OBJECTIVETo find out the regular pattern of pain reaction by pressing along the Governor Vessel at the levels of T3 to L4 on the back in patients with digestive system disease, so as to provide references for diagnosis of the disease.

METHODSThirty patients diagnosed with digestive system disease by gastroscopy and colonoscopy as well as 16 patients with digestive symptoms without accurate diagnosis by endoscopy checks were observed. Pressing was applied from Zhiyang (GV 9) to Yaoyangguan (GV 3), including non-acupoints along the Governor Vessel. Positive reaction was recognized since pain, soreness or distension sensation appeared in the space between the spinous process.

RESULTSThe positive ratios of 30 patients with endoscopy checks and 16 without the check accounted for 100.0%. The tender spots, usually 5 to 9 in number, were mainly focused on the relative acupoints and non-acupoints along the Governor Vessel from T6 to T10.

CONCLUSIONThe pain reaction from Lingtai (GV 10) to Zhongshu (GV 7), which are at the level of T6 to T10, along the Governor Vessel is closely related with digestive system disease. And it can be regarded as function criterion of the digestive system and important reference of auxiliary diagnosis.

Acupuncture Points ; Adult ; Aged ; Back ; physiopathology ; Diagnosis, Differential ; Digestive System Diseases ; diagnosis ; physiopathology ; Female ; Humans ; Male ; Meridians ; Middle Aged ; Pain ; Pain Measurement ; Sensation

OBJECTIVETo evaluate the effectiveness of open reduction and internal fixation and repair of palmar ligment in treating trans-scaphoid perilunate dislocation.

METHODSFrom June 1995 to June 2001,14 patients with trans-scaphoid perilunate dislocation were treated with open reduction and internal fixation and repair of palmar ligment. Among them,there were 13 males and 1 female,the ranging in age from 21 to 38 years,averaged 25.4 years. All patients were posterior dislocation and all operations were performed within 2 weeks after injury.

RESULTSAll patients were followed up from 24 to 60 months with an average of 28.3 months. Thirteen scaphoid fractures were primary healed and functions of wrist joint were good. Bone disunion was found in 1 case and part functions of wrist joint were limited. No found necrosis of lunate and scaphoid. According to clinical scoring system of Cooney, 9 case got excellent results, 3 good, 1 fair and 1 poor.

CONCLUSIONOpen reduction and internal fixation and repair of palmar ligament is effective in treating trans-scaphoid perilunate dislocation,which can early provide steady fixation for scaphoid,and profit to recover blood supply of lunatum and subterminal scaphoid.

Adult ; Early Diagnosis ; Female ; Humans ; Joint Dislocations ; diagnosis ; physiopathology ; surgery ; Lunate Bone ; injuries ; physiopathology ; Male ; Recovery of Function ; Scaphoid Bone ; injuries ; physiopathology ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the expression of enhancer of zeste homolog 2 (EZH2) in esophageal squamous cell carcinoma and its association with the prognosis of postoperative patients.

METHODSSurgical specimens were obtained from 102 patients with esophageal squamous cell carcinoma undergoing radical resection in our hospital from 1996 to 2006. Immunochemistry was employed to examine EZH2 protein expressions in the specimens, including 102 carcinoma tissue specimens, 30 adjacent tissue specimens and 30 normal esophageal tissue specimens. The expression levels of EZH2 were analyzed in relation to the clinicopathological parameters of the patients including gender, age, tumor differentiation, TNM, and lymph node metastasis. The postoperative patients were followed up to analyze the association of EZH2 expression with the clinical outcomes.

RESULTSThe esophageal squamous cell carcinoma tissue showed a higher EZH2 expression than the adjacent and normal esophageal tissues. EZH2 expression was higher in poorly differentiated carcinoma than in well differentiated tissue, and also higher in cases with lymph node metastasis than those without; the expression was higher in TNM stage II/III patients than in stage I patients but lower than in stage IV patients. The patients with low EZH2 expression was found to have a longer survival time than those with high EZH2 expression (P<0.05).

CONCLUSIONEZH2 plays an important role in the differentiation and metastasis of esophageal squamous cell carcinoma, and a high EZH2 expression is associated with a poor outcome in the the postoperative patients.

Carcinoma, Squamous Cell ; diagnosis ; metabolism ; Enhancer of Zeste Homolog 2 Protein ; Esophageal Neoplasms ; diagnosis ; metabolism ; Humans ; Lymphatic Metastasis ; Polycomb Repressive Complex 2 ; metabolism ; Postoperative Period ; Prognosis

OBJECTIVETo evaluate efficacy of adjuvant chemotherapy after D2 dissection on survival for patients with gastric cancer.

