Adolescent ; Adult ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Cystic Fibrosis ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Young Adult

Child ; Congresses as Topic ; Humans ; Pediatrics

Objective To compare the clinical effect of neoadjuvant chemoradiotherapy (nCRT) and neoadjuvant chemotherapy (nCT) in the treatment of locally advanced esophageal squamous cell carcinoma.Methods The retrospective cohort study was conducted.The clinicopathological data of 156 patients with local advanced esophageal squamous cell carcinoma who were admitted to the Zhongshan Hospital of Fudan University from January 1,2010 to December 31,2015 were collected.Among 156 patients,59 undergoing nCRT were allocated into the nCRT group and 97 undergoing nCT were allocated into the nCT group.Patients in the nCRT group and nCT group respectively received 2 cycles chemotherapy by the TP regimen+40 Gy radiotherapy (2 Gy/d) and 2 cycles chemotherapy by the TP regimen.Patients were evaluated by imaging examinations after 6 weeks neoadjuvant therapy completion,and then underwent abdominal and right chest-left cervico three-incision thoracoscopic surgery.Observation indicators:(1) treatment situations;(2) postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed once every 3 months within 2 years and once every 6 months after 3 years up to January 2017.Follow-up included levels of tumor markers [carcinoembryonic antigen (CEA) and SCC-Ag],thoracic or abdominal computed tomography (CT),neck and abdominal ultrasonography and gastroscopy or PET/CT examination if necessary.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range) and comparison between groups was analyzed using the nonparametric test.Count data were analyzed using the chi-square test or Fisher exact probability.Comparison of ordinal data was done by the nonparametric test.The survival rate was calculated using the life table method and survival was analyzed by the Log-rank test.Results (1) Treatment situations:all the patients in the 2 groups were able to burden neoadjuvant therapy and thoracic esophagectomy.Six patients in the nCRT group and 15 in the nCT group had conversion to open surgery.Operation time,volume of intraoperative blood loss,cases with postoperative readmission of ICU,cases with complications,cases with perioperative death and duration of hospital stay were (201 ± 25) minutes,(137± 66)mL,5,24 (10 with pulmonary complications,8 with anastomotic leakage,3 with hoarseness,2 with cardiovascular complications and 1 with chylopleura),0,12 days (range,9-93 days) in the nCRT group and (195±20) minutes,(133±58) mL,8,30 (11 with anastomotic leakage,10 with pulmonmy complications,4 with hoarseness,2 with cardiovascular complications,1 with postoperative hemorrhage,1 with delayed gastric emptying and 1 with chylopleura),1,11 days (range,9-78 days) in the nCT group,respectively,with no statistically significant difference between the 2 groups (x2 =0.883,t =0.102,0.692,x2 =0.048,1.541,Z =0.225,P＞ 0.05).(2) Postoperative pathological examination:R0 resection rate was 96.6％ in the nCRT group and 93.8％ in the nCT group,with no statistically significant difference between the 2 groups (x2 =0.589,P＞0.05).Results of postoperative pathological examination showed that G0,G1,G2 and G3 of tumor regression grade were respectively detected in 18,16,7,18 patients in the nCRT group and 4,5,4,84 patients in the nCT group,with a statistically significant difference between the 2 groups (Z=-7.151,P＜0.05).Stage 0,Ⅰ,Ⅱ,ⅢA,Ⅲ B and ⅣA of postoperative ypTNM stage were respectively detected in 16,9,23,4,6,1 patients in the nCRT group and 4,9,37,6,34,7 in the nCT group,with a statistically significant difference between the 2 groups (Z=-4.890,P＜0.05).The down-staging was detected in 48 patients of the nCRT group and 50 patients of the nCT group,with a statistically significant difference between the 2 groups (x2=13.957,P＜0.05).(3) Follow-up and survival situations:of 156 patients,153 were followed up for 12-82 months,with a median time of 36 months.The 1-,3-,5-year overall survival rates were 88.1％,61.4％,34.9％ in the nCRT group and 81.4％,43.8％,23.1％ in the nCT group,with a statistically significant difference between the 2 groups (x2=4.336,P＜0.05).Conclusion The nCRT in the treatment of locally advanced esophageal squamous cell carcinoma can enhance postoperative pathological response rate,down-staging rate and overall survival rate compared with nCT,without increasing incidence of perioperative complications.

Objective To investigate the clinical characteristics of acute inhalational metallic nickel poisoning and its treatment effect.Methods Data including epidemiology,clinical features,laboratory tests,imaging examinations,therapy protocol as well as prognosis were collected and analyzed.Results Thoracic CT scan of all patients demonstrated as bilateral diffuse infiltration.Nickel concentration in both blood and urine were high in all patients and the concentration was positively associated with poisoning severity.All 4 patients received glucocorticoid treatment,2 of whom with acute respiratory distress syndrome were admitted to ICU to initiate mechanical ventilation and were given sodium dimercaptopropanesulfonate.All patients survived to hospital discharge.Conclusions Acute inhalational metallic nickel poisoning is uncommon and early symptoms are inconclusive.The blood and urine nickel concentration is helpful to judge the severity of the disease.Pulmonary diffuse infiltration is the main clinical feature.Glucocorticoid,chelation therapy as well as symptomatic treatment are effective therapies to relief disease severity.

