Pu Xiang-cheng, a famous TCM physician in Sichuan Province, were engaged in medicine for dozens of years, with complete and systematical theory and great academic attainments. He summarized whole course of acupuncture and moxibustion treatment by means of verses with easy to be understood and easy to be read aloud, from examination of acupoints, location of acupoints, needling depth, manipulation, reinforcing and reducing to treatment of diseases in departments of internal medicine, surgery, gynecology and five sense organs, etc., and treatment of fainting during acupuncture. This is valuable medical book in recent time and clinically, it has profound inductive significance for later generations.
Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; China ; Humans ; Meridians ; Moxibustion

Objective To explore the therapeutic effect and medication safety of low-dose erythromycin treatment on intractable allergic rhinitis(AR) associated with bronchus asthma.Methods Totally 173 cases of children received outpatient treatment because of AR associated with asthma,their ages ranging from 3 to 14 years.Among them,78 cases developed intractable AR with symptoms of asthma having been controlled or satisfactorily controlled after 2 courses of conventional treatment.Seventy-six children with intractable AR received full follow-up and were randomly divided into observation group and control group.The control group was given different second-generation antihistamines,when necessary,supplemented by nasal glucocorticoids.In the observation group,the same treatment as it was done in control group was continued,plus oral treatment with erythromycin enteric-coated capsules(10 mg?kg-1?d-1,which were taken 3 times a day for 1 month) to the observation group.Both observation group and control group were in accordance with the norms of the treatment of asthma.Results The improvement rate,inefficiency and the total efficiency were different between observation group and control group,and the diffe-rence was statistically significant(?2=12.629,8.412,8.412,Pa0.05).Their liver function was also monitored and was found normal before treatment and after the replacement of drugs for 1 month,including alanine ami-notransferase,aspartate aminotransferase,albumin,globulin,and were found normal.Conclusions On the basis of conventional treatment,low-dose erythromycin treatment of intractable AR is effective and safe.However,the treatment must be limited to the refractory cases,and the appropriate indications must be strictly observed.

OBJECTIVETo study the therapeutical effect of the tangential excision of razor graft for the spacious giant congenital naevi in children.

METHODSThe surface layer of the giant naevi, mainly razor graft, was excised tangentially using electrical dermatome. Then the left naevi was removed by dermabrasion.

RESULTSThe satisfactory effects were obtained in 9 of 16 cases. The colour of operative area approached the normal skin, occasionally with scattered pigmentation and hypertrophic scars. In 6 cases, the colour appeared lighter than before. One case relapsed after half a year.

CONCLUSIONSThe congenital giant naevi in children could be treated using the tangential excision of razor graft. The short-term results might be expected.

Adolescent ; Child ; Child, Preschool ; Dermatologic Surgical Procedures ; Female ; Follow-Up Studies ; Humans ; Male ; Nevus ; congenital ; surgery ; Skin Transplantation ; methods ; Surgical Flaps

BACKGROUNDBipolar electro-coagulation has a reported efficacy in treating epilepsy involving functional cortex by pure electro-coagulation or combination with resection. However, the mechanisms of bipolar electro-coagulation are not completely known. We studied the acute cortical blood flow and histological changes after bipolar electro-coagulation in 24 patients with intractable temporal lobe epilepsy.

METHODSTwenty-four patients were consecutively enrolled, and divided into three groups according to the date of admission. The regional cortical blood flow (rCBF), electrocorticography, the depth of cortex damage, and acute histological changes (H and E staining, neuronal staining and neurofilament (NF) staining) were analyzed before and after the operation. The t-test analysis was used to compare the rCBF before and after the operation.

RESULTSThe rCBF after coagulation was significantly reduced (P < 0.05). The spikes were significantly reduced after electro-coagulation. For the temporal cortex, the depth of cortical damage with output power of 2-9 W after electro-coagulation was 0.34 ± 0.03, 0.48 ± 0.06, 0.69 ± 0.06, 0.84 ± 0.09, 0.98 ± 0.08, 1.10 ± 0.11, 1.11 ± 0.09, and 1.22 ± 0.11 mm, respectively. Coagulation with output power of 4-5 W completely damaged the neurons and NF protein in the molecular layer, external granular layer, and external pyramidal layer.

CONCLUSIONSThe electro-coagulation not only destroyed the neurons and NF protein, but also reduced the rCBF. We concluded that the injuries caused by electro-coagulation would prevent horizontal synchronization and spread of epileptic discharges, and partially destroy the epileptic focus.

Adult ; Electrocoagulation ; methods ; Epilepsy ; surgery ; Epilepsy, Temporal Lobe ; surgery ; Female ; Humans ; Male ; Temporal Lobe ; surgery ; Young Adult

OBJECTIVETo compare the impact of various types of neck dissection on postoperative shoulder function.

METHODSThe shoulder functions of 66 patients with oral squamous cell carcinoma (OSCC) and cN0 necks who underwent various types of neck dissection were evaluated by Constant's shoulder function test and neck dissection impairment index at least 12 months after surgery.

