Adult ; Female ; Humans ; Kartagener Syndrome

Objective To evaluate the efficacy and safety of sunitinib as first line treatment in patients with metastatic renal cell carcinoma (RCC). Methods This study included 46 Chinese patients who were diagnosed with metastatic RCC after radical nephrectomy. The patients received oral sunitinib (50 mg once daily on a 4 weeks on, 2 weeks off) on a 6 weeks cycle dose schedule until disease progression or intolerable toxicities occurred. Results The overall objective response rate was 32.6% (95% confidence interval [CI, 19.1% to 46. 1%]), and the disease control rate was 86.9%,with complete response (CR) 0 (0%), partial responses (PRs) 15 (32.6%), stable disease (SD) 25(54.3 %), and progression disease (PD) 6 ( 13. 1%). The median progression-free survival was 11 months, and the 1-year survival rate was 65.2%, while the median overall survival (mOS) has not been reached. The main adverse events included fatigue 33 (71.7%), skin discoloration 29 (63.0 %),anorexia 28 (60.9%), hand-foot syndrome 26 (56.5%), oral mucositis 25 (54.3%), hypertension 19 (41.3%), facial edema 18 (39.1%), diarrhea 17 (37.0%), hemorrhage 17 (37.0%), nausea 15 (32.6%), and hematological toxicity: leukopenia 32 (69.6%), neutropenia 30 (65.2%), thrombocytopenia 28 (60.9%), anemia 21 (45.7%). Most of grade 3/4 serious adverse events were thrombocytopenia in 15 (32. 6%) patients. Conclusions Sunitinib has a prominent effect in metastatic renal cell cancer in a Chinese population with mostly mild to moderate adverse reactions. More attention should be paid to grade 3/4 adverse reaction of thrombocytopenia.

Objective To investigate the optimal window width and window level for measuring the airway dimensions with spiral CT scan in Japanese white big-ear rabbits so as to lay the foundation for airway stenting in animal experiments. Methods Multi-slice spiral CT scanning of cervico-thoracic region was performed in 30 healthy adult Japanese white big-ear rabbits, the anteroposterior and transversal diameter of the thoracic trachea, the anteroposterior diameter of the right and left bronchus were measured with lung window, mediastinum window and special fat window separately. The revealing rate of the tracheal wall and the measuring results in different windows and levels were recorded and compared with the anatomical data. The differences of the relevant data were statistically analyzed. Results With lung window, the tracheal wall was well demonstrated, but the relevant data were smaller than that with mediastinum window. With mediastinum window, the data were bigger and the tracheal wall border appeared blurred. The results obtained with fat window were close to the actual anatomical data. Conclusion For accurately measuring the anteroposterior and transversal diameter of the thoracic trachea in Japanese white big-ear rabbits with multi-slice spiral CT scan, fat window should be adopted, which is helpful for the preparation of tracheal and bronchial stents.

Objective To discuss the anatomic features, clinical presentations, diagnosis,differentiations and treatments of congenital fourth branchial anomaly(CFBA). Methods The clinical data of 8 patients with CFBA were retrospectively analyzed. Results Of the 8 patients aging from 27 to 300 months(median age: 114 months), 4 male and 4 female; 3 untreated previously and 5 recurrent. All lesions, including 1 cyst, 3 sinus (with internal opening) and 4 fistula, located in the left necks. Three patients presented acute suppurative thyroiditis, 4 deep neck abscesses, and 1 neck lump. Preoperative examinations included barium esophagogram, direct laryngoscopy, ultrasonography, CT, MRI, and so on.The principles of managements were adequate drainage, infection control during acute period and radical surgery during quiescent period. Classic surgical approach consisted of complete excision of branchial lesions, dissection of recurrent laryngeal nerve and partial thyroidectomy. Selective neck dissection was applied in recurrent cases to extirpate branchial lesions, scarrings and inflammatory granuloma.Postoperatively, 1 case was with local incision infection which healed by wound care; 1 case was with temporary vocal cord paralysis which completely recovered 1 month after operation. No recurrence was found in all of 8 cases with follow-up of 13 to 42 months (median: 21 months). Conclusions CFBA relates closely anatomically with recurrent laryngeal nerve and thyroid grand. The barium esophagogram and direct laryngoscopy are the most useful diagnostic tools. CT and MRI are all beneficial to the diagnosis of CFBA.The treatment key to CFBA is the complete excision of lesion during a quiescent period after inflammatory control, together with the dissection of recurrent laryngeal nerve ,partial thyroidectomy and partial resection of lamina of thyroid cartilage (if necessary), which all can decrease the risk of complications and recurrence.For recurrent cases, selective neck dissection is a safe and effective surgical procedure.

