Objective To systematically analyze the effect of adjuvant chemotherapy after radical operation in advanced gastric cancer .Methods The related literatures published at home and abroad were retrieved from the electronic databases including CNKI ,PubMed ,Elsevier ,Springer ,Oxford from January 2003 to December 2013 ,then 11 articles of the randomized controlled trial (RCT) of the comparison between the postoperative adjuvant chemotherapy and simple operation were collected .The effect merging and the quantitative systematic evaluation in the aspects of the total survival ,disease free survival and relapse free survival were per-formed with RevMan5 .2 provided by the Cochrane collaboration network .Results 11 articles of RCT were included with 4 points and more by the Jadad scale ,involving 4 433 patients ,among them 2 203 patients with operation plus postoperative chemotherapy and 2 230 patients with surgery alone .The results analysis indicated that the postoperative adjuvant chemotherapy made the pa-tients to obtain the apparent benefit during survival period ,the significant difference had statistical significance .OS :HR= 0 .80 , 95% CI(0 .73 ,0 .88) ,P<0 .01 ;DFS :HR=0 .78 ,95% CI(0 .63 ,0 .97) ,P=0 .02 ;RFS :HR=0 .67 ,95% CI(0 .53 ,0 .85) ,P=0 .001 . Conclusion The postoperative adjuvant chemotherapy can make the patients with radical operation to obtain the apparent benefit during the survival period .The adjuvant chemotherapy of oral capecitabine plus oxaliplatin or oral Tegafur Gimeracil Oteracil Potas-sium after D2 radical operation may be the best scheme at present .

Hydrocarbons, Brominated ; metabolism ; toxicity ; Occupational Exposure

Objective To investigate the characteristics of thyroid surgical emergency related disease and prognosis,provide the basis to improve treatment.Methods Retrospective analysis of 24 cases of thyroid surgical emergency patients in Peking Union Medical College Hospital,Chinese Academy of Medical between 2004 and 2014who was performed,and the Fisher analytic method was used.Results According to the condition of diseases,conservative treatment for 1 case,surgical treatment for 23 cases,interventional therapy for 2 cases were performed.The overall preoperative diagnosis rate was 45.8％.The overall perioperative death were 5 cases (20.8％),total death were 7 cases(29.2％).8 cases preoperative diagnosed or highly suspected thyroid lymphoma patients were received oral or intravenous corticosteroid treatment,with the use of corticosteroids perioperative survival rate increased from 50％ to 100％.Conclusions (1) Thyroid surgical emergency with different causes should quickly make a clinical diagnosis based.on the patient's history and examination,select rational treatments.(2) Thyroid lymphoma patients that preoperative highly suspected or diagnosed,immediate received glucocorticoid treatment can reduce airway obstruction and decrease mortality,should be promoted.

Objective To evaluate the therapeutic efficacy of intratympanic dexamethasone injections combined with prednisone in patients with idiopathic sudden sensorineural hearing loss. Methods A total of 71 patients diagnosed with sudden hearing loss were treated with intratympanic dexamethasone injections plus prednisone (B group) or prednisone alone (A group). Hearing was evaluated by pure tone audiogram performed before initial treatment and at 4 weeks following the final treatment. Results The total recovery rate after the treatment was 81.8% in the B group and 55.3% in the A group. The diflference between two groups was statistically significant (P < 0.05). Conclusion The present study suggests that sudden sensorineural hearing loss patients treated with intratympanic dexamethasone combined with prednisone have a higher likelihood of hearing recovery than those treated with prednisone alone.

Animals ; Calpain ; Humans ; Nervous System Diseases ; chemically induced ; Organophosphate Poisoning

Objective:To investigate a potential role of Toll-like receptor 4(TLR4) ,a pathogen pattern recognition receptor, in the early phase of severely burned rats. Methods: Rats burn model(30% of total body surface area[TBSA],Ⅲgrade) were established with vapor at 108 C for 8 seconds. Rats were sacrificed before and 2,5,12,24,48 and 72 h after burning, and the spleen specimens and peripheral blood samples were harvested. TLR4 mRNA and TNF-?mRNA expression in splenocyte was measured by reverse-transcription PCR(RT-PCR); the expression of TLR4 protein were measured by Western bloting; the endothelial toxicity concentration in plasma was detected by limulus lysate test. Results: It was found that the expression of TLR4 mRNA.TNF-?mRNA,TLR4 protein,and the level of ET were significantly increased in burned group compared with normal control group. The expression of TLR4 mRNA and protein peaked at 8 h after burning, the expession of TNF-?mRNA peaked at 12 h.and the level of ET peaked at 8 h after burnings the peak values of them were (3. 66?0. 51),(2. 27?0. 19), (1.65?0. 23),and (11. 68?2. 63) Eu/ml, respectively, all significantly higher than those of the control group(P

BACKGROUND: Previous studies have proved platelet-rich fibrin (PRF) with osteoinduction ability, and the centrifugal speed and time to prepare rabbit advanced PRF (A-PRF) with the most similar structure to that of human PRF have been determined.OBJECTIVE: To observe the histological changes during A-PRF-induced osteogenesis.METHODS: Thirty Japanese white rabbits were randomly divided into A-PRF and blank control groups (n=15 per group).The full-thickness defect models were established on the rabbit parietal bone, followed by implanted with A-PRF or nothing, respectively. The model rabbits were killed immediately, at 2, 4, 8 and 12 weeks after modeling, to grossly observe the bone formation, and the histological changes in the defect region were observed through hematoxylin-eosin staining, Masson staining and immunohistochemistry.RESULTS AND CONCLUSION: Unhealed defects were observed in the blank control group. Gross and histological observations showed that the speed, amount and maturity of bone formation in the A-PRF group were significantly better than those in the blank control group immediately, 4, 8 and 12 weeks after modeling (P < 0.05). Our findings suggest that the rabbit skull bone defect is successfully established. A-PRF can induce osteogenesis, and more mature newly born bones appear with time. Additionally, osteoclasts can act with osteoblasts synergically under the A-PRF induction to promote the bone formation.

