Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; pathology ; therapy ; Catheter Ablation ; Humans ; Lung Neoplasms ; secondary ; surgery ; Neoplasm Recurrence, Local ; Osteosarcoma ; pathology ; secondary ; therapy ; Salvage Therapy

Objective: To analyze the experience in the treatment of intraductal papillary Mucinous tumors(IPMT) of the pancreas.Methods: We retrospectively analyzed the clinical and imageological features of 30 IPMT patients,17 males and 13 females,who underwent operations in our department from May 2003 to December 2005.The patients with intraductal papillary mucinous adenoma(IPMA) were included in the benign group,and those with intraductal papillary mucinous borderline tumor(IPMB) and intraductal papillary mucinous carcinoma(IPMC) in the malignant group.Results: There were more males than females in the malignant group(76.5% vs 30.8%,P40 mm,which were considered to be the predictors of malignancy.Conclusion: Clinical and imageological features differ signifcantly between different pathological types of IPMT.The presence or absence of mural nodules,the diameter of the main pancreatic duct and the size of the tumor may help differentiate the malignancy from benignancy of IPMT.

Aged ; Axilla ; Axillary Vein ; surgery ; Blood Vessel Prosthesis ; Breast Neoplasms ; complications ; pathology ; surgery ; Female ; Histiocytoma, Malignant Fibrous ; complications ; pathology ; surgery ; Humans ; Jugular Veins ; surgery ; Male ; Neoplasm Recurrence, Local ; Upper Extremity Deep Vein Thrombosis ; etiology ; surgery ; Vascular Grafting ; methods

Objective To explore the possibility of non-discarding blood after cisplatin hyperther-mic antiblastic perfusion(HAP)in treating the patients with malignant bone tumor of lower extremity.Methods Forty patients consisted of 31osteosarcomas and9malignant fibrous histiocytomas of bone.The clinical stages were wholly classified intoⅡB stage according to Ennekings surgical staging system for muscu-loskeletal tumors.The patients were divided into three groups:group1:discarding blood group(10cases),in whom200ml of the400ml blood remaining in heart-lung machine was discarded after HAP;group2:Non-discarding blood group(25cases),the blood remaining in heart-lung machine was not discarded after HAP and re-infused into systemic circulation;group3:systemic chemotherapy group(5cases),cisplatin was infused intravenously.The regional and the systemic blood cisplatin concentrations were determined at3,30and60minutes during HAP,and the systemic blood cisplatin concentrations were determined at0,0.5,1,2,4,8,12,24,48and72hours after HAP in the group1and group2.While1h after cisplatin infusion in-tra venously in the group3,the blood cisplatin concentration were also measured.Results The regional blood cis platin concen tra tions were high er than that in systemic blood at the time during HAP.The systemic blood cisplatin concen trations after HAP,ex cept at0minute in the group2were higher than that in the group1,there were sig nificant statistic differences between the two groups.The systemic blood cisplatin con-cen trations after HAP in the group2were simi lar to that after systemic chemotherapy.No severe adverse ef-fects in the group1were found.The Ennek ings surgical stagings for the tumors were turned fromⅡB intoⅡA in all the patients.Conclusion The method of non-discarding blood after HAP is available,it is not only local treatment ,but also systemic chemotherapy in the patients with malignant bone tumor of lower ex-tremi ty for limb-salvage surgery.

