Objective To summarize the key point of application of acellular dermal matrix(ADM)in operative cooperation of pharyngeal tissue repair.Methods In order to rebuild the air-tight cavity,ADM was sewn to the anterior vertebrae fascia in 7 patients with pharyngeal malignant tumor undergoing total laryngectomy or pharyngolaryngectomy to rebuild the posterior wall of the laryngopharynx.Meanwhile the muscular flap of the pectoralis major Was used to rebuild the anterior and lateral walls of the laryngopharynx.Results There was no reject reaction or pharyngeal fistula in these 7 cases and the wound surface were all mucous membranized.All the incisions reached the primary healing.Conclusions ADM is easy to get and possesses good histocompatibility and compatible thickness.It is easy to be managed during operation and can modify the peripharyngeal defect with the combination of muscular flap of the pectoralis major or any other neck tissue.Strict nursing preparation before operation and perfect cooperation during operation are key steps to complete the surgery successfully.

Objective To observe the effects of recombinant human interleukin 11(rhIL-11) on proliferation, migration and invasion of A549 cells, and the mechanism thereof. Methods Final concentrations of 0, 10, 20, 50 and 100μg/L rhIL-11 were added into pulmonary adenocarcinoma A549 cells. The cell proliferation was detected by MTT. The wound-healing, transwell migration assay were used to validate the capability of the migration and invasion of A549 cells. Matrix metallopro-teinases (MMP)-2 and MMP-9 protein expressions were revealed by Western blot assay. Results The proliferation of A549 cells was not significantly changed by rhIL-11. The cell capability to migrate and invade was significantly increased 24 h af-ter treatment with rhIL-11 (P<0.05). The expression levels of MMP-2 and MMP-9 were significantly un-regulated, and which were increased with the increased concentrations of rhIL-11 (P<0.05). Conclusion rhIL-11 can promote the migra-tion and invasion of A549 cells, and the up-regulation of MMP-2 and MMP-9 expression might be one of the mechanisms.

BACKGROUND:In allogene hematopoietic stem cell transplantation,the choice of preconditioning scheme is an important link of the success of hematopoietic stem cell transplantation,and a major research direction of stem cell transplantation.The myeloablative pretreatment scheme has great toxicity,and pretreatment related death rate is high.Thus,it is necessary to explore an ideal pretreatment scheme to expect a decrease in side effects and relapse.OBJECTIVE:To observe the effect of modified Bu/CY pretreatment regimen for treating hematologic malignancies.METHODS:The 8 patients were selected at the Department of Hematology,Haikou Municipal People's Hospital Affiliated to Xiangya School of Medicine,Central South University from November 2003 to March 2008,and received modified Bu/CY pretreatment:cytarabine 2.0-3.0 g/(m2·d)×2 d,intravenous drip,for 24 consecutive hours;myleran 4 mg/(kg·d)×3 d;cyclophosphamide 50 mg/(kg·d)×2 d;methyl-cyclohexyl nitrosourea 25 mg/(m2·d)×1 d;antithymocyte globulin 25 mg/(kg·d)×4 d. We have increased the arabinosylcytosin dose twice,and changed to a 24-hour infusion via intravenous drip,so that pretreatment strength was increased and promote lasting implantation of hematopoietic stem cells,based on the modified program.Graft-versus-host disease(GVHD)prevention:cyclosporin A and mycophenolate mofetil would be used advanced to minus 7 days (one day before stem cell transfusion is minus 1)based on the classic methotrexate regimen.The ABO blood group changes and DNA were tested in patients before and after ransplantation.RESULTS AND CONCLUSION:①The detection of hematopoietic reconstitution after transplantation:All patients have received hematopoietic reconstitution,with no pretreatment-related death.The white blood cells reduced to 0 after-3- +7 days of hematopoietic stem cell transplantation,and continues to(3-22)days,+10- +21 days white blood cells ＞ 1.0×109/L,+11- +51 days,platelets ＞ 20x109/L.②Incidence of GVHD:of 8 patients,there were GVHD Ⅳ grade(intestinal)in 1 case,acute graft-versus-host disease grade Ⅰ-Ⅱ in 3 cases.Above-mentioned results indicated that the further modification of BU/CTX2 regimen may be an effective pretreatment program,with a few side effects,which is better than the classic total-body irradiation/CY regimen.What's more,it is simple accurate,reliable rote of anti-leukemia and will be a safe and effective method for treating hematologic malignancies.

