Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Cyclophosphamide ; administration & dosage ; Diagnosis, Differential ; Female ; Humans ; Panniculitis ; drug therapy ; pathology ; Panniculitis, Nodular Nonsuppurative ; pathology ; Prednisone ; administration & dosage ; Vincristine ; administration & dosage

Objective To investigate the efficacy of sorafenib alone or combination with transarterial chemoembolization(TACE)and percutaneous local cryotherapy(PLCT)for advanced hepatocellular carcinoma patients without operation opportunity. Methods Sixty-four advanced hepatocellular carcinoma patients were selected as our subjects,who were underwent treatment of sorafenib alone or combination with TACE and PLCT. Thirty-two cases with sorafenib therapy were served as sorafenib group and another 32 cases with sorafenib in combination with transarterial chemoembolization and PLCT were served as combination group. All patients were followed up for 6 - 32 months. The treatment efficacy and tumor development were recorded. Results All surgeries of the patients were succeed and no death or serious operation complications occurred. Of 64 patients, 11 were achieved a complete remission( CR),31 cases with partial remission( PR),14 cases with stable development(SD),and 8 cases with progressive disease(PD). In the sorafenib group,3 cases were with CR,11 patients with PR,12 with SD,and 6 patients with PD. In the combination group,8 patients were with CR,20 patients with PR,2 patients with SD and 2 patients with PD,and the difference was significant between the two groups(χ2 = 14. 028,P = 0. 003). The median periods to tumor progression were 20 and 53 weeks in the sorafenib group and the combination group,and the difference was significant( χ2 = 14. 773,P = 0. 000). Conclusion For hepatocellular carcinoma patients without operation opportunity,sorafenib combined with TACE and PLCT can increase the tumor remission rate and prolong the periods to tumor progression in patients with hepatocellular carcinoma.

BACKGROUND:Total knee arthroplasty for knee osteoarthritis accompanied with extra-articular deformity is stil chal enging. An individual replacement plan should be designed to obtain good mechanical axis and to recover suitable soft-tissue balance. OBJECTIVE:To observe the safety and feasibility of individual y designed one-stage total knee arthroplasty for knee osteoarthritis combined with ipsilateral femoral extra-articular deformity. METHODS:A total of eight patients with knee osteoarthritis combined with ipsilateral femoral extra-articular deformity were enrol ed in this study. According to preoperative plan, five patients underwent intra-articular compensatory osteotomy, and the remaining three received extra-articular corrective osteotomy. Multi-planar deformities as wel as soft-tissue conditions were recorded. Main outcome measures included the hospital for special surgery score, Western Ontario and McMaster Universities Arthritis Index score and alignments deviation. RESULTS AND CONCLUSION:The patients were averagely fol owed up for 29 months. The hospital for special surgery score changed from preoperative 32.5 points to postoperative 87.5 points. The Western Ontario and McMaster Universities Arthritis Index score was increased from preoperative 37.1 points to postoperative 88.8 points (P<0.05). Mean mechanical axis deviation (either varus or valgus) changed from preoperative 17.1° to postoperative 1.4° (P<0.05). Al cases with extra-articular corrective osteotomy healed within 3 months, and none had postoperative infection, loosening or venous thromboembolic events. One patient was with 5° residual knee anti-sheets. Results verified that one-stage total knee arthroplasty procedures are effective in the treatment of knee osteoarthritis accompanied with ipsilateral femoral extra-articular deformity in accordance with individual preoperative plan.

Adolescent ; Adult ; Child ; Factor VIII ; genetics ; metabolism ; Hemophilia A ; blood ; diagnosis ; Humans ; Male ; Young Adult

BACKGROUND:Genetic factors, environment, chronic infection, and autoimmune disorders are considered to be involved in the pathogenesis of ankylosing spondylitis. Genetic factors play an important role in the pathogenesis of the disease. Ethnic and regional diversity of differentialy expressed genes has become research hotspot because of family aggregation and ethnic diversity of ankylosing spondylitis.
OBJECTIVE:To screen differentialy expressed genes in Xinjiang Uygur and Han patients with ankylosing spondylitis by microarray screening and compare differences in gene expressions.
METHODS: Uygur and Han patients with active ankylosing spondylitis in department of rheumatology of our hospital were randomly colected with five patients for each. In addition, three healthy volunteers were selected as controls. RNA from peripheral blood was extracted and used for microarray hybridization after probe preparation to screen differentialy expressed genes in ankylosing spondylitis samples and the microarray results were verified by semi-quantitative RT-PCR analysis.
RESULTS AND CONCLUSION: Twenty differentialy expressed miRNAs were screened in Uygur and Han patients with active ankylosing spondylitis (P < 0.05). From relationship analysis of target genes and miRNAs, 15 target genes corresponding to the 79 miRNAs involved in human leucocyte antigens and interleukins which linked to human immunity system were found. These findings suggest that differentialy expressed genes can be screened from Uygur and Han patients with ankylosing spondylitis.

