Objective To evaluate the clinical effect of local POME optical treatmeat in patients with severe vulvovaginal candidiasis (VVC) . Methods Ninety-eight patients, who were diagnosed as severe vulvovaginal candidiasis from January to December 2009 in Beijing Wuzhou Women's Hospital gynecologicalclinic,were enrolled into this study and divided into control and physiotherapy groups randomly. The patients of control group (re =48) were treated with oral Fluconazole and had Miconazde Nitrate suppositories settlement into vagina, while in the physiotherapy group (n =50) the patients accepted local POME optical treatment combined with the same medications as control. The therapeutic effect were evaluated and compared according to the subjective symptoms and VVC scores in both groups. Results The clinical symptoms of physiotherapy group were relieved within 4 hours after the treatment, which were significantly depressed compared to before the treatment (itching score 1.4 ±0.3 vs. 2. 8 ±0. 5,P <0. 05;pain score 1.5 ±0.4 vs. 2. 8 ±0. 3,P <0. 05),while obvious improvements were observed in control group untill 48 hours later (itching score 1. 8 ± 0. 6 vs.2.9 ±0.3,P<0. 05;pain score 1.5 ±0.5 vs. 2. 8 ±0.4,P <0. 05). The VVC scores were significantly lower in physiotherapy group than control after treatment at different timepoints (24 h VVC Score 5. 3 ± 1. 6 vs. 9. 5 ±2. 1,P<0. 05;48 h Score 4. 8 ±1.0 vs. 7.9 ±2. 3,P<0. 05),but no significant difference was observed in the comparison of VVC Scores between two groups 72 h after treatment (P > 0.05). Conclusion Local POME optical treatment combined with drug treatment in severe VVC patients not only has better effect than drug treatment alone,but also relieves clinical symptoms more quickly.

Objective:To investigate the effect of O-6-methylguananine-DNA methyltransferase (MGMT) gene promoter methylation status on the treatment and prognosis of elderly patients newly-diagnosed with glioblastoma (GBM).Methods:Clinical data of 65 newly-diagnosed GBM patients admitted to Tianjin Huanhu Hospital from January 2012 to December 2018 were retrospectively analyzed. All patients received intensity-modulated radiotherapy after surgery and 49 patients received temozolomide (TMZ) monotherapy. All patients were divided into the MGMT(+ ) group and MGMT(-) group according to the methylation status of MGMT promoter. Kaplan- Meier method and log-rank test were used for univariate survival analysis, and Cox regression model was used for multivariate prognostic analysis. Results:The median overall survival (OS) for all patients was 18.0 months. The median OS was 27.0 months and 15.3 months in the MGMT(+ ) group and MGMT(-) group, respectively. Univariate analysis revealed that tumor number, MGMT promoter methylation, postoperative concurrent chemoradiotherapy were significantly related to clinical prognosis ( P=0.029, P=0.001 and P<0.001). In multivariate analysis, tumor number and postoperative concurrent chemoradiotherapy were identified as significant prognostic factors for OS ( P=0.037, P=0.004). In the MGMT(+ ) group, the median OS was 27.0 months for patients receiving concurrent chemoradiotherapy and 12.0 months for radiotherapy alone ( P=0.040). In the MGMT(-) group, the median OS was 17.0 months for concurrent chemoradiotherapy patients and 10.0 months for radiotherapy alone ( P=0.122). Conclusions:MGMT promoter methylation status is significantly associated with longer OS in elderly GBM patients. Conventional fractional radiotherapy combined with concurrent and sequential TMZ chemotherapy probably yields better survival benefits.

We evaluated the patient in the early,advanced or healing phase of the disease by MRI in the treatment of chronic brucellosis spondylitis and to guide the clinical treatment.MRI images of 40 patients with clinically diagnosed chronic brucellosis spondylitis were analyzed retrospectively.The imaging findings of early,advanced and healing patients were summarized.MRI showed abnormal signals in the vertebral body,intervertebral disc,paraspinaI and psoas muscle.It is early stage if the intervertebral space was normal,and advanced stage if combined with interverbral space stenosis.It demonstrated short T1 and short T2 signal or similar to the normal vertebral body,combined with intervertebral space stenosis,for the healing stage.According to the specific imaging manifestations of chronic brucellar spondylitis in the course of disease development,it is possible to evaluate the clinical stage of the disease and guide the rational selection of clinical treatment.

Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Esophageal Neoplasms ; genetics ; metabolism ; pathology ; Gene Frequency ; Humans ; Lymphatic Metastasis ; Neoplasm Invasiveness ; Neoplasm Staging ; Polymorphism, Genetic ; Prognosis ; Proportional Hazards Models ; Risk Factors ; Survival Rate ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Objective To retrospectively investigate and compare the clinical features in type 2 diabetic patients with various lesions of diabetic nephropathy.Methods One hundred and fifty patients of type 2 diabetes mellitus were registered from December 1990 to April 2004,among them 73 cases of diffuse glomerulosclerosis (DIF)and 77 nodular glomerulosclerosis(NOD)were all proven by renal biopsy.Data such as the durations of diabetes mellitus and hypertension,body mass index(BMI),diabetic retinopathy,HbA_1c,plasma albumin, proteinuria,urine N-acetyl-?,-glucosaminidase,urine osmolarity,ereatinine clearance rate(Ccr)were collected and compared.Results(1)Compared with the patients with DIF,the patients with NOD had longer duration of diabetes mellitus[(122.0?8.1 vs 56.0?7.8)months,P

Objective To investigate the expression of IL-23 and IL-23 mRNA in allograft and peripheral blood of mice receiving skin transplantation under different immune states. Methods Mice skin allograft models were established and divided into 3 groups: synergeneic transplant group (BALB/c→BALB/c), allogeneic transplant group (C57BL/6→BALB/c), donor spleen cells infusion group (C57BL/6→BALB/c). Peripheral blood plasma concentration of IL-23 was measured by ELISA. RT-PCR was used to detect the expression of IL-23 mRNA in the skin allograft. Results There was no significant difference in the IL-23 and IL-23 mRNA expression among all three groups one day after skin transplantation (P＞0. 05). On the day 3, 5, and 7 after skin transplantation, there was significant difference in the IL-23 and IL-23 mRNA expression levels between synergeneic transplant group, donor spleen cells infusion group and allogeneic transplant group (P ＜ 0. 01 ), but there was no significant difference between synergeneic transplant group and donor spleen cells infusion group (P＞0. 05). Conclusion The high expression levels of IL-23 and IL-23 mRNA were detected when early acute rejection took place in recipient mice. IL-23 could serve as a predictable and prognostic marker for the acute rejection. Infusion of donor spleen cells can significantly prolong the allograft survival.

Objective To evaluate the efficacy and security of splenic artery ligation for severe hypersplenism during liver transplantation.Method Thirty-two liver transplant patients with preoperative hypersplenism were selected,including 17 cases (ligation group) treated by splenic artery ligation during liver transplantation,and rest 15 patients as non-ligation group.The fluctuation of white blood cells,platelets and volume of spleen were compared between these two groups.At the same time,splenic infarction,postoperative infection,recurrent gastrointestinal bleeding,splenic artery steal syndrome and other complications were observed in these two groups.Result All recipients were followed up for over 6 months.One recipient in ligation group died of multiple organ dysfunction caused by delayed recovery of liver donor with the survival rate being 94.1％ (16/17).The survival rate in non-ligation group was 93.3 ％ (14/15) (one recipient died of respiratory failure caused by pulmonary infection).There was no statistically significant difference in survival rate between these two groups (P＞0.05).Splenic necrosis wasn't detected in the ligation group.The splenic volume in ligation group was significantly less than that in non-ligation group (P＜0.01).The products of splenic maximum length and wide diameter shrunk 33.17-± 8.26 cm2 and 22.47 ± 7.25 cm2 in ligation group and non-ligation group,respectively.The platelet counts of ligation group were significantly greater than those of non-ligation group in all the observation points within 6 postoperative months (P＜0.01).The white blood cell counts of ligation group were greater than those of non-ligation group at the first week postoperatively (P＜0.01),whereas,there was no statistically significant difference between these two groups from then on (P＞0.05).The infection incidence of ligation group was lower than that of non-ligation group within 6 postoperative months (P ＜0.05).Statistically significant differences in recurrent gastrointestinal bleeding and splenic artery steal syndrome weren't found between these two groups (P＞0.05).Conclusion Splenic artery ligation in liver transplantation is safe and effective.It can rapidly increase the counts of platelet and white blood cell in the earlier postoperative time,which is beneficial to patient's recovery.Besides,it adds no correlative complication.

