Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

Objective To investigate the ex pr ession of squamous cell carcinoma antigen (SCC-Ag) and carcinoembryanic antigen (CEA) and its clinical significance in patients with lung cancer. Meth ods The pre-treatment serum from 134 patients with lung cancer from 1998 to 2002 were analyzed for the SCC-Ag level and CEA level by IMX, and the correlation of the SCC-Ag level and CEA level with the clinicopathologic charac teristics were also detected. Results Significant correlations were found between the pre -treatment SCC-Ag level, and CEA level and the pathologic classification, clin ical stage, the positive rate of diagnosing lung cancer was raised by combined a ssay with serum SCC-Ag and CEA. Conclusion Pre-treatment and after-treatment measurement of serum SCC-Ag level and CEA level can be used for diagnosis, prediction of pr ognosis and monitor of after-treatment recurrence in patients with lung cancer.

Objective To investigate the relationship between mental status and some physical indicators,so as to identify the influencing factors of anxiety and depression in health check-up populations.Methods A total of 3885 health check-up adults enrolled in this investigation.Self-rating anxiety scale (SAS),self-rating depression scale (SDS),and Symptom Checklist 90 (SCL90) were used to evaluate mental health of the participants.Physical indicators,including body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),serum free three iodine armour gland original acid (FT5),serum free thyroxine (FT4),and thyroid-stimulating hormone (TSH),were retrospectively reviewed.Pearson correlation analysis was used to assess the relationship between mental health and physical signs,and the Logistic regression analysis was performed to confirm the influencing factors of anxiety and depression.Results Increased prevalence of anxiety and depression was found in females or those with lower education level.For the health check-up populations,anxiety and depression were negatively correlated to BMI,SBP,DBP,LDL-C,FT3 and FT4.In Logistic regression analysis,LDL-C,FT3 and FT4 were related to SDS score,while SBP,FT3,and FT4 were related to SAS score.Conclusion Our data suggest that emotion could be affected by gender and education level; SBP,LDL-C,FT3,and FT4 may be protective factors of anxiety and depression.

The experience of Professor LI Zhidao is introduced in the treatment of mental disorders by "regulating the heart and smoothing the liver". In his experience, the basic prescription includes: penetrating needling technique from Neiguan (PC 6) to Jianshi (PC 5), Ximen (PC 4), penetrating needling technique from Qiuxu (GB 40) to Zhaohai (KI 6) and penetrating needling technique at four groups of acupoints on the gallbladder meridian [Hanyan (GB 4) to Xuanlu (GB 5) and Xuanli (GB 6), Qubin (GB 7) to Shuaigu (GB 8), Shuaigu (GB 8) to Tianchong (GB 9), Tianchong (GB 9) to Fubai (GB 10) and Touqiaoyin (GB 11)]. The manipulation with respiration involved is combined with interactive needling technique so that the patients can feel the weak needling sensation at the local acupoint regions during the treatment. In the paper, the concrete clinical cases are introduced to explain this application and the satisfactory efficacy achieved. The therapeutic method provides a new approach to the clinical treatment of mental disorders.
Acupuncture Therapy ; Adult ; Female ; Heart ; physiopathology ; Humans ; Liver ; physiopathology ; Mental Disorders ; physiopathology ; therapy ; Meridians ; Middle Aged

Objective To investigate the clinical significa nc e and the relationship between the serum squamous cell carcinoma antigen (SCC-A g) levels and the biological characteristics in patients with cervical carcinoma . Methods The pre-post-treatment sera from 500 patients w ith cervical carcinoma from 1998 to 2002 were analyzed for the SCC-Ag levels by IMX; and the correlation between the SCC-Ag level and the clinicopathologic ch aracteristics were also detected. Results Significant corre lation was found between the pre-treatment SCC-Ag level and pathologic classif ication, and clinical stage (P0.05); The pre-treatm ent SCC-Ag level is significantly higher than that of post-treatment (P

Background As a new tonometer,it is necessary to assess the clinical value of Icare rebound tonometer.Objective This study was to compare the intraocular pressure(IOP)values measured by Icare with that measured by GAT,and discuss the clinical value of leare rebound tonometer. Methods IOP measurement was performed on 152 eyes of 78 subjects with suspicious glaucoma,glaucoma,refractive error and normal examinnee by Icare and GAT respectively.The Icare IOP was measured firstly and then the GAT IOP was carried out with the 3-or 5-minute interval.The IOP values were compared between Ieare and GAT.This study was approved by Ethic Committee of Wuhan General Hospital of Chinese PLA.Written informed consent was obtained from each subject prior to this study. Results The mean IOP values of Icare and GAT were(19.16±5.03)mmHg and(18.41±4.52)mmHg respectively.The differences between Icare IOP and CAT IOP were less than or equal to 1 mmHg in 96 of 105 eyes(63.2%).The positive correlation was found between the Icare IOP and GAT IOP(r=0.940,P<0.01).The Ieare IOP was lower than that of GAT when IOPIcare<16 mmHg,however,the IOP of Icare were higher when IOPIcare≥6 mmHg;the IOP of Icare were higher than that of GAT in the total CCT range.The correlation coefficients of IOP of Icare or CAT with CCT were 0.341(P<0.01)and 0.333(P<0.01),respectively. Conclusion Compared with GAT,Icare is more feasible in clinic because it is practicable and reliable.

