Background and purpose: The aim of this study was to determine the necessity of central compartment neck dissection in laryngeal cancer.Study Design: Retrospective study at a tertiary referral medical center. Methods:Patients with laryngeal squamous cell cancer who underwent neck dissection were evaluated, and a retrospective analysis of clinicopathologic factors and follow-up data were performed. Results: One hundred and eighteen patients from 1999 to 2009 were enrolled. There were 11.9% central compartment lymph node metastasis in all patients, including the 10 patients with central compartment lymph node metastasis in 34 patients underwent compartment neck dissection and 4 patients do not underwent compartment neck dissection but had central neck recurrence in the follow up time. Subglottic or pyriform extension were risk factors in central compartment lymph node metastasis and central neck recurrence (P=0.002). Central compartment lymph node metastasis had closed relationship with levelⅣmetastasis (P<0.001), extracapsular extension (P=0.001), vascular extension (P=0.015) and poor local control rates (P=0.035) respectively. Patients who were positive for lateral neck lymph node metastasis had poor disease-free survival rate (P=0.014) and poor local control rates (P=0.025), and supraglottic cancer had a trend to metastases to levelⅡ(P=0.044). Conclusion:Central compartment neck dissection might be considered a potential therapeutic approach for patients with laryngeal cancer.

Objective To report clinical study of diabetic foot with microsurgical treatment.Methods 32 cases basing on physical treatment underwent operation which included reconstruction of vessel under DSA and flap transfer and relaxation of nerves.Results 8 eases were examined with DSA after operation,it showed that the bypass grafts were unobstructed and the distal blood were improved;All flap were lively. Conclusion The ulcer of the patients with diabetic foot was closed early and the blood supply of the limb have been reconstructed by microsurgical treatment,it can not only avoid amputation or lower the limb amputation level,but also improve the life quality of patients and obtain social benefit.

OBJECTIVETo study therapeutic effects between hook plate fixation and modified Weaver-Dunn surgery for the treatment of acromioclavicular joint dislocation.

METHODSForty patients with fresh acromioclavicular joint dislocations of type III according to Rockwood classification were reviewed. All the patients were divided into two groups: hook plate fixation group and modified surgery group. There were 20 patients in hook plate fixation group, including 13 males and 7 females, with an average age of (37.45 +/- 14.29) years old; 12 patients had injuries in the left and 8 patients had injuries in the right; preoperative Constant-Murley score was 40.75 +/- 10.40. And there were 20 patients in modified surgery group,including 11 males and 9 females, with an average age of (41.65 +/- 14.83) years old; 11 patients had injuries in the left and 9 patients had injuries in the right; preoperative Constant-Murley score was 42.75 +/- 8.18. The Lazzcano standard, Constant-Murley score and imaging changes were used to evaluate shoulder joint function before and after surgery.

RESULTSAll the patients were followed up,and the duration ranged from 7 to 32 months,with an average of 24 months. According to Lazzcano evaluation, 16 patients got an excellent result,3 good and 1 poor in modified surgery group with no re-dislocation, and 1 patient had pain more than middle degree; while in hook plate fixation group, 9 patients got an excellent result, 7 good and 4 poor, 1 patient had re-dislocation, and 3 patients got pain more than middle degree. The therapeutic effects of modified surgery group were better than those of hook plate fixation group. Constant-Murley scores:preoperative 42.75 +/- 8.18 vs 93.40 +/- 4.04 at the latest follow-up in modified surgery group; preoperative 40.75 +/- 10.40 vs postoperative 88.40 +/- 4.81 and 92.05 +/- 4.49 at the latest follow-up in hook plate fixation group. The postoperative scores all improved compared to preoperative scores in two groups. And there was no statistical difference of scores at the latest follow-up between two groups.

CONCLUSIONThe surgery of allograft tendon transplantation combined with anchor fixation to strengthen coracoclavicular ligament, as well as part transposition of acromiocoracoid ligament and resection at the distal part of clavicle may got safety fixation and less postoperative complications compared with hook plate internal fixation.

Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Bone Plates ; Case-Control Studies ; Clavicle ; surgery ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; instrumentation ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the expression of thymidylate synthase (TS) in patients with advanced lung adenocarcinoma and its relation with the therapeutic effect of pemetrexed.

METHODSThe clinicopathological data of 38 patients with stage IIIIB/IV lung adenocarcinoma receiving pemetrexed treatment were retrospectively analyzed. The tumor samples of the patients were collected for detecting TS expression using RT-PCR, and the therapeutic effect of the treatment was analyzed.

