OBJECTIVETo understand long-term survival rate after combined androgen blockade (CAB) in patients with advanced prostate cancer.

METHODSA selected population of 59 patients with advanced prostate cancer were treated with CAB. 28.81% (17/59) of patients had clinical locally advanced disease (stage T3-4N0M0), and 45.76% (27/59) of patients had metastatic disease (stage TxNxM+). Overall, patients were followed for a median of 62 (range 6-136) months.

RESULTSOf the 59 patients with advanced prostate cancer, 3-year, 5-year and 7-year overall survival rates were 79.36%, 61.46% and 49.15%, respectively. The 5-year survival rate were 80.77% and 32.65% for clinical locally advanced disease and metastatic disease. Specifically, men with poorly differentiated prostate cancer had a 5-year survival of only 30% when compared with men with well-differentiated prostate disease who had a 5-year survival of 86.21%.

CONCLUSIONBased on these findings, men with poorly differentiated cancer, stage T3c-4NxMx or TxNxM+ and PSA level above 30 microg/L had a high probability of dying from their advanced prostate cancer.

Aged ; Androgen Antagonists ; therapeutic use ; Combined Modality Therapy ; Flutamide ; therapeutic use ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms ; drug therapy ; mortality ; surgery ; Survival Rate

OBJECTIVETo investigate the monitoring and therapeutic methods of nonoperative management of blunt splenic injury.

METHODSEighty-two cases with nonoperative management of 95 patients of blunt splenic injury from September 2005 to April 2008 were analyzed retrospectively. Percutaneous peritoneal drainage was applied to 75 cases, and auto-blood transfusion was applied to 38 cases. Eighty-two cases were followed up from 3 weeks to 8 months.

RESULTSEighty-two patients with nonoperative management were treated successfully, including 34 cases classified as grade III to IV, 6 cases over 55-years-old, 14 cases with severe multiple injury (ISS > or = 16) and 37 cases whose drained peritoneal blood volume were over 500 ml. The drained peritoneal blood volume was 30 to 2400 ml. The total volume of auto-blood transfusion was 22 300 ml and the average volume was 613 ml. All cases were followed up without delayed hematocele or peritoneal infection.

CONCLUSIONSMost hemodynamically stable patients with blunt splenic injury can be healed with nonoperative management. The treatments including percutaneous peritoneal drainage and transfusion of auto-blood can significantly increase the performance rate and the achievement ratio of nonoperative management of blunt splenic injury.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spleen ; injuries ; Wounds, Nonpenetrating ; therapy ; Young Adult

This study examined the prevalence of primary open-angle glaucoma (POAG) among residents aged ≥50 years living in Yongchuan district of Chongqing. Stratified cluster sampling was employed in random selection to estimate the prevalence of glaucoma from April to June, 2005. Twenty-nine villages or neighborhood communities were randomly selected in urban area (Zhongshan Road), suburban area (Shanjiao Town) and exurban area (Zhutuo Town) of this district. All the respondents underwent detailed ophthalmic examinations. The examinations included questionnaire investigation, visual acuity test, naked-eye examination, measurement of peripheral anterior chamber depth (Van Herrick's technique), detection of intraocluar pressure (IOP) with a Perkins hand-held applanation tonometer (HA-2) and examination of the optic disc by using a 78 diopters (D) lens (including the cup-disc ratio, cup/disc ratio asymmetries, horizontal and vertical diameter, notching and optic disc hemorrhages). A total of 5938 residents were actually examined, and the response rate was 85.19%. The crude prevalence of POAG was 0.86% (n=51/5938, 95% CI 0.64%-1.11%). There were 24 males and 27 females in the glaucoma group. The glaucoma prevalence was not significant different in case number between the male and female subjects (P=0.4900). Furthermore, no association between age or schooling and POAG was noted (P=0.8030, 0.0734). Out of 51 subjects with POAG, unilateral glaucoma-related blindness occurred in 38 subjects (74.5%) and bilateral glaucoma-related blindness was found in 7 subjects (13.7%). This study exhibited that the prevalence of POAG was 0.86% among residents aged ≥50 years living in Yongchuan District of Chongqing. The vision loss caused by POAG in this population was obviously higher than that previously reported in other studies. Glaucoma management, detection of affected persons and handling of the burden of glaucoma should be the priorities of the agenda of local health authorities of Western China.
Aged ; Blindness ; diagnosis ; epidemiology ; China ; epidemiology ; Female ; Glaucoma, Open-Angle ; diagnosis ; epidemiology ; physiopathology ; Gonioscopy ; methods ; Health Surveys ; methods ; statistics & numerical data ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Prevalence ; Surveys and Questionnaires ; Vision Disorders ; diagnosis ; epidemiology

