Objective To investigate the prognosis of local resection in patients with low rectal cancer, and assess surgical indications for this procedure. Methods One hundred and twenty-four patients with low rectal cancer from Jan 1975 to Dec 2006 were analyzed, the clinicopathologic features and surgical, outcome were examined as prognostic factors. Survival rate was estimated by Kaplan-Meier method and compared by Log-Rank test, prognostic factors were analyzed by multivariate COX proportional hazards model. Results The 5-year survival rate of 124 patients underwent local resection was 90.7 %(97/107), there were 4.8 %(6/124) patients with complications and 15.3 %(19/24) ones with local recurrence.The infiltration, vascular invasion, the size of tumor and the histological grade were significant prognostic factors of overall survival, but gender, age, the tumor site and the macroscopic type were not. Multivariate analysis indicated that the tumor infiltration were independent poor prognostic factor. Conclusion Local resection is suitable for Tis and T1 low rectal cancer, and those with high local recurrence factors should undergo radical resection. Strict follow-up and adjuvant therapy is necessary for local excision.

BACKGROUND:A series of studies have found that mesenchymal stem cells play an important role in the prevention and cure of acute lung injury in adult animals.
OBJECTIVE:To further validate the effects of human umbilical cord mesenchymal stem cells on endotoxin-induced acute lung injury in newborn rats.
METHODS:Total y 120 newborn rats aged 7 days were randomly assigned to three groups. Intraperitoneal injection of 3 mg/kg endotoxin was done to establish neonatal rat model of acute lung injury in the model and stem cellgroup. Rats in the normal saline group were intraperitoneal y injected with 0.1 mL normal saline. After 30 minutes of modeling, the rats in the stem cellgroup were subjected to intraperitoneal injection of 0.1 mL human umbilical cord mesenchymal stem cells (1×106). The same volume of normal saline was administered in the normal saline and model groups. Lung tissue and blood specimens from newborn rats were taken at 6 hours, 1 day, 2 days, 4 days, and 7 days after treatment to observe lung pathological changes and detect levels of serum tumor necrosis factor-alpha and interleukin-10 as wel as myeloperoxidase activity in the lung tissue.
RESULTS AND CONCLUSION:The lung hematoxylin-eosin staining and myeloperoxidase activity indicated acute lung injury in the model group. At 4 and 7 days after modeling, the severity of lung injury in the stem cellgroup was lighter than that in the model group. Compared with the model group, the interleukin-10 level was significantly increased in the stem cellgroup, while the level of tumor necrosis factor-alpha was significantly reduced (P<0.05). These findings suggest that human umbilical cord mesenchymal stem cells transplanted into newborn rats with acute lung injury can reduce lung inflammation, and the main mechanism may be that human umbilical cord mesenchymal stem cells can balance anti-inflammatory and pro-inflammatory factors and reduce lung injury through immune regulation.

OBJECTIVE: Dynamic observation of Epstein-Barr virus (EBV) DNA load before and after the treatment in patients with Nasopharyngeal carcinoma (NPC), predicting the incidence of distant metastasis and offering more personalised choice of therapies. METHOD: Fifty-four cases of patients with NPC were taken by fluorescence quantitative PCR assay of EBV DNA load before and after the treatment, all patients were followed up according to plan and carried out the progression-free survival (PFS) and overall survival (OS). RESULT: EBV DNA load in plasma of patients with NPC can partly reflect the clinical characteristics of patients; EBV DNA load in some patients with distant metastasis was higher than those patients with continuous remission when they were not started treatment (P < 0.05); For those patients whose EBV DNA copies were lower than 20,000 copies/mI before the treatment, the progression-free survival and overall survival rates were higher than those high expression patients, and the difference were statistically significant (PF < 0.01 and P < 0.05). CONCLUSION The EBV DNA load in the plasma of NPC patients can partly predict the occurrence of distant metastases before treatment.
Adolescent ; Adult ; Aged ; Carcinoma ; DNA, Viral ; blood ; Female ; Herpesvirus 4, Human ; genetics ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; therapy ; virology ; Neoplasm Metastasis ; Viral Load ; Young Adult

