Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Gallstones ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion

Objective To review the clinical data of reduction mammoplasty by central pedicle technique,and to summarize all kinds of the complications to modify the technique for improvement of long term aesthetic effects.Methods The postoperative complications were analyzd and then an approach was used to investigate the pattern of the blood supply and the nerve distribution of breast.Based on the anatomical study,a modified double-circle reduction mammoplasty technique was designed to treat patients with hypertrophical breasts. Results With a follow-up for 3 months to 3 years,the patients who underwent this modified central pedicle technique,had an invisible scar,good projection,the better shape of breast and preserved their sensation of nipple-areola complex.Conclusions Modified central pedicle technique is a safe and reliable technique,especially ideal for Chinese women.The blood supply is rich and the sensation of nipple-areola complex is preserved.The fixation of the gland tissue is more important than the dermal-bra.

Objective To compare the dose distribution of the three-dimensional conformal radiotherapy(3D-CRT)and 5-field or 7-field intensity modulated radiation therapy(IMRT), and to explore the value of IMRT in preoperative radiotherapy for rectal cancer.Methods Ten rectal cancer patients treated with preoperative combination radiotherapy and chemotherapy were enrolled in this study. 3D-CRT plan and the 5.field or 7-field IMRT plans were performed for each patient.The conformal index (CI),heterogeneity index(HI)of the planning target volume(PTV)and the dose of normal organs of 3D-CRT plan(3D-CRTp)and the 5-field or 7-field IMRT plans(IMRT5fp or IMRT7fp)were analyzed with the dose-volume histogram.Results The CI values of PTV were 0.91,0.87 and 0.78 in IMRT7fpIMRT5fp and 3D- CRT but with IMRT7fp>IMRT5fp>3D-CRTp(t=-5.69、-8.91,P<0.01),respectively.The HI values of PrV were 1.09,1.08 and 1.05 in IMRT5fp,IMRT7fp and 3D- CRTp but with IMRT5fp >IMRT7fp>3D- CRTp(t=3.41、-6.89,P<0.01),respectively.The ratio of dose volume were 0.08,0.10 and 0.19(t=2.79、3.52,P<0.05)in IMRT7fp,IMRT5fp and 3D- CRTp on the small intestine V50,with 0.07,0.10 and 0.19(t=2.58、3.40,P<0.05)in IMRT7fp,IMRT5fp and 3D-CRTp on the bladder V50 and 0.01,0.01 and 0.05(t=3.00、3.17,P<0.01)in IMRT7fp,IMRT5fp and 3D- CRTp on the fomoral head V45.The ratio of dose volume were 0.31 and 0.38(t=3.91,P<0.01)in IMRT7fp and IMRT5fp on the bone marrow V50,with 0.07 and 0.10 in IMRT7fp and IMRT5fp on bladder V45.Conclusions IMRT plan is superior to 3 D- CRT plan in dose conformal degrees of PTV with preoperative radiotherapy of rectal cancer and can significantly protect the normal tissues.The 7-field IMRT plan might be the optimal plan for dose conformal degree and dose uniformity compared with 5-field IMRT.

Objective To investigate whether Ki-67 and DNA topoisomerase Ⅱ α (Topo Ⅱ α) are effective prognostic markers in patients with primary hepatocellular carcinoma (HCC) after liver transplantation.Methods This retrospective cohort study included 105 patients with HCC who underwent liver transplantation in a single center from 2001 to 2012.The demographic features,clinicopathological data,expressions of Topo I c and Ki-67 as detected by immunohistochemistry.The long-term survival and the potential prognostic factors,together with standard histologic parameters,were analyzed by univariate and multivariate analyses.Results A positive correlation was found between Topo II α and Ki-67 levels in HCC (r ＝ 0.469,P ＜ 0.01).Multivariate analyses showed that Ki-67 was an independent prognostic risk factor of recurrencefree survival (HR ＝ 2.296,P ＜ 0.05).The 5-year overall survival rate was related to tumor size (HR ＝ 1.743,P ＜ 0.05),AFP (HR ＝ 2.291,P ＜ 0.05),histological grade (HR ＝ 0.283,P ＜ 0.01),and high expressions of Ki-67 (HR ＝ 1.977,P ＜ 0.05) and Topo Ⅱ α levels (HR ＝ 1.883,P ＜ 0.05).The KaplanMeier analysis showed that there was a significant difference in the 5-year recurrence-free survival rate (40.4％ vs.57.6％) between patients with high and low expressions of Ki-67,which were significantly lower in the high Topo Ⅱ α expression patients (13.5％ vs.63.8％) (P ＜0.01).The 5-year overall survival rates were significantly lower in the high Ki-67 expression patients (12.7％ vs.61.1％,P ＜0.01) when compared with the low Ki-67 expression patients,which were significantly lower in the high Topo Ⅱ α-and Ki-67 expression patients (10.7％ vs.54.5％,P ＜0.01) than the low Topo Ⅱ α-or Ki-67 patients.Conclusions Ki-67 was associated with recurrence and metastasis in patients with primary hepatic carcinoma after liver transplantation.High expression of both Ki-67 and Topo Ⅱ α were associated with poor prognosis in these patients.

