis paniculata, 28 compounds were isolated and identified from the 80% ethanol extract. There are 20 flavonoids: 5, 5'-dihydroxy-7, 8, 2'-trimetroxyflavone (1), 5-hydroxy-7, 8, 2', 6'-tetramethoxyflavone (2), 5, 3'-dihydroxy-7, 8, 4'-trimethoxyflavone (3), 2'-hydroxy-5, 7, 8-trimethoxyflavone (4), 5-hydroxy-7, 8, 2', 3', 4'-pentamethoxyflavone (6), wightin (7), 5, 2', 6'-trihydroxy-7-methoxyflavone 2'-O-beta-D-glucopyranoside (8), 5, 7, 8, 2'-tetramethoxyflavone (10), 5-hydroxy-7, 8-dimethoxyflavanone (11), 5-hydroxy-7, 8-dimethoxyflavone (12), 5, 2'-dihydroxy-7, 8-dimethoxyflavone (13), 5-hydroxy-7, 8, 2', 5'-tetramethoxyflavone (14), 5-hydroxy-7, 8, 2', 3'-tetramethoxyflavone (15), 5-hydroxy-7, 8, 2'-trimethoxyflavone (16), 5, 4'-dihydroxy-7, 8, 2', 3'-tetramethoxyflavone (17), dihydroneobaicalein (18), andrographidine A (19), andrographidine B (20), andrographidine C (21) and 5, 2'-dihydroxy-7, 8-dimethoxyflavone 2'-O-beta-D-glucopyranoside (22); three diterpenoids: andrograpanin (23), neoandrographolide (24) and andrographolide (25); two phenylpropanoids: trans-cinnamic acid (26) and 4-hydroxy-2-methoxycinnamaldehyde (5); and oleanolic acid (9), beta-sitosterol (27) and beta-daucosterol (28). Compound 1 is a new flavone, compound 4 is a new natural product, compounds 2, 3 and 5 were isolated from the Androggraphis genus for the first time and compounds 6-9 were isolated from this plant for the first time.
Andrographis ; chemistry ; Diterpenes ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Flavonoids ; chemistry ; isolation & purification ; Molecular Structure ; Oleanolic Acid ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry

OBJECTIVESTo observe the vaporesection efficiency of the 2 micron laser to the prostatic gland in benign prostatic hyperplasia, and investigate the method of estimating the amount of the vaporesected prostatic tissues during transurethral vaporesection of the prostate using the 2 micron laser system in the treatment of benign prostatic hyperplasia.

METHODSTotal 9 fresh prostatic gland specimens were obtained from patients with BPH under open surgical procedures, and vaporesected under a simulated transurethral environment with the 2 micron laser system immediately after weighted. Energies and time consumptions were noted, collections of vaporesected tissue specimens and the remnants of the prostatic glands were weighted after the procedures. The ratios of the vaporized tissues and the collected tissues to the whole vaporesected tissues were calculated respectively. The vaporesection efficiency of the 2 micron laser to the prostatic tissues was also calculated.

RESULTSAmong the total lost tissues, about (65.6 +/- 1.5) percent of which were that of vaporized, and nearly (34.5 +/- 1.5) percent were resected. Linear correlation between the weight of collected prostatic tissue(x) and the weight of prostatic gland specimens(y) could be defined as a formula of [y = 3.245x - 6.475 (t = 15.097, P = 0.000)].

CONCLUSIONThe amounts of the whole prostatic tissues removed by the 2 micron laser could be calculated from the collected resected prostatic specimens under a simulated transurethral surgical procedure.

Humans ; In Vitro Techniques ; Laser Therapy ; methods ; Lasers ; Male ; Prostate ; surgery ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods

OBJECTIVETo summarize the 5-year follow-up to 2 micron continuous wave laser vaporesection for the treatment of patients with low urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), and evaluate the safety and clinical effects of the treatment.

METHODSFrom October 2006 to September 2007, 236 cases with low urinary tract symptom secondary to BPH were treated transurethrally under epidural or general anesthesia using the 70 Watt 2 micron laser system. Vaporesection of the prostate was performed with the traditional "U" or the "dividing" method. The 210 cases who met the inclusion criteria in this study were selected for further observation. Baseline and perioperative data were recorded and evaluated in resection time, transfusion rate, catheter-time, improvements in maximal urinary flow rate (Qmax), international prostate symptom scores (IPSS), quality of life (QoL), and post voiding residual volume (PVR).