RESULTSTS positivity was found in 26.32 (10/38) of the patients. TS positivity was not correlated to gender, TNM stage or PS score. The total response rate of pemetrexed treatment (CR+PR) was 34.21 (13/38) in these patients, and the rate was 39.29% (11/28) in TS-negative patients, as compared to 20.00% (2/10) in the positive patients (P=0.087). Patients with low TS expression had significantly higher control rate by pemetrexed treatment than those with TS overexpression [89.29% (25/28) vs 40.00% (4/10), P=0.002].

CONCLUSIONTS expression may serve as a potential indicator of chemosensitivity to pemetrexed in patients with advanced lung adenocarcinoma.

Adenocarcinoma ; drug therapy ; enzymology ; Antineoplastic Agents ; therapeutic use ; Female ; Folic Acid Antagonists ; therapeutic use ; Glutamates ; therapeutic use ; Guanine ; analogs & derivatives ; therapeutic use ; Humans ; Lung Neoplasms ; drug therapy ; enzymology ; Male ; Middle Aged ; Pemetrexed ; Retrospective Studies ; Thymidylate Synthase ; metabolism

OBJECTIVETo study the role of procalcitonin (PCT) in the diagnosis of acute pyelonephritis (APN) in children.

METHODSRetrospective analysis was performed on the clinical records of children aged under 3 years who were diagnosed with primary urinary tract infection (UTI) from September 2011 to February 2012. These children were divided into those with upper UTI (UUTI) (APN) and those with lower UTI (LUTI) (non-APN) based on 99mTc-dimercaptosuccinic acid (DMSA) renal scan results as a gold standard. The UUTI and LUTI groups were compared in terms of serum levels of PCT and C-reactive protein (CRP). Receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic values of serum PCT and CRP.

RESULTSSixty-five children with UTI, including 39 cases of APN and 26 cases of LUTI, were included in this study. The APN cases had significantly higher serum levels of PCT (3.08 ng/mL vs 0.37 ng/Ml; P<0.01) and CRP (6.25 mg/L vs 3.01 mg/L; P<0.01) than the LUTI cases. The sensitivity and specificity of serum PCT level for APN were 84.6% and 88.5%, respectively, with an area under the ROC curve (AUC) of 0.873 (95%CI=0.781-0.965) and an optimal threshold point of 1.03 ng/mL. The sensitivity and specificity of serum CRP level for APN were 71.8% and 69.2%, respectively, with an AUC of 0.735 (95%CI=0.612-0.858) and an optimal threshold point of 3.91 mg/L.

CONCLUSIONSAs a result of its high sensitivity and specificity for the disease, serum PCT can be used as a marker in the early diagnosis of APN in children.

C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Protein Precursors ; blood ; Pyelonephritis ; blood ; diagnosis ; ROC Curve ; Sensitivity and Specificity

INTRODUCTIONThis prospective observational case series aimed to determine whether the lateral decubitus position, which is commonly adopted during sleep, has an effect on intraocular pressure (IOP) in normal controls.

METHODSPatients without glaucoma were recruited from those visiting outpatient clinics for non-glaucomatous conditions. The left eye of each patient was included. IOP was first measured using Tono-Pen® XL applanation tonometer in the supine position, following which a second measurement was immediately obtained for the left lateral head position. Measurements were obtained with the patient lying on one soft and one hard pillow for each position, and patients remained awake during these measurements. One tonometry reading was obtained for each position. Readings were recorded only when the average of four independent readings produced a statistical confidence index of 5%. Results were analysed using the paired Student's t-test for comparison of the means.

RESULTSIOP in the left lateral decubitus position (17.48 ± 3.18 mmHg) was significantly higher than in the supine position (14.48 ± 3.09 mmHg) when using soft pillows (p < 0.001). When hard pillows were used, IOP in the left lateral decubitus position also exceeded that measured in the supine position (16.65 ± 3.54 mmHg vs. 13.65 ± 3.58 mmHg; p < 0.001). There was no statistically significant difference in the IOPs measured for the same position when different kinds of pillows were used.

CONCLUSIONThe lateral decubitus position adopted during sleep is associated with changes in IOP in healthy volunteers.

