0. 05). Conclu-sion The THT and THC have bioequivalence.

Ear ; surgery ; Humans ; Parotid Neoplasms ; surgery ; Surgical Procedures, Operative ; methods

OBJECTIVETo investigate the frequency of micrometastasis in levels lII - IV of clinical negative neck (cN0) in patients with squamous cell carcinoma (SCC) of oral tongue, and to discuss the management of cervical lymph node for cN0 tongue SCC.

METHODSA total of 471 cervical lymph nodes derived from 25 patients with cN0 tongue SCC, including 263 lymph nodes in level III and 208 lymph nodes in level IV, were included in this study. All lymph nodes were re-examined by anti-cytokeratin (CK) immunohistochemical staining combined with semi-serial section per 500 microm.

RESULTSAmong the 25 cases, seven patients were confirmed harboring metastasis in 11 lymph nodes of level III, and no positive lymph node in level IV was detected by routine hematoxylin-eosin (HE) staining. 11 positive lymph nodes in level IIl, which confirmed by HE staining, were also detected by immunohistochemical staining with CK combined with semiserial section. Among the 460 cervical lymph nodes in which HE staining did not show metastasis, only one lymph node in level III harboring a 2.0 mm x 1.5 mm micrometastasis was detected by immunohistochemical staining with CK, and no positive lymph node in level IV was detected by immunohistochemical staining with CK.

CONCLUSIONThe frequency of occult metastasis in level IV was very low, so it seemed unnecessary to dissect level IV for all patients with cN0 tongue SCC.

Adult ; Aged ; Carcinoma, Squamous Cell ; Female ; Humans ; Keratins ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck ; Neoplasm Micrometastasis ; Tongue ; Tongue Neoplasms

OBJECTIVETo evaluate speech outcomes in patients of maxillary reconstruction with free fibula composite flap.

METHODSSpeech measurements of 20 patients of maxillary reconstruction with free fibula composite flap were collected. Palatopharyngeal valve, the symmetry and movement of soft palate, hypernasality and nasal emission were examined by nasoendoscopy. At the same time the speech intelligibility was measured.

RESULTSNo palatopharyngeal valve insufficiency was found and all the soft palates had good symmetry and movement. The average speech intelligibility was 98.4%.

CONCLUSIONSFree fibula composite flap can reconstruct the phonatory structure and support the function of soft palate, which can restorate speech function well. It is a good choice for maxillary reconstruction.

Adult ; Female ; Fibula ; Humans ; Male ; Maxilla ; surgery ; Middle Aged ; Speech Intelligibility ; Surgical Flaps

OBJECTIVETo compare the impact of various types of neck dissection on postoperative shoulder function.

METHODSThe shoulder functions of 66 patients with oral squamous cell carcinoma (OSCC) and cN0 necks who underwent various types of neck dissection were evaluated by Constant's shoulder function test and neck dissection impairment index at least 12 months after surgery.

RESULTSThe patients with accessory spinal nerve reserved had better shoulder function than those with accessory spinal nerve resected. In the group with accessory spinal nerve reserved, the patients receiving selective neck dissection (SND) showed better shoulder function than those with modified radical neck dissection (MRND). The shoulder dysfunction and pain arising from SND were minor in patients with selective neck dissection.

CONCLUSIONSThe shoulder function after SND was superior to those after RND and MRND.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; physiopathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Mouth Neoplasms ; pathology ; physiopathology ; surgery ; Neck Dissection ; methods ; Shoulder ; physiopathology

The objective of this study was to explore the clinical significance of measuring serum free light chains (sFLC) and to compare with serum total light chains (free and binded) in multiple myeloma (MM). sFLC in 20 newly diagnosed MM patients and 20 cases of healthy people as control were measured by immuno-nephelometric assays; the serum light chains and kappa/lambda ratio were measured in all patients, while immunofixation electrophoresis (IFE) tests were carried out at the same time in 18 out of 20 patients. The results showed that the abnormality of serum free light chains and kappa/lambda ratio were found in all of the 20 newly diagnosed MM patients (p < 0.01). The measurement of sFLC showed higher sensitivity than the total serum chains (p < 0.01). It is concluded that the method testing sFLC by immuno-nephelometric assay combined with kappa/lambda ratio is valuable for MM diagnosis, and the measurement of sFLC can be used as one of indicators for MM diagnosis.
Adult ; Aged ; Biomarkers, Tumor ; blood ; Female ; Humans ; Immunoglobulin kappa-Chains ; blood ; Immunoglobulin lambda-Chains ; blood ; Male ; Middle Aged ; Multiple Myeloma ; blood

OBJECTIVETo explore the correlation between the exposure levels and serum protein fingerprints in population exposed to silica.

