Background and purpose:Advanced pancreatic cancer is characteristic of poor treatment eff icacy and short survival time. Gemcitabine is considered as front-line therapy for advanced pancreatic cancer. Gemcitabine combinations have shown a favorable impact on survival. We compared gemcitabine-based combination cheme therapy and gemcitabine(GEM) alone in patients with advanced pancreatic cancer through Meta analysis in phase Ⅲ clinical trials. Methods:MEDLINE and EMBASE searches were supplemented by information from trial registers of phase Ⅲ randomized controlled trials(RCTs) for GEM-based combination therapy and GEM alone for advanced pancreatic cancer. A quantitative meta-analysis was carried out by two reviewers based on the inclusion criteria from all available RCTs. The Meta-analysis involved 6-months and 1-year survival rate and objective remission rate(ORR) . Results:The Meta-analysis included 20 RCTs. The result of our Meta-analysis showed that there was signifi cant improvement in the GEM combination group with regard to the 1-year survival rate(RR:0.87,95%:(0.78,0.96) ,P=0.008) . The other result of our meta-analysis showed no signifi cant difference between two groups. Conclusion:GEM-based combination therapy may be effective with regard to the survival rate compared with GEM alone.

Objective:To investigate the changes of CD4+T cells,CD8+T cells and myeloid derived suppressor cells( MDSC) in immune organs of lung cancer mice.Methods: Lung cancer mouse models were made by subcutaneously injection of Lewis lung cancer cell line( LLC).The CD4+T cell,CD8+T cell and MDSC were detected by flow cytometry.Results:Compared to that of normal control mice,the ratio and numbers of CD4+and CD8+T cell were significantly decreased in the spleen and lymph nodes of lung cancer mice.The number of CD4+T cells had no significant change while CD8+T cells decreased in the bone marrow of lung cancer mice.However,the ratio and number of MDSC were significantly increased in the bone marrow,spleen and lymph nodes of lung cancer mice compared to that of normal control mice.Conclusion: The development of lung cancer leads to decreased T cells and increased MDSC;which may induce immune tolerance to tumor cells.

Objective To explore the bronchoscopic features of endobronchial tuberculosis induced by lymphatic fistula and the efficacy of interventional treatment. Methods The data on 31 patients with endobronchial tuberculosis induced by lymphatic fistula who had received bronchoscopic diagnosis and treatment in our hospital during the period of January 2010 to June 2013 were reviewed. The bronchoscopic features , along with the frequency of interventional therapies and duration of the therapies , were retrospectively analyzed; and the efficacy of the therapies and the related complications were assessed. Rusults The endoscopic appearance showed: granuloma (19.4%), necrosis (51.6%), granuloma with necrosis (25.8%), and fistulous opening (3.2%). Dark gray matter or carbon deposition inside the lesions was the characteristics of endobronchial tuberculosis induced by lymphatic fistula. There were 76 orificium fistulae in 31 patients , mostly in the right side. The median frequency of treatment was five in patients with single orificium fistulae and the median treatment duration was 65 days; whereas the median frequency of treatment was nine in patients with multiple fistulae and the median treatment duration was 108 days. There were significant differences between the two groups (P < 0.05 for both comparisons). The effectiveness rate of treatment was 98.7%. The therapy-related complication was of a small amount of bleeding, with a rate of 2.1%. Conlusions Endobronchial tuberculosis induced by lymphatic fistula shows certain characteristics under bronchoscopic examination. Bronchoscopic clamping combined with infusions with antituberculosis agents is a safe, simple, effective therapeutic method.

