Fuzzy Logic ; Humans ; Occupational Diseases ; etiology ; Risk Assessment

Objective： A prospective randomized trial was performed to evaluate the contribution of neoadjuvant chemotherapy in the patients with locoregionally advanced nasopharyngeal carcinoma. Methods： The patients with locoregionally advanced nasopharyngeal carcinoma were treated with either radiotherapy alone (RT group) or neoadjuvant chemotherapy plus radiotherapy (CT/RT group). Neoadjuvant chemotherapy consisting of 2-3 cycles of cisplatin (20 mg/m2 on Day 1 to Day 5), bleomycin (7 mg/m2 on Day 1 and Day 5), and 5-FU (500 mg/m2 on Day 1 to Day 5) followed by radiotherapy was given to CT/RT group. All patients were treated in a uniform definitive-intent radiation therapy in two groups. Results： From 1992 to 1993, 457 patients were enrolled and 440 patients (221 in RT group, 219 in CT/RT group) were assessable. The 5-year overall survival (OS) rates were 62％ for CT/RT group and 55％ for RT group (P=0.1335)； The 5-year relapse free survival rate was 48％ versus 58％ , respectively (P=0.0539). The 5-year free local recurrence (FLR) rate was 82％ for CT/RT group, 74％ for RT group (P=0.0412). There was no significant difference in free distant metastasis (FDM) between two treatment groups (CT/RT group, 79％ ; RT group, 75％ ; P=0.4177). Subgroup analyses showed that neoadjuvant chemotherapy improved local control in patients with T3-4 disease, and had no effect in preventing distant metastases in patients with N2-3 disease. Conclusion： Despite improving FLR and RFS, neoadjuvant chemotherapy and radiatherapy failed to gain other survival benefit or reduce distant metastases in patients with locoregionally advanced nasopharyngeal carcinoma. The indication for neoadjuvant chemotherapy is proposed.

OBJECTIVETo investigate the therapeutic effect of scalp flaps pedicled with superficial temporal vessel and hair removal for reconstruction of facial skin defects.

METHODSFrom Jan. 2010 to Dec. 2011, 6 cases with large facial skin defects were treated with scalp flaps pedicled with superficial temporal vessel and hair removal. At the first stage, the skin expanders were implanted subcutaneously at the homolateral side according to the defect size. After the expansion was finished, the expanded flaps pedicled with superficial temporal vessel were used to reconstruct the facial skin defects at the second stage. 2 weeks after operation, hair removal was performed to remove the hair on flaps. 4-6 treatments were needed.

RESULTSSeven flaps in 6 cases were survived completely. The wounds at donor sites were closed directly. The effect of hair removal was reliable. The patients were followed up for 6 months to 1 year. The flap color, texture and thickness had a good match with surrounding skin tissue.

CONCLUSIONSIt is a good option to reconstruct facial skin defects with scalp flaps pedicled with superficial temporal vessel and hair removal.

Adolescent ; Face ; surgery ; Hair Removal ; Humans ; Reconstructive Surgical Procedures ; Scalp ; transplantation ; Surgical Flaps ; blood supply ; transplantation

BACKGROUNDAlveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis (E. multilocularis) and is a rare but life-threatening disease. This disease commonly is characterized by an infiltrative, tumor-like growth of the E. multilocularis metacestode in the liver of human. Liver transplantation is an effective therapy for end-stage of hepatic AE, but the characteristics of host immunity associated with E. multilocularis infection with organ transplantation are poorly defined. We hereby aimed to study the immunological status and allograft heart survival in inbred rats with E. multilocularis infection.

