1.Radical surgery of lung cancer with chest wall invasion and reliable methods of chest wall reconstruction
Xiang ZHUANG ; Zhaohui WANG ; Qiang LI ; Yangchun XIE
Chinese Journal of Medical Aesthetics and Cosmetology 2011;17(2):92-94
Objective To study the efficacy of radical surgery for the invasion of chest wall by lung cancers and the different methods of chest wall reconstruction. Methods A retrospective analysis of clinical data was conducted in 27 cases of lung cancer with chest wall invasion in this hospital. 24 cases received lobectomy, 3 cases received pneumonectomy, and all cases received wall reconstruction. The size of chest wall defect after resection ranged from 6.5 cm × 5.4 cm × 5.0 cm to 15.5 cm × 12.5 cm ×10.0 cm. The number of rib resection for each patient ranged from 1 to 4. The reconstructive methods were as follows: using polyester fabric to reconstruct costal pleura, using plexiglass, stainless steel wire and grid-like titanium plate to reconstruct bone defect, and using nearby muscle flap and pedunculated muscle flap to reconstruct muscle defect. Results Pathologic diagnosis was non-small cell lung cancer,including 22 cases of squamous cell carcinomas and 5 adenocarcinomas. There were pulmonary infections in 6 cases, chest hemorrhage in 1 case and chest purulence in 1 case. One-year survival was 77. 9 %,3-yearsurvival was 58.3 %, and 5-year survival was 29. 1 %. Conclusion The lung cancer with chest wall invasion is advisable to make active use of radical surgery. The different methods and repair materials are chosen to reconstruct the chest wall defect, supplemented by comprehensive treatments.
2.Peripapillary retinal nerve fiber layer thickness distribution in myopia patient measured by 3D-OCT
Wenjuan, ZHUANG ; Jingjing, ZHAO ; Shanshan, LI ; Xueqiu, YANG ; Wei, XIANG
Chinese Journal of Experimental Ophthalmology 2014;32(12):1117-1121
Background As assessment of the peripapillary retinal nerve fiber layer (RNFL) has been an important approach for detecting structural damage in patients with glaucoma and myopia is a vital risk factor of primary open glaucoma,it is urgent to establish the correlation between RNFL thickness and myopia,not only for understanding the characteristics of RNFL with the change of the degree of myopia,but also for identifying those myopic patients with the early stage of glaucoma.Objective This study was to assess the influence of myopia for the thickness of RNFL measured by 3D optical coherence tomography (3D-OCT).Methods Two hundred and fifty-eight eyes of 258 myopic subjects from General Hospital of Ningxia Medical University were recruited.The myopic eyes were divided into low myopia group (42 eyes,-0.5 D ≤ SE ≤-3.0 D),middle myopia group (120 eyes,-3.0 D<SE≤-6.0 D),high myopia group (58 eyes,-6.0 D<SE≤-8.0 D) and extreme high myopia group (38 eyes,SE >-8.0 D).The peripapillary RNFL thickness profile including temporal,superior,nasal and inferior quadrants and each of the 12 clocks was measured by 3D-OCT.The measured values were compared among different degrees of myopia,and the correlations between spherical equivalent (SE) and axial length with RNFL thickness were analyzed using linear regression equation.Results The RNFL thickness was gradually declined with the increase of SE and elongation of axis,showing significant differences among the 4 groups in the superior,nasal and inferior quadrants and mean RNFL thickness (F=10.48,15.60,3.31,8.98,all at P<0.05),but temporal RNFL thickness was increased with the SE rise,with markedly difference among the 4 groups (F =2.92,P =0.03) ; and RNFL thicknesses in the superior,nasal,inferior quadrants and mean RNFL thickness were evidently declined in the high and extreme high myopia group in comparison with low myopia group (all at P<0.05).The overall RNFL parameters at 1:00,2:00,3:00,4:00,5:00,6:00,8:00,12:00 o'clock sectors were thinning as the increase of SE (all at P<0.05) and unchanged at the 7:00,9:00,10:00,11:00 sectors in different SE groups (all at P> 0.05).Negative correlations were found between axial length or SE with the RNFL thicknesses at superior,nasal and inferior quadrants,average thickness as well as 1:00,2:00,3:00,4:00,5:00,6:00,11:00,12:00 o 'clock,and positive correlation was seen between the axial length or SE with the RNFL thicknesses at temporal quadrant.Conclusions The thickness of RNFL varys with the different degree of myopia and axial length.
