Adult ; Histiocytosis, Sinus ; Humans ; Male ; Nasal Cavity ; Paranasal Sinuses

Objective:To explore the possibility and methods of surgical treatment(ST) for huge primary liver cancer(HPLC).Methods:The clinical data of 86 HPLC were analyzed retrospectively and the main challenges as well as their counter measures during ST are concluded.Results:Among the 86 cases,there were 10 cases which complicated with portal vein(PV),and 5 cases with IVC thrombus respectively;there were 76 cases with HBV cirrhosis,2 HCV cirrhosis,there were 60 and 26 cases of primary and secondary hepatectomy in which included regular right(9 cases),left hemihepatectomy(8 cases)and combined hepatectomy(69 cases).Six cases received PV embolism before surgery.There were 10 and 5 cases of cancer thrombus extraction from PV and IVC respectively.In this group,81 patients were cured,and the perioperative mortality was 5.8%(5/86).The postoperative one—year survival rate for the patients was 77.9%.Conclusions:ST for HPLC is safe and acceptable.Full of preoperative assessment,careful intraoperative exploration,and surgical skill played a key roles.

Objective:To investigate the clinical efficacy of intramedullary nailing combined with bone cement in repair of segmental bone defects after tumor resection.Methods:A retrospective analysis was conducted of the 5 patients with malignant bone tumor who had been treated at Department of Orthopaedics, Qiannan People's Hospital from April 2018 to September 2019 for remaining segmental bone defects following limb salvage surgery. They were 4 males and one female, aged from 11 to 55 years (average, 35.4 years). Their defects ranged from 6 to 21 cm (average, 12.3 cm) after tumor resection. By the Karnofsky performance score (KPS) for long-term quality of life, all of them scored less than 50 points. Of them, 3 were treated by interlocking intramedullary nails and bone cement filling, and 2 by elastic intramedullary nails and bone cement filling. In the 2 cases with defects of 21 cm and 13 cm, the fixation was assisted by a plate and an external fixator. Defect length after resection, operation time and intraoperative bleeding were recorded; the efficacy was evaluated by the Enneking functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system, visual analogue scale (VAS), and KPS.Results:All the 5 patients had uneventful surgery, with operation time ranging from 112 to 225 min (average, 154.2 min), intraoperative bleeding from 300 to 500 mL (average, 382 mL), and defect length after resection from 6 to 21 cm. The 5 patients were followed up for 6 to 28 months. Of them, 2 died of disease progression 6 and 7 months after surgery, respectively. According to the Enneking's evaluation, one patient scored 28 points, 2 patients 23 points and 2 patients 21 points, giving a high degree of satisfaction. Their VAS scores 6 months after surgery ranged from 1 to 6, averaging 3.6; their postoperative KPS scores ranged from 60 to 80, averaging 72.Conclusion:In repair of segmental bone defects after tumor resection, intramedullary nailing combined with bone cement filling can relieve pain of patients and lead to satisfactory short-term curative efficacy.

Objective　To investigate the protective effects of alcoholic extracts of Ganoderma lucidum (GL) and its combination with Rad ix Salviae Miltiorrhizae (RSM), Radix Bupleuri (RB), and Fructus Schisandrae Chi nensis (FSC) respectively on experimental hepatic injuries. Methods　Hepatic injury models were established with the injections of carbon tetrac hloride (CCl4) or D-galactosamine(D-GlaN) into mouse, and then the therapeut ic agents at same dose were given respectively. The activity of cholinesterase(C hE) and alaline aminotransferase(ALT) in the serum and hepatic homogenate, the c ontents of malonyl dialdehyde (MDA), alkaline phosphatase (ALP) and reduced glut athione (GSH) in hepatic homogenate from all mouse were determined. The morpholo gic changes of the livers were also observed with VG staining. Results 　In CCl4 treated mice, serum ALT activity was increased markedly wh ile ChE acti vity decreased significantly. GL and GL+RB, GL +FSC could relieve these changes ; GL combined with all other agents could inhibit the GSH accumulation, but only GL+FSC had a suppressive effect on MDA increase and made it return to normal. For D-GlaN treated mice, all agent groups had little effect on the activity of ChE; Only GL dramatically reduced the increased activity of ALT; GL +RSM could e liminate the GSH, but not significant; GL and all GL combinations could decrease the increased MDA (P<0.01). Pathological observation showed that hepatocyte damage in GL group and GL+FSC group incline d to recover. Conclusion　The results indicate that Ganoderma lucidum is an effective agent against hepatic injuries, especially combined wi th F ructus Schisandrae Chinensis, which may be associated with its anti-hepatocyte oxidation.

