Radiotherapy is an important treatment on gynecological tumors,especially for brachyther- apy.~(137)Cs,~(192)Ir were usually used in the past,but the local control and survival rates were not increased obvi- ously.The machines,that was made in China,of ~(252)Cf neutrons brachytherapy were used already by many hos- pitals in our country and played a preponderant role more and more.It can increase the local control and sur- vival rates effectively on gynecological tumors.

Congresses as Topic ; Head ; surgery ; Neck ; surgery ; Otolaryngology

OBJECTIVETo investigate the clinical application of different perforator neurofasciocutaneous flaps at the distal legs for defects at the lower legs and feet.

METHODS24 patients with defects at the lower legs and feet were treated with five kinds of perforator neurofasciocutaneous flaps, including 7 flaps with the retrolateral supramalleolar cutaneous perforator, 2 flaps with the lateral retromalleolar perforator, 2 flaps with the higher cutaneous perforator of the peroneal artery, 8 flaps with the anterolateral supramalleolar cutaneous perforator of the peroneal artery, 5 flaps with the medial supramalleolar cutaneous perforator of the posterior tibial artery. The flap size ranged from 5 cm x 4 cm-14 cm x 12 cm.

RESULTSPartial necrosis occurred at the distal end of flap in one case. All the other flaps survived completely with primary healing. 15 cases were followed up for 1-36 months with satisfactory cosmetic and functional results.

CONCLUSIONSSuitable perforator neurofasciocutaneous flaps at the distal legs can be selected for differently located defects at the lower legs and feet, leaving comparatively less morbidity at donor site.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Leg ; surgery ; Male ; Middle Aged ; Perforator Flap ; Young Adult

Objective To compare the different effects of 1% diatrizoate meglumine,2.5% mannitol and water as oral contrasts in PET/CT scan in gastrointestinal tract delineation and 18F-fluorodeoxyglucose (FDG) uptake. Methods Sixty-one patients referred for PET/CT scan without gastrointestinal diseases were divided into three groups randomly ( random number method). One liter of 1% diatrizoate meglumine,2.5% mannitol,or water was orally taken by groups 1 (25 cases),2 (20 cases) and 3 ( 16 cases),respectively before scan. The scan was performed with GE Discovery LS PET/CT scanner in two-dimensional (2D) mode 50 min after 18F-FDG (5.55 MBq/kg) injection. Patients with abdominal lesions were excluded from this study. The degree of gastrointestinal filling and 18F-FDG uptake was evaluated by 3 nuclear medicine physicians using visual analysis according to a 4-grade classification method:none,mild,moderate,and high. Statistically analysis was performed by Kruskal-Wallis,Mann-Whitney and paired t tests.Results Both the differences of serum glucose and insulin levels were not significant before and after contrast taken in group 2. Group 2 had better gastrointestinal filling than that of group 1 and also better than group 3 except in rectum. The stomach,jejunum,ascending,and transverse colon were better filled in group 1 than in group 3. The degree of 18F-FDG uptake of group 3 was significantly higher than that of group 2 in stomach,jejunum and ileum (z= -3. 192,-3.290,-3.290,all P＜0.05),and was also significantly higher than that of group 1 (z = - 3. 603,P ＜ 0.05) in jejunum. The degree of 18 F-FDG uptake of group 3 was significantly lower than that of group 1 in ascending colon (z = - 2. 706,P ＜ 0. 05 ) and was significantly lower than that of group 1 and 2 in transverse and descending colon (z= - 3. 503,- 2.403,- 4.225,-4. 027,all P ＜0.05),and was also significantly lower than that of group 2 in rectum (z = -4. 128,P ＜0. 01 ). The maximum CT values in stomach,jejunum,ileum and ascending colon in group 1 were ( 132 ±23),(191 ±31),(313 ±47) and (374±53) HU,respectively,whose difference was significant (t = -7.088--1.781,all P ＜0. 01 ). Conclusion Oral iso-osmotic mannitol intake has better gastrointestinal filling and less physiological 18F-FDG uptake compared to diatrizoate meglumine and water.

