Objective To establish a model to predict the clinical response of neoadjuvant chemotherapy for nasopharyngeal car‐cinoma ,and provide basis for the individual treatment .Methods The clinical data of 63 cases of advanced nasopharyngeal carcinoma patients who have received neoadjuvant chemotherapy in the past 2 years were analyzed retrospectively .Univariate and multivariate analyses were performed using the Logistic analyses to identify efficacy factors .Results The response rate in nasopharyngeal tumor and lymph node metastasis were 39 .7% and 50 .8% ,respectively .Single factor analysis showed that patients with no distant metas‐tasis ,cranial nerve inviolated ,EBV negative and high expression of Ki67 were more sensitive to therapy .Logistic analysis showed that the influencing factors for the effect of the new chemotherapy include :distant metastasis ,cranial nerve inviolated and EBV . Thus ,the prediction model would be:Logit= -0 .470 -2 .863 × distant metastasis + 1 .328 × cranial nerve invasion+ 3 .639 × EBV ,its sensitivity ,specificity ,positive predictive value and negative predictive value were 79 .4% ,82 .8% ,84 .4% and 77 .4% . Conclusion The distant metastasis ,cranial nerve invasion and EBV infection were important predictive factors for neoadjuvant chemotherapy of nasopharyngeal carcinoma .This model could be used to predict the response of patients with nasopharyngeal carci‐noma .

Objective　To evaluate the therapeutic effect of phacoemulsification for complicated cataract secondary to uveitis. Metho ds　Twenty-one eyes of 19 patients with complicated cataract secondary to uveitis were emulsified in situ frature technique after blunt separation of iris posterior synechiae, excision of organized membrane with scissors and st retching pupil. Results　The visual acuities with correction on e week after operation was≥ 0.5 in 16 eyes (76.2%), and ≥0.2 in 18 eyes (85.7% ). The major complications were iris damage and corneal edema. No rupture of pos terior capsule and corneal decompensation were found. After operation, a round p upil was obtained in 19 eyes (90.5%) and an irregular pupil in 2 eyes (9.5%).Conclusion　This operation is suitable for complicated cataract se condary to uveitis, and worth to popularize due to the minimization of iris dam age and postoperative inflammation in the anterior chamber, good visual acuity r ehabilitation earlier.

Objective To explore the evaluation value of serum Ghrelin and pleural effusion in patients with acute pancreatitis . Methods Eighty patients with acute pancreatitis treated in our hospital from February 2011 to February 2014 were divided into mild case group (31 patients) and severe case group (49 patients) according to the severity of the disease .Venous blood samples were collected at time point including :admission ,48h after admission and after discharge at empty stomach in the morning ,and CRP level ,WBC ,PCT level of patients were checked .The concentration of serum Ghrelin of patients were mensurated by enzyme linked immunosorbent assay and pleural effusion were diagnosed by sternum .Results Compared with the patients in the mild case group , serum Ghrelin ,CRP level ,APACHE score ,CT score and Ranson score were higher in the severe case group and the hospital day of patients in the severe case group was longer(P<0 .01) .The area under the curve of CRP level ,pleural effusion ,Ghrelin ,Ghrelin combined with pleural effusion of ROC were 0 .708 3 ,0 .749 6 ,0 .852 4 and 0 .910 8 .Ghrelin combined with pleural effusion has the best evaluation effect on the patients with acute pancreatitis .The sensibility ,specificity ,accuracy of CRP were 93 .6% ,69 .4% and 73 .7% ;the sensibility ,specificity ,accuracy of pleural effusion were 75 .2% ,88 .7% and 76 .8% ;the sensibility ,specificity ,accuracy of Ghrelin were 86 .9% ,88 .2% and 85 .3% ;the sensibility ,specificity ,accuracy of Ghrelin combined with pleural effusion were 90 .1% ,92 .6% and 91 .4% .Conclusion Serum Ghrelin and pleural effusion have high sensibility ,specificity and accuracy in pa‐tients with acute pancreatitis and has high clinical value .

Age Factors ; Child Nutritional Physiological Phenomena ; Child, Preschool ; Diet ; Eating ; Female ; Humans ; Male ; Sex Factors

Child, Preschool ; Eye Injuries ; complications ; Humans ; Male ; Orbital Diseases ; etiology ; Syndrome

OBJECTIVETo evaluate the value of cytomorphologic and immunocytochemical approaches in the diagnosis of hematologic neoplasms in serous effusion.

METHODSThe cytospin and Thinprep smears of effusion specimens were prepared from 23 cases of lymphoid malignancies with histological confirmation and 30 cases of benign effusions used as control. Morphological assessment of the cellular components was conducted, including the ratio of mesothelium to lymphocyte, karyomorphism of lymphoid cell and the presence of apoptosis and mitosis. Immunocytochemical study was performed in all the cases, with flow cytometry in one case.

