OBJECTIVE: To investigate the feasibility of utilizing pedicled sternocleidomastoid clavicular periosteocutaneous flap to reconstruct the laryngotracheal defect after tumor resection. METHOD: To review 6 cases of laryngotracheal defect resulting from resction of thyroid papillary carcinoma(4/6) or subglottic laryngeal carcinoma (2/6) (T1~2N1~2M0 , UICC,2002), laryngotracheal stenting was also employed in all cases. Half a year after surgery, the stoma was sutured if no local recurrence took place and safety was proved after tracheal tube had been obstructed for days. The follow-up time lasted from half a year to 3 years. RESULT: Four cases (4/6) were extubated successfully without event, one case could intermittently plug the tracheal tube. One patient couldn't breath with tracheal tube plugging. CONCLUSION To reconstruct the laryngotracheal defect with pedicled sternocleidomastoid clavicular.periosteocutaneous flap after tumor resection is feasible in selected cases and could get satisfactory clinical results either in respiration or phonation.
Back ; Carcinoma ; surgery ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Clavicle ; Head and Neck Neoplasms ; Humans ; Laryngeal Neoplasms ; surgery ; Larynx ; Neck Muscles ; Neoplasm Recurrence, Local ; Reconstructive Surgical Procedures ; Squamous Cell Carcinoma of Head and Neck ; Stents ; Surgical Flaps ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; surgery

Gene knockout by ZFNs (zinc-finger nucleases) is efficient and specific, and successfully applied in more than 10 organisms. Currently, it is unclear whether this technology can be used for knocking-out enhanced green fluorescent protein (EGFP) gene in transgenic goats. Here we constructed and used ZFN-coding plasmids to produce genetic knockouts in the cells of cloned fetus produced from donor cells by microinjection of EGFP gene. Following introduced plasmids into caprine primary cultured fetus fibroblasts by electroporation, targeting of a transgene resulted in sequence mutation. Using the flow cytometric analysis, we confirmed the disappearance of EGFP expression in treated cells. Sequence from PCR products corresponding to targeted site showed that insertion of a G into the exon of EGFP resulted in frame shift mutation. These results suggest that ZFN-mediated gene targeting can apply to caprine fetus fibroblasts, which may open a unique avenue toward the creation of gene knockout goats combining with somatic cell nuclear transfer.
Animals ; Base Sequence ; Cloning, Organism ; Electrophoresis ; Endonucleases ; genetics ; metabolism ; Fetus ; Fibroblasts ; metabolism ; Gene Knockout Techniques ; Gene Targeting ; methods ; Goats ; Green Fluorescent Proteins ; genetics ; Molecular Sequence Data ; Mutation ; Zinc Fingers

Objective To explore the efficacy of a new elastic suspension strap orthosis, designed by the authors, in improving the motor function and walking ability of stroke patients. Methods Thirty-nine stroke pa-tients less than 1 month after stroke were recruited and divided randomly into a treatment group and a control group. The patients in the treatment group accepted walking training with the assistance of an elastic suspension strap orthosis, 5 times a week for 8 weeks, while the control group accepted the same training without the assistance of the elastic suspension strap orthosis. Results The treatment group improved significantly more than the control group with regard to its average Fugl-Meyer score, the functional ambulation categories of its members, and their walking speeds. Conclusions The elastic suspension strap orthosis could help correct abnormal gait patterns, improve walking speed, and enhance the recovery of walking ability in stroke patients.

Objective To explore the relationship between dietary patterns and non alcoholic fatty liver disease (NAFLD) in Karamay adults.Methods A total of 2377 subjects aged 20-75 years old who took health check-up during April and June 2011 were included in this investigation.Body mass index (BMI),waist to hip ratio (WHR),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),total cholesterol (TC),aspartate aminotransferase (AST) and serum uric acid (SUA)were measured.Food intake patterns and life style of the participants were accessed by using food frequency questionnaire (FFQ).Main component analysis and multivariate logistic regression model were used to explore the association of dietary patterns with NAFLD.Results Five dietary patterns were identified,including condiment dietary pattern, western dietary pattern, conventional healthy dietary pattern,snacks and bean pattern,and high protein dietary pattern.Subjects of condiment dietary pattern,western dietary pattern or conventional healthy dietary pattern showed significantly different prevalence of NAFLD (x2 values were 149.873,8.247 and 18.766,respectively; all P ＜ 0.05).In condiment dietary pattern,age,BMI,WHR,SUA and TG were significantly different in Q4 group (F values were 8.42,5.64,12.78,10.72 and 9.63,respectively; all P ＜0.05).For those with western dietary pattern,age,WHR,SBP,SUA,TC and TG showed significant different trend (F values were 9.84,6.87,6.11,10.61,6.87 and 8.13,respectively; all P ＜ 0.05).However,subjects with conventional healthy dietary pattern showed a significant different trend of age,BMI,WHR,SBP,SUA and AST (F values were 19.13,11.09,13.89,6.11,15.12,6.19,respectively ; all P ＜ 0.05).After age,BMI,WHR,SBP,SUA,AST,TC and TG were adjusted,the risk of NAFLD of those with condiment pattern or western pattern were significantly increased (odds ratio (OR) were 1.33 (95％ confidence interval (CI) 0.95-1.87) and 1.36 (95％ CI 0.979-1.902),respectively).Conclusion Dietary pattern may be associated with NAFLD.People need to learn healthy dietary habit to prevent NAFLD.

