Esophageal Neoplasms ; drug therapy ; pathology ; Humans ; Induction Chemotherapy ; Neoplasm Staging ; Preoperative Period

Objective To study the neuroprotective effects of neuregulin-1?(NRG-1?) on the nervous behavioral function,cerebral infarction volume,brain water content(BWC),neuronal apoptosis and aquaporin-4(AQP-4) expression in astrocytes after cerebral ischemic reperfusion and the related mechanism in mice.Methods Intraluminal thread methods were applied to establish the middle cerebral artery occlusion reperfusion models in the mice.Neuregulin-1?(2?g / kg) was injected into the internal carotid artery for treatment.The nervous behavioral function was evaluated with Bederson's test.The cerebral infarction volume was observed with tetrazolium chloride staining.The BWC was measured by dry-wet weight comparing.The apoptosis positive cells were counted by immunofluorescence assay.The expression of AQP-4 was determined by immunohistochemical assay.Results Nervous behavioral malfunction appeared in all the mice with left middle cerebral artery occlusion and/or reperfusion.The infarction focus showed in the ischemic hemisphere after the injury.The BWC,the number of neuronal apoptosis cells and AQP-4 expression in astrocytes were higher than those in the sham group. In the NRG-1? treatment group,the nervous behavioral function was improved 24 hours after ischemia,the number of apoptosis positive cells reduced and the infarction volume decreased significantly compared with the control group(P0.05).In the groups of reperfusion for 22,46 and 70 hours,the five indexes mentioned above were significantly different from those in the corresponding control groups(P

Objective To evaluate the value of intraduetal ultrasonography (IDUS) in diagnosing biliary and pancreatic disorders. Methods The findings by endoscopic retrograde cholangiopancreatography (ERCP) and IDUS from 19 patients with suspected biliary and pancreatic disorders from July 2006 to August 2007 in our hospital were analyzed retrospectively. Results Of the 19 patients, 17 had obstructive jaundice (including 6 eases of cholangiocarcinoma, 2 pancreatic adenocareinoma, 2 gallbladder carcinoma, 2 chole-docholithiasis with bile duct stricture, 2 autoimmune pancreatitis, 1 papillary adenocarcinoma, 1 papillary adenoma, and 1 sclerosing cholangitis) and 2 intraduetal papillary mueinous tumor (IPMT). The diagnosis was confirmed by surgery and pathological findings in 11 patients. The diagnostic accuracy of ERCP and IDUS was 73. 7% (14/19) and 84. 2% (16/19), respectively, and that of ERCP combined with IDUS was 89. 5% (17/19). The sensitivity and specificity of ERCP to differentiate benign bile duct strictures from ma-lignant ones were 100. 0% (11/11) and 83.3% (5/6), respectively; and those of IDUS were 100. 0%(11/11) and 100. 0% (6/6), respectively. The sensitivity and specificity of ERCP in diagnosing cholan-gioeareinoma were 83.3% (5/6) and 60% (3/5), respectively; and those of IDUS were 100. 0% (6/6) and 40. 0% (2/5), respectively. Conclusion Combination of ERCP with IDUS can improve the diagnostic accuracy of pancreaticobiliary disorders. Additionally, IDUS shows higher sensitivity and specificity in differ-entiation between benign and malignant bile duct strictures, but it is still difficult to identify the etiologic factors of malignant bile duet strictures by IDUS.

Objective To explore the clinical efficacy of proximal femoral locking compression plate (LCP)fixation in elderly intertrochanteric fractures patients. Methods 30 cases of intertrochanteric fracture fixed with LCP were collected,and the functional recovery of all hip joints was observed. Results The average follow-up and healing time of all cases was 10 months(6 to 14 months)and 3.5 months respectively. Hip joint function of 27 cases was excellent( Harris scoring≥90) ,that of the other 3 cases was good ( Harris scoring:80 ～ 89). Conclusion The proximal femoral LCP fixation had a good clinical value in treatment of elderly intertrochanteric fracture patients. It had many advantages, such as simplicity, rigid fixation, less trauma and bleeding, shorter operative time, less complications, high heal rate, etc.

