In recent years, based on the phase III clinical study, postoperative chemoradiation, perioperative chemotherapy with ECF regimen and postoperative adjuvant chemotherapy with oral S-1 have become the standard adjuvant treatment of resectable gastric adenocarcinoma in the United States, Europe, and Japan, respectively. Since the Southwest Oncology Group in 2001 reported a large phase III randomized clinical trial INT0116, adjuvant chemoradiotherapy has become a standard treatment for gastric adenocarcinoma. With the rapid development of chemoradiotherapy technique, clinical researches for using operation combined with chemoradiotherapy to treat gastric adenocarcinoma emerged one after another, including adjuvant postoperative chemoradiation, preoperative chemoradiation, and chemoradiation combined with intraoperative radiotherapy and so on. This review will summarize the recent treatment protocol using chemoradiotherapy for resectable gastric adenocarcinoma, and comprehensively evaluate the clinical value and significance of chemoradiotherapy for resectable gastric adenocarcinoma.
Chemotherapy, Adjuvant ; Clinical Trials, Phase III as Topic ; Combined Modality Therapy ; Humans ; Perioperative Care ; Radiotherapy, Adjuvant ; Randomized Controlled Trials as Topic ; Stomach Neoplasms ; drug therapy ; radiotherapy ; surgery

The aim was to investigate the cytolytic activity of cytotoxic T lymphocytes (CTL) induced by dendritic cells (DC) derived from human cord blood in vitro. Human cord blood mononuclear cells (CBMNC) were cultured in vitro with addition of various cytokines. DC was confirmed by morphology, immune phenotype and capacity of stimulating MLR (mixed lymphocyte reaction). CTL were generated through the co-culture of autologous T lymphocytes and DC. (51)Cr-release assays were performed for the measurement of cytotoxicity of CTL. The results showed that distribution of the subgroups of T lymphocytes in CBMNC was similar to that in adult peripheral blood. The percentage of CD1a-expressing cells in CBMNC was very low, merely (0.41 +/- 0.09)%. During culture, DC became larger and more irregular in shape. Spiny dendrites or multiple cell processes in morphology emerged on the surface of DC. Among the cell populations at 15 days of culture, there were (28.4 +/- 3.55)% of CD1a-expressing cells, (63.67 +/- 23.33)% of CD86-positive, (8.7 +/- 1.49)% of CD83-positive and (32.5 +/- 1.53)% of HLA-DR-positive cells. DC derived from CBMNC is capable of stimulating the proliferation of allogeneic lymphocytes in MLR. CTL derived from autologous T lymphocytes induced by dendritic cells pulsed with lysates of HL-60 cells, possessed specific cytolytic effects against HL-60 cells. In conclusions, relatively high percentage of CD1a-expressing cells can be generated in culture system of this study. DC derived from cord blood is able to induce the production of anti-leukemic CTL in vitro.
Antigens, CD1 ; analysis ; Cytotoxicity, Immunologic ; Dendritic Cells ; immunology ; Fetal Blood ; immunology ; Humans ; Immunophenotyping ; Leukemia ; immunology ; T-Lymphocytes, Cytotoxic ; immunology

Bacteria ; drug effects ; isolation & purification ; Drug Resistance ; Escherichia coli ; drug effects ; Female ; Haemophilus influenzae ; drug effects ; Humans ; Klebsiella pneumoniae ; drug effects ; Male ; Microbial Sensitivity Tests ; Respiratory Tract Infections ; microbiology ; Staphylococcus aureus ; drug effects ; Streptococcus pneumoniae ; drug effects

OBJECTIVETo investigate the effects of hysteroscopic treatment of women with previous cesarean scar defect (PCSD).

METHODSFrom May 2006 to October 2008, 12 patients with PCSD were diagnosed and treated hysteroscopically in our hospital, all of them were successful followed-up for one year postoperatively, and their clinical data were analyzed.

RESULTSAll 12 hysteroscopic procedures were completed successfully, and there were no surgical complications. Nine patients with longer periods and 1 patient with intermenstrual spotting preoperatively remained asymptomatic after hysteroscopic surgery, and 1 patient with longer periods and infertility experienced normal periods, while remained infertility, and the remaining 1 patient complaining postcoital bleeding preoperatively had recurrence of the bleeding.

CONCLUSIONHysteroscopic surgery of women with PCSD was minimally invasive and effective.

