Objective: To understand the pathogenesis of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and to investigate its differential diagnosis, clinical manifestations, treatment and prevention. Methods: By analyzing the clinical data of 4 patients with BRONJ in the retrospective study with reviewing related literatures in the world to make a summary of it Results: Cases of 4 patients mainly presented recurring pain, discharging of pus and disposure and necrosis of the bone. 3 patients received surgical and antibiotics treatments, one of them had local infection which was under control by oral antibiotic. The other 2 patients had no infection and recurrence. Conclusion BRONJ is caused by jaw necrosis due to bisphosphonate inhibition of osteoclast function. For the reason that none of the treatments is unified and satisfied, we should focus on the risk factors in prevention. Appropriate surgery treatment could be well controlled the process of the BRONJ which should be popularization in our study.

Antineoplastic Agents ; therapeutic use ; Apoptosis ; drug effects ; Caspase Inhibitors ; Drug Resistance, Neoplasm ; Gene Expression Regulation, Neoplastic ; Inhibitor of Apoptosis Proteins ; metabolism ; Neoplasms ; drug therapy ; metabolism ; pathology

OBJECTIVETo compare the clinical safety and efficacy of laparoscopic versus open colorectal resection in octogenarians. Methods Studies comparing laparoscopic colorectal resection with open colorectal resection in octogenarians were identified from the Medline, Embase, Ovid, and Cochrane databases from 1990 to 2012. The methodological quality of the selected studies was assessed to determine studies suitable for inclusion. Meta-analysis was performed by fixed or random effects model.

RESULTSFive observational studies with a total of 685 patients (330 laparoscopic colorectal resections and 355 open colorectal resections) were identified. Laparoscopic colorectal resection was associated with a prolonged operative time (WMD=27.89, P<0.01) and a lower rate of overall complications (OR=0.58, P<0.01), wound infection (OR=0.50, P<0.05), cardiovascular complication(OR=0.53, P<0.05), quicker bowel function return (WMD=-0.83, P<0.01), and shorter length of hospital stay (WMD=-3.60, P<0.05). No differences were found with regard to anastomotic leak (OR=1.13, P>0.05), prolonged ileus (OR=0.71, P>0.05), respiratory complication (OR=0.59, P>0.05),mortality (OR=0.67, P>0.05), and reoperation (OR=0.85, P>0.05).

CONCLUSIONLaparoscopic colorectal resection is as safe as open colorectal resection, and is more favorable in terms of length of hospital stay and bowel function return in octogenarians.

Aged, 80 and over ; Anastomotic Leak ; Colectomy ; methods ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Treatment Outcome

OBJECTIVETo investigate the outcome of surgical treatment for gastrointestinal stromal tumor(GIST) and the associated factors.

METHODSA total of 277 patients with GIST underwent primary surgical treatment from January 1990 to February 2010 at the Cancer Center of Sun Yat-sen University. The clinical data were retrospectively reviewed and the pathological examination was reviewed. Follow-up was performed.

RESULTSThere were 176 males and 101 females. The age ranged from 20 to 81 years old (median,57). Location of the tumor included colorectum (n=28),small bowel(n=76), stomach(n=173). All the patients had en bloc resection, including local excision in 98 patients, organ resection in 64, and extended resection in 115. The 5-year survival rates were 83.5%, 71.9%, and 61.9% in the three different procedures, respectively, and the difference was not statistically significant(P>0.05). Cox model showed that the tumor size, recurrence and metastasis were independent risk factors associated with the prognosis in GIST patients(P<0.05).

CONCLUSIONSSurgery remains the major approach for gastrointestinal GIST. Complete resection is the principal treatment. Extensive resection or extended lymph nodes dissection is not associated with improved survival.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrointestinal Stromal Tumors ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

OBJECTIVETo study the correlation between noise and blood pressure and/or hypertension, and its age characteristic.

METHODSThe pure tone audiometric and blood pressure examinations were performed in 14537 workers from 157 factories. Hearing impairment was used as a surrogate indicator of cumulated noise exposure. The associations of hearing impairment and duration of noise exposure with blood pressure and hypertension were analyzed respectively after age and gender stratification.

RESULTSMost of the objects were males (81.2%), younger than 35 years old (77.8%), and the duration of exposure to noise was less than 5 years (73.6%). The prevalence of hearing impairment in males was significantly higher than that in males, and increased with age and duration of noise exposure. Only in males with age younger than 35 years old, the systolic and diastolic blood pressures of subjects with sensorineural hearing loss significantly enhanced, and the diastolic blood pressure and prevalence of hypertension increased with duration of noise exposure. The risk of hypertension in males with sensorineural hearing loss significantly increased, the odds ratios in subjects with age younger than 35 years old and with age older than 35 years old were 3.0 (95%CI: 1.5 ∼ 6.1) and 2.1 (95%CI: 1.2 ∼ 3.4), respectively.

