Cardiomyopathies ; diagnosis ; etiology ; Child ; Humans

Objective To observe the efficacy and adverse reaction of NP and GX regimens in the treatment of the anthracycline-and-taxane-resistant advanced breast cancer.Methods Totally 75 patients with advanced breast cancer were divided into two groups,and received NP or GX regimen.NP group (n =40):NVB 25 mg/m2,day 1,day 8,iv.drip; DDP 25 mg/m2,day 1-3,iv.drip.GX group (n =35):GEM 1000 mg/m2 day 1,day 8,iv.drip; XEL 2500 mg/m2,day 1-14,bid po.Every 21 days was a cycle.The efficacy and adverse reaction were evaluated after two cycles.Results The overall response rates in the NP and GX group were 42.5 ％ (17/40) and 40.0 ％ (14/35).The median TTP of two group were 7 and 6.5 months.The MST was 15.8 and 15.0 months in the NP and GX group.The 1-and 2-year survival rates were 60.0 ％,32.5 ％ and 57.1％,31.4 ％.The increase ratio of Karnofsky were 50.0 ％ and 42.9 ％.There were not significant difference between the two groups in terms of their treatment response (P ＞ 0.05).The main adverse reactions in the two group were myelosuppression,gastrointestinal reaction and phlebitis.Hand-foot syndrome in GX was significantly higher than that in NP group,Gastrointestinal reactions in NP was significantly higher than that in GX group (P ＜ 0.05).Conclusion NP and GX regimens are effective for patients with metastatic breast cancer,their adverse reactions are tolerable,so they can be regarded as a ltermate regimens for anthracyclines and taxanes resistant patients with metastatic breast cancer.

Objective To report microsurgical treatment of severed palm caused by crush injury. Methods From 1998 to 2002, 14 patients with severed palm and destructive crush injury were treated in our hospital. According to the specific severity and level of different injuries, replantation of severed palm with vessel transfer, replantation of fingers to the distal forearm with resection of wrist and palm, replantation of severed palm combined the thumb reconstruction were applied to reserve a maximal part of hand or fingers. Results Of the 14 cases of replantation, 3 experienced death of middle or index finger and the others all survived. The follow up of 11 cases lasted more than 6 months. After functional exercises, 10 cases recovered the function of pinch, and 1 case nearly regained normal functions. All of them regained sensation and the two point discrimination was 8 to 10 mm. Conclusion Reasonable replantation for severed palm with crush injury is still a method to regain part of hand functions.

OBJECTIVE:To screen Gongshisong's active sites for anti-sports fatigue. METHODS:Gongshisong extract was prepared with 80% ethanol extraction technology,and extracted with petroleum ether,chloroform,ethyl acetate and n-butyl alco-hol after dispersed with water to obtain the extract. 70 mice were randomly divided into blank control group(1% sodium carboxy-methylcellulose,CMC-Na),positive control group [Rhodiola wallichiana capsules,590 mg/(kg·d)],petroleum ether,chloro-form,ethyl acetate and n-butyl alcohol extracts and aqueous layer of Gongshisong groups(TS,TL,TY,TZ,TW groups). Gong-shisong extracts groups was given relevant medicine 2.5 g(crude drug)/(kg·d),ig,for consecutive 7 days. Exhaustion time of bur-den swimming test was detected. 70 mice were grouped according to above method,and the contents of liver glycogen,muscle gly-cogen and the coefficient of liver were tested in mice. 80 mice were grouped according to above method,and model group was es-tablished additionally(1% CMC-Na). The contents of lactic acid(LA),creatine kinase(CK)and urea nitrogen(BUN)in serum of mice were determined after 90 minutes of unburden swimming. RESULTS:Compared with blank control group,exhaustion time of burden swimming mice in TS,TY and TZ groups prolonged;the content of liver glycogen increased in TY,TZ and TW groups;the content of muscle glycogen increased in TS and TW groups;the contents of BUN,LA and CK in mice increased in model group (P<0.05 or P<0.01). Compared with model group,the serum content of BUN in mice decreased in TS and TY groups;that of LA in mice decreased in TZ and TW groups;that of CK in mice decreased in TS group (P<0.05 or P<0.01). CONCLUSIONS:The petroleum ether and n-butanol extract site and water layer of Gongshisong are good anti-fatigue active sites.

