Radiation-induced stomatitis is a frequent side effect for head and neck cancer patients undergoing radiotherapy, which affects both the treatment and the life quality. The direct effects of radiation, oxidative stress, transcription factor, proinflammatory cytokine and pathogenic microorganism are involved in the onset of radiation-induced stomatitis. The pathologic process can be divided into five phases including initiation, up-regulation, amplification, ulceration and healing. Understanding of the pathogenesis and risk factors provides basis for prevention and control of radiation-induced stomatitis.

Objective To investigate the correlation between levels serum zinc,selenium,chromium,copper and blood glucose in diabetic patients.Methods The 136 cases of type 2 diabetes were enrolled in our hospital during September 2013 to December 2015 in the observation group,and 136 cases of physical health in our hospital during the same period were recruited in the control group.Then the levels of serum zinc,selenium,chromium,copper contents and glycemic index,oxidative stress indicators were detected.Results The serum zinc,selenium content of the observation group were significantly lower than those in the control group(P<0.05),no significant difference were observed in the serum chromium,copper contents between two groups(P>0.05);the levels of FBG,2 h PBG,glycated hemoglobin,MDA,and HOMA-IR of observation group were higher than those of control group,the HOMA-β,I30/G30,SOD,GSH-Px levels were lower than those in the control group(P<0.05);the serum zinc,selenium contents were negatively correlated with FBG,2 h PBG,glycated hemoglobin,MDA levels,and HOMA-IR(P<0.05),while positively correlated with HOMA-β,I30/G30,SOD,GSH-Px(P<0.05).Conclusion Serum zinc,selenium contents in type 2 diabetes significantly decrease and closely be related with blood glucose levels,they can reduce blood sugar,promote insulin secretion,increase insulin sensitivity,and adjust the oxidative stress reaction.

OBJECTIVE: Regional nodal metastasis in nasopharyngeal carcinoma plays an important role in the definition of radiotherapy area and clinical stage. It is also one of the main factors influencing prognosis. This study was designed to explore the pattern of metastatic lymph nodes for patients with nasopharyngeal carcinoma, which might provide a basis for clinical treatment and research. METHOD: From Jan. 2009 to Jul. 2011, 1 298 histologically diagnosed nasopharyngeal carcinoma patients had routine MRI scan before radiotherapy in The First Affiliated Hospital of Guangxi Medical University. Diagnostic radiologists and radiation oncologists together assessed the nodal distribution according to the guideline CT-based delineation of lymph node levels. Then,Chi-square test was used to analyze the correlations between T stage and nodal metastasis rate and between nodal diameter and nodal extracapsular invasion. RESULT: Of 1298 patients, 1067 (82.2%) had nodal involvement. The distributions were as: 20 in level I b,604 in level II a,883 in level II b,330 in level III, 78 in level IV, 162 in level Va,49 in level Vb,967 in retropharynx. Leap metastasis rate was 0.69%. In these patients, a total of 2464 positive nodes,including 1589 (64.52%) extra capsular spread nodes, were detected. The rate of nodal extracapsular invasion was higher when the axial diameter increased. No significant correlation was found between T stage and nodal involvement. CONCLUSION The level II and retropharyngeal node are the most frequently involved regions. They have similar metastatic rate and are both the first echo node to metastases of nasopharyngeal carcinoma. Level I metastasis is very low. There is a positive correlation between the proportion of extracapsular spread of metastatic lymph nodes and the axial diameter of lymph nodes. The cervical node involvement of nasopharyngeal carcinoma spread orderly down the neck, and the incidence of skip metastasis is rare. There is no significant difference between T stage and nodal involvement.
Adolescent ; Adult ; Aged ; Carcinoma ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; pathology ; Young Adult

Objective To study operative treatment of severe tibial pilon fracture.Methods Between March 2010 and September 2016,29 patients with severe pilon fracture received operative treatment and complete follow-up at Department of Orthopaedic Surgery,Maternal and Child Care Service Centre of Guangzhou Nansha District.They were 24 men and 5 women,aged from 23 to 62 years (average,40.3 years).According to AO/OTA classification,9 cases were type C1,12 type C2 and 8 type C3.There were 6 open and 23 closed fractures.Of them,27 were complicated with fibular fracture.Open reduction and intenal fixation was conducted in 22 cases and limited internal fixation combined with external fixation in 7.Results This cohort was followed up for an average of 15 months (from 12 to 25 mouths).All the fractures obtained union after an average of 16 weeks (from 8 to 28 weeks),but the union in 5 cases was delayed.According to American Orthopaedic Foot and Ankle Society (AOFAS) criteria for ankle and hind foot,16 cases were rated as excellent,9 as good,3 as fair,one as poor,yielding an excellent to good rate of 86.2％.The main complications included superficial necrosis of wound skin in 3 cases,which were cured by skin flap repair after wound treatment,and superficial and deep infection both in 2 cases,which were cured by dressing change.Conclusions Severe tibial pilon fractures should be treated according to their different types and severities of soft tissue injury,using different operative methods and timing.

Post-stroke depression often seriously affects the prognosis and quality of life of patients and many clinical trials had shown that Chai Hu Shu Gan San (柴胡疏肝散) combined with selective serotonin reuptake inhibitors (SSRIs) had good efficacy and minor side effects. We aimed to conduct this metaanalysis to evaluate the efficacy and safety of Chai Hu Shu Gan San as an adjuvant drug for SSRI in treating post-stroke depression. We searched PubMed, EMBASE, Cochrane Library, Wanfang, China Biology Medicine disc (CBM), Chongqing VIP, and CNKI (China National Knowledge Infrastructure) from their date of foundation to December 15, 2018. Literature screening, data extraction and quality assessment were conducted by two authors independently. The data synthesis and analysis were performed by using Review Manager (RevMan) 5.3 software and sensitivity analysis was conducted to assess the robustness of the results. Finally, a total of 22 articles were included. The meta-analysis confirmed the advantages of the combination of SSRI and Chai Hu Shu Gan San, mainly from four aspects: the Hamilton Depression (HAMD) scale score (MD=3.66; 95% DI=2.33-4.98; p<0.001), the Modified Edinburgh Scandinavian Stroke Scale (MESSS) score (MD=4.87; 95% CI=2.32-7.43; p<0.001), the efficacy rate (OR=3.50; 95% CI =2.61-4.69; p<0.001) and the incidence of adverse reactions (OR=0.28; 95% CI=0.17-0.46; p<0.001). No significant publication bias was observed, and sensitivity analysis suggested a good stability of the results. According to the present evidence, we concluded that Chai Hu Shu Gan Sa