Objective To investigate association between human leukocyte antigen DQB1 (HLADQB1 ) gene polymorphisms and bronchial asthma among Mongolian and Han nationalities. Methods Sequence-specific primer polymerase chain reaction (PCR-SSP) was used to detect frequencies of HLA DQB1 genotypes and alleles in 50 cases of Han and 68 Mongolian asthmatic patients, and 50 Han and 54 Mongolian healthy controls, respectively. Difference in gene frequencies between the two nationalities was estimated by odds ratio (OR) and chi-square test. Results Frequency of the HLA-DQB1 0602 allele was significantly higher in Han patients with bronchial asthma than that in healthy Han nationality (OR = 6.163,P ＜0.01 ). Frequency of the HLA-DQB1 0603/0608 allele decreased in Mongolian asthmatic patients, as compared to that in healthy Mongolians ( OR = 0.199, P ＜ 0.05 ). Frequency of the HLA-DQB1 0301/4 allele was significantly higher in Mongolian asthmatic patients as compared to that in healthy Mongolians ( OR =2.074,P ＜0.05). Frequency of the HLA-DQB1 0301/4 allele was significantly higher in Mongolian than that in Han asthmatic patients ( OR = 2.482 ,P =0.05). Frequency of the HLA- DQB1 0602 allele was significantly higher in healthy Mongolians than that in healthy Han nationality ( OR = 3.341, P ＜ 0.05 ), in contrast, frequency of the HLA-DQB1 0402 allele was significantly lower in healthy Mongolians than that in healthy Han nationality ( OR = 0.209, P ＜ 0.05 ). Conclusions The HLA-DQB1 0603/0608 allele is possibly a protective gene and the HLA-DQB1 0301/4 allele a susceptible gene for bronchial asthma in Mongolians, and the HLA-DQB1 0602 allele is possibly a susceptible gene for bronchial asthma in Han nationlity.

Objective To compare three kinds of irradiation treatment plans for cervical and upper thoracic esophageal cancer,in order to arrived at proper decision for the patient.Methods From February 2001 to June 2004,43 such patients were studied with three different simulated treatment plans made including conformal plan,conventional four-field plan and conventional two-field plan for every one.All plans were evaluated with iso- dose curve and dose-volume histogram.Results GTV on 95% isodose curve was 99.5%,98.2% and 87.4% in conforaml plan,conventional four-field plan and conventional two-field plan,respectively;PTV_1 and PTV_2 on 95% isodose with 97.8%,97.2%,94.8% and 95.8%,86.6%,73.7%.The volume of＞20 Gy dose of left lung accepted was 18.6%,17.2% and 32.3%,in conformal plan,conventional four-field plan and conventional two-field plan,respectively;the right lung received 20.5%,19.9% and 35.5%.Conclusions Conformal plan is the best in radiotherapy,as it can provide ideal dose distribution of irradiated target with adequate protection of the normal tissues.Conventional four-field plan,being easy to carry out,can replace the conformal plan in most situations.Conventional two-field has the most uneven dose distribution and largest lung volume irradiated.

Adolescent ; Adult ; Analgesics ; administration & dosage ; Anesthetics, Intravenous ; administration & dosage ; Flurbiprofen ; administration & dosage ; Humans ; Hypnotics and Sedatives ; administration & dosage ; Midazolam ; administration & dosage ; Middle Aged ; Molar, Third ; Pain Measurement ; Pain, Postoperative ; prevention & control ; Patient Satisfaction ; Preoperative Care ; Prospective Studies ; Tooth Extraction ; Young Adult

OBJECTIVETo investigate the feasibility of continuing warfarin when international normalized ratio (INR) was less than 2.5 before tooth extraction in the elderly.

METHODSOne hundred elderly outpatients with prolong use of warfarin and maintaining INR < 2.5 before tooth extraction served as observation group, 200 elderly outpatients without taking anticoagulant and antiplatelet medicine served as control group. All the patients underwent a single non-impacted tooth extraction. Postoperative bleeding at different time was observed.