METHODSRandomized clinical trials (RCT) that compared adjuvant chemotherapy after D2 dissection with D2 dissection alone for gastric cancer were searched with Pubmed, Cochrane, Embase and CBM databases. Eligible trials published between 1990 and 2012 were included in the study. The quality of RCTs was assessed by the Jadad scale. Data synthesis and statistical analysis were performed by RevMan 5.1 software.

RESULTEight RCTs with 3633 patients were included in this study. Among them, 1824 patients received adjuvant chemotherapy and 1809 patients didn't. Adjuvant chemotherapy was associated with a significant benefit in terms of overall survival (RR = 0.76, 95% CI: 0.69-0.84), disease free survival (RR = 0.72, 95%CI: 0.66-0.80) and recurrence rate (RR = 0.69, 95% CI: 0.62-0.77).

CONCLUSIONAdjuvant chemotherapy was associated with survival benefit for gastric cancer after D2 dissection.

Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Gastrectomy ; Humans ; Male ; Neoplasm Recurrence, Local ; Prognosis ; Randomized Controlled Trials as Topic ; Stomach Neoplasms ; drug therapy ; mortality ; surgery ; Survival Rate

Abstract】 【Objective】To investigate the effect and mechanism of ginsenoside Rb1 attenuating human umbilical vein endothelial cells(HUVEC) senescence induced by high glucose through Sirt3/SOD2 pathway.【Methods】The senescence of HUVEC induced by high glucose(40 mmol/L)was assessed by senescence-associated β-galactosidase(SA-β-Gal)staining,and the expression of plasminogen activator inhibitor 1(PAI-1)and P16. Annexin V-FITC/PI was performed to measure apoptotic effect. The expression of sirtuins 3(Sirt3)and superoxide dismutase 2(SOD2)was detected by western blot. Meanwhile,the level of intracellular malondialdehyde(MDA)and the activity of SOD2 were measured.【Results】Treatment of HUVEC with high glucose for 24 hours induced premature senescence instead of apoptosis,as indicated by a larger proportion of the cells stained with SA-β-Gal and the up-regulated expression of PAI-1 and P16. Pretreatment of HUVEC with ginsenoside Rb1(40 μmol/L)could reverse endothelial cell senescence,as indicated by the reduced SA-β-Gal positive cells and the down-regulated expression of PAI-1 and P16. Furthermore,ginsenoside Rb1 pretreatment upregulated the protein expression of Sirt3 and SOD2,and eventually increased the activity of SOD2 and decreased the level of MDA.【Conclusion】Ginsenoside Rb1 could antagonize high glucose-induced premature senescence of HUVEC via Sirt3/SOD2 signaling pathway.

BACKGROUNDThere is no detailed report about the angiographic leakage of polypoidal choroidal vasculopathy (PCV) lesions on indocyanine green (ICG) angiography. This study aimed to investigate the angiographic leakage of polypoidal lesions in PCV on ICG angiography.

METHODSOne hundred and forty-four eyes of 137 patients diagnosed as PCV were prospectively observed. Fundus examination, fluorescein angiography, and ICG angiography were performed. Leakage of polypoidal lesions and clinical features were recorded according to the angiograms.

RESULTSIn all 144 eyes, 110 eyes showed angiographic leakage (leakage group) on ICG angiography and three subtypes of leakage group were noted, which were polypoidal dilations leakage (47 eyes, 42.7%), branching vascular networks leakage (14 eyes, 12.7%) and leakage of both (49 eyes, 44.5%). The other 34 eyes showed regression of polypoidal lesions (regression group). In leakage group, the rates of pigment epithelial detachment (PED), best corrected visual acuity (BCVA) < 0.1 and old subretinal hemorrhages were 56.4% (62 eyes), 19.1% (21 eyes), and 4.6% (5 eyes) respectively, compared with 8.8% (3 eyes), 50% (17 eyes) and 38.2% (13 eyes) of regression group (P < 0.001). The history of regression group was significantly longer (P < 0.001).

CONCLUSIONSAngiographic leakage and regression can be observed in PCV lesions. Leakage of both polypoidal dilations and branching vascular networks is the most common subtype in leakage group. PCV in leakage group is more likely to be related to PED, better BCVA and shorter history, while PCV regression group tends to relevant to old subretinal hemorrhage, worse BCVA and longer history. This may reflect that the former is active or in the early course while the later is resting or in the late phase of PCV.

