Objective To explore the efficacy of implantation of 125I seeds combined with radiotherapy and/or chemotherapy for local recurrent lung cancer at a late stage.Methods A total of thirty-two patients were received implantation of 125I seeds therapy with a MPD of 110 to 140 Gy in our hospital.CT scan was used for guidance.Before the operation,a therapeutic plan was made by TPS.The therapeutic target volume(PTV)included the clinical target volume(CTV)plus the surrounding tissues 1 cm adjacent to the edge of CTV.The activity of each seeds was set at 0.7 mCi.The distribution of the seeds was checked by CT scan immediately after the implantation.Then,chemotherapy or radiotherapy was carried out in 3 to 7 days.EP,NP,or TP was used for the patients receiving chemotherapy.Results In 2 to 4 months after the treatments,the CR,PR,and NC were 46.9%(15/32),37.5%(12/32),and 15.6%(5/32),respectively.The rate of complete local control was 84.4%(CR+PR).The 1-and 2-year survival rate in this series were 78.6%(22/28)and 66.7%(10/15).Four of these patients survived over 3 years.Eleven of the patients(34.4%)developed pneumothorax after the implantation,3 of them were cured by chest drainage;9 patients(28.1%)had hemorrhage including 5 cases of intrapulmonary bleeding and 4 cases of emptysis.In 3 cases(9.4%),the seeds missed the target,and dropped into the diaphragmatic muscle at the thoracic cavity(2 cases)or out of the target area(1 case).No seeds migration or radiation-induced lung injury was found.Conclusion Implantation of 125I seeds combined with radiotherapy and/or chemotherapy is effective for patients with local recurrent lung cancer at a late stage.

Objective The aim of this study was to analyse characteristics of CRC in a cohort under the age of 40 .Methods Using single center retrospective cohort study ,we reviewed the prospectively collected database of 2 897 colorectal cancer patients who had undergone curative CRC resections in Chongqing Medical University between 2010 and 2014 .175 patients (5 .8% ) were under 40 ,in which six patients for various reasons (including recurrent colorectal cancer hospital ,incomplete information ,etc .) were excluded .A group of 180 consecutive patients over the age of 40 undergoing surgery for colorectal cancer in the same centre was used as control .Results There had no difference in tumor classification and tumor location between the younger group (<40) and the older group(>40) ,but the lymph node positive rate in younger group was higher ,unable to accurately grasp the preopera‐tive lymph node status ,lead to lack of preoperative staging ,and that made it difficult to preoperative treatment options .Conclusion Therefore ,to young people in colorectal preoperative neoadjuvant chemoradiation indications and the assurance of intraoperative re‐section range ,we need to do more consideration.

Objective To study the influence of 125I seed interstitial brachytherapy in parotid region on the recovery of facial nerve function. Methods A total of the data of 21 patients with primary parotid carcinoma were treated with resection and 125I interstitial brachytherapy. All the patients had no facial palsy before operation and the prescribed dose was 60 Gy. During 4 years of follow-up, the HouseBrackmann grading scales and ENoG were used to evaluate the function of facial nerve. According to the modified regional House-Brackmann grading scales, the facial nerve branches of patients in affected side were divided into normal and abnormal groups, and were compared with those in contra-lateral side.Results Post-operation facial palsy occurred in all the patients, but the facial palsy recovered within 6 months. The latency time differences between affected side and contralateral side were statistically significant in abnormal group from 1 week to 6 months after treatment ( t = 2.362, P = 0.028 ), and were also different in normal group 1 week after treatment ( t = 2.522, P = 0.027 ). Conclusions 125I interstitial brachytherapy has no influence on recovery of facial nerve function after tumor resection and no delayed facial nerve damage.

Objective To describe the clinical application of microvascular anastomotic device in head and neck reconstruction.Methods From July,2013 to November,2013,microvascular free flaps were transferred to reconstruct the defects simultaneously after tumor resection of head and neck region in 12 cases in Department of Oral and Maxillofacial Surgery,Peking University School of Stomatology.Microvascular anastomotic coupling devices (MACD) were used in vascular anastomosis.The clinical data were collected and analyzed,including the selection of free flap,diameter of donor and recipient vessels,type of MACD,time of anastomosis,instant patency of anastomosis.The flap was monitored closely after operation and the final survival rate was calculated.Results Twelve microvascular free flaps were done in this series,including 6 fibula flaps,4 forearm flaps and 2 anterolateral thigh flaps.Totally 17 MACD were used by end-to-end anastomosis in this series,including 5 arterial anastomosis and 12 venous anastomosis.The anastomose time using MACD was from 4 to 10 minutes,with a median time 6.8 minutes.The instant patency rate of anastomosis was 100％.There were some blood leakages near the anastomotic stoma in 1 arterial anastomosis using MACD.It was resolved successfully by changing a new MACD.Conclusion Our primary clinical experience showed that the MACD was well suited to the microvascular reconstruction of head and neck defect.The feasibility and reliability was confirmed by our clinical cases.It should be recommended as a safe,fast and reliable adjuvant anastomotic instrument for free tissue transfer.