Objective To investigate the clinical effects of autologous tumor immune cells (DC-CIK)assisted interventional therapy in the treatment of advanced primary liver cancer.Methods Totally 76 patients with advanced primary liver cancer were divided into 2 groups with 38 cases in each group by random number table method.The control group were merely treated with interventional therapy while the ob-servation group were treated with autologous DC-CIK cell assisted interventional therapy.The short-term curative effect,adverse reactions,liver function indexes before and after treatment,alpha fetal protein (AFP)and changes of immune function were compared between the 2 groups. Results There was no statistically significant difference in short-term curative effect and incidence of adverse reactions between the 2 groups (P >0.05).After treatment,the levels of AST,ALT and AFP in the observation group [(30.4 ±6.0)u/L,(45.2 ±3.8)u/L,(168.5 ± 49.3)mg/L]were significantly lower than those in the control group [(65.1 ±6.3)u/L,(61.8 ±5.3)u/L,(315.2 ±39.5)mg/L],and the differences were statistically significant (P <0.05).After treatment,CD3 +,CD4 + and CD4 +/CD8 + in the observation group were significantly higher than those in the control group (P <0.05).Conclusion Autologous DC-CIK cell assisted interventional therapy can sig-nificantly improve the liver function of patients with advanced primary liver cancer,and it can reduce the level of tumor marker AFP and sig-nificantly improve the immune function of patients.

Objective To introduce extrapedicular infiltration anesthesia as an improved method of local anesthesia which applied to unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty.Methods From March 2015 to March 2016,20 patients in our hospital received percutaneous vertebroplasty or percutaneous kyphoplasty with 1％ lidocaine local infiltration anesthesia and extrapedicular infiltration anesthesia.The visual analogue score of patients during the operation and whether they needed additional sedative anesthesia were evaluated.The anaesthetic effect of nerve root block was observed.Results The visual analogue score of all the patients ranged from 1 point to 3 point,averagely (2.5 ± 0.7) point.Among the 20 patients,there were 2 cases of 1 point,7 cases of 2 point and 11 cases of 3 point.No patients required additional sedative anesthesia,and no nerve root block effects were observed.Conclusion Extrapedicular infiltration anesthesia provides good local anesthetic effects without significant complications,which deserved further use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.

Objective To compare the advantages and disadvantages of 3D BRAVO and TRICKS for detecting cerebral venous sinus thrombosis (CVST) and to explore the MR scanning methods on CVST.Methods A retrospective analysis was conducted on 40 patients who were diagnosed with CVST in the Fourth Affiliated Hospital of Kunming Medical University from January 2011 to June,2014.All the patients underwent TRICKS scan and 3D BRAVO examination and were classified into 3 groups based on dural venous sinuses,deep cerebral vein and superficial cerebral vein.Detection rates of TRICKS and BRAVO were evaluated and the results were analyzed.Result Detection rates of dural venous sinuses by TRICKS and BRAVO were 98.0％ and 100％ respectively.Detection rates of deep cerebral vein were 92.9％ and 100％ respectively.No significant difference was found (P＞0.05).Detection rates of superficial cerebral vein were 66.7％ and 100％ respectively.Significant difference was found between the two (P＜0.05) Conclusion BRAVO technology can clearly demonstrate the details of CVST,especially in superficial cerebral vein.With the combination use of TRICKS sequences,it will be of higher diagnostic value.

Objective To explore the association of COX-2 Gly587Arg polymorphism with the risk of primary liver cancer.Methods Two hundred and seventy patients with primary liver cancer and 540 health people were selected as our subjects.DNA were extracted from peripheral blood lymphocytes,and genotypes were measured by polymerase chain reaction-restriction fragment length polymorphism method.Odds ratios(OR) and 95％ confidence intervals(CI) were estimated by logistic regression.Results Two kinds of genotype (587Gly/ Gly and Gly/Arg) were found in all participants.No one carried 587Arg/Arg genotype.Among primary liver cancer patients,91.5％ (247/270,) 8.5％ (23/270) of individuals carried 587Gly/Arg and Gly/Arg genotype,which was significantly higher than that of controls (96.5％ (521/540,) 3.5％ (19/540)).Multivariate Logistic regression analysis showed that individual carried 587Gly/Arg genotype had an increased risk of developing primary liver cancer (OR =2.56,95％ CI =1.37-4.79,P =0.003) compared with 587Gly/Gly carriers.Conclusion COX-2 Gly587Arg polymorphism is a risk factor for primary liver cancer in Han.