RESULTSThere was significant difference in postoperative bleeding at 5, 10, 30 min, 24 h after extraction and there was no significant difference at 48 h between control group and observation group (P < 0.05) and no bleeding was found in either group at 48 h (incidence of bleeding were 0%).

CONCLUSIONSIt was feasible to continue warfarin for the elderly maintaining INR < 2.5 undergoing a single non-impacted tooth extraction by monitoring postoperative bleeding and hemostatic treatment measures.

Age Factors ; Aged ; Aged, 80 and over ; Anticoagulants ; administration & dosage ; adverse effects ; Female ; Humans ; International Normalized Ratio ; Male ; Middle Aged ; Postoperative Hemorrhage ; etiology ; Tooth Extraction ; adverse effects ; Warfarin ; administration & dosage ; adverse effects

OBJECTIVETo investigate the feasibility of continuation of aspirin before tooth extraction in the elderly.

METHODSThe patients enrolled in this study were the elderly requiring a single non-impacted tooth extraction. 300 elderly outpatients used lidocaine local infiltration anesthesia, 200 patients without using aspirin before tooth extraction served as control group I, 100 patients with prolong use of aspirin before tooth extraction as observation group I. 300 elderly outpatients used compound articaine local infiltration anesthesia, 200 patients without using aspirin before tooth extraction served as control group II, 100 patients with prolong use of aspirin before tooth extraction as observation group II.Bleedings at 5, 10, 30 min, 24 h after tooth extraction were observed and the relationship between postoperative bleeding and intake of aspirin was analyzed.

RESULTSThere was no significant difference at 5, 10, 30 min, 24 h in postoperative bleeding after extraction between control group I and observation group. The incidence of bleeding of observation group II after tooth extraction at 5 min was higher than that of control group II and there was no significant difference at 10, 30 min, 24 h between the two groups.

CONCLUSIONSContinuation of aspirin have no influence on postoperative bleeding. Therefore we suggest that there was no indication to discontinue aspirin for the elderly before a single non-impacted tooth extraction.

Aged ; Aged, 80 and over ; Anesthesia, Local ; Aspirin ; adverse effects ; Female ; Humans ; Lidocaine ; Male ; Middle Aged ; Oral Hemorrhage ; etiology ; Platelet Aggregation Inhibitors ; adverse effects ; Postoperative Hemorrhage ; etiology ; Tooth Extraction ; adverse effects

OBJECTIVETo analyze treatment and prognostic factors of 74 patients with dermatofibro-sarcoma protuberans (DFSP).

METHODSFrom August 1990 to November 1999, 74 patients with DFSP confirmed pathologically were treated. There were 52 males and 22 females with a median age of 37 years (range 4 to 80 years) on diagnosis. Seventeen patients were treated by extensive excision and 2 by limited excision. Fifty-two patients had surgical resection alone (S), and 22 postoperative radiotherapy (S + R) of 50-70 Gy. The multivariate parameters were analyzed using Cox model. Kaplan-Meier and Log-Rank test were used to evaluate the results of the recurrence-free survival.

RESULTSThe rate of recurrence was 28.4% for all patients. The 5-year recurrence-free survival rate (RFSR) was 66.6% and the 10-year RFSR was 52.5%. The 5-year and 10-year in the S group were 58.4% and 41.2%, compared with 90.0% and 83.3% in the S + R group (P < 0.05). The 5-year and 10-year RFSR in the pathologically positive margin group were 57.5% and 41.4% respectively, compared with the 75.0% and 56.6% in the pathologically negative group (P < 0.05). Multivariate analysis suggested radiotherapy and negative pathological margins were favorable prognostic factors.

CONCLUSIONPost-operation radiotherapy and pathological margin are the independent prognostic factors.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Combined Modality Therapy ; Dermatofibrosarcoma ; mortality ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Care ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Skin Neoplasms ; mortality ; radiotherapy ; surgery

OBJECTIVETo investigate the clinical features, treatment modalities and the prognosis of nasal type NK/T cell lymphoma.

