Objective To evaluate the clinical effectiveness of the treatment for the intramedullary broad dissemination of the malignant bone tumor of limbs by microwave heliotherapy combined with prosthesis replacement.Methods From June 2001 to April 2012,19 patients with intramedullary broad dissemination of malignant bone tumor of limbs were treated with microwave heliotherapy combined with prosthesis replacement.There were 12 males and 7 females,47 years old on the average (ranging from 11 to 65 years).The tumors involved:primary malignant tumor 11 cases,metastases of the scapula 8 cases.Locations of tumors involved:the distal femur 8 cases,the proximal tibia 6 cases,the proximal humerus 3 cases and the proximal femur 2 cases.After the patients were examined with MRI and the level of osteotomy was determined,the prostheses were custom-made.The exposures of the all tumors were via the conventional surgical approach.The lesions were heated at 50 ℃ for 20 min by 2 450 MHz microwave,with surrounding soft tissue protected by copper mesh.The level of osteotomy was determined by the result of preoperative imaging measurement.The prosthesis was installed after the microwave heliotherapy.Results The duration of surgery was from 60 min to 150 min (100 min on average).The blood loss was from 300 ml to 1200ml (600 ml on average).All patients were followed-up for 10 months to 5 years (2.7 years on average).1 case with chondrosarcoma relapsed 18 months after surgery,and survived with tumors.1 case with malignant fibrous histiocytoma died due to multiple metastases 8 months after surgery.1 case with Ewing sarcoma died due to pulmonary metastases 23 months after surgery.The remaining 7 cases with the primary malignant bone tumors did not recur or transfer during the follow-up period.6 cases with the metastases died due to metastases 5 to 20 months after surgery.The functions of shoulder joint of 3 proximal humerus tumor patients were restricted,while 16 patient's function weren't restricted.Conclusion The clinical results demonstrated that the microwave heliotherapy combined with prosthesis replacement was an ideal treatment for the intramedullary broad dissemination of the malignant bone tumor of limbs.

Objective To study the expression of VEGF-C and its receptor in breast carcinoma tissue and in peritumoral tissue,as well as their clinic significance.Methods Immunohistochemistry SP method was used to examine the expression of VEGF-C and VEGFR3 in 70 cases of breast cancer and in its peritu- moral tissue.Results In all 70 cases of breast cancer,the positive expression rate of VEGF-C in breast car- cinoma tissue was 78.6 %,and its rate in peritumoral tissue was 54.3 %.There was a significant stastistic dif- ference between the two groups(P

Objective To compare clinical outcomes in eyes with macula-off rhegmatogenous retinal detachments (RRD) with peripheral breaks managed by surgical protocols that result in either complete (CSFD) or partial subretinal fluid drainage (PSFD).Methods Following the clinical detection of a maculaoff RRD with peripheral retinal breaks,patients were offered the opportunity to enroll in the study,and those patients who signed the consent were evaluated for eligibility based upon the inclusion and exclusion criteria for this clinical study,and if fully eligible they were assigned prospectively to one of the two surgical designs (PSFD or CSFD,1∶ 1) using a random number table.Seventy-two eyes of 72 patients were enrolled and studied.Patients were treated with 25G plus vitrectomy,endolaser or transscleral cryopexy,either complete (n=36),or partial (n=36) subretinal fluid drainage,and 14％C3F8 (PFO) was used for intraocular tamponade.After surgery,all patients were kept in a supine position for 24 hours,and then in a clinically optimal position for 6-10 days.The study patients were examined at 1,3 and 6 months after surgery with thorough ophthalmic examinations.Macular optical coherence tomography (OCT) imaging was acquired in 1 month.Anatomical and visual outcomes as well as intra-operative and postoperative complications of the two groups were compared.Furthermore,the persistence of subfoveal fluid in OCT images and the symptoms of distortion at 3 months were measured and recorded.The primary study endpoint of anatomic retinal reattachment for each group was based upon the 6-month time-point.Results The preoperative baseline characteristics between the two groups were not significantly different.The single-operation success rates were 88.9％ and 91.6％ respectively for the CSFD and the PSFD groups (x2 =0.158,P＞0.05).The mean best corrected visual acuity (BCVA) at 6 month endpoint were 0.99± 0.52 minimum resoluation angle in logarithmic (logMAR) for the CSFD group and 1.07±0.34 logMAR for the PSFD group(t=0.580,P=0.564).The mean operative time was longer in the CSFD group (62.25± 4.32) minutes than that in the PSFD group (47.9 ± 5.0) minutes (t =0.580,P=0.564).seven of 29 (24.1％) phakic eyes in the CSFD group had lens injury during SRF drainage,and none of the 31-phakic eyes in the PSFD group sustained lens damage.Residual PFO was present in 6 of 36 CSFD cases (16.7％).Successful retinal reattachment after primary surgery was achieved in 33) PSFD eyes and in 32 CSFD eyes based upon OCT imaging at 1 month demonstrated reattached foveae with no residual subfoveal fluid.Among these patients,22 patients (62.5％) in the CSFD group and 23(69.7％) patients in the PSFD group reported distortion in the operated eye or/and a difference in image size between the two eyes at the 6 month visit (P=1.00).Conclusions Partial subretinal fluid drainage during pars plana vitrectomy for the repair of macula-off RRD with peripheral breaks is effective.The success rates are not statistically different.Additionally,PSFD procedures can simplify the surgery procedure,shorten operative time and,and to some extent,reduce the incidence of complications relevant to the CSFD approach.

