To analyze clinical usage of traditional Chinese medicine ( TCM ) injections in a hospital , to evaluate the rationality and economy, so as to promote drug rational use. Methods: Based on the quantity of issue drugs in computer information management system, using the amount of sorting method and the dosage frequency analysis method, according the defined daily doses (DDDs) of the drug to calculate DDDs and the average daily cost(DDC) , sort the total amount of drug usage and DDDs then seek their ratio. Results:Medicine of the cardiovascular system and the antitumor system is rising in a hospital from 2011 to 2013. Amount structure of cardiovascular system drugs is always beyond 60%, and total usage amount of TCM injections remained as top 3. Individual TCM injections sort ratio exceeds the specified range. Conclusion:In overall, the clinical TCM injections use synchronism better, which is basic rational in a hospital, the clinical departments could choose the drug of appropriate price according to actual condition.

Objective:To investigate the mutations of the epidermal growth factor receptor (EGFR) gene and its clinical signifi-cance in non-small cell lung cancer (NSCLC). Methods:The EGFR gene mutations of exons 18 to 21 in NSCLC were detected by us-ing the ADx-ARMS? detection kit method. Results:The total mutation percentage in exons 18 to 21 of the EGFR gene was 45.8%(98/214) in NSCLC. These mutations predominantly occur in exons 19 and 21. EGFR gene mutation percentages were found in exons 18 (0.93%, 2/214), 19 (22.0%,47/214), 20 (2.3%, 5/214), and exon 21 (20.6%, 44/214) in the NSCLC. Two NSCLC cases were identified to have double EGFR gene mutations of exons 19 and 21. EGFR gene mutations were more frequently observed with adenocarcinoma histology (50.3%, 93/185) than with squamous cell carcinoma (17.2%, 5/29) (P=0.001). EGFR gene mutations occur more frequently in NSCLC cases in women than in men (P=0.002). EGFR gene mutations were significantly higher in NSCLC with lymphatic metastasis (66.7%) than in NSCLC without lymphatic metastasis (39.5%) (P<0.05). However, no evident association was found between EGFR gene mutations and age, as well as tumor grade and clinical stage of NSCLC (P>0.05). Conclusion:NSCLC, especially lung adenocar-cinomas, has exhibits frequent EGFR gene mutations in China. EGFR gene mutations in exons 19 and 21, combined with the clinical pathological features of lung cancer, can serve as the molecular marker to evaluate the efficacy of EGFR TKI for NSCLC patients.

OBJECTIVETo investigate the clinical and pathological features of patients with concurrent gastric adenocarcinoma and primary gastric mucosa-associated lymphoid tissue (MALT) lymphoma.

METHODSA 77-year-old man referred to Beijing Cancer Hospital for the evaluation of two primary cancers of stomach revealed by gastroscope was reported. The English literature was retrieved and analyzed.

RESULTSTotal gastrectomy was performed. Histological examination confirmed that the gastric body lesion was consistent with advanced poorly differentiated adenocarcinoma, while the lesion at the fundus with low grade MALT lymphoma. A systematic review of literature in English was performed, and 40 similar patients from 12 studies were found. There were 25 males(61.0%). More patients with adenocarcinoma were at early stage (65.9%) and the majority of lymphoma was low grade (82.9%). Furthermore, most of the patients experienced Helicobacter pylori infection (72.5%). As for therapeutic strategy, most of the patients underwent subtotal or total gastrectomy.

CONCLUSIONSConcurrent gastric adenocarcinoma with MALT lymphoma is rare. The characteristics of these tumors are still unclear. The majority of gastric adenocarcinoma is at early stage, and most of the patients have Helicobacter pylori infection. The treatment is mainly based on gastric adenocarcinoma.

Adenocarcinoma ; surgery ; Aged ; Gastrectomy ; Humans ; Lymphoma, B-Cell, Marginal Zone ; pathology ; surgery ; Male ; Stomach Neoplasms ; pathology ; surgery

