Objective To evaluate the prevention and treatment of rectal complications following 125I brachytherapy for prostate cancer. Methods A total of 90 patients with locally advanced prostate cancer was treated by transrectal ultrasound guided prostate 125I brachytherapy combined with maximal androgen blockage from November 2001 to June 2006. The patients were followed every 1～3 months postoperatively, and rectal complications was analyzed and treated. Results Eighty-nine patients were followed for 1～55 months (mean, 22 months). The incidences of rectal complications at grade Ⅰ, Ⅱ, Ⅲ, and Ⅳ were 11.2% (10/89), 6.7% (6/89), 0%, and 2.2% (2/89), respectively. Symptomatic therapy was conducted in 16 patients with grade Ⅰ or Ⅱ complications, which were symptomatically relieved 6 months later. The grade Ⅳ complications occurred in 2 patients, one of whom underwent repeated examinations and treatment for proctitis, and the other of whom was complicated with severe diabetes and received a laparocolostomy with cystostomy. Conclusions The optimal medical treatment for radiation proctitis is follow-up checkups and observations. To reduce the incidence of urethrorectal fistula, excessive examinations and treatment should be avoided. Accompanying diabetes should be treated promptly and actively.

Objective To investigate the clinical value of 125I particle implantation brachytherapy combined with intermittent hormonal therapy for treating clinical moderate and high risk non-metastatic prostate cancer.Methods A prospective study was proceeded and 100 cases with moderate and high risk (cT≥T2b,Gleason score ≥ 7,pre-biopsy PSA ≥ 10 ng/ml)non-metastatic prostate cancer were included.The selected patients were divided into two group.In the study group,patients were treated with 125I particle implantation combined with intermittent hormonal therapy.In the control group,patients were treated with only intermittent hormonal therapy.Hormonal therapy was maximal androgen blockage for two groups,including bicalutamide 50 mg oral every day and Leuprorelin 3.75 mg subcutaneous injection every 28 days.There were 50 cases in each group and clinical trial agreements were signed.During follow-up,PSA were tested every month.Chest X-ray and whole-body hone scanning were checked every 6 months.Hormonal therapy was stopped when patient's PSA level fell to 0.2 ng/ml,and keep stabilized for 3 months.When PSA level elevated for 3 times continuously and over 1 ng/ml,hormonal therapy was initiated again.The IPSS scores were documented before treatment and every 3 months after treatment.Adverse reactions of urinary tract and rectum were assessed every 3 months after 125I particle implantation in study group.The ratio of the first time to stop hormonal therapy,the time duration of first hormonal therapy and stable phase,re-hormonal therapy free survival rate,bone metastasis free survival rate,castration resistance prostate cancer(CRPC) free survival rate,cancer-specific free survival rate and overall survival rate were compared.Results The 100 cases in this study were followed up for 24-40 months,with an average time of 31.6 months.In study group,the PSA level in all cases descended to the level of stopping hormonal therapy.The time duration of hormone therapy ranged from 4 to 12 months,with an average time of 6.3 months.21 (42％) cases had a PSA elevation again to restart hormonal therapy.In control group,the PSA level in 47 cases descended to the level of stopping hormonal therapy.The time duration of hormone therapy ranged from 5 to 15 months,with an average time of 7.2 months.34 (68％) cases had a PSA elevation again to restart hormonal therapy.There was no significant difference in percentage of cases of stopping hormone therapy and in time duration of hormonal therapy for the first cycle.Instead,there were significant differences in stable phase after first cycle hormonal therapy between two groups (27.2 months vs.17.7 months;P ＜ 0.001).When analyzed by Kaplan-Meier survival curve,there was no significant difference in cancer-specific survival rate and overall survival rate.There were significant differences in Re-hormonal therapy free survival (P =0.002),bone metastasis free survival (P =0.04) and CRPC free survival(P =0.005).Conclusions Compared with intermittent hormonal therapy alone,125I particle implantation brachytherapy combined with intermittent hormonal therapy could prolong the hormonal sensitive time in moderate and high risk nonmetastatic prostate cancer patients and control the progress of the prostate cancer.