RESULTSAmong the 23 tumor cases, 14 represented disease relapse, and in the remaining nine cases, the serous effusion was the primary manifestation. The proportion of mesothelium was low in the tumor group, being less than 10% in 20 cases (87.0%, 20/23). It was more than 10% in most of benign cases (20/30, 66.7%). Lymphoid cells were prominent (> 80% cells) in 69.6% of the tumor cases, and the cellular component in some control cases (63.3%, 19/30) showed fewer lymphocytes. Nipple-like projection of lymphocytic nuclei could be detected in almost all the tumor cases (91.3%, 21/23), but was occasionally found in the control group (26.7%, 8/30). Apoptosis and mitosis were obvious in lymphomatous effusion, but observed in only 6.7% of the control cases. Significant difference of the previously mentioned cytomorphologic features existed between the tumor and control groups (P < 0.01). The results of immunocytochemical staining in cell block were identical to the corresponding immunohistochemistry, and one case of mantle cell lymphoma was confirmed by flow cytometry. The cytologic findings seen in all the 23 studied cases were in agreement with the corresponding histologic diagnosis.

CONCLUSIONSSome cytomorphologic features, including decreased number of mesothelium, increased number of lymphoid cells, nuclear nipple-like projection, and the presence of apoptosis and mitosis, are very useful for diagnosing lymphoid malignancy in serous effusion. Immunocytochemistry is an important approach to the cytodiagnosis and classification of lymphoma.

Adult ; Aged ; Aged, 80 and over ; Apoptosis ; Ascitic Fluid ; pathology ; Cyclin D1 ; metabolism ; Cytodiagnosis ; methods ; Female ; Humans ; Immunohistochemistry ; Interferon Regulatory Factors ; metabolism ; Lymphocytes ; pathology ; Lymphoma ; complications ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; complications ; metabolism ; pathology ; Male ; Middle Aged ; Mitosis ; Pleural Effusion, Malignant ; etiology ; metabolism ; pathology ; Young Adult

Objective To study the effect of low-frequency suprathreshold repetitive transcranial magnetic stimulation (rTMS) of the unaffected hemisphere on recovery of motor function in patients with acute stroke. Methods A total of 26 patients with middle cerebral artery territory infarction were randomly assigned to unaffected hemisphere stimulation group and control group (not receiving any stimulation,n=13).The patients in the stimulation group were treated with rTMS 3 to 5 d after the onset of symptoms with the frequency of 1 Hz and 70％ of the intensity (about 2.1T actual output) and the 1200 pulses per day for 10 consecutive d.The motor evoked potential (MEP) latency,central motor conduction time (CMCT),scores of National Institutes of Health Stroke Scale (NIHSS) and modified Barthel index (MBI) of the affected brain region were recorded on the 1 st of experiment (before the treatment),10 and 40 d after treatment. Results The scores of clinical futction scale and neuroelectrophysiologic parameters before treatment had no statistical significance between the 2 groups (P＞0.05).The scores of clinical function scale after the treatment in the 2 groups were obviously higher than those before treatment (P＜0.05). And the improvement of motor function in the unaffected hemisphere stimulation group was statistically obvious as compared with that in the control group (P＜0.05):the score of NIHSS and the MBI in the stimulation group were obviously higher than those in the control group (P＜0.05).The neuroelectricity physiological indexs in the 2 groups after treatment gained improvement in comparision to those before treatment:the MEP latency on the 40th d of treatment and CMCT on the 10th and 40th d of treatment in the unaffected hemisphere stimulation group was significantly different as compared with those before treatment (P＜0.05); the CMCT on the 10th and 40th d of treatment in the unaffected hemisphere stimulation group was shorter as compared with that in the control group. Conclusion The frequency of 1 Hz and 70％ of the intensity (about 2.1T actual output) in rTMS of the unaffected hemisphere can shorten CMCT and improve the motor function in patients with acute stroke.

OBJECTIVETo explore the clinical techniques and effects of repairing skin defects of the forefoot by free perforating flap nourished by peroneal artery.

METHODSFrom June 2007 to June 2011, 11 patients with skin and soft tissue defects of the forefoot were repaired by free peroneal artery perforating flap in emergent or subemergent. There were 10 males and 1 female with an average age of 28.6 years old ranging from 23 to 46 years old. Among them, 4 cases injured for traffic accidents, 3 for crush and 4 for machine strangulation. In all cases, the defect area of forefoot tissue varied from 2.0 cm x 4.0 cm to 4.0 cm x 8.5 cm,and the adopted area varied from 2.5 cm x 4.5 cm to 4.0 cm x 9.0 cm. The operation time was from 6 to 96 h (averaged 31.8 h). The blood vessels were anastomosed end-to-end.

RESULTSAll of the transferred free flaps survived uneventfully. Nine of them were successfully followed up from 6 to 24 months. The appearance, elasticity and functions of flaps were satisfied accompanied with slight damage of donor site although seemed bloated. The smaller donor site could be intimately seamed if necessary.

CONCLUSIONThe vessels anatomy of knee with antegrade extended peroneal artery was relative constant with a moderate thickness and simple operation, is useful to repair small or middle areas of skin defects in forefoot.