BACKGROUND: Effective mobilization and collection of hemopoietic stem cells are initial factors for peripheral stem cell transplantation, while they make sure a permanent reconstruction of hemopoiesis. Mobilization and collection have been developed; however, the collection is more, and the yield of hemopoietic stem cells is various. OBJECTIVE: To investigate the best time of mobilization and collection of peripheral blood stem cells from healthy donors. METHODS: A total of 16 donors who were selected from Haikou People's Hospital between January 2003 and December 2008 were randomly divided mobilization group (A, n=6) and mobilization + collection group (B, n=10). A group was subcutaneously injected with 5.0-10.0 μg/(kg·d) recombinant human granulocyte colony-stimulating factor (rhG-CSF) (Filgrastim), and B group was treated with rhG-CSF and intravenously injected with 10 mg dexamethasone. Peripheral stem cells were collected twice in each group. The two groups were collected at the fourth and 5~(th) day of mobilization after the second or 4th hour subcutaneous injection of rhG-CSF. The collection was 4.0-5.0 mL, the manhandled volume was 3.0-5.0 mL, and the total blood volume was 6.7-10.1 L. RESULTS AND CONCLUSION: Number of mononuclear cells was (4.0-8.0)×10~8 kg~(-1) in the two groups. The cell concentration of fourth hour was higher than the second hour after rhG-CSF treatment (P < 0.05). The mononuclear cell concentration of fourth hour was higher than the second hour after the fourth and 5~(th) day of rhG-CSF treatment. Our research showed that we could collect sufficient amount of cells (to a high concentration) by one time, which had reasonable collection time - value-effectiveness relationship, when the cycle blood volume was 1.8-2.2 times of circulating blood volume.

Objective To evaluate the correlation between the expression level of Nanog gene and clinical outcomes of GP regimen in the advanced non-small cell lung cancer (NSCLC).Methods 62 patients of NSCLC were treated by GP method,and the outcomes were investiged between Nanog positive and nagetive patients.The expression level of Nanong was evaluated by RT-PCR and immunohistology.Results 30 out of 62 patients (48.4 ％) were Nanog positive,9 patients (28.1％) were Nanog positive,and 23 out of 32 patients were Nanog negative (71.9 ％) who have the positive effect (CR+PR).However,among 32 treatment nagetive cases,there were 21 cases (70.0 ％) who were Nanog positive and 9 cases (30.0 ％) were Nanog negatve.Survival analysis showed that 5-years lifetime of Nanog positive patients was shorter than Nanong nagetive patients.Conclusion Nanog overexpression decreases the sensitivity of GP regimen and lifetime of NSCLC patient.Nanog expression level may provide a useful factor for clinical treatment and prognosis of NSCLC patient.

Objective To evaluate the effect of neoadjuvant chemotherapy on advanced gastric cancer before laparoscopic radical gastrectomy.Methods 46 advanced gastric cancer cases in our hospital from January 2010 to January 2013 were included in experimental group who were given two courses of neoadjuvant chemotherapy with FOLFOX regimen prior to surgery,the responsives (38 cases) received two more courses of neoadjuvant chemotherapy before surgery,and those in whom the chemotherapy was judged as ineffective (8 cases),received radical gastrectomy 21 days later.As a control,36 diseasematched cases went on upfront surgery without neoadjuvant chemotherapy.All these 82 cases underwent successful laparoscopic gastrectomy.Results The overall effective rate of neoadjuvant chemotherapy was 59％.Before the operation,the differences of pathological staging between the two groups were significantly different; The difference in operation time,the intraoperative blood loss and harvested lymph node number between the experimental group and control group was not statistically different (P ＞ 0.05).The R0 resection rate in experimental group (63％) was higher than in the control group (36％),P ＜0.05.The recurrence rate and mortality rate in experimental group was lower than that in the control group,P ＜ 0.05.Conclusions In advanced gastric carcinoma preoperative neoadjuvant chemotherapy significantly improved the resection rate and reduced postoperative recurrence and mortality rate.