Objective To observe the clinical effects of Dexmedetomidine in combination with Sevoflurane for hysteroscopic resection. Methods 72 patients underwent hysteroscopic resection from January 2014 to December 2015 were divided into study group and control group according to the anesthesia mode. Patients in study group were in combination anesthesia mode of intravenous infusion of Dexmedetomidine and Sevoflurane inhalation, while patients in control group received Sevoflurane inhalation only. The clinical parameters and adverse reactions were observed and studied. Results Compared with control group, significant differences were shown in patients heart rate at T2, T3 and T4 and breathing rate at T2 in observation group (P < 0.05). Compared with T1 phase, there was statistical significance in study group patients systolic blood pressure (SBP), diastolic blood pressure (DBP), RR at T2, HR at T3, T4 (P < 0.05); Compared with control group, patients in study group had short onset time of anesthesia and long recovery of consciousness, while there has no statistical significance of the two groups (P > 0.05). Compared with control group, the respiratory depression, sedative effect of Ramsay sedation score, wakefulness, alertness / sedation score of observation method (OAA/S), digital pain score (NPRS), postoperative uterine contraction pain score, postoperative nausea and vomiting of study group had significant statistical differences (P < 0.05). Conclusion Combination anesthesia mode of intravenous pumping Dexmedetomidine and inhalation of Sevoflurane has good clinical effects for patients undergoing hysteroscopic resection.

Objective To explore the value of ectopic gastic mucosa imaging in diagnosis of Meckel′s diverticulum.Methods Twenty-five cases suspected of gastrointestinal bleeding underwent conventional ectopic gastic mucosa imaging with 99mT_cO_4-.The diagnostic criteria Meckel′s diverticulum was that abnormal radio active accumulation in the abdomen observed.Results Three cases of ectopic gastic mucosa imaging was positive,and the diagnosis was all confirmed by surgery and pathology examination.The rest 22 cases were caused by other reasons confirmed by affirmative examinations.Conclusions Ectopic gastic mucosa imaging is easy to conduct,safe with no injury to the patients.It can be the first choice of examination in the diagnosis of gastrointestinal bleeding in children.

im To study the structure-function relationship of hTNFα . Methods We compared the cytotoxicity, receptor binding ability and toxicity in animal body of wild type(wt)hTNFα with its mutants including R2K-, N30S-, R32W-, L157F-hTNFα , and two multi-site mutants(R32W-L157F-hTNFα and R2K-N30S-R32W-L157F-hTNFα ). Results We found that the two multi-site mutants remained similar cytotoxicity to several human tumor cell lines as wild type hTNFα . However, their cytotoxicity to L929 cells were decreased sharply as compared with those of wt hTNFα . The two multi-site hTNFα mutants had lower binding activity with hTR75 than hTR55. We also found that compared with the wild type, the LD50 of the mutant R32W-L157F-hTNFα was decreased about 300 fold and the dose of mutant R2K-N30S-R32W-L157F-hTNFα resulted in 30％ death was 700 folds lower than LD50 of wt hTNFα . To certify the systematic toxicity of the mutant R2K-N30S-R32W-L157F-hTNFα , we assayed its toxicity to monkeys and found that its systematic toxicity was lower than that of wt hTNFα. Conclusion A 4-site mutants(R2k-N30S-R32W-L157F-hTNFα )of hTNFα is obtained, which the mutant may possess potential application value in clinical therapy.

BACKGROUND:Currently, the study of total hip arthroplasty in elderly is more. Perioperative treatment and postoperative rehabilitation are increasingly perfect, but the study of middle-aged total hip arthroplasty is less, especialy long curative effect in postoperative and long-term folow-up stil has many problems to be solved. In China, there are few studies addressing how to select the prosthesis during total hip arthroplasty in middle-aged patients, which kind or material of prosthesis is better, so the evidence for clinical application is less. OBJECTIVE:To compare and analyze the repair effects of bone cement total hip arthroplasty and uncemented total hip arthroplasty in middle-aged patients. METHODS:A total of 60 middle-aged patients who received total hip arthroplasty in the Department of Orthopedics, Xinjiang Uygur Autonomous Region Chinese Medicine Hospital from January 2005 to January 2008 were folowed up for 5 years. Their mean age was (37±6) years. There were 32 cases undergoing uncemented total hip arthroplasty and 28 cases receiving bone cement total hip arthroplasty. At 6 months, 2 and 5 years after replacement, Harris score for recovery of limb function and imaging findings were compared and analyzed. RESULTS AND CONCLUSION: Harris score for recovery of limb function was significantly better in the uncemented total hip arthroplasty group than in the bone cement total hip arthroplasty group at 6 months, 2 and 5 years after replacement (P < 0.01). No complications were found at 6 months in the uncemented total hip arthroplasty group, but one case affected osteolysis at 2 years and two cases experienced prosthesis loosing at 5 years after arthroplasty. In the bone cement total hip arthroplasty group, two cases had osteolysis and one case had prosthesis loosing at 6 months after arthroplasty, three cases had prosthesis loosing at 2 years, and two cases affected linear permeability dissolvement at 5 years after arthroplasty. These findings suggest that uncemented prosthesis achieved a high rate of functional restoration and a low rate of complications in middle-aged patients. Uncemented total hip arthroplasty had satisfactory clinical and radiographic outcomes at a minimum of 5-year folow-up.

This article,in view of the research status and development tendency of hospital core competence,introduced the index selection process and constructed the evaluation index system of core competence.This system comprises 3 level-1 indexes (social reputation,hospital health resources and development potential)and 9 level-2 indexes,with recommendations on improvements of the existing system.