Objective To investigate the clinical features,diagnosis and therapy of adrenal incidentalomas. Methods The data of 66 cases of adrenal incidentalomas were retrospectively analyzed. Results The accuracy rates of localization detected by B-Ultrasound,CT scan and MRI were 84.3%,100% and 100% respectively. The accuracy rates of qualitative diagnosis by B-Ultrasound, CT scan and MRI were 30.0%,75.5% and 79.2% respectively. There were 60 cases underwent operation and the postoperative pathological examination confirmed that there were 31 cases of adrenal cortical adenoma, 6 cases adrenal cyst, 5 myelolipoma, 5 pheochromocytoma, 3 adrenal cortical carcinoma, 3 metastatic carcinoma, 3 ganglioneuroma, 1 adrenal neurilemmoma, 1 adrenal hematoma, and 1 nodular hyperplasia of adrenal cortex. Conclusions Ultrasonography is the first choice of scanning adrenal incidentaloma. However the CT scan and MRI are satisfactory in localization of the tumour. The qualitative diagnosis of adrenal incidentaloma will depend on the diameter, imaging features of tumors, the age of patients, and endocrine examination.

The stability of melittin in different solvents (water, deoxygenated water, physiological saline, PBS, 50% ethanol, ethanol, glycerol)was studied and the results showed that the stability of melittin is not influenced by light, temperature and pH in 50% ethanol, which melittin can be completed dissolved when compared with ethanol and glycerol, in such, 50% ethanol was chosen as solvent storage when measured content of melittin. Then the effect of different concentrations of PBS, the pH of PBS and rat skin ho- mogenates were tested, and the results showed that melittin was degraded rapidly at low concentration solution and low ionic strength. Increasing pH of PBS and rat skin homogenate can accelerate the degradation of melittin. These researches provide an experimental ba- sis for further study of melittin.
Animals ; Drug Stability ; Ethanol ; chemistry ; Hydrogen-Ion Concentration ; Melitten ; chemistry ; Rats ; Skin ; drug effects ; Solvents ; chemistry ; Temperature

In order to investigate the characteristics of transdermal delivery of ferulic acid under the treated of microneedle arrays and the influence on permeability of rat skin capillaries, improved Franz-cells were used in the transdermal delivery experiment with the rat skin of abdominal wall and the length of microneedle arrays, different insertion forces, retention time were studied in the influence of characteristics of transdermal delivery of FA. The amount of FA was determined by HPLC system. Intravenous injection Evans blue and FA was added after microneedle arrays treated. Established inflammation model was built by daubing dimethylbenzene. The amount of Evans blue in the rat skin was read at 590 nm wavelength with a Multiskan Go microplate reader. Compared with passive diffusion group the skin pretreated with microneedle arrays had a remarkable enhancement of FA transport (P <0.01). The accumulation of FA increased with the enhancement of insertion force as to as the increase of retention time. Microneedle arrays with different length had a remarkable enhancement of FA transport, but was not related to the increase of the length. The research of FA on the reduce of permeability of rat skin capillaries indicated that the skin pretreated with microneedle arrays could reduce the content of Evans blue in the skins of rat significantly compared with the untreated group. The permeation rate of ferulic acid transdermal delivery had remarkable increase under the treated of microneedle arrays and the length of microneedle arrays ,the retention time so as to the insertion force were important to the transdermal delivery of ferulic acid.
Administration, Cutaneous ; Animals ; Coumaric Acids ; administration & dosage ; pharmacokinetics ; Male ; Needles ; Rats ; Rats, Sprague-Dawley ; Skin Absorption

Rhinosinusitis is a popular disease in otorhinolaryngology.A guideline document,European position paper on rhinosinusitis and nasal polyps (EPOS) developed on the basis of evidencebased medicine was used in clinical teaching.Theoretical teaching was promoted by reading and understanding EPOS.Meanwhile,EPOS was used in clinical practices of preclinical ward round,case analysis and independent bed charge,which laid a solid foundation to help otorhinolaryngology postgraduates fully grasp the theoretical knowledge of rhinosinusitis and nasal polyps,improve clinical practice abilities and develop standardized philosophy of diagnosis and treatment finally.

