observation group than in the control group at T1 and T2 (P < 0.01). These findings indicate that dexmedetomidine for sedation after hip replacement can lessen inflammatory response and contribute to the recovery of hip function.

Objective To investigate the clinical efficacy of three-dimensional conformal radiotherapy combined with XELOX program chemotherapy in the treatment of postoperative local recurrence of rectal cancer.Methods One hundred and twenty-nine patients with postoperative local recurrence of rectal cancer were divided by random digits table method into treatment group (65 cases) and control group (64 cases).The patients in treatment group were treated with three-dimensional confonmal radiotherapy combined with XELOX program chemotherapy.The patients in control group were treated with XELOX program chemotherapy.The short-term effect,symptom control rate,long-term efficacy and adverse reaction were observed.Results The efficiency rate in treatment group [ 90.8％ (59/65) ] was significantly higher than that in control group [ 73.4％(47/64) ] (P ＜ 0.05 ).The improvement rates of pain,hematochezia and incomplete obstruction between treatment group and control group had significantly statistical differences [95.2％(40/42) vs.75.0％(27/36),92.9％(26/28) vs.79.5％(31/39),94.7％(18/19) vs.75.0％(9/12)](P ＜0.05).The 1,2,3-year survival rates between treatment group and control group had significantly statistical differences [ 67.7％ ( 42/62 ) vs.43.5 ％ ( 27/62 ),53.2％ ( 33/62 ) vs.30.6％ ( 19/62 ),38.7％ ( 24/62 )vs.14.5％ (9/62)] (P ＜ 0.01 ).The adverse reaction in two groups were mainly bone marrow suppression,gastrointestinal reactions,hand-fcot syndrome and radiation cystitis.The incidence rate of adverse reaction in treatment group was slightly higher than that in control group,but there was no significant difference between two groups (P ＞ 0.05).Conclusion Three-dimensional conformal radiotherapy combined with XELOX program chemotherapy in patients with postoperative local recurrence of rectal cancer can improve the short-term effect,symptom control rate and long-term survival rate.

Objective To explore the value of dynamic contrast-enhanced MRI (DCE-MRI)and diffusion tensor imaging(DTI)in grading of glioma.Methods 3.0T DCE-MRI and DTI scans were performed in 31 patients with glioma confirmed by pathology.Capacity volume transfer constant (Ktrans ),extravascular extracellular volume fraction (Ve ),exchange rate constant (Kep ),initial area under the gadolinium concentration-time curve (iAUC),and relative fractional anisotropy (rFA)were measured in the low grade glioma (LGG)and the high grade glioma (HGG).The correlation between parameters of DCE-MRI and rFA with microvessel denisity (MVD)and microvessel structure (MVS)were performed by Spearman rank correlation analysis.Results The MVD and MVS were positive correlation with the grading of glioma.Ktrans ,Kep ,Ve ,iAUC and rFA values of the LGG were (0.02±0.01)min-1 ,1.82 (0.18-8.54)min-1 ,0.05±0.03, 2.47±1.66 and 0.55±0.22,respectively.Ktrans ,Kep ,Ve ,iAUC and rFA values of the HGG were (0.1 1±0.02)min-1 ,1.31 (0.12-7.58)min-1 ,0.28±0.10,10.84 ±6.46 and 0.28 ±0.08,respectively.The differences of all parameters between the LGG and the HGG were statistically significant,except for Kep (P <0.05 ).Ktrans ,Ve and iAUC values were positive correlation with MVD and MVS (P <0.05),and rFA values were negative correlation with MVD and MVS (P <0.01).Conclusion The quantitative parameters of DCE-MRI and DTI have important values in grading of glioma and evaluating tumor angiogenesis and microvessel structure.

BACKGROUND: Facial nerve injury causes facial nerve paralysis (or facial palsy) and even results in psychosocial disturbances of the patients. Repair the injured facial nerve and reconstruction of the nerve function as early as possible have been the primary concern in clinical studies.OBJECTIVE: To investigate the timing and surgical approaches for repairing facial paralysis in order to provides evidences for its therapeutic and prognostic evaluation.DESIGN: Case analysis based on patients.SETTING: Hospital of Plastic Surgery of Chinese Academy of Medical Sciences.PARTICIPANTS: Nine patients with traumatic facial paralysis hospitalized in the Hospital of Plastic Surgery of Chinese Academy of Medical Sciences from December 1993 to November 2001.METHODS: Facial nerve anastomosis was performed microsurgically along with the implantation of the sural nerve graft into orbicular muscle of the eye 3 or 4 months after nerve injury in the 9 patients. The clinical data of the patients were retrospectively reviewed.MAIN OUTCOME MEASURES: The facial nerve function was evaluated with House-Brackmann scale and photographs of the patients' faces before and after surgical treatment were taken.RESULTS: In the follow-up of these patients lasting 6 months to 2 years,all the patients attained satisfactory outcome.CONCLUSION: Early operation is crucial for the treatment of traumatic facial paralysis,with facial nerve anastomosis as the primary choice. The implantation of the nerve graft into muscle is also indicated for repairing traumatic facial paralysis in some cases. The importance of individualized treatment choice is reiterated on the basis of cicatrectomy and the extent and specific features of the injury.

OBJECTIVEOn the basis of the concept of adhesive deformity from upper eyelid fold formation, the clinical results after using various methods to correct the adhesive deformities are summarized.

METHODSA total of 33 cases of adhesive deformity from upper eyelid fold formation have been treated using various corrective methods including taking off the sutures, shifting of the septal fat or the pre-septal orbicularis muscle, transferring of pretarsal orbicularis muscle, grafting of autogenous fat tissue, and repairing or/and shortening of the palpebral levator. Postoperative follow-up ranged from 3 months to 2 years.

RESULTSThe effective results have been got with the used methods except shifting of the pre-septal orbicularis muscle or transferring of pretarsal orbicularis muscle.

CONCLUSIONSThe suitable methods to correct the adhesive deformity from upper eyelid fold formation must be chosen according to the causes and the local situations.

We tried to construct and identify the recombinant replication-deficient adenovirus vector coding for human tissue factor pathway inhibitor 2 (hTFPI-2) gene by AdMax system in HEK293 cells. Firstly, we obtained hTFPI-2 gene from the recombinant plasmid pIRES2-EGFP-TFPI-2 by PCR using primers with restriction endonuclease site of EcoRI or SacI. After digesting the hTFPI-2 gene and plasmid PDC316-IRES-EGFP shuttle vector, we ligated them with T4 ligase and formed the recombinant shuttle vector PDC316-IRES-EGFP-hTFPI-2. It was confirmed that the ligation product was inserted the gene of hTFPI-2 correctly by sequencing. Then we took cotransfection of HEK293 cells with the recombinant shuttle vector and genomic plasmid pBHGloxdeltaE1,3Cre by liposome lipofectamine2000, and finished the package of recombinant adenovirus Ad-hTFPI-2. The results of the PCR test and restriction endonuclease digestion confirmed the successful construction of the recombinants Ad-hTFPI-2. Furthermore, we measured the titre of Ad-hTFPI-2 with the aid of green fluorescence protein expression after multiplication and purification. The titre was 0.931 x 10(12) pfu/ml. Finally, we infected U937 monocytes by purified Ad-hTFPI-2, and determined the infection efficiency and the TFPI-2's level and activity. The efficiency of Ad-hTFPI-2 infection in U937 cells was 89.33%. After infected by Ad-hTFPI-2, the TFPI-2's level in supernatant increased about 7 fold. Also the TFPI-2 in supernatant had activities of inhibiting trypsin and plasmin. The recombinant adenovirus with the hTFPI-2 gene was constructed successfully. It will be helpful for the further investigation of its potentiality to be applied in antiatherosclerosis.
Adenoviridae ; genetics ; metabolism ; Defective Viruses ; genetics ; metabolism ; Genetic Vectors ; genetics ; Glycoproteins ; biosynthesis ; genetics ; Humans ; Monocytes ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection ; U937 Cells