Objective To investigate the effects of propofol on the proliferation and apoptosis of lung cancer cells as well as the related molecular mechanisms.Methods HCC827 cells were seeded in well plates with a density of 1×106 and then randomly divided into 5 groups:control group (group C),intralipid group (group E),low-dose propofol group (1.5μL/mL,group P1),medium-dose propofol group (2.2μL/mL,group P2),and high-dose propofol group (3.2μL/mL,group P3).At 6 h,24 h and 48 h after propofol treatment,the cells were collected to detect their proliferation and apoptosis.At 6h after treatment,the cells were collected for the measurement of Nrf2 mRNA and protein by RT-PCR and Western blot.Results Cell inhibition rate (IR)and apoptosis as well as Nrf2 mRNA and protein expressions in group E did not differ significantly from those in group C (P>0 .0 5 ).Compared with those in groups C and E,IR and apoptosis and Nrf2 mRNA and protein expressions were significantly increased in groups P1,P2 and P3 (P<0.05).Conclusion Propofol can inhibit the proliferation of cancer cells and promote cell apoptosis,thereby inhibiting the reoccurrence and metastasis of cancer cells probably via regulating the activation of Nrf2 expression.

BACKGROUND:Co-culture withembryonic stem cels or embryonic tissues can induce differentiation of carcinoma cels into normal epithelial cels or decreasemalignancyof carcinoma cels.Acelular embryoid bodies retain the structure and important cytokines of embryonic tissues.
OBJECTIVE:To prepare acelular embryoid bodies from mouse embryonic stem cels and to investigate their effects on differentiation of mouse Lewis lung carcinoma cels at three-dimensional culturein vitro.
METHODS:Mouse embryonic stem cels(D3)were dynamicaly cultured for 7 days to produce embryoid bodiesfolowedbydecelularization with 0.1% sodium dodecyl sulfate. Mouse Lewis lung carcinoma cels were co-cultured with acelular embryoid bodiesas test group or culturedinthree-dimensionalmatrigel mediumfor 7 days as control group, respectively. Cel proliferation and expression of E-cadherin were detected by immunohistochemical staining and western blot assay, respectively. In addition, mRNA expressions ofSlug and E-cadherin were observed using RT-PCR technology.
RESULTSAND CONCLUSION:Uniform mouse embryoid bodieswere successfuly prepared, andwere completely decelularized with sodium dodecyl sulfate. After 7-day three-dimensionalmatrigelculture, in the control group,multicelular tumor spheroidswere formed,accompanied byahigherKi67positive rate;Lewis lung carcinoma cels in the test group were repopulated in the acelular embryoid bodies showing significantly lowerKi67positive rate. Compared with the control group, the absorbance ofPaxilin in the test group was significantly smaler, and the absorbance of E-cadherin was significantly higher (P< 0.05). Besides, mRNA expressions of Slug and E-cadherin were significantly decreased and increasedin the test group compared with the control group, respectively(P< 0.05). These findings indicate that the acelular embryoid bodies can promote differentiation of mouse Lewis lung carcinoma celsinthree-dimensional culturein vitro.

OBJECTIVETo investigate the clinical effects of endoscopy-assisted sialolithectomy for the calculus in the Stensen's duct.

METHODSFrom August 2005 to July 2013, 67 consecutive patients with calculus (or foreign bodies) in the Stensen's duct underwent explorative and interventional endoscopy in our hospital. The stones (or foreign bodies) were removed by endoscopy-assisted technique. After operation, the patients were followed-up periodically, and treatment effects were analyzed.

RESULTSAmong the 67 patients, the stones (or foreign bodies) were completely removed in 58 cases, and almost completely removed in 3 cases, with a success rate of 87% (58/67). Among the 61 stone-removed cases, treatment options included direct removal with aid of basket or forceps (24 cases), basket entrapment and opening-up of the ostium (21 cases), basket entrapment and mucosal incision near the ostium (8 cases), open removal via buccal incision (2 cases) and open removal via pre-auricular flap (6 cases). During the 6-90 months' follow-up of the 61 cases, 48 cases were asymptomatic, 7 had mild symptoms, 3 developed ductal obturation, 1 had numbness in the parotid region, and the remaining 2 were missed.

CONCLUSIONSEndoscopy-assisted sialolithectomy is a safe and effective gland-preservation technique for the patients with parotid gland calculus.