Total mesorectal excision(TME) has become the standardized modality in rectal cancer surgery. The strict quality control of surgery has been introduced. The improvement of surgery quality resulted in the decrease of local recurrence rate and the increase of survival rate. TME becomes the model that quality control of surgery improved outcomes. In view of this, in recent years, complete mesocolic excision (CME) and extralevator abdominoperineal excision (ELAPE) have been established as the corresponding standardized procedures, which shows the preliminary clinical effects. Utilization of laparoscopic surgery for management of colorectal cancer has been widely accepted. Laparoscopic TME and CME will further improve the overall outcomes of colorectal cancer.
Abdomen ; Colorectal Surgery ; Humans ; Laparoscopy ; Mesocolon ; Perineum ; Quality Control ; Rectal Neoplasms ; Rectum ; Survival Rate

Vessel identification and dissection are the key processes of laparoscopic complete mesocolic excision (CME). Vascular injury will lead to complications such as prolonged operative time, intraoperative hemorrhage and ischemia of anastomotic stoma. Superior mesenteric artery (SMA), superior mesenteric vein(SMV), gastrointestinal trunk, left colic artery(LCA), sigmoid artery and marginal vessels in the mesentery have been found with possibility of heteromorphosis, which requires better operative techniques. Surgeons should recognize those vessel heteromorphosis carefully during operations and adjust strategies to avoid intraoperative hemorrhage. Preoperative abdominal computed tomography angiography(CTA) with three-dimensional reconstruction can find vessel heteromorphosis within surgical area before operation. Adequate dissection of veins instead of violent separation will decrease intraoperative bleeding and be helpful for dealing with the potential hemorrhage. When intraoperative hemorrhage occurs, surgeons need to control the bleeding by simple compression or vascular clips depending on the different situations. When the bleeding can not be stopped by laparoscopic operation, surgeons should turn to open surgery without hesitation.
Colonic Neoplasms ; surgery ; Dissection ; Hemorrhage ; prevention & control ; Humans ; Laparoscopy ; Mesenteric Artery, Inferior ; Mesenteric Veins ; Mesocolon ; surgery

Objective To compare the differentiating effect of Berg Balance Scale (BBS), Mini-Balance Evaluation Systems Test (Mini-BESTest) and Brief-BESTest on the risk of falls in chronic obstructive pulmonary disease (COPD) patients. Methods From September, 2016 to March, 2017, 22 COPD patients with history of falls and other age-matched 66 COPD patients without history of falls were assessed with BBS, Mini-BESTest and Brief-BESTest. The data were compared with paired Logistic regression, Log-likelihood estimate, and the skewness coefficient were calculated. Results BBS, Mini-BESTest and Brief-BESTest all were valuable for differentiating the risk of falls in COPD patients. Log-likelihood estimate value was the least in Brif-BESTest (5.372), followed with Mini-BESTest (12.918) and BBS (17.644). There was not a ceiling effect in Brief-BESTest and Mini-BESTest, but there was in BBS. Conclusion All the BBS, Mini-BESTest and Brief-BESTest can predict the risk of falls in patients with COPD, and Brief-BESTest is the most predictive. There is a ceiling effect in BBS for COPD patients, but not in Brief-BESTest and Mini-BESTest.

