Acupuncture Therapy ; Acute Disease ; Fatal Outcome ; Hemorrhage/mortality* ; Humans ; Needles/adverse effects* ; Pharynx/injuries* ; Postoperative Complications ; Postoperative Hemorrhage/etiology*

Administration, Oral ; Adolescent ; Condylomata Acuminata ; drug therapy ; Cyclophosphamide ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Penile Diseases ; drug therapy ; Vulvar Diseases ; drug therapy

Background and purpose: Because of the aggressive nature of hilar cholangiocarcinoma and the absence of effective adjuvant therapy, surgical radical resection offers hilar cholangiocarcinoma patients the only choice. Research focus include preoperative assessment, the use of preoperative biliary drainage, the range of hepatic resection, and the range of lymphadenectomy. To investigate the clinical experience and efifcacy of combined hepatectomy in the treatment of hilar cholangiocarcinoma. Methods: Two hundred and seven patients with hilar cholangiocarcinoma treated surgically in the First Afifliated Hospital of Kunming Medical University form Jan. 2007 to Oct. 2013 were retrospectively analyzed. Results:Of the 207 patients, 125 patients who received radical resection (R0 resection) and the curative resection rate was 60.4%. One hundred and iffty-six cases were treated in combined hepatectomy group, 51 cases in non-hepatectomy group, the rate of R0 resection was 70.5%in hepatectomy group and 29.4%in non-hepatectomy group, and the difference was signiifcant (P<0.01). Two patients died perioperatively, the main postoperative complications included hepatic function insufifciency and bile leakage. One hundred and seventy-two patients were followed up, the median survival time of the 102 patients who received R0 resection was 45 months, and the 1, 3, 5 year survival rates were 96.1%, 59.1%and 17.2%. The median survival time of the 70 patients who received R1-2 resection was 26 months, and the 1, 3 year survival rates were 81.3%and 19.2%, and none of the patient survived for over 5 years. The survival rate of patients who received R0 resection was signiifcantly higher than those who received R1-2 resection (χ2=39.121, P<0.01). In the hepatectomy group was awarded the R0 resection in patients with postoperative 1, 3, 5 year survival rate was 97.8%, 63.9% and 18.0%, in non-hepatectomy group received R0 resection in patients with postoperative 1, 3, 5 year survival rate was 83.3%, 20.8%and 8.3%. There were signiifcant differences in the postoperative survival rate between both group (χ2=5.988, P=0.014). Conclusion:Radical excision is the key to improve the long term survival. Combined hemihepatectomy and standardized lymph node resection has signiifcantly improved the radical resection rate and the efifcacy of treatment for hilar cholangiocarcinoma.

OBJECTIVETo study the correlation between the inflammatory factors in the serum and the induced sputum and the hypothalamic-pituitary-adrenal (HPA) axis function in advanced lung adenocarcinoma patients of different syndromes.

METHODSTotally 71 patients with advanced lung adenocarcinoma were assigned to three groups according to syndrome differentiation, i.e., Shen-yang deficiency (SYD) group (28 cases), Fei-qi deficiency (FQD) group (23 cases), and yin deficiency fire excess (YDFE) group (20 cases). Another 41 healthy subjects were enrolled as the normal control group. Sputum was induced and blood samples were collected for measurement of cytokines including tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta (TGF-beta), interleukin-6 (IL-6), and interferon gamma (INF-gamma). The cytokine assay was performed using Bio-Plex Pro multi assay technology. 24-h collection of urine was performed and salivary samples of the diurnal rhythm profiles [including urinary free cortisol (UFC), urinary 17-hydroxycorticosteroids (17-OH), urinary 17-ketosteroid (17-KS), and cortisol in the serum and saliva] were obtained for assessment of the HPA axis activity.

