Surgical resection has been accepted as a radical therapy for patients with colorectal cancer, but most of them will develop regional recurrence or distant metastasis. With the development and improvement of novel drugs and methods, they will bring survival hope to patients. In this article, we review the developments in chemotherapy for patients with advanced colorectal cancer.

OBJECTIVETo compare therapeutic effects between patella replacement and patella osteotomy in total knee arthroplasty.

METHODSFrom April 2004 to April 2011, 52 patients (54 knees) were enrolled in the clinical trail of total knee arthroplasty, who received patella replacement (24 knees, including 13 males and 11 females,ranging in age from 53 to 78 years old or patella osteotomy (30 knees,including 16 males and 12 females,ranging in age from 55 to 79 years old. The average follow-up period was 56 months,ranging from 20 to 80 months. The American HSS Score for knee, the Feller score for patella, range of motion (ROM) for knee, patient satisfaction and complications related to the patella were used to evaluate therapeutic effects.

RESULTSIn the patella replacement group,the preoperative and final follow-up HSS scores of patients were 38.4 +/- 8.2 and 91.2 +/- 8.6 respectively; Feller scores were 13.6 +/- 6.2 and 25.2 +/- 4.2; scores of anterior knee pain were 3.9 +/- 3.2 and 11.2 +/- 3.7; ROM were (78 +/- 26) degrees and(108 +/- 18) degrees. In the patella osteotomy group,the preoperative and final follow-up HSS scores of patients were 39.5 +/- 8.4 and 91.0 +/- 8.5 respectively;Feller scores were 13.4 +/- 6.5 and 25.6 +/- 4.0; scores of anterior knee pain were 3.7 +/- 3.1 and 11.3 +/- 3.6; ROM were (76 +/- 27) degrees and (110 +/- 19) degrees. In the patella replacement group,patient's satisfaction was 91%, and complication related to the patella was 16.7%; in the patella osteotomy group, patient's satisfaction was 89%, and complications related to the patella was 10.0%. There were no statistically significant differeneces in final follow-up HSS scores, Feller scores, scores of anterior knee pain and ROM between the two groups. However,there was no significant difference of patient's satisfaction between them. There was statistically significant differenece of patella-related complications between the two groups, and the complication rate in the patella replacement group was higher than that in the patella osteotomy group.

CONCLUSIONTotal knee arthroplasty with patella replacement or patella osteotomy dramatically relieves pain and improves the knee function. Patella-related complications are associated with its treatment methods, but post-operative anterior knee pain and patient's satisfaction are not related to treatment methods of the patella.

Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Case-Control Studies ; China ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Osteotomy ; adverse effects ; Pain, Postoperative ; epidemiology ; etiology ; Patella ; surgery ; Treatment Outcome

Adolescent ; Brain Neoplasms ; diagnosis ; Child ; Child, Preschool ; Endocrine System Diseases ; etiology ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Infant ; Luteinizing Hormone ; blood ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

Objective To explore the efficacy and safety of metformin therapy on obese nondiabetic children with hyperinsulinemia.Methods Twenty-two obese nondiabetic children with hyperinsulinemia were divided into two groups:control group(dietary counseling and exercise) and treatment group(dietary counseling and exercise combined with metformin).The changes of body mass index(BMI),fasting glucose(FPG),fasting insulin(FINS),insulin resistance(HOMA-IR),2 h PG,2 h INS,total cholesterol(TC) and triglyceride(TG),before and after treatment were determined,and the findings were compared and analyzed.Results After treatment,there were significant differences in BMI,TC,FINS,HOMA-IR levels(P0.05),except the BMI(P

OBJECTIVETo compare the differences between computer aided identification and ultra-thin layer slicing in measuring the lesions of femoral head necrosis,and to confirm the accuracy and practicability of computer aided method.

