Objective To evaluate the efficacy of low dose 5-fluorouracil (5-Fu) combined with triamcinolone in the treatment of keloids, comparing with results with use of triamcinolone treatment alone.Methods Patient records from 2012 to 2013 were reviewed.45 patients (56 keloids) were completely randomized into 2 groups.Low dose of 5-Fu combined with triamcinolone were used to treat keloids in group A, while triamcinolone alone was used in group B.The therapeutic effects were evaluated by the certification of excellent remission, remission, inefficacy and total efficacy.The results were analyzed with statistics.Results In group A (27 keloids), the excellent remission cases were 16 (59.3%), the remission cases were 9 (33.3%), and the inefficacy cases were 2 (7.4%).The total percentage of efficacy in group A was 92.6%.In group B (29 keloids), the excellent remission cases were 9 (31.0%), the remission cases were 12 (41.4%), and the inefficacy cases were 8 (27.6%).The total therapy efficacy percentage of group B was 72.4%.Both the total percentage of efficacy and the excellent remission percentage in group A were apparently higher than those of group B, and the differences between the two groups were of statistical significance (P<0.05).The recurrence rates of group A were 3.7% (one case) while that of group B were 24.1% (7 cases).The differences between the two groups were also of statistical significance (P<0.05).Conclusions Low dose 5-Fu combined with triamcinolone is superior to intralesional triamcinolone therapy alone in the treatment of keloids.

ObjectiveTo observe the expression of syntaxin-1 in hippocampus of adult rats with hypothyroidism and the role of different doses of thyroid hormone replacement therapy,further to explore the molecular mechanism of brain damage.MethodsAll 44 male adult SD rats were randomly divided into 4 groups according to their body mass(250 - 300 g):hypothyroidism group,routine dosage thyroxine treatment group,high dosage thyroxine treatment group and control group (11 in each group).Hypothyroidism group,routine dosage thyroxine treatment group and high dosage thyroxine treatment group received daily intraperitoneal injection of propylthiouracil (PTU) 10 mg/kg.Hypothyroidism group was given PTU by intraperitoneal injection for two weeks after the previous four week treatment,the routine dosage thyroxine treatment group and the high dosage thyroxine treatment group were given 50,200 μg/kg L-thyroxine daily intraperitoneally for two weeks; the control group received daily intraperitoneal injection of saline.The levels of serum T3,T4 were assayed by radioimmunoassay method,and the level of syntaxin-1 in hippocampus was analyzed by immunohistochemistry.ResultsIn the hypothyroidism group,the levels of serum T3,T4[(0.34 ± 0.04),(43.01 ± 2.95)nmol/L] were significantly lower than those in the control group[(0.65 ± 0.05),(55.20 ± 3.56)nmol/L,all P ＜ 0.05].In the routine dosage of thyroxine treatment group,the levels of serum T3,T4[(0.63 ± 0.05),(55.04 ± 3.77)nmol/L] were not significantly different compared to the control group (all P ＞ 0.05 ).In the high dosage thyroxine thyroid hormone treatment group,the levels of serum T3,T4[(1.11 ± 0.10),(96.68 ± 6.42)nmol/L] were significantly higher than those in the control group(all P ＜ 0.05).The levels of syntaxin-1 protein in the CA1,CA3 and dentate gyrus(DG) of all layer regions of hippocampus (0.059 ± 0.016,0.064 ± 0.014,0.068 ± 0.016,0.069 ± 0.017,0.072 ± 0.016,0.070 ± 0.011,0.051 ± 0.012,0.072 ± 0.017) were significantly higher compared to the control group(0.037 ± 0.008,0.045 ± 0.010,0.042 ±0.009,0.040 ± 0.010,0.053 ± 0.009,0.042 ± 0.009,0.032 ± 0.007,0.047 ± 0.010,all P ＜ 0.05).In the routine dosage and the high dosage thyroxine thyroid hormone treatment group,the level of syntaxin-1 in CA1,CA3and DG regions(0.041 ± 0.011,0.046 ± 0.017,0.044 ± 0.014,0.037 ± 0.008,0.051 ± 0.010,0.043 ± 0.010,0.033 ± 0.011,0.045 ± 0.014 and 0.040 ± 0.010,0.045 ± 0.011,0.043 ± 0.010,0.033 ± 0.009,0.050 ± 0.010,0.041 ± 0.009,0.032 ± 0.009,0.046 ± 0.009)were not significantly different compare to the control group(all P＞0.05).ConclusionThe expression of syntaxin-1 in hippocampus of adult-onset hypothyroidism is increased,which can be reversed by routine dosage treatment of thyroxine.