RESULTSA higher level of serum IL-6 and a lower level of 24-h UFC and 17-OH were found in the SYD group (P < 0.05). The urinary 17-KS was obviously lower in the SYD group than in the normal control group and the YDEE group (P < 0.05). Compared with the FQD group and the normal control group, a higher serum level of TNF-alpha and a lower level of IFN-gamma were found in the SYD group and the YDFE group (P < 0.05). The TNF-alpha and TGF-beta levels in the induced sputum obviously increased in the SYD group (P < 0.05). The IFN-gamma level in the induced sputum obviously decreased in the YDFE group (P < 0.05). The serum and salivary cortisol obviously decreased from 8: 00 am to 8:00 am the next morning in the SYD group (P < 0.05). The serum cortisol level was negatively correlated with serum TNF-alpha (r = -0.26, P = 0.03) and serum IL-6 (r = -0.25, P = 0.03). The salivary cortisol level was negatively correlated with IL-6 in the induced sputum (r = -0.29, P = 0.02). The serum IFN-gamma was positively correlated with urinary 17-OH (r = 0.21, P = 0.03).

CONCLUSIONSThe inflammatory factors of advanced lung adenocarcinoma patients of SYD syndrome were up-regulated, with the most obvious decreased or disarranged HPA axis functions. The levels of IL-6, TNF-alpha, and IFN-gamma were closely correlated with the HPA axis functions. The transformation from qi deficiency, yin deficiency to Shen-yang deficiency existed in lung adenocarcinoma patients. The levels of IL-6, TNF-alpha, and IFN-gamma in the serum and the induced sputum, as well as the HPA axis functions are important indices for microscopic syndrome typing of lung adenocarcinoma.

Adenocarcinoma ; blood ; physiopathology ; Adolescent ; Adult ; Aged ; Case-Control Studies ; Cytokines ; blood ; Female ; Humans ; Hypothalamo-Hypophyseal System ; metabolism ; physiopathology ; Inflammation ; Lung Neoplasms ; blood ; physiopathology ; Male ; Middle Aged ; Neoplasm Staging ; Pituitary-Adrenal System ; metabolism ; physiopathology ; Sputum ; chemistry ; Young Adult

Objective To investigate the spatial-temporal distribution characteristics of varicella outbreak in Jiading District in Shanghai from 2015 to 2018. Methods Varicella epidemic report data was collected from the national system of disease control and prevention and analyzed by spatial-temporal scanning statistic methods. Results There were 5 889 varicella cases reported from the year 2015 to 2018, and the annual average incidence rate was 91.68 per 100 000.The incidence rate for children below 3 years old was found to be the highest, reaching 621.45 per 100 000, which was significantly higher than that for the group of 18 years old and above (χ²=16 616.788, P < 0.001).There were 5.41% and 5.31% of the cases in September and February, respectively, which were lower than other months, and the peak incidence occurred in December and November, accounting for 13.41% and 11.95%, respectively.The highest and lowest incidence rates were 151.80 per 100 000 occurring in central urban area and 59.89 per 100 000 in rural area, respectively.The spatial-temporal scanning showed that the low population density area had a wide cluster range and a low effect value.The high population density area has small cluster range and high effect value. Conclusion The incidence of vanicella presents a trend of population, seasonal and regional clustering.Therefore, targeted measure should be taken to prevent varicella in focus population.

To improve the quality standard of Angelica sinensis, solve the problem of lacking relevant reference substance, a new method-based on the standard reference extract (SRE) was applied to achieve the quality control of Angelica sinensis. SRE of Angelica sinensis was obtained by chromatographic separation technology. After calibration of three makers of the SRE, an UPLC analytical method was developed to determinate the contents of the makers. T-test was used for comparison of the determination results of two methods (reference substances and SRE as reference, respectively), and the results demonstrated that there is no significant difference between the two methods. The presented method is very convenient and practical, which can be used for the quality control of Angelica sinensis.
Angelica sinensis ; chemistry ; Calibration ; Chromatography, High Pressure Liquid ; standards ; Drugs, Chinese Herbal ; chemistry ; standards ; Quality Control ; Reference Standards

OBJECTIVEThe aim of work was to evaluate the efficacy of microvascular decompression (MVD) in patients with trigeminal neuralgia (TN) associated with hypertension.

METHODSFive hundred and thirty-eight cases of TN associated with hypertension treated with MVD were retrospectively analyzed, all the cases were treated with MVD in the zone of the ventrolateral medulla oblongata and inspected postoperative blood pressure.

RESULTSAmong 538 cases, 341 cases (63.4%) had cure result, 71 cases (13.2%) had obvious effectiveness, 53 cases (9.8%) had effectiveness, and 73 cases had no effectiveness. Four hundred and eighty-three cases have been followed 1.0 approximately 15.8 years, mean 6.3 years. At the time of their follow-up, 313 cases had cure result, 63 cases had obvious effectiveness, 42 cases had effectiveness and 65 cases had no effectiveness.

