Objective To investigate the clinical efficacy and safety of 5-aminolaevulinic acid-photodynamic therapy(ALA-PDT) in treatment of anorectal condyloma acuminatum.Methods 95 cases who suffered from male multiple condyloma acuminatum were randomly divided into two groups.There were 50 cases in the treatment group and 45 cases in the control group.There were no statistically significant between two groups in age,sex,course of disease,skin lesions,the size and the distribution.The treatment group was treated by photodynamic therapy combined with recombinant human interferon α-2b Gel while the control group was treated only by photodynamic therapy.The treatment time lasted 7-10 days later if the Lesion was not completely removed.Totally,1-4 treatment sessions were given.Then the rate of recovery and recurernce of the two groups were compared.Results The recovery rate in treatment group was 94.0％ (47/50) and 88.9％ (40/45) were found in control group.There were no significant difference in the two groups (x2 =0.290,P ＞ 0.05) ;The recurernce rate of the treatment group was 2.0％ (1/50) and the control group was 13.3％ (6/45),the two groups had significant differences (x2 =4.457,P =0.035).Conclusion ALA-PDT combined with recombinant human interferon α-2b Gel in the topical treatment of anorectal condyloma acuminatum is safe and effective,whcih may serve a therapeutic option for anorectal condyloma acuminatum.

Objective To discuss the treatment and clinical efficacy of repair of soft tissue and nerve defect of thumb with island flap of first dorsal metacarpal artery based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve.Methods The skin and nerve defect in 14 thumbs were repaired by dorsal island flap of index fingers based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve.The size of skin defect ranged from 52 mm × 32 mm to 10 mm × 8 mm.The length of the nerve defect ranged from 9 mm to 22 mm.Results The average followup was 6-35 months.All 14 flaps survived with satisfactory appearance and function.The injured side of thumb pulp sensation recovered S3 + and the injured two-point discrimination ranged from 4 mm to 7 mm.No scar contracture or sensory dysfunction complication were observed in the donor sites.Conclusions The repair of soft tissue and nerve defect of thumb with dorsal island flap of index finger based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve is recommendable,since it can obtain satisfactory clinical efficacy and be easily and conveniently oerformed.

Iatrogenic traumatic biliary stricture is one of the difficult points in the biliary surgery,and operation is the only definitive treatment. The operative opportunity,surgical procedure and techniques are important for the prognosis.From January 1998 to December 2011,173 patients with iatrogenic traumatic stricture were admitted to the Eastern Hepatobiliary Surgery Hospital. According to the Bismuth classification of traumatic biliary stricture,10 patients were in type Ⅰ,22 in type Ⅱ,87 in type Ⅲ,38 in type Ⅳ and 16 in type Ⅴ.Excision of the traumatic stricture with end-to-end anastomosis was performed on 19 patients.Of the 173 patients,154 were treated by Roux-en-Y duodenojejunostomy, and 8 of them received additional hemihepatectomy or partial hepatectomy.A total of 155patients were followed up,with a median time of 74 months,the total excellent and good rate was 94.8％ ( 147/155 ).Surgery is the most effective therapy for iatrogenic traumatic biliary stricture. Optimal timing, reasonable surgical methods, strictly following the principle of biliary surgery and perfect operative skills are key points for a better prognosis.

Objective To detect the serum levels of folate,homocysteine (Hcy)and vitamin B12 in the patients with non-small cell lung cancer (NSCLC),and to clarify the clinical significance of folate, Hcy and vitamin B12 in the diagnosis and prognosis assessment of NSCLC.Methods 35 patients with NSCLC were chosen as NSCLC group, and 30 healthy people were selected as control group,excluding hypertension,anemia,family disease history and other related factors.The expression levels of serum folate, Hcy and vitamin B12 were examined by circulating enzymatic method and electrochemical luminescence method.The correlations between the levels of serum folate, Hcy and vitamin B12 of the objects in two groups were analyzed by Pearson test.Results The serum Hcy level of the patients in NSCLC group was significantly higher than that in control group (P <0.01).The serum folate level of the patients in NSCLC group was significantly lower than that in control group (P <0.01),while there was no significant difference in vitamin B12 levels between two groups (P > 0.05).The serum Hcy level was negatively correlated with folate level (r=-0.505,P =0.002),but was not correlated with vitamin B12 (r =-0.084,P =0.633).The serum folate level was not correlated with vitamin B12 (r=-0.039,P =0.826).Conclusion The serum Hcy level of NSCLC patient is significantly increased and it has diagnostic and prognostic values in the NSCLC patients.

