OBJECTIVETo explore the effects of sacral canal injection on nerve root local inflammatory factors in rat model with lumbar disc herniation, in order to identify its mechanism of treatment.

METHODSForty-eight male SD rats were randomly divided into sham operation group(group A), model group (group B), Chinese medicine group(group C) and western medicine group(group D). There were 12 rats in each group. The model of lumbar disc herniation was established using compression and inflammatory stimulation in group B, C, D. All rats were given epidural catheterization and group A and B with physiological saline (1 ml/kg), group C with mixed liquor of 2% lidocaine and compound Danshen injections and physiological saline (2:2: 16) and group D with mixed liquor of 2% lidocaine and triamcinolone acetonide injection and physiological saline (2:2:16), once a week for a total of three treatments. Four rats were killed every 1 week after injection for once, and the inflammatory factors of tumor necrosis factor (TNF-alpha), prostaglandin E2 (PGE2), interleukin-l (IL-1) and interleukin-6 (IL-6) were detected by ELISA method.

RESULTSThe levels of TNF-alpha, PGE2, IL-1 and IL-6 in compressed nerve tissues in group B were increased than those of group A (P < 0.01). The levels of PGE2, IL-1 and IL-6 in group C and D were decreased than those of group B, and group D was much less(P<0.05). There was no significant difference in level of TNF-alpha among group B, C, D (P > 0.05).

CONCLUSIONCompound compression with inflammatory stimulation can lead to massive release of inflammatory mediators, such as TNF-alpha, PGE2, IL-1 and IL-6. Both injection with compound Danshen injections and triamcinolone acetonide injections by sacral canal can reduce the levels of part inflammatory mediators (PGE2, IL-1 and IL-6), and the effect of Glucocorticoid is better than Danshen (P < 0.05).

Animals ; Dinoprostone ; analysis ; Disease Models, Animal ; Injections ; Interleukin-1 ; analysis ; Interleukin-6 ; analysis ; Intervertebral Disc Displacement ; drug therapy ; immunology ; Lumbar Vertebrae ; Male ; Rats ; Rats, Sprague-Dawley ; Salvia miltiorrhiza ; Spinal Nerve Roots ; immunology ; Triamcinolone Acetonide ; administration & dosage ; Tumor Necrosis Factor-alpha ; analysis

OBJECTIVETo explore the better treatment for the third lumbar transverse process syndrome.

METHODSNinety cases were randomly divided into an acupotomy group, a blood pricking group and a combined therapy group, thirty cases in each group. In acupotomy group, three points such as the third lumbar transverse process point were released with acupotomy, and then Tuina was applied. In blood pricking group, blood pricking therapy was applied at Qihaishu (BL 24) or Weizhong (BL 40). In combined therapy group, both of releasing with acupotomy and blood pricking were applied. The therapeutic effects of three groups were evaluated by of simplified Chinese version of the Oswestry Disability Index (SCODI) and Visual Analogue Scale (VAS) before, immediately after treatment and 1 week after treatment.

RESULTSAfter treatment, compared with scores sofore treatment, VAS scores were all reduced (both P < 0.05), and it in combined therapy group was lower than those in other groups (both P < 0.05); SCODI scores showed no significant differences in groups (both P > 0.05) except in combined therapy group (P<0. 05). One week after treatment, compared with scores immediately after treatment, SCODI scores and VAS scores were reduced in each group (all P < 0.05), and the scores in combined therapy group were lower than those in other two groups (both P < 0.05).

CONCLUSIONReleasing with acupotomy and blood pricking are the effective therapies for the third lumbar transverse process syndrome, can remarkably relieve the pain and improve movement function of lumbus, and the therapeutic effect is more obvious.

Acupuncture Therapy ; Adolescent ; Adult ; Bloodletting ; Combined Modality Therapy ; Female ; Humans ; Lumbar Vertebrae ; physiopathology ; Middle Aged ; Pain Measurement ; Spinal Diseases ; physiopathology ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the difference in surgical stress between gasless endoscopic thyroidectomy through anterior chest approach and conventional thyroidectomy.