METHODSFrom June 2012 to December 2013, the X-ray and MRI of 24 patients (24 hips on unilateral) were reviewed, who had avascular necrosis of the femoral head (ANFA) at late stage (stage III and IV) according to the ARCO international staging system. There were 15 males and 9 females, with an average age of (65.1 ± 8.8) years old, ranged 33 to 74 years old. Based on the software system with seeds point identification, the ragional adaptive search method with computer aid was used to calculate the volume of necrotic lesion in femoral on MRI. Then the pathological slices of those intraoperative femoral heads were made to measure the gross volume of necrotic lesion in femoral head,and the values were compared with the data in the computer.

RESULTSFor 24 hips, by the calculation of computer, the necrotic volume was (20.00 ± 3.04) cm (ranged, 18.72 to 21.29 cm³). Under the pathological section, the necrotic volume of the femoral head was (19.89 ± 3.17) cm³ (ranged, 18.55 to 21.23 cm³). In computer and pathology two kinds of measurement, the two entire femoral head volume had no significant difference using these two measurements (t = -1.227, P = 0.232).

CONCLUSIONComputer aided identification for necrotic area of femoral head adaptive can demonstrate the morphology of femoral head necrosis accurately and reliably, which will help surgeon better understand the morphology and orientation in femoral head.

Adult ; Aged ; Diagnosis, Computer-Assisted ; Female ; Femur Head Necrosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged

Objective To discuss the meanings and methods of the screening, diagnosis and treatment of the left subclavian artery stenosis before the coronary artery bypass grafting (CABG). Methods A total of 612 patients intend to perform coronary artery bypass grafting in Tianjin Thoracic Hospital,and who were with severe stenosis or occlusion with left subclavian artery were screened by non invasive arteriosclerosis before operation. The diagnosis was confirmed by computerized tomography angiography(CTA),then the stenting angioplasty to the left subclavian artery was performed.The off-pump bypass surgery with the left internal thoracic artery(LITA)-left anterior descending artery (LAD) bypass was performed one week after operation.Results The CTA and digital subtraction angiography(DSA)confirmed the results of the left subclavian stenosis according to the non-invasive artery testing.All the 5 patients were performed with the stenting angioplasty to the left subclavian artery successfully,and the residual stenosis rate was<10%.The clinical symptoms were markedly improved after operations in all symptomatic patients,and the systolic pressure difference was<20 mmHg in two upper extremities.The blood flow was enough in LITA during the LITA-LAD bypass.The angina pectoris was improved after the operation. No coronary-subclavian artery steal phenomenon occurred. Neither stroke, myocardial infraction nor death occurred during perioperative period.All the patients were followed up for a time of 6-12 months,and the average time was about 10 months.No posterior circulation,upper limbs or myocardial ischemia occurred,and the systolic pressure difference was<20 mmHg in two upper extremities.Conclusion The non-invasion testing is of unique value in the screening of the left subclavian artery stenosis.

AIM: To test the ability of multifocal visual evoked potential (mfVEP) in the detecting of glaucoma by comparing the mfVEP recorded from normal subjects and glaucoma patients.METHODS: The mfVEP of 32 normal eyes (n =21) and of 58 eyes (n =37) with primary glaucoma were recorded with the Vision Monitor electrophysical apparatus by the second kernel analysis and to determine the correlation of the topographic location between them.RESULTS: There were significant variability (the coefficient of variation was 43.05%) in mfVEP RMS amplitude in the normal subjects; The RMS amplitude of eyes with glaucoma were smaller than that of the normal eyes and significantly statistical difference were found in the relatively center (namely the 0° -10° ring zone) and in superior nasal quadrant (P＜0.05) while there were no significantly statistical differences of the latency time between them.CONCLUSION: The normal subjects have large individual variability of mfVEP responses. The RMS amplitude of the mfVEP of glaucomatous eyes descends, especially in center zone and superior nasal quadrant.

OBJECTIVETo investigate the expression and distribution of intrahepatic CD4+ CD25+ regulatory T cells in immuno-tolerant and immuno-clearance phase of patients with chronic hepatitis B.