Adult ; Female ; Foot Injuries ; surgery ; Forefoot, Human ; surgery ; Free Tissue Flaps ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; surgery ; Young Adult

Objective To observe the effect of hyperlipidemia on pancreatic microcirculation in anintact hyperlipidemic acute pancreatitis animal moldel.Methods Among 30 healthy hamsters enrolled,20were fed normally while,the other 10 were given high fat feed for four weeks.Then 10 animals givennormal feed with normal serum lipids and no ultrasonic changes in the organs including liver,biliary tractand pancreas,were randomly (random number) selected and divided into normal control group (C group)and acute pancreatitis group (AP group) averagely.Five animals given high fat feed with 3 times serumnormal triglyceride level and no ultrasonic changes in the organs including liver,biliary tract and pancreas,were randomly selected as hyperlipidemic acute pancreatitis group (HLAP).The animals in C group wereundergone fake surgery.While the animals in other two groups were carried out surgery based on Schmidtmethod and were injected 3.5％ taurocholic acid sodium into pancreatic duct with a infusion pump.Acridineorange (2 mL/kg) was injected in the inferior vena cava 6 hours later,then laser confocal microscopefluorescence imaging system were utilized to dynamically observe pancreatic microcirculation in living animal models and the variables including average microvascular diameter (MVD),functional capillary density (FCD),microvessel flow velocity (MFV) and leukocyte adhesion were recorded.Pancreatic tissue were collected and cut slices for pathological grading.Result When compared with AP group and C group,pancreas microcirculation function index MVD (μm),FCD (piece/mm2),MFV (μm/s) in the HLAP group decreased,while leukocyte adhesion (piece/mm2) increased significantly [MVD:HLAP group 2.40 ± 0.26 vs.AP group 5.54 ± 0.43,C group 7.56 ± 0.42 (P ＜ 0.05);FCD:HLAP group 4.20 ±0.84 vs.AP group 7.56 ± 1.14,C group 11.40 ± 1.14 (P ＜ 0.05);MFV:HLAP group 58.80 ± 9.63 vs.AP group 131.00 ± 12.94,C group 224.40 ± 15.63 (P ＜ 0.05);leukocyte adhesion:HLAP group 343.60±13.86vs.AP group 114.00 ±8.03,C group 18.80 ±2.28;(P＜0.05)].The pancreatic pathology score was higher in HLAP group [HLAP group 10.00 ± 1.59 vs.AP group 6.60 ± 1.14,C group 1.00 ± 0.71 (P ＜ 0.05)].Conclusion Hypedipidemia may aggravate the impair ment of pancreatic microcirculation and promote microcirculation dysfunction.

Objective To observe the clinical efficacy of nimodipine and acarbose in the treatment of patients with diabetic peripheral neuropathy and its effect on nerve conduction velocity and nerve-related growth factor.Methods Seventy-six patients with diabetic peripheral neuropathy were randomly divided into treatment group and control group,38 cases in each group.Patients in control group were given nimodipine 40 mg,three times a day.On the basis of control group,treatment group was given acarbose 50 mg,three times a day.All patients were treated for a month.The clinical efficacy,nerve conduction velocity,nerve-related growth factor and adverse drug reactions in two groups were compared.Results After treatment,the total effective rates in treatment group and control group were 89.47％ (34 cases/38 cases) and 60.53％ (23 cases/38 cases),with significant difference(P ＜0.05).After treatment,the nerves peroneus communis,median nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) in treatment group were (45.88 ±4.06),(51.69 ±4.56),(44.12 ±4.09) and (46.29 ± 5.71) m · s-1,had significant difference with those in control group,which were (41.16 ±3.83),(44.98 ±4.46),(39.52 ±3.19) and (43.13 ± 4.46) m· s-1 (all P ＜ 0.05).The levels of free fatty acid (FFA),tumor necrosis factor-α (TNF-α) and myelin basic protein (MBP) in treatment group were (471.45±44.28)μmol·L-1,(11.15 ± 1.18) pg · mL-1 and (1.90 ±0.14) μg · L-1,had significant difference with those in control group,which were (542.79 ±46.68) μmol ·L-1,(18.21 ±1.92) pg· mL-1 and (3.41 ±0.38) μg · L-1(all P＜0.05).The levels of vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF) in treatment group were (943.39 ±97.85) and (4.87 ±0.58) ng· L-1,had significant difference with those in control group,which were (755.94 ±70.11) and (3.09 ±0.26) ng · L-1 (all P ＜0.05).The adverse drug reactions in treatment group were 1 case of diarrhea,3 cases of abdominal distension,with the incidence of 10.53％ (4 cases/38 cases).There were 1 case of mild dizziness,2 cases of digestive tract reaction,2 cases of bloating and mild abdominal discom fort in control group,with the incidence of 13.16％ (5 cases/38 cases).There was no significant difference in the incidence of adverse drug reactions between the two groups (P ＞ 0.05).Conclusion Nimodipine combined with acarbose in the treatment of diabetic peripheral neuropathy can effectively improve the nerve conduction velocity and nerve -related growth factor,and the clinical effect is good with high safety.