OBJECTIVETo observe the effect of Shuanghuanglian injection on cerebral expression of nuclear factor-kappaB (NF-kappaB) in mice with viral encephalitis.

METHODSThe mice with experimental viral encephalitis received treatment with Shuanghuanglian injection at the dose of 0.2, 1.5, and 5 for 5, 10 or 20 consecutive days. The total RNA of the brain tissue was extracted to analyze the protein and mRNA expression of NF-kappaB using Western blotting and RT-PCR, respectively.

RESULTSCompared with the control group, the mice with experimental viral encephalitis showed significantly increased protein and mRNA expressions of NF-kappaB (P<0.01). Treatment with Shuanghuanglian injection at the doses of 0.2 and 1.5 mg/kg significantly lowered NF-kappaB protein and mRNA expressions in the brain of mice with viral encephalitis (P<0.05), and the effect was even more obvious at the dose of 5 mg/kg (P<0.01).

CONCLUSIONShuanghuanglian injection can reduce the expression of NF-kappaB in the brain of mice with viral encephalitis in a dose- and time-dependent manner.

Animals ; Blotting, Western ; Brain ; drug effects ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Encephalitis, Viral ; drug therapy ; genetics ; metabolism ; Gene Expression Regulation ; drug effects ; Injections ; Male ; Mice ; Mice, Inbred BALB C ; NF-kappa B ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo elevate the prognostic value of minimal residual disease (MRD) detection by four-color flow cytometry with the antibody panel in childhood B-cell acute lymphoblastic leukemia (B-ALL).

METHODSThe clinical data of 183 children with newly-diagnosed acute B-ALL and who accepted MRD detection between October 2010 and March 2012 was retrospectively reviewed. According to the detection time and result of MRD, the 183 children were classified into four groups: MRD negative (n=37) and positive (n=18) in the induction chemotherapy and MRD negative (n=113) and positive (n=15) in the maintenance chemotherapy.

RESULTSDuring both induction and maintenance chemotherapy, the percentage of patients at high and median risk in the MRD positive group was higher than in the MRD positive group (P<0.05). In the maintenance chemotherapy group, the 3- year cumulative incidence of relapse in MRD positive patients was higher than negative patients (P=0.04). The Cox's proportional hazards regression analysis showed that insensitive reaction for prednisone (RR=1.005, 95%CI: 0.864-1.170, P=0.032), bone marrow morphology that did not meet M1 on the 15th day (RR=6.454, 95%CI: 2.191-19.01, P=0.002) and MRD&ge;0.01% (RR=1.923, 95%CI: 0.750-4.933, P=0.043) were risk factors for relapse in children with B-ALL.

CONCLUSIONSThe four-color flow cytometry with the antibody panel can distinguish from MRD positive patients from negative patients with B-ALL. The result of MRD detection, as prednisone sensitivity and bone marrow morphology on the 15th day, is also a independent prognostic factor in children with B-ALL.

Child ; Child, Preschool ; Female ; Flow Cytometry ; methods ; Humans ; Infant ; Male ; Neoplasm, Residual ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; immunology

OBJECTIVETo investigate the feasibility and reliability of the measurement of critical anatomic landmarks of endoscopic endonasal anatomy of pterygopalatine fossa and infratemporal fossa using multislice spiral computed tomography (MSCT), and to illustrate the spatial relationship of the surgical landmarks in pterygopalatine fossa and infratemporal fossa through an endoscopic endonasal view and radiological images.