Objective:To investigate the safety and short-term efficacy of laparoscopic pro-ximal gastrectomy (LPG) for proximal gastric cancer and adenocarcinoma of esophagogastric junction.Methods:The retrospective cohort study was conducted. The clinicopathological data of 385 patients with proximal gastric cancer and adenocarcinoma of esophagogastric junction who underwent LPG in the 15 medical centers, including the First Affiliated Hospital of Xiamen University et al, from January 2014 to March 2022 were collected. There were 304 males and 81 females, aged (63±9)years. Of the 385 patients, 335 cases undergoing LPG were divided into the laparoscopic group and 50 cases undergoing open proximal gastrectomy were divided into the open group. Observation indicators: (1) intraoperative and postoperative situations; (2) follow-up; (3) stratified analysis. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Repeated measurement data were analyzed using the repeated ANOVA. Results:(1) Intraoperative and postoperative situations. The operation time, cases with reconstruction of digestive tract as esophagogastric anastomosis and esophageal-jejunal anastomosis, cases with postoperative pathological staging as stage 0?Ⅰ and stage Ⅱ?Ⅲ, duration of postoperative hospital stay, cases with postoperative early complications were (212±96)minutes, 270, 65, 177, 107, 10(range, 8?14)days, 40 in patients of the laparoscopic group, with 51 cases missing the data of postoperative pathological staging. The above indicators were (174±90)minutes, 39, 11, 22, 28, 10(range, 8?18)days, 10 in patients of the open group. There were significant differences in the opera-tion time and postoperative pathological staging between the two groups ( t=2.62, χ2=5.93, P<0.05), and there was no significant difference in the reconstruction of digestive tract, duration of post-operative hospital stay, postoperative early complications between the two groups ( χ2=0.19, Z=0.40, χ2=2.50, P>0.05). (2) Follow-up. Of the 385 patients,202 cases were followed up during the post-operative 12 months, including 187 cases in the laparoscopic group and 15 cases in the open group. Cases with reflux esophagitis, cases with esophageal anastomotic stenosis were 48, 11 in patients of the laparoscopic group, versus 5, 2 in patients of the open group, showing no significant difference in the above indicators between the two groups ( P>0.05). The body mass index (BMI), hemoglobin (Hb), albumin (Alb) at postoperative 6 months and 12 months were (21±3)kg/m 2, (130±15)g/L, (40±4)g/L and (21±3)kg/m 2, (132±14)g/L, (41±4)g/L in patients of the laparoscopic group, versus (21±3)kg/m 2, (121±19)g/L, (37±5)g/L and (21±3)kg/m 2, (125±21)g/L, (43±6)g/L in patients of the open group. There were significant differences in postoperative Hb between the two groups ( Fgroup=5.88, Ftime=5.49, Finteraction=19.95, P<0.05) and there were significant differences in time effect of postopera-tive BMI and Alb between the two groups ( Ftime=9.53, 49.88, P<0.05). (3) Stratified analysis. ① Incidence of postoperative of reflux esophagitis and esophageal anastomotic stenosis in patients with different reconstruction of digestive tract. Of the 202 patients, cases with reconstruction of digestive tract as esophagogastric anastomosis and esophageal-jejunal anastomosis were 168 and 34, respectively. The incidence rates of postoperative of reflux esophagitis were 26.79%(45/168)and 23.53%(8/34)in cases with reconstruction of digestive tract as esophagogastric anastomosis and esophageal-jejunal anastomosis, showing no significant difference between them ( χ2=0.16, P>0.05). Cases undergoing esophageal anastomotic stenosis were 13 in patients with reconstruction of diges-tive tract as esophagogastric anastomosis. ② The BMI, Hb, Alb in patients with different reconstruc-tion of digestive tract. The BMI, Hb, Alb were (24±3)kg/m 2, (135±20)g/L, (41±5)g/L in the 168 patients with reconstruction of digestive tract as esophagogastric anastomosis before the operation, versus (23±3)kg/m 2, (130±19)g/L, (40±4)g/L in the 34 patients with reconstruction of digestive tract as esophageal-jejunal anastomosis before the operation, showing no significant difference between them ( t=1.44, 1.77, 1.33, P>0.05). The BMI, Hb, Alb at postoperative 6 months and 12 months were (21±3)kg/m 2, (128±16)g/L, (39±4)g/L and (21±3)kg/m 2, (131±16)g/L, (41±4)g/L in the 168 patients with reconstruction of digestive tract as esophagogastric anastomosis, versus (20±4)kg/m 2, (133±13)g/L, (43±3)g/L and (21±3)kg/m 2, (135±12)g/L, (44±3)g/L in the 34 patients with reconstruction of digestive tract as esophageal-jejunal anastomosis. There were significant differences in the group effect and time effect of postoperative Alb between patients with different reconstruction of diges-tive tract ( Fgroup=15.82, Ftime=5.43, P<0.05), and there was also a significant difference in the time effect of postoperative BMI between them ( Ftime=4.22 , P<0.05). Conclusion:LPG can be used to the treatment of proximal gastric cancer and adenocarcinoma of esophagogastric junction, with a good safety and short-term efficacy.

OBJECTIVETo summarize and analyze the clinical features, diagnosis, surgical approaches and treatment outcomes of patients with primary nasal sinus osteoma.

METHODSA retrospective review of 48 cases with primary nasal sinus osteoma treated from January 2007 to December 2013 was performed. All patients underwent preoperative CT scan and postoperative histopathologic examination. The surgical approaches included lateral rhinotomy in 14 cases, nasal endoscopic resection in 12 cases, coronal surgical incision craniotomy in 13 cases, combined craniofacial approach in 4 cases, and Caldwell-Luc approach in 5 cases.

RESULTSThe postoperative pathological diagnosis consisted of 3 variants, including 20 for compact type and 15 for cancellous type, and 13 for mixed type. Six cases were lost to follow-up and 42 cases were followed up for 6-60 months, 5 cases recurred. The post-operative complications included sinus mucous cyst in 4 cases, cerebrospinal fluid leak in 3 cases.

CONCLUSIONSNasal sinus osteoma are common. CT or MRI is helpful to evaluate the osteoma size, location and possible sources, and to make operation scheme. Surgery is the first choice for sinus osteoma. Lateral rhinotomy and nasal endoscopic resection can be applied to most sinus osteoma. The prognosis of sinus osteoma is good, with fewer recurrence.

Craniotomy ; Endoscopy ; Humans ; Magnetic Resonance Imaging ; Mucocele ; Nose ; Osteoma ; diagnosis ; pathology ; Paranasal Sinus Neoplasms ; diagnosis ; pathology ; Paranasal Sinuses ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome