OBJECTIVETo compare the difference in the clinical efficacy on cervical spondylosis of vertebral artery type (CSA) treated with thermosensitive moxibustion at different dosages.

METHODSSixty cases of CSA were randomized into a saturated moxa dosage group and a regular moxa dosage group, 30 cases in each one. The thermosensitive moxibustion was adopted in the two groups. The mild suspended moxibustion was applied at two acupoints with the strongest thermosensitization. In the saturated moxa dosage group, the moxibustion time was determined by the disappearance of thermosensitization. In the regular moxa dosage group, 15 min was required on each acupoint. The treatment was given twice a day for first 4 days in the two groups. Since the 5th day, the treatment was given once a day, continuously for 10 times, and totally 14 days were required. The score of symptoms and function and clinical efficacy were compared between the two groups before and after treatment as well as 6-month follow-up after treatment.

RESULTSThe curative and effective rate was 56.7% (17/30) after treatment and 60.0% (18/30) in 6-month follow-up after treatment in the saturated moxa dosage group, which were superior to 26.7% (8/30) and 30.0% (9/30) in the regular moxa dosage group respectively (P < 0.01, P < 0.05). The scores of clinical symptoms and function after treatment and in follow-up were improved apparently as compared with those before treatment in both groups (all P < 0.01). The scores of clinical symptoms and function after treatment and in follow-up in the saturated moxa dosage group were increased much more apparently than those in the regular moxa dosage group (after treatment: 22.32 +/- 4.64 vs 17.43 +/- 3.21; in follow-up: 23.01 +/- 4.76 vs 18.32 +/- 2.13, both P < 0.01).

CONCLUSIONThe thermosensitization moxibustion of saturated dosage achieves the superior short-term and long-term efficacies in the treatment of CSA as compared with the regular moxibustion dosage.

Acupuncture Points ; Adult ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; instrumentation ; Spondylosis ; physiopathology ; therapy ; Vertebral Artery ; physiopathology

Objective To investigate the metabolism of strychnine (STN) and the metabolic interaction between STN and glycyrthetic acid (GA) in vitro.MethodsHuman liver microsomes (HLM) and human recombinant cytochrome P450 (CYP) isoforms were employed to study the metabolism of STN and the metabolic interaction of STN with GA in vitro.ResultsIn HLM,the Km,Vmax,and clearance of STN were 88.50 μmol/L,0.88 nmol/(mg·min),and 9.93 mL/(mg·min),respectively.STN was metabolized mainly by CYP3A4.However,STN noncompetitively inhibited CYP3A4-catalyzed testosterone 6β-hydroxylation with IC50 value of 5.9 μtmol/L and Ki value of 5.5μmol/L.Moreover,GA competitively inhibited STN metabolism with IC5o value of 10.6 μmol/L and Ki value of 17.7 μmol/L.ConclusionAlthough STN is mainly metabolized by CYP3A4 in vitro,STN has noncompetitive inhibition on CYP3A4-catalyzed testosterone 6β-hydroxylation.Moreover,GA could competitively inhibit STN metabolism.The present work is helpful to elucidate the metabolic interaction between STN and GA.

Objective To evaluate the blood supply features and effectiveness of arterial chemoembolization for pedunculated hepatocellular carcinoma.Methods Angiography and chemoembolization via supplying blood arteries of tumor were performed in five patients with pedunculated hepatocellular carcinoma.Interventional procedure was carried out with tumor vascular infusion of 350 mg hot elemene emulsion and tumor embolization by cisplantin-lipidol emulsion(cisplantin 60-80 mg+lipidol 8-15 ml)and glutin.Results Ten interventional procedures(TACE)were undertaken in 5 patients.Angiography showed that tumor blood supply mainly coming from collateral circulation adjacent to the tumors,but partially from hepatic artery.Tumor sizes decreased from 30% to 50% in 5 cases,and AFP declined in 4 cases after the treatment. Conclusion Pedunculated hepatocellular carcinoma possessing different blood supply features from intrahepatocellular carcinomas.But transarterial ehemoembolization is still an effective method of choice for this treatment.

ObjectiveTo observe the inhibition effect of docetaxel-loaded lipid microbubbles (DLLM) combined with ultrasound targeted microbubbles destruction (UTMD) on microvessel in rabbit VX2 liver tumor models.MethodsSixty rabbits were randomly divided into 6 groups (n= 10),i.e.Doc group (used docetaxel only),DLLM group (used docetaxel-loaded lipid microbubbles),Doc+US group (used docetaxel combined with ultrasound positioning irradiation),PLM+US group (used microbubbles combined with ultrasound positioning irradiation),DLLM+US group (used docetaxel-loaded lipid microbubbles combined with ultrasound positioning irradiation) and control group.The expression of CD34 and VEGF and microvessel density (MVD) were compared among different groups.ResultsAfter treatment,the expression of CD34 in DLLM+US group was lower,the MVD of DLLM+US group was markedly lower than that of the other groups (P＜0.01),while the expression of VEGF in this group was the lowest among all 6 groups (P＜ 0.01).ConclusionDLLM combined with UTMD can inhibit the generation of microvessels in rabbit VX2 liver tumor,thus inhibit the growth of the tumor.

15mm~2)of dural sac cross-sectional area to values smaller than 75 mm~2 was found during examination in axial loading,or if a suspected disc herniation,narrow lateral recess,narrow intervertebral foramen,or intraspinal synovial cyst changed to being obvious at the axial loading examination,they were regarded as additional information.Results After axial loading CT examination,AVI was found in 16 of 40 patients.A significant decrease of dural sac area was found in 13 patients.Intervertebral disc herniation was more severe in 7 patients,lateral recess or interverbral foramen narrowed in 4 patients,no intraspinal synovial cyst was found.After axial loading MRI examination,AVI was found in 19 of 60 patients.A significant decrease of dural sac area was found in 13 patients.Intervertebral disc herniation became severe in 10 patients,lateral recess or interverbral foramen narrowed in 8 patients,no intraspinal synovial cyst was found.AVI was found in 32 of 79(40.5%)patients with sciatica and 2 of 20(10.0%)patients with low back pain(?~2=7.45 P

Objective: To assess changes of liver function in HIV-positive children with/without HBV/HCV co-infection after 1 year of highly active antiretroviral therapy ( HARRT ) . Methods: Seventy-eight pediatric AIDS patients with HBV/HCV co-infection,19 pediatric AIDS patients with HBV co-infection and 44 pediatric AIDS patients without HBV/HCV co-infection who received HAART at least for 1 year were enrolled .HIV-1 viral load was quantitatively detected using a standardized reverse transcriptase-polymerase chain reaction assay , and blood cells were determined by three-color flow cytometry . Anti-HCV antibody and HBsAg was detected using an enzyme-linked immunosorbent technique , and ALT, AST and TBIL were detected by automatic biochemical analyzer .Results: After 1 year-HAART, the viral load was decreased to the lowest limit of detection in 90 .34% patients ( t=2 .61 , P<0 .01 ) , and CD4 +T cell counts were increased from 170 .187 ±132 .405/μl to 796 .014 ± 158 .491/μl ( t=3 .17 , P<0 .01 ) .The levels of ALT and AST were elevated ( t=2 .02 , P <0 .05 ) , while the ALT and AST levels in patients receiving nevirapine (NVP) based HAART increased from 18.28 ±13.74 U/L and 24.23 ±8.09 U/L to 55.35 ±22.40 U/L and 69.97 ±26.72 U/L, respectively(t=3.80,t=4.11;Ps<0 .01 ) .The increment of ALT and AST in NVP based HAART were significantly higher than that in the efavirenz based HAART (ALT:46.28 ±13.35 U/L vs 37.70 ±15.25 U/L and AST:19.53 ±7.23 U/L vs 1.25 ±0.21 U/L, respectively; t=4.53, t=5 .79;Ps<0 .01 ) , particularly in patients co-infected with HIV/HBV/HCV ( ALT:54 .32 ±22 .85 U/L vs 16 .89 ±14 .42 U/L and AST:41 .71 ±19 .26 U/L vs -3 .44 ±15.59 U/L, respectively; t=3.42, t=2.98, Ps<0.01).Conclusion: HARRT can repress HIV-1 replication effectively , but it also cause the damage of liver function , especially in patients with HBV and/or HCV co-infection.

OBJECTIVETo investigate the clinicopathological features of primary gastrointestinal non-Hodgkin's lymphomas (PGI-NHL) and their prognostic values.

METHODSThe clinical and pathological data of 216 patients diagnosed as PGI-NHL from Zhejiang Cancer Hospital were analyzed retrospectively. χ² test, log-liner model analysis, COX proportional hazard regression analysis and Life-table survival analysis were used to analyze the survival status of the patients by SAS 8.2 software, and Log-rank test was performed to couple the overall survival rates with different prognostic factors.

RESULTSTotally, the age of onset was 8 to 89 years with the median age of 56.5 years. Male versus female was 1.27∶1(121∶95). The most frequently involved location was stomach (147 cases, 68.1%), followed by ileocecus (25 cases, 11.6%), large intestine (20 cases, 9.3%), small intestine (17 cases, 7.9%) and multiple GI involvement (5 cases, 2.3%). 182 cases were classified as B cell lymphomas, 22 cases as T cell lymphomas, and 12 cases not classified exactly due to insufficient data. The 3-year and 5-year survival rates of the patients were 69.4% and 53.3%, respectively. Univariate analysis revealed that age＞60 years, ECOG≥2, high LDH level, stage Ⅲ-Ⅳ, IPI≥2, T cell type and intestinal involvement were predictors for poor prognosis. IPI≥2, T cell type and intestinal involvement were independent adverse predictors for prognosis by multiple COX proportional hazard regression analysis. Among different treatment groups, cases received chemotherapy combined with local radiotherapy gained the best survival status.

