Objective To investigate the common complications related to glomus jugulare tumors surgery,their influencing factors,and to search for the effective treatments of these complications.Methods A retrospective study was undertaken on the complications observed in 47 patients with glomus jugulare tumors who underwent 51 times of operation via trans external auditory canal approach,the retroauricular approach,and modified infratemporal fossa approach type A.All cases were followed up over 1 month after surgery.Results Of 51 cases,the most frequent complication was total conductive hearing loss which occurred in 21 cases(41.2%),facial paralysis was found in 15 cases(29.4%) and lower cranial nerve palsy was found in 14 cases(27.5%) after one month.Other complications were cerebrospinal fluid(CSF) leak,hearing disability and vertigo,each in 3 cases(5.9%);cerebral infarction,partial auricle necrosis and parotid gland fistula,each occurred in one case(2.0%).Pre-operative selective embolization of feeding vessels can reduce intraoperative blood loss significantly in most cases.Effective hemostasis and hypotensive anesthesia during operation were the important ways to prevent complications and hematoma within operating field.CSF leak in this series was an uncommon complication.Two cases with CSF leak from the wound had been successfully controlled with conservative treatment.One case with CSF leak required surgical management.None of these patients developed meningitis.Conclusions There is a low level of serious post-operative complications in operation on glomus jugulare tumor.Factors found to be relevant to post-operative complications are tumor type and tumor size.The key factors to avoid the complications include surgical experience,surgical skill and preoperative evaluation of patients′ imaging information.

Objective To investigate whether genotypes of CYP3A5,MDR1 and cyclooxygenase-2 are associated with the sensitivity of vinorelbine-platinum to NSCLC.Methods The genotypes of CYP3A5(*3),MDR1 (2677G>T at exon 21 and 3435C>T at exon 26 and their haplotypes),cyclooxygenase-2 (-1 195G>A) were determined by RFLP-PCR and chemotherapy responses were analyzed in 69 non-small-celllung cancer (NSCLC) Chinese Han patients.They received a combination chemotherapy of vinorelbine-cispla-tin.Chi-square test was used to investigate the potential association of genotype with chemotherapy response.OR and 95% C1 were calculated.Results The 3435 CC genotype was associated with a significantly betterchemotherapy response compared with the combined 3435 CT and 1Tr genotypes(P=0.033).The 2677 GG genotype was also associated with a significantly better chemotherapy response compared with the combined 2677 GT and IT genotype(P=0.012).Moreover.patients with the 2677 G-3435 C haplotype seemed to have a better response to chemotherapy compared with those with the other haplotypes(P=0.063).CYP3A5*3 was not likely to correlate with sensitivity of vinorelbine-platinum to NSCLC.Cyclooxygenase-2-1195G>A was likely to have better response to vinorelbine but not statistically significant(P=0.067).Conclusion Polymor-Dhisms of MDR1 3435 C>T and MDR1 2677 G>A/T can be used for predicting treatment response to vinorel-bine-cisplatin chemotherapy in NSCLC patients.

Objective To study the expression and significance of miR-26a in intrahepatic cholangiocarcinoma.Methods The expression of miR-26a in 46 intrahepatic cholangiocarcinoma(ICC) tissues and peritumoral tissues was detected by quantitative real time polymerase chain reaction (qRT PCR).The intrahepatic eholangiocarcinoma cell line HCCC-9810 and RBE were transfected with miR 26a mimics and miR 26a inhibitors,respectively,by lipofectamine 2000.The growth curves were constructed by the CCK 8 method.The migration and invasion ability was demonstrated by wound healing and transwell assay.The cell cycle was analyzed by flow cytometry.The potential mechanism was illustrated by Western blotting.Results For the 46 ICC tissues and peritumoral tissues,miR 26a levels were significantly higher in the tumor tissues than in the peritumoral tissues (P＜0.05).Vascular invasion,TNM Ⅲ～Ⅳ stage and lymph node metastasis were significantly associated with high miR 26a expression levels (P＜0.05),but gender,age,tumor amounts,tumor encapsulation,tumor diameter and tumor differentiation showed no significant association (P＞0.05).Enhanced cell proliferation,migration and invasion ability,accelerated G0/G1 phase to S phase transition,activated AKT by PTEN suppression were observed in HCCC-9810 cells with up regulation of miR-26a.Conversely,cell proliferation,migration and invasion ability was inhibited,G0/G1 phase was blocked and AKT was restrained by PTEN increase wkh down regulation of miR-26a in RBE cells.PTEN mRNA in versely correlated with the miR-26a level (r=-0.8272,P＜0.01).Patients with a high miR-26a expression had significantly poorer overall survival (P＜0.05).A high miR 26a exprcssion,multiple tumors and lymph node metastasis were independent prognostic factors of overall survival (P＜0.01).Conclusion Overexpression of miR-26a in intrahepatic cholangiocarcinoma correlated with clinicopath ological features and overall survival,and it potentially promoted tumor proliferation and metastasis through the PTEN/AKT pathway.

