Coronary Restenosis ; therapy ; Drug-Eluting Stents ; adverse effects ; Humans ; Treatment Outcome

Objective To estimate the effects of different surgical treatments of giant cell tumor of bone(GCTB) of long bone in children.Methods The effects of surgical treatment of 15 cases suffered from GCTB were observed.The tumors were rated according to the system of Enneking classification,stageⅠwas managed with a curettage combined with local adjuvant treatment and filled by allograft bone or with curettage and filled by cement of bone.StageⅡb was treated by en bloc resection followed by reconstruction with large segment bone of allograft.The follow-up was given in all patients.Results The follow-up period was 7 years(ranged 2-16 years).In all 15 children patients with GCTB,there were 13 children in stageⅠ,9 patients with curettage combined with local adjuvant treatment and allograft bone showed good bone knitting and rehabilitation without deformity and functional problem and locally recurred;4 patients with curettage and filled by cement of bone showed 2 cases locally recurred.Two children in stageⅡb treated by en bloc resection followed by reconstruction with large segment bone of allograft were perfectly incorporated without evidence of obvious immune rejection,collapse,fracture and locally recurred,but the limb-suffered was short about 2 cm.Conclusions Stage Ⅰtreated by a curettage combined with local adjuvant treatment and filled by allograft bone can get good effect,but only treated by a curettage and filled by cement of bone has 50% locally recurred.TheⅡb treated by en bloc resection followed by reconstruction with large segment bone of allograft might influence the limb growth,but without locally recurred.

Adult ; Diagnosis, Differential ; Female ; Humans ; Hysterectomy ; Leiomyomatosis ; pathology ; surgery ; Sarcoma, Endometrial Stromal ; pathology ; Uterine Neoplasms ; pathology ; surgery ; Uterus ; blood supply ; Vascular Neoplasms ; pathology ; surgery

Objective To evaluate the effect of TGF-β1 and IL-1β expression in serum on acute radiation-induced heart disease (RIHD) in patients with thoracic tumors.Methods Three-dimensional conformal radiotherapy (3D-CRT) or intensity modulated radiotherapy (IMRT) was delivered at 1.8-2.0 Gy,5 times per week to a total dose of 50-66 Gy to 44 patients with lung cancer and 10 patients with esophagus cancer.The target and organs at risk dose distribution were analyzed by 3-dimensiond treatment planning system.The expressions of TGF-β1 and IL-1β in serum were detected by enzyme linked immunosorbent assay before and at the end of the irradiation.The cardiac injury was evaluated by detecting the cmyocardium creatase,cardiac troponin I (cTnI),electrocardiogram and cardiac function before and at the end of the irradiation within 90 d.The acute RIHD was evaluated by the Common Terminology Criteria V 3.0 (NCI-CTCAE 3.0).The expressions of TGF-β1 and IL-1β in the serum of RIHD patients with thoracic tumors were analyzed.Results The expression of TGF-β1 in serum was (888.4 ± 41.1) μg/L before the irradiation and approached to (926.1 ± 23.1) μg/L at the end of the radiotherapy.The expression level of TGF-β1 in the serum of acute RIDH group was (900.6 ± 34.5) μg/L,higher than that of normal group [(865.7 ±47.0) μg/L,t =-2.646,P ＜0.05)].The acute RIDH was correlated with the expression level of TGF-β1 before irradiation and the difference before and at the end of irradiation (r =0.378,0.311,P ＜0.05).The IL-1β expression had no significant difference before and after irradiation.The expression of TGF-β1 in serum before and at the end of irradiation had positive correlation with the expression of IL-1β at the end of the irradiation (r =0.416,0.389,P ＜ 0.05).Conclusions The expression of TGF-β1 in the serum of patients with thoracic tumor increases after irradiation and correlated with the acute RIHD,but the expression of IL-1β in serum has no relationship with RIHD.TGF-β1 could induce the expression of IL-1β at the end of the irradiation.

Objective To investigate the features of familiar facial palsy,ophthalmoplegia and dysphagia characterized by autosomal dominant inheritance in a family and to discuss the classification and pathogenesis of the disease.Methods Clinical,electrophysiological,pathological examinations were performed and blood samples were obtained from 5 patients and 26 family members.PCR protocol was used to identify a certain gene. Results In the 5 patients receiving physical examination,all had ptosis,external ophthalmoplegia,facial paralysis,dyphagia,hoarseness,decreased pharyngeal reflex;4 had amyotrophy of muscle of tongue,temporal nuscle,masseter and muscles of distal lower limbs;3 had proximal limb asthenia and distal limbs amyotrophy.Compared to those of oculopharyngeal muscular dystrophy(OPMD)with similar symptoms and signs,both electrophysiological manifestation and pathological findings of the family members supported the diagnosis of muscular dystrophy,but the(GCG)6(GCA)3GCG in the first exon of PABPN1 mutated neither in normal family members nor in patients.Conclusions This family presents clinical manifestations somewhat resembling to those of OPMD and distinctive to other disorders,but has a totally different genetic background from OPMD.It may be a new subtype of muscular dystrophy.

Objective To find the different plasma-associated proteins of rheumatoid arthritis (RA) by using two-dimensional gel electrophoresis for understanding the pathogenesis of RA. Methods The total protein from either RA patients or normal ones was prepared by means of immobilized pH gradient based on two-dimensional gel electrophoresis. After silver staining, gel-image analysis was performed by using PDQuest. The differentially expressed proteins were identified by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF-MS). Results 2-DE patterns of plasma from controls and RA patients were presented. The results showed that average number of protein spots was 592 and 563 respectively, and the corresponding average matching rate was 89% and 87% respectively. Gel-image analysis revealed that there were 24 differential protein spots. A total of 15 differential protein spots were successfully identified by MALDI-TOF-MS, of which 6 proteins were up-regulated as compared with control. Conclusion The differentially expressed proteins can be observed in plasma from RA and controls, which can be used to elucidate the pathogenesis of RA for further study.