BACKGROUND: Nanotechnology has widely used in tissue engineered reconstruction in recent years. Most reports are concerning carbon nanomaterials in bone reparation, but the study of peripheral nerve regeneration is poorly understood.OBJECTIVE: To improve the physical, chemical and biological properties of chitosan/collagen composite nerve conduit with functionalized carbon nanotubes, in addition, to investigate the therapeutic effect of this novel material.DESIGN, TIME AND SETTING: The same body controlled experiment of animals was performed at the Tissue Engineering Laboratory and The Key Laboratory of Thin Film and Microfabrication Technology, Shanghai Jiao Tong University from February 2005 to November 2006.MATERIALS: The carbon nanotubes were mixed with 2% chitosan solution, coated on the die to prepare chitosan/collagen composite nerve conduit with functionalized carbon nanotubes. The chitosan/collagen tubes were served as controls.METHODS: A total of 80 male adult-rats were prepared a 4 mm accessory nerve defects models, and repaired by nerve conduit in the experimental material and control material groups. In the auto nerve grafts group, the removed nerve was connected to the broken end. In the blank control group, there was no other treatment except removing 2 mm nerves. The left sides were served as experimental sides and the right sides as within-subject controls.MAIN OUTCOME MEASURES: The repairing outcomes were measured by electrophysiological, myophysiological, and histological measurements.RESULTS: The accessory nerve defects were repaired in a rat model using carbon nanotubes in chitosan/collagen-based composite nerve conduit. As time passed after the surgery, good results of the electrophysiological, myophysiological and histological measurements were achieved, which were similar or superior to those of the nerve autografts.CONCLUSION: The carbon nanotubes in chitosan/collagen-based composite can be an ideal candidate for peripheral nerve regeneration.

OBJECTIVETo investigate the clinicopathologic features, immunophenotyping, differential diagnoses and prognosis of histiocytic sarcoma (HS).

METHODSThe clinical and pathologic findings of 4 cases of HS were reviewed. The samples were used for paraffin section, HE stain, immunohistochemistry stain by EnVision method, electron microscope observation. Follow-up information was available in all patients.

RESULTSThe age of patients, 2 males and 2 females, ranged from 22 to 65 years old (median, 43.25 years). The sites of involvement included lymph node (2 cases), skin or soft tissue (1 case) and colon (1 case). The tumor cells were widespread infiltration, diffused distribution, no adhesion to each other. Tumor cells were middling and large, round, orbicular-ovate, polygon, epithelium appearance, plentiful cytoplasm and acidophilia, cystose. Nucelus was round, orbicular-ovate, dissymmetry. Nuclear chromatin was vacuole appearance, basophilia nucleolus, caryocinesia and pathological mitotic figure. Three of the cases showed conjugate nuclei, increased pleomorphism with multinucleated tumor giant cell formation. Focal cytoplasmic with foamy appearance was identified in 2 cases. One case demonstrated foci of spindly sarcomatoid appearance. Hemophagocytosis was identified in 2 cases. The tumor cells of 4 cases were often accompanied by various numbers of inflammatory cells. Immunohistochemical study showed that all cases were diffusely positive for α-1-ACT, CD68, CDl63 and lysozyme. Three of 4 cases also expressed CD45, CD45RO. The electron microscope results of 4 cases showed that the tumor cells were plentiful cytoplasm and a few cytolysosome in the cytoplasm, and no birbeck cytorrhyctes, cell-cell junction and digitation. Amongst the 4 patients with follow-up information available, three died of the disease 6-13 months after diagnosis. One patient, whose lesion was localized at the skin and soft tissue, survived at the present time.

CONCLUSIONHS was a scarce malignant tumor with mature histiocyte morphology and immunophenotype character. The diagnosis should be based on tissue morphology, immunohistochemistry and electron microscope observation to exclude other disorders.

Adult ; Aged ; Diagnosis, Differential ; Female ; Histiocytes ; pathology ; Histiocytic Sarcoma ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Immunophenotyping ; Male ; Microscopy, Electron ; Middle Aged ; Young Adult

Objective To explore the interactive teaching model for CT imaging based on PACS, and provide the clinician and young radiologist with continued medical education. Methods 100 M trunk net was adopted in PACS and 10 M was exchanged on desktop. Teaching model was installed in browse and diagnosis workstation. Teaching contents were classified according to region and managed according to branch model. Text data derived from authoritative textbooks, monograph , and periodicals. Imaging data derived from cases proved by pathology and clinic. The data were obtained through digital camera and scanner or from PACS. After edited and transformed into standard digital image through DICOM server, they were saved in HD of PACS image server with file form. Results Teaching model for CT imaging provided kinds of cases of CT sign, clinic characteristics, pathology and distinguishing diagnosis. Normal section anatomy, typical image , and its notation could be browsed real time. Teaching model for CT imaging could provide reference to teaching, diagnosis and report. Conclusion PACS based teaching model for CT imaging could provide interactive teaching and scientific research tool and improve work quality and efficiency.

Humans ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; genetics ; metabolism ; Protein Isoforms ; genetics ; metabolism ; Stomach Neoplasms ; genetics ; metabolism ; Tumor Cells, Cultured