Objective To evaluate core needle biopsy (CNB) in detecting estrogen receptor (ER) and progesterone receptor (PR) of HER2,Ki67,and molecular classification of breast cancer.Methods Clinical data of 188 breast cancer patients admitted from Nov 2012 to Jun 2015,were retrospectively analyzed.All patients received both CNB and open excision biopsy (OEB).Immunohistochemistry (IHC) was used to evaluate the expression of ER,PR,HER2 and Ki67.All cases were categorized into four molecular subtypes:Luminal A,Luminal B,triple negative breast canccr and HER2 over-expression breast cancer.Kappa test was used to evaluate the consistency of CNB and OEB.Results Concordance rate of ER,PR,HER2 receptor status and Ki67 value were 94.68％,93.62％,94.68％ and 73.40％.There was no difference between CNB and OEB for non-Luminal tumors (P =0.774).Ki67 expression in OEB samples was higher than in CNB samples (25.90％ vs.21.65％,P ＜ 0.001).Concordance rate between CNB and OEB for molecular subtypes was 72.34％ (K =0.606 4).Conclusions CNB is accurate in evaluating ER,PR,HER2 and Ki67 in breast cancer.CNB is accurate in diagnosing non-Luminal molecular subtypes of breast cancer.

OBJECTIVE: To evaluate the influence of fewer courses and prolonged intervals of chemotherapy on survival rate of advanced non small cell lung cancer (NSCLC) patients treated by sequential chemo-radiation therapy combined with traditional Chinese medicine (TCM). METHODS: From Jan. 2000 to Dec. 2001, 54 untreated advanced NSCLC patients (2 stage IIIa, 18 stage IIIb, 34 stage IV) were treated by sequential chemo-radiation therapy combined with TCM. The courses of chemotherapy were reduced and the intervals of chemotherapy were longer than that of the standard regimen. The efficacy and survival rate were documented and the prognostic factors were analyzed. RESULTS: Complete remission (CR) was observed in 1 case and partial remission (PR) in 20 cases. The overall objective response rate was 40.4%. Median survival was 15.3 months, 1-, 2- and 3-year survival rate were 53.7%, 28.9% and 9.6% respectively. The median survival of stage III and IV were 21.8 months and 12.5 months respectively. The 1-, 2-, and 3-year survival rates of stage III were 65.0%, 49.5%, 24.7% and that of stage IV were 47.0%, 23.3%, 0%, respectively. The quality of life was improved in most of the patients. Cox's proportional hazards regression showed that improved quality of life and treatment of TCM were the significant prognostic factors of overall survival. CONCLUSION: Chemotherapy and radiotherapy combined with TCM is beneficial to extending the interval of chemotherapy, improving the quality of life, and increasing the survival rate of advanced NSCLC patients.

Objective To investigate the effect of escharectomy on rats' pulmonary NF-?B activation and the expression of pulmonary proinflammatory cytokines in early stage of burn injury.Method Wistar rats were randomly divided into three groups:group A(control group),group B(postburn without escharectomy),group C(escharectomy at early stage of burn injury).Thermal-injuried rats underwent 35% TBSA full-thickness burns. Activation of pulmonary NF-?B at 12 hours and 24 hours postburn was tested by electrophoretic mobility shift assay (EMSA),and at the same time expressions of pulmonary TNF-?mRNA were measured by reverse transcription polymerase chain reaction(RT-PCR)and release of pulmonary TNF-?were assayed by enzyme-linked immunosorbent assay(ELISA).Results Compared with control group,activity of pulmonary NF-?B in group B was markedly increased,reached(19.56?1.36)?10~4 A at 12 hours and(15.23?1.94)?10~4 A at 24 hours,which was higher than that in group A[(4.36?0.38)?10~4 A,P

Objective To confirm the distribution of high arsenic drinking water and the situation of endemic arsenism in Hubei Province, to provide reference basis for prevention and control of endemic arsenic disease. Methods Using typical investigation and sample investigation in 2006 and 2007, the arsenic content of water was detected sampled from 19 counties(cities or communities). And those water samples which were close to or exceeded the stipulated standard were rechecked by the national standard method. Furthermore, the situation of endemic arsenism was investigated in the cities having high arsenic contents of water. Results In 2006,10 028 water samples of 446 villages in 6 counties (cities or communities) were tested, the wells of high arsenic (> 0.05 mg/L) were found in 5 counties (cities or communities) and the proportion of the well that exceeded stipulated standard was 5.29%(530/10 028); In 2007,19 086 water samples of 1282 villages in 17 counties(cities or communities) were tested, the wells of high arsenic were found in 11 counties(cities or communities), and the proportion of the well that exceeded stipulated standard was 1.74%(333/19 086). In these two years, 29 114 water samples were tested, in which 863 water samples were exceeding the stipulated standard. The 2.96% of total wells exceeded stipulated standard and mainly distributed in 179 villages of 12 counties(cities or communities). And the highest arsenic content of water sample was 2.012 mg/L. In the endemic arsenism area, 2 critical, 1 moderate and 1 mild arsenism patients had been found. Conclusions The water of high arsenic content are scattered in Hubei Province and the situation of endemic arsenism disease is mild. Improving water aiming at decreasing arsenic and establishing patient files should be carried out immediately.