Animal models with kidney disease are generally divided into two types. One belongs to the models which imitate human kidney disease by the artificial operations, such as anti-glomerular basement membrane antibody nephritis, Heymann nephritis, anti-Thyl. 1 antibody nephritis, BSA nephritis and puromycin nephropathy. The other one pertains to the models which make themselves kidney disease, and appear the pathological characteristics naturally as like as human, such as HIGA mice with IgA nephropathy and NZB/WF1 and MRL/1pr mice with lupus nephritis. In addition,the transgenic animal models with kidney disease can also be established by the modern molecular biologic techniques including gene knockout and siRNA transfection. As for the studies related with kidney disease in pharmacodynamics and pharmacology of Chinese herbal medicine (CHM), it is important to understand deeply the features of each animal model with kidney disease, and select accurately the proper models according to the different experimental objectives, and then, build the special models provided with the combination of disease with syndrome in traditional Chinese medicine (TCM). Therefore,it is the developmental direction for the further study to establish animal models with kidney disease, which should possess the characteristics of syndrome in TCM.
Animals ; Diabetic Nephropathies ; etiology ; Disease Models, Animal ; Humans ; Kidney Diseases ; etiology ; Medicine, Chinese Traditional ; Mice ; Streptozocin

Objective To explore the incidence and risk factors of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The clinical data of 72 cases allo-HSCT from Oct 2004 to Dec 2008 were analyzed. Thirteen factors possibly correlated with the development of aGVHD were analyzed. Results aGVHD was developed in 32 cases (44.4 %), in which grades Ⅰ aGVHD was 11.1%, gradesⅡaGVHD was 18.1%, and grades Ⅲ-Ⅳ aGVHD was 15.3 %. The univariate analysis showed that diagnosis, the status of disease, use ATG, conditioning regimen, donor type,ABO blood group disparity between donor and recipient, CD34+ cell number, early engraftment and neutropenic infection, HLA locus were associated with the occurence of aGVHD (P ＜0.1). On the COX regression mode, an increased risk of aGVHD was associated with HLA mismatch (HR =2.58, P ＜0.005), GVHD prophylaxis without ATG (HR =2.94, P ＜ 0.001), and unrelated donor (HR =1.97, P ＜0.01). Conclusion aGVHD is a common complication after allo-HSCT, and HLA mismatch and unrelated donor are independent risk factors for aGVHD.

BACKGROUND:In vitro experiments have demonstrated that the biodegradable mesh-like microporous baloon made of macromolecular materials has obvious advantage of anti-leakage, which is capable of maintaining calcium homeostasis, has no inhibitory effects on cel growth and on microscopic interdigitation formation between new bone and bone cement. OBJECTIVE:To evaluate the therapeutic effects of biodegradable mesh-like microporous baloon with calcium bone cement on vertebral fractures based on animal experiments. METHODS:The fracture model was established in 48 New Zealand rabbits, in which a bone dril was introduced after successful puncture at sites near left low extremity of the femur. These rabbit models were randomized into two groups: experimental group with calcium phosphate bone cement and biodegradable mesh-like microporous baloon and control group only with calcium phosphate bone cement. Clinical parameters such as blood cel count, biochemistry, and CT/X ray were examined at 1, 3 and 6 months after implantation of the baloon and bone cement. After that, the specimens were fixed for pathological analysis. RESULTS AND CONCLUSION:The operation was performed under general anesthesia with no eventful infusion of bone cement. The expansion of baloon was satisfactory without definite extravasation of bone cement in the experimental group. In the control group, cement diffusion was found with pulmonary embolism occurring in three New Zealand rabbits. No statistical significance for blood cel counts and biochemistry was found between pre- and postoperation or between two groups. The materials in the two groups had favorable biocompatibility with injured bones without obvious immunological response. In the experimental group, the baloon wal was thinned and partial bone tissues grew into the cement at 1 month; at 3 months, a large amount of bone tissues grew into the cement and cement volume diminished; at 6 months, the baloon disappeared and only a smal amount of cement left in the bone tissues. In the control group, it was difficult to determine when the cement degraded. The biodegradable mesh-like microporous baloon combined with calcium bone cement is superior to bone cement alone in the management of vertebral fractures.