BACKGROUND: Most animal experiments of transgene are derived from mice; therefore, it is necessary to establish a focal cerebral ischemiareperfusion model and significant to prevent and cure ischemic cerebrovascular diseases.OBJECTIVE: To establish a convenient and reliable model with middle cerebral artery occlusion reperfusion (MCAO/R) in mice.DESIGN: Randomized controlled animal study.SETTING: Institute of Cerebrovascular disease, Affiliated Hospital of Medical College of Qingdao University.MATERIALS: Twenty healthy BALB/c mice, of both genders, weighing 25-30 g, of SPF grade, were divided into sham operation group (n=5), ischemia group (n=10) and 22-hour reperfusion group (n=5) on the basis of digital table. In addition, according to digital table, 130 healthy male Kunming mice were divided into sham operation group (n=10), 24-hour ischemia group (n=30), 2-hour ischemia/22-hour, 46-hour and 70-hour reperfusion groups with 30 in each group; meanwhile, 30 female mice were divided into sham operation group, 24-hour ischemia group and 2-hour ischemia/22-hour reperfusion group with 10 in each group. All Kunming mice were weighing 25-30 g and of SPF grade.METHODS: The experiment was carried out in the Institute of Cerebrovascular Disease, Affiliated Hospital of Medical College of Qingdao University from July 2005 to March 2006. The 6-0 suture with silica gel covered at an end was sent from the left external carotid artery (ECA) into internal carotid artery (ICA) till arriving at the initiation of middle cerebral artery (MCA) to block the blood stream in it, then drawing the suture from ICA 2 hours after occlusion to accomplish reperfusion. Mice were cut off their heads in sham operation group at 24 hours after operation, in ischemia group at 24 hours after blocking blood stream and in reperfusion group at 24, 48 and 72 hours after operation. Reliability of models was evaluated with neurology score and tetrazolium chloride stain. Longa standard scores: neurology score ≥ 1 point was regarded as successful models;coronal sections of brain tissue were stained with tetrazolium chloride, and the white region was regarded as infarcted volume.MAIN OUTCOME MEASURES: Neurology score and infarcted volume after staining of triphenyltetrazolium chloride in brain tissue.RESULTS: All mice were involved in the final analysis. ① Successful rate was 20% of BALB/c mice, 66.7%-73.3% of male Kunming mice and 40%-50% of female Kunming mice. ② Brain sections of BALB/c mice in sham operation group were orange at both sides of cortex and infarction focus was not observed. A big infarcted volume was observed on brain sections of mice in ischemia group, and infarcted volume counted for 50%-70% as homonymy hemisphere on optochiasmatic coronal sections. The condition of Kunming mice was similar to that of BALB/c mice, but infarcted volume counted for 40%-65%. In addition, condition in ischemiareperfusion group was similar to that in ischemia group. A big infarcted volume was observed on brain sections, and infarcted volume counted for 50%-75% as homonymy hemisphere on optochiasmatic coronal sections.The condition of Kunming mice was similar to that of BALB/c mice, but infarcted volume counted for 40%-65%.CONCLUSION: The model with MCAO/R in mice characterizes by relatively smaller trauma, and the ischemic region is stable; therefore, it can be used to accurate timing control of ischemia/reperfusion. This model is an ideal one for researching pathophysiological changes, prognosis and therapy in cerebrovascular disease.

Objective To study diagnosis and treatment of rhabdomyosarcoma (RMS) in children.Method The clinical data of 43 children with RMS was retrospectively reviewed from Nov 2004 to May 2012.Their long-term survival was followed up.Forty-three children with RMS(male 26,female 17) in Beijing Tongren Hospital were enrolled.Their median age on diagnosis was 6 years old.We confirmed the diagnosis according to pathological diagnosis.Comprehensive treatment included chemotherapy,surgery and implantation of radioactive seeds,and so on.Statistical analysis was used on clinical data and treatment efficacy.Result The median follow up time of 43 cases with RMS in children was 31 mouths until May 2012.Four cases abandoned,39 cases were followed up.The cases of complete remission were 27(69％),and the cases of partly remission were 7 (18％),and the cases of dead were 5 due to cerebral metastasis.Overall survival rate was 87％ (34/39).Eight cases were treated with 125Ⅰ particles implants into its location,7 cases responded,1 case was invalid.Conclusion Although anatomic structure of RMS of head and neck was very complex,and the prognosis of it with metastatic disease was inferior,the muttidisciplinary treatment can still improve the clinical remission rate.In particular,high risk RMS with 125Ⅰ particles implants and large dose chemotherapy would be beneficial.