Objective To investigate the effects of sulforaphane (SFN) on proliferation and invasion of human small cell lung cancer NCI-H446 and the activity of matrix metalloproteinase (MMP) -9.Methods NCI-H446 cells were cultured with 0,25,50,100 μmol/L SFN for 24 ～ 72 h,then MTT assay was employed to detect cell proliferation.Chamber invasion assay was used to study the cell invasion,and gelatin zymography assay was implied in MMP-9 enzyme activity.Results After treatment of 25,50,100μmol/L SFN,the growth of NCI-H446 cells were inhibited.When cells were incubated with 25,50,100μmol/L of SFN for 72h,the inhibition ratio was ( 11.1 ± 2.26 ) ％,( 25.2 ± 3.24 ) ％ and ( 44.6 ±4.2) ％,respectively,the difference was statistically significant compared with the solvent control group ( t =10.685,8.417,5.264,P ＜0.05 ).Chamber invasion assay showed that NCI-H446 cell invasion could be reduced.25,50,100 μmol/L of SFN could decrease the trans-membrane cells to (48.6 ± 1.84)％,(35.4 ± 2.22) ％ and (27.8 ± 1.36) ％,and it was statistically significant compared with the solvent control group ( t =6.341,5.562,4.925,P ＜0.05 ),respectively.In addition,MMP-9 activity was significantly inhibited by SFN.25,50,100 μmol/L of SFN could decrease the gray value of MMP-9 to 764 ±18.4,685 ± 14.74 and 638 ± 21.54 ( control group 822 ± 12.53,t =4.971,7.582,11.235,respectively,P ＜0.05).Conclusions SFN can inhibit NCI-H446 cells growth,invasion and the activity ofMMP-9.

Objective To investigate the pathological features,diagnosis and treatment of primary malignant melanoma in esophagus (PMME).Methods The clinical data of 3 patients with PMME who were admitted to the Beijing Friendship Hospital from January 2008 to June 2009 were retrospectively analyzed.All the patients received esophageal barium radiography,electronic fiberesophagoscopy,esophageal endoscopic ultrasonography,computed tomography,and underwent surgery.Adjuvant therapy and immunotherapy were applied postoperatively.Results The results of barium radiography showed irregular filling defect presentation in the distal esophagus.The results of endoscopy showed a purple black tumor with a length of 3-8 cm in the esophagus.The results of endoscopic ultrasonography showed that the tumor was derived from the mucosal layer with low echo density.The results of computed tomography showed thickness of the lower segment of the esophagus.All the 3 patients received left thoracic approach esophagectomy and esophagogastrostomy.Histopathology and immunohistochemistry confirmed malignant melanoma.The expressions of Mart-1,HMB-45 and S-100 antigen were positive.The survival time of 2 patients was longer than 3 years,and 1 patient died of metastasis 6 months after operation.Conclusions PMME is a kind of rare and malignant tumor with dismal prognosis.Surgical management is the first choice,adjuvant chemotherapy and immunotherapy are hopeful to increase the survival time of the patients.

Objective To determine the consistency between quantitative CT perfusion measurements of colorectal cancer obtained from single section with maximal tumor dimension and from average of whole tumor,and compare intra-and inter-observer consistency of the two analysis methods.Methods Twenty-two patients with histologically proven colorectal cancer were examined prospectively with 256-slice CT and the whole tumor perfusion images were obtained.Perfusion parameters were obtained from region of interest (ROI) inserted in single section showing maximal tumor dimension,then from ROI inserted in all tumor-containing sections by two radiologists.Consistency between values of blood flow (BF),blood volume (BV) and time to peak (TTP) calculated by two methods was assessed.Intra-observer consistency was evaluated by comparing repeated measurements done by the same radiologist using both methods after 3 months.Perfusion measurements were done by another radiologist independently to assess inter-observer consistency of both methods.The results from different methods were compared using paired t test and Bland-Altmnan plot.Results Twenty-two patients were examined successfully.The perfusion parameters BF,BV and TTP obtained by whole tumor perfusion and single-section analysis were (35.59 ± 14.59) ml · min-1 · 100 g-1,(17.55 ±4.21) ml · 100 g-1,(21.30 ±7.57) s and (34.64 ± 13.29)ml· min-1 · 100 g-1,(17.61 ±6.39)ml± · 100 g-1,(19.82 ±9.01)s,respectively.No significant differences were observed between the means of the perfusion parameters (BF,BV,TTP)calculated by the two methods (t =0.218,-0.033,-0.668,P ＞ 0.05,respectively).The intra-observer 95％ limits of consistency of perfusion parameters were BF-5.3％ to 10.0％,BV-13.8％ to 10.8％,TTP-15.0％ to 12.6％ with whole tumor analysis,respectively; BF-14.3％ to 16.5％,BV-24.2％ to 22.2％,TTP-19.0％ to 16.1％ with single section analysis,respectively.The inter-observer 95％ limits of consistency of perfusion parameters were BF-8.0％ to 8.3％,BV-10.9％ to 11.5％,TTP -14.5％ to 11.1％ with whole volume analysis,respectively; BF-10.2％ to 14.1％,BV-19.0％ to 17.6％,TTP-22.0％ to 24.0％ with single section analysis,respectively.Conclusion There was no statistically different between the single section and whole volume analysis of tumor perfusion CT.The whole volume perfusion analysis apparently improves intra-and inter-observer consistency and can reflect the whole tumor angiogenesis more accurately and repeatedly.