OBJECTIVE: To investigate cervical esophageal reconstruction by means of laryngo-tracheal flap after resection of hypopharyngeal carcinoma with cervical esophageal involvement. METHOD: Eleven cases of hypopharyngeal carcinoma with cervical esophageal involvement. Unilateral piriform sinus and cervical esophagus were involved in 8 cases (8/11) while bilateral piriform sinus, posterior pharyngeal wall and cervical esophagus were involved in 3 cases. After resection of laryngeal, pharyngeal and esophageal tumors and bilateral neck dissection, direct anastomosis of larynx and trachea with esophagus of cervico-thoracic segment was performed if circular structure of larynx and trachea could be preserved (3/11), pectoralis major myocutaneous flap was employed if only part of pharynx and larynx could be preserved (8/11). Postoperative radiochemotherapy was adopted and follow-up lasted for 1-5 years. RESULT: All cases healed without event except for one case of pharyngeal fistula and one case of chylous fistula which also healed after about 2 weeks dressing change. All patients got normal diet without anastomotic stricture. There was no recurrence in 6 patients at the 3 years follow-up, 4 patients had metastases in the neck and 1 patient had thoracic esophageal carcinoma with hepatic metastasis arid gave up further treatment. The overall 3-year survival rate was 54.5%. CONCLUSION Using laryngo-tracheal flap to reconstruct cervical esophagus after resection of hypopharyngeal carcinoma with cervical esophageal involvement is a recommendable method that is simple in processing, reliable in effect and less in postoperative complications.
Carcinoma, Squamous Cell ; Esophagus ; pathology ; Head and Neck Neoplasms ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Larynx ; Neck ; Neck Dissection ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Pharynx ; Postoperative Complications ; Reconstructive Surgical Procedures ; Squamous Cell Carcinoma of Head and Neck ; Surgical Flaps ; Survival Rate

AIM: A new HPLC-MS method was developed to determine finasteride in human plasma. METHODS: Two formulations of finasteride tablets were given to 20 healthy male volunteers according to a randomized 2-way cross-over design. The samples were extracted by ethyl acetate under basic conditions, then were separated by C18 column and determined by mass detector. RESULTS: The calibration curve of finasteride was linear and intra-day and inter-day RSD were less than 10 %. The pharmacokinetics parameters of the two formulations (4.5 ± 0.5) h for t1/2; (3.0 ± 0.7) and (2.8 ± 0.9) h for tmax, respectively. The results indicated that there was no significant difference on cmax, A UC0-24, t1/2 or tmax values between the two formulations. CONCLUTION: The relative bioavailability of tablets I with respect to tablets Ⅱ is (99.3 ± 9.2) % by the A UC0-24 measurement, and bioe quivalence is observed between the two tablets.

Objective To evaluated the effectiveness and safety ofLianhua Jizhi Tablets for acute trachitis and bronchitis with syndrome of phlegm-heat obstructing.Methods A randomized double-blind, placebo-controlled and multi-center clinical trial design was selected. Totally 240 cases were randomly divided into experimental group and control group, 120 cases in each group, of which 237 cases were included in the analysis of FAS. Experimental group was givenLianhua Jizhi Tablets, while control group was given placebo, 12 tablets/day, 7 days for a course. Curative effect of acute trachitis and bronchitis, TCM syndrome and disappearance of cough, cough and sputum symptom scores and area under the curve (AUC) were observed. The safety was evaluated. Results The cure rates of disease in experimental group and control group were 66.67% (78/117) and 29.17% (35/120), respectively;cure rates of TCM syndrome in experimental group and the control group were 68.38% (80/117) and 27.50% (33/120), respectively;there was statistically significant difference in area under the curve of cough and sputum symptom score between the two groups (P<0.01). Disappearance rates (cure) of daytime cough in experimental group and control group were 52.99% (62/117) and 13.33% (16/120), respectively;disappearance rates (cure) of nocturnal cough in experimental group and control group were 76.52% (88/115) and 31.90% (37/116), respectively;there were no side effects in experimental group.ConclusionLianhua Jizhi Tablets can significantly relieve clinic symptoms in the treatment of acute trachitis and bronchitis, and have good clinical efficacy and safety.

