Objective: To study the clinical manifestations of the head and neck angiosarcoma and the re-lationship of the staging with clinical treatment and prognosis. Methods: The clinical data of 21 patients with head and neck angiosarcoma treated in our hospital between January 1993 and January 2008 were retro-spectively analyzed. By studying the medical records of all patients and reviewing the related literatures, we discussed the clinical manifestations of these patients and the relationship of staging with clinical treatment and prognosis of head and neck angiosarcoma based on soft tissue sarcoma staging of AJCC2002' 6th. SPSS 17.0 software was used for statistical analysis. We calculated the survival rate using Kaplan-Meier method and compared the survival curves using log rank test. Results: Among these 21 cases, 10 were treat-ed with non-combined treatment, and the other 11 cases were treated with combined treatment. There were 6 stage Ⅰ cases, 3 stage Ⅱ cases, 1 stage Ⅲ case, and 11 stage Ⅳ cases. The 1-, 3-, 5- and 10-year total sur-vival rates were 72.2%, 41.3%, 27.5% and 13.8%, respectively. The average time of recurrence or metastasis was 4 months. Twelve cases had local recurrence (accounting for 57.1%), and 11 cases had distant metasta-sis (accounting for 52.4%). The metastatic sites included lymph node in 5 cases, lung in 4 cases, liver in 1 case, and bone in 1 case. Different treatment modalities (χ~2=8.31, P=0.004) and tumor staging (χ~2=9.74, P=0.002) were prognostic factors. Conclusion: There are no unified treatment strategies for angiosarcoma of the head and the neck. The overall prognosis is still not ideal. Biological treatment has been applied to clinical practice. Preoperative combined treatment has positive results. Tumor staging is an important factor affecting the prognosis. Surgery-based combined treatment can improve patient survival.

Exosome is a self-secreted phospholipid bilayer nanovesicles, and has shown great potential in drug delivery field due to the important advantages of low immunogenicity and homologous targeting. Phototherapy, mainly includes photodynamic therapy (PDT) and photothermal therapy (PTT), utilize light to activate photoactive drug for tumor cell killing. The advanced therapeutic strategy shows low toxic side-effect and non-invasion precise advantages, and thus has made great progress in tumor treatment over the past few years. Therefore, using exosomes as a drug delivery system to deliver phototherapeutic agents can improve therapeutic performances with a reduced side-effect, and further enhance their application potential for clinical tumor therapy. This review focus on the rising cross-subjects field involving exosomes and phototherapy, and mainly introduce the research progress and relative case of exosomes-based delivery system for cancer phototherapy. Additionally, the advantages and challenges of exosome-based phototherapy are also discussed and proposed.

Adult ; Aged ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Neoplasm Recurrence, Local ; diagnostic imaging ; Neoplasm, Residual ; diagnostic imaging ; Positron-Emission Tomography

Adult ; Facial Neoplasms ; Facial Nerve ; Humans ; Male ; Neurilemmoma

Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Neck ; surgery ; Thyroidectomy ; methods ; Young Adult

Objective To assess the efficacy of mycophenolate mofetil (MMF) combined with prednisone in the treatment of idiopathic membranous nephropathy (IMN) patients with positive serum phospholipase A2 receptor (PLA2R) antibody.Methods An open prospective study was performed on twenty-four biopsy-proven IMN patients with positive serum PLA2R antibody in Guangzhou First People''s Hospital from June 2012 to June 2016.The 24 patients were divided into two groups: MMF group in which MMF combined with prednisone was given for 12 months and CTX group in which intravenous cyclophosphamide (CTX) was monthly given combined with oral prednisone.Results After 6 months of immunosuppressive therapy,complete remission and partial remission rates were 25.0% vs.16.7% and 25.0% vs.25.0% in the MMF group and CTX group,respectively (P>0.05).In the MMF group and CTX group,serum PLA2R antibody in the same amount (8/12,66.7%) of patients turned negative.At the end of twelve-month treatment,all patients with negative PLA2R antibodies achieved complete or partial remission.Clinical remission (including complete and partial remission) rates in the MMF group and CTX group were both 66.7%.After immunosuppressive therapy,the levels of proteinuria and serum albumin in the two groups were significantly improved,but no significant difference were found between the two groups (proteinuria:F within-grouP=98.688,P<0.01;F between-grouP=0.133,P=0.719;F cross-grouP=1.223,P=0.304;serum albumin:F within-grouP=30.629,P<0.01;F between-grouP=0.137,P=0.715;F cros-grouP=0.455,P=0.565).At the end of six and twelve months of treatment,the proteinuria (after six months,MMF group: (2 893±2 515) mg/g vs.(6 236±2 117) mg/g,t=-3.522,P=0.002;CTX group: (2 690±2 254) mg/g vs.(5 386±2 447) mg/g,t=-2.808,P=0.010;after twelve months,MMF group:1 025(99-4 635) mg/g vs.(6 236±2 117) mg/g,Z=-3.291,P<0.0005;CTX group: (775(41-3 517) mg/g vs.(5 386±2 447) mg/g,Z=-3.118,P=0.001) and serum albumin levels (after six months,MMF group: (28.5±9.7) g/L vs.(19.8±4.4) g/L,t=2.841,P=0.012;CTX group: (29.0±7.6) g/L vs.(22.3±4.1) g/L,t=2.690,P=0.016;at the end of twelve months of treatment,,MMF group: (32.4±8.5) g/L vs.(19.8±4.4) g/L,t=4.570,P<0.0005;TX group: (32.2±7.9) g/L vs.(22.3±4.1) g/L,t=3.862,P=0.001) of the two groups were better than those prior to treatment.Conclusion For the IMN patients with positive serum PLA2R antibody,MMF combined with prednisone was as effective as conventional CTX combined with prednisone in the negative conversion of PLA2R antibody and the remission.The negative conversion of PLA2R antibody after 6 months of immunosuppressive treatment was an important indicator of predicting the remission.