RESULTSOut of the 210 cases, 179 cases were followed up to 5 years finally. All the surgical procedures were successfully conducted under epidural or general anesthesia. Mean operation time was (80 ± 22) minutes, and mean retrieved prostatic tissue was (24.9 ± 4.2) g. Resected prostatic tissues could be easily flashed out of the bladder. There were no significant differences in serum sodium concentrations and hemoglobin levels before and after the surgery. Mean catheter time and hospital stay was (114 ± 35) hours and (5.7 ± 1.9) days respectively. Only one postoperative secondary hemorrhage was found and treated with blood transfusion. During the 5-year follow-up, Qmax increased from (8.6 ± 3.5) ml/s preoperatively to (23.6 ± 4.2) ml/s by the end of the follow-up (P < 0.01), IPSS and QoL-Score improved from 25.3 ± 5.2 and 4.1 ± 1.3 to 6.1 ± 3.0 and 1.4 ± 0.8 respectively (P < 0.01), and PVR decreased from (248 ± 89) ml to (15 ± 13) ml. The 3 patients developed urinary incontinence and recovered 3 months later through functional exercises with the help of acupuncture. Five patients were found to have urethral stricture 3 months after the surgery and recovered with the treatment of urethral dilatation (3 cases) or internal urethrotomy (2 cases) respectively.

CONCLUSIONSTransurethral vaporesection of prostate using the 2 micron continuous wave laser system is a safe and effective treatment for benign prostatic hyperplasia with obvious improvements in subjective and objective voiding parameters, which were evident at 3 months after the surgery and were sustained throughout the 5-year long-term follow-up.

Aged ; Aged, 80 and over ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Postoperative Complications ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods

OBJECTIVETo investigate the characteristics of transurethral partial cystectomy with a 2 µm laser in diagnosis and treatment for the bladder submucosal lesions in adults.

METHODSNine patients with suspected pathological diagnosed bladder submucosal lesions in out-patient department were diagnosed and treated transurethral with a 2 µm laser under sacral block between August 2009 and December 2010. The diameters of tumors were 1.5 - 2.5 cm. A 2 µm laser was used to incise the full-thickness bladder wall around the tumors. The entire bladder wall was peeled between the detrusor muscle layer and outer connective tissues. Tumors with bladder wall at the base were removed together and sent for pathological examination. The surgical procedures, intraoperative hemorrhage, intraoperative and postoperative complications were observed, pathological diagnosis and postoperative follow-up were performed.

RESULTSAll operations were successful. Mean operative time was 36.4 minutes (range 25 to 47 minutes), perioperative blood loss was minimal. There was no obturator nerve reflection and no hemorrhage detected after surgery. Postoperative pathological diagnosis included leiomyoma in 3 cases, pheochromocytoma in 3 cases, endometriosis in 1 case and metastatic bladder cancer in 2 cases.

CONCLUSIONSTransurethral partial cystectomy with a 2 µm laser can diagnose and treat bladder submucosal lesions. The procedures are effective and safe. Patients could get accurate pathological diagnosis without further painful and some bladder tumors can be treated by minimally invasive surgery.

Adult ; Aged ; Cystectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Treatment Outcome ; Urinary Bladder Neoplasms ; surgery

Objective To observe the clinical effect of intensity modulated radiation therapy (IMRT) combined with apapatinib mesylate in the treatment of elderly patients with locally advanced cardia adenocarcinoma and its effect on vascular endothelial growth factor receptor (VEGFR). Methods Forty-six elderly patients with locally advanced cardia cancer who were unwilling to accept surgery or couldn't get complete removal of cancers in Xuzhou Hospital Affiliated to Jiangsu University between January 2015 and April 2016 were collected. All the patients were randomly divided into the control group (23 cases) and the observation group (23 cases) according to the random number table method. The control group received radiotherapy alone. In the observation group, oral apatinib (500 mg/d) was taken in the first day of radiotherapy after breakfast until the disease progress or death occurred. Results The total effective rate was 92 % (19/23) in the observation group and 60 % (10/23) in the control group. There was a significant difference between the two groups(χ2=5.86,P <0.05). After treatment, the average level of VEGFR in both groups was decreased[(76.3±4.9)vs.(55.0±2.3)pg/ml],and there was a significant difference between the two groups (t = 3.93, P < 0.05). The common adverse reactions were blood adverse reactions and gastrointestinal reactions. The incidence rate of gastrointestinal reaction was both 83 %, and the blood adverse reaction was 100 %, and there was no significant difference between the two groups (both P > 0.05). Hypertension, proteinuria and rash response in the observation group were increased compared with the control group,but noⅣ grade of adverse reactions occurred. The median progression-free survival time was 10 months in the observation group and 8 months in the control group respectively (P = 0.01). Conclusion IMRT combined with apatinib in the treatment of elderly patients with locally advanced gastric cardia has a favorable efficacy and tolerance.

OBJECTIVETo evaluate the effectiveness of anterior versus posterior surgical treatments of thoracolumbar fractures.

METHODSRandomized controlled trials (RCTs) and clinical controlled trials (CCTs) were identified from MEDLINE (1966 - 2006.7), EMBASE (1966 - 2006.7), PubMed (1996 - 2006.7), Cochrane Library (Issue 2, 2006).We hand-searched Chinese Journal of Orthopedics (from establishment to May 2006) and Orthopaedic Journal of China (from establishment to May 2006). RCTs and CCTs were included. Data were extracted by two reviewers with designed extraction form. RevMan 4.2.8 software was used for data analysis.

RESULTSTwo RCTs and four prospective clinical trials were included. The combined results showed that compare with posterior surgical management, anterior approach in the treatment of thoracolumbar fractures proved the less incidence of complications; better neurologic recovery and corrected kyphosis angle; more complete and reliable decompression of the canal. However, there was not difference between the two groups in the general status outcomes.

