Objective To evaluate the clinical features and early management of combined thoracoabdominal injury (CTI).Methods A retrospective study was carried out in 29 cases with CTI treated surgically.There were 21 cases with penetrating injuries and 8 cases with blunt injuries.All cases were associated with penumothorax and/or hernothorax at various degrees and 13 cases complicated with shock.In this study thoracotomy was performed in 17 cases,laparotomy in 6 cases,thoracotomy plus laparotomy in 5 cases and combined thoraco-laparotomy in 1 case.Results The injury severity score in this series was (40.16±15.23) scores.Four cases were died from hemorrhagic shock (2 cases),pericardial tampenade(1 case) and multiple organ failure(1 case).Conclusions CTI has high mortality rate,and the most frequent cause of death is hypovolemic shock.The operative approach is based on individual injury condition.Early diagnosis and timely surgical intervention are key to improving the cure rate and reducing mortality in severe CTI.

Aim To investigate the possible roles of age, bodyheight, mass and body mass index(BMI) in Lumbar1-4 bone mineralcontent (L1-4BMC), L1-4 areal bone mineral density(L1-44BMD) and L1-4volumetric bone mineral apparent density(L1-4BMAD) of Chinese adoles-cents with early ankylosing spondylitis (AS). Methods Thirty-one maleChinese adolescent outpatients with early AS were included. Age (y),total body mass (kg), height(cn) and body mass index (BMI, kg/m2)of subjects were obtained. L1-44BMC(g) and L1-4 BMD(g/cm2) were e-valuated by using DEXA, and L1-4 BMAD(L1-44BMC/Area3/2, g/cm3)was subsequently calculated. Correlation and multiple regression analyseswere performed. Results Multiple regression revealed that height ( P =0.000) and BMI(P=0.009) were significantly positively related toL1-44BMC (R=0.759, Radj2=0.545, P=0.000 ＜0.01), and heightplayed the pivotal roles in significant correlation with L144BMC(R =0. 676 Radj2 = 0. 439, P = 0. 000) . Body mass significantly positivelycorrelated with both L-44BMD ( R = 0. 657, Radj2 = 0. 412, P = 0. 000)and L1-4BMAD (R=0.551, Radj2=0.280, P=0.001) .Therefore,height as well as BMI significantly positively correlated with L144BMC andmass was definitely associated with both L1-4BMD and L1-4BMAD in ado-lescents with early AS in this study. Conclusion Height and mass couldhave significantly positive effects on axial bone mass and densities ofadolescents with early AS.

OBJECTIVETo investigate the treatment of chyle leak following radical resection for colorectal cancer.

METHODSThe incidence of chyle leak was compared between the different surgical approaches (open vs. laparoscopic) as well as different tumor locations (right, left colon or rectum) in 1259 patients undergoing radical resection for colorectal cancer.

RESULTSOverall incidence of chyle leak was 3.6% (46/1259) after surgery. Forty-five patients were successfully managed by conservative treatment and one patient required re-operation. No patients died. The incidence of chyle leak was not significantly different between the open (3.2%, 18/570) and laparoscopic (4.1%, 28/689) groups (P>0.05). However, right colectomy was associated with a significantly higher rate of chyle leak (9.6%, 16/167) as compared to left colectomy(2.6%, 7/268) and anterior resection (2.8%, 23/824) (P<0.05).

CONCLUSIONSConservative treatment is effective in early stage of chyle leak after radical resection for colorectal cancer. Right colectomy is associated with higher risk for chyle leak.

Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Chylous Ascites ; diagnosis ; etiology ; therapy ; Colectomy ; Colorectal Neoplasms ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; etiology ; therapy ; Retrospective Studies

OBJECTIVETo study the anti-tumor effects of all-trans retinoic acid (ATRA) and mechanisms of its action.

METHODSHuman esophageal carcinoma cell line EC9706 cells were treated with ATRA at different concentration. The proliferation inhibition was examined by MTT assay. Morphological examination, TUNEL method and flow cytometry were used to detect the apoptosis and changes of cell cycle. Immunohistochemical method was used to detect the expression of apoptosis-related genes caspase-3 and bcl-2. The semi-quantification of protein expression was analyzed by pathological image analysis.

