Objective To elucidate the clinical characteristics of multiple primary malignant neoplasms(MPMNs) in elderly patients,and the relationship between MPMNs and its prognosis.Methods The data of 155 patients,including 114 males and 5 females,who were hospitalized to the authors' department during 1974 to 2007 and were diagnosed as MPMNs were retrospectively analyzed.Among them there were 119 patients with MPMNs in digestive system,accounting for 76.77%.The analyses for the characteristics of MPMNs included the sites of neoplasms,the age of onset,length of interval,pathologic types and survival time.Results The median age of onset of the first,second and third tumor were 71,77 and 78.5 years old,respectively.In the digestive system the earliest tumor occurred in stomach(40.4%),and then large intestine(34.5%),esophagus(10.5%) and liver(8.7%) sequentially.Most of them were adenocarcinoma.When the whole body was concerned,the neoplasms occurred earliest in the digestive system,and then the respiratory system,urinary system,male reproductive system and hematological system in sequence.Adenocarcinoma was the primary carcinoma in the digestive system.There were 26 synchronous multiple primary cancers(SMPC) and 93 metachronous multiple primary cancers(MMPC) in the 119 cases,and the intervals in MMPC were 156 totally.Conclusion Multiple primary cancers in the gastrointestinal tract occur commonly.The predilection sites of MPMNs in elderly patients are stomach and large intestine,and most of the neoplasms are adenocarcinoma.The prognosis of MMPC is better than SMPC.The longer the intervals between the first tumor and the second one,the better the prognosis of the patients will be.

Objective To observe the effect of free muscle localization and ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with rehabilitation training on lower limb spasm of cerebral palsy children.Methods Sixty-one cerebral palsy children with lower limb spasticity were randomly divided into a manual localizing group (31 cases) and an ultrasound-guided group (30 cases).The children of both groups underwent BTX-A injection at adductors,hamstrings and calf triceps.The former group was injected with bare hands,while the latter was injected under the guidance of ultrasound.Both groups were administered with rehabilitation training from the 3rd day onwards after injection.Before and 12 weeks after the injection,the modified Ashworth scale (MAS) and gross motor function scale (GMFM) were used to evaluate the lower limb spasticity and function in 2 groups.Results Before the injection,there was no significant difference between the 2 groups in terms of MAS and GMFM scores (P ＞ 0.05).However,12 weeks after the injection,the average MAS scores of the two groups decreased,and that of the ultrasound-guided injection group (1.43 ±0.50) was significantly lower than that of the manual localizing group (1.77 ± 0.56).After the injection,the average GMFM scores of both groups increased,and that of the ultrasound-guided injection group was significantly higher than the manual localizing group (67.10 ± 11.25).Conclusion Ultrasound-guided injection of BTX-A with intensive rehabilitation training can significantly reduce the lower limb spasticity in children with cerebral palsy,and increase their motion of joint and motor function,and improve their posture and gait.

Objective To observe the effect of ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with orthosis training for the treatment of lower limb spasticity for children with cerebral palsy.Methods Fifty-four patients with spastic cerebral palsy were randomly divided into an observation group and a control group using a random number table.Patients in the control group were given conventional rehabilitation training,while those in the observation group were additionally given ultrasound-guided BTX-A injection,followed by daily knee-ankle-foot orthosis rehabilitation training 24 h after the injection.Before and 6 weeks after treatment the lower limb function of the 2 groups was evaluated using the modified Ashworth scale (MAS) and the gross motor function measure (GMFM).Adductor angles,popliteal angles and motor ranges of the ankle joint were also measured and compared.Results After 6 weeks the average MAS scores were lower than before treatment in both observation[(1.26±0.63) vs (3.07±0.68)] and control group [(2.56±0.71) vs (2.89±0.64).And in both groups the average GMFM scores,adductor angles and popliteal angles,as well as range of motion of the ankle were all much better than before treatment.The observation group,however,improved significantly more than the control group(P ＜ 0.05).Conclusion Ultrasound-guided injection of BTX-A can effectively alleviate spasticity of lower extremity for children with cerebral palsy with accurate positioning,obvious curative effect and less adverse reactions.Knee-ankle-foot orthosis rehabilitation training after the injection can further alleviate spasticity and improve the motor function of the limbs.