OBJECTIVETo improve the paramedian forehead flap for nasal reconstruction.

METHODSBased on the findings of the Cutaneous branch of supratrochlear artery, the forehead musculo-cutaneous flap was divided into the musculo-flap and the skin-flap in 3 patients. The musculo-flap were used to reconstruct the septi-bone structure, and envelop silicon nasal-frame, while the skin-flap were used to reconstruct the nose. In 6 patients, the forehead flap was used as a skin-flap just with the muscle pedicle to reconstruct a nose with good appearance of nasal subunits, without the secondary operation.

RESULTSIn all of 9 cases, the cutaneous-branch of supratrochlear artery was found 1.7-2.0 cm above the orbital-rim. Eight patients got good results, only 1 patient had to do the secondary operation to coverage the exposed nasal frame.

CONCLUSIONSThe cutaneous-branch of supratrochlear artery could be an anatomical finding to form the forehead skin-flap and it is a good choice to be used to reconstruct a nose, even in complicated cases.

Adolescent ; Adult ; Female ; Forehead ; Humans ; Male ; Muscles ; transplantation ; Nose ; surgery ; Patient Satisfaction ; Reconstructive Surgical Procedures ; methods ; standards ; Skin Transplantation ; methods ; Surgical Flaps ; Treatment Outcome

OBJECTIVETo discuss the integrated autologous fat graft technique in face recontouring.

METHODSIn this study we treated 83 cases of face recontouring with 3L3M technique (low pressure suction, low speed centrifugation, low volume, multi-plane, multi-tunnel, multi-point injection). Each case was treated 1-3 times and the interval period is 3-6 months. The result was based on comparing the photos taken from pre-operation and post operation, observing the expression recovery, cysts, local absorption, and patients self evaluation.

RESULTSLong time follow up showed that fat graft can be alive in the recipient site for long time after 1-3 times autologous fat injection. More than 73.5% patients were satisfactory with the curative effect while less than 4.8% patients were unsatisfactory.

CONCLUSION3L3M integrated fat graft technique is an effective and safe treatment in face recontouring.

Adipose Tissue ; transplantation ; Adolescent ; Adult ; Face ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

OBJECTIVETo study 3 different strategies of urine drainage following hypospadias urethroplasty, the clinical nursing in their application, and their effects.

METHODSWe retrospectively analyzed the clinical data of 595 cases of hypospadias treated by urethroplasty. After surgery, 133 of the patients underwent urine drainage by suprapubic cystostomy (group A), 202 by urethral stent- tube indwelling (group B), and 260 by early initiative micturition with the urethral stent-tube (group C). All the patients received routine postoperative nursing care required for hypospadias repair.

RESULTSOperations were successfully completed in all the cases. Group C showed a remarkably shorter hospital stay and lower incidence rates of urinary fistula and urethral stricture than groups A and B (P<0.05), but there were no significant differences in the three indexes between A and B (P<0.05).

CONCLUSIONFor urine drainage following hypospadias repair, early initiative micturition with the urethral stent-tube can significantly reduce postoperative complications, decrease difficulties and workload of nursing care, and shorten the hospital stay of the patient.

Cystostomy ; Drainage ; methods ; Humans ; Hypospadias ; surgery ; Length of Stay ; Male ; Postoperative Complications ; prevention & control ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stents ; Urethra ; surgery ; Urethral Stricture ; prevention & control ; Urinary Fistula ; prevention & control ; Urine ; Urologic Surgical Procedures, Male

OBJECTIVETo explore the clinical value of "triple-rule-out" protocols using dual-source computed tomography for aortic dissection (AD) assessment.

METHODSTotally 25 patients suspecting of suffering from AD were examined on a dual-source computed tomography scanner. Two-dimensional and three-dimensional reconstruction was performed in all patients by means of multiplanar reconstruction, curved planar reformation, maximum intensity projection, and volume rendering. All images were read by two experienced radiologists in consensus. All patients were divided into AD group (n=12) and NO AD group (n=13) , The average Hounsfield unit values of true and false lumen were compared between superior of the aortic around the first endoleak and inferior of the aortic around renal artery.

