Objective To explore the clinical value when treating cervical cancer of supplementing radiotherapy with hyperbaric oxygen treatment. Methods Fifty-eight cervical cancer patients were randomly divided into 2 groups; the HBO group (n=28) received radiotherapy combined with hyperbaric oxygen treatment; a control group (n = 30) received only radiotherapy. Results The complete response rate (CR) of the HBO group was 75.0% , the partial response rate (PR) was 7.1% ,the effective rate(CR + PR) was 92.8% , the total 3 year survival rate was 71.4% , the local recurrence rate was 10.7% , and all of these results were significantly different from the controls (P

Objective:To detect the expression of tumor necrosis factor alpha in (TNF alpha) breast cacner and its relationship with imaging features.Methods:Using immunofluorescence and flow cytometry to detect the expression of TNF-α in MDA-MB-231 and MCF-7.Collect 82 patients with mammary gland disease,which was confirmed by pathological tissue,its pathological data,imaging data,and by immunohistochemistry to detect the expression of TNF-α in breast tissues,and analyze and the relationship between its expression and the pathological features and imaging characteristics.Results:TNF-α high expression in MDA-MB-231,the expression of TNF-oα in malignant breast tumor tissue significantly higher than that in benign tumor,the expression quantity associated with lymph node metastasis,TNM stages,strengthen uniform in MRI,the boundary and the shape of the X-ray Mammography (P=0.01),and color flow signal strength in ultrasound (P＜0.05).Conclusions:TNF alpha in breast tumor tissue was unusually high expression,and is closely related to some of the imaging features of breast tumor.

Objective: To explore the clinical symptoms of effective blood volume deficiency caused by ultrafiltration in hemodialysis patients with chronic renal failure, and to analyze the changes of blood pressure during the formation of symptoms. Methods: From October 2016 to February 2019, 146 patients with maintenance hemodialysis were selected from the Yangquan coalmine group General Hospital for 39 658 hemodialysis.There were 3527 cases of clinical symptoms of definable hypovolemia.The characteristics of clinical symptoms in the early stage of dialysis (>0-≤60 min), medium (>60-≤180 min) and late (>180-≤240 min) were analyzed.To define the hypotension, hypertension and maintenance blood pressure in dialysis, and to count the incidence of various blood pressure when clinical symptoms appear.The mean arterial pressure (mean arterial pressure, MAP) measured at the onset of the disease was compared with (MAP) at the onset of dialysis, and the evolution of (MAP) was classified.The dialysis interval weight gain≥5% or<5%, was counted for the onset of the condition caused by dialysis ultrafiltration.To analyze the clinical symptoms of hemodialysis caused by ultrafiltration speed and excess. Results: The incidence of clinical symptoms was 8.9% (3527/39658). The clinical symptoms caused by the insufficiency of effective blood volume are manifested in each period of dialysis, and have the characteristics of disease.Blood pressure index can not accurately reflect the correlation of clinical symptoms.There were 493 cases of effective blood volume deficiency during dialysis >0-≤60 min.Among them, 341 cases of hypotension, accounting for 69.1% (341/493), 79 cases of hypertension, accounting for 16.1% (79/493), 73 cases of maintaining blood pressure, accounting for 14.8% (73/493). The incidence of clinical symptoms was increased when dialysis was >60-≤180 min, which was related to continuous or excessive ultrafiltration.There were 1306 cases in total, including 1003 cases of hypotension, accounting for 76.8% (1003/1306); 179 cases of hypertension, accounting for 13.7% (179/1306); 124 times of maintaining blood pressure, accounting for 9.5% (124/1306). Dialysis>180-≤240 min is the high incidence period of clinical symptoms, which is related to continuous ultrafiltration and exceeding the setting of dry body mass.There are 1728 cases in total, including 1408 cases of hypotension, accounting for 81.5% (1408/1728); hypertension is reduced, but there are still cases of stubborn hypertension.When the clinical symptoms of hypovolemia occurred, 1989 cases were hypotension, which was easy to attract clinical attention; 763 cases were hypotension, which was stable before the clinical symptoms appeared, and then the blood pressure dropped suddenly; 446 cases were significantly higher than before the clinical symptoms appeared, which made it difficult to judge the clinical symptoms; 329 cases maintained the blood before the dialysis pressure.Excessive water retention in the whole process of dialysis has clinical symptoms, the total number of times increased significantly.The incidence of common water retention was less than that of dialysis>180-≤240 min.The osmotic pressure of plasma colloid and crystal affects the refilling of plasma, the change of ultrafiltration mode and the change of dialysis temperature on blood pressure and blood volume. Conclusion Because of the characteristics of the disease and the particularity of the treatment, the hemodialysis ultrafiltration process is prone to the related clinical symptoms caused by insufficient effective blood volume.However, the occurrence of clinical symptoms is not synchronous with the change of blood pressure.To improve the understanding of clinical symptoms of insufficient blood volume, to achieve early detection and early treatment is conducive to the safe treatment of follow-up hemodialysis and better completion of ultrafiltration target value.