OBJECTIVETo investigate the long-term outcome of CO₂ laser microsurgery for laryngeal cancer.

METHODSSeventy patients with laryngeal cancer were treated with CO₂ laser microsurgery. All patients were followed up for at least 36 months (36 - 108 months).

RESULTSDuring the 36-108 months follow-up, 64 patients were alive, and 6 patients died of recurrence. The total 5-year survival rate was 91.4%, 5-year local control rate was 81.4%, 5-year local recurrence rate was 18.6%, and the neck metastasis rate was 4.3%. All survivals had normal breathing and good phonation.

CONCLUSIONSThe long-term outcomes of CO₂ laser microsurgery for laryngeal cancer are good, with rapid recovery and few complications, well protected laryngeal function and quite good quality of life. Laser surgery should be the priority of treatment for early stage laryngeal cancer. However, laser surgery for advanced laryngeal cancers and supraglottic laryngeal cancers should be carefully chosen.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Lasers, Gas ; therapeutic use ; Lymphatic Metastasis ; Male ; Microsurgery ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Quality of Life ; Recovery of Function ; Survival Rate ; Treatment Outcome

Objective To assess the feasibility,the risks and the advantages of endoscope-assisted submandibular gland resection using a retroauricular hairline incision ( RAHI) by comparing it with the conventional submandibular gland resection.Methods Twenty eight patients with benign lesions of the submandibular gland were included in the prospective clinically controlled study.Thirteen patients had endoscope-assisted resection using the RAHI approach and 15 cases had conventional transcervical approach resection.The size,location and adjacency of all lesions were evaluated by CT or MRI before surgery.The pathologic diagnoses of all cases were identified as benign diseases using fine needle aspiration biopsy.The two groups were compared for incision length,operation time,bleeding,incision cosmetic result,and complications.Results All 28 operations were successfully performed.Incision length in the endoscopic group was significantly longer than that in the trancervical group (Z =-4.516,P＜0.01),and the surgical time was longer in the endoscopic group( Z =-3.263 ,P ＜0.01) .After three months the mean subjective satisfaction score for the incision scar in the endoscopic group was significantly higher than that in the trancervical group(Z=-4.472,P＜0.01).In the endoscopic group,2 cases (15.4%) with temporary numbness of the earlobe and 1 case (7.7% ) with a temporary marginal mandibular nerve paralysis were found postoperatively.However,they recovered within 1 month.All 28 patients were disease free with a follow-up of 10 to 24 months (median of 18 months).Conclusions Endoscope-assisted submandibular gland resection via RAHI is feasible and safe for the treatment of benign submandibular gland lesions.In comparison with the transcervical approach,this method can provide better cosmetic results without significant complications.

With improved overall survival of cervical cancer patients, the importance of the quality of life (QOL) is increasingly recognized. This study was conducted to compare the QOL of women with different stage cervical cancer before and after treatment to facilitate improved cervical cancer prevention and treatment. We used the generic Medical Outcomes Study Short Form-36 (MOS SF-36) to collect QOL information. Based on SF-36, we interviewed cervical cancer patients at West China Second Affiliated Hospital and Sichuan Cancer Hospital between May 2010 and January 2011. A total of 92 patients with precancerous lesions, 93 with early cancer, and 35 with advanced cancer responded to our survey. Average physical component summary (PCS) scores were significantly different between the three groups at every time point (P < 0.05). Average mental component summary (MCS) scores were significantly different between the three groups after treatment (P < 0.05). Average PCS and MCS scores increased gradually from the pretreatment to posttreatment period for patients with precancerous lesions. However, they reached the lowest at 1 month after treatment for patients with early and advanced cancers and rebounded between 1 and 6 months after treatment. Our results indicate that patients with precancerous lesions and early cervical cancer show better overall QOL than do those with advanced cervical cancer. Additionally, patients with early cancer recover more quickly than do those with advanced cancer in terms of both physical and mental functions. Thus, early detection and treatment initiatives may improve the QOL for patients with precancerous lesions and cervical cancer.
Adult ; Aged ; Carcinoma in Situ ; pathology ; therapy ; Cervical Intraepithelial Neoplasia ; pathology ; therapy ; Chemoradiotherapy ; China ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Lymph Node Excision ; Middle Aged ; Neoplasm Staging ; Precancerous Conditions ; pathology ; therapy ; Quality of Life ; Surveys and Questionnaires ; Uterine Cervical Neoplasms ; pathology ; therapy ; Young Adult