AIM: To investigate the expression of tissue factor(TF) induced by oxidized high density lipoprotein(oxHDL) in human umbilical vein cell line,ECV304,and the related mechanisms.METHODS: Four main groups were designed: the negative,the positive(ECV304 with histamine),the HDL group and the oxHDL group.Quantitative real-time polymerase chain reaction(RQ-PCR) and Western blotting were used to detect the expression level of TF.The specific inhibitors of MAPKs,SP600125(c-jun terminal NH2 kinase,JNK),SB203580(p38 MAP kinase,p38 MAPK),PD98059(extracellular signal-regulated kinase,ERK1/2) were used to investigate the underlying mechanisms.RESULTS: The TF expression in normal ECV304 cell line was not detected.Histamine administration resulted in a significant expression of TF in ECV304 cell line,with strongest effect after 1 h co-incubation at concentration of 1?10-5 mol/L histamine(about 4.8-fold higher expression of TF compared with that of 1?10-9 mol/L histamine).Expression level of TF was detected after stimulated with oxHDL in dose-and time-dependent manners.The highest expression of TF mRNA was found at 20 mg/L oxHDL and 6 h co-incubation,with 1.8-fold and 5.3-fold increase in TF expression,respectively,compared with that at 10 mg/L oxHDL and 2 h co-incubation.20 mg/L oxHDL also caused an apparent augmentation of TF protein expression,about 1.5-fold higher compared with that stimulated by 40 mg/L oxHDL.HDL co-incubation did not cause a detectable expression of TF protein.The mRNA levels of TF in ECV304 cell line induced by oxHDL were decreased by 95.0%,81.0%,87.0%,respectively(all P

Objective To investigate the efficacy of telephone follow-up on anxious and depressive emotions of cancer patients with chemotherapy.Methods A total of 77 patients were randomly divided into experimental group (n =39,telephone follow-up)and control group (n =38,without telephone follow-up).SAS and SDS scales were used to evaluate emotion status of patients.Results After treatment,the scores SAS and SDS of experimental group were both low-er than control group,the difference was statistically significant(P <0.05).Conclusion Tele-phone follow - up significantly relieved the anxious and depressive emotions of patients with chemotherapy.

Objective To investigate the efficacy of telephone follow-up on anxious and depressive emotions of cancer patients with chemotherapy.Methods A total of 77 patients were randomly divided into experimental group (n =39,telephone follow-up)and control group (n =38,without telephone follow-up).SAS and SDS scales were used to evaluate emotion status of patients.Results After treatment,the scores SAS and SDS of experimental group were both low-er than control group,the difference was statistically significant(P <0.05).Conclusion Tele-phone follow - up significantly relieved the anxious and depressive emotions of patients with chemotherapy.

Tyrosine hydroxylase deficiency induced dopa-responsive dystonia is a treatable neurometabolic disease,which is relatively rare in clinic. In this paper,we present a case of dopa-responsive dystonia caused by tyrosine hydroxylase deficiency and reviewed relevant literature to investigate the pathogenesis,clinical manifestations,diagnosis and treatment of dopa-responsive dystonia caused by tyrosine hydroxylase deficiency. Finally,we concluded that peripheral blood prolactin may be a biomarker of tyrosine hydroxylase deficiency,Genetic testing in patients with clinically suspected tyrosine hydroxylase deficiency may be the only way to confirm the diagnosis,and early identification of the diagnosis and levodopa treatment may significantly improve the prognosis.

