Objective To compare the efficacy and safety of modified FOLFOX4 program with docetaxel-oxaliplatin-5-fluorouracil (DOF) program as neoadjuvant chemotherapy in stage Ⅲ gastric cancer patients.Methods In 86 cases of stage Ⅲ gastric cancer patients,42 received modified FOLFOX4 chemotherapy,44 cases were treated by DOF program.After two cycles of chemotherapy,the treatment effect and adverse reactions were evaluated.Results The total effectiveness in modified FOLFOX4 group and DOF group was 60％ (25/42) and 68％ (30/44) respectively (P ＞ 0.05).Tumor control rate was 83％ (35/42) and 89％ (39/44) respectively (P ＞ 0.05).The incidence of nausea,vomiting and leukopenia was higher in DOF group than modified FOLFOX4 group (P ＜ 0.05).The D2 lymph node dissection rate between modified FOLFOX4 group and DOF group was 80％ (20/25) and 87％ (26/30) respectively (P ＞ 0.05),the R0 resection rate was 72％ (18/25) and 83％ (25/30) respectively (P ＞ 0.05).In 43 R0 resection patients using FOLFOX4 the median survival time was 38.7 months,1-,3-year survival rate was 90％,and 60％ ; while that in DOF group the median survival time was 39.6 months,1-,3-year survival rate was 95％,and 75％.Multivariate analysis showed that postoperative TNM stage only was an independent risk factor for prognosis.Conclusions TNM stage was the independent risk factor for prognosis of gastric carcinoma patients after radical gastrectomy.

The data collected from 34 type 2 diabetic patients receiving intensive insulin therapy for six years showed that the yearly mean HbA1C was less than 7.0％,and none of the patients showed severe hypoglycemia,occurrence or evident progression of retinopathy or nephropathy,and the islet β cell function gained improvement.The DQOL score,used to evaluate the quality of patients' life had no significant change during the observation ( P ＞0.05 ).It is satisfactory and safe to maintain long-term glycemic control with prolonged intensive insulin therapy in patients with type 2 diabetes,and that such therapy does not induce untoward influence on the quality of diabetic patients life.

BACKGROUNDThe subtemporal transtentoral approach has been reported for nearly two decades; however it was not well used due to some limitations in dealing with large and giant petroclival meningiomas. The clinical outcome and merit of the modified subtemporal transpetrosal apex approach in large and giant petroclival meningiomas, as well as the choices, the improvements and the therapy strategies of the microsurgical approach in such patients were evaluated in this study.

METHODSTotally 25 cases of large and giant petroclival meningiomas undergone the modified subtemporal transpetrosal apex approach between April 2004 and January 2010 were enrolled in this study. The choice and improvement of the approach, the basis of anatomy and related research, the effect of accessory equipment, the exposure of tumor and the changes of neurofunction pre- and post-operation were all reviewed retrospectively. The operation outcomes and complications in this approach were also compared with those in the transpetrous presigmoid approach done in 14 cases in the same period.

RESULTSAll 25 cases underwent the modified subtemporal transpetrosal apex approach under electrophysiologic monitoring of cranial nerves and brain stem function. Trochlear nerve was partly wrapped in 14 cases, totally wrapped but can be explored in the initial segment of the cerebellum tentorium in 8 cases, totally wrapped and could not be seen until tumor was partly removed in 3 cases. The cerebellum tentorium was cut along the temporal bone from the anterior part of the apex to the mastoid part of superior petrous sinus in 6 cases, from the posterior part of the apex to the mastoid part of superior petrous sinus in 19 cases. Gross tumor resection was accomplished in 17 (68%) patients, subtotal resection in 7 (28%) patients, and partial resection in 1 (4%) patient. The most common postoperative complication was new neurological deficits or aggravations of preexisting deficit (64%). Follow-up ranged from 3 to 69 months. Compared with the transpetrous presigmoid approach done in 14 cases in the same period, the modified subtemporal transpetrosal apex approach showed obvious advantages such as simplicity in manipulating, microinvasiveness, less time-consuming, less complication, higher rate of tumor resection though the rates of gross tumor resection might be of no significant difference.