Dental Care ; Endoscopy ; Humans ; Parotid Gland ; pathology ; surgery ; Salivary Duct Calculi ; surgery ; Salivary Ducts ; Surgical Flaps

BACKGROUNDBrachytherapy offers an innovative method of delivering conformal high-dose radiation to a defining target tumor. The aim of this study is to investigate the value and effect of using radioactivity ¹²⁵I seed permanent implants combined with chemotherapy in the management of stage III or IV lung cancer.

METHODSForty-two lung cancer patients in stage III and IV (15 center lung cancer) who couldn't be relieved by routine methods were treated with ¹²⁵I seed permanent micropuncture implant brachytherapy and chemotherapy. The dose and distribution of seeds was decided by treatment planning system, and CT was used during ¹²⁵I seed permanent implant treatment. Distribution of seeds and complication was reviewed by CT scan after treatment. Chemotherapy was performed in 3 to 7 days after implanting. The effect was observed by X-ray, CT and MRI every 3 or 4 weeks.

RESULTSThe satisfaction rate of seed distribution was 83.3% (35/42). The response rate of treatment was 85.7% (36/42), including complete response rate 26.2% (11/42), partial response rate 59.5% (25/42), no change rate 14.3% (6/42). Effective rate of pain relief was 83.3% (15/18). Thirteen patients (31.0%) had complication of mild hemothorax, 8 (19.0%) with bleeding in lung and 5 (11.9%) with hemoptysis. Three patients (7.1%) had mild pneumothorax and 1 patient (2.4%) had a malposition seed. Leucopenia and radiation pneumonia didn't occurred.

CONCLUSIONS¹²⁵I seed micropuncture implant has less trauma and complication, and is a safe and effective method. This method might be helpful in the treatment of lung cancer and can be selectively used in clinic.

Objective: To investigate the safety and efficacy of 125I radioactive seed implantation in the treatment of mediastinal lymph node metastasis. Methods: Records of 53 patients enrolled in Shaanxi Provincial Tumor Hospital from June 2014 to June 2018 with me-diastinal lymph node metastasis treated by computed tomography (CT)-guided 125I seed implantation were analyzed retrospectively. The preoperative treatment planning system was validated after the surgery. Intraoperative and post-operative complications were re-corded. The improvement in quality of life was observed. Chest CT follow-up was conducted 1 month, 3 months, 6 months, 1 year, and 2 years after treatment. The local focus control was evaluated. The median survival and total survival were recorded, and the survival prognosis and causes of death were analyzed. Results: The median survival time was 254 days (8.5 months), one-year survival rate was 48.67%, and complete and partial response rate was 83.02% (44/53). Multivariate Cox model analysis showed that the survival progno-sis was related to the Eastern Cooperative Oncology Group (ECOG) score, distant metastasis at the time of implantation, concurrent chemotherapy after implantation, and secondary seed implantation (P<0.05). The rates of developing pneumothorax and hemoptysis during and after the surgery were 20.75% (11/55) and 13.20% (7/55), respectively. No patients died. After implantation, the remission rate of cough, shortness of breath, pain, hoarseness, and superior vena cava syndrome was 60.00%-82.61%. Conclusions: CT-guid-ed 125I seed implantation in the treatment of mediastinal lymph node metastasis has the advantages of minimal trauma, remarkable cu-rative effect, safety, and feasibility. It has important application value and is worthy of further clinical application.

Objective:To investigate the safety and dose of 4D template (real-time adjustable angle template) in the treatment of advanced malignant tumors with 125I seeds. Methods:98 patients with advanced malignant tumors admitted to Department of Thoracic Surgery of Shaanxi Provincial Tumor Hospital were treated with 4D template-navigated radioactive 125I seed implantation from June 2018 to December 2019. Preoperative TPS plan, intraoperative optimization, postoperative verification of immediate dose and postoperative evaluation of implantation dose were performed. The treatment results were observed. Results:All 98 patients completed the seed implantation. The implantation dose of GTV of implantation site receiving external irradiation was (12 489±414) cGy and the dose of no external irradiation was (15 036±514) cGy. V 100% was 84.7%-94.1%, and 88.2%-93.7%. The implantation dose of CTV was (7 450±621) cGy, and (9 080±761) cGy. The quality of dose implantation was evaluated as: excellent in 89 cases (91%, 89/98), good in 7 cases (7%, 7/98), fair in 2 cases (2%, 2/98), and poor in 0 case, respectively. The symptom relief rate of patients with pain was 92%(36/39). The 1-and 2-year local control rates were 61%, 36% and 82%, 54% in patients treated with and without external irradiation, respectively. The difference was statistically significant ( P=0.02). The incidence rates of pneumothorax and hemoptysis were 19%(9/48) and 10%(5/48). No corresponding complications were observed in other parts of the patients. Conclusion:4D template-assisted 125I seed therapy is safe and effective for malignant tumors, and intraoperative adjustment of needle angle and dose optimization can realize the precise control of implantation dose.