METHODSThe data of 39 such patients treated from June 2000 to December 2003 were retrospectively reviewed. Twenty three patients were treated by combined chemoradiotherapy, basing on anthracycline-containing CHOP or similar regimens (median 5 cycles). Eleven patients by chemotherapy alone, 2 by radiotherapy alone and 2 aged patients by palliative chemotherapy or radiotherapy. Radiotherapy was given by high energy photon ray combined with electron beam with a median curative dose of 56 Gy in conventional fractionation. Bivariate correlations and univariate prognostic factors were analyzed.

RESULTSMedian follow-up time for the 21 patients who were still alive was 22.5 months. The overall remission rate (RR) after initial treatment was 66.7% (21 CR, 3 PR). Chemotherapy alone got a CR rate of only 37.5%. The overall local control rate was 59.4%. Local relapse rate after curative radiotherapy was 25.0%. Radiotherapy was positively correlated with local control (P = 0.000) and time to disease progression (TTP, P = 0.002). Skin and intestine were among the extranodal relapse sites. Fifteen patients had highly aggressive tumors with a median survival time of only 5 months. Univariate analysis showed that significant favorable survival prognostic factors were: radiotherapy (P = 0.001); lower risk International Prognostic Index (IPI, P = 0.001); complete remission after primary treatment (P = 0.000); pre-diagnostic history > 2 months (P = 0.024); and free of skin involvement (P = 0.034).

CONCLUSIONMost of nasal type NK/T cell lymphoma are in early stage when diagnosed. Radiotherapy remains to be the mainstay of treatment. Combined chemoradiotherapy needs further improvement for the progressive disease type. Some patients may have highly aggressive tumors with poor prognosis. Optimal prognostic factors and individualized treatment regimens need to be investigated.

Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Killer Cells, Natural ; Lymphoma, T-Cell ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Nose Neoplasms ; pathology ; therapy ; Prognosis ; Remission Induction ; Retrospective Studies

OBJECTIVETo improve the biological properties of decellularized aortic valves by polyethylene glycol (PEG)-mediated covalent incorporation of vascular endothelial growth factor (VEGF).

METHODSPEG crosslinking of decellularized aortic valves were completed via a Michael-type addition reaction, followed by covalent incorporation of VEGF through another Michael-type addition reaction between the unsaturated propylene acyl of PEG and the thiol groups on cysteine residues of VEGF. The effect of VEGF incorporation was evaluated by enzyme-linked immunosorbent assay (ELISA) and immune fluorescence assay. The endothelial progenitor cells (EPCs) were seeded on decellularized aortic valves with or without these modifications, and after 10 days of culture, the valves were examined for DNA content and by hematoxylin-eosin staining and scanning electron microscopy.

RESULTSImmune fluorescence and ELISA showed that the maximal VEGF incorporation on the decellularized aortic valve reached 908.94∓0.27 pg. Compared with the unmodified valves and the valves with PEG crosslinking, decellularized aortic valves with covalent incorporation of VEGF significantly promoted the adhesion and proliferation of EPCs, which formed a confluent cell monolayer on the valve surface.

CONCLUSIONSPEG-mediated covalent incorporation of VEGF in the decellularized aortic valves improves the adhesion and proliferation of the seeded EPCs to facilitate the construction of tissue-engineered heart valves.