Objective To improve the prognosis and radical resection of the extended pancreaticoduodenectomy for patients with pancreatic cancer in the ucinate process involving mesentery mot. Methods From Jan. 2004 to Dec. 2007, a total of 23 ( 14 male and 9 female, aged between 30 and 72 years old) patients with pancreatic cancer in the ucinate process involving mesentery root were treated in our department. Curative resection was performed for all patients by the extended pancreaticoduodenectomy with superior mesenteric artery (SMA) isolation and mesentery root resection. The surgical procedure, the safety and prognosis were analyzed retrospectively. Results 12 patients underwent the procedure, among them 11 also underwent combined SMV partial resection and reconstruction. The operation time was (4.2 ± 1.1 ) hours, and the blood loss was ( 1 635 ± 1 362) ml with the blood transfusion of ( 1 609 ± 1 462 ) ml. There was no operation related death in this case series, and mild to severe diarrhea occurred in 6 cases. The post-operative stay ranged 9 to 30 days. The pathological examination showed that the tumor size was (5.3 ± 1.4) cm. 13 patients (57%) had one or more lymph nodes metastasis. 20 patients (87%) had nerve involvement. Among 11 patients with SMV partial resection and reconstruction, 10 patients had endangium involvement. 22 patients had negative surgical margins for all specimens. Rapid intra-operative frozen pathological examination showed negative surgical margins in one patient, however, post-operative paraffin section pathological examination revealed nerve involvement between SMA and celiac trunk. After a follow-up of 5 to 42 months, liver metastasis occurred in 4 patients, and local recurrence occurred in 3 patients. The 1-year and 2-year accumulated survival rates were 77.2% and 42.5%, respectively. Conclusions Isolation SMA and the mesentery resection in extended pancreaticodudenectomy were safe and useful. Using this modified technique, Radical operation resection could be achieved in the treatment of pancreatic cancer in uncinate process.

Objective To observe and analyze clinical characteristics of diabetes patients suffering from pancreatic cancer . Methods We recruited 107 cases of pancreatic cancer(66 without diabetes and 41 with diabetes) and 100 diabetes patients without pancreatic pancreas as control .Patients′ demographic information ,degree of tumor differentiation ,serum markers etc .were com‐pared in order to find out the relevant clinical features of diabetes patients suffering from pancreatic cancer .Results (1)Patients with pancreatic cancer mostly were middle‐aged males .55 .1% of them suffering from dysglycemia ,18(16 .8% ) and 41(38 .3% ) of whom had impaired fasting glucose and diabetes ,respectively .(2)Compared with their without diabetes counterparts ,pancreatic cancer with diabetes were more prone to be asymptomatic and weight loss(P< 0 .05) .(3)Compared with their without diabetes counterparts ,pancreatic cancer with diabetes had significantly higher levels of fasting blood glucose(FBG) andγ‐glutamyltranspep‐tidase(γ‐GT)(P<0 .05) .(4)When compared with diabetes control ,pancreatic cancer with diabetes were older and shorter duration and lower body mass index(BMI)(P<0 .05) .They were more prone to weight loss(P<0 .05) .Moreover ,serum CA19‐9 and CEA levels in them were significantly higher than those in the diabetes control(P<0 .05) .Conclusion Older age ,shorter duration ,low BMI are all risk factors for diabetes patients to develop pancreatic cancer .Being asymptomatic and weight loss are their clinical characteristics .CA19‐9 and CEA are both sensitive serum markers to detect pancreatic cancer patients with diabetes .

OBJECTIVESTo evaluate the clinical characteristics, in-hospital and three-year outcome in ST-elevation myocardial Infraction (STEMI) patients receiving conservative treatment (CT), thrombolytic treatment (TT) and primary percutaneous coronary intervention (PCI) in Beijing.

METHODSThis 12-month prospective, multicenter registry study was conducted in 19 hospitals with 808 patients with STEMI in Beijing between Jan. 2006 and Dec. 2006, 518 (64%) received PCI, 106 (16.1%) received TT and 184 (22.8%) received CT therapy. Patients were followed up for 3 years.

RESULTSAt baseline, the age of patients in CT group [(64.5 ± 13.5) years] was significantly higher than those in TT group p(57.9 ± 11.0) years] and in PCI group [ (60.4 ± 12.3) years, all P<0.01]; and the median time from symptom onset to hospital in CT group (207 min) was significantly longer than those in TT group (130 min) and PCI group (130 min, all P<0.01). Emergency Medical Service (EMS) use was significantly higher in PCI group (184/518, 35.5%) than in CT group (46/184, 27.3%) and TT group (29/107, 25.0%, all P<0.05). Health insurance holder was the highest in PCI group (P<0.01). PCI was performed less frequently than thrombolytic therapy [66.6% (345/518) vs. 80.2% (85/106)m P=0.02] during off-hours and more frequently performed in tertiary hospitals than in secondary hospitals[66.8%(437/651) vs. 52.6% (81/154, P<0.01)]. The in-hospital mortality and the cardiovascular mortality at 3 year after hospital discharge was significantly higher in CT group [9.2% (17/185) and 9.4% (15/159)] than in PCI group [3.5% (18/518), 4.5% (20/446)] and TT group [6.6% (7/106), 2.3% (2/86), all P<0.01]. Patients in PCI group had the highest adherence level of aspirin, β-blocker, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers or statins at 3-years follow-up (all P<0.05). Multivariable Cox proportional hazards regression analysis showed that only PCI was associated with lower risk of cardiovascular death (HR-0.40, 95% CI:0.21-0.73, P<0.01).