METHODSThe patients with thyroid nodules who would undergo thyroidectomy between November 2006 and February 2008 in Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Sun Yat-sen University, were randomly divided into gasless endoscopic thyroidectomy group or conventional thyroidectomy group, with 25 cases and 22 cases respectively. Before and after surgery, white blood cell count (WBC), serum C-reactive protein (CRP) and interleukin-6 (IL-6) were measured to assess the surgical stress response.

RESULTSAt 12 h, 24 h and 48 h after surgery, no significant difference was found between the two groups in WBC (t = -0.172, 1.774 and 2.039 respectively, P > 0.05), serum CRP (t = -0.927, -1.701 and -1.813, P > 0.05) and IL-6 (t = 0.098, -2.019 and -1.121, P > 0.05).

CONCLUSIONThe stress response of gasless endoscopic thyroidectomy is similar with that of conventional thyroidectomy.

Adult ; C-Reactive Protein ; metabolism ; Female ; Humans ; Interleukin-6 ; metabolism ; Leukocyte Count ; Male ; Thyroid Neoplasms ; metabolism ; surgery ; Thyroidectomy ; methods ; Treatment Outcome

OBJECTIVETo evaluate the imaging features of MR Imaging (MRI) and MR cholangiopancreatography (MRCP) and their clinical value in the diagnosis of extrahepatic cholangiocarcinoma.

METHODSMRI was performed in 54 patients with extrahepatic cholangiocarcinoma proved surgically and pathologically, MRCP in 44 patients, Gadolinium-enhanced in 29 patients. MRI, MRCP and pathological findings were analyzed retrospectively.

RESULTSBy MRI, the mass was shown (n = 39) and all bile duct thickened (n = 13) in extrahepatic cholangiocarcinoma. Gadolinium-enhanced ones revealed calcified focus (n = 22). By MRCP, interrupted, abruptly cut-off or cone-like changes of the bile duct (n = 16), beak-like or mouse tail changes (n = 26) or tumbler mouth appearance (n = 2) were shown. The bile duct distal to the obstruction was observed in 29 patients. Of the 54 patients examined by MRI in combination with MRCP, correct tumor localization was made in 52 (96.3%) and correct judgement of tumor nature in 50 (92.6%).

CONCLUSIONConventional MRI is an effective supplement to MRCP in the diagnosis of extrahepatic cholangiocarcinoma. MRCP combined with MRI is able to significantly improve the diagnostic accuracy of MR examination.

Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; diagnosis ; Bile Ducts, Extrahepatic ; pathology ; Cholangiocarcinoma ; diagnosis ; Cholangiopancreatography, Magnetic Resonance ; Female ; Humans ; Image Enhancement ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo evaluate the effect of high intensity focused ultrasound (HIFU) for liver cancer.

METHODSHIFU treatment was performed in 44 liver cancer patients under general anesthesia and ultrasound positioning. Before and after HIFU treatment, the clinical symptoms, liver functional tests, AFP and MRI were evaluated.

RESULTSAfter HIFU treatment, the remission rate of clinical symptoms was 87.5% (28/32), with the scanty ascites in 3 patients disappeared. ALT (79.73 +/- 12.31 U/L) and AST (103.47 +/- 24.55 U/L) before HIFU were reduced to normal in 84.6% (22/26) and 73.5% (25/34) patients. AFP in 64.3% (18/28) patients decreased > or = 50% of the original value. After HIFU, MRI showed coagulative necrosis and blood supply reduction or disappearance of tumor in the target region.

CONCLUSIONHIFU treatment pocesses good effect on liver cancer, which will offer a considerable weight in noninvasive local treatment of hepatic tumor.

