OBJECTIVETo study the safety and efficacy of three-dimensional conformal radiotherapy in combination with temozolomide in treatment of patients with diffuse brainstem glioma.

METHODSTwelve patients with MRI-confirmed diffuse brainstem glioma received 54 Gy three-dimensional conformal radiotherapy for 6 weeks with 1.8 Gy per fraction, 5 times per week. All of the patients were given daily oral temozolomide 75 mg/m(2) during radiotherapy. Four weeks after radiotherapy, all of the patients received 6 cycles of temozolomide, each cycle lasted 5 days with 28 days interval between each two cycles. 150 mg/m(2) of temozolomide was given for the first cycle for five days, followed by 200 mg/m(2) of the drug for the rest of the cycles if no significant drug-related toxicities were observed. Magnetic resonance imaging and laboratory tests were performed to evaluate the efficacy and adverse reactions.

RESULTSIn the 12 patients, CR was 1 case (8.3%), PR 6 cases (50.0%), SD 2 cases (16.7%), and PD 3 cases (25.0%). The overall clinical benefit rate was 75.0%. Progression-free survival rate was 75.0% (9/12) at 6 months and 50.0% (6/12) at 1 year. The one-year overall survival rate was 75.0%. There were no severe temozolomide-related toxicities.

CONCLUSIONSConcurrent temozolomide with three-dimensional conformal radiotherapy and followed by 6 cycles of temozolomide chemotherapy for diffuse brainstem gliomas have a better clinical efficacy, good tolerance and with no severe toxicities.

Adolescent ; Adult ; Antineoplastic Agents, Alkylating ; adverse effects ; therapeutic use ; Brain Injuries ; etiology ; Brain Stem Neoplasms ; pathology ; therapy ; Chemoradiotherapy ; Child ; Dacarbazine ; adverse effects ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Female ; Glioma ; pathology ; therapy ; Humans ; Leukopenia ; chemically induced ; Male ; Middle Aged ; Radiation Injuries ; etiology ; Radiotherapy, Conformal ; adverse effects ; methods ; Remission Induction ; Survival Rate ; Young Adult

Objective To investigate the clinical effects of minimally invasive poking reduction technique in the treatment of single segment thoracolumbar fractures without neural impairment.Methods From February 2011 to June 2015,83 cases of thoracolumbar fractures without neural impairment underwent minimally invasive pedicle screw fixation in Linyi Central Hospital were selected and randomly divided into two groups.Group A (40 cases) was treated with poking reduction technique by percutaneous polyaxial pedical screw fixation,43 patients in group B were treated with only percutaneous polyaxial pedicle screw fixation.The perioperative index,pre-and postoperative radiography,relief of the low back pain and general health status of the two groups were recorded and compared.Results There were no statistically significant differences in the operation time,operative blood loss,hospitalization time.All patients were followed up for 20-27months (average 24 months),the scores of visual analogue scale (VAS) and Oswestry disablity index(ODI) had no statistically significant differences between the two groups in the same period(all P ＞ 0.05).Before operation,the Cobb angle,sagittal index and anterior height of the fracture vertebral body in group A were (66.3 ± 14.2) ％,(20.4 ± 6.5) °,(21.9 ± 6.6) °,respectively,which in group B were (64.8 ± 13.5) ％,(14.5 ± 7.7) °,(15.6 ± 5.9) °,respectively,the differences were not statistically significant (all P ＞ 0.05).After operation,the Cobb angle,sagittal index and anterior height of the fracture vertebral body in group A were (93.8 ± 9.8)％,(5.3 ± 3.3) °,(5.4 ± 2.0) °,respectively,which in group B were (88.0 ± 10.6) ％,(4.1 ± 2.8) °,(8.1 ± 4.7) °,respectively,the differences were statistically significant (t =8.893,2.345,3.351,all P ＜ 0.01).Conclusion The effect of poking reduction technique by percutaneous polyaxial pedical screw fixation is better than simply polyaxial pedicle screw in the treatment of thoracolumbar fracture,which is a safe and effective operation method.