Objective Toinvestigatethemethod,safetyandefficacyoftranscatheterarterialchemoembolization(TACE)combined withargonheliumknifecryoablationintreatmentofadvancedprimaryhepaticcancer.Methods FiftyGfourpatientswithadvanced primaryhepaticcancerunderwentTACEfirstly,andfollowedbytheargonhelium knifecryoablationunderCT/ultrasoundguiding percutaneouspunctureafter1－2weeks.2－3cyclesofcryotherapywereperformedduringtheoperation.Afteroperation,enhanced CT/MRIwasperformedtofollowGup.Results Themediansurvivaltimewas17.6months.The6Gmonthsurvivalratewas100%,the 12Gmonthsurvivalratewas89.34%,thetumorprogressiontimewas9.3 months,andtheshortestsurvivalperiodwas8 months.Recent curativeeffectevaluationshowedCRin9patients,PRin34patients,SDin6patients,PDin5patients(RR＝79.62%,DCR＝90.74%). Conclusion TACEcombinedwithargonheliumknifecryoablationisasafeandeffectivetreatment,whichprovidesanewtreatment planforpatientswithprimaryhepaticcancer.

Objective ToexploretheeffectofTIPS+GCVEcombinedwithPSEonhemodynamicsinpatientswithlivercirrhosis,portal hypertensionandsplenomegaly.Methods 56patientswereincludedfromJanuary2015toDecember2016 whounderwentTIPS+GCVEcombinedwithPSE.Patientswerefollowed-upon1month,3months,6monthsand1yearaftersurgery,andstatisticanalysis weredoneonportalveinhemodynamicindex:portalveintrunkdiameter(PVD),portalveinvelocity(PVV),portalvenousbloodflow (PVF),splenicveintrunkdiameter(SVD)andvelocityofbloodflowinsplenicvein(SVV).Results Thereweresignificantdifferencesinportal veinpressurebeforeandafterthebypassinall56patients.PVDandPVV weresignificantlydifferentbetween3and6 monthsafter surgeryandpre-surgery.PVF wassignificantlydifferentcomparing6 monthsand1yearaftersurgery withpre-surgery.SVDand SVV weresignificantlydifferentbetween3 months,6 monthsand1yearaftersurgeryandpre-surgery.Conclusion TIPS+GCVE combinedwithPSEcouldeffectivelyreduceportalveinpressure,improveportalveinandspleenveinbloodflow,increaseportalvenousblood flow,andimprovepatients’liverfunction.

Objective:To explore the reasons for delayed medical treatment in patients with polycystic ovary syndrome (PCOS) using the treatment pathway theory as a framework, and to propose corresponding strategies to guide timely medical care for PCOS patients.Methods:Purposeful sampling was used to select 14 PCOS patients who sought treatment at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School between November 2022 and May 2023. Semi-structured interviews were conducted, and directed content analysis was applied to analyze and extract data.Results:The delay in seeking medical treatment for PCOS patients ranged from five to 60 months. Four main themes and 11 sub-themes were identified as reasons for treatment delays: misconception and delayed recognition of the disease (misunderstanding of symptoms, intermittent symptom presentation) ; delayed seeking of medical help (mismanagement of symptoms, feelings of shame, role conflict, distance and financial constraints, lack of social support) ; delayed diagnosis by healthcare providers (misdiagnosis by healthcare providers, lack of medical resources and services) ; and delayed participation in treatment (lack of health education from medical staff, no immediate fertility needs) .Conclusions:Delays in seeking medical care for PCOS patients are common. Efforts should be made to enhance public education on PCOS for adolescent and reproductive-age women, emphasize the management of the disease in patients without immediate fertility needs, improve primary healthcare institutions' capacity for managing PCOS, and mobilize the social support system to encourage patients to seek medical treatment early, thus reducing the occurrence of delayed medical care.