METHODSRat models of AE were established by injecting the E. multilocularis suspension made from E. multilocularis infected tissues into the abdomen of Lewis (LEW) rats. Three months later, in the experimental group, allograft heart transplantation was performed from Brown-Norway (BN) rats to the E. multilocularis infected LEW rats. In the control group, we transplanted hearts from BN rats to healthy LEW rats. The influence of the disturbed immune system in E. multilocularis infected rats on the heart transplantation was assessed, including observation of allograft heart survival time, histopathological examination of grafts and immunohistochemical examination of infiltrating cells (CD4(+) T cells, CD8(+) T cells and eosinophile granulocytes), measurement of interleukin (IL)-4 and interferon (IFN)-γ in the serum by enzyme-linked immunosorbent assay (ELISA) and analysis of CD4(+)CD25(+) regulatory T cells in peripheral blood by fluorescence activated cell sorting (FACS) flow cytometric analysis.

RESULTSThe survival time of recipients in the experimental group was prolonged compared with those in the control group. The numbers of graft infiltrating CD8(+) T cells were decreased whereas the graft infiltrating eosinophil granulocytes (CD15(+)) were increased in grafts in the experimental group (P < 0.05). Furthermore, the proportion of CD4(+)CD25(+) regulatory T cells in the peripheral blood was 10.8% on average in the experimental group, which was significantly higher than that in the control group (6.1%). In addition, the level of serum IL-4 in E. multilocularis infected rats was higher than that in the control group rats, whereas the level of serum IFN-γ in experimental group was lower than that in the control group when graft rejection occurred (P < 0.05).

CONCLUSIONSThis study suggests that E. multilocularis infection could prolong the allograft survival time through the polarization of Th1/Th2-type cells and induction of CD4(+)CD25(+) regulatory T cells. This strategy may provide a new idea for establishing transplantation tolerance.

Animals ; Echinococcosis ; blood ; immunology ; Echinococcus multilocularis ; immunology ; pathogenicity ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Gerbillinae ; Heart Transplantation ; Immunohistochemistry ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Male ; Rats

BACKGROUND AND OBJECTIVEWe previously reported that C-KIT overexpression and mutation exist in biopsy samples of nasopharyngeal carcinoma (NPC). Yet whether Imatinib had an inhibitory effect on the proliferation of NPC in vitro was still unknown. So, this study examined whether sensitivities to Imatinib of other cell lines are different and whether C-KIT expression and mutations exist, to analyze the correlations between them.

METHODSThe expression of C-KIT in NPC cell lines, including CNE-1, CNE-2, Hone-1, C-666, SUNE-1, 5-8F, and nasopharyngeal epithelial (NPE) cell line NP-69, were detected by Western blot. Direct sequencing of polymerase chain reaction (PCR) products was performed to analyze the sequences of C-KIT from the above-mentioned cell lines. Inhibitory effects on proliferation by Imatinib on these cell lines were determined by CCK-8 assay. Pearson product moment correlation and t test were used to analyze the correlation betweeen C-KIT overexpression, C-KIT gene mutation, and the inhibitory effect of Imatinib.

RESULTSCompared with NPE cell line NP-69, NPC cell lines CNE-1, CNE-2, Hone-1, C-666, SUNE-1, and 5-8F had significantly higher levels of C-KIT expression. Heterozygous IVS17+78T>C were found in CNE-1, CNE-2, Hone-1, and NP-69 cell lines, homozygous IVS17+78T>C was found in C-666, and no mutation was found in SUNE-1 or 5-8F. Imatinib had a dose-dependent inhibitory effect on proliferation for CNE-1, CNE-2, Hone-1, C-666, SUNE-1, and 5-8F. No significant correlation between the inhibitory effects of Imatinib, C-KIT overexpression, or C-KIT mutation was found.

CONCLUSIONC-KIT overexpression and intron mutation were found in NPC cell lines and Imatinib had a dose-dependent inhibitory effect on proliferation for NPC cell lines, yet no significant correlation between C-KIT overexpression, C-KIT mutation, or the inhibitory effect of Imatinib was found.