The comparative efficacy of 2 anthelmintics (ivermectin and levamisole) against Baylisascaris transfuga migrating and encapsulated larvae was studied in mice. A total of 60 BALB/c mice inoculated each with about 1,000 embryonated B. transfuga eggs were equally divided into 6 groups (A-F) randomly. Mice of groups A and B were treated with ivermectin and levamisole, respectively, on day 3 post-infection (PI). Mice of groups A-C were killed on day 13 PI. Similarly, groups D and E were treated with ivermectin and levamisole, respectively, on day 14 PI, and all mice of groups D-F were treated on day 24 PI. The groups C and F were controls. Microexamination was conducted to count the larvae recovering from each mouse. The percentages of reduction in the number of migrating larvae recovered from group A (ivermectin) and B (levamisole) were 88.3% and 81.1%, respectively. In addition, the reduction in encapsulated larvae counts achieved by ivermectin (group D) and levamisole (group E) was 75.0% and 49.2%, respectively. The results suggested that, to a certain extent, both anthelmintics appeared to be more effective against migrating larvae than encapsulated larvae. However, in the incipient stage of infection, ivermectin may be more competent than levamisole as a larvicidal drug for B. transfuga.
Animals ; Anthelmintics/*administration & dosage ; Ascaridida Infections/*drug therapy/parasitology ; Ascaridoidea/*drug effects ; Disease Models, Animal ; Female ; Ivermectin/*administration & dosage ; Larva/drug effects ; Levamisole/*administration & dosage ; Male ; Mice ; Mice, Inbred BALB C ; Rodent Diseases/drug therapy/parasitology ; Treatment Outcome

OBJECTIVETo investigate the number of drinking occasions per day and average amount consumed per drinking occasion of primary and middle school students in four cities of China, and understand the relationship among drinking occasion, average amount consumed per drinking occasion and total drinking water.

METHODSA total of 5914 primary and middle school students from Beijing, Shanghai, Guangzhou and Chengdu were selected using multiple-stage random sampling method, and 5868 students completed the study from September to October in 2011. The detailed information of amounts and types of daily drinking water was recorded by subjects using a 24 hours measurement for seven consecutive days. Analysis of the relationship among drinking occasion, average amount consumed per drinking occasion and total drinking water was carried out.

RESULTSThe daily total drinking water of subjects was (1089 ± 540) ml; the daily number of drinking occasions was (4.7 ± 1.8) times, with 79.1% (4639/5868) of subjects reporting 6 or less drinking occasions. The amount consumed per drinking occasion was (239 ± 96) ml, plain water (231 ± 112) ml, and beverages (237 ± 112) ml. The number of drinking occasions of subjects was positively correlated with total drinking water (r = 0.614, P < 0.05), and negatively correlated with the average amount consumed per drinking occasion (r = -0.211, P < 0.05). Total drinking water and the average amount consumed per drinking occasion was positively correlated (r = 0.598, P < 0.05).

CONCLUSIONThe number of drinking occasion of primary and middle school students more than 6 times was fewer in four cities of China, but the average amount of beverages consumed per drinking occasion was relatively more. With the increasing of drinking occasion, the average amount consumed per drinking occasion decreased, but total drinking water increased.

Adolescent ; Beverages ; Child ; China ; Diet Surveys ; Drinking ; Drinking Water ; Female ; Humans ; Male ; Students ; Surveys and Questionnaires ; Urban Population

To investigate the expression of phospholipase C-gamma1 (PLC-gamma1) in mouse embryonic tissues, serial tissue sections were prepared routinely for immunocytochemistry for PLC-gamma1. The results showed that PLC-gamma1 was expressed in the cartilage, skeletal muscles, myocardium, the collecting tubule of the kidney, connective tissues and the brain, suggesting the important role PLC-gamma1 and the related signal pathway may play in the development of mouse embryonic tissues.
Animals ; Brain ; embryology ; enzymology ; Cartilage ; embryology ; enzymology ; Embryo, Mammalian ; enzymology ; Female ; Fetal Heart ; enzymology ; Immunohistochemistry ; Kidney ; embryology ; enzymology ; Mice ; Muscle, Skeletal ; embryology ; enzymology ; Phospholipase C gamma ; biosynthesis ; Pregnancy

OBJECTIVETo compare the clinical effects and graft outcomes of 4 surgical approaches for nephrectomy in living related kidney donors.