Background and purpose:High expression of excision repair cross-complementing 1 (ERCC1) is related to resistance in patients treated with platinum-containing regimens. The ERCC1 antibody 8F1 was usually used in past studies, but it was found to have no-speciifcity recently. This study aimed to investigate the predictive role of a new ERCC1 antibody 4F9 to platinum chemotherapy in non-small cell lung cancer (NSCLC) patients. Methods:Expression of ERCC1 was detected using antibody 4F9 by immunohistochemistry (IHC) in 72 NSCLC tissues. The relationship between the expression of ERCCl and the clinical pathological parameters, the efficacy of platinum chemotherapy and overall survival of patients were explored by statistical analysis. Results: The high expression of ERCCl protein was 55.5%in 72 cases. There was no signiifcant correlation between the ERCC1 expression with gender, age, pathological type, clinical stage and lymphatic metastasis (P>0.05). Patients with low expression of ERCC1 had signiifcantly higher response rates to platinum chemotherapy, longer median survival time and 2-years survival rate comparing with those with high expression of ERCC1 (62.5%vs 37.5%;22.9 vs 18.4 month;46.9%vs 37.5%), respectively (P<0.05). Conclusion:The expression analysis of ERCC1 using new ERCC1 antibody 4F9 by IHC method is helpful to assign chemotherapeutic regimen, and guide individual platinum chemotherapy for post-operation patients.

Objective To explore the effect of the self-designed cotton-padded covering for a modified lithotomy position on preventing complications in the lower limbs in patients undergoing gynecological laparscopic surgery.Methods A total of 320 patients undergoing radical hysterectomy or deep invasive endometriosis were selected and randomly divided into an observation group(n=160) and a control group(n=160).The patients in the control group were placed on the routine lithotomy position,the lower extremity and popliteal space protected with oasis outline cushion in the control group,while the patients in the observation group were placed on the same pads,the lower extremity and popliteal space protected with the self-designed cotton-padded coverings.Results The average temperature of the lower limbs of patients after operation in the observation group was significantly higher than that in the control group (P<0.01).The incidences of complications in the observation group were significantly lower than those in the control group(all P<0.05). Conclusion The self-designed cotton-padded covering for modified lithotomy position can effectively prevent the complications of the lower limbs and improve the comfort of patients.

Objective To investigate and evaluate the clinical value of full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas.Methods Seventy-two patients,who underwent full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas,were selected from the Medical Center of Pituitary Adenomas of our hospital from January 2009 to March 2012.To retrospectively investigate pre- and post-operation symptoms,hormone levels,images information,operation information,complications,following-up information and so on.Results Among the 72 consecutive patients,there were 22 nonfunctioning adenomas,twenty-four prolactin secreting adenomas,seven somatotropin secreting adenomas,five adrenocorticotropic hormone secreting adenomas,one thyrotropin secreting adenomas,and 13 multi-secreting adenomas.The tumor removal was total in 56(77.8％),subtotal 13(18.0％),and partial 3(4.2％).Five cases had CSF leaks,and 6 diabetes insipidus.After 3-24 months of follow-up,the levels of increasing-hormone declined to normal levels in most patients.Conclusion Full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas is a kind of technique which is safe,minimally invasive,having less complications and fast recovery.However,it is necessary for surgeons to accept systematic and specialized training,and own advanced equipments.