Objective To investigate the clinical value of a newly designed surgical therapy for familial polyposis coli by severing the superior mesenteric artery&vein in order to make a complete lysis of the mesentery and an ileum pouch and the anal anastomosis within the entire muscular sheath of the rectum.Methods Six patients with familial polyposis coli(5 males and 1 female,aged 24-36 years)were admitted and underwent the procedure which was consisted of:(1)An incision was made in the left middle and lower parts of the rectus abdominis;(2)The greater omentum was retained and the large intestine was removed;(3)At the juncture of the sigmoid colon and the rectum,the muscular sheath was dissociated 0.5cm,the mucous membrane of the rectum was stripped in a revolving manner,the nourishing artery and vein in the membrane were exposed,and clamped and cut in sequence up to the anocutaneoue line;(4)The rectal mucous membrane was completely removed;(5)Under the right colonic artery,the superior mesenteric artery and vein were severed;(6)An N-,J-or W-shaped pouch was made in the ileum accordingly:(7)An anastomosis of the ileum pouch and the anal canal was made within the entire muscular sheath of the rectum,and a drainage was placed;(8)The mesostenium was fixed on the fight posterior abdomen,the small intestines were spread out to the right side,and the mesostenium was covered on the coarse surface of the colon bed:(9)A tube was placed in the left lower abdomen for a vacuum aspiration for 2 days after operation,combined with the suction drainage,to eliminate the pelvic effusions;and(10)The abdomen was closed.Results Patients were able to discriminate stools and flatus 3-7 days after operation.and the formed stools occurred 7-10 days after operation.Five patients were followed-up for 3-17 years,with averagely one defecation a day,with no night defecation and seepage.Urination was normal;In another one patient who underwent the procedure 4 months ago the defecation was twice a day,with no night defecation.All the 6 patients had normal autonomic nerve function and sexual function as well as normal defecation and urination,with no recurrence of polyposis coli or infection.The small bowel functions well with no ischemia related symptoms.Conclusion Cutting the superior mesenteric artery and vein and then making anastomosis of the ileum pouch and the anal canal within the muscular sheath of the rectum is a new surgical approach to familial polyposis coli.It is safe and significantly improves the patients' life quality.

This study was aimed to establish a method for assay of 4-terpineol, α-terpineol, bornyl acetate and methyl-n-nonylketone in Houttuynia cordata with gas chromatography-mass spectrometry (GS/MS) for the first time in order to provide experimental evidences for its quality control. Undecylen was analyzed quantitatively. GC/MS method was used in the content determination of 4 kinds of components in Houttuynia cordata. GC conditions were that the temperature was firstly increased to 70oC for 5 min, and then 5oC·min-1 to 140oC for 5 min. Then, the temperature was increased by 10oC·min-1 to 250oC for 10 min. The temperature of the injection port was 230oC. The carrier gas was high purity helium. The flow rate was 1.0 mL·min-1. The split ratio was 10:1. The sample quantity was 1 μl. MS conditions were that the detector was MS, EI was 70ev, the temperature of four poles was 150oC, the temperature of ion source was 230oC. The results showed that there was good linearity of four components, which were 4-terpineol, α-terpineol, bornyl acetate and methyl-n-nonylketone obtained within the ranges of 6.492~129.84μg·min-1, 1.097~21.944 μg·min-1, 12.128~242.56 μg·min-1, and 84.76~169.52 μg·min-1, respectively. The average recoveries of the four components were 81.2%, 80.6%, 88.3%, and 84.6%, respectively. The RSDs were 1.5%, 2.3%, 1.1%, and 0.7%, respectively. It was concluded that the method was simple, sensitive, and easy to operate. The simultaneous measurement of multiple indexes on the component for quality evaluation of Houttuynia cordata can effectively reflect the quality of Houttuynia cordata. It can also be used in the quality assessment of fresh Houttuynia c ordate .