CONCLUSIONSModified subtemporal transpetrosal apex approach has obvious advantages compared with the transpetrous presigmoid approach. Some complications need to be solved by practice and modification of the approach as well as the accumulation of the experiences.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Meningioma ; pathology ; surgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Young Adult

Objective To investigate the relationship of serum and carcinoma levels of plasminogen activator inhibitor-1 (PAI-1)with clinical characteristics in patients with endometrial carcinoma.Methods Serum level of PAI-1 was determined by using enzyme-linked immunosorbent assay(ELISA) in patients with endometrial carcinoma (n =40),uterine prolapsed with normal endometrial tissues(n=40).The protein expression of PAI-1 in endometrial tissue was detected by using immunohistochemistry in patients with endometrial carcinoma and uterine prolapse patients.Results Serum level of PAI-1 was higher in patients with endometrial carcinoma than in uterine prolapse patients with normal endometrial tissues(19.43±7.12 μg/L vs.6.58±2.33 μg/L,P＜0.05).The rate of positive expression of PAI-1 was higher in endometrial carcinoma tissue than in uterine prolapse tissue[62.5 ％ (25/40) vs.7.5 ％ (3/40),P ＜ 0.01].Compared with early-stage endometrial carcinoma,advanced endometrial carcinoma had an increased rate of positive expression of PAI-1 (P ＜0.01).Compared with endometrioid adenocarcinoma,other pathological types of endometrial carcinoma had an increased rate of positive expression of PAI-1 (P ＜ 0.05).Poorly differentiated endometrial carcinoma versus highly differentiated endometrial carcinoma had an increased positive rate of PAI-1 (P ＜0.05).The rate of positive expression of PAI-1 was higher in endometrial carcinoma with myometrial invasion than without myometrial invasion(25/31 vs.0/9,P＜0.01).Conclusions The expression level of PAI-1 may be related to the invasion and metastasis of endometrial carcinoma.

Objective To investigate the calcification characteristics and biological activity of hepatic alveolar echinococcosis(HAE). Methods Retrospective analysis of 60 patients in the First Affiliated Hospital of Xinjiang Medical University from June 2016 to April 2017 with hydatid positive or surgical pathology confirmed HAE.All patients underwent abdominal CT scan and double-phase enhanced PET-CT examination were confirmed with single lesion.The CT and PET-CT features were analysed,and the maximum standard uptake value (SUVmax) of the focal lesion on the PET-CT was measured. According to the calcification,HAE patients were divided into A,B,C type.Kruskal-Wallis H test was used to compare the difference of SUVmax between lesions of different HAE types. Results Sixty patients with hepatic alveolar echinococcosis were evenly divided into A,B and C by different calcifications.The median SUVmax of A,B and C were 3.41(2.17 to 3.75),7.45(6.77 to 9.01)and 6.67(6.28 to 9.01),respectively.The median SUVmax within three types was statistically significant (χ2=4.429, P<0.05). Conclusion The biological activity of different HAE calcifications is different.

Objective To analyze the clinical and imaging features of a family(3 patients)with familial hemangioblastoma,and their diagnosis and prognosis.Methods The detailed data about clinical and imaging features of all patients diagnosed as familial hemangioblastoma,admitted to our hospital from October 2004 to May 2010,were analyzed,and the lesions of other regions,besides the tumor lesion,were observed.Results No lesions of other regions were noted in these 3 patients.Cranial MRI showed that 2 had cystic and solid tumor and 1 had solid tumor;,total removal was performed on these patients under microscope; regular follow-up was given and no recurrence was noted.Conclusion Familiar hemangioblastoma is serious hereditary disease; and MRI is the most important detective method; microsurgical operation is the most important therapy.Early diagnosis and treatment should be given to the patients with familiar hemangioblastoma due to its high recunence rate,having difficulty in operation and its trend to combining with other lesions of the other parts.

