Objective To evaluate the anticonvulsant effect of midazolam and diazepam when administered nasally on maximal electroshock seizure and metrazol seizure threshold test models .Methods Rats were randomly divided into 7 groups:model group, low-dose, middle-dose and high-dose of midazolam nasal spray groups , diazepam nasal spray in low-dose, middle-dose and high-dose of midazolam nasal spray groups .After the establishment of the maximal electroshock seizure( MES) and metrazol seizure threshold test models ( MST) in rats, the anticonvulsant effects of different doses of midazolam and the clinically used antiepileptic drug diazepam were evaluated and compared .HE staining was used to observe the histopathological changes in the hippocampus , cortex and amygdala in rats .Results Significant anticonvulsant effects were observed on MES and MST in rats pretreated with different dosages of midazolam .In addition , the anticonvul-sant effects of midazolam were stronger than those of diazepam at the same dosage on MES and MST (P<0.05,P<0.01). Histopathological results showed that both midazolam and diazepam could effectively prevent the seizure -induced brain inju-ries, inhibit the increase of microglial cells and the inflammatory cell infiltration in the hippocampus, cortex and amygdala, and reduce the nucleus pycnosis and neuronophagia .Conclusion Midazolam has significantly anticonvulsant and neuropro-tective effects on different seizure models when administered nasally in rats .

Objective To summarize the long term outcomes and prognostic factors of nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy.MethodsFrom Nov 2001to Dec 2009,totally 416 newly diagnosed NPC patients was treated in our hospital.The prescribed dose was 70-78 Gy to the gross tumor volume and 70 Gy to the positive neck nodes,60 Gy to the clinical target volume,and 50-56 Gy to the clinically negative neck.Among 333 stage Ⅲ/Ⅳ patients according to the 2010 UICC staging system,187 received concurrent chemoradiotherapy with a regimen of weekly cisplatin 30mg/m2.Local control rate (LC),overall survival (OS),disease-hree survival (DFS) and distant metastasis-free survival (DMFS) were estimated using the Kaplan-Meier method.ResultsThe follow up rate is 98.0％.158 patients was followed up more than 5 years.The 5 years LC,OS,DFS and DMFS of whole group were 87.7％,82.1％,71.8％ and 84.5％.Sex,Age,T stage and N stage were independent prognostic factors for OS (x2=4.59,11.20,19.40,18.00,P=0.03,0.00,0.00,0.00),T and N stage were independent prognostic factors for DFS (x2=33.50,21.20,P=0.00,0.00) and DMFS (x2=11.90,14.60,P=0.01,0.01).The 5 years LC,OS,DFS and DMFS for local-regional advanced disease with or without concurrent chemotherapy was 82.2％ and 90.7％ (x2=1.72,P=0.19),70.2％ and 83.4％ (x2=1.42,P=0.23),62.8％ and 73.2％ (x2=2.83,P=0.09),78.0％ and 83.2％ (x2=0.37,P=0.55)respectively.Conclusions The long term outcomes of nasopharyngeal carcinoma treated by intensitymodulated radiotherapy was encouraged.The role of concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma treated by intensity-modulated radiotherapy needs further investigated.

OBJECTIVETo study therapeutic effects of minimally invasive percutaneous plate osteosynthesis for the treatment of intertrochanteric femoral fractures of Evans III, IV in elderly patients.

METHODSFrom December 2007 to April 2010, 23 patients with intertrochanteric femoral fractures were reviewed. Among the patients, 11 patients were male and 12 patients were female,ranging in age from 62 to 90 years, with a mean of 72.8 years. According to Evans classification, 13 patients were type III and 10 patients were type IV. All the patients were treated with proximal femoral locking plate (minimally invasive percutaneous plate osteosynthesis, MIPPO) surgery.