Objective To investigate the mechanism of recombinant human growth hormone(rhGH) in articular cartilage defect repair in vivo.Methods The cylindrical,full-thick articular cartilage defects,(3.5 mm) in diameter,were made in the knee joints of 25 rabbits.rhGH of 0.1 U/kg was injected into the right knee joints 3 times a week for 4 weeks and equal volume of physiological saline to the left knee joints as control.The animals were killed respectively in 4,6,8,12,24 weeks,and the macroscopic,histologic and ultrastractural examinations were performed.Results The repairing process in experimental group was faster and better than that in the control.In the experimental groups,the defect was filled on week 4,the regenerated cartilage mainly in the shallow region and fibrous tissue in the deep region;on week 24,the regenerated tissue was morphologically close to the neighbour normal cartilage,hard to differentiate by macroscopy;Light microscopy showed the defect recovered to normal cartilage structure and the electron microscopy showed a large quantity of mature cartilage cells.In the control groups,the defect was of shallow introcession,mainly of fibrous tissue.The histological examination showed the significant difference between experimental and control groups(P

Objective　To understand the trends of serum lipid concentration and the prevalence of dyslipidemia in adults aged 35 years and older, and to compare the regional differences in lipids. Methods　Based on the data of Anhui Province in the Early Screening and Comprehensive Intervention Project for High-risk Groups of Cardiovascular Disease in China from 2017 to 2021, the change trend of blood lipid level and the prevalence rate of each region were plotted according to the year and different regions in the province, and the influencing factors of dyslipidemia were analyzed by multivariate regression model. Results　The overall average levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) demonstrated an increase followed by a slight decrease with age annually, while the levels of high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) fluctuated minimally. From 2017 to 2020, TC levels improved annually but increased again in 2021. Similar to TG and non-HDL-C, the average LDL-C level decreased annually from 2017 to 2019, while rebounded in 2020 and 2021 compared with the previous three years. In contrast, the HDL-C level continued to decline. With the exception of HDL-C, the overall blood lipid levels in the northern Anhui (n=31 716) were higher than those in the southern Anhui (n=50 681), and the lowest levels were found in the central Anhui (n=38 246). The prevalence of hypercholesterolemia (7.400%, 2 347/31 716), high LDL-C (5.228%, 1 658/31 716), low HDL-C (9.935%, 3 151/31 716), hypertriglyceridemia (18.212%, 5 776/31 716), and high non-HDL-C (5.789%, 1 836/31 716) were highest in the northern Anhui. Age, region, senior high school or above, smoking, drinking, systolic blood pressure, blood glucose, and body mass index were independent factors for dyslipidemia (P<0.05). Conclusion　The blood lipid level and prevalence of dyslipidemia in adults aged ≥35 years in Anhui Province have not yet reached an ideal control level, especially in the northern part of Anhui Province where there is a need for enhanced awareness and timely intervention measures for lipid-related diseases to effectively extend the life expectancy of residents.

Objective To explore risk factors in the mortality of casualties and to find a way to improve trauma emergency service. Method The possible factors likely related to the mortality of casualties were taken into account based on each stage of trauma emergency so as to find the independent risk factors by using univariate and multivariate analyses. Results A total of 3 659 casualties were enrolled in this study.Of them, 226 casualties died and the mortality rate was 6.18%. Following factors were related to mortality after univariate analysis: age, cause of trauma, injury severity score, Glasgow come scale come on the scene, professional emergency treatment on the scene, intubation in the ambulance, debridement and hemostasis in the ambulance, low blood pressure at admission, closed drainage of pleural cavity, emergency operation, CVP monitoring in ICU and mechanical ventilation in ICU. After multivariate analysis, six factors were independently related to the mortality of casualties as follows: Glasgow coma scale, injury severity score, mechanical ventilation, blood pressure at admission, age and professional emergency treatment on the scene. Conclusions It has a great significance to investigate the risk factors of mortality for casualties. Severity of trauma and age were independently associated with the outcomes of trauma. Besides, improving prehospital care and stabilizing the trauma patients in early phase can further decrease the mortality.

Objective To determine risk factors in nosocomial infection of trauma patients during intensive care unit stay. Methods A retrospective study was carried out. A total of 1103 trauma patients admitted to the intensive care unit of five tertiary hospitals in Zhejiang Province in 2009 were reviewed. Demographic data, injury severity score and other variables related to the trauma services were collected. Univariate and multivariate analysis were processed to identify the independent risk factors of nosocomial infection in trauma patients during stay in intensive care unit. Results Overall, 171 patients( 15.5% )developed nosocomial infection during ICU stay. Of 1103 patients, 157 patients (14.2% ) died, and the 59 fatal patients were from infection group. The mortality rate in infection group was 34.7% , which was significantly higher than that in non - infection group (10.5% ). The independent risk factors of nosocomial infection in all the patients determined by using multivariate analysis included central venous monitoring, mechanical ventilation, age ≥65, the length of ICU stay > 14 days and injury severity score ≥ 16. For the severe trauma patients, central venous monitoring, mechanical ventilation, the length of ICU stay > 14 days were independent risk factors of nonsocomial infection. Conclusions The severity of injury, age, the length of ICU stay and invasive procedures were related to the nosocomial infection. To standardize the invasive procedures and to reduce the length of ICU stay may decrease the infection rate of trauma patients.