METHODSIncluded in this study were eleven fixed cadaver heads (22 pterygopalatine fossa and infratemporal fossa), which were prepared from MSCT scans for establishing a spatial coordinates system to calculate the radiological anatomic data and attaining 3D reconstruction image, and also were anatomically dissected to get anatomic data. The anatomic data in two groups were compared, the endoscopic and radiological images of the same regions acquired during the endoscopic endonasal approaches observed.

RESULTSThe distance (x(-) ± s) from nasal columella to sphenopalatine foramen, pterygoid canal, foramen rotundum, foramen ovale, foramen spinosum, carotid canal, foramen lacerum in radiological group were: (68.83 ± 3.00), (72.49 ± 2.88), (75.26 ± 3.14), (88.55 ± 5.00), (95.19 ± 4.31), (106.76 ± 3.77), (88.16 ± 2.87) mm and in anatomic group were: (68.90 ± 3.04), (72.73 ± 3.08), (75.44 ± 3.07), (89.75 ± 4.13), (96.22 ± 3.37), (106.68 ± 3.75), (88.47 ± 2.64) mm. There was no statistical difference between two groups (t value were -0.856, -1.134, -0.920, -1.923, -1.903, 2.820 and 1.209, respectively, all P > 0.05). Sphenopalatine foramen, pterygoid canal, foramen rotundum, foramen ovale, foramen spinosum, foramen lacerum, carotid canal were the corresponding anatomic structures in endoscope and radiology, which provided the surgeons with anatomic landmarks to identify the spatial relationship of the surgical structures in pterygopalatine fossa and infratemporal fossa.

CONCLUSIONSMSCT measurements of anatomic landmarks are feasible and reliable, can be used in clinical individualized surgery. The corresponding anatomic structures of endoscopic and radiological landmarks provide useful reference to surgeons when operating in these areas through an endoscopic endonasal approach.

Endoscopy ; Humans ; Imaging, Three-Dimensional ; Pterygopalatine Fossa ; anatomy & histology ; diagnostic imaging ; Skull Base ; anatomy & histology ; diagnostic imaging ; Tomography, Spiral Computed

OBJECTIVE: To compare the pathomorphologic changes between the pancreas in acute necrotizing pancreatitis (ANP) and that in acute deaths of rats (within 48 hours) so as to find the distinctions. METHODS: The animal models of ANP and other acute deaths (electroshock, mechanic asphyxia/strangle, and acute poisoning with tetramine) were established according to the criteria. Half-quantitative grading and image quantitative analysis methods were employed to observe the gross and microscopic changes of the pancreases. RESULTS: Three features including inflammation infiltrate, fat necrosis and calcium deposit in the ANP group were considerably different from that in other acutely died rat group (P<0.05). CONCLUSION Inflammation infiltrate, fat necrosis and calcium deposit are the most important pathologic features found in ANP by common light microscope, distinguishing ANP from postmortem pancreatic autolysis.
Animals ; Autolysis ; Female ; Forensic Pathology ; Male ; Pancreas/pathology* ; Pancreatitis, Acute Necrotizing/pathology* ; Poisoning/pathology* ; Postmortem Changes ; Rats ; Rats, Sprague-Dawley

Objective To summarize the surgical experiences of treating the frontal sinus cerebrospinal fluid rhinorrhea (FS-CSFR) via combined transfrontal and intranasal endoscopic approaches. Methods We retrospectively analyzed the clinical data of 17 patients with FS-CSFR,received surgery in our hospital from 1996 to 2009, with emphasis on postoperative complications,clinical outcomes and key technology involved in surgery via combined transfrontal and intranasal endoscopic approaches. Results Of the 17 patients, 9 were successfully repaired after 1 surgery via combined transfrontal and intranasal endoscopic approaches; the other 8 were initially treated by endoscopic intranasal approach alone, of which 5 (62.5%) were successful and 3 failed. And then, the 3 patients subsequently underwent the surgery via combined transfrontal and intranasal endoscopic approaches and succeeded. These 12 patients with FS-CSFR, performed surgeries via combined transfrontal and intranasal endoscopic approaches were successfully repaired with quick recovery, mild complications, and no significant facial scars. Follow up was performed for 6 to 10 y and no CSFR recurrence was noted. Conclusion Surgery via combined transfrontal and intranasal endoscopic approaches offers advantages not only in overcoming the difficulty and defects of intranasal endoscopy but also in providing a few traumas and an easy approach, which helps the recovery.