Objective To investigate the changes of serum diamine oxidase(DAO) levels in patients with severe acute pancreatitis(SAP) and their relationship with computed tomography severity index(CTSI) score and gastrointestinal dysfunction.Methods A total of 60 SAP patients were recruited into group SAP,the other 40 healthy people were recruited into control group,DAO,lactic acid,tumor necrosis factor-α(TNF-α),intestinal trilobites factor(ITF),cream ball epidermal growth factor 8(MFG-E8) were compared in the two groups.Results DAO,lactic acid,TNF-α in SAP group with onset within 72 hours were(3.09±1.33)U/mL,(928.50±69.37)ng/mL and (269.41±31.85)pg/mL,which were significantly higher than(1.20±0.58)U/mL,(311.64±38.25)ng/mL and (38.24 ± 3.03)pg/mL in the control group,the differences were statistical significant(P<0.05).The serum levels of ITF,MFG-E8 in SAP group were(3.60±0.35)ng/mL,(81.49±27.32)pg/mL,which were significant lower than(4.39±0.26)ng/mL,(234.17±49.08)pg/mL in the control group,the differences were statistical significant(P<0.05).In the SAP group,the serum levels of DAO showed significant positive correlations with D-lactate,TNF-α levels,CTSI score,APACHEⅡ score,gastrointestinal dysfunction score(P<0.05),but had significant negative correlation with ITF,MFG-E8(P<0.05).Conclusion Serum DAO level evaluated significantly in patients with SAP,and closely related to the severity of the disease and the dysfunction of the gastrointestinal tract.

Objective To investigate clinieopathologic characteristics and therapy of local advanced welldifferentiated thyroid carcinoma.Methods Data of 23 cases of advanced well-differentiated thyroid carcinoma treated from Jan.1996 to Dec.2005 were retrospectively reviewed.The data included age,pathologic type,local invasion,operative plan,postoperative complications and survival duration.Results Histology showed there were 15 cases of papillary carcinoma,6 ca8es of follicular carcinoma,and 2 cases of papiIlary follicular carcinoma.8 cases had local invasion into recurrent laryngeal nerve,12 cases had invasion into trachea,3 cases had trachea and esophagus invasion,and 8 cases had suprahyoid muscle invasion.All the 23 cases underwent resection procedure.According to surgical procedure,they were divided into radical resection group(n=6),tumor resection group(n=14)and tumor debulking group(n=3).2 cases received radiotherapy after thyroidectomy in tumor debulking group.All patients were followed up.Overall survival rate after 1 year,3 years and 5 years Was 91.3%(21/23),82.6%(19/23),and 60.8%(14/23)respectively.Prognosis of radical tumor removal group and tumor resection group was obviously better than that of tumor debulking group.Conclusions Prognosis is good for local advanced well-differentiated thyroid carcinoma patients receiving resection.Protection of local organ function Can enhance postoperative life quality.

AIM:To test the hypothesis that wild-type p53 regulates the expression of p-glycoprotein. METHODS: While Hep3B cells lack expression of both p53 and retinoblastoma tumor suppressor genes because of deletions, were transfected to a wild-type (wt) p53 cDNA and control vector by a liposome method. After G418 selection, stable wt-p53 transformants, and control vector transformants (pNeo) were obtained. The expression of the p53,p21 and P-gp was analyzed by Northern or Western blot methods. In both transformants, cytotoxic effect of doxorubicin and mitomycin was evaluated by MTT assay, and accumulation of doxorubicin was detected by flow cytometer. RESULTS: In wt-p53 transformants, induction of transcriptionally active p53 was confirmed by the increase of P21 waf1/cip1 protein. Levels of P-gp reduced in the cells expressing wild-type p53 were linked to wt-p53 activity. The wt-p53 transfectants were more sensitive to doxorubicin and mitomycin compared with the pNeo transformants, and the accumulation of doxorubicin in the wt-p53 transfectants was 13 times as much as pNeo transformants. After both transformants were treated with doxorubicin at 0.2 mg/L for 24 hours, apparent apoptosis occurred in the wt-p53 transrormants. CONCLUSION: Restoration of wt-p53 activity in Hep3B leads to more sensitive to chemotherapeutic agents because of decrease of p-glycoprotein expression.

Objective To discuss causes and corresponding prevention for groin pain occurred early after total hip arthroplasty(THA).Methods A retrospective study was done on 189 cases(193 hips)treated with THA including unilateral procedures in 185 hips and bilateral procedures in eight hips to analyze common causes for early groin pain.Results Groin pain was found in 9.3% hips(18/ 193)during hospital stay,including 1.6%(3 cases)with deep infection,1.6%(3 cases)with incision infection,1%(2 cases)with posterior dislocation,4.1%(8 cases)with leg lengthening and 1%(2 cases)with hematoma.Conclusions Despite of the numerous diagnostic alternatives available to the orthopedic surgeon,detailed history,careful physical examination,necessary laboratory and imaging stud- ies can contribute to a correct determination of causes for groin pain.Meanwhile,appropriate indication, accurate preoperative radiographic measurement,intraoperative standardized surgical procedures and per- fect rehabilitation are necessary to avoid complications.