Objectlve To assess the clinical effects and safety of intravitreal injection of conbercept and macular photocoagulation for non-ischemic macular edema secondary to branch retinal vein occlusion (BRVO).Methods A total of 50 patients (50 eyes) with non-ischemic macular edema following BRVO were retrospectively analyzed.Patients were divided into 2 groups:ICI group (26 eyes) received intravitreal injection of conbercept,laser group (24 eyes) received standard-of-care grid laser for macular edema.The best-corrected visual acuity (BCVA) and central macular thickness (CMT) were observed before and 1 week,1 month,2 months and 3 months after treatment.Then,the changes in pre-treatment and post-treatment were compared,and the related complications were recorded.Results The difference of BCVA before treatment was not significant between two groups (P ＞ 0.05).BCVA at 1 week,1 month,2 months and 3 months after treatment in two groups were all improved,the differences were statistically significant compared with before treatment (all P ＜ 0.05),and the differences were statistically significant between two groups after treatment (all P ＜0.05).At 3 months after treatment,BCVA of 18 patients (69.23％) in ICI group and 8 patients (33.33％) in ICI group improved 2 lines.The difference of CMT before treatment was not significant between two groups (P ＞ 0.05),CMT at 1 week,1 month,2 months and 3 months after treatment in two groups were all decreased,the differences were statistically significant compared with before treatment (all P ＜ 0.05),and the differences were statistically significant between two groups after treatment (all P ＜0.05).13 eyes received repeat intravitreal injection in ICI group,including 2 eyes at 1 month,7 eyes at 2 months with CMT ＞250 μm,and 3 eyes at 3 months.No severe side effect related with drug and intravitreal injection occurred in the two groups.Conclusion Mean BCVA change and CMT change are significantly greater in the intravitreal injection of conbercept than the standard-of-care grid laser group for the macuiar edema secondary to non-ischemic BRVO.

