OBJECTIVE: To observe the efficacy of modified acupotome combined with blocking therapy in patients with carpal tunnel syndrome (CTS). METHODS: Fifty-five patients with CTS were divided into three groups, which were modified acupotome group including 26 CTS patients with 28 lesions treated by modified acupotome combined with blocking therapy, traditional acupotome group including 14 CTS patients with 16 lesions treated by traditional acupotome combined with blocking therapy, and blocking therapy group including 15 CTS patients with 15 lesions only treated by local blocking. The treatment outcome and one-year recurrence rate were observed. RESULTS: The response rate and one-year recurrence rate after operation in the modified acupotome group were 85.7% (24/28) and 20.8% (5/24) respectively, which had no significant differences as compared with 81.3% (13/16) and 38.5% (5/13) in the traditional acupotome group. The response rate and one-year recurrence rate after operation in the above two groups were both improved significantly as compared with those in the blocking therapy group which were 46.7% (7/15) and 85.7% (6/7) respectively. There were no acupotome-related adverse effects and injuries observed in the modified acupotome group. CONCLUSION: The modified acupotome is a considerable treatment method for CTS with respect to its simple manipulation and high effectiveness.

Objective To develop an UPLC-MS/MS method for simultaneously determination of five components (adenosine,cytidine,guanosine,mannitol and adenine) in Qiangshenpaidu capsules. Methods The UPLC separation was performed on an Agilent ZOBAX SB-C18(2.1 mm×150 mm,5 μm) column.Isocratic elution was carried out with mobile phase consisting of methanol-0.1%formic acid (5∶95) at a flow rate of 0.2 mL.min-1.The mass spectrometer was operated in the positive ionization electrospray ( ESI) mode using multiple monitoring ( MRM) for analysis of five components. Results Adenosine,cytidine,guanosine,mannitol and adenine were all analyzed with good precision and accuracy. The linear ranges were 35-1 120 ng.mL-1( r=0.998 1) ,10-320 ng.mL-1( r=0.996 4) , 30-980 ng.mL-1( r=0.999 3) , 40-1 280 ng.mL-1( r=0.993 4), 25-800 ng.mL-1(r=0.996 5),respectively.The recoveries of six analytes ranged from 97.4% to 103.6% and the relative standard deviations were all below 4.7%. Conclusion A sensitive,accurate and suitable UPLC-MS/MS method has been developed,and the method could be applied for the determination of adenosine,cytidine,guanosine,mannitol,and adenine in Qiangshenpaidu Capsules.

Objective To investigate the effects of preoperative selective gastric arterial chemoembolization on the tumor vasculature in patients with gastric carcinoma.Methods 40 patients with gastric cancer were divided into two groups :(1)gastric arterial influsion(GAI)group;and (2)gastric arterial chemoembolization(GAE)group.The peripheral vein plasma tumor necrosis factor(TNF ?) and thrombomodulin(TM)were determined before radiologic intervention(RI),and1d,3d after R1;and the gastric vein plasma TNF ? and TM were also determined during operation.The curative surgical resection of gastric cancer was performed between 7 and 10 days after treatment.Stomach histological alterations were observed postoperatively.Results Compared with GAI group ,the plasma TNF ? levels increased markedly at all the time points,and gastric vein plasma TM levels decreased siginificantly in GAE group (P

Objective To investigate the value of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in evaluating therapeutic response of hepatoma treated with radiofrequency ablation (RFA).Methods Totally 48 cases of patients with hepatic carcinoma (48 lesions) admitted in Xiangya Hospital of Central South University from September 2012 to January 2014 were selected.All patients underwent radiofrequency ablation,of which 30 patients were diagnosed by pathology after surgery,18 patients by clinical diagnosis.All patients underwent two-dimensional contrast-enhanced ultrasound (2D-CEUS) and 3D-CEUS 1 month and 3 months after RFA treatment to evaluate the therapeutic response,and the results of contrast-enhanced ultrasound and enhanced computed tomography (CT) [or magnetic resonance imaging (MRI)] were compared.The final diagnostic results of pathologic biopsy or more than two imaging examinations [ultrasonography,CT,MRI,positron emission tomography (PET)],tumor markers,and more than 3 months follow-up of patients were used as the gold standard.The sensitivity,specificity and accuracy of dynamic 3D-CEUS,2D-CEUS,enhanced CT (or MRI) in the diagnosis of tumor inactivation were calculated respectively.Results After radiofrequency ablation,dynamic 3D-CEUS could provide more valuable information in 75.0％ (36/48) lesions,which contribute to assess the efficacy of radiofrequency ablation.While compared with 2D-CEUS,3D-CEUS did not change the diagnosis or clinical management in 12 (25.0％) lesions.40 of 48 lesions were found no-enhancement in entire CEUS procedure suggesting that the tumor completely inactivated,while 8 lesions showed local enhancement on the edge of lesion suggesting that part of the tumors were active.39 of 48 lesions showed no-enhancement and other 9 with irregular enhancement on enhanced CT (or MRI).The sensitivity,specificity and accuracy of CEUS and enhanced CT (or MRI) in detection of residual tumor after radiofrequency ablation were 80.0％,100％,95.8％ and 80.0％,97.4％,93.8％,respectively.Conclusions There was no statistical significance among 3D-CEUS,2D-CEUS and enhanced CT or MRI in evaluating therapeutic response of hepatoma treated with radiofrequency ablation.But 3D-CEUS can provide more valuable information,3D-CEUS has potential usefulness in the evaluation of percutaneous radiofrequency ablation of hepatic tumors.