Antineoplastic Agents ; pharmacology ; Benzamides ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; virology ; Cell Line ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Epithelial Cells ; cytology ; metabolism ; Herpesvirus 4, Human ; isolation & purification ; Heterozygote ; Homozygote ; Humans ; Imatinib Mesylate ; Introns ; Mutation ; Nasopharyngeal Neoplasms ; genetics ; metabolism ; pathology ; virology ; Nasopharynx ; cytology ; Piperazines ; pharmacology ; Proto-Oncogene Proteins c-kit ; genetics ; metabolism ; Pyrimidines ; pharmacology

Objective： The current study was designed to investigate the diagnosis and the treatment of osteoradionecrosis of the skull base (ORN) in the patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods： All patients (n=12) diagnosed as nasopharyneal carcinoma and osteoradionecrosis of the skull base were studied retrospectively with their clinical manifestations, diagnoses, therapies and prognoses. Results： ORN was found with characteristic CT and endoscopic findings, they were never seen in the patients with NPC relapse. The latent periods of ORN in the patients after primary radiotherapy were 3 - 15 years, while the periods were 7 months - 2 years in the patients after reirradiation. Six patients with local ORN were operated, 1 patients was died of exhaustion; Six patients with extensive ORN were treated using conservative methods, 3 patients were died of severe nasopharyngeal bleeding, while one were died of exhaustion. Conclusion： The ORN of the skull base after radiotherapy could be diagnosed by CT and endoscopic findings. The patients with extensive ORN or radiation induced cranial neuropathy were associated with poor prognosis. The most common causes of death were severe nasopharyngeal bleeding and exhaustion.

Objective：The fifth edition of the International Union Against Cancer (UICC) staging manual defines new rules for classifying nasopharyngeal carcinoma (NPC). The study was conducted to assess the effectiveness of the manual to predict the prognosis for Chinese patient populations. Methods：From August 1992 to December 1993, a total of 621 consecutively admitted patients with nondisseminated NPC were treated with definitive-intent radiation therapy alone. A computer database containing all information for staging was formed on presentation. The extent of disease of each patient was restaged according to the 1997 UICC system. Results：The 1997 UICC system creates subgroups (Stages Ⅰ -Ⅳ ) that are assigned to 38 (6.1％ ), 270 (43.5％ ), 156 (25.1％ ), and 157 (25.3％ ) patients, respectively. The incidence of parapharyngeal extension was 74.1％ (460/621). Of these patients (460) with parapharyngeal extension, 310 (67.4％ ) patients were classified as T2 disease, The 5-year Overall survival(OS) rates were 89％ , 70％ , 53％ , and 37％ for Stages Ⅰ -Ⅳ , respectively. The 1997 UICC system showed highly significant differences between the overall stages for both OS and relapse-free survival(RFS). The 1997 UICC T-classifications showed significant correlation with local failure, and N classification was accurate in predicting freedom from distant metastasis(FDM). Conclusion：The 1997 UICC staging system for NPC is prognostically useful for Chinese patient populations. However, an uneven patient number distribution was noted. Subdivision of parapharyngeal extension should be included in future revisions of the staging system.

OBJECTIVETo find out the vector ability and function of Nosopsyllus wualis leizhouensis in the transmitting plague.

METHODSIn T: 19 degrees C +/- 1 degrees C, RH: 85% +/- 5%, data regarding the vector ability as cluster spreading, single flea spreading, single flea transmitting plague to single animal, formative bacterial embolus and infection fleas life-span through experiments was gathered.

RESULTSThe rate of infection on fleas was 94.64%, with 100% transmission rate of colony to spread, and 30% from single flea spreading to single animal. In the experiment of single flea transmission, all of the 388 rattus loseas were bitten by the fleas with bacterial, but only 9 animals were characteristically infected with the transmission potential, vector efficiency, survival potential of embolus, vector index as 0.360, 0.257, 0.868 and 0.223 respectively. The mean survive days of infected flea feed with blood were 17.58 (1 - 58), and the mean survive days of hunger infected flea were 7.25 (1 - 16). Formative bacterial embolus days were 8.80 (2 - 16) and the rate of embolus flea was 78.12%.

