Humans ; Oral Medicine ; Photofluorography

Humans ; Osteogenesis, Distraction ; instrumentation

Objective To evaluate the prognosis for patients with squamous cell carcinoma of cervical lymph node metastases from an unknown primary site who had different clinical stages and were irradiated to different fields. Methods The clinical date of 60 patients with cervical lymph node metastatic squamous cell carcinoma from an unknown primary site(no including patients with supraclavicular node metastases) were retrospectively analyzed. Results The overall 5-year survival rates(OSR) was 68.5%, the OSR of patients with N 1,N 2 and N 3 stage were 100%, 68.0% and 40.9% respectively(? 2=7.29,P=0.026). The OSR of patients with one lateral neck, whole neck and large fields irradiation were 66.5%, 74.5% and 54.6% respectively(? 2=1.38,P =0.501). The Cox proportional hazard model showed that clinical stages of cervical lymph node had an significant effect in patients survival(P=0.032). The 5-year local control rates(LCR) 65.6%, the LCR of patients with N 1,N 2 and N 3 stage were 100%, 63.2% and 34.6% respectively(? 2=5.51, P=0.064). The LCR of patients with one lateral neck, whole neck and large fields irradiation were 87.6%, 51.0% and 72.7% respectively(? 2=2.55, P =0.279). The 5-year subsequent appearance rates of occult primary cancer(SAR) was 21.2%, the SAR of patients irradiated by small(one lateral neck or whole neck) and large fields were 23.3% and 12.5% respectively(? 2=0.52, P =0.469). Conclusions The clinical stages of cervical lymph node is an important prognostic factor for survival and the local control rates has a decreasing trend as the stage increases. The subsequent appearance rates of occult primary cancer of patients irradiated by small fields has a higher trend than its of patients irradiated by large fields, but the control rates and survival rates have no significant difference in different fields irradiated.

Gastrectomy ; methods ; Humans ; Laparoscopy ; Stomach Neoplasms ; surgery

OBJECTIVE To develop a suitable and easy method for detecting AmpC ?-lactamases.METHODS The function with different cloxacillin concentrations in cloxacillin-potentiated disc diffusion test was compared and estimated with FOX three-dimensional extract test to show the best concentration of cloxacillin.RESULTS Cefoxitin three-dimesional test indicated that 48 strains were detected out to produce AmpC ?-lactamases among 130 clinical isolates of Gram-negative bacilli strains.when the discs contained 200 ?g cloxacillin the CAZ,CTX,CRO and ATM alone could separately detect 87.5%,87.5%,87.5% and 33.3% highly producing AmpC ?-lactamases strains.When the combination of CTX with CRO,almost 95.8% could be detected out.CONCLUSIONS With the combination of CTX and CRO,the cloxacillin-potentiated disc diffusion test can specifically detect AmpC ?-lactamases and easy to be used in clinical laboratories.

Objective To evaluate the clinical effect of cervical cerclage in the treatment of pregnant with uterine cervical incompetence.Methods The clinical and follow -up data of 25 pregnant women with uterine cervi-cal incompetence who taken cervical cerclage were retrospectively analyzed.Results In 25 pregnant women with uterine cervical incompetence,there were 22 cases of neonatal survival,3 cases of abortion,surgical success rate was 88.0%.Conclusion Cervical cerclage is effective in the treatment of pregnant women with uterine cervical incompe-tence,and the timing of surgery should choose 14 -18 weeks gestation.

This study investigated the role of glucose in the biogenesis of high-density lipoprotein cholesterol (HDL-C). Mouse primary peritoneal macrophages were harvested and maintained in Dulbecco's modified Eagle's medium (DMEM) containing glucose of various concentrations. The cells were divided into 3 groups in terms of different glucose concentrations in the cultures: Control group (5.6 mmol/L glucose), high glucose concentration groups (16.7 mmol/L and 30 mmol/L glucose). ATP-binding cassette transporter A1 (ABCA1) mRNA expression in the macrophages was detected by semi-quantitative RT-PCR 24, 48 and 72 h after glucose treatment. The results showed that ABCA1 mRNA expression in the 16.7 mmol/L glucose group was not significantly different from that in the control group at all testing time points (P>0.05 for each). In the 30 mmol/L glucose group, macrophage ABCA1 mRNA expression was not changed significantly at 24 h (P=0.14), but was substantially decreased by 40.4% at 48 h (P=0.009) and by 48.1% at 72 h (P=0.015) as compared with that in the control group. It was concluded that ABCA1 is of vital importance for HDL-C biogenesis. High glucose may hamper HDL-C biogenesis by decreasing ABCA1 expression, which contributes to low HDL-C level in diabetes.

