Objective To compare the value for predicting prognosis between ENETS and AJCC TNM staging system in G-NEC patients.Methods Clinical data of 28 G-NEC cases from January 2005 to September 2015 in Tianjin Medical University General Hospital were analyzed and follow-up data were staged by he ENETS and AJCC TNM staging system.The survival curves were drawn using Kaplan-Meier method.Univariate analysis was performed by Log-rank test.Results Evaluated by ENETS TNM staging system on these 28 G-NEC patients,5 cases (18％) were classified at stage Ⅱ,20 cases (71％) were at stage Ⅲ,3 cases (11％) at stage Ⅳ,and significant difference in survival time was found between the three stages (P ＜ 0.05).By the AJCC TNM staging system,1 case (4％) was classified at stage Ⅱ,24 cases (86％) were at stage Ⅲ,and 3 cases (11％) at stage Ⅳ,and significant difference in survival time was found between three stages.Conclusions AJCC TNM staging system is more valuable for predicting prognosis of G-NEC,while the ENETS TNM staging system is more accurate in evaluating G-NEC biologic behavior.

This study is to investigate the transportation of scutellarin in cell and live models and study on mechanism of absorption and transport of scutellarin in mouse liver. The concentration of scutellarin in plasma and liver from control and pretreated groups was determined by high performance liquid chromatography. The uptake of scutellarin was examined in control hepatocytes group, induced hepatocytes group and induced hepatocytes plus pravastatin group. Pravastatin can affect the pharmacokinetics of scutellarin in mouse: CL is decreased while AUC is increased. The scutellarin absorption of hepatocyte induced group was higher than that of control group, but was decreased in the group with pravastatin added. The research showed that there was potential drug interaction between pravastatin and scutellarin. The drugs may compete for oatp2 mediated transport pathway consisted in the uptake of scutellarin in liver.

OBJECTIVE: To explore the changes of parathyroid hormone (PTH) and serum calcium alter total thyroidectomy and summarize the methods to prevent and treat the hypoparathyroidism and hypocalcernia. METHOD: Seventy-three patients with total thyroidectomy in our hospital were divided into three groups according to the scope of the operation. The serum concentrations of PTH and calcium were measured and compared before surgery and after surgery 1 h, 1 d, 3 d and 5 d. RESULT: In three groups, the serum concentrations of PTH and calcium were significantly decreased (P<0. 05) after surgery and low serum PTH and hypocalcemia occured. The severity of low serum PTH and hypocalcemia was as follows: total thyroidectomy with bilateral compartment lymph node dissection (CLND)>total thyroidectomy with unilateral CLND>total thyroidectomy. The differences were statistically significant. The levels of PTH after surgery 1 hour and 1 day were effective to predict hypocalcemia. CONCLUSION Total thyroidectomy can affect the parathyroid function. The greater the scope of surgery, the higher the possibility of postoperative hypoparathyroidism. The reasonable operative procedures and more protection of parathyroid during operation can reduce the incidence of hypoparathyroidism. The level of postoperative PTH can be used as a predictive index of hypocalcemia.
Calcium ; blood ; Humans ; Hypocalcemia ; blood ; Hypoparathyroidism ; blood ; surgery ; Incidence ; Lymph Node Excision ; Parathyroid Glands ; physiology ; Parathyroid Hormone ; blood ; Postoperative Period ; Thyroidectomy

ObjectiveTo observe the clinical efficacy of electroacupuncture plus herbal-partitioned moxibustion in treating temporomandibular joint disorder.MethodNinety patientswith temporomandibular joint disorder were randomized into a treatment group of 45 cases and a control group of 45 cases. The treatment group was intervened by electroacupuncture plus herbal-partitioned moxibustion, while the control group was by medication. The therapeutic efficacy was evaluated after 3 treatment courses by a specially-assigned person.ResultThe recovery rate and total effective rate were respectively 64.4% and 97.8% in the treatment group versus 37.8% and 82.2% in the control group, andthe total effective rate and recovery rate in the treatment group were significantly higher than that in the control group (P<0.05); regarding the comparison of the efficacy and treatment duration of the recovered subjects, the recovery rates at the end of the 1st course, 2nd course and 3rd course in the treatment group were all markedly higher than that in the control group (P<0.05), indicating that electroacupuncture plus herbal-partitioned moxibustion can shorten the period of treatment for temporomandibular joint disorder. The therapeutic efficacy of the treatment group was significantly superior to that of the control group(P<0.05).ConclusionElectroacupuncture plus herbal-partitioned moxibustion can produce a significant efficacy in treating temporomandibular joint disorder.

Objective To compare the long-term efficacy of the traditional open surgery (OSP) with the thoracic endovascular aneurysm repair (TEVAR) in the treatment of patients with the complicated Stanford B aortic dissection. Methods The retrospective analysis of the clinical data was conducted in 118 patients (OSP 45 vs. TEVAR 73) with the complicated type B aortic dissection from January 2004 to January 2015. The long-term survival rate was compared between the two groups and the influencing factors of the postoperative survival was analyzed by using the Cox-regression analysis. Results Significant differences in age, sex and operation time were observed between the two groups (P < 0.05, P < 0.01); No significant difference in the benefit of long-term survival was found between the two groups (P > 0.05). The refractory hypertension and preoperative aortic overall diameter > 55 mm were the risk factors for the long-term survival (P = 0.021, OR = 11.1, 95%CI:1.428 ~ 86.372; P = 0.001, OR = 4.5, 95%CI: 1.842 ~ 11.346). Conclusions Compared with OSP, no obvious advantage of TEVAR was shown in the ten-year overall cumulative survival. In view of the influence factors of refractory hypertension and the aortic diameter for the long-term survival , we should pay attention to the blood pressure control and the performance of endovascular repair technology whether pre- or post-operation.