CONCLUSIONNosopsyllus wualis leizhouensis could serve as vector and important in the mode of plague transmittion.

Animals ; Female ; Insect Vectors ; microbiology ; Male ; Plague ; transmission ; Rats ; Siphonaptera ; microbiology

BACKGROUND: Unicompartment knee replacement is more popular for small trauma, rapid recovery, low less complications and almost normal knee mechanics, and has been used to repair unicompartmental knee diseases. At abroad, unicompartmental knee arthroplasty for advanced spontaneous osteonecrosis of knee (SONK) has obtained satisfactory outcomes, but its long-term efficacy and safety are not known in China. OBJECTIVE: To explore the short-term effectiveness of unicompartmental knee arthroplasty for advanced SONK. METHODS: Clinical data of 12 SONK patients (12 knees) admitted between January and August 2015 were analyzed retrospectively. Unicompartmental knee arthroplasty was operated by the same surgical team using the 3rdgeneration of Oxford?Unicompartmental Knee. The Visual Analogue Scale, femorotibial angle, range of motion of the knee and Hospital for Special Surgery scores were used to evaluate the curative efficacy at 3, 6, 12, and 18 months postoperatively. RESULTS AND CONCLUSION: (1) All patients were followed up for 12-18 months. The incision in all patients achieved primary union, and no infection, lower limb venous thrombosis or fracture occurred. (2) At the end of follow-up, the Visual Analogue Scale scores were significantly reduced from preoperative (6.67±0.78) to (1.75±0.97); the Hospital for Special Surgery scores were significantly increased from preoperative (63.92±7.27) to (91.67±2.87); the femorotibial angle changed from preoperative (178.28±3.38)° to (176.82±2.37)°(All P < 0.05). But the range of motion of the knee joint did not differ significantly before and after surgery. (3) That is to say, unicompartmental knee arthroplasty obtains satisfactory short-term efficacy in the treatment of advanced SONK.

Systemic chemotherapy is the basic palliative treatment for metastatic nasopharyngeal carcinoma (NPC); however, it is not known whether locoregional radiotherapy targeting the primary tumor and regional lymph nodes affects the survival of patients with metastatic NPC. Therefore, we aimed to retrospectively evaluate the benefits of locoregional radiotherapy. A total of 408 patients with metastatic NPC were included in this study. The mortality risks of the patients undergoing supportive treatment and those undergoing chemotherapy were compared with that of patients undergoing locoregional radiotherapy delivered alone or in combination with chemotherapy. Univariate and multivariate analyses were conducted. The contributions of independent factors were assessed after adjustment for covariates with significant prognostic associations (P < 0.05). Both locoregional radiotherapy and systemic chemotherapy were identified as significant independent prognostic factors of overall survival (OS). The mortality risk was similar in the group undergoing locoregional radiotherapy alone and the group undergoing systemic chemotherapy alone [multi-adjusted hazard ratio (HR) = 0.9, P = 0.529]; this risk was 60% lower than that of the group undergoing supportive treatment (HR = 0.4, P = 0.004) and 130% higher than that of the group undergoing both systemic chemotherapy and locoregional radiotherapy (HR = 2.3, P < 0.001). In conclusion, locoregional radiotherapy, particularly when combined with systemic chemotherapy, is associated with improved survival of patients with metastatic NPC.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; drug therapy ; radiotherapy ; secondary ; surgery ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; drug therapy ; radiotherapy ; secondary ; surgery ; Lung Neoplasms ; drug therapy ; radiotherapy ; secondary ; surgery ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; drug therapy ; pathology ; radiotherapy ; Neoplasm Staging ; Paclitaxel ; administration & dosage ; Palliative Care ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Survival Rate ; Young Adult