Objective To investigate the status of self‐management of blood pressure (BP) among elderly hypertensive patients living in new rural communities of Shanghai. Methods We enrolled a total of 2 241 hypertensive patients over 60 years old who participated in the National Key Research and Development Project "Cohort study on hypertension" of the 13th Five‐Year Plan in Langxia, Shanghai from May to July 2018. Questionnaires, physical examinations, and laboratory tests were conducted. We collected participants' demographic information, cardiovascular history, and self‐management behaviors related to hypertension. The status of self‐management of BP among participants with hypertension was analyzed. Pearson's chi‐squared test was used to explore the differences between males and females. Results Participants'mean age was (70.0±6.8) years, and males accounted for 38.8% of all participants. The systolic and diastolic BP levels of participants were (147.8±15.4) mmHg (1 mmHg=0.133 kPa) and (82.8±9.8) mmHg, respectively. The systolic blood pressure level of women was higher than that of men, and the diastolic blood pressure level of men was higher; the difference was statistically significant (all P<0.05). The awareness, treatment, and control rate of hypertension were 79.0%, 78.0%, and 25.6%, respectively. Males had a significantly higher control rate than females (P<0.05). The status of self‐management of blood pressure was as follows: (1) As to lifestyle, 84.4% of participants lacked exercise, and 69.2% were overweight or obese. The prevalence of smoking and drinking was higher in males (40.7% and 46.2%, respectively), and the proportion of females (12.4%) with anxiety and/or depression was higher than that of males (P all<0.001). (2) Concerning BP‐monitoring, only 10.1% of participants measured BP every week, 22.9% had BP measurement instruments at home, and 4.6% recorded their BP levels. There was no significant difference in self‐blood pressure monitoring behavior between men and women. (3) Regarding adherence to medication treatment, 97.6% took antihypertensive drugs regularly, and 21.6% were on combination therapy. The proportion of men taking combined drugs was higher than that of women, but there was no significant difference. Conclusions The rates of awareness, treatment, and control of hypertension in elderly hypertensive patients in new rural communities of Shanghai were above the national average. However, the status of self‐management of BP was still not satisfactory. More attention should be paid to healthy lifestyle, home BP monitoring, and effective pharmaceutical treatment strategies for hypertension.

Objective:To evaluate the long-term efficacy of percutaneous microwave ablation (MWA) therapy for hepatocellular carcinoma.Methods:2054 cases with Barcelona Clinic Liver Cancer (BCLC) stage 0~B at the Fifth Medical Center of the Chinese People's Liberation Army General Hospital from January 2006 to September 2020 were retrospectively collected. All patients were followed up for at least 2 years. The primary endpoint of overall survival and secondary endpoints (tumor-related survival, disease-free survival, and postoperative complications) of patients treated with ultrasound-guided percutaneous MWA were analyzed. Kaplan-Meier method was used for stratified survival rate analysis. Fine-and-Gray competing risk model was used to analyze overall survival.Results:A total of 5 503 HCC nodules [mean tumor diameter (2.6±1.6) cm] underwent 3 908 MWAs between January 2006 and September 2020, with a median follow-up time of 45.6 (24.0 -79.2) months.The technical effectiveness rate of 5 375 tumor nodules was 97.5%. The overall survival rates at 5, 10, and 15-years were 61.6%, 38.8%, and 27.0%, respectively. The tumor-specific survival rates were 67.1%, 47.2%, and 37.7%, respectively. The free tumor survival rates were 25.8%, 15.7%, and 9.9%, respectively. The incidence rate of severe complications was 2.8% (108/3 908). Further analysis showed that the technical effectiveness and survival rate over the passing three time periods from January 2006-2010, 2011-2015, and 2016-September 2020 were significantly increased, with P ?

OBJECTIVE: To determine the combined cytotoxic effect and the molecular basis of triptolide and sodium cantharidinate on hepatoma cell line 7721.
 METHODS: After treating the hepatoma cell line 7721 with triptolide(9, 18, or 36 μg/mL) and/or sodium cantharidinate (2, 5, or 10 μg/mL), cell viability assay and apoptosis were examined by MTT and flocytometry, respectively. The protein levels of caspase 3 and nuclear factor κB were analyzed by Western blot.
 RESULTS: Viability of hepatoma cell line 7721 was inhibited by either the therapy of triptolide and/or sodium cantharidinate (P<0.05) in a time- and dose-dependent manner. The combined effects of both drugs were better than those of the single drug (P<0.05). The combined therapy down-regulated the expression of NF-κB p65 (P<0.05) while up-regulated the expression of caspase-3 (P<0.05).
 CONCLUSION Triptolide and sodium cantharidinate exert a synergistic toxic effect on hepatoma cell line 7721, which is related to increasing capase-3 activity and suppression of NF- κB.
Apoptosis ; drug effects ; Cantharidin ; pharmacology ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; Caspase 3 ; drug effects ; Cell Line, Tumor ; Diterpenes ; pharmacology ; therapeutic use ; Down-Regulation ; Drug Therapy, Combination ; Epoxy Compounds ; pharmacology ; therapeutic use ; Humans ; Liver Neoplasms ; drug therapy ; NF-kappa B ; drug effects ; Phenanthrenes ; pharmacology ; therapeutic use ; Transcription Factor RelA