The X-ray computed tomography (CT) appearance of 4 cases with pulmonary cryptococcosis (PC) diagnosed by pathological examination in our hospital was retrospectively analyzed. The appearances of PC on CT were various: solitary lesion in 1 case, multiple lesions in single lobe in 2, and multiple lesions in multiple lobes in 1. There were total 52 lesions in 4 cases; the diameter of nodules or masses was 3 - 75 mm. Cavitations were found in 1 case; lesions appeared obviously enhanced and one lesion showed central necrosis. Two cases underwent pulmonary lobectomy; and 2 cases received core cutting needle biopsies, after antifungal therapy for 3 months to 1 year the lesions showed being absorbed. In summary, the CT appearance of PC is non-specific with various modes and forms. PC should be considered when multiple nodules or masses scattered in subpleural zone, accompanied with ground-glass opacity and obviously enhanced. The examination of pathogen and pathology at the beginning is crucial for improving diagnostic accuracy.

Objective To observe the effects of wild jujube seed decoction (WJSD) on learning memory and the levels of malondialdehyde (MDA) and the activities of supemxide dismutase (SOD) and nitric oxide synthase (NOS) in the brain of the pathogeny model rats with sleep deprivation (SD). Methods Levels of learning memory and MDA, and activities of SOD and NOS in rats' brain were assayed after SD induced by made-self multiple platform method ( MMPM), senescence induced by D-galactose, and Yin and blood-deficiency induced by eyclophosphamide and hydrocortisonum. Results After 48 h SD, the levels of learning memory was lower in the model group( ( 108.9 ± 12.5 ) s, ( 89 ± 11.5 ) s, ( 0 ) ) than those in the environmental control group ( ( 47.3 ±4.6)s,(9±1.4)s,(6.5 ±1.2))(( t=4.36,3.18,2.07, P＜0.01＝＝. While MDA, and activities of SOD and NO in rats'brain higher in the model group( (3.8 ±0.6) ,(3.0 ±0.5)nmol · mgprot-1 ,(229.7 ±25.8) ,(236.3± 25.2 ) U · mgprot - 1, ( 5.7 ± 0. 8 ), ( 5.4 ± 0.9 ) U · mgprot - 1 ) than those in the environmental control group ( (2. 1 ±0.4) ,(1.6 ±0.4)nmol · mgprot-1 ,(155.5 ±10.6) ,( 147.2 ±26.1 )U · mgprot-1 ,(2.8 ±0.7),(2.9 ± 0.5 ) U · mgprot -1 ) ( t = 2.89,3.01,6.78,5.94,3.10,3.46, P ＜ 0.05 ＝. However, the observation of the groups treated with WJSD, the levels of learning memory showed a tendency in returning to normal level (P ＜ 0.05 ＝ ,and MDA, and activities of SOD and NO of the high dose of WJSD showed a tendency in returning to normal leve1 (P ＜ 0.05 ＝ ,and the low dose of WJSD showed a tendency in returning to normal level too(P ＜ 0.05 ＝. Conclusion WJSD can improve the disability of learning and memory of the pathogeny rats model, and its one of mechanism maybe involve the reduction of neural cell damage with free radical and NO.

Objective To study the clinical characteristics of early esophageal varices bleeding after endoscopic varices liga-tion EVL in advanced schistosomiasis patients. Methods The data of 206 advanced schistosomiasis patients who received VEL were collected and studied retrospectively. Results There were 17 cases of early esophageal varices bleeding after EVL in-cluding 1 died case the early hemorrhage rate was 8.25% and the mortality rate was 0.5%. The early bleeding occurred from the 4th to 12th day and 76%occurred from the 7th to 9th day postoperatively. The direct cause of hemorrhagic was ligation ring falling off and the inducements were the improper diet 10 cases 58.8% and increased abdominal pressure 6 cases 35% . All the cases of early esophageal varices bleeding occurred in the patients whose liver function being Child-Pugh C. Conclu-sions The incidence and mortality of EVL early postoperative hemorrhage are both low and mostly occur from the 7th to 9th day postoperatively. We should pay attention to the diet and nursing and the patients with Child-Pugh C liver function are the high risk group.