Objective To evaluate the clinical effectiveness of the treatment for the proximal femur malignant bone tumor by conducting intercalary diaphyseal endoprosthetic reconstruction.Methods Form June 2011 to July 2014,7 patients who had proximal femur malignant bone tumor were treated with intercalary diaphyseal endoprosthetic reconstruction.There were 3 males and 4 females,61.8 years old on the average (ranging from 28 to 76 years).The tumors involved:4 case of the limbs primary malignant tumor,1 case of osteosarcoma,1 case of juxtacortical osteosarcoma,1 case of malignant lymphoma with pathological fracture,and 1 case of malignant fibrous histiocytoma with pathological fracture,as well as 3 cases of the Metastatic breast cancer of the proximal femur.All patients were evaluated by plain radiography,CT and MRI before operation.After these 7 patients were examined with MRI and the level of osteotomy was determined,prosthesis fitting is ready.The exposures of all the tumors were via the femur lateralis surgical approach.According to the general principles of tumor surgery,expose the tumor segment and soft tissue tumors.The segment of involved bone was then removed,with a surrounding cuff of normal tissue overlying the tumor.The level of osteotomy was determined as the result of preoperative imaging measurement.The proximal and distal femur intramedullary canals are reamed.The prosthesis is assembled and installed after the cement used.Results The duration of surgery was from 45 min to 120 min (90 min on average).The blood loss was from 200 ml to 800 ml (400 ml on average).All patients were followed-up for 6 months to 2 years (14 months on average).1 case with osteosarcoma died due to pulmonary metastases 18 months after surgery.The remaining 3 cases with the primary malignant bone tumors did not recur or transfer during the follow-up period.1 case with the metastases was comprehensive treated in another hospital,and survival with tumors.The remaining 2 cases with the metastases did not recur or transfer during the follow-up period.Conclusion The clinical results demonstrated that the intercalary diaphyseal endoprosthetic reconstruction was an ideal treatment for the proximal femur malignant bone tumor.

Objective To investigate the relationship between glucose excursion and cognitive function in aged type 2 diabetes. Methods A total of 248 aged type 2 diabetes were recruited in this study,all of them wore continuous glucose monitoring system (CGMS) for 3 d to evaluate the glucose excursion including mean amplitude of glycemic excursions (MAGE) which was used for assessing intra-day glycemia variability,and mean daily difference (MODD) which represented day-to-day glycemic variability.During the period of CGMS monitoring,all subjects accepted mini mental status examination (MMSE) for evaluating cognitive function.The relationships of MAGE and MODD with performance on cognitive tests were assessed. Results The over intra-day glucose excursion group had lower MMSE score than the narrow intra-day glucose excursion group[(24.25±6.75)vs.(25.97±0.47),P=0.025].The MMSE score was decreased in over day-to-day glucose excursion group compared with the narrow day-to-day glucose excursion group [(24.21 ± 6.47) vs. (26.01 ± 5.49),P =0.019]. A statistically significant association was observed between MAGE and the score of MMSE(r=- 0.308,P＜0.001),and between MODD and MMSE(r=-0.226,P =0.001).Conclusions Glucose excursion may affect cognitive function in aged type 2 diabetes.The over glucose excursion decreases the score of MMSE.

Objective To assess the effectiveness of donepezil versus huperzine in the treatment of elderly patients with mild cognitive impairment (MCI).Methods Total 122 elderly patients with MCI were divided into two groups:donepezil treatment (5.0 mg once daily) (n=71) and huperzine treatment group (0.1 mg twice daily) (n=51).All the patients were followed up for 24 weeks.Before and 12 weeks,24 weeks after drug treatment,the cognitive functions were evaluated,including MMSE,MOCA,ADAS-cog,CDR,GDS,ADL,HIS and HAMD.Results There was no significant difference in age,sex,education time and neuropsychology rating scales between the groups before drug use.As compared with the score before drug use,the donepezil group showed a significant increase in MMSE after 12-weeks (t=4.47) or 24-weeks (t=6.16) (P＜0.01),a decrease in the score of ADAS-cog after 12-weeks (t=2.33,P＜0.05) or 24-weeks( t=3.68,P＜0.05),and an increase in the score of MOCA after 24-weeks drug use (t=2.56,P＜0.05).The huperzine group showed significant improvement in MMSE after 24-weeks drug use (t=2.80,P＜0.05),but there was no difference in other time points or in the score of MOCA and ADAS-cog as compared with the score before drug use.After 24 weeks' treatment,the donepezil group had higher MMSE (t=2.01,P＜0.05) and lower ADAS-cog (t=2.09,P＜0.05) scores than the huperzine group.30 patients (total effective rate was 42.3 ％) and 9 patients (total effective rate was 17.6 ％ ) became improved in donepezil and huperzine group,respectively,with significant difference (x2 =8.26,P＜0.01 ).There were 5 cases in the donepezil group and 3 cases in the huperzine group getting slight side-effects which disappeared by continuing to take drugs or by adjusting drug taking time.Conclusions Donepezil and huperzine as the cholinesterase inhibitors are effective and safe,and the efficacy of donepezil is faster and better in treating elderly patients with MCI.