METHODSBetween June, 2004 and June, 2007, 119 living related kidney donors underwent nephrectomy via different surgical approaches, and their clinical data were retrospectively analyzed. Of these donors, 22 received retroperitoneal open nephrectomy, 21 had retroperitoneoscopic nephrectomy, 13 had hand-assisted laparoscopic nephrectomy, and 63 underwent transperitoneal open nephrectomy. The operating time, warm ischemia time of the graft, renal graft artery and vein lengths, reduction rate of recipient serum creatinine in the first 3 days after renal transplantation, mean hospital stay and complications of the donors were compared between the 4 surgical approaches.

RESULTSOpen surgeries were associated with significantly shorter operating time (P=0.0033) and warm ischemia time of the graft (P=0.0001), longer hospital stay (P=0.0000), higher hospital expenses (P=0.0000), faster postoperative reduction of recipient serum creatinine (P=0.0001), and longer renal artery and vein lengths (P=0.0000 on the left and P=0.0001 on the right) than laparoscopic surgeries. In the laparoscopic surgery group, subcutaneous emphysema occurred in 1 case, DGF in 2 cases, and lumbar vein hemorrhage in 2 cases for which open surgery was performed. In the open surgery group, only one case required reoperation due to adrenal gland hemorrhage. All the kidney grafts were successfully harvested without other complications observed in the donors.

CONCLUSIONSBoth open and laparoscopic surgeries are safe for nephrectomy in living related kidney donors, and the selection of the surgical approaches depends on the kidney and donor conditions and the surgical proficiency of the surgeons.

Adult ; Female ; Humans ; Kidney Transplantation ; Laparoscopy ; methods ; Living Donors ; Male ; Middle Aged ; Nephrectomy ; methods ; Retrospective Studies ; Tissue and Organ Harvesting

Objective To investigate the molecular mechanism of sulforaphane(Sul)promoting bone marrow stem cells(BMSCs)differentiating into osteoblasts.Methods BMSCs were divided into the control group(without any treatment),induction group(induction of osteogenic differentiation),and induction+Sul group(induction of osteogenic differentiation with the addition of 40 μmol/L of Sul).The adenovirus-shRNA-Mock,-shRNA-TET1,-shRNA-TET2,and-shRNA-TET3 were transfected into BMSCs as the shRNA-Mock group,shRNA-TET1 group,shRNA-TET2 group,and shRNA-TET3 group.BMSCs were cultured in cell culture medium containing osteogenic differentiation induction medium and 40 μmol/L of Sul,and then transfected with adenovirus-shRNA-TET1,-shRNA-TET2,-shRNA-TET3,and-shRNA-Mock as the induction+Sul+shRNA-TET1 group,induction+Sul+shRNA-TET2 group,induction+Sul+shRNA-TET3 group,and induction +Sul+shRNA-Mock group.The mRNA and protein expression levels of Runx2 after BMSCs differentiated into osteoblasts were determined by qPCR and Western blot.The DNA content of Runx2 promoter region bound to Histone H3 after BMSCs differentiated into osteoblasts was determined by chromatin immunocoprecipitation(ChIP).The methylation level of Runx2 promoter region of BMSCs differentiated into osteoblasts was determined by HpaⅡenzyme and MspⅠenzyme digestion combined with qPCR.The degree of BMSCs differentiated into osteoblasts was determined by alizarin red staining.Results Compared with the induction group,the mRNA and protein expression levels of Runx2 in the induction+Sul group were significantly increased(P<0.05);the content of DNA in the Runx2 promoter region bound to Histone H3 was increased(P<0.05),the methylation level of Runx2 promoter region was reduced(P<0.05),and the alizarin red staining score was elevated(P<0.05).Compared with the induction+Sul group,the content of DNA in the Runx2 promoter region bound to Histone H3 in the induction+Sul+shRNA-TET1 group was decreased(P<0.05),the methylation level of Runx2 promoter region was increased(P<0.05),and the alizarin red staining score was decreased(P<0.05).While there was no significant change among the induction+Sul+shRNA-TET2 group,induction+Sul+shRNA-TET3 group,induction+Sul+shRNA-Mock group(P>0.05).Conclusion Sul can promote the differentiation of BMSCs into osteoblasts through promoting DNA demethylation of Runx2 promoter region by TET1.