METHODSLiquid chip time-of-flight mass spectrometry technology was used to investigate the serum profiles in control group (30 cases), group exposed to silica (30 cases), silicosis group (I stage, 25 cases) and suspected silicosis group (30 cases), and screen the differential expression proteins. The correlation between the levels of the differential expression proteins and the exposure levels was performed.

RESULTSFive differential expression proteins were found among 4 groups, the expression of 5081 and 5066 proteins was upregulated, and the expression of 3954, 2021 and 1777 proteins was downregulated. There was no the correlation between the exposure levels and the peak with M/Z among those proteins.

CONCLUSIONthe results of present investigation indicated there was no correlation between the exposure levels and protein/peptide peak.

Adult ; Blood Proteins ; analysis ; Case-Control Studies ; Dust ; analysis ; Female ; Humans ; Male ; Mass Spectrometry ; Middle Aged ; Occupational Exposure ; analysis ; Peptide Mapping ; Proteomics ; Silicon Dioxide ; toxicity ; Silicosis ; blood

OBJECTIVETo observe anti-HEV IgG response to vaccination of recombinant antigen fragments and evaluate its protection from Hepatitis E Virus infection in rhesus monkeys (Macaca mulatta).

METHODSTwelve monkeys were divided into three groups and immunized respectively with three different recombinant antigens: namely Ag1 (carboxyl terminal 431 amino acids of ORF2), Ag2 (128aa fragment at the carboxyl terminal of ORF2), and Ag3 (full length ORF3 ligated with two ORF2 fragments encoded by 6743-7126nt and 6287-6404nt). The monkeys were challenged intravenously with fecal suspension from experimentally infected rhesus monkeys, and the other three monkeys served as the placebo group for challenge with HEV. The dynamic changes of the levels of ALT and anti-HEV IgG were examined. Pathological changes of liver tissue were observed by light microscope. Excretion of virus was detected by RT-nPCR.

RESULTSHepatic histopathology of two monkeys in the placebo group was consistent with acute viral hepatitis, and ALT was elevated 3-4 weeks after inoculated with virus, up to 10-20 times higher than normal level. The liver tissue of monkeys immunized with antigen kept normal, ALT in several monkeys elevated mildly, and anti-HEV IgG conversation occurred at 1-2 weeks after vaccination, with the titer reaching 1:12,800. The virus RNA could be detected by RT-nPCR from days 7 to 50 in monkeys of control group, and from days 7 to 21 in vaccinated monkeys after challenged with virus.

CONCLUSIONSThe recombinant antigens could induce the production of anti-HEV IgG, which protected rhesus monkeys from acute Hepatitis symptoms related to HEV infection.

Animals ; Antigens, Viral ; immunology ; Hepatitis E ; prevention & control ; Hepatitis E virus ; immunology ; Immunoglobulin G ; immunology ; Macaca mulatta ; RNA, Viral ; blood ; Recombinant Proteins ; immunology ; Vaccination ; Viral Hepatitis Vaccines ; immunology

OBJECTIVETo research the efficacy,security and necessity of combined therapy for preventing postsurgery stiffness after elbow fracture.

METHODSFrom May 2009 to April 2010, 60 patients with elbow fractures treated by operation were randomly divided into two groups: combined therapy group and past procedure group. Thirty patients in the combined therapy group,including 12 males and 18 females, ranging in age from 23 to 63 years, averaged (43.53 +/- 7.74) years old; 15 patients had two parts fractures, including humeral intercondylar fractures combined with olecroanon and (or) ulna coronoid process fractures in 8 cases, fractures of exterior and interior humeral condyle combined with capitulum radius in 3 cases, fractures of olecroanon and ulna coronoid process in 3 cases, fractures of olecroanon and capitulum radius in 1 case; other 15 patients had one part fractures, including fractures of exterior or interior humeral condyle in 8 cases,fractures of olecroanon or ulna coronoid process in 6 cases, fractures of capitulum radius in 1 patient. Thirty patients in the past procedure group,including 11 males and 19 females, ranging in age from 24 to 67 years, averaged (46.13 +/- 6.22) years; 15 patients had two parts fractures, including fractures of humeral intercondylar fracture combined with olecroanon and(or) ulna coronoid process in 7 cases, fractures of exterior and interior humeral condyle combined with capitulum radius in 2 cases,fractures of olecroanon and ulna coronoid process in 5 cases,fractures of humeral intercondylar fracture combined with capitulum radius in 1 patient; 15 pa- tients had one part fracture, including fractures of exterior or interior humeral condyle in 6 cases, fractures of olecroanon or ulna coronoid process in 8 cases, fractures of capitulum radius in 1 patient; the patients in the past procedure group were treated with past procedure methods. Mayo Elbow Performance Score (including gmotion of elbow joint) and security (using X-ray to recheck displacement fracture, internal fixation failure and heterotopic ossification) were evaluated at postoperative 6 months. From 2002 to 2006, 30 patients were reviewed as historical control group, including 17 males and 13 females, ranging in age from 27 to 62 years, averaged (47.17 +/- 7.83) years; 15 patients had two parts fractures, including fractures of humeral intercondylar combined with olecroanon and(or) ulna coronoid process in 7 cases, fractures of exterior and interior humeral condyle combined with capitulum radius in 1 case, fractures of olecroanon and ulna coronoid process in 6 cases, fractures of ulna coronoid process and capitulum radius in 1 case; 15 patients had one part fractures,including fractures of exterior or interior humeral condyle in 9 cases, fractures of olecroanon or ulna coronoid process in 5 cases,fractures of capitulum radius in 1 case. The Mayo Elbow Performance Score of the patients in historical control group was evaluated retrospectively at postoperative 6 months and the results were compared with that of past procedure group.