OBJECTIVEThe aim of this study was to identify six miRNAs expressed in plasma of patients with pancreatic cancer (PCa) and analyze their value as a diagnostic index of pancreatic cancer.

METHODSPlasma total RNAs were extracted from 30 PCa patients and 26 normal controls, and the abundance of six microRNAs was measured using real-time PCR. The possibility to combine them with CA19-9 as diagnostic biomarkers was analyzed.

RESULTSThe expression level of miR-21, miR-210, miR-155, miR-20a, miR-25 and miR-196a in plasma of patients with pancreatic cancer were 1.65×10(6), 5.98×10(4), 2.83×10(3), 3.47×10(6), 2.76×10(6), and 1.03×10(3) (copies/µl), while the normal controls were 4.08×10(5), 2.54×10(4), 8.55×10(2), 1.79×10(6), 9.32×10(5), and 4.67×10(2) (copies/µl), respectively, with a significant difference between the two groups (P < 0.05). The areas under the ROC curve of miR-21, miR-210, miR-155, miR-20a, miR-25 and miR-196a were 0.893, 0.810, 0.820, 0.766, 0.816 and 0.729, respectively. MiR-21 had the highest diagnostic value when it was used as diagnostic marker alone. The combination of miR-155 and miR-25 was more effective to distinguish PCa from normal than to be used alone, and the area under the ROC curve was 0.913 (95%CI 0.838-0.988) .When CA199 associated with miR -210 and miR-25, respectively, the areas under the ROC curves were 0.96 (95%CI was 0-1.0) and 0.942 (95% CI was 0.876-1.0), which were higher than CA199 alone (0.862, 95%CI was 0.748-0.975). There was a high improvement in diagnostic sensitivity and accuracy when miR-210 and miR-25 were combined with CA19-9, respectively.

CONCLUSIONSPlasma miR-21, miR-155, miR-25, miR-210 have diagnostic value for pancreatic cancer, and deserve further study.

Aged ; Biomarkers, Tumor ; blood ; genetics ; CA-19-9 Antigen ; blood ; Case-Control Studies ; Female ; Humans ; Male ; MicroRNAs ; blood ; Middle Aged ; Pancreatic Neoplasms ; blood ; diagnosis ; genetics ; ROC Curve ; Real-Time Polymerase Chain Reaction

Objective To investigate whether 3D-guided cone-shaped segmentectomy can achieve comparable long-term outcomes with lobectomy for deep early-stage lung cancer with diameter≤2 cm. Methods We retrospectively screened patients with deep early-stage non-small cell lung cancer (NSCLC) with diameter≤2 cm who underwent lobectomy or segmentectomy in the First Affiliated Hospital of Nanjing Medical University from 2012 to 2018. All pulmonary segmentectomy was performed using 3D-guided cone-shaped segmentectomy with segment or subsegment as the resection unit. Univariate and multivariate regression analyses were performed by Cox proportional hazard regression model. The patients who underwent segmentectomy and lobectomy were matched 1∶1 by propensity-score matching analysis. The oncological outcomes of two groups were compared. Results Our cohort was divided into a segmentectomy group (n=222) and a lobectomy group (n=127). The age, total nodule size, solid component size and proportion of pure solid nodule in the lobectomy group were significantly higher than those in the segmentectomy group. The median follow-up time was 49 months. Surgical margins were negative in all patients. The local recurrence rate of segmentectomy was 0.45%. The disease-free survival (DFS) rate and overall survival (OS) rate of patients in the segmentectomy group were significantly better than those in the lobectomy group (5-year DFS rate: 98.64% vs. 89.77%, P<0.001; 5-year OS rate: 99.55% vs. 92.10%, P<0.001). Multivariate regression analysis showed that the differences between two groups were not significant [DFS rate: HR=0.52. 95%CI (0.11, 2.59), P=0.427; OS rate: HR=0.08. 95%CI (0.00, 3.24), P=0.179] after adjusting for other factors. After propensity score matching, 77 patients were preserved in both segmentectomy group and lobectomy group, with the mean nodule size of 1.44 cm and 1.49 cm and the mean consolidation tumor ratio (CTR) of 0.46 and 0.52, respectively. There was no statistical difference in DFS rate (P=0.640) or OS rate (P=0.310) between the two groups. Conclusion 3D-guided cone-shaped segmentectomy can be an acceptable treatment for low-grade malignant NSCLC deep in lung parenchyma with diameter≤2 cm, and its oncology effect is not inferior to lobectomy.