RESULTSThe operative time ranged from 45 to 60 min, with an average of 50 min. The blood loss ranged from 60 to 100 ml, averaged 80 ml. All the patients were followed up,and the duration ranged from 9 to 18 months, with an average of 11 months. The healing time based X-ray ranged from 3 to 6 months, with an average of 4 months. According to hip scoring criteria evaluation: 18 patients got an excellent results, 5 good.

CONCLUSIONFor the treatment of intertrochanteric femoral fractures of Evans III, IV in elderly patients, MIPPO has advantages such as small trauma, reliable fixation, which has good clinical application.

Aged ; Aged, 80 and over ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; instrumentation ; methods ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; adverse effects ; instrumentation ; methods ; Skin ; Treatment Outcome

Objective To investigate the treatment outcome of primary mucosal melanoma of the nasal cavity and paranasal sinuses and the role of radiotherapy in the treatment of this disease .Methods The clinical data of 52 patients with primary mucosal melanoma of the nasal cavity and paranasal sinuses who were admitted to our hospital from 2001 to 2014 were analyzed retrospectively.Among these patients, 18 received surgery alone, 31 received surgery combined with radiotherapy ( 24 received surgery and postoperative radiotherapy and 7 received preoperative radiotherapy and surgery ) , and 3 received radiotherapy alone.The surgery+radiotherapy group and the surgery group were matched using propensity score matching.Results The median follow-up was 59 months.The 5-year local control ( LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) of all patients were 49%, 48%, 22%, and 45%, respectively.After matching, the surgery+radiotherapy group had a significantly higher LC than the surgery group (88%vs.43%, P=0.028), but the two groups had similar 5-year DMFS (67%vs.57%, P=0.955), 5-year DFS (58%vs.24%, P=0.131), and 5-year OS (67%vs. 67%, P=0.727 ) .The negative margin rates in the preoperative radiotherapy+surgery subgroup and the surgery+postoperative radiotherapy subgroup were 100%and 50%, respectively ( P=0.004) .Conclusions Surgery combined with radiotherapy can improve the LC rate in patients with primary mucosal melanoma of the nasal cavity and paranasal sinuses, and preoperative radiotherapy can increase the negative margin rate.

Objective To analyze the treatment outcomes of patients with primary sphenoid sinus malignancies. Methods Sixteen patients with primary sphenoid sinus malignancies admitted to our hospital from 2000 to 2013 were analyzed retrospectively. No patients were newly diagnosed with cervical lymph node metastasis. One patient had stageⅣA disease, while fifteen had stageⅣB disease. Eleven patients received surgery followed by radiotherapy, one surgery alone, three radiotherapy alone, and one chemotherapy alone. All surgeries were cytoreductive . The median dose of radiotherapy was 69. 96 Gy ( 56.00?80. 56 Gy ) . Results The 3?year local control ( LC) , distant metastasis?free survival ( DMFS) , disease?free survival ( DFS) , and disease?specific survival ( DSS) rates were 67%, 69%, 44%, and 58%, respectively, in all patients, and 67%, 55%, 30%, and 41%, respectively, in patients treated with cytoreductive surgery followed by radiotherapy. All orbital contents and skull base were preserved. In all patients, the local recurrence, distant metastasis, and lymph node recurrence rates were 25%, 37%, and 6%, respectively. There were no independent predictors for the LC and DSS rates based on the prognostic analysis. Conclusions With the orbital contents and skull base preserved, the cytoreductive surgery followed by radiotherapy yields satisfactory outcomes and a low lymph node recurrence rate in the treatment of sphenoid sinus malignancies. The prophylactic irradiation of cervical lymph nodes is not recommended in clinical practice.

OBJECTIVETo assess the clinical effects of (125)I interstitial brachytherapy for malignant tumors.

METHODSOne hundred and twelve patients with malignant tumors of stage II stage and III under went radical resection combined with (125)I intraoperative implantation. Seven days and three month after operation WBC count and immune markers were observed. Blood biochemistry ultrasonography and X-ray were performed to observe recurrence and metastasis of tumors per three months.

RESULTSIn the 112 patients, 3 died of tumor recurrence in six months, and others survived with the longest time of 35 months.