Objective To investigate the expression of human leukocyte antigen F (HLA-F) in hepatocellular carcinoma (HCC) tissues and to evaluate its relation to clinicopathological features and prognosis of HCC.Methods HLA-F expression of tumor lesions and their adjacent normal liver tissues from 115 HCC patients were analyzed by immunohistochemistry,and its relationship between HLA-F expression and the clinicopathological features and prognosis of HCC patients was also analyzed.Results HLA-F expression was positive in 47.0％ (54/115) of the HCC lesions and in 10.6％ (7/66) of the normal liver tissues (x2 =24.799,P ＜ 0.05).HLA-F expression in HCC lesions was significantly correlated with portal vein invasions (x2 =7.644,P =0.006),tumor number (x2 =4.210,P =0.040) and patient sex (x2 =6.759,P =0.009).The mean survival time of the HLA-F positive HCC patients was 34.0 months(95％ CI:27.5-40.5 months),which was significantly shorter than that of HLA-F negative HCC patients(44.6 months,95％ CI:38.3-50.9months) (x2 =5.148,P =0.023).HLA-F expression was an independent predictor of overall survival of HCC patients.Conclusions Positive HLA-F expression is negatively correlated with the prognosis of HCC patients.

Objective To analyze the characteristics ot lymph node metastasis and prognostic factors for carcinoma of papilla of Vater (CPV) after pancreaticoduodenectomy (PD).Methods From January 2005 to December 2010,94 patients with CPV underwent PD and dissection of regional lymph nodes at the Eastern Hepatobiliary Surgery Hospital.We carefully evaluated nodal involvement in the patients to determine the lymphatic spread of CPV and analyzed the clinicopathological variables in relation to prognosis.Results The overall rate of nodal involvement was 46.8％.Using the UICC staging (7th edition),lymphatic invasion in pT1,pT2,pT3 and pT4 were 15.4％ (2/13),62.7％ (32/51),80.0％ (8/10) and 100％ (2/2),respectively.The metastatic rates in the posterior pancreaticoduodenal lymph nodes,the mesopancreatic lymph nodes,the hepatoduodenal ligamental lymph nodes and the proper hepatic periarterial lymph nodes were 30.9％ (29/94),21.3％ (20/94),11.7％(11/94) and 6.4％ (6/94),respectively.Significant prognostic factors were tumor pT stage (P＜0.01),duodenal wall infiltration (P =0.001),liver metastasis (P =0.001),pancreatic paren chymal invasion (P=0.004),nodal involvement (P＜0.01) and different regional lymph nodes invasion (the posterior pancreaticoduodenal,P＜0.01; the mesopancreatic,P＜0.01; the hepatoduodenal ligamental,P＜0.01; the proper hepatic periarterial,P=0.010).Cox regression analysis for overall survival revealed that the posterior pancreaticoduodenal nodal involvement (P＜0.01),the mesopancreatic nodal involvement (P＜0.01) and duodenal wall infiltration (P=0.019) were significant independent prognostic risk factors.Conclusions The mesopancreatic lymph nodes and the posterior pancreaticoduodenal lymph nodes should equally be regarded as the first stop in lymphatic spread of CPV.Therefore,we should pay much attention to these regional lymph node dissections,especially to ensure complete resection of the uncinate process and the mesopancreas.