Objective To explore the significance of peritubular capillary C4d deposition in the diagnosis, treatment and prognosis of the patients with acute renal allograft rejection.Methods 86 allograft biopsies obtained from 78 kidney transplants were examined by immunohistochemistry on routine paraffin sections using anti-C4d polyclonal antibody. The relationship of C4d and functions, therapies and prognoses of allografts was analyzed. Results There were 32 allograft biopsies with Banff type Ⅰ rejection, 51 with Banff type Ⅱ rejection and 3 with Banff type Ⅲ rejection. Thirty biopsies were positive in C4d deposition. For 28 patients, at least one biopsy exhibited peritubular C4d deposition. There was no significant difference between type Ⅰ and type Ⅱ rejection ( 21.9 % vs 39.2 % , P= 0.101 ). The C4d~ + group had proportionately more patients with pregnant history (P= 0.020 ), more patients with high panel-reactive antibody levels (P= 0.013 ), and more retransplanted patients (P= 0.016 ). Mean serum creatinine was significantly higher in C4d positive patients than in negative patients[( 312.56 ? 196.26 ) ?mol/L vs ( 210.97 ? 136.59 ) ?mol/L, P= 0.0115 ]. Patients with C4d deposition were more commonly resistant to antirejection therapy with bolus steroids ( 75.0 % vs 28.0 % , P= 0.000 ) and ATG ( 66.7 % vs 12.5 % , P= 0.027 ). More patients with peritubular C4d deposition lost their grafts during the study period (64.3 % vs 90.0 %, P= 0.006 ).Conclusion Acute rejection with C4d deposition were resistant to antirejection therapy with steroids and/or ATG, and associated with inferior graft outcome.

[Objective]To investigate the effect of treating degenerative spondylolisthesis by transforaminal lumbar interbody fusion with microendoscopic surgery.[Method]From January 2005 to December 2005,17 cases who underwent transforaminal lumbar interbody fusion with a pedicle screw system by microendoscopic surgery were analyzed retrospectively.The index diagnosis was degenerative lumbar spondylolisthesis with herniated nucleus pulposus in 11 cases,and with spinal canal stenosis in 5 cases.There were 10 male and 7 female,average age was 47.6(ranged,35～68)years.According to Meyerding grading system,roentgengram showed that there were 10 cases of grade Ⅰ?,7 cases of grade Ⅱ?,11 cases of L_4 and 6 L_5.[Result]Seventeen cases were reviewed after surgery.The postoperative follow-up ranged from 12 months to 24 months(averaged 16.2 months).Operative time averaged 160 minutes.Estimated blood loss averaged 120 ml.Mean length of hospital stay was 8 days.There were no nerve injury occurred during operation.No cases converted to open operation.In complications,one case suffered from intervertebral infection.Outcomes were quantified using Oswestry Disability Index.The average Oswestry score decreased from 48.3% preoperatively to 16.5% at 3 month and 14.0% at 6 month postoperatively.The rate of excellent and good was 97.5%.At last follow-up,all patients had solid fusions by radiographic criteria.[Conclusion]Transforaminal lumbar interbody fusion for lumbar vertebral degenerative spondylolisthesis by microendoscopic surgery has the advantages of shorter skin incision,less tissue damage,less blood loss and quicker postoperative recovery.

Objective To observe the dynamic change of cytokines and effect of different stimulating combinations on dominant regulation, and describe the microenviroment character of local immune response. Methods PBMCs were separated from peripheral blood of healthy donors with density gradient centrifugation. The expression levels of cytokine genes under different stimulating combinations, including IL-2, IFN-?, IL-12, IL-4, IL-10 and TGF-?1, were detected by ELISA and RT-PCR. Results ELISA results indicated that secretion level of IL-2, IL-4, IL-12 and IFN-? were inhibited by IL-10. There were significant differences in IL-4 and IL-12 between control group and stimulating groups under the stimulation by anti-CD3 monoclonal antibody (McAb) or anti-CD3 McAb + anti-CD28 McAb combination. Significant differences in IL-2 only appeared in anti-CD3 antibody stimulating group. The concentrations of IFN-? were decreased moderately. At the mean time, IL-10 significantly promoted the secretion of TGF-?1 under the anti-CD3 McAb stimulation. There were similar results on the genes level for the studied cytokines. Conclusion The induction and maintenance of dominant regulation were dependent mainly on IL-10, which inhibits the overexpression of IL-4 and IL-12. It is the vital step for dominant regulation to avoid the mono-polarization development at the beginning of immune response.

[Objective]To investigate the clinical effects of the treatment of thoracolurnbar fracture with pedicle screw system under endoscopy assisted X-tube system.[Method]Twenty-one cases of pure thracolumbar fracture without neural impairment were treated with pedicle screw system under endoscopy assisted X-tube system.With the image intensifier,the pedicle based in the affected segments were localized and exposed through 4 small incisions(3cm).Transpedicular fixation and reduction by endoscopy assisted X-tube system were performed through the 4 small incisions.[Result]Twenty-one cases were followed up for 12-18 months(averaged,14 months).Radiography showed good reduction fixation of the vertebral bodies,good correction of the kyphosis deformities and good restoration of lumbar motion.[Conclusion]The treatment of thoracolumbar fracture with pedicle screw system under endoscopy assisted X-tube system is indicated for thoracolumbar fracture without neural impairment.This technique has advantages of minimal invasion and early functional recovery.