OBJECTIVETo compare the differences in pain reaction, hemodynamics and clinical efficacy between extracorporeal shock wave lithotripsy (ESWL) after injection with flurphen mixture (mixture of droperidol and fentanyl citrate) at Shenshu (BL 23) and simple ESWL in the patients.

METHODSSixty-four cases of urinary calculi with ESWL were randomized into an observation group and a control group, 32 cases in each one. In the observation group, 15 to 20 min before ESWL, flurphen mixture (droperidol injection 1.25 mg and fentanyl citrate injection 0.05 mg were diluted to 6 mL with 0.9% sodium chloride solution 4.5 mL) was injected at bilateral Shenshu (BL 23). In the control group, no any adjuvant therapy and medication were used before ESWL. The changes in blood pressure and heart rate, visual analogue scale (VAS) score, lithotripsy frequency till calculi complete removal and the rate of calculi complete removal after the first lithotripsy were observed in the two groups.

RESULTSIn the control group, blood pressure and heart rate were higher during lithotripsy than those before lithotripsy (both P<0.05). In the observation group, the differences in blood pressure and heart rate were not significant statistically as compared with those before lithotripsy (both P>0.05). The blood pressure and heart rate during lithotripsy in the observation group were apparently lower than those in the control group (both P<0.05). VAS scores during lithotripsy in the observation group were lower apparently than those in the control group (both P<0.05). The lithotripsy frequency in the observation group was less than that in the control group. The rate of calculi complete removal in 1 week after the first lithotripsy in the observation group was higher than that in the control group [75.0% (24/32) vs 50.0% (16/32), P<0.05].

CONCLUSIONThe flurphen mixture at Shenshu (BL 23) significantly alleviates pain reaction in patients undergoing ESWL, avoids the fluctuation of hemodynamics and improves the clinical effect of lithotripsy.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Analgesics ; administration & dosage ; Female ; Hemodynamics ; Humans ; Kidney Calculi ; therapy ; Lithotripsy ; adverse effects ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; Young Adult

Objective To investigate the expression of MnSOD and E-cadhefin in nasopharyngeal carcinoma(NPC) tissue and its relationship with clinicopathological features and prognosis. Methods The expression of MnSOD and E-cadherin were detected by immunohistochemistry method in 60 NPC patients. Results Of the whole group,lymph node positive group and lymph node negative group,the strong positive rate of MnSOD protein was 47% (28/60) ,49% (25/51 patients) and 33% (3/9) (x2 =0.76,P =0.382), respectively.The corresponding strong positive rate of E-cadherin protein was 47% (28/60) ,43% (22/51) and 78% (7/9) (x2 =3.69,P =0.047) ,respectively.The expression of MnSOD increased with T stage and N stage.The higher expression of MnSOD was significantly associated with the larger size of metastatic lymph node(r =0.46 ,P =0.002) ,more radioresistance and poorer prognosis,but not with the region of lymph node metastasis(r =0.223,P = 0.116).The lower expression of E-cadherin was closely relevant with higher N stage and the smaller region of lymph node metastasis(r =-0.33,P = 0.020),but not with T stage,lymph node size or radiosensitivity(r =-2.19,P=0.093;r=-0.07,P=0.623;r=-0.18,P=0.170).Multi variate analysis showed that MnSOD and E-canherin were independent prognostic factors (x2= 4.45,P = 0.035;x2 =5.12,P=0.024). Conclusions High expression of MnSOD may stimulate tumor growth and reduce radiosensitivity.High expression of E-cadherin may inhibit lymphatic metastasis,while has no rela tionship with tumor growth and invasion.MnSOD and E-cadherin could affect the prognosis of NPC patients.