RESULTSThe patients with accessory spinal nerve reserved had better shoulder function than those with accessory spinal nerve resected. In the group with accessory spinal nerve reserved, the patients receiving selective neck dissection (SND) showed better shoulder function than those with modified radical neck dissection (MRND). The shoulder dysfunction and pain arising from SND were minor in patients with selective neck dissection.

CONCLUSIONSThe shoulder function after SND was superior to those after RND and MRND.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; physiopathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Mouth Neoplasms ; pathology ; physiopathology ; surgery ; Neck Dissection ; methods ; Shoulder ; physiopathology

OBJECTIVETo investigate the frequency of micrometastasis in levels lII - IV of clinical negative neck (cN0) in patients with squamous cell carcinoma (SCC) of oral tongue, and to discuss the management of cervical lymph node for cN0 tongue SCC.

METHODSA total of 471 cervical lymph nodes derived from 25 patients with cN0 tongue SCC, including 263 lymph nodes in level III and 208 lymph nodes in level IV, were included in this study. All lymph nodes were re-examined by anti-cytokeratin (CK) immunohistochemical staining combined with semi-serial section per 500 microm.

RESULTSAmong the 25 cases, seven patients were confirmed harboring metastasis in 11 lymph nodes of level III, and no positive lymph node in level IV was detected by routine hematoxylin-eosin (HE) staining. 11 positive lymph nodes in level IIl, which confirmed by HE staining, were also detected by immunohistochemical staining with CK combined with semiserial section. Among the 460 cervical lymph nodes in which HE staining did not show metastasis, only one lymph node in level III harboring a 2.0 mm x 1.5 mm micrometastasis was detected by immunohistochemical staining with CK, and no positive lymph node in level IV was detected by immunohistochemical staining with CK.

CONCLUSIONThe frequency of occult metastasis in level IV was very low, so it seemed unnecessary to dissect level IV for all patients with cN0 tongue SCC.

Adult ; Aged ; Carcinoma, Squamous Cell ; Female ; Humans ; Keratins ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck ; Neoplasm Micrometastasis ; Tongue ; Tongue Neoplasms

To probe the effects of Trichinella spiralis muscle larval somatic proteins on small cell lung cancer H446 cells and the possible mechanism of anti-tumor,H446 cells were culture with 0.2 mg/mL,0.4 mg/mL,0.6 mg/mL,0.8 mg/mL,1.0 mg/mL,and 1.2 mg/mL somatic proteins respectively.The experimental group was set and no dosing as control group.MTT colorimetric assay was used to test the effects of T.spiralis muscle larval somatic proteins on the proliferative activity of H446 cells.We used flow cytometry (FCM) to test the influence of T.spiralis muscle larval somatic proteins induced H446 cells apoptosis.The real-time PCR and Western blot methods were used to detect the expression of Cyt-C and apoptotic protease activating factor 1(Apaf-1) mRNA and protein.The MTT colorimetric assay showed that T.spiralis muscle larval somatic proteins could inhibit the proliferation of H446 cells;the flow cytometry showed that polypide proteins acted on H446 cells after 24 h appeared an obvious effect on promoting apoptosis.Results of real-time PCR and Western blot analysis indicated that compared with the control group,Cyt-C and Apaf-1 showed up-regulated expression.T.spiralis muscle larval somatic proteins could inhibit proliferation activity and induce the apoptosis of H446 cells,and its effects may be related to up-regulated expression of Cyt-C and Apaf-1.

OBJECTIVETo study the feasibility and effect of substituting esophagus with stomach or colon without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preserved.

METHODSTwenty-four patients with cervical esophageal carcinoma were retrospectively reviewed. The esophagus was resected and substituted with 19 gastric pull-up and 5 colon interposition. Nineteen patients received radiotherapy postoperatively (dose 50 - 70 Gy).

RESULTSTwenty two patients were follow up over 3 years. The 3- and 5-year survival rates for T2 were 3 and 1, for T3, T4 8 and 3, respectively. The laryngeal function preservation rate was 77% (17/24) and the decannulation rate was 75% (12/16). The complication rate was 29%.

CONCLUSIONSurgical resection of cervical esophageal carcinoma with removal of the extraesophageal invaded tissues while preserving the laryngeal function is possible. The continuity of the esophagus is restored by stomach transposition and colon interposition. Combined with radiotherapy, the survival rate and life quality of the patient might be improved.

Adult ; Aged ; Esophageal Neoplasms ; mortality ; physiopathology ; surgery ; Esophagoplasty ; methods ; Female ; Follow-Up Studies ; Humans ; Larynx ; physiopathology ; Male ; Middle Aged ; Quality of Life ; Survival Rate ; Thoracotomy

OBJECTIVETo review the experience of different surgical construction methods for hypopharyngeal cancer with cervical esophageal invasion.