To investigate the relationship between single nucleotide polymorphisms (SNPs) of CACNA1C (SNPs rs58619945, rs7316246 and rs216008) and susceptibility of chronic spontaneous urticaria (CSU) as well as the curative effect of non-sedating antihistamine drugs.
 Methods: Peripheral blood were extracted from 191 CSU patients to collect DNA. Urticaria Activity Score 7 (UAS7) and Dermatology Life Quality Index (DLQI) changes were collected from these patients with different non-sedating antihistamine drugs. PubMed retrieval system was used to select the 3 SNPs (rs58619945, rs7316246 and rs216008) of CACNA1C. Susceptibility of CSU and curative effect of non-sedating antihistamine drugs (desloratadine, mizolastine, fisofenadine) in 189 CSU patients and 105 controls with different SNPs were compared with Chi-squared test. Data of 105 southern Chinese controls were extracted from the 1 000 genome database.
 Results: Frequency of rs58619945 G allele in the CSU patients was significantly higher than that in the controls [OR(95%CI)=0.660(0.470-0.925), P=0.016]. However, there was no significant differences in rs7316246 and rs216008 between the CSU patients and the controls. Meanwhile there was no significant difference in general curative effect of the 3 drugs in the 3 SNPs (rs58619945: OR=0.843, P=0.454; rs7316246: OR=2.103, P=0.102; rs216008: OR=0.237, P=0.363). There was significant difference in different alleles of rs216008 in the patients administered by desloratadine [OR(95%CI)=0.480(0.247-0.933), P=0.029]. No difference was shown in the 3 SNPs in patients administered by mizolastine.
 Conclusion: The rs58619945 A/G might be related to susceptibility of CSU, and the rs216008 mutation might affect drug response of desloratadine.
Calcium Channels, L-Type ; genetics ; Chronic Disease ; Genetic Predisposition to Disease ; Histamine H1 Antagonists, Non-Sedating ; therapeutic use ; Humans ; Loratadine ; analogs & derivatives ; therapeutic use ; Polymorphism, Single Nucleotide ; Prognosis ; Retrospective Studies ; Urticaria ; drug therapy ; genetics

OBJECTIVETo investigate the treatment and prognosis for rN3 neck recurrence of nasopharyngeal carcinoma (NPC) after primary radiotherapy.

METHODSA total of 37 cases with rN3 neck recurrence after radiotherapy in NPC between October 2003 and August 2013 were retrospectively analyzed. Of them 19 cases presented with lymph node (LN) metastasis in supraclavicular fossa, 18 cases had metastasis LN > 6 cm, 10 cases received chemoradiotherapy, and 27 cases underwent neck dissection including modified radical neck dissection (MRND) for 9 cases, radical neck dissection (RND) for 18 cases. Six of 18 cases with RND underwent reconstructive surgery with pectoralis major flap, 12 cases received postoperative radiotherapy and 20 cases had postoperative adjuvant chemotherapy.

RESULTSEight patients had documented recurrence or residue, 17 patients developed distant metastases, one patient showed recurrence and distant metastasis. The 5-year overall survival rate and disease-free survival rate were 27.5% and 21.6% respectively, and the median survival time was 41 months. The survival rate in surgery group was significantly higher than that in chemoradiotherapy group, and the prognosis of patients with LN > 6 cm was better than that of patients with metastasis LN to supraclavicular fossa.

CONCLUSIONSPatients with rN3 NPC are prone to metastasis, and patients with supraclavicular fossa lymph node metastasis had poor prognosis. Surgery combined with chemoradiotherapy is an effective treatment for the patients without distant metastasis.

Antineoplastic Combined Chemotherapy Protocols ; Carcinoma ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Disease-Free Survival ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Neck ; Neck Dissection ; Neoplasm Recurrence, Local ; diagnosis ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Nonpharmaceutical interventions (NPIs) have been commonly deployed to prevent and control the spread of the coronavirus disease 2019 (COVID-19), resulting in a worldwide decline in influenza prevalence. However, the influenza risk in China warrants cautious assessment. We conducted a cross-sectional, seroepidemiological study in Shandong Province, Northern China in mid-2021. Hemagglutination inhibition was performed to test antibodies against four influenza vaccine strains. A combination of descriptive and meta-analyses was adopted to compare the seroprevalence of influenza antibodies before and during the COVID-19 pandemic. The overall seroprevalence values against A/H1N1pdm09, A/H3N2, B/Victoria, and B/Yamagata were 17.8% (95% CI 16.2%-19.5%), 23.5% (95% CI 21.7%-25.4%), 7.6% (95% CI 6.6%-8.7%), and 15.0 (95% CI 13.5%-16.5%), respectively, in the study period. The overall vaccination rate was extremely low (2.6%). Our results revealed that antibody titers in vaccinated participants were significantly higher than those in unvaccinated individuals (P < 0.001). Notably, the meta-analysis showed that antibodies against A/H1N1pdm09 and A/H3N2 were significantly low in adults after the COVID-19 pandemic (P < 0.01). Increasing vaccination rates and maintaining NPIs are recommended to prevent an elevated influenza risk in China.