Objective To explore the operative method for reconstruction of superior vena cave (SVC) and its branches in the treatment of patients with malignant mediastinal or pulmonary tumors through anterior mediastinotomy. Methods From 2001 to 2004 year, 22 patients with malignant mediastinal tumor or lung cancer received the resection of tumors and the reconstruction of the superior vena cave and its branches through anterior mediastinotomy. The operative efficacy was followed up in all patients. Results There was neither severe operative complications nor operative death in this group of patients, and 2 patients died of tumor recurrence in one year of post-operation, while others survived till now. Only one artificial graft occlusion occurred one month after operation. Conclusion The complete resection of malignant mediastinal or pulmonary tumors and the reconstruction of superior vena cave and its branches through anterior mediastinotomy is simple and reliable, and can remarkably improve the survival time of the short-term and long-term of the patients with malignant mediastinal or pulmonary tumor invading SVC.

BACKGROUND:Traditional core decompression and al ograft fibula supporting can reduce the stress load within femoral head and improve mechanical properties of femoral head. However, it cannot provide supports for maintaining the stability of five pathological areas fol owing femoral head necrosis. OBJECTIVE:To observe the clinical effect of fan-shaped decompression and al ograft fibula supporting internal fixation in treatment of early femoral head necrosis in adults, taking al ograft fibula grants as the control. METHODS:Forty patients with early femoral head necrosis were randomly divided into treatment group and control group, receiving fan-shaped decompression plus al ograft fibula supporting internal fixation and traditional decompression plus al ograft fibula grafting, respectively. The therapeutic effects in two groups were observed and compared. After treatment, patients were detected by bilateral hip anteroposterior films, Harris scoring and X-ray ARCO staging to evaluate the col apse severity and restoration of necrosis. RESULTS AND CONCLUSION:At the last fol ow-up, Harris scores in the treatment group were significantly higher and the repairing effect was better than control group (P<0.05). In treatment group, 18 hips restored wel (72%) and 7 hips delayed or failed to restore (28%);in control group, 9 hips restored wel (60%) and 6 hips delayed or failed to restore (40%). Our findings indicate that, fan-shaped decompression plus al ograft fibula supporting internal fixation yields a more complete decompression, a higher stability of femoral head and a more reliable supporting, compared with traditional decompression plus al ograft fibula grafting.

BACKGROUND:Elderly patients with degenerative lumbar degeneration often appear insufficient holding power of pedicle screw in spine surgery, which is prone to occur de-pinning and leads to insecure fixation. How to increase the holding power of screws has become a hot research. OBJECTIVE:To observe the early clinical effect of pedicle screws with cement augmentation for treating lumbar degenerative diseases in elderly patients. METHODS:A total of 65 old patients with lumbar degenerative diseases received a treatment between August 2012 and April 2014, and were divided into two groups according to the treatment strategy:treatment group (n=24;internal fixation of pedicle screws with cement augmentation) and control group (n=41;routine internal fixation of pedicle screws). General conditions of patients in two groups were observed and compared. Visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) score system were used for evaluating the lumbar and back pain, and restoration of neurological function in lower limbs respectively. RESULTS AND CONCLUSION:Al of the patients successful y received the surgery and then were fol owed up from 3 to 20 months. The anterioposterior and lateral X-ray film revealed no loosening, loss, fracture of the screws, and no loss of intervetebral space height was found. There was no significant difference in the blood loss and hospital stay between two groups (P>0.05). JOA at postoperative 3 and 6 months, and VAS score at postoperative 3 months were significantly improved after the treatment of pedicle screws with cement augmentation, when compared to control group (P<0.05). VAS scores showed no difference at 6 months postoperatively in two groups (P>0.05). Pedicle screws with cement augmentation for treating lumbar degenerative diseases have the advantages of improving the screws holding strength, reconstructing the stability of lumbar vertebra and obtaining clinical efficacy on degenerative spine.