Objective To explore the method for repair of total avulsion of 2~4 fingers and to find the best procedure. Methods The wrap-round flap with part toenail combind with the dorsal pedical flap to repair soft tissue defect of the dorsal of finger and part of the palmar of finger, the second simepulp flap to repair soft tissue defect of the palmar of finger,transfer of two tissues with one pedicle to repair total avulsion of 2~4 fingers. Results All of 9 composite transplants in 6 cases were survived,the received areas were primary healing in 8 finger,1 case repaired by the bilateral wrap-round flaps and second simepulp flaps for index and middle finger,the distal phalanx of middle finger necrosis because of dislocation of DIP,3 months later,injury healed after the necrosis of phalanx excised,but the nail and the nail bed were dead.Except 1 case which the grafted skin necrotized in the donor area of the big toe,the rest had primary healing.All cases were followed up 6~14 months,the activity of joints were: MP 0-70,PIP 0-40.The repaired pulps had excellent appearance,the nail was fine,1 finger's mail was atrophy and 1 finger's nail was defect.The donor area had good fountion without pain and edema,the grafted skin had normal color and the activity of joints were nomal. Conclusion The wrap-round flap with part toenail combined with the second simepulp flap is a good approach in treatment of the skin avulsion injury in the finger.

Objective To increase the awareness of thyroid diseases through observing the relationship between ultrasound indications of thyroid and thyroid disease,and to enhance the understanding of thyroid disease through outpatient data.Methods Two hundred women aged 25 to 50 with thyroid imaging data were selected from the Department of Ultrasonography,the First Affiliated Hospital of Harbin Medical University.Seven indications including age,body weight,thyroid volume,the number of nodules,nodule size,nature of nodules and thyroid disease were recorded.Thyroid cases were divided into four groups based on their sonographic changes of color Doppler ultrasound:normal group (136 cases):sonographic changes of thyroid were approximately normal ; mild degree group (9 cases):consisting of patients with mild thyroid disease,diffused thyroid enlargement or combined cystic nodules; moderate degree group (38 cases):consisting of patients with moderate thyroid disease,hyperthyroidism or hypothyroidism; severe degree group (17 cases):consisting of patients with severe thyroid disease,thyroiditis and/or with hemorrhage and calcification.Data were analyzed using the method of clinical case observation and SPSS 16.0.Results We found that in mild degree group the discriminant coefficients of thyroid volume,the nature of thyroid nodules and nodule size were 0.085,0.169 and 0.695; but in sever degree group the corresponding values were 0.158,0.344 and 0.484,respectively,and the difference between the two groups was statistically significant (x2 =43.3,df =18,P ＜ 0.01).Conclusions The nature,size and area of thyroid nodules are closely related to the progression of thyroid disease.The color Doppler ultrasound data of outpatients as a part of hospital statistics have important theoretical and practical value.

Objective:To evaluate the efficacy and safety of oral prednisone acetate and oral prednisone acetate combined with local injection of triamcinolone acetonide for the prevention of esophageal stricture after endoscopic submucosal dissection (ESD) for early esophageal cancer and precancerous lesions.Methods:Data of 52 patients with early esophageal cancer or precancerous lesions hospitalized from December 2014 to February 2019 in Zhongda Hospital of Southeast University were analyzed retrospectively. They were divided into the control group (group A, n=20), oral hormone group (group B, n=17) and oral medication combined with local injection group (group C, n=15). The rates of stenosis and refractory stenosis, endoscopic dilatation times after ESD, time interval of first dilation after ESD and adverse events related to the operation and administration of glucocorticoids were compared among the three groups. Results:The differences in stenosis rates [85.0% (17/20) VS 47.1% (8/17) VS 46.7% (7/15), P<0.01], rates of refractory stenosis [75.0% (15/20) VS 23.5% (4/17) VS 20.0% (3/15), P<0.01], and endoscopic dilatation times [3.50 (2.25, 6.00) VS 0.00 (0.00, 2.50) VS 0.00 (0.00, 2.00), P<0.01] were statistically significant among the three groups. In pairwise comparison, the above indicators in group B and group C were significantly lower or less than those in group A ( P<0.05), but there were no statistical differences between group B and group C ( P>0.05). The time intervals of the first dilation after ESD were significantly different among the three groups (27.7±9.4 d VS 110.1±46.0 d VS 147.4±9.4 d, P<0.01). In pairwise comparison, the first dilation intervals in group B and group C were longer than that in group A ( P<0.01), and this indicator in group C was longer than that in group B ( P<0.01). Two patients in the control group developed perforation after ESD but they were treated actively and recovered finally. No severe ESD, steroid, or perforation related adverse events occurred in any other patient of the three groups. Conclusion:Both oral prednisone and oral prednisone combined with local injection of triamcinolone acetonide after ESD can effectively and safely prevent esophageal stricture after ESD. Oral administration combined with local injection of corticosteroids can prolong the time interval of the first dilation after ESD, which is beneficial to the psychological recovery and the improvement of patients’ life quality after the operation.