RESULTSMayo score of combined therapy group was (91.00 +/- 7.81)surpassed to (76.83 +/- 10.71) of the past procedure group and (73.17 +/- 1.99) of historical control group (F = 24.98, P < 0.05). The range of motion of elbow was (102.40 +/- 9.16) degrees of combined therapy group surpassed to (83.57 +/- 6.21) degrees of the past procedure group (t = 9.325, P < 0.05). There were no internal fixation loose,obvious fracture displacement and heterotopic ossification in each X-ray examination of patients in the combined therapy group. The Mayo score of historical control group was (73.17 +/- 11.99), showing no significant differences when compared with (76.83 +/- 10.71) of the past procedure group (LSD, P = 0.172).

CONCLUSIONCombined therapy including different stage, different method combination and different subject to practice to prevent postsurgery stiffness after elbow fracture is effect, security and necessity.

Adult ; Aged ; Case-Control Studies ; Combined Modality Therapy ; Elbow Joint ; injuries ; surgery ; Female ; Fractures, Bone ; surgery ; Humans ; Joint Diseases ; physiopathology ; prevention & control ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

Objective To evaluate the additional role of 99mTc-MIBI SPECT-CT imaging before parathyroidectomy (PTX) for secondary hyperparathyroidism (SHPT) patients.Methods A total of 359 SHPT patients from the First Affiliated Hospital of Nanjing Medical University were enrolled in the study from April 2011 to January 2016.Patients were divided into two groups according to the difference of 99mTc-MIBI imaging techniques preoperatively.Patients in group A had dual-phase 99mTc-sestamibi parathyroid scintigraphy performed only.Patients in group B had SPECT-CT parathyroid scintigraphy added in the early phase.With the parathyroid glands confirmed by pathology after operation being the referencc,scnsitivity,specificity,consistency and surgical success rates of the patients in two groups were compared.Results 359 patients (166 men and 193 women) were enrolled,among which 339 on hemodialysis and 20 on peritoneal dialysis.The average age of those patients was (45.90± 11.20) years and median dialysis age was 84 (60.0,120.0) months.Total detection sensitivity,specificity,consistency in group A (169 patients) were 65.54％,56.52％,65.24％ and in group B (190 patients) were 73.84％,84.62％,74.21％ respectively.Total sensitivity and consistency were higher in group B than those in group A (P ＜ 0.01),while no difference in total specificity was observed between two groups (P=0.055).In group A,detection sensitivity of parathyroid glands were 47.56％,77.44％,57.14％ and 79.88％ in right upper gland (RU),right lower gland (RL),left upper gland (LU) and left lower gland (LL) respectively.Consistency in group A were 48.52％,77.51％,56.21％ and 78.70％ respectively.In group B,sensitivity were 58.33％,83.78％,69.78％ and 82.89％ in RU,RL,LU and LL respectively.Consistency in group B were 59.47％,84.21％,70.53％ and 82.63％ respectively.Sensitivity and consistency of upper glands were lower than lower glands in both groups (P ＜ 0.01).When SPECT-CT was added,sensitivity and consistency of upper glands for both sides were higher in group B than those in group A,while no difference of surgical success rates was found between two groups (87.57％ vs 92.63％,P=0.107).Conclusion 99mTc-MIBI SPECT-CT can be combined with anatomic image effectively and increase the sensitivity and consistency of total and upper parathyroid glands.It can also make the accurate location of the lesions,which improves the efficiency of the operation.