RESULTSATRA inhibited the proliferation of EC9706 cells moderately. Apoptosis in EC9706 cells was induced by ATRA treatment. The morphology of EC9706 cells showed changes such as nuclear chromatin condensation and fragmentation. Sub-G1 peak was found by flow cytometry. The maximal apoptosis rate was 32.6%. The expression of caspase-3 gene was enhanced. The expression of bcl-2 gene was decreased. All these effects were presented in a dose-dependent and time-depend manner.

CONCLUSIONApoptosis is one of the key mechanisms of ATRA action on EC9706 cells.

Antineoplastic Agents ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Esophageal Neoplasms ; metabolism ; pathology ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Tretinoin ; administration & dosage ; pharmacology

OBJECTIVETo investigate the perioperative characteristics and surgical methods in treating the old with degenerative lumbar spinal stenosis.

METHODSFrom January 2000 to October 2007, 36 patients with degenerative lumbar spinal stenosis with the age more than 60 years,including 16 males and 20 females, the age from 60 to 81 years with an average of 67.5 years. Of all patients, 6 cases were treated by simple surgical decompression, 16 cases by decompressive laminectomy, 20 cases by decompressive laminectomy combined with internal fixation and fusion.

RESULTSNo death cases occurred during perioperation and complication occurred in 14 cases, including cerebrospinal fluid leakage in 3 cases, incision late healed in 1 case, heart abnormal symptom in 1 case, respiratory infection in 1 case, gastrointestinal symptom in 4 cases, urinary system infection in 1 case, spirital symptom in 1 case. After symptomatic treatment, all complications improved. All the cases were followed up from 6 months to 5 years with an average of 2.5 years. Oswestry scoring improved from preoperative 45.66 +/- 7.12 to postoperative 16.80 +/- 5.75, there was significant difference between before and after operation (P < 0.05).

CONCLUSIONThe age and heath condition are not operative absolute contraindication in treating old with degenerative lumbar spinal stenosis,with the proper operation modus after controlling concomitant diseases, the surgical treatment could guarantee the satisfactory therapeutic effect.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Spinal Stenosis ; physiopathology ; surgery ; therapy ; Treatment Outcome

OBJECTIVETo evaluate efficacy and safety of Baimai ointment (see symbol in text) in the treatment of wrist-dysfunction after distal radius fracture.

METHODSFrom April, 2011 to June, 2012, 43 patients with distal radius fracture were treated with plaster fixation. All the patients were divided into two group: test group and control group. Twenty-one patients in test group and 22 in control group, and the baseline was balance (P > 0.05). The 21 patients in test group were treated with Baimai ointment (see symbol in text), fomentation, functional exercises. The 22 patients in control group were treated with placebo, fomentation, functional exercises. Foment affected side wrist with wet towel in 20 min before medication, with the temperature between 50 degrees C and 60 degrees C. Smear drugs uniformly in range of 3 cm in the vicinity of palm stripes after drying (about 3 g) and take functional exercises for the activities of wrist and hand. Continuous follow the program per 8 hours once and follow-up for 8 weeks. The Wrist's pain was assessed with VAS. The wrist's activities were measured with the protractor of orthopedic. Measure The grip strength was measured with dynamometer. The wrist's function were assessed with the table of Cooney.

RESULTSThe test group had a significantly better results than those of control group in the extent of wrist's pain throughout the treatment (P < 0.001), and grip strength on the 28th day and the 56th day (P < 0.05), and Cooney functional assessment on the 56th day (P < 0.05). Wrist's activities had no significane difference throughout the 8 weeks (P > 0.05). There were no drug adverse reactions occurred.

CONCLUSIONTibetan Baimai ointment (see symbol in text) has the treatment of wrist-dysfunction after distal radius fracture for external use, which can reduce the extent of wrist's pain, promote grip strength recovery in the middle and late of process, promote wrist's function recovery latterly, and safety for external use.

Adult ; Aged ; Case-Control Studies ; Double-Blind Method ; Female ; Humans ; Male ; Medicine, Tibetan Traditional ; Middle Aged ; Ointments ; Radius Fractures ; drug therapy ; physiopathology ; Recovery of Function ; Wrist Joint ; drug effects ; physiopathology

OBJECTIVETo explore the effect and mechanism of Poly I:C in inducing growth inhibition and apoptosis of human hepatocellular carcinoma SMMC-7721 cells.