RESULTSIn AD group, there were 6 patients with DeBakey type 1, 2 patients with DeBakey type 2, and 4 patients with DeBakey type 3. The image quality was rated on a 3-point scale as excellent in 10 patients (83.3%) and good in 2 patients (16.7%) . All cases was fully evaluable in NO AD group. The average Hounsfield unit values of true lumen between superior of the aortic around the first endoleak and inferior of the aortic around renal artery showed no significant difference between AD and NO AD group.

CONCLUSIONDual-source computed tomography offers a non-invasive, accurate, and rapid way to evaluate AD.

Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; diagnostic imaging ; Angiography ; methods ; Aortic Aneurysm ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; methods ; Young Adult

OBJECTIVETo explore the effect of changes of processing time on the surface properties of titanium coating formed by micro-arc oxidation (MAO).

METHODSForty-four disc-shaped pure titanium specimens with 10 mm diameter and 1 mm thickness were equally divided into 4 groups and processed by MAO technique in electrolytes containing 0.2 mol/L calcium acetate (CA) and 0.02 mol/L β-glycerol phosphate disodium salt pentahydrate (β-GP). The processing time were set at 1 min, 5 min, 10 min and 15 min respectively. The topograph of the MAO film surface and the film-substrate interface was observed by a scanning electron microscopy (SEM), and the composition was analyzed by an energy dispersive spectroscope (EDS) incorporated in the SEM. The phase and the microstructure of the film were analyzed by X-ray diffraction (XRD). The roughness of the film was measured using a roughness tester. The surface static contact angle was detected by a contact angle measurement instrument and the surface energy was calculated accordingly.

RESULTSWith the increase of processing time from 1 min to 15 min, the pore size increased from (1.30 ± 0.07) µm to (1.55 ± 0.09) µm, and film thickness increased from (10.2 ± 1.1) µm to (20.9 ± 2.9) µm. The content of the Ca in the film increased accordingly, and Ca/P increased from 1.99 to 2.45, and the surface energy increased from 24.62 mJ/m(2) to 39.49 mJ/m(2). Meanwhile, the XRD pattern indicated that rutile increased but anatase and titanium decreased gradually. At the time of 15 min, part of the MAO film peeled off.

CONCLUSIONSProcessing time has impact on the thickness, surface topography, crystal component and surface energy of titanium MAO coating. MAO film treated for 5 - 10 min demonstrated favorable surface properties.

Dental Implants ; Dental Materials ; chemistry ; Materials Testing ; Oxidation-Reduction ; Surface Properties ; Titanium ; chemistry

OBJECTIVETo study the clinical features, endoscopic findings, pathologic diagnosis and treatment options of intestinal follicular lymphoma first presenting with gastrointestinal symptoms.

METHODSThe clinical features, pathologic findings and follow-up data were retrospectively studied in 9 cases of intestinal follicular lymphoma. Immunohistochemical study for CD3, CD5, CD20, CD21, Ki-67, bcl-2, bcl-6, CD10 and cyclin D1 was carried out.

RESULTSSeven of the 9 patients were females and two were males. The age of patients ranged from 5 to 60 years (mean = 44 years). The clinical manifestations included abdominal pain (5 cases), blood in stool (3 cases) and abdominal distension (1 case). The commonest site of involvement was ileocecal region (6/9). Endoscopic examination had been carried out in 6 patients and all showed the presence of multiple polyps. Five cases had undergone endoscopic biopsy. Histologic examination of the endoscopic biopsies showed lymphoma cells located mainly in mucosal layer, forming vague nodules with ill-defined boundaries. Plasma cells and eosinophils were not conspicuous. Immunohistochemically, the tumor cells in all cases diffusely expressed CD20, CD10 and bcl-2. The staining for CD3, CD5 and cyclin D1 was negative. Lymphoid cells with weak CD10-positivity were identified in the interfollicular regions. Four cases were treated with surgical resection and chemotherapy. The other 3 cases received chemotherapy only and the remaining cases were treated conservatively. All of them were still alive on follow up.

CONCLUSIONSPrimary intestinal follicular lymphoma affects predominantly elderly patients and has a female predilection. The commonest site of involvement is ileocecal region. Endoscopic examination shows polypoid changes. The disease often runs a relatively indolent clinical course. The prognosis is better than that of primary nodal follicular lymphoma.