Objective To survey the prevalence of greenhouse farmer's lung and related risk factors in part of rural areas of Liaoning Province.Methods Using uniform scheme,procedures and questionnaire,a survey for 5420 farmers(2660 men and 2760 women)with complete data who work inside greenhouses was performed in Shenyang,Xinmin,Chaoyang,and Jinzhou between August 2006 and June 2009.Pulmonary function tests was performed for every active farmer.Results Greenhouse farmer's lung was diagnosed in 308 cases,205 men(66.55%,205/308)and 103 women(33.44%,103/308),a prevalence of 5.7%(308/5420).The prevalence rate of greenhouse farmer's lung in males was significantly higher than that in females(?2=39.93,P0.05).In the 308 cases,the number of patiernts presented with fever chill,cough/sputum,chest tightness/shortness of breath were 180(58.44%),192(62.34%),160(51.95%)respectively,and the number of crepitations,radiological changes,spirometry abnormalities and serum IgE antibodies(+)was 164(53.25%),153(49.68%),147(47.73%)and 136(44.16%)at the time of the study.62.34%(192/308)of patients with greenhouse farmer's lung were mild and 38.66%(116/308)were severe.Conclusion The total prevalence rate of greenhouse farmer's lung in part of rural areas of Liaoning Province was 5.7% and multiple risk factors were associated with the disease.

This article reports a patient with extensive high-pressure injection injury of the hand caused by mistaken injection of polyurethane material into the index finger, who was diagnosed and treated in the Department of Orthopedics of Huzhou Central Hospital in 2019. Both the digital artery and digital nerve were involved, and the polyurethane involved the right palm along the flexor tendon sheath of the index finger and wrist. Due to the lack of X-ray development, the scope of the first debridement was small, and the blood supply to the fingertip was poor. Finally, the patient's right index finger was amputated due to infection and necrosis. MR or B-ultrasound should be perfected before operation to clarify the extent of polyurethane involvement. The initial thorough debridement or multiple debridements are necessary to improve the prognosis. If the blood supply of the fingers is poor, the blood supply can be reconstructed by skin flap transplantation.
Finger Injuries/surgery* ; Humans ; Polyurethanes/adverse effects* ; Plastic Surgery Procedures ; Skin Transplantation ; Surgical Flaps/surgery* ; Treatment Outcome

【Objective】 To investigate the expression and significance of phosphorylated receptor tyrosine kinase(p-AXL) in diffuse large B cell lymphoma(DLBCL), and the clinical value of its co-expression with BCL-2 and /or c-MYC split gene. 【Methods】 Totally 118 cases of DLBCL were collected in the First Affiliated Hospital of Sun Yat-sen University from 2012 to 2017, and prepared as tissue array. p-AXL, c-MYC and BCL-2 proteins were detected by immunohistochemistry, and c-MYC split gene was detected by FISH staining. 【Results】 p-AXL protein was stained on tumor cells’membrane or in the cytoplasm of DLBCL cells. p-AXL was expressed more commonly in Non-GCB type than in GCB type. The expression of p-AXL was significantly correlated with the chemotherapy effect(P<0.01), and the expression of c-MYC split gene or BCL-2 protein separately(P<0.01). Co-expression of p-AXL and c-MYC, or BCL-2, or both of them was significantly correlated with the Hans typing(P<0.01). The PFS of p-AXL positive patients was obviously lower than that of p-AXL negative patients(P<0.05). The OS of p-AXL positive patients was also lower than that of the negative patients, but the difference had no statistical significance(P>0.05). Univariate analysis showed that p-AXL and male, p-AXL and Non-GCB type, p-AXL and c-MYC co-expression, p-AXL and c-MYC and/or BCL-2 co-expression were the risk factors for PFS and OS in DLBCL patients(P<0.05). Multivariate analysis showed that p-AXL positive in male(P<0.05) and p-AXL/c-MYC co-expression(P<0.01) were independent risk factors for PFS and OS in DLBCL patients. 【Conclusions】 p-AXL protein is expressed in DLBCL, and its expression is significantly related to the expression of c-MYC and BCL-2. p-AXL expression is associated with lower chemotherapy response rate, shorter progression-free survival and shorter overall survival. p-AXL/c-MYC co-expression or p-AXL positive in male may be an independent prognostic factor for DLBCL patients.