Intraspinal synovial cysts are commonly found in the lumbar spine and occur less commonly in the cervical spine. Occurrence of a cyst in the thoracic spine causing myelopathy is extremely rare. We report here the radiological findings of a case of a thoracic intraspinal synovial cyst that caused myelopathy at the T2-3 level with an accompanying review of the clinical literature.
Spinal Cord Diseases ; Spine ; Synovial Cyst

Toxoplasma gondii can modulate host cell gene expression; however, determining gene expression levels in intermediate hosts after T. gondii infection is not known much. We selected 5 genes (ALDH1A2, BEX2, CCL3, EGR2 and PLAU) and compared the mRNA expression levels in the spleen, liver, lung and small intestine of genetically different mice infected with T. gondii. ALDH1A2 mRNA expressions of both mouse strains were markedly increased at day 1-4 postinfection (PI) and then decreased, and its expressions in the spleen and lung were significantly higher in C57BL/6 mice than those of BALB/c mice. BEX2 and CCR3 mRNA expressions of both mouse strains were significantly increased from day 7 PI and peaked at day 15-30 PI (P<0.05), especially high in the spleen liver or small intestine of C57BL/6 mice. EGR2 and PLAU mRNA expressions of both mouse strains were significantly increased after infection, especially high in the spleen and liver. However, their expression patterns were varied depending on the tissue and mouse strain. Taken together, T. gondii-susceptible C57BL/6 mice expressed higher levels of these 5 genes than did T. gondii-resistant BALB/c mice, particularly in the spleen and liver. And ALDH1A2 and PLAU expressions were increased acutely, whereas BEX2, CCL3 and EGR2 expressions were increased lately. Thus, these demonstrate that host genetic factors exert a strong impact on the expression of these 5 genes and their expression patterns were varied depending on the gene or tissue.
Aldehyde Dehydrogenase/*genetics/metabolism ; Animals ; Brain/metabolism/parasitology ; Chemokine CCL3/*genetics/metabolism ; Early Growth Response Protein 2/*genetics/metabolism ; Gene Expression Profiling ; Humans ; Lung/metabolism/parasitology ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Inbred Strains ; Nerve Tissue Proteins/*genetics/metabolism ; Organ Specificity ; Spleen/metabolism/virology ; Toxoplasma/*physiology ; Toxoplasmosis/*genetics/metabolism/parasitology ; Urokinase-Type Plasminogen Activator/*genetics/metabolism

INTRODUCTIONThe prevalence of hiatal hernias and para-oesophageal hernias (PEHs) is lower in Asian populations than in Western populations. Progressive herniation can result in giant PEHs, which are associated with significant morbidity. This article presents the experience of an Asian acute care tertiary hospital in the management of giant PEH and parahiatal hernia.

METHODSSurgical records dated between January 2003 and January 2013 from the Department of Surgery, Changi General Hospital, Singapore, were retrospectively reviewed.

RESULTSTen patients underwent surgical repair for giant PEH or parahiatal hernia during the study period. Open surgery was performed for four patients with giant PEH who presented emergently, while elective laparoscopic repair was performed for six patients with either giant PEH or parahiatal hernia (which were preoperatively diagnosed as PEH). Anterior 180° partial fundoplication was performed in eight patients, and mesh reinforcement was used in six patients. The electively repaired patients had minimal or no symptoms during presentation. Gastric volvulus was observed in five patients. There were no cases of mortality. The median follow-up duration was 16.3 months. There were no cases of mesh erosion, complaints of dysphagia or recurrence of PEH in all patients.

CONCLUSIONGiant PEH and parahiatal hernia are underdiagnosed in Asia. Most patients with giant PEH or parahiatal hernia are asymptomatic; they often present emergently or are incidentally diagnosed. Although surgical outcomes are favourable even with a delayed diagnosis, there should be greater emphasis on early diagnosis and elective repair of these hernias.

Adult ; Aged ; Digestive System Surgical Procedures ; methods ; Elective Surgical Procedures ; Female ; Hernia, Hiatal ; diagnostic imaging ; surgery ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Singapore ; Surgical Mesh ; Tertiary Care Centers ; Treatment Outcome

Introduction: Untreated iron deficiency (ID) can lead to severe anaemia, requiring blood transfusion, or increased mortality risk. Globally intravenous (IV) iron is increasingly recognised as a recommended option for patients. This study aims to evaluate the budget impact associated with introducing a new intravenous (IV) iron, ferric derisomaltose (Monofer® [IIM]) as one of the treatment options for the management of ID in the Ministry of Health Malaysia (MOHM) setting. Methods: A 5-year budget impact model was developed from 2020 to 2024 for patients with ID that require a high iron dose (≥500 mg), using the perspective of MOHM. The model was built with four external medical specialists, each with experience and deep knowledge of ID management, to support estimations on the future development of iron use in Malaysia. Results: Compared to the current market mix with the existing IV iron products (i.e., iron sucrose and iron dextran), a cost-saving of MYR 53,910 could be achieved with the introduction of IIM in 2020. The uptake of IIM into MOHM over five years is estimated to lead to an overall budget saving of MYR 11,837,524 over a 5-year time horizon. Conclusion: The use of IIM in place of the current IV iron products in MOHM resulted in a significant cost saving by reducing the number of visits required to achieve the targeted iron dose and the shorter IV infusion time with IIM.