Adult ; Cesarean Section ; adverse effects ; Cicatrix ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Hysteroscopy ; Postoperative Complications ; surgery ; Uterine Diseases ; surgery

Professor LUO Cai-gui's experience of acupuncture at acupoint "Baliao" with twisting manipulation for treatment of low back pain is introduced. This method has significant efficacy on improving low back pain and numbness of lower extremities, which is characterized with short-time manipulation, quick de-qi and long effective time. The acupuncture methods, manipulations, precautions, etc. are elaborated in details. A typical case is added.
Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Humans ; Low Back Pain ; therapy ; Male ; Middle Aged

Long-segment lichen sclerosus (LS) urethral stricture is a challenge for urologists. Limited data are available for surgeons to make a surgical decision between Kulkarni and Asopa urethroplasty. In this retrospective study, we investigated the outcomes of these two procedures in patients with LS urethral stricture. Between January 2015 and December 2020, 77 patients with LS urethral stricture underwent Kulkarni and Asopa procedures for urethroplasty in the Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (Shanghai, China). Of the 77 patients, 42 (54.5%) underwent the Asopa procedure and 35 (45.5%) underwent the Kulkarni procedure. The overall complication rate was 34.2% in the Kulkarni group and 19.0% in the Asopa group, and no difference was observed ( P = 0.105). Among the complications, no statistical difference was observed in the incidence of urethral stricture recurrence ( P = 0.724) or glans dehiscence ( P = 0.246) except for postoperative meatus stenosis ( P = 0.020). However, the recurrence-free survival rate between the two procedures was significantly different ( P = 0.016). Cox survival analysis showed that antiplatelet/anticoagulant therapy use ( P = 0.020), diabetes ( P = 0.003), current/former smoking ( P = 0.019), coronary heart disease ( P < 0.001), and stricture length ( P = 0.028) may lead to a higher hazard ratio of complications. Even so, these two techniques can still provide acceptable results with their own advantages in the surgical treatment of LS urethral strictures. The surgical alternative should be considered comprehensively according to the patient characteristics and surgeon preferences. Moreover, our results showed that antiplatelet/anticoagulant therapy use, diabetes, coronary heart disease, current/former smoking, and stricture length may be contributing factors of complications. Therefore, patients with LS are advised to undergo early interventions for better therapeutic effects.
Male ; Humans ; Urethral Stricture/etiology* ; Retrospective Studies ; Constriction, Pathologic/surgery* ; Lichen Sclerosus et Atrophicus/surgery* ; Treatment Outcome ; Urologic Surgical Procedures, Male/methods* ; China ; Urethra/surgery* ; Postoperative Complications/etiology* ; Mouth Mucosa ; Diabetes Mellitus/etiology* ; Anticoagulants ; Coronary Disease

OBJECTIVETo identify clinical features and diagnostic tests that would alert the otolaryngologist to consider myasthenia gravis (MG) in the differential diagnosis of dysphonia, we reviewed the clinical characteristics of MG whose initial symptom is dysphonia.

METHODS31 patients who presented with dysphonia as their initial and primary complaint are reported, their symptoms and signs are observed and analyzed.

RESULTSPatients with dysphonia as their initial symptom of MG may complain of vocal fatigue, difficulty sustaining or projecting their voices, breathy voice or intermittent hoarseness. These symptoms are characterized by fluctuating weakness and abnormal fatigability. Flexible fibroendoscopic examination revealed that patients had incomplete adduction of the vocal folds, fatigue of the tensors of the vocal fold, incomplete glottic closure, vocal cord paralysis, saliva pooling over the bilateral or unilateral pyriform sinus. Neostigmine test revealed dramatic improvement in all patients. Serum levels of anti-Ach-R antibodies were tested in 19 cases, only 5 cases were abnormality. All patients had improved after treatment

CONCLUSIONSVoice changes can be the first sign of early MG. Based on fluctuating weakness or weak voice at the end of the day, a positive neostigmine test, significantly higher circulating antibody to acetylcholine receptor, a diagnosis of MG could definitively be made.

Adolescent ; Adult ; Age Distribution ; Diagnosis, Differential ; Dysphonia ; diagnosis ; etiology ; Female ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; complications ; diagnosis ; Sex Distribution ; Young Adult

OBJECTIVETo investigate the protective effect of insulin on vascular endothelial cells of rats at early post-burn stage,and its mechanism.

METHODSAdult male Sprague-Dawley rats were randomly divided into 3 groups: i. e, sham scald group (n = 7), scald group (n = 7) and treatment group (n = 7). The rats in the latter 2 groups were subjected to 30% TBSA full-thickness burns with 94 degrees C water, and the sham scald rats were treated with 37 degrees C water. Intra-peritoneal injection of 40 ml/kg isotonic saline solution and subcutaneous injection of 3 units/kg insulin were given to the rats in treatment group after being subjected to 30% TBSA full-thickness burns. Subcutaneous injection of equal amount of isotonic saline was given to the sham and burn groups. The changes in vascular endothelial cell structure were observed with electron microscopy at 24 post-scald hours(PSH). Meanwhile, the blood glucose contents, the serum levels of nitric oxide (NO) and nitric oxide synthetase (NOS) were determined with oxidase method and colorimetric method, respectively.