3.Research on Inclusive Rehabilitation for People with Disabilities
Yingqiang LI ; Xiang ZHANG ; Zhenzhong MAO ; Yilin HE ; Zhiping ZHUANG
Chinese Journal of Rehabilitation Theory and Practice 2014;(9):808-811
Based on international framework of rehabilitation, this paper summarized the theories and practice of rehabilitation in Shenzhen. An inclusive rehabilitation model had been established in Shenzhen in light of international concepts of rehabilitation, in which the functions of medical rehabilitation, education, employment, assistive technology, care, right protection, accessible environment and culture had been integrated. The comprehensive services had been provided through this model and the target of inclusive development had been realized.
4.Systematic video-assisted mediastinoscopic lymphadenectomy in the treatment of resectable non-small cell lung cancer
Ke MA ; Xiang WANG ; Tianpeng XIE ; Xiaojun YANG ; Ping XIAO ; Xiang ZHUANG ; Qiang LI
Chinese Journal of Thoracic and Cardiovascular Surgery 2013;(6):377-379
Objective This study was performed to assess the clinical feasibility of video-assisted mediastinoscopic lymphadenectomy in the treatment of resectable lung cancer.Methods Between March 2011 and May 2012,we retrospectively analyzed the data from 56 patients who underwent video-assisted mediastinoscopic lymphadenectomy(VAMLA).In patients receiving tumour resection subsequently,radicality of the previous mediastinoscopic dissection was controlled during thoracotomy.Results Mean operative time of video-assisted mediastinoscopic lymphadenectomy was(42.0 ± 13.5) min(range of 26-86 min).Mean number of resected lymph nodes was 12.4 ± 6.7 (range of 5-24).In video-assisted mediastinoscopic lymphadenectomy,the rates of lymph node dissection of stations 2,4,5,7,8 were 54.5%,92.7%,58.2%,100%,61.8%,respectively,there was no operative mortality and morbility.90.9% patients achieved radical dissection.Conclusion Video-assisted mediastinoscopic lymphadenectomy is a clinically feasible procedure and provides more accurate staging of mediastinal node in lung cancer patients.It also plays an important role in minimal invasive surgery and neoadjuvant therapy.
5.The characteristic of regional cerebral glucose metabolism in Wilson's disease using 18F-FDG PET
Xiang-song, ZHANG ; Ming, SONG ; Jia-jun, ZHUANG ; Li, LI ; Tian-zi, JIANG ; Xun-hua, LI
Chinese Journal of Nuclear Medicine 2008;28(5):333-335
Objective The aim of this study was to investigate the characteristic of regional cerebral glucose metabolism in patients with Wilson's disease (WD) using 18F-fluorodeoxyglucose (FDG) PET.Methods Thirteen WD patients and 12 normal controls were studied by brain 18F-FDG PET, and the data were analyzed by visual analysis, semi-quantification and statistical parametric mapping (SPM). The radioactivity ratios of lenticular nuclei, caudate, thalamus and cerebellum to cerebral cortex and the ratio of lenticular nuclei to caudate were calculated, respectively. SPSS 11.0 software for statistics was also used to analyze the data. Results In WD patients, radioactivity of lenticular nuclei and candate was significantly decreased compared with controls. The radioactivity ratios of lenticular nuclei and caudate to cerebral cortex in WD patients were both significantly lower than that in normal controls (0.95±0.05 vs 1.26±0.05, t =15, P < 0.05 ; 1.02±0.06 vs 1.17±0.05, t = 8, P < 0.05), and the ratio of lenticular nuclei to caudate in WD patients was significantly higher than that in normal controls (0.93±0.06 vs 1.09±0.06, t =9, P< 0.05). Conclusion As compared with normal controls, patients with WD had significantly decreased glucose utilization in the basal ganglia, especially in the lenticullar nuclei.