BACKGROUND:Rena gel and expansive sponge are two kinds of nasal packing materials, but there is stil a lack of comprehensive analysis on their filing effects.
OBJECTIVE:To compare the therapeutic efficacy of Rena gel and expansive sponge on nasal hemorrhage and postoperative nasal packing as wel as adverse reactions.
METHODS: A computer-based search of CBM, PubMed, EMBASE, Cochrane Library was performed for articles addressing randomized controled trials of Rena gel and expansive sponge as filing materials. The keywords were “Rena gel, randomized controled, expansive sponge” in Chinese and English, respectively. Then, aching feeling during filing and removal, sweling pain, bleeding, and bleeding control were compared and analyzed through a Meta-analysis.
RESULTS AND CONCLUSION:There were four randomized controled trials, involving 115 patients. The severity of pain was higher in the expansive sponge group than the Rena gel group when the filing materials were placed or removed (P < 0.05). However, there was no difference in the severity of pain between the two groups at 6 hours of filing (P > 0.05). The severity of sweling pain was higher in the expansive sponge group than the Rena gel group at 1 and 6 hours after filing (P < 0.05). When the filing materials were removed, the expansive group showed more severe bleeding than the Rena gel group (P < 0.05). No differences in the bleeding when filing and bleeding control were found between the two groups (P> 0.05). In addition, it was more difficult to fil or remove the expansive sponge from the nasal cavity (P < 0.05). These findings indicate that the Rena gel is superior to the expansive sponge in terms of pain, sweling pain, and bleeding when filing or removing the materials. But there is no difference in bleeding control between the two kinds of filing materials.

Children with pediatric tumors have better prognosis and longer survival than adults, suggesting that attention should be paid to the long-term complications induced by radiotherapy. In this article, the data from more than 40 clinical studies of pediatric tumor radiotherapy published in the recent decade were retrospectively analyzed. Long-term complications of nervous system, cardio-cerebrovascular system, respiratory system, endocrine system, urinary system, reproductive system, skeletal development, long-term secondary tumors were considered and the corresponding radiation dose-volume parameters were summarized, aiming to guide radiation oncology physicians and physicists to optimize radiotherapy plans for children with pediatric tumors.

Objective To study the first metacarpal dorsal artery anatomy,and explore the flap based on the branch chain of the first metacarpal dorsal artery.To provide anatomical basis for clinical application of the flap.Methods The origin,courses and distribution of the branch chain of the first metacarpal dorsal artery from 8 fresh hand specimens perfused by red latex were explored from January,2015 to December,2016.Results There was a dorsal artery network in the dorsal side of the first metacarpal.The radial and ulnar dorsal artery of the first metacarpal originated from the radial artery and along the first metacarpal lateral margin to go down.The initial diameter of the radial dorsal artery was (0.82±0.06)mm.The initial diameter of the ulnar dorsal artery was (0.74±0.05) mm.And anastomosed with the dorsal branches of the thumb inherent arteries.The both inherent arteries of thumb give off dorsal branches count (2.62±0.34).The initial diameter of proximal dorsal branch was (0.32±0.03) mm.The initial diameter of distal dorsal branch was (0.24±0.08) mm.Conclusion The radial and ulnar dorsal vascular chain of the first metacarpal were constant.The anastomosed branches with the dorsal branches of the thumb inherent arteries were abundant.The free flap or retrograde flap based on the vsscular chain has reliable blood supply.And without destroyed the main artery of thumb.

ObjectiveTo investigate the consistency between the results of passive particle agglutination test ( PPA ) and ELISA on Mycoplasma pneumonia ( M.pneumonia ) infection.Study the diagnostic value of both assays.Methods From November 2010 to May 2011,the serum samples of ]191 patients with respiratorysymptoms were collected fromAffiliatedHospitalof JiningMedical University.All samples were tested for antibody levels against M.pneumonia using PPA,and for IgM,IgG,IgA subclass using ELISA.The correlation between the results of two methods was evaluated by Kappa test and Spearman rank correlation analysis.The variances of the antibody subclasses among samples with different PPA titers and different age groups were analyzed by Kruskal-Wallis test.The infection status of patients was analyzed based on ELISA results and the clinical relevance of both assays was evaluated in comparison with clinical diagnosis for samples with high PPA titer.ResultsThe level of agreement between the results of PPA and ELISA was 84.3％,with Kappa value of 0.642 ( P ＜0.01 ).The prevalence of IgM and IgA antibody against M.pneumonia was significantly different among samples with various PPA titers ( P ＜0.05 ).The prevalence of IgM subclass was higher in chill and teeuager groups,while that of IgA and IgG were higher in elderly group.Antibody isotyping results suggested that 58.1％ of PPA positive samples (75 cases),especially 96.4％ of samples with high PPA titer ( 27 cases),were of current infection,which was in consistent with clinical diagnosis.ConclusionPPA showed good consistency with ELISA on diagnosis of Mycoplasma pneumonia infection.Antibody subclass determination hy ELISA indicates disease progression,thus to differentiate current infection from past.