Adult ; Aged ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Ultrasonic Therapy ; Ultrasound, High-Intensity Focused, Transrectal

Objective:To identify the proliferation effect and angiogenic ability of CXCL4 on human dermal microvascular endothelial cells(HDMECs),and to explore the secretion of vasomotion factors.Methods:HDMECs were treated with gradient concentration to test the proliferation of HDMECs.CCK-8 was used to explicated the proliferation of HDMECs.The effect of CXCL4 on angiogenic ability of HDMECs was determined by tube formation assay.The mRNA levels of endothelin-1(ET-1),Fli-1,AngiotensinⅡtype 1 receptor(AT1R) and endothelin-1 type A receptor (ETAR) were detected by real-time quantitative polymerase chain reaction (Real-time PCR).Results:The specific receptor of CXCL4 was expressed on HDMECs.CXCL4 could inhibit the proliferation of HDMECs and the number of tube formation in a dose-depend manner.After CXCL4 intervention,the relative amplification multiples of ET-1,AT1R were significantly increased(P<0.05),Fli-1 was decreased(P<0.05),and ETAR had no change as compared with the control group.Furthermore,CXCL4 antagonist could reverse the effects of CXCL4 on HDMECs.Conclusion:CXCL4 inhibit the proliferation and angiogenesis of HDMECs and induce the secretion of ET-1 and AT1R,reduce the secretion of Fli-1 in a dose-dependent manner.

The diagnosis of postradiation nasopharyngeal skull base lesions in petients with nasopharyngeal carcinoma (NPC) is still a tough problem in clinical practice. An early and accurate diagnosis is important for subsequent management. We prospectively evaluated the diagnostic value of plasma Epstein-Barr virus(EBV) DNA in detecting postradiation nasopharyngeal skull base lesions in NPC patients. From July 2006 to September 2010, 90 patients with postradiation NPC (34 women and 56 men; median age: 42 years) met the selection criteria and were recruited in this study. All postradiation nasopharyngeal skull base lesions were found in the latest magnetic resonance imaging (MRI) examinations before endoscopic surgery, and the nasopharyngeal cavity was normal under flexible nasopharyngoscopy. Plasma EBV DNA detection was performed within 2 weeks before endoscopic surgery. A total of 90 endoscopic operations were successfully performed without any postoperative complications. Recurrences confirmed by postoperative pathology were found in 30 patients. The specificity, positive and negative predictive values of plasma EBV DNA detection were better than those of MRI. In addition, combining plasma EBV DNA detection with MRI improved the specificity and positive predictive values of MRI. Plasma EBV DNA detection followed by MRI would help to diagnose recurrence whereas MRI was unable. These results indicate that plasma EBV DNA is an effective and feasible biomarker for detecting postradiation nasopharyngeal skull base lesions in NPC patients.
Adult ; Carcinoma, Squamous Cell ; blood ; radiotherapy ; virology ; DNA, Viral ; blood ; Endoscopy ; Female ; Follow-Up Studies ; Herpesvirus 4, Human ; genetics ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; radiotherapy ; virology ; Nasopharynx ; pathology ; Neoplasm Recurrence, Local ; diagnosis ; virology ; Neoplasm, Residual ; Osteoradionecrosis ; diagnosis ; surgery ; Prospective Studies ; Skull Base ; pathology

BACKGROUNDImaging-guided thermal ablation using different energy sources continues to gain favor as a minimally invasive technique for the treatment of primary and metastatic hepatic malignant tumors. This study aimed to evaluate the performance of microwave ablation with 2450-MHz internally cooled-shaft antenna in ex vivo and in vivo porcine livers.

METHODSAll studies were animal care and ethics committee approved. Microwave ablation was performed using a noncooled or cooled-shaft antenna in 23 ex vivo (92 ablations) and eight in vivo (36 ablations) porcine livers. Diameters of the coagulation zone were observed on gross specimens. The coagulation diameters achieved in different microwave ablation parameter groups were compared. Curve estimation analysis was performed to characterize the relationship between applied power and treatment duration and coagulation diameter (including short-axis and long-axis diameter).

RESULTSCoagulation zones were elliptical and an arrowed-shaped carbonization zone around the shaft was observed in all groups. But the antenna track was also coagulated in the noncooled-shaft antenna groups. In ex vivo livers, the short-axis diameter correlated with the power output in a quadratic curve fashion (R(2) = 0.95) by fixing ablation duration to 10 minutes, and correlated with the ablation duration in a logarithmic curve fashion (R(2) = 0.98) by fixing power output to 80 W. The short-axis reached a relative plateau within 25 minutes. In in vivo livers, short-axis diameter correlated with the coagulation duration in a sigmoidal curve fashion (60 W group R(2) = 0.76, 80 W group R(2) = 0.87), with a relative plateau achieved within 10 minutes for power settings of 60 W and 80 W.