6.Surgical management of mediastinal lymph node metastasis of thyroid carcinoma
Zhaohui WANG ; Jin CHEN ; Chunhua LI ; Xiang ZHUANG ; Qiang LI ; Shaoxin WANG
Chinese Journal of Endocrine Surgery 2016;10(4):276-279
Objective To explore the surgical technique for mediastinal lymph node metastasis of thyroid cancer.Methods We retrospectively reviewed clinical records of 46 patients with metastatic thyroid cancer in mediastinal lymph nodes and having received surgical treatment in Department of Head Neck Surgery and Thoracic Surgery of Sichuan Cancer Hospital from Feb.2004 to Apr.2015.We analyzed the diagnosis,surgical treatment methods,operative approach,and postoperative complications of these patients.Results The main metastatic region was superior mediastinum especially level 2 (2R/2L,lower parathymic lymph nodes) according to AJCC-UICC standard in 31 patients (67.39%);16 patients (34.78%) had level 3 and level 4 (4R/4L lower parathymic) lymph node netastasis and 4 patients (8.696%) had level 5 (subaortic lymph node) and level 6 (para-aortic lymph node) metastasis.39 patients were pathologically diagnosed with papillary carcinoma,6 patients were diagnosed with medullary carcinoma,and 1 patient was diagnosed with follicular carcinoma.There were 14 patients with stage Ⅰ disease,5 patients with stage Ⅱ disease,3 patients with stage Ⅲ disease,22 patients with stage Ⅳa disease,and 2 patients with stage Ⅳc disease.The most common complications were hoarseness,chylous fistula,hypocalcaemia,and airway obstruction.Patients were followed-up from 1 to 8 years.During the follow-up period,4 cases were lost to follow-up and 2 patients died.Conclusions The main treatment approach for mediastinal lymph node metastasis of thyroid cancer is surgical operation.Pre-operative CT or MRI is needed to evaluate the metastatic region of the lymph nodes and to choose appropriate operative approach.
7.Bacteriological study of single nasal sinusitis and sensitivity of antibiotics
Xiang LIU ; Qiang ZHANG ; Jiangneng ZHUANG ; Mingrong YANG ; Lin LI ; Meihua ZHENG ; Jiangyan LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2000;(11):499-500
Objective :To properly understand the bacterial distribution and susceptibility to antibiotics in thesinus of nasal sinusitis. Method:The mucosal and secretione in sinus were taken from 135 patients who sufferedwith single nasal sinusitis, by functional endoscopic sinus surgery, were cultured for bacteria. Meanwhile the an-timicrobial susceptibility was determined for ordinary antibiotics. Result: The bacterial growth was present in88.15 % of cases ,mixed bacterial growth was present in 52.10 % of all bacterial ,anaerobe growth was present in39.06%00 of all bacteria. the susceptibility to penicillin was in 53.12%0 of all bacteria and cefaolin was in 87.50%.The susceptibility to metronidazole was in 94.67 % of all anaerobes. Conclusion:We think the method that peni-cillin in combination with streptomycin and metronidazole, sufameth oxazole united with metronidazole, cefaolinadded metronidazole were effective in nasal sinusitis treatment before the antimicrobial susceptive examinationhad been done.