Animals ; Aortic Valve ; drug effects ; Cell Adhesion ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Endothelial Cells ; cytology ; drug effects ; Heart Valve Prosthesis ; Polyethylene Glycols ; pharmacology ; Stem Cells ; cytology ; drug effects ; Swine ; Tissue Engineering ; Vascular Endothelial Growth Factor A ; pharmacology

OBJECTIVE: To evaluate the relevant indicators affecting difficulty in the extraction of impacted mandibular third molars and score difficulty of different operation and risk indicators, so as to build an intuitive and accurate scale to help operators make more accurate analysis and prediction of difficulty before the operation. METHODS: Based on literature and the clinical review, the difficulty indicators of tooth extraction were summarized. Firstly, 10 doctors from Peking University School and Hospital of Stomatology who had been engaged in alveolar surgery for a long time established an expert nominal group, and then rated whether the summarized indicators needed to be retained in the form of face-to-face questionnaires. A level 1 and 2 item frame for evaluating difficulty in the tooth extraction was formed after discussion; Then Delphi method was used to send a questionnaire to 30 experts by e-mail. After two rounds of scoring and modification, the scale of difficulty in the extraction of impacted mandibular third molars was formed. RESULTS: The recycling rate of two rounds of questionnaires was 100.0%, which showed that the experts were very enthusiastic about the study; The authority coefficients (Cr) of the two rounds of Delphi expert consultation were both 0.92, which showed that the results were representative and authoritative. After two rounds of grading and revision, the variable coefficient (CV) decreased and the Kendall's concordance coefficient (W) increased, which were statistically significant: In the first round, the CV was 0.24 and W was 0.56 (P < 0.001), and in the second, the CV was 0.19 and W was 0.72 (P < 0.001), which indicated that there was a good convergence among the expert opinions. Finally, a scale of difficulty in the tooth extraction containing 12 items at level A and 37 items at level B was formed, including operation difficulty indicators, risk difficulty indicators and common difficulty indicators. CONCLUSION Based on comprehensive literature retrieval, the study has put forward the concept that difficulty in the extraction of impacted mandibular third molars is composed of operation difficulty and risk difficulty. Using Delphi method, the long-term clinical experience and professional knowledge of experts are transformed into quantitative indicators as a scoring scale. The scale has certain representativeness and authority.
Delphi Technique ; Humans ; Mandible/surgery* ; Molar, Third/surgery* ; Tooth Extraction ; Tooth, Impacted/surgery*

OBJECTIVE: To observe the clinical effect of high suspension and low incision (HSLI) surgery on mixed haemorrhoids, compared with Milligan-Morgan haemorrhoidectomy. METHODS: A multi-centre, randomized, single-blind, non-inferiority clinical trial was performed. Participants with mixed haemorrhoids from Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing Rectum Hospital, Air Force Medical Center of People's Liberation Army of China, and Puyang Hospital of Traditional Chinese Medicine were enrolled from September 2016 to March 2018. By using a blocked randomization scheme, participants were assigned to two groups. The experimental group was treated with HSLI, while the control group was treated with Milligan-Morgan haemorrhoidectomy. The primary outcome was the clinical effect evaluated at 12 weeks after operation. The secondary outcomes included the number of haemorrhoids treated during the operation, pain scores, use of analgesics, postoperative oedema, wound healing, incidence of anal stenosis, anorectal manometry after operation, as well as surgical duration, length of stay and total hospitalization expenses. A safety evaluation was also conducted. RESULTS: In total, 246 eligible participants were enrolled, with 123 cases in each group. There was no significant difference in the clinical effect between the two groups (100.00% vs. 99.19%, P>0.05). Compared with the control group, the number of external haemorrhoids treated during the operation and the pain scores after operation were significantly reduced in the experimental group (P<0.05 or P<0.01); the patient number with wound healing at 2 weeks after operation and the functional length of anal canal at 12 weeks after operation were significantly increased in the experimental group (P<0.05). There was no significant difference in the incidence of anal stenosis, the numbers of patients using analgesics and patients with postoperative oedema between the two groups after operation (P>0.05). The surgical duration and length of stay in the experimental group were significantly longer than those in the control group, and the total hospitalization expense was significantly higher than that in the control group (all P<0.05). No adverse events were reported in either group during the whole trial or follow-up period. CONCLUSION HSLI had the advantages of preserving the skin of anal canal completely, alleviating postsurgical pain and promoting rapid recovery after operation. (Registration No. ChiCTR1900022883).