RESULTSThe injury of arterial endothelial cells in the treatment group was obviously alleviated compared with that in burn group. The blood glucose content in the treatment group (7.1 +/- 0.7 mmol/L) was significantly lower than that in scald group (8.2 +/- 1.0 mmol/L, P < 0.05), though it was much higher in both groups than that in sham scald group (4.9 +/- 0.8 mmol/L, P < 0.01) at 24 PBH. The serum content of NO, total NOS and cNOS in treatment group were obviously higher than those in scald group (P < 0.01), but there was no obvious difference in iNOS content between the two groups(P > 0.05).

CONCLUSIONInsulin exhibits protective effect on vascular endothelial cells in severely scalded rats at the early post-burn stage, and it is attributed to its promotion of cNOS level leading to NO production.

Animals ; Blood Glucose ; analysis ; Burns ; blood ; drug therapy ; pathology ; Disease Models, Animal ; Endothelial Cells ; drug effects ; pathology ; Insulin ; therapeutic use ; Male ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Random Allocation ; Rats ; Rats, Sprague-Dawley

BACKGROUNDThe application of pulmonary valved conduit to reconstruct the continuity between right ventricles and pulmonary artery is one of the major surgeries. This study aimed to establish an in vivo model of in situ implantation using pulmonary valved conduit in large animals under off-pump condition to validate the long-term effects of artificial pulmonary valved conduit.

METHODSDomesticate juvenile male sheep and tissue-engineered porcine pulmonary valved conduit were used for the experiment: 30 sheep, weighing (15 ± 3) kg (range 13 to 17 kg) were randomly divided into two groups which were all operated under general anesthesia by off-pump surgery (group 1) and left thoracotomy (group 2). Two different off-pump surgical methods were used to perform cannulation in sheep pulmonary artery to replace part of sheep pulmonary artery with pulmonary valved conduit which will work together with sheep pulmonary artery and valves. During the experiments, animal survival, complication rates, operating time and blood loss were recorded to compare the results between groups and to establish a surgical method with minimal invasion, simplicity, safety, and high success rates.

RESULTSIn group 1, a total of 15 cases of surgeries were performed, in which two sheep died; the operative mortality was 13.3% (2/15). In group 2, a total of 15 cases of surgeries were performed, and the surgical mortality rate was 0 (0/15). The operation time and blood loss in group 2 was significantly better than that in group 1. The postoperative echocardiograms showed that, after the surgeries by these two methods, the blood flows were normal, and the valves can open and close freely. Autopsy after 6 months showed that the inner wall and the valves of pulmonary valved conduit were smooth with no thrombus formation.

CONCLUSIONThese two off-pump methods are feasible and safe with fewer traumas; but the second method is better and particularly suitable for the establishment of a juvenile animal model.

Animals ; Heart Valve Prosthesis ; Male ; Pulmonary Valve ; Sheep ; Swine ; Tissue Engineering

OBJECTIVES: In Korea, the term for schizophrenia has been changed from 'split-mind disorder' to 'attunement disorder'. This study compared the stigma of, and prejudice against, people with schizophrenia, according to use of the term 'split-mind disorder' or 'attunement disorder'. METHODS: We conducted a survey of 360 college students majoring in nursing science in order to assess their prejudice regarding the danger posed by schizophrenia and discrimination regarding relationships and privileges for patients with schizophrenia using the social stigma scale and the discrimination scale for patients with mental illness, respectively. Study subjects were randomly divided into two groups, and the same scales were assigned to each group using different instructions, beginning with either 'split-mind disorder' or 'attunement disorder'. RESULTS: In multivariate analysis, scores for prejudice with regard to the danger posed by, and discrimination against, patients with schizophrenia were significantly higher in the group assigned the term split-mind disorder, compared with the term attunement disorder. Scores for discrimination with regard to relationships and privileges were significantly lower for subjects with experience to contact the mentally ill, compared to those without such experience. CONCLUSION: Our findings suggest that renaming split-mind disorder as attunement disorder can result in reduced prejudice and discrimination against people with schizophrenia. In addition to renaming schizophrenia, implementation of anti-stigma campaigns, including contact with schizophrenia patients, may help to reduce discrimination against them.
Discrimination (Psychology) ; Humans ; Korea ; Mentally Ill Persons ; Multivariate Analysis ; Prejudice ; Schizophrenia ; Social Stigma ; Weights and Measures