Objective To discuss the clinical characteristics and treatment of amenorrhea caused by Tripterygium Wilfordii polyglycoside (TWP).Methods The sexual hormone levels of 25 outpatients of The First Affliated Hospital Of Wenzhou Medical College who suffered from secondary amenorrhea after the use of TWP were examined before and after the hormone therapy.In addition,the clinical presentations were observed.Results (1)The E2 level went down lower than 73.2pmol/L while FSH went up higher than 40U/L in all the 25 patients.Among them,24 patients were confirmed of the diagnosis of premature ovarian failure.⑵HT is an effective way for 20 patients.The total efficiency of the therapy was 80%.⑶The E2 secreted by ovary was higher (63.19?10.81)pmol/l vs. (365.45?161.60) pmol/L and FSH(110.72?21.52)U/L vs. 11.46?17.70)U/Lsecreted by pituitary was lower after therapy than before.⑷After the second period of therapy, the clinical perimenopausal symptoms of all the patients were improved to different degrees.Conclusion TWP may result in the disorders of ovarian functions, but and HT in time may be an effective therapy.

Objective To evaluate the limitation of image-based classification and delineation of cervical nodes proposed in 1999. Methods 259 consecutive nasopharyngeal carcinoma patients received contrast-enhanced transverse CT scan from July to November in 2003, the scanning range extended from the skull base to the inferior border of the clavicle, with thickness set at 5?mm per slice from the skull base to the oropharynx, and 1?cm per slice from the oropharynx to the clavicle. Interpretation of the images and assessment of the involved nodes distribution were performed by both radiation oncologists together with diagnostic radiologists according to 1999 image-based classification and delineation of the neck. Then we evaluated whether this classification could fully cover all the lymphatic drainage areas of the neck. Results 218 cases had nodal involvements. Nodal distributions were 0 in levelⅠA, 6 in levelⅠB, 136 in level ⅡA, 171 in level ⅡB, 78 in level Ⅲ, 20 in level Ⅳ, 33 in level VA, 27 in level VB,0 in level Ⅵ and Ⅶ, 5 in supraclavicle and 102 in retropharyngeal space, respectively. Among another 57 cases who belonged to none of the above levels, 2 cases had lesions in the preauricular area, the rest 55 medial to the border of internal carotid artery, 2?cm from inferior to the skull base to the hyoid bone. Conclusions The 1999 image-based classification of the neck nodes,being essentially rational, did not fully cover the retropharyngeal space. It would be better to shift the inferior boundary of the retropharyngeal space to the level of the hyoid bone.

We enrolled 60 patients with American Association of Anesthesiologists grade Ⅰ - Ⅱ undergoing unilateral total knee arthroplasty. All patients received combined epidural and spinal anesthesia,and a nerve stimulator was used to guide placement of a femoral nerve catheter. Patients were divided into three groups according to the catheter location on X-ray : psoas muscle group ( n = 18 ), iliacus muscle group (n = 19) and local group (n =23). Visual analog scale (VAS) pain scores were recorded at rest and with movement at 4, 24 and 48 h postoperatively and sensory blockade of the femoral, obturator and lateral femoral cutaneous nerves was recorded at 24 h.There were no significant differences in femoral nerve blockade among the three groups. Obturator nerve blockade was significantly better in the psoas muscle group than in the iliacus muscle and local groups, and was also better in the local group than in the iliacus muscle group. There was no significant difference in lateral femoral cutaneous nerve blockade between the psoas muscle and iliacus muscle groups, but there was better blockade in both these groups than in the local group. At 4 h postoperatively, VAS pain scores at rest were significantly lower in the psoas muscle group than in the iliacus muscle and local groups, but there were no significant differences in VAS pain scores with movement among the three groups. At 24 and 48 h postoperatively, VAS scores at rest and with movement were significantly lower in the psoas muscle group than in the iliacus muscle and local groups.