METHODSThe expression of FoxP3 was detected in 19 cases of immuno-tolerant phase and 12 cases of immuno-clearance phase by immunohistochemistry. The relation between the intrahepatic expression of FoxP3 and the clinicopathological features were analyzed.

RESULTSThe positive signal of FoxP3 is located in nuclear of lymphocyte and mainly aggregated in portal areas as well as occasionally scattered in hepatic sinusoids. The expression of intrahepatic FoxP3 in the group of immuno-tolerant phase was significantly increased than those in normal control (P < 0.01), and greatly decreased than those in immuno-clearance phase (P < 0.01). No correlation was observed among the expression of intrahepatic FoxP3, ALT, levels of HBV DNA, HBeAg positive, in patients of immuno-clearance phase, respectively. There were significant differences between immuno-tolerant phase and immuno-clearance phase age, ALT, TBIL, PTA, HBV-DNA and detection of HBeAg but not in sex and family history of HBV infection.

CONCLUSIONCD4+ CD25+ regulatory T cells may play important roles in the clearance of HBV as well as in liver inflammation and injury during chronic HBV infection.

Adolescent ; Adult ; CD4 Antigens ; immunology ; Female ; Forkhead Transcription Factors ; genetics ; immunology ; Gene Expression ; Hepatitis B virus ; immunology ; Hepatitis B, Chronic ; genetics ; immunology ; virology ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; Male ; Middle Aged ; T-Lymphocytes, Regulatory ; immunology ; Young Adult

Objective To analyze and compare the MRI appearances of ovarian thecoma with pathologic findings in order to improve the knowledge of the disease.Methods Nineteen cases of ovarian thecoma confirmed by histopathology were analyzed.MRI morphological characteristics and signal intensity of the lesions were observed and compared with findings of pathomorphology.Correlation analysis between tumor size and amount of ascites was made.Results Ovarian thecoma displayed iso-or hypointense signal on T_1WI and significant hypointensity in the focal lesion on T_2WI.Hyperintensity occurred when cystic degeneration of the lesions existed.Fibrous septation was detected in some lesions.After enhancement,most lesions showed mild early enhancement with slight increase on the delayed phase.Pathological necrosis and cystic degeneration were seen in 9 cases which corresponded to the number and shape of the cystic lesions on MRI.A large amount of collagen hyperplastic was found between the oncocytes microscopically in 15 cases, which displayed significant hypointensity in the focal lesion on T_2WI;another 4 cases showed relatively less amounts of collagen hyperplastic and more oncocytes,which appeared moderate intensity in the focal leisom on T_2WI.The amount of ascites was not significantly correlated with the lesion size(r=0.43,P=0.10). Conclusions Hypointensity on T_2WI and mild enhancement pattern due to poor blood supply are the characteristics of ovarian thecoma.The MR findings can reflect the pathologic features of the tumor,which is helpful in the diagnosis and differential diagnosis.

Objective To summarize the manifestation and treatment of acquired hemophilia A in pa- tients with systemic lupus erythematosus(SLE).Method A case was investigated retrospectively and the lit- erature was reviewed.Results A 25-year-old woman with a 5 year history of SLE was admitted to hospital due to abdominal pain.She was diagnosed with acquired factorⅧinhibitor deficiency based on a prolonged activated partial-thromboplastin time(APTT,135.3 s),reduced factorⅧactivity(0.9%)and factorⅧin- hibitor(26.1 BU/ml).Sonography and magnetic nuclear resonance of the abdomen confirmed the presence of a retro-uterine hematoma.The patient was initially treated with intravenous pulse and oral corticosteroids,factorⅧplasma concentrated and intravenous immunoglobulin.Clinical and biological improvement was promptly obtained.Conclusions Attention should be paid to the association between SLE and acquired hemophilia A. Combination therapy may be recommended as initial therapy for the management of acquired hemophilia A in patients with SLE.But no standardized treatment can be recommended at present.