【Objective】 To explore the diagnosis, treatment and prognosis of renal cell carcinoma (RCC) patients with Stauffer syndrome. 【Methods】 The clinicopathological and follow-up data of 17 RCC patients with Stauffer syndrome who underwent operation during Sep.2014 and Aug.2019 were retrospectively analyzed. The survival was analyzed with Kaplan-Meier curve and log-rank, and related factors affecting the prognosis were determined with univariate and multivariate Cox regression model. 【Results】 The pathological results included clear cell RCC in 14 cases, papillary RCC in 2 cases, and poorly differentiated tissue in 1 case. The liver function recovered within 3 months after operation in 5 cases, within 6 months in 3 cases, within 1 year in 4 cases, and did not recover in 3 cases. During the follow up of 6 to 72 (average 54.1) months, the 1-, 3-, and 5-year survival rates were 88.2% (15/17), 76.5% (13/17) and 52.9% (9/17), respectively. Survival analysis showed that the cancer-specific survival (CSS) of RCC patients with Stauffer syndrome was low, and tumor size, AJCC stage, lymph node metastasis and Stauffer syndrome were predictors of poor prognosis. 【Conclusion】 The prognosis of RCC patients with Stauffer syndrome is poor, and early surgical intervention should be conducted. The liver function of most patients can return to normal gradually after surgery. Continuous examination of liver function has significant meaning for tumor recurrence, metastasis and prognosis.

OBJECTIVE: To explore the trend of changes in the parameters of the spine-pelvic sagittal plane before and after surgery in patients with double-segment lumbar spondylolisthesis (LSL) and to evaluate the value of the surgical effect. METHODS: A retrospective analysis of 95 double-segment lumbar spondylolisthesis patients treated with posterior lumbar interbody fusion from October 2019 to October 2020 were analyzed, including 31 males and 64 females;age ranging from 41 to 63 years old, with an average of (52.10±4.35) years old;degree of lesion, 47 patients with gradeⅠand 48 patients with gradeⅡ. The surgical efficacy was evaluated according to the Oswestry dysfunction index(ODI) improvement rate at 3 months after operation. ODI improvement rate ≥50% was considered good, and <50% was considered bad. Ninety-five patients were divided into good curative effect group (74 cases) and poor curative effect group (21 cases) according to surgical curative effect. The clinical data, such as gender, age, body mass index, course of disease, degree of disease, operation time, intraoperative blood loss, and comorbidities were compared between two groups were compared. The parameters of spine pelvis sagittal plane were observed before and 3 months after operation, including spine sacral angle (SSA), T1 pelvic angle (TPA), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS). Clinical symptoms were evaluated using visual analogue scale (VAS) and ODI. The correlation between the changes of spine pelvis sagittal plane parameters and the changes of VAS and ODI before and after surgery were analyzed, and the value of spine pelvis sagittal plane parameters in evaluating the surgical efficacy of patients with double level lumbar spondylolisthesis at 3 months after surgery was evaluated. RESULTS: The courses of disease and surgical time in the group with poor efficacy were longer than those in the group with good efficacy, and the degree of lesion was higher in the group with poor efficacy (P<0.05). The SSA, TPA, LL, and SS of the group with good efficacy were higher than those of the group with poor efficacy before and 3 months after surgery, while the PT was lower than that of the group with poor efficacy (P<0.05). The changes in SSA, TPA, LL, PT, and SS before and after surgery in the group with good efficacy were greater than those in the group with poor efficacy (P<0.05). The VAS and ODI of both groups were lower at 3 months after surgery than before, and the group with good efficacy was lower(P<0.05). The changes in VAS and ODI before and after surgery in the group with good efficacy were greater than those in the group with poor efficacy (P<0.05). The changes in SSA, TPA, LL, PT, SS before and after surgery were positively correlated with the changes in VAS and ODI (P<0.05). Three months after surgery, SSA, TPA, LL, PT, and SS were used to evaluate the surgical efficacy of patients with dual level lumbar spondylolisthesis. The area under the curve (AUC) was 0.868, 0.797, 0.875, 0.822, and 0.853, respectively. The combined evaluation of all indicators resulted in the highest AUC, 0.927, and the best sensitivity and specificity were 90.50% and 91.89%, respectively. CONCLUSION The spine pelvis sagittal plane parameters SSA, TPA, LL, and SS of patients with double level lumbar spondylolisthesis before and after surgery show an upward trend;PT shows a downward trend;PI do not change significantly. And the changes of SSA, TPA, LL, SS, and PT are closely related to the patient's pain level and the improvement of lumbar function, which can be used as parameters to evaluate the surgical efficacy.
Female ; Animals ; Male ; Humans ; Adult ; Middle Aged ; Spondylolisthesis/surgery* ; Retrospective Studies ; Sacrum ; Blood Loss, Surgical ; Body Mass Index