CONCLUSIONSIt was pathogenesis of nedulla oblongata by abnormal vascular tab, long-term aching stimulation and emotional stress. It was an effective method to treat TN associated with hypertension with MVD in this zone.

Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical ; methods ; Female ; Humans ; Hypertension ; complications ; Male ; Medulla Oblongata ; pathology ; Microsurgery ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Trigeminal Neuralgia ; complications ; surgery ; Vascular Surgical Procedures ; methods

TCM non-medicine therapies include acupuncture, moxibustion, point-application, point injection, acupuncture point thread implanting, etc, which have been widely used in the clinical treatment for stable period of chronic obstructive pulmonary disease (COPD). TCM non-medicine therapies can significantly control the progress of the disease and improve the life quality of patients. This article reviewed the clinical study on TCM non-medicine therapies for stable period of COPD in recent 5 years, in order to provide some references for the treatment of COPD.

Objective To evaluate the value of modified calcofluor white fluorescent staining in the histopathological diagnosis of subcutaneous mycosis,in order to provide a new method for histopathological diagnosis of subcutaneous mycosis.Methods A total of 21 lesional skin tissues were collected from patients with subcutaneous mycosis in the Affiliated Hospital of Chengde Medical University between 1987 and 2017,and embedded in paraffin.Then,each paraffin-embedded tissue section was cut into 4 4-μm-thick serial sections,and subjected to modified calcofluor white fluorescent staining,hematoxylin and eosin (HE) staining,periodic acid Schiff (PAS) staining and Gomori methenamine silver nitrate (GMS) staining respectively.Positive rates and staining outcomes were compared among the above staining methods.Statistical analysis was carried out with SPSS 19.0 software by using chi-square test for comparing the positive rates among the above 4 staining methods.Results Of 21 patients with fungal infections,14 (66.67％) were positive for modified calcofluor white fluorescent staining,5 (23.80％) for HE staining,6 (28.57％) for PAS staining,and 11 (52.38％) for GMS staining.The positive rate by modified calcofluor white fluorescent staining was significantly higher than that by HE staining and PAS staining (x2 =6.718,5.200,respectively,both P ＜ 0.05),while no significant difference was observed between the modified calcofluor white fluorescent staining and GMS staining (x2 =0.693,P =0.530).Conclusion The modified calcofluor white fluorescent staining is an accurate method for detecting fungi,and has a certain application value in the histopathological diagnosis of subcutaneous mycosis.

Objective To compare the features of contrast enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) of hepatic angiomyolipoma (HAML), and to explore their relationship with pathologic findings. Methods Thirty patients with 31 resected or punctured and pathologically proved hepatic angiomyolipomas in Southwest Hospital of Third Military Medical University from January 2006 to December 2012 were selected in this retrospective study. CEUS and CECT features were evaluated and analyzed with pathology findings in 30 patients with HAML preoperatively. The proportion of typical performance by CEUS compared with CECT in this group was analyzed with Fisher exact propability. Results Seventeen lesions were inhomogeneous hyperechoic under conventional ultrasound observation. Twenty lesions demonstrated typical imaging characteristics by CEUS, eleven lesions showed atypia CEUS imaging characteristics. There were seventeen lesions on CT indicates the presence of fat. Seven lesions demonstrated typical imaging characteristics by CECT, twenty-four lesions presented atypical CECT imaging characteristics. The proportion of showing typical imaging characteristics by CEUS was higher than by CECT (64.5%vs 22.6%, P=0.002). Among the eleven mixed type HAML lesions, seven lesions showed typical CEUS imaging characteristics and two lesions demonstrated typical CECT imaging characteristics. In the ten myomatous type HAML lesions, six lesions displayed typical CEUS imaging characteristics and two lesions revealed typical CECT imaging characteristics. Among the eight lipomatous type HAML lesions, six lesions showed typical CEUS imaging characteristics and three lesions displayed typical CECT imaging characteristics. Conclusions Conventional ultrasound combining with CEUS can demonstrate the echoic and blood perfusion characteristics of HAML in most cases. The features of CEUS and CECT were varied in different histological types.