Objective Our study was aimed to study the clinical effect of carbon dioxide laser in the treatment of adult laryn -geal papilloma . Methods Clinical data of patients with adult laryngeal papilloma received treatment at our hospital from January 2012 to June 2014 was retrospectively analyzed .Patients were divided into two groups according to the type of treatment , observation group:received carbon dioxide laser treatment;control group:received tumor forceps treatment .Participants included 61 cases of pa-tients, the observation group of 26 cases, control group 35 cases.Compare the general clinical data , short-term clinical effects(opera-tion time, length of hospital stay , complications , short-term curative effect ) , the change of immune inflammation indexes before and after operation and postoperative recurrence in 1 year of two groups patients. Results The operation time and the length of hospital stay in observation group was significantly lower than that in control group[(33.66 ±4.71)min vs (37.19 ±5.21)min,(4.07 ±1.25)d vs (4.83 ±1.38)d, P<0.05].On the 3th day, The levels of CRP、IL-6、TNF-αand IL-1βin observation group were ( 6.15 ±1.67 ) mg/L, (6.51 ±1.12)ng/L, (23.56 ±4.16)ng/L, (5.25 ±1.21) ng/L, those in control group were (12.20 ±3.41)mg/L, (15.63 ±
4.11) ng/L, (36.16 ±7.37) ng/L, (12.63 ±4.12) ng/L.The differences of these parameters between the two groups were signifi-cant (P<0.001).Observation group patients had a lower rate of recurrence 1 year after surgery than that of control group patients (12.00%vs 37.93%, P=0.029). Conclusion In the treatment of adult laryngeal papilloma , carbon dioxide laser can achieve a better minimally invasive and lower postoperative recurrence when compare to tumor forceps treatment .

Objective To observe the significance of rehabilitation integrated system for stroke patients. Methods From October, 2013 to June, 2015, 95 stroke patients were divided randomly into experimental group (n=48) and control group (n=47). The experimental group received rehabilitation under the guide of rehabilitation integrated system, while the control group in the routine process. They were assessed with simplified Fugl-Meyer Assessment (FMA) and Barthel Index (BI) before and 3 months after treatment. The satisfaction was also inves-tigated. Results There was no significant difference between groups in the differences of scores of FMA and BI before and after treatment (t<1.044, P>0.05), while the satisfaction was higher in the experimental group (t=4.287, P<0.01). Conclusion The application of rehabilitation integrated system may improve the process of treatment and the efficiency of management, and result in more satisfaction of the stroke pa-tients.

Objective To explore the role of white matter injuries in the schizophrenia induced by the NMDA re-ceptor antagonist. Methods Adult male C57BL/6J mice (8 week old) were equally divided into four groups. One group was sub-chronically treated with saline solution, and the other three groups were intraperitoneally treated with MK-801 at dose of 0.025 mg/mL (M1), 0.050 mg/mL (M2) and 0.100 mg/mL (M3) in a volume 10 ml per kilogram body weight. All ani-mals were tested using Morris water maze at the 9th-15th day and using the Hole Board exploration as well as Rota Rod performance tests on the 16th day. The myelin basic protein (MBP) and the ultrastructure of the myelin sheaths in the cor-pus callosum were then examined using immunohistochemical methods, transmission electron microscope technique and stereological methods. Results The repeated sub-chronic MK-801 treatment did not induce impairment of spatial learning and memory in Morris water maze. The MK-801 treatment at 0.25 mg/kg and 1.00 mg/kg but not at 0.50 mg/kg resulted in less exploration to a new environment. The myelin staining with anti-MBP antibody was less intense in all three schizo-phrenic groups when compared to saline control group (P<0.01). Furthermore, MK-801 treatment caused pathological al-terations of the myelin sheaths including segmental demyelination of myelinated fibers and splitting of myelin sheath lamel- lae in schizophrenic groups. The ratio of the injured myelinated nerve fibers in the corpus callosum of MK-801 treated mice [M3 group, (22.42 ± 4.24)%] was significantly higher when compared to the control mice [(3.84 ± 1.35)%,P<0.01)]. Conclusions The present study demonstrated the white matter damages, mainly low MBP expression and segmental demye-lization in the corpus callosum in the mice sub-chronic treated with MK-801, indicating that the white matter changes might be involved in the schizophrenia induced by NMDA antagonist.