OBJECTIVE To establish the characteristic chromatogram of the volatile oil in the standard decoction of Qingshang juantong decoction， and preliminarily infer the main active components of volatile oil that affect the clinical therapeutic effect. METHODS The volatile oil in the standard decoction of Qingshang juantong decoction was extracted by steam distillation. The ultra-high performance liquid chromatography （UPLC） characteristic chromatograms of 15 batches of samples were established by the Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）， and the similarity evaluation was carried out. The volatile oil of standard decoction was identified by UPLC coupled with quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF/MS）. Then the volatile oil components were analyzed by GC-MS. RESULTS The similarities of UPLC characteristic chromatograms for volatile oil of 15 batches of Qingshang juantong decoction were between 0.949 and 0.997. A total of 12 common peaks were obtained. According to the UPLC-Q-TOF/MS， the main components were methyl eugenol， E-ligustilide， E-butylidenephthalide and so on. A total of 23 components were identified by GC-MS， which were mainly 3，4，5-trimethoxy- methylbenzene， patchouli alcohol， Z-ligustilide and so on. CONCLUSIONS The characteristic chromatograms of the volatile oil in the standard decoction of Qingshang juantong decoction is established， and it is inferred that methyl eugenol， ligustilide， E- butylidenephthalide， patchouli alcohol， 3，4，5-trimethoxy-methylbenzene might be the main active components affecting the clinical therapeutic effect of the volatile oil of Qingshang juantong decoction.

Background: Esophageal cancer is one of the leading causes of cancer deaths worldwide. T-cell immunoglobulin and mucin domain-containing protein 3 (Tim-3) has been shown to be implicated in the tumor immune escape, and associated with tumor progression and poor prognosis in a variety of malignancies. Aims: To investigate the expression of Tim-3 in esophageal tumorigenesis and its clinical significance. Methods: Paraffin-embedded tissues from 103 esophageal cancer, 21 high-grade esophageal intraepithelial neoplasia, 16 low-grade esophageal intraepithelial neoplasia, and 20 chronic esophagitis were collected in this study. Using immunohistochemistry, the expression level of Tim-3 was evaluated; and the correlation of Tim-3 expression in cancerous tissue with the clinicopathological parameters of esophageal cancer was analyzed. Results: Tim-3 expression was increased from chronic esophagitis, low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia to esophageal cancer (0.271±0.138, 0.368±0.198, 0.443±0.147, and 0.639±0.119, P<0.05). Moreover, Tim-3 expression was significantly correlated with depth of tumor invasion, regional lymph node metastasis and TNM staging of esophageal cancer (P<0.05), whereas no relationship was found between Tim-3 expression and gender, age and tumor location of esophageal cancer (P>0.05). Conclusions: Tim-3 expression is increased in esophageal tumorigenesis; overexpression of Tim-3 in esophageal cancer is closely correlated with tumor progression. Tim-3 might be served as a biomarker for development, progression and prognosis of esophageal cancer.

Adult ; Aged ; Arthrogryposis ; diagnosis ; Female ; Hereditary Sensory and Motor Neuropathy ; diagnosis ; Humans ; Male ; Middle Aged ; Pedigree ; Young Adult

OBJECTIVETo investigate the therapeutical effect and side-effect of docetaxel combined with cisplatin (DDP) on the treatment of local advanced esophageal cancer with concomitant radiation therapy.

METHODSNinety patients with LOCAL advanced esophageal squamous cell carcinoma were divided into two groups: (DDP + 5-Fu) group and (docetaxel + DDP) group. Chemotherapy was carried out every 4 weeks for a total of 4 courses. The radiation dose was 50.4 Gy/28FX.

RESULTSThe median survival time of patients in the (DDP + 5-Fu) group was 16 months and that in (docetaxel + DDP) group was 21 months (P = 0.0278). The 3-year survival rate in the (docetaxel + DDP) group was obviously higher than that in the (DDP + 5-Fu) group (23.9% vs. 12.1%). The ORR in (docetaxel + DDP) group (84.5%) was significantly higher than that in the (DDP + 5-Fu) group (71.1%) (P = 0.025). No significant differences were observed in the incidence of side-effects in the two groups.

CONCLUSIONSThe conventional dose chemotherapy of docetaxel + DDP with concomitant radiation therapy showed a better partial remission rate and long-term survival rate for the treatment of local advanced esophageal cancer than the traditional chemotherapy (DDP + 5-Fu) with concomitant radiation therapy and the side-effects are not increased.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; pathology ; radiotherapy ; Cisplatin ; administration & dosage ; adverse effects ; Combined Modality Therapy ; Cystic Fibrosis ; etiology ; Dose Fractionation ; Esophageal Neoplasms ; drug therapy ; pathology ; radiotherapy ; Female ; Fluorouracil ; administration & dosage ; adverse effects ; Follow-Up Studies ; Humans ; Leukopenia ; chemically induced ; Male ; Middle Aged ; Neoplasm Staging ; Remission Induction ; Survival Rate ; Taxoids ; administration & dosage ; adverse effects ; Young Adult