BACKGROUND:Previous studies have reported the cause and treatment of biliary complication. However, how to improve operative technique for preventing the complication is rarely reported.
OBJECTIVE:To explore the effect of operational skil s during liver transplantation on biliary complications.
METHODS:Biliary complications in 475 patients who underwent liver transplantation were retrospectively analyzed. The relationship between operational skil s and biliary complications after liver transplantation was observed. The potential risk factors about operative technique were summarized. Some preventive interventions for biliary complications were suggested.
RESULTS AND CONCLUSION:Biliary complication was diagnosed in 36 (7.6%) of 475 patients who underwent liver transplantation. They were nonanastomotic biliary stricture (n=19, 4.0%), anastomotic biliary stricture (n=7, 1.5%), biliary leakage (n=3, 0.6%), twisted common biliary duct (n=3, 0.6%), residual common duct stone (n=1, 0.2%), and neoformative common duct stone (n=3, 0.6%). There was no difference in the incidence of nonanastomotic biliary stricture among the three biliary anastomotic styles. The possibility of anastomotic biliary stricture in placing T-drainage tube group was lower than the other two groups according to clinical data. Nevertheless, there was no statistical difference between these three groups. Infusing UW into the liver from cranial mesenteric vein and douching the biliary duct immediately while taking the donor could decrease the incidence of biliary complication after liver transplantation (P=0.013 and P=0.018, OR=0.26 and OR=0.28), the later factor could also decrease the incidence of nonanastomotic biliary stricture (P=0.001, OR=0.09). Meanwhile, some operational skil s also decrease the incidence of biliary complications, such as protecting the artery around the biliary duct, and elevating the liver when suturing the common biliary duct.

Objective To investigate the related factors of the prognosis of arterial embolectomy of acute cardiogenic cerebral embolism caused by atrial fibrillation.Methods The clinical data of using vein thrombolysis bridging artery embolectomy or arterial embolectomy alone for the treatment of patients with acute cardiogenic cerebral embolism of cerebral large artery occlusion due to atrial fibrillation were analyzed retrospectively.From January 2015 to December 2016,22 consecutive inpatients with cardioembolic cerebral embolism caused by paroxysmal or persistent atrial fibrillation were enrolled,including 10 patients with the 90-day modified Rankin Scale (mRS) score 0-2 (good recovery group) and 12 patients with mRS scores 3-6 (poor recovery group).The clinical features,imaging data,and treatment of the patients in both groups were compared.The factors such as age,gender,preoperative international standardization ratio (INR),embolism position,whether bridging vein thrombolysis before thrombectomy,National Institutes of Health Stroke Scale (NIHSS) score at the onset,time of onset to reperfusion (TOR),whether using tirofiban,times of thrombectomy,modified Thrombolysis In Cerebral Infarction (mTICI) blood flow grade,and postoperative intracranial symptomatic intracerebral hemorrhage were analyzed.Results There were no significant differences in age,gender,preoperative INR,embolism position,the number of intravenous thrombolysis before thrombectomy,the number of using tirofiban in surgery,the proportion of the above mTICI 2b grade,and the proportion of symptomatic cerebral hemorrhage after surgery of the patients between the two groups (P>0.05).The NIHSS score 15.2±2.0 at the onset in the good recovery group was lower than 22.9±8.4 in the poor recovery group.There was significant difference between the two groups (P<0.05).The TOR time (307±86 min) in the good recovery group was less than that of the poor recovery group (426±145 min).There was significant difference between the two groups (P<0.05).Embolectomy was performed 1.5 (0.5,3.0) times in the good recovery group,which was less than the poor recovery group (4.0 [2.0,7.0] times).There was significant difference between the two groups (P<0.05).Conclusions Shortening the time of reperfusion and reducing the number of embolectomy during operation are the important factors for improving the prognosis of patients when atrial fibrillation causes arterial embolectomy in patients with acute cerebral embolism.However,a study of larger sample is needed for further exploration.

Adult ; Carcinoma ; complications ; Female ; Humans ; Kidney Neoplasms ; complications ; Solitary Fibrous Tumors ; complications ; Thyroid Neoplasms ; complications