Objective:To evaluate the clinical efficacy of maintenance chemotherapy for patients who had local advanced non-small cell lung cancer (NSCLC) and was responsive to primary radiotherapy and chemotherapy. Methods:One hundred and twenty patients with stage ⅢA or ⅢB NSCLC received 4 cycles of chemotherapy combined with radiotherapy. The 63 patients who achieved certain remission were randomly divided into maintenance chemotherapy group(n=33) and control group(n=30). The patients in maintenance chemotherapy group (treatment group) received vinorelbine (20 mg/m2, d 1 and d 8, per 28 d a cycle) and those in control group were not given maintenance chemotherapy. The clinical efficacy, survival rate and adverse reaction of the two groups were evaluated. Results:There are a longer median time to progression(TTP) in treatment group compared with control group (8.5 month vs 5.0 month, P<0.05). The 1-and 2-year survival rates were 66.7% and 36.4% in the treatment group and 60.7% and 32.1% in the control group, respectively. The difference between the survival rates of two groups was not significant (P>0.05). Conclusion:Maintenance vinorelbine-based chemotherapy prolonged the median time to progression but had no effect on survival time in patients with local advanced NSCLC who responded to induction chemotherapy.

The pathological position of hypersecretion of airway mucus is in airway mucosa. Modern TCM theory believes that the airway mucosa belongs to the triple energizer membranous system of TCM, and the airway mucus is a part of TCM water-liquid system. Based on the TCM physiological characteristics of children, this article explored the pathogenesis of airway mucus hypersecretion in children, and believed that the airway mucus hypersecretion was the result of the disorder of water-liquid metabolism in TCM, which was closely related to the function of qi transformation of triple energizer membranous system. Failure of qi transformation in triple energizer is the core pathogenesis of hypersecretion of airway mucus in children. The deficiency of yang qi in children leads to the disorganization of vaporization in triple energizer, which leads to the insufficiency of movement and transformation function, the failure of water and qi in water, the stop of water and water accumulation, the abnormity of water and grain. The disorder of water-liquid metabolism leads to the occurrence of high airway mucus secretion in children.

Objective To determine the effect of ostecytic TGF-β/Smad4 signaling on osteoblastic and osteoclastic differentiation in bone marrow stromal cells (BMSCs).Methods Mice with osteocytic TGF-β/Smad4 conditional knock down (Smad4ot CKD) were generated as previously by crossing DMP1-8kb-Cre mice with Smad4lox(ex8)/lox(ex8) mice.The osteocytes were isolated from tibial and femoral diaphysis and co-cultured with wild-type BMSCs.ALP staining, Alizarin red staining and TRAP staining were performed to show osteoblastic and osteoclastic differentiation.Then, their marker genes were detected by qPCR and proteins measured by Western blot.ResultsThe expression of Runx2 and Osterix were reduced in smad4 CKDot co-cultured with BMSCs compared with controls(P<0.01).Similarly, the specific markers of osteoblastic differentiation were decreased (P<0.01).Additionally, the expression of RANKL was not significantly changed in with BMSCs.However, OPG was highly expressed incontrol group compared with smad4 CKD in co-cultured group (P<0.05).Thus, the radio of RANKL/OPG was significantly reduced (P<0.05).Furthermore, the expression of RANK was inhibited.Conclusions The terminally-differentiated osteocytes are the cells regulating bone metabolism, while down-regulation of osteocytic-TGF-β/Smad4 inhibits BMSC osteoblastic and osteoclastic differentiation.

OBJECTIVETo investigate the clinical effects of wrist joint fixation in flexion-ulnar position for the treatment of Colles fracture.

METHODSFrom January 1998 to June 2008,120 patients with Colles fracture were treated with wrist joint fixation with plaster in flexion-ulnar position. There were 52 males and 68 females with an average age of 57.6 years (ranged, 22 to 90); 41 cases were left, 69 cases were right, and 10 cases were hibateral. All of them were fresh closed fractures. According to fracture displacement to typing, type I of 34 cases, type II of 36 cases, type III of 32 cases, type IV of 18 cases.

RESULTSWith dislocated (II-IV type) 86 patients were followed up for 10 months in average. 86 cases with displaced fragments achieved clinical bony union. According to standard of Dienst, 59 cases got excellent results, 12 good, 10 fair, and 5 poor.

CONCLUSIONThe wrist fixation with plaster in flexion-ulnar position in treating Colles fracture may maintain good fixation after reduction and obtain better functional recovery.

Adult ; Aged ; Aged, 80 and over ; Biomechanical Phenomena ; Casts, Surgical ; Colles' Fracture ; physiopathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Recovery of Function ; Wrist Joint ; surgery

Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.