Aged ; Aged, 80 and over ; Choroid ; blood supply ; Choroid Diseases ; diagnosis ; Female ; Fluorescein Angiography ; methods ; Humans ; Indocyanine Green ; Male ; Middle Aged ; Peripheral Vascular Diseases ; diagnosis

OBJECTIVETo study the diagnosis and treatment of a second primary malignant tumor induced by previous radiotherapy.

METHODSFrom March 1970 to March 1997, 108 nasopharyngeal cancer (NPC) patients who developed a second primary malignant tumor induced by radiotherapy were treated. There were squamous carcinoma 43 (39.8%), sarcoma 26 (24.1%), malignant fibrous histiocytoma 14 (13.0%), adenoid cystic carcinoma 12 (11.1%), thyroid papillary adenocarcinoma 8 (7.4%) and malignant melanoma 5 (4.6%). Fifty patients underwent operation, 32 received radiotherapy, 18 received chemotherapy and 8 received operation combined with chemotherapy.

RESULTSThe 3- and 5-year tumor-free survival rates were 64.0% and 36.0% in the operation group. They were 34.4% and 18.8% in the radiotherapy group.

CONCLUSIONSurgery, if not contra-indicated, is the first choice for the second primary malignant tumor induced by radiotherapy. Aggressive treatment for these patients is, hence, indicated clinically.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Radiation-Induced ; diagnosis ; mortality ; therapy ; Neoplasms, Second Primary ; diagnosis ; mortality ; therapy ; Radiotherapy ; adverse effects ; Survival Rate

OBJECTIVETo analysis the efficacy and safety of lamivudine (made in China) therapy for 52 weeks in adolescent patients with chronic hepatitis B (CHB).

METHODSOne hundred and five teenage CHB patients were treated with lamivudine 100 mg once daily for 52 weeks. Patients with elevated ALT at baseline were in group 1 and those with normal ALT were in group 2. The changes of HBV DNA, HBV seromarkers and ALT at the end of 12, 24 and 52 weeks after lamivudine therapy were compared with those at baseline. Adverse events were recorded and evaluated.

RESULTSAt the end of 52 weeks of lamivudine therapy, HBV DNA-ve, HBeAg loss and anti-HBe seroconversion were observed in 92.0%, 24.4% and 22.0% in group 1 patients and 76.1%, 14.2% and 14.2% in group 2 patients respectively. No significant differences were found between two groups. At 12, 24 and 52 weeks, normalization rates of ALT were 59.0%, 66.7% and 76.0%, normal ALT with undetectable HBV DNA were 44.9%, 64.1% and 70.7% at the same time. During 52 weeks lamivudine treatment 26 mild adverse events were observed in 18 patients.

CONCLUSIONLamivudine can inhibit HBV replication rapidly and normalize ALT in majority adolescent CHB patients. HBeAg loss or seroconversion of anti-HBe was observed in some of these patients. All patients in this study were safety and well tolerated.

Adolescent ; Alanine Transaminase ; blood ; Antiviral Agents ; adverse effects ; therapeutic use ; Child ; DNA, Viral ; blood ; Female ; Hepatitis B Antibodies ; blood ; Hepatitis B e Antigens ; blood ; immunology ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Interferons ; administration & dosage ; therapeutic use ; Lamivudine ; adverse effects ; therapeutic use ; Male ; Mutation ; genetics ; Reverse Transcriptase Inhibitors ; adverse effects ; therapeutic use ; Safety ; Treatment Outcome

OBJECTIVETo introduce a new method for enlarging the survival area of an expanded flap.

METHODSAfter the skin expander was inflated with enough injection, the first delaying was performed. In the operation, two incisions were made in the skin and subcutaneous tissue superficial to the expander capsule on both sides of the long axis of the expanded flap. After 10 to 14 days, the second delaying followed, in which one pedicle was divided to form a unilateral-pedicled, super-long random flap. When the flap was transferred to the recipient Since 2000,this technique has been used in 16 patients. All the area, the door site was closed directly.

RESULTSflaps survived completely.

CONCLUSIONSThe technique of twice delaying can enlarge the survival area of the expanded skin flap.

Adolescent ; Adult ; Child ; Cicatrix ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps

OBJECTIVEApplicate autologous buccal mucosal graft pre-transplantation for urethral reconstruction of complicated hypospadias by staging.

METHODSFrom 1999 to 2003, 40 patients have been treated by method of autologous buccal mucosal graft pre-placing. There were two models: graft onlay and graft-tube for urethral reconstruction, and the 2rd operation was accomplished half year later.

RESULTSAll patients healed without urethral fistula.

CONCLUSIONThe method is valuable for treatment of complicated hypospadias.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Urethra ; surgery ; Young Adult