CONCLUSIONSThe internally cooled microwave antenna may be advantageous to minimize collateral damage. The short-axis diameter enlargement has a plateau by fixing power output.

Animals ; Catheter Ablation ; Liver ; surgery ; Microwaves ; Swine

OBJECTIVETo compare oncologic adequacy of resection and long-term oncologic outcomes between laparoscopic-assisted surgery (LS) and open surgery (OS) in the treatment of rectal cancer.

METHODSLiterature searches of electronic databases (PubMed, Embase, Web of Science,and Cochrane Library) and manual searches up to June 30, 2010 were performed to identify RCTs comparing values of oncologic adequacy of resection, recurrence and survival following LS and OS. Fixed and random effects models were used.

RESULTSSix RCTs enrolling 1033 participants (LS group:577 cases, OS group:456 cases)were included in the meta-analysis. Number of lymph node harvested was similar(WMD=-0.38, 95%CI:-1.35-0.58, P=0.43). LS had a slightly higher circumference resection margin(CRM) positive rate with no statistical significance[7.94% vs. 5.37%; risk ratio(RR)=1.13; 95%CI:0.69-1.85, P=0.63]. There was no significant difference between the two groups in local recurrence (RR=0.55; 95%CI:0.22-1.40, P=0.21). The 3-year overall survival [Hazard ratio(HR)=0.76; 95%CI:0.54-1.07, P=0.11] and 3-year disease-free survival(HR=1.16; 95%CI:0.61-2.20, P=0.64) were not significantly different between the two groups.

CONCLUSIONCompared with open surgery, laparoscopic surgery of rectal carcinoma offers similar oncological clearance and long-term oncological outcomes.

Humans ; Laparoscopy ; Laparotomy ; Randomized Controlled Trials as Topic ; Rectal Neoplasms ; surgery ; Treatment Outcome

【Objective】 To compare clinical outcomes between bipolar umbilical cord coagulation(BCC) and radiofrequency ablation(RFA) after selective fetal reduction in monochorionic diamniotic twin pregnancy. 【Methods】 We retrospectively analyzed all cases of monochorionic diamniotic twin pregnancies who received selective fetal reduction in The First Affiliated Hospital of Sun Yat-sen University from 2009 to 2019. Patient underwent regular antenatal care during the whole pregnancy and finally delivered in our hospital. The impact of basic conditions of the patients, different methods of reduction, gestational weeks of delivery and other factors on the final pregnancy outcomes and neonatal outcomes were studied. The data were analyzed by SPSS20.0. 【Results】 The frequency of tightening feeling of the lower abdomen of RFA group and BCC group after surgery were 65.0% and 61.5%, respectively(P > 0.05). The symptom was relieved after symptomatic treatment. In addition, time of surgery and the hospitalization days were not statistically different between the two groups. The median gestational age at delivery of the RFA group was 36^6/7(26^4/7 ~ 40^6/7) weeks, which was later than 32^4/7 (29^0/7~37^4/7) weeks of the BCC group, without statistical significance(P > 0.05). The proportion of patients who delivered before 37^0/7 weeks in the BCC group was higher than that in the RFA group(100% vs. 62.5%, P = 0.024). In the neonatal outcomes, the rate of low birth weight infants in the BCC group was greater than that in the RFA group(92.31% vs. 52.5%, P = 0.025), but the differences in the rate of very low birth weight infants and the rate of small for gestational age infant were not statistically significant(both P values are greater than 0.05). The rate of neonatal transfer pediatrics or intensive care unit in the BCC group was greater than that of the RFA group(84.62% vs. 30%, P = 0.001). In a multivariate analysis of the effects on neonatal outcomes, multivariate logistic regression was used to analyze the association between different indicators and the incidence of low birth weight infants. The results showed that gestational weeks < 27^0/7 weeks was a risk factor for low birth weight infant(OR = 2.091, 95% CI, 0.312 to 14.162, P = 0.032) . 【Conclusions】 The effects of RFA and BCC on the pregnancy outcome and neonatal outcome are different. We should consider various factors when we choose individualized method of pregnancy reduction.