Objective To investigate the therapeutic effect and mechanism of NLRP3 inflammasome inhibitor-dapansutrile(OLT1177)-against acute radiation lung injury.Methods Mice were divided into the control group,OLT1177 injection group,irradiation group,and irradiation+OLT1177 injection group.A single dose of 22 Gy whole-lung 60Co radiation was used to establish a model of acute radiation lung injury.After 6 h of radiation,OLT1177(100mg/kg,once daily)was administered intraperitoneally.After 14 consecutive days of administration,lung tissues were collected and weighed while the lung coefficient was calculated.Hematoxylin-eosin(HE)staining and F4/80 immuno-histochemical staining were used to observe the pathological changes and inflammatory cell infiltration in lung tissues.Real-time quantitative PCR(qPCR)was used to detect the transcription levels of NLRP3,IL-1β,and other mRNAs in lung tissues.Serum cytokines such as TNF-α and IL-6 were measured by cytometric bead array(CBA).The activation of Caspase-1 and IL-18 was detected by Western blotting.Results Radiation caused acute inflammation in the lung tissues of mice,manifested as edema in the lung tissues and destruction of the alveolar structure,increased macrophage infiltration,and elevated expressions of inflammatory genes NLRP3,IL-1β,TNF-α,and IL-6 in the lung tissues and higher serum levels of TNF-α,IL-6.Treatment with OLT1177 significantly improved the above symptoms induced by radiation.OLT1177 inhibited the activation of NLRP3 inflammasome downstream Caspase-1 and IL-18 induced by radiation.Conclusion OLT1177 can significantly alleviate acute radiation lung injury in mice,which may be due to its inhibition of NLRP3 inflammasome activation induced by radiation.

OBJECTIVE: To explore the clinical feature, the reason of misdiagnosis and mistreatment, influential factor of prognosis in patients with extranodal NK/T cell lymphoma-nasal type. METHOD: A retrospective study was made on the clinical data of 34 patients with extranodal NK/T cell lymphoma-nasal type. Among them, 10 cases were staged I(E) intra-cavity, 15 cases were I(E) ex-cavity, 6 cases were II(E) and 3 cases were IV(E). Among them, 29 cases were in nasal cavity, 5 cases were outside nasal cavity; 14 cases were treated with single chemotherapy or radiation therapy, 20 cases were treated with radiation therapy add chemotherapy. RESULT: The total rate of misdiagnosis and mistreatment were 58.8% (20/34), 52.3% (18/34), respectively. The 5-year survival rate of the I(E) intra-cavity group were 60.0% (6/10), and those of I(E) ex-cavity group were 26.7% (4/15), and those of II(E) group and IV(E) group were 16.7% (1/6), 0% (0/3), respectively There was significant difference between 3 groups by statistical analysis (P < 0.01). The 5-year survival rate of I(E) ex-cavity group treated with single therapy were 0% (0/6), and those of I(E)-cavity group treated with combined therapy were 50% (1/2). CONCLUSION The early clinical manifestation of extranodal NK/T tell lymphoma-nasal type is atypical and which is hard to diagnose and treat. Diagnosis depends on pathologic biopsy and immunohistochemistry, there are many factors that influence the prognosis of this disease, in which the clinical stage is a major factor. It is crucial for diagnosing and treating early.
Adolescent ; Adult ; Aged ; Diagnostic Errors ; Female ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; therapy ; Male ; Middle Aged ; Nose Neoplasms ; diagnosis ; therapy ; Retrospective Studies ; Survival Rate ; Young Adult

OBJECTIVE: To carry out G-banded chromosomal karyotyping and chromosomal microarray analysis (CMA) for a fetus featuring multiple malformations. METHODS: The fetus was found to have increased nuchal thickness, generalized edema, asymmetric lower limbs, tetralogy of Fallot, nasal bone anomaly and cleft palate. Following amniocentesis, G-band karyotyping and CMA were carried out. RESULTS: The fetus had a karyotype of 47,XX,+i(12)(p10) [14]/46,XX[6]. CMA has identified a 33.9 Mb duplication at 12p13.33-p11.1, which was suggestive of tetrasomy 12p. CONCLUSION Combined chromosomal karyotyping and CMA can delineate the origin of abnormal chromosomal fragments during prenatal diagnosis. The fetus was diagnosed with Pallister-Killian syndrome.