Objective To observe the effects of rosuvastatin on the homocysteine (Hcy)-induced expression of matrix metalloproteinase 2 (MMP 2) and cell migration in rat vascular smooth muscle cells (VSMCs), and to explore the possible mechanism of Hcy-induced atherosclerosis and the role of statins in reversing atherosclerosis. Methods In one cell culture plate, the cultured rat VSMCs were incubated with different concentrations of Hcy (0, 50, 100, 500, 1000 μmol/L and 5000 μmol/L) in vitro for 24 h, 48 h and 72 h. And in another cell culture plate, the different concentrations of rosuvastatin (10-9, 10-8, 10-7, 10-6, 10-5 mol/L and 0 mol/L) were added to the cultured rat VSMCs (while the concentration of Hcy was 1000 μmol/L). The MMP 2 expression and enzyme activity were determined by gelatin zymography and Western blotting. The effects of Hcy and rosuvastatin on cell migration and invasiveness of VSMCs were observed. Results Hcy (50-5000 μmol/L) increased the protein expression, and Hcy (50-1000 μmol/L) increased enzyme activity of MMP 2 significantly. But Hcy (5000 μmol/L) inhibited activity of MMP 2 (F=9.31, 6.44 and 5.97, all P＜0.05). Rosuvastatin (10-9-10-5 mol/L) inhibited Hcy-induced expression and enzyme activity increasing of MMP 2. The counts of cell migration of VSMCs were 18.32±2.17, 32.68±4.34, 44.75±4.08, 61.39±5.21, 79.74±5.54 and 90.78±5.83, while the concentration of Hcy was 0, 50, 100, 500, 1000 μmol/L and 5000 μmol/L respectively (F=5.31, P＜0.05). The counts of cell migration of VSMCs were 79.74±5.54, 62.53±6.41, 48.37±5.66, 31.41±4.79, 19.27±3.62 and 11.17±2.33, while the concentration of rosuvastatin was 10-9, 10-8, 10-7, 10-6 and 10-5 mol/L respectively (F=4.99, P＜0.05). Rosuvastatin could decrease the stimulation of Hcy-induced migration of VSMCs. Conclusions Hcy can influence the MMP 2 protein expression/activity in VSMCs, and rosuvastatin can inhibit augmentation of Hcy-induced MMP 2 expression/activity and migration of VSMCs. It may be one of the multiple-effects of rosuvastatin reducing atherosclerosis.

Objective To investigate the potential clinical factors associated with the prognosis and relapse of adult onset Still's disease(AOSD).Methods The factors possibly influencing the prognosis and relapse of AOSD were analyzed by logistic regression and COX regression in the cohort study.Ninety-six con- secutive inpatients of AOSD diagnosed based on Yamaguchi criteria in the hospital from March 1996 to September 2004 were included in the study.Results Nine cases(9.4%)were lost during the follow-up. Eleven patients(12.6%)were diagnosed as other diseases(5 with other rheumatic diseases,4 with tumor and 2 with infections)in the 87 follow-up cases.In 76 cases,3 patients(3.9%)died and 33 patients(43.4%) got remission over one year after treatment.Splenomegaly(OR=3.14,95%CI=1.01～9.74)and treated with methotrexate(OR=0.22,95%CI=0.07～0.67)were associated with the prognosis from the logistic regression analysis of the 76 cases.The serum ferritin(RR=I.05,95%CI=1.01～1.08)and treated with methotrexate (RR=0.13,95%CI=0.02～0.76)were associated with relapse from the COX regression analysis of the 61 remis- sion cases.Conclusion We need to be very cautious in the follow-up of AOSD patients because some of them may change to other diseases.Methotrexate may be an importent therapy of AOSD not only in improve- ment the prognosis but also in reduction of relapse.

OBJECTIVETo determine the factors affecting post-operative velopharyngeal function of cleft palate patients aged over two years old.

METHODSThe data on 245 patients, including first visit case records and those in the database, were searched and recorded. Post-operative velopharyngeal function and clinical features, such as cleft ratio, adequate ratio, diagnosis, operative age and method, were analyzed retrospectively.

RESULTSCleft ratio and adequate ratio in the velopharyngeal competence (VPC) group were not statistically different from those in the velopharyngeal incompetence (VPI) group. The difference in VPC rate in different age groups and diagnosis was not significant. The post-operative VPC rates under different methods were significantly different.

CONCLUSIONThe current therapeutic schedule for patients younger than two years old is inappropriate for patients older than two years old. Cleft ratio is not the main factor affecting postoperative velopharygeal function. Sommerlad-Levator Veli Palatini reconstructional operation combined with sphincter pharyngoplasty can obviously improve the velopharyngeal function of patients aged 2 years old and up. This method should be applied in primary palatoplasty.

Child, Preschool ; Cleft Palate ; Female ; Humans ; Infant ; Male ; Palatal Muscles ; Pharynx ; Postoperative Period ; Reconstructive Surgical Procedures ; Retrospective Studies ; Velopharyngeal Insufficiency