Objective: To evaluate the inhibitory effect of tumor vaccines in colon carcinoma model mice. Methods: Mouse bone marrow⁃derived dendritic cells（BMDCs）were stimulated by using CpG β⁃glucan nanoparticles（CNP）in vitro. The BMDCs were divided into PBS group，NP group（without CpG nanoparticles），Lysate group（MC38 cell lysate）and CpG group（CpG1826），which were determined for the expression of marker molecules on the surface by flow cytometry and for the contents of interleukin⁃6（IL⁃6）and IL⁃12p40 in the culture supernatant by ELISA. The tumor lysate nano⁃vaccine was pre⁃ pared by mixing 50 mg／mL tumor lysate（MC38 cell lysate）with 200 mg／mL CNP in a volume ratio of 1∶1，with which mice were subcutaneously immunized as Vaccine group. Vaccine group，PBS group，CNP group and Lysate group were im⁃ munized once a week，for three times in total. Mice were subcutaneously inoculated with MC38 cells，2 × 105 cells for each， in the right lower limb 1 h after the last immunization，and measured for tumor volume once every three days to plot the tumor growth curve. The ratios of CD3+ CD4+ T and CD3+ CD8+ T cells in the blood were analyzed by flow cytometry and the levels of tumor necrosis factor⁃α（TNF⁃α）and interferon γ（IFNγ）in the blood and spleen of mice were determined by ELISA. Results: CNP effectively increased the expression of CD11c+ CD80+，CD11c+ CD86+，CD11c+ MHC⁃Ⅱ+ and the secretion of IL⁃6 and IL⁃12p40 in BMDCs in vitro，which were significantly higher than those in other 4 groups（t = 4. 3 ~ 46. 2，each P < 0. 05）. Compared with that of the other three groups，the tumor volume of mice in Vaccine group decreased significantly（t =2.6~3.4，eachP <0. 05）；TherewasnosignificantdifferenceinCD3+ CD8+ TandCD3+ CD8+ Tcellratios（t = 0.5~ 1. 9，each P > 0. 05）；The content of IFNγ in blood increased significantly（t = 3. 8 ~ 4. 6，P < 0. 05），while thatof TNF⁃α showed no significant difference（t = 0. 4 ~ 2. 0，each P > 0. 05）；However，the contents of IFN γ and TNF⁃α in spleen increased significantly（t = 6. 3 ~ 13. 0，each P < 0. 001）. Conclusion The prepared nano⁃vaccine of tumor lysate improvedtheimmune level in mice and effectively inhibited the growth of colon carcinoma.

Objective To study and analyze the negative psychological statue in HIV/AIDS patients and explore the nursing strategy.Methods The data of 102 HIV/AIDS patients were recorded.then measured by symptom check list(SCL-90),self-rating depression scale(SDS)and serf-rating anxiety Scale(SAS).Results 77 cases(75.49%)had different degrees of psychological problems.Other than hostility.the scores of somatization,compulsion,relationship,depression,anxiety,terror,paranoia and psychosis were obviously abnormal compared to normal model.The occurrence rates of depression and anxiety were 67.65%(69/102) and 43.13% (44/102),respectively.Conclusions Most HIV/AIDS patients are in an obviouslv ahnormal psychological statue.The occurrence rates of depression and anxiety are high.According to the patients'negative emotion,the pertinent psychological intervention and nursing strategy for HIV/AIDS patients are suggested to improve patient's psychological statue.It should be necessary for improving patient's living qualities.