Objective:To analyze the clinical feature and treatment of head-neck malignant fibrous histiocytoma (MFH).Method:A retrospective analysis on the clinical data of 28 cases of MFH were carried out, of which 9 were in the maxilla, 3 in the nasal cavity, 5 in the larynx, 3 in the parotid, 3 in the temporal bone, 1 in the hypothyroid, and 4 in the head and neck region. All of the cases underwent immune histochemistry: 4 cases of surgery alone, 23 cases of surgery followed by radiotherapy, and 1 case of radiotherapy alone.Result:Except 5 cases lost follow-up after 1 year, all the other cases were followed-up over 3 years, the survival rate for 1 or 3 years was respectively 96.4%(27/28) and 57.1%(16/28); 23 cases were followed up for 5 years, the survival rate was 26.1%(6/23). The recurrent rate in 3 years was 60.7%(17/28) ,with 1 to 7 times recurrence at a mean interval of 5.6 months. Twelve recurrent cases were adopted expanded resection of non-defined operation except 1 case with radiotherapy.Conclusion:The diagnosis of MFH depends on the technology of immune histochemistry. Early diagnosis, expanded resection, and integrated therapy could reduce the recurrence and increase the survival rate; the recurrence could adopt expanded resection of non-defined operation to prolong the life.

Objective To explore the effect of TGF-β microbubble targeting on the treatment of skeletal muscle injury in rats.MethodsEighty SD rats of 2 months old were randomly divided into experimental group(including TGF-β microbubble),pure drug group,microbubble group(exclusive drug) and control group,20 SD rats in each group.Four groups accepted ultrasonic transmission with consistent time and frequency.The contraction stress and stress relaxation of injured gastrocnemius muscle were measured,the changes of injured gastrocnemius muscle were observed by light microscope and electron microscope.Results There was no statistically significant difference in contraction stress of gastrocnemius muscle among all groups at 1,5,9 days after injury(P>0.05).And at 14 days,the contraction stress of gastrocnemius muscle of the experimental group and the pure drug group were obviously higher than those of the rest two groups,the differences were significant(P<0.05).The difference of gastrocnemius muscle contraction stress was statistically significant between the experimental group and the pure drug group(P<0.05).For the stress relaxation of gastrocnemius muscle,the experimental group was lower than the other three groups at 1 day after injury,the differences were significant(P<0.05).Light microscopy showed the number of muscle fiber in the experimental group increased obviously at 9 days after injury.There was no scarring at 14 days after injury.Electron microscope showed mitochondria and sarcoplasmic reticulum increased in the experimental group,and the new muscle cells and satellite cells were significantly more than those of the rest three groups.Conclusion TGF-β cell targeted therapy can obviously improve the shrinkage stress of skeletal muscle in rats after injury and recover the stress decay,which can obviously promote the injury repair and regeneration of skeletal muscle,and reduce scar formation at the same time.

Objective To compare epididymis-sparing orchiectomy (group A) with traditional orchiectomy (group B ) in patients with advanced prostate cancer,and to evaluate which procedure is better.Methods A total of 60 cases of advanced prostate cancer patients were enrolled,with 30 cases in group A and 30 cases in group B.They were given oral anti-androgen from 1 day after castration.Serum level of testosterone and prostatic specific antigen (PSA) was detected before castration,and 1 week,1,3,6,9 and 12 months after castration.Patient satisfaction was also evaluated.Results On time point of 12 months after castration,the average level of serum testosterone was 0.2 nmol/L (95 ％ confidence interval,0.1 ～ 0.9 nmol/L) in group A and 0.3 nmol/L (95％ confidence interval,0.2 ～ 0.9 nmol/L) in group B (P ＞0.05 ) ; the average value of PSA was 0.22 ng/ml in group A and 0.27 ng/ml in group B (P ＞0.05 ) ; patient satisfaction rate was 96.7％ (29/30) in group A and 53.3％ (16/30) in group B.Conclusions No significant difference of testosterone level and PSA is found between the 2 groups.However,epididymis-sparing orchiectomy meets the psychological needs better because it helps to maintain the appearance of the scrotum through epididymis preservation and epididymoplasty.