METHODSSMMC-7721 cells were treated with different doses of Poly I:C for 24, 48, and 72 h, and the cell growth inhibition rate was analyzed with CCK-8 assay. The cell cycle and the apoptosis were analyzed using flow cytometry with Annexin-V and PI staining, and quantitative RT-PCR analysis were used to detect the expression of TLR3, TRIF, and IFN-beta mRNA in cells.

RESULTSIn the cells exposed to Poly I:C at low, moderate, and high doses, the inhibitory rates was the highest in high-dose Poly I:C group, and at a given Poly I:C dose, prolonged exposure resulted in significantly increased cell growth inhibition rate (P<0.05). Flow cytometry showed that Poly I:C induced cell apoptosis in a time- and dose-dependent manner and significantly increased the percentage of G1-phase cells as compared with that in the control group. The mRNA level of TLR3, TRIF, and IFN-beta were also increased following Poly I:C treatment in comparison with the control group.

CONCLUSIONPoly I:C can induce significant growth inhibition and apoptosis of SMMC-7721 cells in a dose- and time-dependent manner possibly by causing cell cycle arrest and TLR3 signaling pathway activation that leads to IFN-beta production and cell apoptosis.

Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Humans ; Interferon-beta ; genetics ; metabolism ; Liver Neoplasms ; pathology ; Poly I-C ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Receptors, Cholecystokinin ; metabolism ; Signal Transduction ; Toll-Like Receptor 3 ; genetics ; metabolism

OBJECTIVETo investigate the expression of Fas/FasL in infantile hemangiomas and discuss the role of Fas/FasL in the pathologic evolution of infantile hemangioma.

METHODThe EnVision immunohistochemical stain and RT-PCR technique was used to examine the expression of Fas/FasL protein and mRNA in the infantile hemangiomas.

RESULTS(1) In the early and middle proliferating stage, a number of infantile hemangioma cells expressed Fas. In the late proliferating stage, the number of positive cells increased obviously and the expression of Fas mRNA was reaching the strongest level. In the early regressing stage the Fas still existed in some cells and after that the expression decreased quickly. (2) Up to the middle proliferating stage, there were a few of FasL(+) cells foound. In the late proliferating stage, the number of FasL(+) cells increased significantly. From the early regressing stage, the number of FasL(+) cells decreased rapidly and disappeared.

CONCLUSIONThere may exist significant correlation between the expression of Fas/FasL and the development of the infantile hemangioma cells. The apoptosis of the infantile hemangioma cells mediated by Fas/ FasL may be the major reason of the spontaneous involution of infantile hemangioma.

Apoptosis ; Child ; Child, Preschool ; Fas Ligand Protein ; metabolism ; Hemangioma ; metabolism ; pathology ; Humans ; Hyperplasia ; Infant ; RNA, Messenger ; metabolism ; Signal Transduction ; fas Receptor ; metabolism

Animals ; Clostridium difficile ; classification ; genetics ; Humans ; Molecular Typing ; Ribotyping

Natural killer (NK)/T-cell lymphomas represent a rare type of lymphoma derived from either activated NK cells or cytotoxic T cells. They are most commonly extranodal and tend to present as destructive lesions within the midline facial structures. Other than the nasal cavity and Para nasal sinuses, several other extra nodal sites of involvement have been reported, including the pharynx, gastrointestinal tract, and testis. Occasionally, pleural effusion has also been observed. Here, a case of lymphoma of NK/T-cell type presented as pleural effusion was reported. The patient was previously misdiagnosed as B cell non-Hodgkin's lymphoma by pathological and immunohistochemistry (IH) analysis for pleural membrane biopsy specimen. After the analysis of the pleural fluid cells by a combination of morphologic, immunophenotypic, cytogenetic and molecular (MICM) methods in Beijing Dao-Pei hospital, some lymphoblasts were found morphologically, which expressed cytoplasmic CD3 (cCD3) and CD56 by flow cytometry analysis and had a clonal T-cell receptor gamma (TCR-gamma) gene rearrangement by molecular analysis, so that the diagnosis was finally corrected as NK/T-cell lymphoma and an allogeneic stem cell transplantation was successfully performed. In conclusion, this unusual case highlights the significance of MICM combined techniques for the diagnosis of lymphoma, as well as an unusual presentation of a rare disease and the successful treatment.
Cytological Techniques ; Humans ; Lymphoma, Extranodal NK-T-Cell ; complications ; diagnosis ; Male ; Middle Aged ; Natural Killer T-Cells ; Pleural Effusion ; diagnosis ; etiology