CONCLUSION(125)I interstitial brachytherapy for malignant tumor is simple, safe and effective.

Adult ; Aged ; Brachytherapy ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes ; therapeutic use ; Male ; Middle Aged ; Neoplasms ; radiotherapy ; therapy ; Retrospective Studies ; Treatment Outcome

ObjectiveTo investigate the role of chemoradiotherapy in the preoperative radiotherapy for locally advanced head and neck squamous cell carcinoma. MethodsFrom Sep. 2002 to Dec. 2008,totally 157 locally advanced head and neck squamous cell carcinoma (HNSCC) patients was assigned to preoperative concurrent chemoradiotherapy group ( n =81 ) or preoperative radiotherapy alone group ( n =76 ) randomly. The chemotherapy regimen was consisted of cisplatin 30 mg/m2, weekly. The radiotherapy in both groups was identical. The primary lesion will continue concurrent chemoradiotherapy or radiotherapy for those the tumor response was or nearly complete remission (CR) and those who refused surgery when evaluated at DT50 Gy, the others will receive surgery 1 month later if the tumor response was less than CR.For N3 patients, the planed neck dissection will be done. ResultsThe follow up rate was 98. 1％, 91patients followed up more than 5 years, there were 46 in concurrent chemoradiotherapy group and 45 in radiotherapy alone group. The rate of 5-year local control, overall survival, disease free survival and distant metastasis-free survival for preoperative concurrent chemoradiotherapy group and preoperative radiotherapy alone group were 63％ and 50％ ( x2 =0. 40,P =0. 528), 46％ and 38％ ( x2 =0. 48,P =0. 490) ,41％ and 35 ( x2 =0. 29, P =0. 593 ) ,76％ and 65％ ( x2 =3.38, P =0. 066 ) respectively. Subgroup analysis showed that the 2-years distant metastasis-free survival of preoperative concurrent chemoradiotherapy group and preoperative radiotherapy alone group were 88％ and 60％ ( x2 =5.99,P =0. 014). ConclusionsPreoper -ative concurrent chemoraidotherapy with the regimen of cisplatin 30 mg/m2 weekly did not improve the overall survival for locally advanced HNSCCwhen compared with preoperative radiotherapy alone.Preoperative concurrent chemoradiotherapy improved the distant metastasis-free survival of locally advanced hypopharyngeal and laryngeal carcinoma.

Objective To evaluate the clinical characteristics,outcome and prognostic factom of adolescent nasopharyngeal carcinoma.Methods Between Jan 1990 and Dec 2009,totally 148 pathological confirmed nasopharyngeal carcinoma(NPC)patients with age≤20 years were treated in our hospital,including stage Ⅱ 8,stage Ⅲ 58,stage Ⅳ 81,and unknown 1 when restaged by TNM system(UICC 2002),ninty-four(63.5%)patients were treated with radiotherapy alone,54(36.5%)patients were treated with radiotherapy combined with cisplatin-based chemotherapy.Results The median follow-up time for all patients was 44.5 months.The 5-year overall survival(OS),local-regional control(LRC)and distant metastasis-free survival(DMFS)rateswere 82.9%,85.1%and 78.6%.There were 42 patients(28.4%)failed with 16 regional recurrence and 29 distant metastasis,and 3 with both;bone metastasis was the most common site of distant metastasis(22/29).In univariate analysis,the adverse prognostic factors for OS were stage T4(X2=5.61,P=0.018),radiation dose<70 Gy(X2=5.30,P=0.021),for LRC was radiation dose<70 Gy and for distant metastasis-free survival was the disease history≥6month(X2=4.24,P=0.039).In multivariate analysis,radiation dose<70 Gy and stage T4 were the independent prognostic factors for OS(X2=5.73、5.56,P=0.017、0.018),for LRC was radiation dose<70 Gy(X2=5.81,P=0.016).Conclusions The outcome of the present series was excellent,total nagopharyngeal radiation dose less than 70 Gy is inappropriate.Reduce the distant metastasis and late toxicities were the future direction for the treatment of adolescent nasopharyngeal carcinoma.