CONCLUSIONThe severe hearing impairment induced by noise was associated with hypertension. It is suggested that people should pay attention to the effects of noise on hypertension in young workers.

Adult ; Blood Pressure ; Female ; Hearing Loss, Noise-Induced ; epidemiology ; Humans ; Hypertension ; epidemiology ; Male ; Noise, Occupational

Fcγ receptorIIIa (FcγRIIIa) polymorphism was considered to influence clinical response to therapeutic monoclonal antibody (MAb) against cancer, which is suggested to affect MAb binding and MAb-dependent NK cell-mediated cytotoxicity. The purpose of this study was to examine the FcγRIIIa gene polymorphisms in healthy children and in children with hematological malignancy, and to explore its possible effect on MAb in children with hematological malignancies. 43 healthy children (H) and 20 pediatric patients with hematological malignancies (HM) were enrolled in this study. DNA was isolated from peripheral blood, and then nest-polymerase chain reaction-restriction fragment length polymorphism (nest-PCR and PCR-RFLP) was used to determine the FcγRIIIa-158 genotypes in each groups of subject, digested fragments were subjected to electrophoresis on 15% PAGE. The results showed that there were a higher frequencies of FcγRIIIa-158V/F in H and HM group (72.1% and 75.0% respectively), the frequencies of FcγRIIIa-158V/V were 27.9% and 25.0% in H and HM group respectively, but there was no FcγRIIIa-158F/F in the two groups. No significant difference in distribution of the FcγRIIIa-158 genotype was found between HM and H groups (p > 0.05). It is concluded that FcγRIIIa-158V/F is more frequent, while FcγRIIIa-158V/V is less, but FcγRIIIa-158F/F is very rare in both groups. No significant difference of FcγRIIIa polymorphism distribution is found between healthy and hematological malignancy groups.
Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Genotype ; Hematologic Neoplasms ; genetics ; Humans ; Male ; Polymorphism, Genetic ; Receptors, IgG ; genetics

【Objective】To investigate the role of ER stress and PUMA in 5-FU-induced liver cells injury and apoptosis.【Methods】We established 5-FU-induced liver injury models by intraperitoneally injecting the isodose 5-FU to 10 PUMA knockout mice(PUMA-KO)and 20 PUMA Wild type mice(PUMA-WT). Meanwhile,10 WT mice were intraperitoneally injected with 4-Phenylbutyric acid,the ER stress inhibitor. In the control group,10 KO mice and 20 WT mice were given the same amount of normal saline.After the modeling,serum and liver tissues of the mice were collected to assess the degree of liver pathological injury,measure the expression levels of ALT and AST in serum,and detect the expression levels of PUMA and GRP78 in liver tissues. The changes of these indicators in different treatment groups were observed and compared.【Results】Compared with the WT control group,serum ALT and AST levels were significantly increased in the 5-FU group,H&E staining showed punctate focal necrosis,accompanied by hemorrhage and inflammation. TUNEL staining showed apoptotic cells were markedly added(Z = 3.78,P < 0.001),and expressions of PUMA and GRP78 were obviously augmented,suggesting that both PUMA and ER stress were involved in 5-FU-induced liver cells injury and apoptosis. Then,in the 4-PBA group,we found that the expression levels of GRP78 and PUMA were down-regulated,and apoptosis of liver cells was reduced under the same dose of 5-FU(χ~2= 32.99,Z = 3.78,P <0.001),further confirming that both PUMA and ER stress were involved in this process. Subsequently,it was found that,when induced by the same dose of 5-FU,cleaved caspase-3 staining showed that the liver apoptosis signal of the PUMA knockout mice was lower than the WT mice(χ~2= 33.99,Z = 3.78,P < 0.001),but the difference in the expression of GRP78 between the two groups was not statistically significant. In summary,the expression of PUMA was reduced and the apoptosis of liver cells was attenuated after the inhibition of ER stress;PUMA knockdown could not influence the activation of ER stress but alleviated apoptosis of liver cells.【Conclusions】PUMA mediates ER stress-up-regulated liver cells apoptosis in 5-FU-induced Chemotherapeutic liver injury.