OBJECTIVE: To analyze the clinic and pathologic data of thymic epithelial tumor (TET) and to explore its prognostic factors. METHODS: From June 1997 to September 2007, 137 patients with TET were surgically treated in our hospital. The data included age, gender, symptoms, histological type, stage and grade, pathological findings, and operation reports. The patients were followed up by telephones and mails. The patients were divided into Masaoka I/II group and III/IV group, and WHO A/AB/B1 group and B2/B3/C group. Kaplan-Meier method, log-rank test, and COX regression model were used to analyze the prognostic factors for TET. RESULTS: Among the 137 patients, 124 (90.5%) received complete resection, 9 (6.6%) incomplete resection, and 4 (2.9%) surgical biopsy. The rate of complete resection was significantly higher in Masaoka stages I/II than that in stages III/IV (P<0.001). The overall 5-year and 10-year survival rate was 71.4å and 50.1å, respectively. Patients in stage I/II had better long-term survival than those in stage III/IV (P<0.001). According to WHO histological classification, the 5-year and 10-year survival rate in patients with Type A/AB/B1 TET was significantly higher than that in patients with Type B2/B3/C TET (P<0.001). The 5-year and 10-year survival rate in patients with complete resection was significantly higher than that in patients with incomplete resection and biopsy (P<0.001).Cox regression analysis showed that the prognosis of patients with TET was related to Masaoka stage, WHO histological classification, extent of resection, and age at operation. CONCLUSION Masaoka stage, WHO histological classification, extent of resection, and age at operation are important prognostic factors in patients with TET.
Adolescent ; Adult ; Aged ; China ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasms, Glandular and Epithelial ; mortality ; pathology ; surgery ; Prognosis ; Retrospective Studies ; Survival Rate ; Thymus Neoplasms ; mortality ; pathology ; surgery ; Young Adult

Objective:To explore the differences in the spatial distributions of brain metastases (BMs) from adenocarcinoma and non-adenocarcinoma among non-small cell lung cancer (NSCLS), aiming to provide a reference for developing optimal treatment protocols.Methods:A retrospective analysis was performed on data from 283 patients with NSCLC who underwent radiotherapy at the Zhejiang Cancer Hospital from January 2020 to July 2023. These patients included 191 adenocarcinoma cases with an average age of 62.04 years and 92 non-adenocarcinoma cases with an average age of 63.85 years. CT images with detected BMs of these patients were synchronously deformed and registered into a standard brain template to determine the distribution of BMs in the template. The Dice coefficient was employed to analyze the similarity in the distribution of BMs from adenocarcinoma and non-adenocarcinoma, and two-sample t-test was performed respectively using SPM and Dpabi software to ensure the consistency of the result. For brain regions with the number of BMs greater than or equal to 4, the voxels with a size 2 mm × 2 mm × 2 mm were counted. Results:Non-adenocarcinoma tended to invade the posterior lobe of the cerebellum, precuneus, anterior lobe of the cerebellum, cuneus, middle occipital gyrus, and middle temporal gyrus, with corresponding voxel counts of 2 577, 2 291, 1 947, 1 550, 1 200, and 600, respectively. In contrast, adenocarcinoma was more commonly metastasized to the inferior parietal lobule, posterior lobe of the cerebellum, central frontal gyrus, precentral gyrus, middle temporal gyrus, and precuneus, with the corresponding voxel counts of 211, 201, 194, 186, 137, and 84, respectively.Conclusion:Brain metastases exhibit different distributions between adenocarcinoma and non-adenocarcinoma, and both subtypes prefer to invade specific brain regions.