Objective:To investigate the occurrence of pain symptoms and risk factors of carpal tunnel syndrome (CTS) in automobile manufacturing workers and provide theoretical basis for the prevention of CTS.Methods:From Nov.5th to Nov.19th, 2017, 446 workers in an automobile factory whose work age was above one year participate in questionnaires by cluster sampling. Chi square test and multifactor logistics regression analysis were used to analyze the factors related to the occurrence of CTS pain symptoms in workers.Results:The incidence of CTS pain among workers in this automobile factory was 20.8%. Working in the same position for a long time ( OR=2.137, 95% CI:1.183-3.862) and unable to work reasonably because of uncomfortable posture ( OR =2.067, 95% CI: 1.075-3.974) were identified as the risk factors of CTS pain symptoms by multifactor logistics regression analysis. Working age ( OR=0.537, 95% CI:0.311-0.926) and work break ( OR= 0.489, 95% CI: 0.282-0.849) were identified as the benefit factors of CTS pain symptoms. Conclusion:The incidence of CTS pain in automobile manufacturing workers is related to the posture in the process of labor . Effective ergonomic interventions should be carried out to prevent the occurrence of CTS pain in automobile manufacturing workers.

Objective:To investigate the occurrence of pain symptoms and risk factors of carpal tunnel syndrome (CTS) in automobile manufacturing workers and provide theoretical basis for the prevention of CTS.Methods:From Nov.5th to Nov.19th, 2017, 446 workers in an automobile factory whose work age was above one year participate in questionnaires by cluster sampling. Chi square test and multifactor logistics regression analysis were used to analyze the factors related to the occurrence of CTS pain symptoms in workers.Results:The incidence of CTS pain among workers in this automobile factory was 20.8%. Working in the same position for a long time ( OR=2.137, 95% CI:1.183-3.862) and unable to work reasonably because of uncomfortable posture ( OR =2.067, 95% CI: 1.075-3.974) were identified as the risk factors of CTS pain symptoms by multifactor logistics regression analysis. Working age ( OR=0.537, 95% CI:0.311-0.926) and work break ( OR= 0.489, 95% CI: 0.282-0.849) were identified as the benefit factors of CTS pain symptoms. Conclusion:The incidence of CTS pain in automobile manufacturing workers is related to the posture in the process of labor . Effective ergonomic interventions should be carried out to prevent the occurrence of CTS pain in automobile manufacturing workers.

With the rapid development of organ transplantation in China,the donation after cardiac death (DCD) donor organs are widely used.However,the quality of these organs is relatively poor,so the way to preserve and maintain organ still remains a severe problem.Among them,ischemic reperfusion injury (IRI) impairs the organs severely.Acetaldehyde dehydrogenase 2 (ALDH2) protects organs from stress conditions,including ischemia-reperfusion injury,and the activation and autophagy inhibition also protects the organs from stress conditions as well.Recent studies showed that ALDH2 can regulate autophagy to inhibit the organ injury during ischemia-reperfusion.Our study aims to discuss the new findings in this mechanism.

Objective To compare the biomechanical properties of new type of unicortical and unilateral external fixators by finite element analysis.Methods Firstly,a tibia model was reconstructed based on the CT data images using Mimics software,and then processed and modified by Geomagic Wrap software.Secondly,Solidworks software was used to establish the 3D models for new type of unicortical and unilateral external fixators,and fracture defect was made in the tibia model and then the model was assembled with the external fixators.Finally,mesh delineation was performed using ABAQUS software,and axial compression,torsion and bending loads were applied to the assemblies,respectively,to observe the stress distributions and fracture displacements and to evaluate the biomechanical properties of the 2 types of external fixators.Results The new type of unicortical external fixator had the mean and maximum stresses at the nail-bone interface and the stress distribution at the pin-bone contact surface lower than those of the unilateral external fixator under the three different loads,which behaved better in torsional resistance while worse in axial compression and bending resistance than the unilateral external fixator.Conclusion The new type of unicortical external fixator has the biomechanical stability slightly weaker than that of the unilateral external fixator,which shows sufficient stability and reasonable load distribution when used for temporary fixation with lower likelihood of nail breaking,periprosthetic fractures of the tibia pin tract and loosening of the bone pins when compared with the unilateral external fixator.[Chinese Medical Equipment Journal,2024,45(11):32-38]