目的探讨对老年2型糖尿病患者行空气净化前后动脉血氧分压(PaO2)和二氧化碳分压(PaCO2)的变化。方法55例老年2型糖尿病患者分为观察组(29例)和对照组(26例)。观察组患者所处疗养室每日24h进行空气净化。分别于净化前、净化后第2、3、4周抽取动脉血检测PaO2 、PaCO2 、PH值和氧饱和度。 结果空气净化4周后,观察组PaO2、PaCO2 、氧饱和度有明显改善(P<0.01),PH值无显著性变化。结论空气净化能改善老年2型糖尿病患者的PaO2 、PaCO2。

To investigate the therapeutic effects and associated complications of allogeneic peripheral blood stem cell transplantation (allo-PBSCT). 40 patients with various malignant hematopoietic diseases received allo-PBSCT. The preparative regimens were based on BUCY2 or modified BUCY2. The acute graft-versus host disease (aGVHD) was prevented by cyclosporin A and short-term MTX regimen in all patients. Two patients from donors with one fully mismatched HLA on DRB1 locus and 4 from unrelated donor also administered Zenapox (CD25 MAb) at dosage of 1 mg/kg every day on the day before transplantation and day 4 after transplantation. These 6 patients were also treated with mycophenolate mofetil (MMF). Transfusion of the donor cells: The median of the transfused nucleated cells was 5.38 x 10(8)/kg and that of the CD34+ cells was 7.8 x 10(6)/kg respectively. All the patients gained hematopoietic reconstruction except one who died of infection before engraftment. Seven patients got II degrees-IV degrees aGVHI) and the incidence was 17.5%. Fourteen patients got cGVHD and the incidence was 53.8% in the patients who survived over 6 months. Twenty-eight patients had fever or other characteristics of infection. The median follow-up time was 13.8 months. The incidence of transplantation related mortality (TRM) was 17.5% and 2 patients relapsed (5.0%). It was concluded that allo-PBSCT can reconstruct hematopoiesis quickly and is a favorable therapeutic method for leukemia.
China/epidemiology ; Cyclosporine/*therapeutic use ; Follow-Up Studies ; Graft vs Host Disease/*prevention & control ; Leukemia/*therapy ; Leukemia, Lymphoid/therapy ; Leukemia, Myeloid, Acute/therapy ; *Peripheral Blood Stem Cell Transplantation/adverse effects ; Sepsis/epidemiology ; Sepsis/etiology

Objective To analyse the characteristics of orbital benign and malignant masses on diffusion weighted imaging in combination with conventional MR imaging and evaluate the diagnostic value of apparent diffusion coefficient in distinguishing benign and malignant orbital lesions.Methods Seventy- seven cases with orbital masses,including fifty-five benign lesions and twenty-two malignant tumors,who underwent conventional MRI and diffusion imaging scanning were studied with use of a 1.5 T magnetic resonance system.Quantitative ADC measurements of masses(ADC_M)and of the white matter of eontralateral temporal lobe(ADC_W)were made with two different b-values of 0 and 1000 s/mm~2.The ADC ratio(ADCR)of the lesion to the control was calculated.The receiver operating characteristic curves(ROC) were constructed using various cut points of ADC_M and ADCR for different parameters to differentiate between benign and malignant masses.The area under the ROC curve for each parameter was also calculated. Results All cases were proved by histopathology.The mean ADC_M and ADCR of benign orbital masses were(1.56?0.75)?10~(-3)mm~2/s and 1.85?0.91,respectively.The mean ADC_M and ADCR of malignant orbital masses were(1.09?0.42)?10~(-3)mm~2/s and 1.28?0.53,respectively.There were significant difference both between ADC_M and ADCR of benign and malignant masses(t=2.803,2.735,P

Objective To evaluate endoscopic ultrasonography (EUS) for TN restaging and predicting response to advanced gastric cancer after neoadjuvant chemotherapy. Methods A total of 22 patients,15 males and 7 females, mean age 64 (36-80 years ), with advanced gastric cancer were recruited to the study from June 2007 to December 2009 with written informed consents. All patients underwent 3 cycles of neoadjuvant chemotherapy ( Folfox 6 ), and subsequent surgery ( R0 resction) in 3-4 weeks after chemotherapy. EUS was performed 1-2 weeks before and 1-2 weeks after chemotherapy. EUS TN staging was compared with pathological findings. The correlation of peri-chemotherapy EUS TN staging with postoperative pathological response was evaluated. Results After chemotherapy, the overall accuracy of EUS T staging was 63.6% (14/22), with overstaging (36. 4%, 8/22) more frequent than understaging (0). The overall accuracy of N staging was 54. 5% (12/22) with 4 ( 18. 2%, 4/22) overstaging and 6 ( 27. 3%, 6/22 ) understaging. EUS revealed T and/or N downstaging ( concyrrence of T and N downstaging was accounted once) after chemotherapy in 10 patients, with 9 T downstaging (4 from T3 to T2, 5 from T4 to T3) and 4 N downstaging (4 from N1 to N0). TN downstaging was correlated with pathological response, with 7 patients achieving pathological response 2 and 1 patient 3. Conclusion T and N restaging by EUS after neoadjuvant chemotherapy in patients with locally advanced gastric cancer is not accurate enough. However, T and/or N downstaging confirmed by EUS is well correlated with a better degree of pathological response to chemotherapy.