CONCLUSIONSSocial and clinical setting may affect the physician's decision to provide reperfusion therapy in Beijing for STEMI patients. Better adherence of secondary preventive drugs and lower cardiovascular death are observed in STEMI patients receiving PCI during the 3-year follow-up

Aged ; China ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Percutaneous Coronary Intervention ; Prognosis

The study reports the detection of neuroprotective effect of 10 kinds of coumarin derivatives and explores their possible mechanism. MTT method was used to screen the neuroprotective effect of 10 coumarin derivatives on neurotoxic agents (Aβ25-35 and rotenone) or OGD (oxygen-glucose deprivation). A compound with better protective effect was obtained. Then the effect of this compound on neurotoxic agents on PC12 was detected by the morphological observation. Furthermore, the effect of compound 3 on microglia with lipopolysaccharide (LPS) induced inflammation was detected. And the inflammatory factor was tested. Finally, direct free radical scavenging ability was detected. Compound 3 was found to be the best compound through three neurons toxic models. Not only compound 3 ameliorated cell viability reduced by three neurons toxic models, but also significantly inhibited the production of inflammatory factor (TNF-α and IL-1β). And its free radical scavenging ability is very good, especially the effect on superoxide anion, which is comparable with vitamin C. The significant scavenging effect of compound 3 on superoxide anion might be the mechanism of the neuroprotection. Compound 3 as a potential neural cell protective agent merits further investigation.
Animals ; Coumarins ; chemistry ; Free Radical Scavengers ; chemistry ; Inflammation ; Microglia ; drug effects ; Neurons ; drug effects ; Neuroprotective Agents ; chemistry ; PC12 Cells ; Rats

AIM: To investigate the feasibility of reendothelialization of the injured arterial wall by autologous endothelial cell transplantation and their influences on neointima proliferation. METHODS: New Zealand white rabbits (n=30) were subjected to bilateral iliofemoral artery balloon injury. Cultured, autologous venous endothelial cells were immediately transplanted into one vessel(transplantation group), whereas the contralateral artery received medium only(control group). Reendothelialization of the injured arterial wall was analysed 4 hours or 4 days after cell transplantation by fluorescent tracing、scanning electron microscope(SEM) and Evans blue staining. Pathology analysis was employed 28 days after cell transplantation to evaluate neointima proliferation. RESULTS: The transplanted endothelial cells had adhered into the aterial wall 4 hours after transplantation and began to attach and spread 4 days later. A number of fluorescent labeling endothelial cells were observed in the endothelial injured arterial wall. The vessels in control group were stained nearly completely by Evans blue, whereas about 60% area was not stained in transplantation group. Pathological examination demostrated that neointimal area and maximal intima thickness in transplantation group significant decreased than those in control. CONCLUSION: Autologus endothelial cells were effectively transplanted into the injured arterial wall by balloon catheter, and it can relieve neointima proliferation in the long time.

Objective To evaluate the effect of preoperative radiotherapy and postoperative brachy radiotherapy (POBRT) on patients with primary liver cancer(PLC). Methods 50 patients with PLC were randomly divided into 2 groups:(1)Radiotherapy group, 25 patients who underwent preoperative radiotherapy 14～17 days before hepatectomy and POBRT 3～10 days after hepatectomy ;(2)Control group,25 cases who underwent hepatectomy only. In radiotherapy group, before heptectomy, the single-dose 6Gy per time and 3 sessions were given to each patient. 3～6 ductus were placed for POBRT during operation,and 10Gy of POBRT per time and 2～4 sessions were given postoperatively. In control group,no radio cherapy was given before and after hepatectomy. Results In radiotherapy group, the cancer shrank significantly after preoperative radiotherapy (P