OBJECTIVETo further study the therapy of wasting muscle by myostatin as a new targets, the eucaryotic expression vector coupled the foreign T-helper epitope of tetanus toxin (TT) to the N terminus of myostatin was constructed, and the effects of the gene vaccine on forelimb grip were tested in immunized mice.

METHODSA DNA fragment encoding the TT epitope followed by the N terminus of mature myostatin (330bp) was synthesized. The eucaryotic expression vector of myostatin was constructed and the chinese hamster ovary (CHO) cells were infected with the recombinant plasmids pVAC-TT-Ms by liposome transfection according to routine laboratory procedure. The myostatin expression was tested by cell immunofluorescence technique in transfected CHO. The forelimbs grip were tested in immunized mice with myostatin gene vaccine.

RESULTSThe eucaryotic expression vector of myostatin coupled TT epitope was constructed successfully through the restriction analysis and sequencing. The recombinant plasmids pVAC-TT-Ms met quality criterion as gene vaccine by analysis OD260/280 and electrophoresis. The myostatin expression was detected obviously in transfected CHO. The forelimb grip in immunized mice had an obvious increase. The average value of forelimb grip of the mice immunized with pVAC-TT-Ms was about 29.88% greater than that of control mice.

CONCLUSIONThe construction of eucaryotic expression vector of myostatin coupled TT epitope is successful in expression for recombinant human mature peptide of myostatin. The gene vaccine of myostatin meet quality criterion. The immunized mice has an obvious increase in forelimb grip.

Animals ; CHO Cells ; Cricetinae ; Cricetulus ; Epitopes, T-Lymphocyte ; Genetic Vectors ; Hand Strength ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Muscle, Skeletal ; physiology ; Myostatin ; genetics ; immunology ; Plasmids ; Transfection ; Vaccines, DNA ; genetics ; immunology

Objective To evaluate the multimodal treatment outcomes and patterns of treatment failure in esthesioneuroblastoma at a single institution. Methods One hundred and twelve patients who were newly diagnosed with esthesioneuroblastoma but no distant metastasis in our institution from 1979 to 2014 were retrospectively analyzed. The treatment modes, outcomes, and patterns of treatment failure in these patients were analyzed. According to the modified Kadish staging system, the numbers of patients with stage A, B, C, and D esthesioneuroblastoma were 1, 23, 60, and 28, respectively. Fifty?one patients received surgery and postoperative radiotherapy with or without chemotherapy;forty?six patients received radiotherapy with or without chemotherapy;eleven patients received preoperative radiotherapy and surgery with or without chemotherapy;three patients received surgery with or without chemotherapy; one patient received chemotherapy alone. The survival rates were calculated using the Kaplan?Meier method. Results In all patients, the 5?year sample size was 44, and the 5?year overall survival ( OS ) and disease?free survival ( DFS) rates were 66?4% and 54?7%, respectively. The 5?year OS and DFS rates were 91% and 82% in patients who received preoperative radiotherapy and surgery with or without chemotherapy, 80% and 66% in patients who received surgery and postoperative radiotherapy with or without chemotherapy, and 46% and 37% in patients who received radiotherapy with or without chemotherapy. Three patients treated with surgery alone had relapse of the disease;one patient treated with palliative chemotherapy survived 6 months. Treatment failed in 47 ( 42%) out of 112 patients. In patients with failed treatment, 53% had distant metastasis as the first pattern of treatment failure, 36% had locoregional relapse, and 11% had concurrent distant metastasis and locoregional relapse. Conclusions Surgery combined with radiotherapy is still the recommended multimodal treatment regimen for esthesioneuroblastoma. The multimodal treatment achieves satisfactory local?regional control rate and treatment outcomes in the treatment of esthesioneuroblastoma. The major pattern of treatment failure is distant metastasis.