BACKGROUND: Tumor recurrence in liver transplant recipients greatly affects prognosis of liver transplantation with hepatocellular carcinoma (HCC). How to prevent tumor recurrence has aroused increasing attention. Arsenious acid chemotherapy is considered effective on treating moderate or advanced liver cancer, but its utilization following liver transplantation remains few. OBJECTIVE: To explore the role of arsenious acid on tumor recurrence in liver transplant patients with primary HCC extending Milan criteria. RESULTS AND CONCLUSION: All patients were routinely followed up for 3-32 months. Thirty recipients were presented with tumor recurrence, 16 in the chemotherapy group and 14 in the non-chemotherapy group. Tumor recurred in lung, liver graft and bones in most cases. The total recurrence rate was similar in these two groups, but chemotherapy could delay recurrence after transplantation (P=0.026). There was no significance in 6-month, 1-year survival rate between two groups, but the 2-year survival in the chemotherapy group was higher (P=0.037); 6-month tumor-free survival rates in the two groups had no significance, 1-year and 2-year tumor-free in the chemotherapy group were significantly higher than those in the non-chemotherapy group (P=0.030, 0.023). Intravenous arsenious acid chemotherapy can delay tumor recurrence and prolong survival in liver transplant patients with HCC extending Milan criteria.

Objective Sirolimus is a new, potent immunosuppreasant considered to be nonnephrotoxic. There is limited experience with the use of sirolimus in liver transplant recipients. This study was to investigate the clinical experience of conversion from tacrolimus-based to sirolimus-based immunosuppression in liver transplant recipients. Patients switched to cyclosporine-based immunosuppression during the same period were also enrolled as controls. Methods This retrospective study examined liver transplant recipients who had been switched from tacrelimus-based to sirolimus-based or cyelosporine-based immunosuppressive therapy between January 2004 and January 2008 in the First Affiliated Hospital of Sun Yat-sen University. Patients were divided into 2 groups: those switched to sirolimus-based immunosuppression (group A; n=32); and those switched to cyclosporine-based immunosuppression (group B; n=15). Results The rate of successful conversion was 34.5% in group A (10/32) compared with 45.5% in group B (7/15); this difference was not statistically significant (P>0.05). After conversion, renal function in patients in group A remained normal, while the renal function in patients in group B become abnormal 4 months after conversion (P<0.05). In group A, some simlimus-associated adverse effects occurred but were mild and easy to control. Conclusion Sirolimus can be used safely in place of tacrolimus in liver transplant recipients.

Objective To investigate the clinicopathological factors related with the lymph node ratio (LNR) in colorectal cancer patients.Methods The clinical and pathological data of 177 colorectal cancer patients who were treated by surgery in Shanghai Jiao Tong University Affiliated Sixth People's Hospital from January 2011 to December 2013 were collected.The association between LNR and clinicopathological factors were evaluated by single factor analysis nsingx x2 test.Results Gender,age,tumor location,tumor size,gross type,depth of infiltration,infiltration extent around bowel wall and preoperative serum CA199 concentration were not related with LNR (P ＞0.05),but tumor histological type,tumor differentiation,preoperative serum CEA,CA125 concentration were related with LNR (P =0.001,0.004,0.004,0.025).Conclusions Tumor histological type,tumor differentiation,preoperative serum CEA,CA125 may be the important factors related with LNR in colorectal cancer.

Objective To investigate the application of U100plus laser in treating incarcerated in gallbladder stones. Methods The clinical data of 52 patients accepted U100plus laser lithotripsy of gallbladder neck incarcerated were retrospective analyzed. Results All 52 patients were successful treated by surgery. Twelve patients with gallbladder wall edema, drainage tubes were used to prevent bile leakage after gallbladder surgery. After 2~4 d, the ultrasound examination showed that no abnormal drainage, and tube was removed. The mean operative time was 40 min. The mean intraoperative bleeding was 2 mL. Patients were able to get out of bed 1 day after surgery. The average length of hospital stay was 4 d. Pa-tients were followed up for 6 to 30 months, and no special discomfort, The ultrasonography showed no stone recurrence. Conclusion U100plus laser lithotripsy is a safe and effective method for treating incarcerated gallbladder stones.