OBJECTIVE:To compare the cost-effectiveness of cefazolin sodium pentahydrate versus cefazolin sodium in treat-ment of bacterial infection,and to provide reference for rational drug use in the clinic.METHODS:In retrospective study,207 bac-terial infection patients receiving cefazolin sodium pentahydrate or cefazolin sodium were selected from our hospital during Nov. 2014 to Dec. 2015,including 109 cases in cefazolin sodium pentahydrate group and 98 cases in cefazolin sodium group. Both groups received relevant medicine 2 g,bid,ivgtt,within 7 d. The clinical efficacies,bacteriological efficacies and safety of 2 groups were compared,and pharmacoeconomics of 2 therapy plans were evaluated.RESULTS:The clinical response rates of cefazo-lin sodium pentahydrate group and cefazolin sodium group were 89.91% and 74.49%,with statistical significance(P<0.05);bac-terial clearance rates were 76.32% and 72.13%,with no statistical significance(P>0.05). No drug-related ADR occurred in 2 groups during the treatment. Total shot-term(7 d)cost of cefazolin sodium pentahydrate group and cefazolin sodium group respec-tively were 4 391.43 yuan and 3 396.19 yuan. Using clinical response rate as effect index,cost-effectiveness ratio of them were 48.84 and 45.59,and incremental cost-effectiveness ratio was 64.55,which was lower than per capita GDP of Hengshui city. The sensitivity analysis results were in agreement with the cost-effectiveness analysis. CONCLUSIONS:Under the current economic sit-uation of Hengshui city,cefazolin sodium pentahydrate has cost-effectiveness advantage in the treatment of bacterial infection than cefazolin sodium.

Objective To explore the behavioral characteristics of response to name in 16-30 months old infants with autism spectrum disorders (ASD),in order to provide a theoretical basis for the early identification and early diagnosis.Methods Two professionals,according to the scoring criteria and using video analysis methods,evaluated the response score (RS),reaction time (RT),duration time (DT) and the rate (RR) of response to their names among ASD infants (ASD group,61 cases),who were diagnosed at Child Developmental and Behavioral Center,the Third Affiliated Hospital of Sun Yat-Sen University from April to December 2017.Then they were compared with infants with developmental delays (DD group,32 cases) and neuro-typical (NT group,33 cases) infants.Finally,researchers predicted the diagnosis for ASD infants according to the behavioral indicators,which had significant differences compared with other groups.Results Compared with DD group [RS 2 (1) score,RT 1.32 (4.65) s,DT 2.69(1.84) s] and NT group [RS 2 (1) score,RT 1.37 (4.37) s,DT 2.90 (2.23) s],RS was significantly lower [1 (1)score],RT was significantly longer [5.87 (4.64) s],and DT was significantly shorter [0.77 (1.88) s] in ASD group,and the differences were statistically significant (H =-4.91,-5.94;5.36,5.41;-4.47,-5.78;all P ＜0.05);while the differences between DD group and NT group were not significant(all P ＞0.05).The RR was significantly lower in ASD group [0.25 (0.50)] and DD group [0.50 (0.25)],compared with NT group [0.75 (0.50)],and the differences were statistically significant (H =-6.39,-4.45,all P ＜ 0.01);while the differences between DDgroup and ASD group were not significant(P ＞0.05).When detecting ASD from ASD and NT infants,the area under the receiver operating characteristic curve (AUC) was 0.889 (P ＜0.01);when detecting ASD from ASD and DD infants,AUC was 0.924 (P ＜ 0.01);when detecting ASD from all infants,AUC was 0.868 (P ＜ 0.01),according to all indicators of response to name.Conclusions There are significant differences between ASD infants and DD and NT infants in response to name domain.Behavioral characteristics in the procedure of response to name can predict ASDwell.Response to name as an early social behavioral indicator,being tested at 2 years old,is still of importance for the early identification and early diagnosis of ASD.