Case-Control Studies ; Diabetes Mellitus, Type 2 ; epidemiology ; Glucose Tolerance Test ; Humans ; Risk Factors

OBJECTIVETo investigate the influence of therapeutic bloodletting at Jing-well points and hypothermia on acute cerebral edema after traumatic brain injury (TBI) in rats.

METHODSSeventy-five SD rats were randomly divided into sham-operation group (Sham), TBI group (TBI), bloodletting group (BL), mild-induced hypothermia group (MIH), and bloodletting plus MIH group (BL + MIH) (n = 15). The model of TBI was established by electric controlled cortical impactor (eCCI). The rats of BL group were bloodletting at Jing-well points immediately after injury, twice daily. While the MIH group was settled on a hypothermia blanket promptly after TBI for 6 hours, so that the temperature dropped to 32 degrees. Each of measurement was performed after 48 hours. Magnetic resonance imaging (MRI) was used to evaluate the dynamic impairment of cerebral edema after TBI (n = 3). In addition, mNSS score, measurements of wet and dry brain weight, and Evans Blue assay were performed to investigate the neurologic deficit, cerebral water content (n = 8), and blood-brain barrier permeability (BBB), (n = 4), respectively.

RESULTSMRI analysis showed that the cerebral edema, hematoma and midline shifting of rats in TBI group was more serious than other treatment group. Meanwhile compared with TBI group, the mNSS scores of every treatment group were meaningfully lower (all P < 0.05). Furthermore, treatment with BL+ MIH group was superior to the separated BL and MIH group (all P < 0.01). In addition, brain water content of each intervention group reduced to varying degrees (all P < 0.05), especially that of MIH group and BL + MIH group (P <0.01). BBB permeability of each treatment group was also significantly improved (all P < 0.01), and the improvement in MIH group and BL + MIH group was much better than the BL alone group (P < 0.05, P < 0.01).

CONCLUSIONOur major finding is that bloodletting at Jing-well points and MIH can reduce cerebral edema and BBB dysfunction and exert neuroprotective effects after TBI. The results suggest that the combination of BL and MIH is more effective than other treatment being used alone.

Animals ; Blood-Brain Barrier ; Bloodletting ; Brain ; pathology ; Brain Edema ; prevention & control ; Brain Injuries ; therapy ; Hypothermia, Induced ; Rats ; Rats, Sprague-Dawley

Objective To study the effect of soluble, refolded, recombinant extracellular domain of the human Fc gamma receptor Ⅱ a (huFcγRⅡa) on the binding of human IgG to cells. Methods Extra-cellular domain of the huFcγRⅡ a gene was amplified from recombinant plasmid pe3huR Ⅱ by PCR and then cloned into pET-28a vector. The recombinant plasmid pETshuR Ⅱ was transformed into E. coli BL21 (DE3) after identified by PCR and doubly digested. The inclusion bodies of fusion protein were extracted and purified by washing, dissolved in 6 mol/L guanidine buffer, and refolded by rapid dilution technique. The refolding protein activity was tested by ELISA and flow cytometry. Results Extraceilular domain of the huFcγRⅡa gene was successfully cloned into pET-28a. The results of SDS-PAGE showed that the molecular mass (Mr) of the expressed protein was 24.8 × 103, and the expression rate was 30%. The purity of recom-binant shuR Ⅱ was up to 90% after washing. ELISA showed that the recombinant shuR Ⅱ was able to bind human IgG in a dose dependent manner, shuRⅡ could competitively inhibit the binding of human IgG to huFcγRⅡa expressed on the surface of COS-7 cells by flow cytometry. Conclusion The results demon-strate that it is possible to obtain large quantities of recombinant shuR Ⅱ which has comparable binding prep-erties to those of the whole membrane bound huFcγR Ⅱ a.