OBJECTIVE: To analyze the clinical feature and treatment of head-neck malignant fibrous histiocytoma (MFH). METHOD: A retrospective analysis on the clinical data of 28 cases of MFH were carried out, of which 9 were in the maxilla, 3 in the nasal cavity, 5 in the larynx, 3 in the parotid, 3 in the temporal bone, 1 in the hypothyroid, and 4 in the head and neck region. All of the cases underwent immune histochemistry: 4 cases of surgery alone, 23 cases of surgery followed by radiotherapy, and 1 case of radiotherapy alone. RESULT: Except 5 cases lost follow-up after 1 year, all the other cases were followed-up over 3 years, the survival rate for 1 or 3 years was respectively 96.4% (27/28) and 57.1% (16/28); 23 cases were followed up for 5 years, the survival rate was 26.1% (6/23). The recurrent rate in 3 years was 60.7% (17/28), with 1 to 7 times recurrence at a mean interval of 5.6 months. Twelve recurrent cases were adopted expanded resection of non-defined operation except 1 case with radiotherapy. CONCLUSION The diagnosis of MFH depends on the technology of immune histochemistry. Early diagnosis, expanded resection, and integrated therapy could reduce the recurrence and increase the survival rate; the recurrence could adopt expanded resection of non-defined operation to prolong the life.
Adolescent ; Adult ; Aged ; Female ; Head and Neck Neoplasms ; diagnosis ; surgery ; Histiocytoma, Malignant Fibrous ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective:To observe heart rate circadian rhythm in patients with chronic kidney disease (CKD) stage 5 and to analyze the effects of parathyroidectomy (PTX) on heart rate circadian rhythm in severe secondary hyperparathyroidism (SHPT) patients.Methods:A cross-sectional observation was performed in 213 patients with CKD stage 5 and 96 controls, and the patients were divided into those with severe SHPT (PTX group, n=70) and without severe SHPT (non-PTX group, n=143). Forty-six PTX patients were followed up prospectively. The baseline data were compared among these groups. Holter electrocardiogram was performed for each participant. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Multiple linear regression analysis was used to analyze the related factors of heart rate circadian rhythm in patients with CKD stage 5. Results:The 24-hour, daytime and nighttime mean heart rate in patients with CKD stage 5 were all higher than those in controls, especially in PTX group (all P<0.05). The night/day heart rate ratios of controls and CKD stage 5 patients were (0.81±0.08) and (0.91±0.08) respectively ( P<0.01). Correlation analysis showed 24-hour and daytime or nighttime mean heart rate in patients with CKD stage 5 were positively correlated with serum levels of phosphorus and ln(alkaline phosphatase), while nighttime mean heart rate and night/day heart rate ratio were positively related with serum intact parathyroid hormone level. After adjusting with postoperative follow-up period (median time: 10.9 months), 24-hour and nighttime mean heart rate, and night/day heart rate ratio in PTX patients all decreased significantly (all P<0.01). Conclusions:Heart rate is increased and circadian rhythm is abnormal in patients with CKD stage 5, which are related with mineral and bone disorder. PTX significantly decreases 24-hour and nighttime mean heart rate in severe SHPT patients, and improves the heart rate circadian rhythm.

Objective:To investigate the predictive value of abnormal heart rate circadian rhythm for all-cause mortality in stage 5 chronic kidney disease (CKD 5) patients.Methods:The retrospective study was performed in CKD 5 patients enrolled from the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital) and the Affiliated BenQ Hospital of Nanjing Medical University from February, 2011 to December, 2019. A total of 159 healthy volunteers were enrolled as the healthy control group during the same period. The circadian rhythm of heart rate was monitored by 24-hour Holter. Related indices (including 24-hour, daytime and nighttime mean heart rate, night/day heart rate ratio, 24-hour maximum heart rate, 24-hour minimum heart rate and difference between maximum and minimum of 24-hour heart rate) were calculated. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Cox regression model was used to analyze the risk factors of all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve and Log-rank test were used to compare the differences of cumulative mortality between high ratio group (night/day heart rate ratio>0.91) and low ratio group (night/day heart rate ratio≤0.91). The nonlinear relationship between night/day heart rate ratio and all-cause mortality was analyzed by restricted cubic spline plot. Time-dependent receiver operating characteristic (ROC) curve was used to analyze the predictive value of night/day heart rate ratio for all-cause mortality in CKD 5 patients.Results:A total of 159 healthy volunteers and 221 CKD 5 patients were included in this study. There were 123 males (55.66%) and the age was (52.72±13.13) years old in CKD 5 patients. The total median follow-up time was 50.0 months. Compared with controls, 24-hour, nighttime mean heart rate, 24-hour minimum heart rate in CKD 5 patients were increased (all P<0.05), furthermore, the night/day heart rate ratio was higher [(0.91±0.09) vs (0.81±0.08), P<0.001], showing "non-dipping heart rate". However, the 24-hour maximum heart rate and the difference between maximum and minimum of 24-hour heart rate in CKD 5 patients were lower than controls (both P<0.05). Multivariate Cox regression analysis showed that the increased night/day heart rate ratio (per 0.1 increase, HR=1.557, 95% CI 1.073-2.258, P=0.020) was an independent influencing factor for all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve analysis showed that the cumulative mortality of the high ratio group was significantly increased than that of the low ratio group (Log-rank test χ 2=7.232, P=0.007). From the restricted cubic spline plot, there was a linear effect between night/day heart rate ratio and all-cause mortality ( P=0.141), and when night/day heart rate ratio was above 0.91, the risk of all-cause mortality was significantly increased in CKD 5 patients. According to time-dependent ROC curve, the accuracy of night/day heart rate ratio in predicting all-cause mortality was 70.90% even when the survival time was up to 70.0 months. Conclusions:The circadian rhythm of heart rate in CKD 5 patients displays "non-dipping" state. High night/day heart rate ratio is an independent influencing factor for all-cause mortality in CKD 5 patients.