OBJECTIVE: To evaluate the therapeutic effect of supracricoid partial laryngectomy(SCPL). METHOD: A retrospective analysis of the clinical data of 24 patients undergoing laryngeal carcinoma (including 5 senile patients). In those patients, 14 were glottic cancer, 9 were supraglottic cancer,and 1 were transglottic cancer. Fourteen cases underwent cricohyoidoepiglottopexy, and 10 cases treated with cricohyoidopexy. RESULT: In this study, 3 years and 5 years survival rates were 91.7% and 78.6%. The decannulation rate was 91.7%. All the patients resumed physiologic swallowing. CONCLUSION Supracricoid partial laryngectomy for selected laryngeal cancer is feasible, and also for senile patients. The patients can gain satisfied survival rate and physiologic function.
Aged ; Carcinoma, Squamous Cell ; surgery ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective: The aim of this study was to evaluate the influence of concomitant carcinoma in situ (CCIS) on tumor survival for the upper tract urinary carcinoma (UTUC) through systematic review and meta-analysis. Methods: In the light of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a systematic search of Web of Science, PubMed and EMBASE China National Knowledge Infrastructure (CNKI) and Wanfang database by key words "upper urinary tract urothelial carcinoma" "renal sputum cancer" "concomitant carcinoma in situ" , and "radical ureterectomy" were performed for all reports that included detailed results on the predictors of CCIS. The search deadline is June 2019, and the search terms are English and Chinese. Methodological quality evaluation was performed using the QUIPS tool, and statistical analysis of the relevant data was performed using Stata 12.0 and RevMan 5.3 software. Results: Sixteen articles were included in this study and all published between 2012 and 2019. A total of 11 131 patients with UTUC, including 1 774 (15.9%) patients with CCIS. According to our final results, there was a significant correlation of CCIS with worse cancer-specific survival (CSS) (HR=1.10, 95%CI 1.05-1.16, P<0.001), recurrence-free survival (RFS) (HR=1.15, 95%CI 1.09-1.21, P<0.001) and overall survival (OS) (HR=1.10, 95%CI 1.03-1.17, P=0.003). Begg′s bias analysis showed no significant publication bias in CSS (P=0.822), RFS (P=0.348), and OS (P=0.452). Conclusions This study demonstrated that CCIS was associated with poor oncological outcome and could serve as a independent prognostic factor for patient with UTUC after radical nephroureterectomy.

AIM: To observe the clinical effect of trabeculectomy combined with dexamethasone iontophoresis in the treatment of acute angle-closure glaucoma(PACG)with diabetes mellitus.

METHODS: Totally 42 eyes of 42 patients with acute PACG combined with diabetes in our hospital were selected and divided into trabeculectomy combined with iontophoresis group(group A)and trabeculectomy combined with peribulbar injection of methylprednisolone group(group B)according to different ways of controlling inflammation after surgery. Intraocular pressure, anterior chamber inflammation and complications before and after surgery were compared between the two groups.

RESULTS: The intraocular pressure of the two groups after surgery was significantly improved compared with that before surgery, and the difference was statistically significant(P<0.05). Postoperative anterior chamber inflammation was well controlled in both groups without statistical significance(P>0.05). In terms of complications, group A was significantly superior to group B.

CONCLUSION: Trabeculectomy combined with dexamethasone iontophoresis or peribulbar injection of methylprednisolone can effectively control postoperative intraocular pressure and anterior chamber inflammation in patients with acute angle-closure glaucoma complicated with diabetes mellitus. Among them, the effect of combined dexamethasone iontophoresis in reducing complications is better and patients suffer less pain.

Objective To explore the effect of astragaloside IV on the damaged blood-brain barrier (BBB) in vitro model induced by amyloid-beta protein (Aβ1-42) and the underlying mechanism. Methods Firstly, the non-contact co-culture blood-brain barrier (BBB) model was established by Aβ1-42-induced mouse brain microvascular endothelial cell (bEnd.3) and primary rat astrocyte (As). Then the mice were divided into four groups: control, model (Aβ1-42 30 μmol/L), astragaloside IV low and high dose groups (Aβ1-42 30 μmol/L with Astragaloside IV 50 and 200 μmol/L). The effect of astragaloside IV on the vitality of bEnd.3 induced by Aβ1-42 was detected by methyl thiazolyl tetrazolium (MTT) assay. The permeability of BBB in vitro was determined by detecting the quantity of fluorescein sodium through BBB in various groups. In order to explore the mechanism of its protection, the apoptosis related proteins Caspase-3, cleaved Caspase-3 and tight junction proteins ZO-1, Claudin-5 and Occludin were detected by Western blotting. Results Compared with model group, the astragaloside IV groups improved the activity of bEnd.3 cells significantly (P < 0.001). The protective effect was positively correlated with the concentration of astragaloside IV. Astragaloside IV with low and high dose decreased the permeability of BBB model in vitro (P < 0.001). According to the results of Western blotting, the ratio of cleaved Caspase-3/Caspase-3 was significantly declined, and the expression levels of ZO-1, Claudin-5 and Occludin were significantly increased in astragaloside IV groups (P < 0.05). Conclusion Astragaloside IV may play a BBB protective role by inhibiting the apoptosis of bEnd.3 cells induced by fibrous Aβ1-42 and increasing the expression of tight junction proteins.