OBJECTIVETo evaluate the efficacy and safety of leflunomide in comparison with methotrexate (MTX) on patients with rheumatoid arthritis (RA) in China.

METHODSFive hundred and sixty-six patients with active rheumatoid arthritis were randomly assigned to receive leflunomide at 20 mg once daily or MTX at 15 mg once weekly in a controlled trial. Five hundred and four patients completed the 12-week treatment and some patients continued the treatment for 24 weeks.

RESULTSBoth leflunomide and MTX could improve the symptoms, signs, and joint function, but there were no changes in X-ray observations of patients with rheumatoid arthritis. In the leflunomide group, the overall rates of effectiveness at 12 weeks and 24 weeks were 86.94% and 92.31% respectively; the rates of remarkable improvement were 64.95% and 79.81% respectively. In the MTX group, the overall rates of effectiveness at 12 weeks and 24 weeks were 84.04% and 83.15% respectively; the rates of remarkable improvement were 56.81% and 75.28% respectively. According to intent-to-treat analysis, the ACR 20% response rates at 12 weeks and 24 weeks in the leflunomide group were 62.54% and 67.18% respectively, compared with 60.08% and 61.32% respectively in MTX group. No statistical differences were shown in the efficacy between the two groups (P > 0.05). The adverse events in the leflunomide group were gastrointestinal symptoms, skin rash, alopecia, nervous system symptoms, decreased leukocyte count, and elevation of alanine aminotransferase (ALT). Most of these side effects were mild and transient. The incidence of adverse events in the leflunomide group was 16.84%, significantly lower than that in MTX group (28.17%, P = 0.002).

CONCLUSIONSLeflunomide is effective in the treatment of RA with less adverse events than MTX. Its efficacy is similar to MTX, but the incidence of adverse events and the rate of withdrawal due to adverse events were lower in the leflunomide group than in MTX group.

Antirheumatic Agents ; adverse effects ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Female ; Growth Inhibitors ; adverse effects ; therapeutic use ; Humans ; Immunosuppressive Agents ; adverse effects ; therapeutic use ; Isoxazoles ; adverse effects ; therapeutic use ; Male ; Methotrexate ; adverse effects ; therapeutic use ; Middle Aged

Objective:To establish a method for quality evaluation of Myristica fragrans Houtt. Methods:The common peak was determined with Dehydroisoeugenol as the reference peak, and the HPLC fingerprint of Myristica fragrans was established; then the common peaks were analyzed by High Resolution Liquid Chromatography-mass Spectrometry (HPLC-MS). The chemical components of the common peaks were identified through the calculation and data retrieval of the primary and secondary mass spectra of the characteristic peaks. Results:The HPLC fingerprint of Myristica fragrans was established, and the similarity degree of the 10 batches of samples was above 0.9 and 11 common peaks were established. According to the results of HPLC-MS, the components of 11 common peaks were identified as follow: Methyl eugenol (peak 1), Licarin A (peak 2), Myristol (peak 3), OdoratisolA (peak 4), 2-(3,4-Dimethoxyphenyl) butynoic acid (peak 5), Malabaricon D (peak 6), 5'-Methoxydehydroisoeugenol (peak 7), Dehydroisoeugenol (peak 8), Malabaricone C (peak 9), 4-Methoxy-6-{(2S,3S)-7-methoxy-3-methyl-5-[(1E)-1-propen-1-yl]-2,3-dihydro-1- benzofuran-2-yl}-1,3-benzodioxole (peak 10) and Licarin B (peak 11). Conclusions:The quality of Myristica fragrans could be evaluate with HPLC fingerprint method. HPLC-MS was used to analyze the chemical composition of complex components, which will provide reference for the identification and analysis of chemical components of the extracts and preparations of Traditional Chinese Medicine.

In order to provide efficient medical care to atrial fibrillation patients in the community, the Huamu Community Health Service Center in association with its medical consortium, Renji Hospital have developed a novel atrial fibrillation management system. With the collaboration of general practitioners and specialist team from the tertiary hospital, a special clinic for atrial fibrillation has been set up in the community health service center, which is based on the internet technology and the medical consortium platform. This article introduces the development of this novel system and the initial outcome of the measures, to provide a reference for the management of atrial fibrillation patients in the community.