OBJECTIVETo evaluate the safety and efficacy of paraaortic lymphadenectomy in gastric cancer with meta-analysis.

METHODSRandomized controlled trial comparing D(2)/D(3) and D(2)/D(3) plus paraaortic lymphadenectomy in gastric cancer were identified by two investigators after search strategy was established. Seven randomized controlled trials with 1446 cases were included in this meta-analysis. Fixed effect model or random model was separately used to evaluate the safety and efficacy of paraaortic lymphadenectomy in gastric cancer.

RESULTSTotal complication rate in the D(2)/D(3) plus paraaortic lymphadenectomy group was significantly higher than that in the D(2)/D(3) group (RR 1.34, 95% CI 1.03-1.75, P=0.03), while surgery associated complication between the two groups was almost the same. Lymphorrhea and severe diarrhea was more common in the D(2)/D(3) plus paraaortic lymphadenectomy (RR 16.23 and 9.56, 95% CI 1.99-131.98 and 1.70-53.67, respectively). Anastomotic leak, pancreatic fistula, abdominal abscess, ileus, postoperative bleeding and wound infection were similar. There were no advantages in operating time, amount of blood transfusion, in-hospital stay, reoperation, recurrence and 5-year survival favoring the paraaortic lymphadenectomy group except intra-operative blood loss and rate of blood transfusion (WMD 202.95, 95% CI 116.80-289.10; RR 1.93, 95% CI 1.20-3.10).

CONCLUSIONSParaaortic lymphadenectomy is associated with increased total complication without altering postoperative recurrence and survival. Strict large-scale multicenter controlled trials with long-term follow-up are required.

Aorta, Abdominal ; Humans ; Lymph Node Excision ; adverse effects ; Postoperative Complications ; Randomized Controlled Trials as Topic ; Stomach Neoplasms ; surgery

OBJECTIVETo compare the safety and feasibility of laparoscopic surgery and open surgery in ulcerative colitis.

METHODSA search of published studies in English and Chinese between January 1992 and May 2008 was performed. Nine hundred and twenty-three patients from 16 studies were recruited which met the inclusion criteria. Meta-analysis was performed through fixed effect model or random effect model dependent on heterogeneity.

RESULTSCompared to open procedure, patients with ulcerative colitis undergone laparoscopic surgery were able to tolerate oral intake significantly earlier (P<0.01) with shorter hospital stay (P<0.01) and had lower total complication rate (P<0.01). But duration of laparoscopic surgery was significantly longer than that of open procedure(P=0.04). Laparoscopic procedure was no more superior to open procedure in recovery of bowel function, re-operation rate, intra-abdominal abscess, anastomotic leak, postoperative bowel obstruction, wound infection, blood loss and mortality. The conversion rate was 4.2% in this analysis.

CONCLUSIONLaparoscopic surgery for ulcerative colitis is safe and feasible with better recovery in short-term as compared to the open procedure.

Colitis, Ulcerative ; surgery ; Humans ; Laparoscopy ; Laparotomy ; Safety ; Treatment Outcome

【Abstract】 【Objective】To assess effect of calcofluor white and fluorescent dye labeled concanavalin A in Candida albicans growth and adhesion of cells.【Methods】Yeast cells of 20 strains of Candida albicans were labeled by calcofluor white and Alexa fluor 488 conjugated concanavalin A respectively. The growth of labeled Candida albicans were tested by counts of colony forming unit. Then yeast cells of Candida albicans were co-cultured with macrophages and enterocytes for half an hour. The adhesion of labeled Candida albicans to macrophages and enterocytes were observed by fluorescence microscopy.【Results】No difference was observed on the number of colony forming units between calcofluor white-labeled groupand control group(P=0.942). Also,no difference was observed on the number of colony forming units between Alexa fluor 488 conjugated concanavalin A-labeled group and control group. However,either the number of calcofluor white-labeled Candida albicans or Alexa fluor 488 conjugated concanavalin A-labeled Candida albicans that bound to macrophages was less than that in control group(P=0.000,respectively). Either the number of calcofluor white-labeled Candida albicans or Alexa fluor 488 conjugated concanavalin A-labeled Candida albicans that bound to enterocytes was less than that in control group(P = 0.000,respectively). Hyphae were observed in control group but not in calcofluor white group after yeast cells of Candida albicans were co-cultured with cells for half an hour.【Conclusions】Growth of Candida albicans was not changed,while its adhesion to cells was reduced after its labeling by calcofluor white and Alexa fluor 488 conjugated concanavalin A.The germination of Candida albicans was affected when it had been labeled by calcofluor white.