AIM: To explore the immunity modulation function of aqueous of Forsythia suspense (AFS) and its possible mechanisms. METHODS: Rats of burned model group were burned with vapor under 3mpa pressure and 108℃ temperature for 8 seconds to achieve deep partialthickness bum, to make a thirty percent total body surface area (TBSA)bum. The experiment were divided into five groups: Control group: without any treatment; 8 PBH group: 8 h after burn; the rats of AFS1 guoup, AFS2 group and AFS3 group of them were given AFS 5 g/kg, 2.5 g/kg, 1.25 g/kg once a day by Po. pathway for seven days before burns, respectively. Rats were sacrificed before and 8h after burn, The percentage of Treg cells in CD4~+ T cells was detected by flow cytometry(FCM) ; the expression of Foxp3 mRNA on splenocytes were measured by RT-PCR, and the protein of Foxp3 activity was evaluated by immunohistochemistry staining. RESULTS: Compared with Control group, the expression of Foxp3mRNA and protein on the splenocytes were upregulated markedly(P <0.01), and the percentage of Treg were significantly increased (P < 0.01) in the 8PBH group. AFS1, AFS2 and AFS3 significantly attenuated these increases (P < 0.01), which was dose-dependent. CONCLUSION: AFS has immunity modulation function and mechanism of it is corrected with Foxp3 mRNA on splenocytes.

Objective To investigate the effectiveness of intratympanic dexamethasone injection as a protec-tion agent against cisplatin ototoxicity.Methods Fifty five healthy guinea pigs were randomly divided into four groups.The guinea pigs groups received (group I)0.9% NaCl solution(16 ml/kg)intraperitoneally (IP),(group II)dexamethasone (10 mg/ml)intratympanically(IT),(group III)cisplatin (16 mg/kg)only intraperitoneally(IP) and (group IV)dexamethasone (10 mg/ml)IT followed after 1h by 16 mg/kg cisplatin.Before and 7 days following injections,the ototoxic effect was measured with auditory brainstem response(ABR).The contents of malondiade-hyde(MDA)and activities of superoxide dismutase(SOD)were also measured.Results ABR thresholds before and after dosing were 28.50±4.74,29.00±3.94 dB nHL and 28.67±5.82,31.33±5.81 dB nHL in group I and group II,respectively,with no significant differences (P>0.05).The contents of MDA and activities of SOD were 2.01 ±0.07 mmol/L ,234.10±13.09 U/ml and 2.06±0.09 mmol/L,233.20±13.24 U/ml in the group I and group II, respectively,with no significant differences (P>0.05).ABR thresholds after dosing were 55.33±4.81,and 40.67 ±3.72 dB nHL in the group III and group IV,which were significantly increased,but ABR thresholds in the group IV were significantly lower than that in the group III (P<0.05).The contents of MDA were 5.74±0.17,3.51± 0.18 mmol/L in the group III and group IV,which were significantly increased.SOD activities were 107.90 ± 14.21,and 162.70±11.25 U/ml,which significantly decreased.Nevertheless,in the group IV dexamethasone rela-tively reduced the contents of MDA(P<0.001)while increased the activities of SOD(P<0.001)compared with group III.Conclusion Intratympanic dexamethasone injection presents as an effective treatment modality to prevent cisplatin ototoxicity without any ototoxic effect.

Objective To investigate the clinical manifestations, pathologic features, treatment and prognosis of oncogenic osteomalacia (OO). Methods A 17-year-old male patient was admitted.The patient presented with a 4-year history of progressive lower limb weakness, muscle atrophy and joint pain. Lab tests demonstrated hypophosphatemia. Lumbar and pelvic X-ray showed wedging of the lumbar spine and decreased pelvic bone density. Ultrasonography revealed a low-echo and bloodrich mass measuring 15.1 cm× 14.5 cm× 13.2 cm located at the lower pole of left kidney. Computed tomography showed a voluminous enhanced tumor, supplied by the left renal artery, vice renal artery and a branch of the inferior mesenteric artery. A tortuous vein at the lower part of the tumor drained into the left renal vein. A radioactive octreotide scan was used to study an increased radionuclide-uptake lesion which was initially suspected on the CT scan. The patient was preoperatively diagnosed with left malignant kidney tumor and oncogenic osteomalacia. During a left radical nephrectomy performed through a transperitoneal anterior subcostal incision, a round diameter 15 cm tumor covered by twisted veins was found. The patient recovered well postoperatively. Results The histological diagnosis was renal clear cell carcinoma. Immunohistochemical staining detected Vimentin and RCC were positive and Ki-67antigen index was about 2 %. After lesion removal, the paraneoplastic syndrome resolved. At the 11-month follow-up, no recurrence of the disease was observed. Conclusions Oncogenic osteomalacia is rare and OO with renal cell carcinoma has not been reported so far. OO or rickets should be suspected in those patients who presented with metabolic bone disease associated with hypophosphatemia and inappropriate phosphaturia. If OO syndrome was suspected, in addition to past medical history and imaging, a standard meticulous examination should be initiated promptly. Surgical treatment is still necessary once confirmed. And all of them achieved a good prognosis.