tomography angiography ( CTA) and T12-S1 vertebral computed tomography three-dimensional reconstruction were selected .The operative win-dows of L1 ~L2 OLIF were observed:the vascular window ,bare window ,psoas major window ,ideal operative window and actual operative win-dow.The operative windows ’ percentage accounted for ideal operative window were calculated ,the actual operative window based on an actual operative window of <1 cm,≥1 cm were statistically analyzed ,and the positions of the left renal artery and renal vein in front of operative window of L1 ~L2 OLIF were observed.Results The actual operative window was <1 cm in 2 cases (3.3%) and ≥1 cm in 58 cases (96.7%).In 58 cases,the difference was significant(P=0.008) in gender and men were more than women.The vascular window,bare win-dow and psoas major window accounted for the ideal operative window by 45%,43%and 12%,respectively ,and the actual operative window accounted for the ideal operative window by 55%.The left renal artery and renal vein's walking planes were at between the middle 1/3 of L1 to up 1/3 of L2 .There were 31 cases (51.7%) of the left renal artery being behind the left renal vein .Conclusion The regional anatomy of the operative window of L1 ~L2 OLIF has its own peculiarities,and not all L1 ~L2 levels are suitable for OLIF.The left renal vessels’ walk-ing planes were in front of L 1 ~L2 .Before L1 ~L2 OLIF surgery,surgeons should analyze the imaging anatomimy through imaging .

OBJECTIVE: Analysis of normal young people multiple stimuli ASSR (m-ASSR), single stimuli ASSR (s-ASSR), C-ABR, PTA threshold, exploratory investigation of relevance of hearing test combination thresholds (C-ABR combines with 0.5, 1.0 kHz s-ASSR) predict behavioral thresholds, using a within-subjects design. METHOD: Forty-three normal hearing adults (86 ears) were treated with pure tone audiometry (PTA), m-ASSR, 0.5, 1.0 kHz s-ASSR, C-ABR. Data were analyzed by SPSS 18.0 for bivariate correlation analysis. RESULT: There was significant correlation between thresholds of hearing test combination and PTA,and the correlation coefficient (r) were 0.803, 0.650, 0.649, 0.734 at 0.5, 1.0, 2.0 and 4.0 kHz; while the correlation coefficient (r) between thresholds of m-ASSR and PTA were 0.48, 0.64, 0.57, 0.64. CONCLUSION There is significant correlation between thresholds of hearing test combination and PTA, hearing test combination can be more accurate, more reliable assessment of adults with normal hearing threshold level.
Acoustic Stimulation ; Adolescent ; Adult ; Audiometry, Pure-Tone ; Auditory Threshold ; physiology ; Evoked Potentials, Auditory, Brain Stem ; physiology ; Female ; Humans ; Male ; Young Adult

OBJECTIVE: To explore the strategies of prenatal diagnosis and genetic counseling for fetuses of two families with large deletions of 13q21. METHODS: Two singleton fetuses who were diagnosed with chromosome 13 microdeletions by non-invasive prenatal testing (NIPT) at Ningbo Women and Children's Hospital in March 2021 and December 2021 respectively were selected as the study subjects. Chromosomal karyotyping and chromosomal microarray analysis (CMA) were carried on amniotic samples. Peripheral blood samples were collected from the two couples for CMA assay to determine the origin of abnormal chromosomes identified in the fetuses. RESULTS: The karyotypes of the two fetuses were both normal. CMA revealed that they have respectively harbored heterozygous deletions spanning 11.935 Mb at 13q21.1q21.33 and 10.995 Mb at 13q14.3q21.32, which were respectively inherited from their mother and father. Both deletions had low gene density and lacked haploinsufficient genes, and were predicted to be likely benign variants based on database and literature search. Both couples had opted to continue with the pregnancy. CONCLUSION The deletions of the 13q21 region in both families may be of benign variants. As the follow-up time was short, there was no sufficient evidence for the determination of pathogenicity, though our finding may still provide a basis for the prenatal diagnosis and genetic counseling.
Pregnancy ; Child ; Female ; Humans ; Pedigree ; East Asian People ; Prenatal Diagnosis ; Chromosome Aberrations ; Karyotyping ; Microarray Analysis ; DNA Copy Number Variations