Adult ; Aged ; Female ; Glaucoma ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Posture ; Prospective Studies ; Sleep ; Tonometry, Ocular ; Wakefulness

This study was purposed to investigate the angiogenesis-promoting activities of human mesenchymal stem cells (hMSCs) modified by hepatocyte growth factor (HGF) and the underlying mechanisms. The hMSCs were transfected by recombinant adenoviral vector carrying human HGF gene and seeded onto the chicken chorioallantoic membrane. Three days later, the number of blood vessels was counted and their angiogenic response was compared with those of hMSCs of same generation, recombinant basic fibroblast growth factor (bFGF) and alpha-MEM as control. The expression levels of bFGF, VEGF, angiopoietin-1 and angiopoietin-2 were evaluated by RT-PCR assay. The results showed that gene-modified hMSCs exhibited greatest activity to promote angiogenesis while the angiogenic response was nearly same between groups treated by hMSCs and bFGF, all of which were significantly higher than that observed in control (p < 0.01). RT-PCR analysis revealed that hMSCs constitutively expressed multiple angiogenesis-associated growth factors and their levels seemed up-regulated by HGF gene transfer. It is concluded that HGF gene-modified hMSCs show a potent angiogenesis-promoting function and may be useful in the treatment of ischemic disorders.
Animals ; Cells, Cultured ; Chick Embryo ; Chickens ; Hepatocyte Growth Factor ; genetics ; Humans ; Mesenchymal Stromal Cells ; Neovascularization, Physiologic ; genetics ; Transfection

OBJECTIVETo investigate the effects of adefovir dipivoxil (ADV) on blood phosphorus metabolism in patients with chronic hepatitis B (CHB).

METHODSPatients with hepatitis B surface antigen (HBsAg)-positive CHB were treated with ADV alone, ADV combined with interferon (IFN), or ADV combined with lamivudine (LAM). Changes in levels of calcium, phosphate, urea, and creatinine were assessed at treatment weeks 4, 12, 24, 48, 72 and 96. Statistical analysis was carried out with SPSS 16 software; influential factors were analyzed by ANOVA and non-conditional logistic regression analysis.

RESULTSDuring the course of treatments, 32 (42.6%) of the patients presented with low phosphorus. The highest incidence of low phosphorus was found to have occurred at treatment week 24 (25.0%, 27.5% and 36.4% respectively, with no statistical difference between three groups, x2=0.225, P>0.225). Patients with hypophosphatemia did not show a significant difference in serum phosphorus levels from the other patients (F=1.853, P=0.169). Logistic regression showed a correlation between low phosphorus and sex (x2=7.876, P<0.05), age (t=2.479, P<0.05), and serum creatinine (t =-2.256, P<0.05), but not with blood urea nitrogen or blood calcium (P>0.05).

CONCLUSIONADV antiviral treatment can decrease the blood phosphorous levels of CHB patients, particularly over extended time of treatment, and the occurrence of low phosphorus is more common than of mild phosphorus decrease.Male and elderly patients may be at greater risk of this complication. The incidence and severity of low phosphorus is not significantly different for the different ADV-based treatment regimens.

Adenine ; analogs & derivatives ; Aged ; Antiviral Agents ; Creatinine ; Drug Therapy, Combination ; Hepatitis B, Chronic ; Humans ; Interferons ; Lamivudine ; Male ; Organophosphonates ; Phosphorus

Female ; Hearing Loss, Noise-Induced ; diagnosis ; Humans ; Leisure Activities ; Male ; Music ; Noise ; adverse effects

BACKGROUNDThere were some papers published in the Jonrnal of Science, December 2000 suggesting that one or more important susceptibility genes for late onset Alzheimer's disease (LOAD) were located on the long arm of chromosome 10. Linkage analysis showed maximum lod score close to D10S1225 loci, which indicated the loci might contribute to the etiology of Alzheimer's disease (AD).

METHODSFifty-nine LOAD patients and 107 controls were recruited. Apolipoprotein E (ApoE) genotypes were determined by reverse dot blotting hybridization assay. The D10S1225 was genotyped by 12% nondenaturing polyacrylamide gels electrophoresis and analyzed by silver staining. Statistical analysis was used to compare genotype and allele distributions between LOAD group and control group for ApoE and D10S1225 polymorphisms.

RESULTSApoE epsilon 4 was significantly higher in LOAD group in comparison with the control group (chi(2) = 6.530, P = 0.011). Seven different alleles of D10S1225 have been identified. The length of these gene fragments were 178 bp, 181 bp, 184 bp, 187 bp, 190 bp, 193 bp, and 196 bp, respectively. A total of 21 different genotypes were observed. There was no relationship between D10S1225 polymorphism and LOAD (chi(2) = 4.488, P > 0.05). Conclusion This study suggests that ApoE epsilon 4 is a risk factor for LOAD, however, the results indicated that there is not any possible linkage for disequilibria with a nearby AD risk gene near D10S1225.

Aged ; Aged, 80 and over ; Alleles ; Alzheimer Disease ; genetics ; Apolipoproteins E ; genetics ; Female ; Genotype ; Humans ; Linkage Disequilibrium ; Male ; Middle Aged ; Polymorphism, Genetic