BACKGROUND:Vertebroplasty and kyphoplasty for osteoporotic vertebral compression fractures can result in many complications, such as bone cement leakage and adjacent-level fractures.
OBJECTIVE:To verify the possibility of biodegradable mesh-like microporous polymer bal oon for the treatment of osteoporotic vertebral compression fractures.
METHODS:Biodegradable mesh-like microporous P(DLLA-CL) bal oons were fabricated by electrospinning technique. Coated bal oons with the same specification was fabricated by coating P(DLLA-CL) onto the same mould. Morphology of the bal oons was observed by scanning electron microscopy. The bal oon leakage was observed by eyes after the injection of water or cement. The initial strength and stiffness were measured by a universal testing machine. The proliferation of MC3T3-E1 cel s on the bal oons was determined by laser confocal microscope and cel counting kit-8 assays. The biodegradation of bal oons in simulated body fluid, porcine pancreatic lipase, and fresh human serum was studied by residual weighing and scanning electron microscopy observation. Burst pressure of bal oons was measured after the bal oon was placed into a hole in the vertebral bone. For the in vitro calcium release tests, the bal oons were fil ed with calcium cement, tied, placed into 6atm ultrapure water, and then the calcium concentration was regularly determined.
RESULTS AND CONCLUSION:Mesh-like microporous bal oons presented with good fiber morphology, thickness distribution, and the presence of pores;on the coated bal oon surface, there was absence of specific morphology and porosity. Compared with the coated bal oon, the mesh-like microporous bal oon showed better mechanical properties, liquid permeability and burst pressure, to prevent leakage of bone cement and promote osteoblast adhesion and proliferation. In addition, the degradation of the mesh-like microporous bal oons was more uniform and stable than the coated bal oons, which may increase the calcium concentration in the injured vertebrae and wil be beneficial to the new bone growth and fracture healing.

BACKGROUND:It has become a focus to look for new vertebral body fil ing materials which have the biomechanical property, biological activity and low cement leakage rate.
OBJECTIVE:To investigate the biomechanical characters and cement leakage rate of the vertebral bodies implanted with biodegradable reticulated bal oon and calcium phosphate.
METHODS:Thirty-two vertebral bodies from pigs were randomly divided to four groups. For A group, 2.5-3.0 mL polymethacrylate cement was injected into the body through a unilateral thoracic pedicle pathway;for B group, 2.5-3.0 mL calcium phosphate cement were injected by the same protocol;for C group, the biodegradable reticulated bal oons fil ed with 2.5-3.0 mL calcium phosphate cement were implanted;D group, including normal vertebral bodies, was designed as controls. Leakage of bone cement was observed in each group. The load-shift curves were recorded by an electronic universal testing machine (SCHENCK RSA-250).
RESULTS AND CONCLUSION:The stiffness and strength of A group were significantly higher than those of D group (P<0.05), and the stiffness and strength of B group were statistical y lower than those of D group (P<0.05). The stiffness and strength of C group, otherwise, were similar with those of D group (P>0.05). Cement leakage rate of C group was lower than that of A or B group (P<0.05). Vertebral bodies implanted with biodegradable reticulated bal oons may lead to similar biomechanical characters as the normal vertebral bodies and reduce the cement leakage rate.

Catheter ablation of atrial fibrillation is an evolving field,especially for chronic atrial fibrillation.Several approaches have been performed in clinic practice,which include circumferential pulmonary vein ablation/isolation,left atrial linear ablation,CFAE ablation,pulmonary vein denervation or stepwise ablation.However,a standard approach has not been established.The total successful rates vary from 21% to 95%.The investigations in the mechanism of chronic atrial fibrillation and methods of three-dimensional mapping,and the usage of new source and technique of ablation will increase the successful rate,decrease the recurrence rate and procedure time.The long-term result of ablation of chronic atrial fibrillation and its impact on the structure and function of heart need further investigations.