CONCLUSIONB-cell lymphoma was the main pathological type in PGI-NHL; IPI≥2, T-cell type and intestinal involvement are independent adverse predictors for prognosis; chemotherapy combined with local radiotherapy might be the choice of approach for advanced stage and aggressive PGI-HNL.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; drug therapy ; pathology ; Humans ; Lymphoma, Non-Hodgkin ; drug therapy ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

Purpose To study the clinical features, immunophenotypes and prognostic factors of primary breast diffuse large B-celllymphoma (PBDLBCL). Methods The clinical pathological data of 49 cases of PBDLBCL during January 2006 to December 2016 were retrospectively analysed, and the basic clinical and pathologic data, pathologic types and the immunohistochemical slides by EnVision method for staining were summarized. Results 47 cases were women and 2 cases were men. The age ranged from 24 to 79 year old with the median age of 48 year old. On microscopic observation, tumor cells were large to medium-sized which characterized as diffuse infiltration between the lobules of mammary gland, around the duct, interstitial and fat tissue, some were single file cord pattern. The immunophenotype showed 37 cases were of non-GCB, 12 cases were GCB type. Ki-67 index were greater than 40％. According to Ann Arbor staging, 16 cases were stage I EA, 28 cases were stage Ⅱ EA, 5 cases were stage Ⅳ E. IPI score: 30 cases with 0 ～1 score, 10 cases with 2 score, 9 cases with 3 score. Patients were followed up from 5 to 146 months, The 3-year overall survival (OS) rate was 51.2％ and 5-year OS rate was 36.7％, Single factor analysis showed that there were statistically significant difference in clinical stage, levels of LDH, IPI score, BCL-2 protein expression, and BCL-6 protein expression in 3 and 5 years of OS rate. The multiple factor analysis of Cox regression showed that the increase of IPI risk classification was the independent adverse prognostic factor of primary breast diffuse large B-cell lymphoma. Conclusion The diagnosis of PBDLBCL is confirmed by pathological biopsy and immunohistochemical markers. The immunophenotype was mainly non-GCB type. Comprehensive treatment including surgery, chemotherapy and radiotherapy is appropriate. The prognosis should be comprehensively evaluated by multiple factors. IPI increase risk classification is the independent adverse prognostic factor.

Adult ; Diagnosis, Differential ; Female ; Glycogen ; metabolism ; Glycogen Storage Disease Type II ; pathology ; Humans ; Liver ; metabolism ; pathology ; Muscle, Skeletal ; metabolism ; pathology ; Muscular Dystrophies, Limb-Girdle ; pathology ; Pyomyositis ; pathology ; Young Adult

BackgroundThe meibomian gland carcinoma is an eyelid malignant tumor with a domestic incidence after basal cell carcinoma.Meibomian gland carcinoma is not sensitive to radiation therapy and chemotherapy,and the related factors with its recurrence and metastasis are rarely reported.ObjectiveThis study was to investigate the clinical and pathologic features of meibomian gland carcinoma with multiple operations and the effectiveness of histologically controlled excision.MethodsThe clinical data and the histopathologic sections of 34 cases of the meibomian gland carcinoma diagnosed by pathology were retrospectively analyzed at Zhongshan Ophthalmic Center in September 2003 to April 2011,and the treating effectiveness of histologically controlled excision was evaluated. ResultsIn this group of cases,the appearing rate of the meibomian gland carcinoma was resemble in both lateral eyes.A higher morbidity was on the upper eyelid (26/34,76.5％) and then the lower eyelids (5/34,14.7％ ) and both (3/34,8.8％).The average ages of these cases were 57.5 years old.Sixteen of 21 misdiagnosed cases were identified as chalazion at the first visit,and no histopathological examination was performed in 11 cases after initial operation.Twenty-six cases(76.5％ )were identified as meibomian gland carcinoma in initial histopathologic diagnosis.Two cases had histologically controlled excision and 16 cases had simple excision while 16 cases had chalazion enucleation in the first operation.All the patients had histologically controlled excision in Zhongshan Ophthalmic Center with 58.8％ of the patients having pagetoid invasion.Sixteen cases were followed up for 5 months to 8 years after histologically controlled excision,in which none died of recurrence and metastasis of meibomian gland carcinoma.No significant differences were found in the pathological feature between 16 lost patients and 18 followed-up patients(P ＞ 0.05 ).Conclusions Misdiagnosis of meibomian gland as chalazion is a main cause of repeat operations of meibomian gland carcinoma.Histologically controlled excision is a feasible therapy for the recurrence and metastasis of meibomian gland carcinoma.