Objective To investigate the therapeutic efficacy of endoscopic optic nerve decompression (EOND) on patients with traumatic optic neuropathy (TON) and their related prognostic factors. Methods The clinical data of 103 eyes with TON,admitted to our hospital from January 1995 to February 2001 (n=53) and from March 2001 to December 2009 (n=50),were retrospectively analyzed; the clinical outcomes of these patients after being performed EOND were observed. Univariate analysis (Chi-square test) and logistic regression were performed to analyze the prognostic factors of TON underwent EOND therapy. Results The total effective rate of 103 eyes was 37.86％ (39/103); the effective rate of eyes with residual vision was 83.3％ (20/24),which was significantly higher than that of those without residual vision (24.05％,19/79,P＜0.05).Univariate analysis and multiple factor logistic regression,respectively,showed that 3 variables significantly increased the risk of the visual acuity:no residual vision, interval from injury to surgery for more than 3 d and ethmoid and/or sphenoid sinus hematocele after injury.Other factors such as age,disturbance of consciousness,optic canal fracture,performing of sheathotomy,hormone level and interval from injury to surgery for more than 7 d were not correlated with the efficacy (P＞0.05).Comparing fractures at different sites and with different severities,the efficacy of surgery was also different. The logistic regression equation is P (1)=1/ [1+e-(-2139+2.839X3+1.372X5+2.263X9)]. Conclusion The total therapeutic efficacy of EOND on patients with TON is not satisfactory, especially for those without light perception. The prognostic factors of TON were very complex and interactive; no light perception, interval from injury to surgery for more than 3 d,hemorrhage within the ethmoid and/or sphenoid sinus and lateral or multiple fracture of optic canal are factors affecting the prognosis of EOND for patients with TON. The indication for EOND must be individualized.

OBJECTIVETo summarize the clinical experience of treatment of frontal sinus diseases via combined transfrontal and intranasal endoscopic approaches, and to explore its indications.

METHODSA retrospective study of 24 patients was conducted. All patients were underwent combined transfrontal and intranasal double approaches because of different kinds of frontal sinus diseases, including 16 cases with frontal sinus cerebrospinal fluid rhinorrhea caused by traumatic comminuted fractures located in posterior wall of frontal sinus, 5 cases with osteoma, 3 cases with inverted papilloma (cancer was confirmed in one case).

RESULTSAll sixteen cases with frontal sinus cerebrospinal fluid rhinorrhea were cured after the first attempt. All cases with osteoma and inverted papilloma (including the patient with canceration) were resected completely after the first attempt. Postoperative follow-up lasted from 3 to 132 months in frontal sinus cerebrospinal fluid rhinorrhea, 8-38 months in osteoma, 7-42 months in inverted papilloma and canceration, the median follow-up period was 36 months. No recurrence was found. Operations were successful in all the patients and frontal sinus outflow tracts were unobstructed. No intraoperative or postoperative complications occurred and no disfigurement was found.

CONCLUSIONSThe potential indications for the combined transfrontal and intranasal endoscopic approaches are listed as follows, (1) frontal sinus lesions mainly located on the posterior wall, (2) propensity to recur or malignant neoplasms, (3) the lesions of frontal sinus with their lateral boundaries or operative site beyond the plane of the lamina papyracea.

Adolescent ; Adult ; Aged ; Child ; Endoscopy ; Female ; Frontal Sinus ; surgery ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; surgery ; Retrospective Studies ; Young Adult