8.Age-associated changes in ultrastructure and H+-K+-ATpase of gastric parietal cell in the elderly
Yan ZHUANG ; Songbai ZHENG ; Li XIAO ; Danian JI ; Ping XIANG ; Yulei YIN ; Wei ZHANG ; Jie DU
Chinese Journal of Geriatrics 2012;31(5):413-416
Objective To investigate the age-associated changes of ultrastructure,mRNA and protein expressions of H+-K+-ATPase in elderly gastric parietal cell. Methods Fifty patients with relative normal stomach without gastroduodenal diseases were enrolled,including younger group (aged 20-59 years,n=19) and elderly group (aged≥60 years,n=31).Furthermore,the elderly group was divided into 3 subgroups:60-69 years old (n =11 ),70-79 years old (n=10 ),above 80 years old (n =10).The ultrastructure of gastric parietal cell was observed under electron microscope.The expression of H+-K+-ATPase α subunit mRNA and H+-K+-ATPase β subunit protein were assessed by quantitative real-time PCR and Western-blot,respectively.The ageing-associated changes of all these data were respectively compared. Results No significant difference was showed in the morphology of gastric parietal cell and acid-secretion-associated organelles among all the groups.The average ratio Am to Ac (Am means the area of mitochondria,Ac means the area of cytoplasm) of gastric parietal cell and the average At to Ac ratio (At means the area of secretory canaliculi and tubulovesicular system )between younger group and elderly group had no significant difference[(48.4±7.5) % vs.(50.6±7.6) %,t=-0.775,P=0.444; (13.8±4.1) % vs.(12.2±4.7) %,t=0.984,P=0.332].Meanwhile,there were no distinctions in the expression of H+-K+ -ATPase α subunit mRNA and H+-K+-ATPase protein among all elderly subgroups(F=1.522,2.32,P=0.24,0.114).However,the mRNA expression of H+-K+-ATPase a subunit was higher in the elderly group than in the younger group(t=-3.682,P=0.001).Furthermore,the expression of H+ -K+ -ATPase protein in the elderly group was increased as compared with younger group(t=-3.389,P=0.004). Conclusions Acidsecretion-associated organelles of human gastric parietal cell have no degeneration and the expression of H + -K+-ATPase is in trend of increase with aging,indicating that healthy elderly people have the basis of ultrastructure and molecular biology to maintain well function of acid secretion.
9.Analysis on the feasibility of genechip method in detecting Mycobacterium tuberculosis drug resistance
Xiaohong HU ; Qiyun XIANG ; Qian ZHUANG ; Mo LI ; Yan′e DONG ;
International Journal of Laboratory Medicine 2015;(23):3421-3422,3425
Objective To analyse the sensitivity ,specificity and coincidence rate of genechip method in the detection of resistance to antibacterial agents in Mycobacterium tuberculosis(MTB) ,in order to provide a convenient ,accurate and rapid method for detec‐ting antibacterial resistance in MTB .Methods The DNA sequencing was taken as gold standard ,and antibacterial resistance of the strains of MTB isolated from sputum specimens of 250 cases of patients with tuberculosis from August to December 2014 were de‐tected by using the genechip method and proportion method for susceptibility testing at the same time .Efficacies of the two methods in detecting MTB resistance to rifarnpin and isoniazid were compared .Results The MTB resistance rate to rifarnpin detected by u‐sing the genechip method and proportion method for susceptibility testing was 3 .0% and 3 .5% respectively ;that to isoniazid was 6 .7% and 8 .2% respectively .For detecting M TB resistance to rifarnpin and isoniazid ,the DNA sequencing was taken as gold standard ,the sensitivity ,specificity and coincidence rate of genechip method was higher than those of proportion method for suscep‐tibility testing ,and the test time of genechip method was shorter than that of proportion method for susceptibility testing ,there were statistically significant differences(P<0 .05) .Conclusion Using the genechip method to detecting MTB resistance to rifampin and isoniazid has high sensitivity ,specificity and coincidence rate ,which could replace the proportion method for susceptibility tes‐ting and become an effective method .
10.Analysis of Language Skill in Autistic Children: 300 Cases Report
Xiang ZHOU ; Qiang CHEN ; Hong CHEN ; Heyi LI ; Huijin HU ; Zhicheng ZHUANG ; Shuping ZENG
Chinese Journal of Rehabilitation Theory and Practice 2013;19(4):384-386
Objective To study the natural developing characteristics of language skill of the autistic children. Methods 300 untreated autism children were included. Their developmental characteristics of individuals were evaluated by the Psycho-Educational Profile-Revised (PEP-R). Results The developmental quotient of most children (89.33%) was less than 70. And the developmental quotient gradually decreased with age (P<0.01). The scores of language performance and language verbal were deviation (P<0.01). Conclusion Language characteristics of autistic children without treatment is abnormal in development progress and order, and the situation would be worse with age.