Abdominal Pain ; pathology ; Adult ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child, Preschool ; Combined Modality Therapy ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Endoscopy, Gastrointestinal ; Female ; Follow-Up Studies ; Humans ; Intestinal Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Lymphocytes ; pathology ; Lymphoma, Follicular ; drug therapy ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Neprilysin ; metabolism ; Prednisone ; therapeutic use ; Prognosis ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Retrospective Studies ; Sex Factors ; Vincristine ; therapeutic use ; Young Adult

OBJECTIVETo investigate the clinicopathologic features and differential diagnostic methods for follicular dendritic cell sarcoma.

METHODSHistological and immunohistochemical examinations and EBER in situ hybridization were used to investigate the pathological features of 5 cases of follicular dendritic cell sarcoma, and related literature was reviewed.

RESULTSThere were 3 males and 2 females with a median age of 54 years (range, 28 - 75 years). The location of lesions included lymph node (2 cases), tonsil (1 case), stomach (1 case), and liver (1 case). The growth patterns were fascicular or whorls and/or diffuse. The neoplastic cells were spindle or ovoid in shape with indistinct border and slightly eosinophilic cytoplasm. The nuclei were round, oval or spindle in shape with small distinct nucleoli. Warthin-Finkeldey-like multinucleated giant cells were detected in two cases. Mitotic figures were found in 1-22/10 HPF. Immunohistochemical staining showed that CD21 and CD23 (3 of 5), CD35 (4 of 5), D2-40 (4 of 4), and CXCL13 (3 of 4) were positive in neoplastic cells. EBER was detected in one of five cases by in situ hybridization. Four cases were followed-up for 6 approximately 25 months and no recurrence or death was observed yet.

CONCLUSIONFollicular dendritic cell sarcoma is an extremely rare and should be considered as a moderately malignant tumor, and may present histological polymorphism with certain distinctive features. Immunohistochemistry is necessary in differential diagnosis to distinguish from other tumors.

Adult ; Aged ; Antibodies, Monoclonal ; metabolism ; Antibodies, Monoclonal, Murine-Derived ; Chemokine CXCL13 ; metabolism ; Dendritic Cell Sarcoma, Follicular ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Granuloma, Plasma Cell ; metabolism ; pathology ; Humans ; Liver Neoplasms ; metabolism ; pathology ; surgery ; Lymph Nodes ; metabolism ; pathology ; Male ; Membrane Glycoproteins ; metabolism ; Middle Aged ; RNA-Binding Proteins ; metabolism ; Receptors, Complement 3b ; metabolism ; Receptors, Complement 3d ; metabolism ; Receptors, IgE ; metabolism ; Ribosomal Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Tonsillar Neoplasms ; metabolism ; pathology ; surgery

OBJECTIVETo study the value of loss of CD10 expression in the diagnosis and differential diagnosis of follicular lymphoma (FL).

METHODSOne hundred and twenty-six cases of FL and 31 cases of reactive follicular hyperplasia (RFH) were studied with routine microscopy and immunohistochemistry.

RESULTSLoss of CD10 expression was observed in 37 cases (29.4%) of FL. Three patterns of CD10 loss were demonstrated, as follows: diffuse CD10 loss in all of the neoplastic follicles (33/37, 89%), CD10 loss in most follicles (3/37, 8%) and CD10 loss in only a few follicles (1/37, 3%). In general, loss of CD10 was frequently seen in higher-grade FL. Morphologically, the cases with CD10 loss showed follicular architecture. The neoplastic follicles in high-grade FL were of various sizes and showed irregular margins, while those in low-grade FL were relatively uniform in size with regular margin. Sometimes, the CD10-negative FL cells contained a clear cytoplasm, mimicking monocytoid B cells. On the other hand, CD10 expression was found in all of the 31 cases of RFH studied, with the exception of occasional individual or regressed follicles.

CONCLUSIONSThe expression of CD10 differs in FL and RFH. Loss of CD10 expression is seen mainly in FL. It is thus considered as a valuable parameter in differentiating between FL and RFH.

Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Lymphoma, Follicular ; diagnosis ; metabolism ; pathology ; Male ; Middle Aged ; Neprilysin ; metabolism ; Pseudolymphoma ; diagnosis ; metabolism ; pathology ; Splenic Neoplasms ; diagnosis ; metabolism ; pathology ; Tonsillar Neoplasms ; diagnosis ; metabolism ; pathology ; Young Adult