Objective To observe the efficacy of Tongmai Acupoint Plaster combined with Alprostadil injection for treatment of lower extremity arteriosclerosis obliterans (ASO). Methods Totally 180 cases of ASO Ⅱ(intermittent claudication period) patients were randomly divided into acupoint sticking group, combination group, Western medicine group, with 60 cases in each group. All groups quit smoking, had diet control, proper exercise, control of blood sugar, stop hypolipidemic and anti-coagulation medicine. The acupoint sticking group was treated with Tongmai Acupoint Plaster, each selected with the efficacy of treatment of lower limbs paralysis acupoint 10-12, alternating dressing; dressing was changed 1 time a day, 40 day as a treatment course. Western medicine group was given Alprostadil injection 10 μg, with 10 mL of normal saline, intravenous infusion, once a day, 15 d as a treatment course, for two courses, with 10 d as interval. Combination group was treated with Tongmai Acupoint Plaster combined with Alprostadil injection, the same as the application method above. The clinical efficacy, the scores of symptoms and signs, the ankle brachial index, blood lipid, the peak value of blood flow in the tibial anterior,posterior tibial, and dorsalis pedis arteries were observed and compared between the 2 groups. Results The total effective rate was 78.33% (47/60) in the acupoint sticking group, 80.00% (48/60) in the Western medicine group, and 93.33%(56/60) in the combination group, with the combination group better than the acupoint sticking group and Western medicine group (P<0.05). There was no statistical significance between acupoint sticking group and Western medicine group (P>0.05). There was statistical significance in scores of symptoms and signs, ankle brachial index before and after treatment in the three groups (P<0.05, P<0.01); There was no statistical significance after treatment (P>0.05). There was statistical significance in blood lipids before and after treatment in acupoint sticking group and combination group (P<0.05). There was statistical significance in tibial anterior, posterior tibial, and dorsalis pedis artery peak before and after treatment in the three groups (P<0.05, P<0.01). Conclusion Tongmai Acupoint Plaster has good efficacy in the treatment of ASO, equivalent with the efficacy of Alprostadil injection, which can regulate blood lipids and improve arterial blood flow. Ther combination of them has better efficacy.

BACKGROUND: Tumor recurrence in liver transplant recipients greatly affects prognosis of liver transplantation with hepatocellular carcinoma (HCC). How to prevent tumor recurrence has aroused increasing attention. Arsenious acid chemotherapy is considered effective on treating moderate or advanced liver cancer, but its utilization following liver transplantation remains few. OBJECTIVE: To explore the role of arsenious acid on tumor recurrence in liver transplant patients with primary HCC extending Milan criteria. RESULTS AND CONCLUSION: All patients were routinely followed up for 3-32 months. Thirty recipients were presented with tumor recurrence, 16 in the chemotherapy group and 14 in the non-chemotherapy group. Tumor recurred in lung, liver graft and bones in most cases. The total recurrence rate was similar in these two groups, but chemotherapy could delay recurrence after transplantation (P=0.026). There was no significance in 6-month, 1-year survival rate between two groups, but the 2-year survival in the chemotherapy group was higher (P=0.037); 6-month tumor-free survival rates in the two groups had no significance, 1-year and 2-year tumor-free in the chemotherapy group were significantly higher than those in the non-chemotherapy group (P=0.030, 0.023). Intravenous arsenious acid chemotherapy can delay tumor recurrence and prolong survival in liver transplant patients with HCC extending Milan criteria.

Objective To compare the effects of combined ‘en bloc' liver-pancreas transplantation (LPT) with portal vein drainage and simultaneous combined kidney-pancreas transplantation (KPT) with systemic venous drainage on the pancreatic endocrine function and related metabolism.Methods Four LPT patients and 6 KPT ones with normal hepato-renal function, good quality of life and periodic follow-up received measurement of serum insulin, insulin provocation test, fasting glucose, oral glucose tolerance test, C-peptide, glycated hemoglobin, triglyceride and total cholesterol; and their laboratory test parameters were compared and analyzed.Results In KPT group, 2-h insulin level, C-peptide level and total cholesterol level were significantly higher at 6th month, 3rd and 6th month postoperation (all P<0.05). But there was no significant difference in other parameters between the two groups at 6th month after operation.Conclusion Either KPT or LPT can achieve excellent endocrine function, carbohydrate and lipid metabolism; and the results show that portal venous drainage does not offer major metabolic advantages within 6 months after operation.

Objective To summarize the experience with salvage liver transplantation for patients with recurrent hetaptocellular carcinoma(HCC)after primary liver resection.Methods From 2004 to 2008,376 patients with HCC received liver transplantation in our single center.Among these patients,36 (9.6 %)underwent salvage liver transplantation after primary liver curative resection due to intrahepatic recurrence.There were 29 males and 7 females with the mean age of 46 years old.Sixteen received right lobectomy,10 received left lobectomy and the others received sectionectomy or segmentectomy.As a control group for comparison,we used clinical data of the 147 patients who underwent primary OLT for HCC within Milan Criteria.Results The mean interval between initial liver resection and salvage transplantation was 34.9±16.2 months(1-63 months).Intraoperative bleeding volume,transfusion volume and operative time in the salvage group were significantly different from those in control group (P<0.05).There were no significant difference in post-operative complications,tumor recurrence rate,survival rate and tumor-free survival between these two groups(P>0.05).Conclusion In comparison with primary OLT,although salvage liver transplantation would increase the operation difficulties,it still remains a good option for patients with HCC recurrence after curative resection.