METHODSFrom 1989 to 2000,forty-eight patients with advanced hypopharyngeal cancer and cervical esophageal invasion were retrospectively reviewed, including 38 males and 10 females. The median age was 54. 3 years old, ranged from 26 to 71 years old. According to UICC 1997 criteria, all the tumors were T4 stage and originated from the pyriform sinus (33), posterior pharyngeal wall (14), postcricoid area (1), there were 28 patients in cN0, 15 in cN1, 5 in cN2 and no distant metastasis. Precise preoperative evaluation was performed with computed tomography scan, barium swallow perspective and biopsy. All the patients received modified neck dissection, including both unilateral (38 patients) and bilateral (10 patients). Pharyngoesophageal defect reconstruction methods were: laryngotracheal flap in 11 patients, pectoralis major musculocutaneous flap in 13, laryngotracheal flap combined with pectoralis major musculocutaneous flap in 6, pectoralis major musculocutaneous flap combined with the split graft in 10, stomach pulling-up in 3, colon interposition in 5 patients. Total laryngectomy was carried out in 8 patients. All patients received radiotherapy postoperatively (dose 55 - 75 Gy).

RESULTSThe cervical lymph node metastasis was found in 20 patients. Pathologic findings showed that well, moderately and lower differentiated squamous cell carcinomas were 18, 24, 6 cases, respectively. The overall 3 and 5 year survival rates were 52.1% (25/48) and 27.3% (12/44), respectively. The 3 and 5 year survival rates in functionally preserved group were 65.2% (15/23) and 33.3% (7/21), while in non functionally preserved group were 40.0% (10/25) and 21.7% (5/23), respectively. Fifteen patients laryngeal functions (voice, respiration and deglutition) were completely restored and 8 patients partially restored (voice and deglutition). The decannulation rate was 65% (15/23). The complication included pharyngeal fistulas in 10 cases and splitting of chest wall in 1 cases.

CONCLUSIONSCombined therapy was the best choice for hypopharyngeal cancer with cervical esophageal invasion. The laryngeal function is preserved as far as possible. The continuity of the pharyngoesophagus was restored by pectoralis major musculocutaneous flap, laryngotracheal flap, or combined with the split graft. Stomach transposition or colon interposition was used while the defect of the esophagus was greater.

Adult ; Aged ; Carcinoma, Squamous Cell ; mortality ; pathology ; surgery ; Esophageal Neoplasms ; mortality ; secondary ; surgery ; Esophagus ; pathology ; Female ; Humans ; Hypopharyngeal Neoplasms ; mortality ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate

OBJECTIVETo review the experience of different surgical construction methods and comprehensive treatments for hypopharyngeal cancer.

METHODSThree hundred and fifty-two cases (According to UICC 2002 criteria, stage I, 3; II, 31; III, 134; IV, 184) with hypopharyngeal cancer were retrospectively reviewed from 1999 to 2005 in the Department of Otorhinolaryngology of Qilu Hospital of Shandong University, including 321 males and 31 females. The median age was 58 years old, ranged from 26 to 82 years old. All the tumors originated from the pyriform sinus (272), posterior pharyngeal wall (61), postcricoid area (19). There were no distant metastasis. Two hundred and fourty-one cases were surgically treated with laryngeal functions preserved and 111 cases without laryngeal functions preserved. All the patients received modified neck dissection, including both unilateral (247 patients) and bilateral (105 patients). Pharyngoesophageal defect reconstruction methods in cases with laryngeal functions preserved were: direct suture in 137, pectoralis major musculocutaneous flap in 62, split graft in 2, pectoralis major musculocutaneous flap combined with the split graft in 5, stomach pulling-up in 12, colon interposition in 23 patients. While in cases without laryngeal functions preserved the methods includes: direct suture in 54, laryngotracheal flap in 54 patients, pectoralis major musculocutaneous flap in 7, laryngotracheal flap combined with pectoralis major musculocutaneous flap in 8, stomach pulling-up in 22, colon interposition in 3 patients. All patients received radiotherapy postoperatively (dose 55 - 75 Gy).

RESULTSThe overall 3 and 5 year survival rates were 65.1% (229/352) and 53.6% (142/265), respectively. For stage I, the 5 year survival rate was 3/3, stage II, 80.6%(25/31), stage III, 65.0% (67/103), stage IV, 36.7% (47/128). The 3 and 5 year survival rates in functionally preserved group were 68.0% (164/241) and 59.7% (114/191), respectively, while in non-functionally preserved group were 58.6% (65/111) and 37.8% (28/74), respectively. The cervical lymph node metastasis was found in 239 sides. Pathologic findings showed that well, moderately and lower differentiated squamous cell carcinomas were 84, 163, 105 cases, respectively. Laryngeal functions (voice, respiration and deglutition) were completely restored in 169 patients and partially restored (voice and deglutition) in 72 patients.

CONCLUSIONSCombined surgery and radiotherapy are the best choice for hypopharyngeal cancer. The continuity of the pharyngoesophagus is restored and the laryngeal function is preserved as far as possible. The preservation of laryngeal function and the laryngeal and pharyngeal reconstruction are based on the premise that the tumor was excised completely.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; therapy ; Combined Modality Therapy ; Female ; Humans ; Hypopharyngeal Neoplasms ; therapy ; Laryngectomy ; Male ; Middle Aged ; Pharyngectomy ; Retrospective Studies