CONCLUSIONSTo compare with posterior fixation system, anterior surgical managements in the thoracolumbar spinal trauma might be the optimal choices because the lower rates of complications and loss of corrected kyphosis angle; better neurologic recovery, also. Besides, due to the lack of Evidence-based guidelines for the treatment of thoracolumbar spinal injuries, the results which indicated above need further study.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Treatment Outcome

BACKGROUNDThe safety and efficiency of transurethral laser resection of the prostate to treat benign prostatic hyperplasia have been verified. However, this method does still not manage large volume prostates efficiently. To tackle this problem, we have designed a method of "transurethral dividing vaporesection of prostate" using a 2 micron continuous wave laser. The aim of this study was to evaluate the safety and efficiency of this method in the management of large prostates (> 80 ml).

METHODSIn this study, 45 cases of benign prostatic hyperplasia with a median prostatic volume of (123.7 ± 26.7) ml (range, 80.2-159.8 ml) were treated by the same surgeon under epidural anesthesia. During the surgery, superapubic catheters were needed, and saline solution was used for irrigation. First, the prostate was divided longitudinally into several parts from the bladder neck to the prostatic apex, and then gradually incised transversely chip by chip. Intraoperative blood transfusion rate, postoperative complications, maximum urinary flow rate, International Prostate Symptom Score and quality of life scores were recorded for statistical analysis using SPSS 16.0 software.

RESULTSIntraoperatively, no transurethral resection syndrome was observed, and no blood transfusions were needed. The resected prostatic chips were easily flushed out of the bladder through the resectoscope sheath without the use of a morcellator. Median vaporesection time was (95.0 ± 13.2) minutes (range, 75-120 minutes), and the median retrieved and removed prostatic tissue were (25.2 ± 5.1) g (range, 15.5-34.7 g) and (75.4 ± 16.4) g (range, 43.8-106.1 g), respectively. Median catheter time and hospital stay were (3.3 ± 0.9) days (range, 3-5 days) and (4.8 ± 1.8) days (range, 3-9 days), respectively. After a follow-up of 6 to 12 months, two patients had stress urinary incontinence and three had anterior urethral strictures. Satisfactory improvement was seen in maximum urinary flow rate, International Prostate Symptom Score and quality of life scores.

CONCLUSIONSThis study showed that 2 micron laser vaporesection is a safe treatment for benign prostatic hyperplasia patients with large prostates, and the method of "dividing vaporesection" may help improve both surgical efficiency and patient outcomes.

Aged ; Aged, 80 and over ; Follow-Up Studies ; Humans ; Laser Therapy ; methods ; Male ; Middle Aged ; Prostatic Hyperplasia ; pathology ; surgery ; Transurethral Resection of Prostate

OBJECTIVEEstablish the three-dimensional finite element models of mandibular bilateral sagittal split ramus osteotomy (BSSRO) with rigid internal fixation (RIF), for further study of BSSRO.

METHODSCT scanned technology and the finite element software (ANSYS) were used to establish the original three-dimensional model of mandible, modify the model to animate the BSSRO, then establish the model of RIF, last mesh the model to establish the finite element model of BSSRO with RIF. Apply 100 N occlusion force at the central incisor; calculate the stress distribution of the mandible and the RIF.

RESULTSThree-dimensional finite element models of BSSRO with RIF were established, such as miniplate model, bicortical fixation screw model. When biting with the incisor and fixed with upper plate, the stress of the medial screw position of the distal and medial segment of mandible is high. When fixed with bicortical fixation screw, the highest stress position located at the internal surface of the medial screw' s position of the distal segment of mandible.

CONCLUSIONSThe mentioned methods proved feasible in establishing the finite element models of BSSRO with RIF . The models can be applied to the study of BSSRO with RIF.

Finite Element Analysis ; Fracture Fixation, Internal ; Humans ; Imaging, Three-Dimensional ; Mandible ; diagnostic imaging ; surgery ; Models, Anatomic ; Osteotomy ; methods ; Tomography, Spiral Computed

OBJECTIVEThe aim of this experiment is to know whether active orthopedic appliance is rationale to do presurgical treatment and seek some regularities.

METHODSLaser scanning confocal microscopy and triple fluorochrome labeling in bone were used to observe and study detailed changes occurred in compressed suture systematically.

RESULTSWidened suture and broken fibres between the adjoining bones was observed at the 3rd week postoperatively. At the 3rd week hyperplasia of organic tissue components was also seen. At the 6 and 9th week there were no apparent differences among all groups no matter whether in control group or experimental groups.

CONCLUSIONRetarding injury of compressed suture and surrounding tissue hyperplasia exists. With growth and development wounded suture will gradually assimilate to control group structurally and functionally.

Animals ; Cranial Sutures ; pathology ; ultrastructure ; Female ; Hyperplasia ; Lasers ; Maxilla ; pathology ; ultrastructure ; Microscopy, Confocal ; Rabbits