Objective To compare the dosimetry characteristics of volumetric intensity-modulated arc therapy (VIMAT) and fixed field intensity-modulated radiation therapy (FF-IMRT) for cervix cancer.Methods CT images of 13 patients with cervix uteri cancer were transferred into Eclipse planning system.FF-IMRT and VIMAT plans were optimized on an Eclipse treatment planning system using beam data generated for Varian trilogy linear accelerator.Planning target volume (PTV) and organs at risk were evaluated with dose-volume histogram.To appraise the difference between the techniques,the paired t-test was applied.Results Compared with the FF-IMRT plans,PTV95％ coverage of VIMAT plan group increased (t =9.84,P =0.000),PTV110％ became lower (t =-3.72,P =0.003),Dmax decreased (t =-3.51,P=0.005),and CI became worser (t=5.39,P=0.000).PTV105％,Dmean,and HI had no difference (t =-0.02,-0.60,1.13,P =0.842,0.560,0.283).V30 of the bladder was reduced by about 10％ (t =-4.99,P =0.000),and Dmean and Dmax were 1.4 Gy and 1.5 Gy lower respectively (t =-3.65,-18.03,P =0.004,0.000) ;V40 of the rectum was reduced by about 10％ (t =-2.99,P =0.012),and Dmean and Dmax were reduced by 0.6 Gy,0.8 Gy respectively (t =-2.98,-4.05,P =0.013,0.002) ;V30,V40 and V50 of the small intestine were reduced by 16％,10％ and 11％ (t =-10.85,-4.74,-8.66,P =0.000,0.001,0.000),and Dmax was reduced by 0.8 Gy (t =-9.45,P =0.000) ; V30,V40 and V50 of the bone marrow were reduced by 26％,19％ and 16％ (t =-22.10,-10.19,-4.04,P =0.000,0.000,0.002),and Dmean reduced by 1.9 Gy (t =-16.21,P =0.000) ; D5 of the left and right femoral heads were reduced by 1.6 Gy and 2.7 Gy (t =-2.89,-6.22,P =0.015,0.000).Dmax of the caudate equine was reduced by 1.5 Gy (t=-4.80,P=0.001).V20,V30,V40 and V50 of the body were reduced by 18％,18％,4％ and3％(t=-7.52,-11.75,-6.26,-6.94,P=0.000,0.000,0.000,0.000).Dmean and Dmax of the body decreased by 1.0 Gy and 0.4 Gy (t=-3.72,-3.51,P=0.000,0.005).Average machine unit (MU) decreased by 57％ (t =-40.54,P =0.000).Conclusions cervical cancer Patients with VIMAT technology can get equivalent or superior dose distribution compared with the FF-IMRT technology.And VIMAT technology could reduce MU.But the efficacy needs further clinical evaluation

Objective To study the dosimetric comparison of split field and fixed jaw techniques for large IMRT target volumes in the rectum cancer.Methods CT images of fifteen patients with rectum malignancies and regional target volumes were transferred into Eclipse planning system.SFT plan and FJT plan were performed on an Eclipse TPS using beam data generated for linear accelerator.A standard beam arrangement consisting of seven coplanar fields was used in both techniques.Institutional dose-volume constraints used in rectum cancer were kept the same for both techniques.Target and organs at risk were evaluated.Results PTV95 in FJT plan coverage was lower (t =-2.24,P ＜ 0.05).Dmean in FJT plan was increased (t =2.54,P ＜ 0.05),but Dmax was not different.HI in FJT plan became inferior (t =3.09,P ＜0.05),while CI was not different.There was no difference in dose distribution among bladder,femoral head and cauda equina.The value of V5 of small intestine increased in FJT plan (t =4.76,P ＜0.05),and the values of V20 and V50 of bone marrow were better than those in SFT plan (t =-2.66,-3.36,P＜0.05),while Dmax was higher than that in SFT plan (t =3.30,P ＜ 0.05).The value of V20 of body was higher in FJT plan than that in SFT plan (t =2.48,P ＜0.05).The number of MU was significantly lower in FJT plan than that in SFT plan (t =-9.38,P ＜0.05).The average segments in FJT plan decreased by 39.4％ compared with SFT plan (t =-6.46,P ＜ 0.05).Verification rate in FJT plan group was better than that in SFT plan (t =10.46,P＜0.05),and the treatment time was shortened from 12 to 6 min.Conclusions Compared to SFT technique,patients with rectal cancer who were treated with FJT could get better dose of target and organs,which can meet the clinical treatment requirements.The technique could shorten the treatment time and reduce the treatment MU.It also could increase the number of patients to be treated,reduce their waiting time and reduce the difficulty of QA.