OBJECTIVE: The purpose of this article is to discuss the clinical value of central neck lymph node dissection in papillary thyroid carcinoma, especially in thyroid papillary microcarcinoma (PTMC). Also this article wants to evaluate the diagnostic significance of preoperative ultrasonography of central neck metastasis lymph nodes and the clinical significance of preoperative ultrasonography in central neck lymph node dissection. METHOD: Collected and analyzed 121 cases from September 2012 to December 2013. All of them had done the central neck lymph node dissection with the same standard by the same surgeon in our department. Evaluate the value of preoperative ultrasound diagnostic in thyroid microcarcinoma and non-microcarcinoma. RESULT: In the 121 patients, The 62 patients were diagnosed with PTMC (primary lesion d≤1. 0 cm). Accuracy rate of ultrasound diagnostic was 74. 2% (46/62), the rate of missed diagnosis was 61. 9% (13/21), the rate of misdiagnosis was 7. 3 % (3/41), sensitivity was 38. 1% (8/21), specificity was 92.7% (38/41), positive predictive value was 72. 7% (8/11), negative predictive value was 74. 5% (38/51) and the value of Kappa was 0. 3485. The other 59 patients was diagnosed with thyroid papillary non-microcarcinoma (primary lesion d>1. 0 cm). The accuracy rate was 55. 9% (33/ 59), the rate of missed diagnosis was 58. 3% (21/36), the rate of misdiagnosis was 21. 7% (5/23), sensitivity was 41. 7% (15/36), specificity was 78. 3% (18/23), positive predictive value was 75. 0% (15/20), negative predictive value was 46. 2% (18/39) and the value of Kappa was 0. 1757. CONCLUSION Cervical central lymph node dissection was necessary when the ultrasound diagnosis of cervical central lymph node-positive was prompted suspiciously in the thyroid papillary microcarcinoma. However, when it prompted negative, we could recommend patients to do the prophylactic central lymph node dissection in conjunction with the risk factors. Whether the ultrasound diagnosis of central lymph node was prompted suspiciously or not in the thyroid papillary microcarcinoma and non-microcarcinoma, the central lymph nodes dissection is necessary.
Carcinoma ; diagnostic imaging ; Carcinoma, Papillary ; diagnostic imaging ; Diagnostic Errors ; Humans ; Lymph Node Excision ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; diagnostic imaging ; Neck ; Risk Factors ; Sensitivity and Specificity ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnostic imaging ; Ultrasonography

OBJECTIVE: To study the correlation between the stromal cell-derived factor (SDF-1) and the receptor fusin (CXCR4) in carcinoma of larynx, and investigate some mechanisms of SDF-1/CXCR4 during the development, invasion and lymph node metastasis of laryngocarcinoma. METHOD: Detecting the expression of SDF-1 and CXCR4 by immunohistochemical method (SP) in laryngocarcinoma, paraneoplastic tissues, normal laryngeal mucosa and cervical lymph node. Using Kruskal-Wallis H test, chi2 test, Spearman rank correlation analysis and so on to do statistical analysis. RESULT: The positive expression rate of SDF-1 and CXCR4 in laryngocarcinoma was obviously higher than in paraneoplastic tissues and normal laryngeal mucosa tissues (P < 0.01). And the expression of two proteins was correlated with lymph node metastasis (P < 0.01), clinical stage (P < 0.01) and pathological grading of tumor (P < 0.05). The positive expression rate of SDF-1 and CXCR4 protein in metastasis lymph node tissue was higher than that in non metastasis lymph node tissue (P < 0.01). The expression of SDF-1 is correlated positively with the expression of CXCR4 in laryngocarcinoma. CONCLUSION SDF-1 and CXCR4 protein are highly expressed in laryngocarcinoma and in metastasis lymph node tissue. And they are correlated with lymph node metastasis, clinical stage and pathological grading of the tumor. According to the results, the two proteins may relate to infiltration and metastasis of laryngeal squamous cell carcinoma and play a role of synergistic action in the development and invasion of carcinoma of larynx.
Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Chemokine CXCL12 ; metabolism ; Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymph Nodes ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Receptors, CXCR4 ; metabolism