OBJECTIVETo compare the difference of the clinical efficacy in treatment of nervous tinnitus of kidney deficiency between the combined therapy of Zhuang medicine at Qineihuan point combined with the conventional acupuncture and simple conventional acupancture.

METHODSSixty patients were randomized into an observation group and a control group, 30 cases in each one. In the control group, the conventional acupuncture was applied to Taixi (KI 3), Zhaohai (KI 6), Tinggong (SI 19) and Waiguan (TE 5), etc. and the needles were retained for 30 min. In the observation group, on the basic treatment as the control group, Zhuang medicine acupuncture at Qineihuan point was added. The treatment was given once every day, 10 treatments made one session and there were 2 days of interval between the sessions. In 3 sessions of treatment, the changes of tinnitus were observed and the clinical efficacy was evaluated.

RESULTSAfter treatment, tinnitus score and tinnitus grade were all improved as compared with those before treatment in the two groups (all P<0. 05) and the results in the observation group were better than those in the control group (all P<0. 05). The curative and remarkably effective rate was 63. 3% (19/30) and the total effective rate was 93. 3% (28/30) in the observation group, better than 30. 0% (9/30) and 73. 3% (22/30) in the control group (both P<0. 05).

CONCLUSIONThe combined therapy of Zhuang medicine at Qineihuan point and conventional acupuncture achieves the better efficacy on nervous tinnitus of kidney deficiency as compared with the simple conventional acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Kidney ; physiopathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Tinnitus ; physiopathology ; therapy ; Treatment Outcome ; Yin Deficiency ; physiopathology ; therapy

Objective:To develop a novel regulable sutureless aortic arch prosthesis and to apply it in an animal experimental study.Methods:The arch skeleton of the prosthesis was made of tandem Z-shape NiTiNOL wire;the branch skeleton was made of laser-cut NiTiNOL tube;and the whole skeleton was coated with thin ePTFE film.The blood vessel was anastomosed by di- rect ligature,needing no manual suturing.The prosthesis was applied in swine aortic arch operations under the bypass condi- tion.The practicality for surgery and the feasibility of anastomosis of the prosthesis were assessed.Results:Aortic arch opera- tions were successfully performed in 6 of the 8 experimental animals.The prostheses were easy to use,and the mean bypass time was only 10 min.The blood loss of the anastomoses was less than 100 ml within 8 h postoperatively in 5 animals;one had more blood loss due to prosthesis mismatch.Conclusion:The novel regulable sutureless aortic arch prosthesis has satisfactory practicality for surgery and reliable anastomosis,making it promising in future clinical application.

Objective: To observe the effects of acupuncture plus spinal manipulations on the physical functioning and levels of alkaline phosphatase (ALP), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and osteoprotegerin (OPG) in patients with ankylosing spondylitis (AS). Methods: A total of 128 AS cases were allocated into a control group and an observation group using random number table method, with 64 cases in each group. Patients in both groups took sulfasalazine and meloxicam. Patients in the observation group received additional acupuncture plus spinal manipulations. The efficacy, Bath AS functional index (BASFI), Bath AS disease activity index (BASDAI), and the levels of ALP, ESR, CRP and OPG were compared between the two groups after eight weeks of treatment. Results: After treatment, the symptom scores of traditional Chinese medicine in both groups were decreased (all P<0.05), and these scores in the observation group were significantly lower than in the control group (all P<0.05); the VAS, BASFI and BASDAI scores in both groups were decreased (all P<0.05), and these scores in the observation group were significantly lower than in the control group (all P<0.05); and the ALP, ESR, CRP and OPG levels in both groups were decreased (all P<0.05), and these levels in the observation group were significantly lower than in the control group (all P<0.05). The total efficacy rate was 92.2％ in the observation group, versus 78.1％ in the control group, presenting a statistical significance (P<0.05). Conclusion: Conventional medication combined with acupuncture and spinal manipulations can improve clinical symptoms, accelerate the recovery of physical functioning, and reduce the ALP, ESR, CRP and OPG levels.