Objective To survey the biliary flora in patients with obstructive jaundice due to pancreatic head cancer,also the multiple factors which affect the positive findings of bile culture in these patients.Methods The information of 65 patients with obstruetive jaundice due to pancreatic head eancer,who admitted to surgery in Huashan Hospital from Oetober 2007 to October 2008 were reviewed retrospectively.The factors which may potentially affect the detection of bile pathogen in patients with malignant obstructive jaundice were studied with univarite analysis and muhivariate analysis,including age,history of biliary surgery,yellow stained time,serum alanihe aminotransferase level,serum bilirubin level,CA19-9 level,tumor size,site of obstruction,with or without clinical manifestations of biliary infection,and APACHE Ⅱ score.Results Twenty-five positive cultures happened in 65 bile samples (38.5％),including 21 strains of Gram-negative baeilli (72.4％),6 strains of Gram-positive bacteria (20.7％),and 2 strains of fungi (6.9％).Univariate analysis showed that the relevant factors which may affect the rate of positive bile culture in patients with malignant obstructive jaundice were age,history of biliary surgery,biliary obstruction site,biliary tract infection symptoms and APACHE Ⅱ score.Multivariate analysis showed that age,history of biliary surgery,biliary obstruction site and APACHE Ⅱ seore were independent risk factors.Conctusion Age,history of biliary surgery,biliary obstruction site and APACHE Ⅱ score were independent risk factors which led to positive findings of bile cultures in patients with obstructive jaundice due to pancreatic head cancer.

OBJECTIVE To investigate the transgenerational effects of a hypothala mic-pituitary-ad-renal (HPA)axis -associated neuroendocrine metabolic progra mming alteration fro m F1 to adult second generation (F2)with prenatal ethanol ingestion.METHODS Pregnant Wistar rats were ad ministered with ethanol (4 mg·kg -1·d -1 )fro m gestational day 1 1 until delivery.F1 rats were fed a high-fat diet fro m postnatal week 4 (PW4)and were cross-mated in PW 16 -20.F2 rats were fed a standard diet fro m PW4 and rectal te mperature was measured in PW20,oral glucose tolerance test (OGTT)was con-ducted in PW21 ,blood sa mples and hypothala mus were collected in PW24 to investigate seru m lipids and HPA axis activity.RESULTS Co mparing to the F2 control group ,rectal te mperature in F2 ethanol group were higher (P<0.01 ),sugar tolerance in F2 male group was i mpaired (P<0.05),seru m corti-costerone and hypothala mus arginine vasopressin (AVP) mRNA were increased (P <0.05);seru m insulin were decreased (P<0.05)and male rats showed i mpaired glucose tolerance (P<0.05);seru m high-density lipoproteincholesterol (HDL-C)decrease (P <0.05)and total cholesterol (TCH)/HDL-C and low density lipoproteincholesterol (LDL-C)/HDL-C ratios were markedly increased (P <0.05,P <0.01 ).CONCLUSION Prenatal ethanol exposure induced metabolic syndro me has transgenerational effects,which may originate fro m the intrauterine progra mming of altered HPA axis-associated neuroen-docrine metabolis m.

Objective To investigate the feasibility,safety and efficiency of the establishment of model for Budd-Chiari syndrome with hepatic vein obstruction through endovascular technology in canine.Methods Twenty four dogs were randomly divided into experimental group (n=18) and control group (n=6).Under the surveillance of digital subtraction angiography,the balloon catheter was sent to the target hepatic vein via right external jugular vein,and then the balloon was filled by contrast agent until the target hepatic vein was blocked completely.In the experimental group,3～5 ml the mixture of N butyl-cyanoacrylate and lipiodol was infused into the target hepatic vein through the end hole of the balloon catheter until the hepatic vein flow stasis was achieved.In the control group,equal volume of normal saline was injected.The changes of liver function,portal vein pressure were measured and pathological varieties of target hepatic vein as well as the liver parenchyma were observed in the different periods in the two groups.Results The successful rate of the technique was 100 percent.There were no serious complications such as pulmonary embolism and death in the two groups.In the experimental group,the serum levels of alanine transpeptidase were (52.5 ± 12.5)U/L,(61.3±5.7)U/L,(38.6±9.4)U/L,which were higher than those in control group(P＜0.05) and prealbuminwere (0.18±0.04)g/L,(0.22±0.02)g/L,(0.19±0.06)g/L,which were lower than those in control group(P＜0.05) in the fourth,sixth and eighth weeks after the procedure,respectively.A common trunk formed by the middle and left hepatic veins which was looked as the targetic hepatic vein were completely occluded.the color of the liver appeared light red,dark red and dull black in the fourth,sixth and eighth weeks after the procedure,respectively.However,the hepatic veins were patented in the control group.In experimental group,histopathological observation revealed hepatic cells congestion and edema while a lot of inflammatory cells were seen in the wall of hepatic vein in the fourth week,the hepatic cells changed with severe edema,adipose kind,inner and middle membranes became thicker in the sixth week,and part of the hepatic cells showed hydropic degeneration,besides,inner and middle membrane became more thicker,there was substantially proliferation in elastic fiber hyperplasia in the eighth week.Conclusion Endovascular technology was a safely and effectively way to establish the canine model of Budd-Chiari syndrome with hepatic vein obstruction.

OBJECTIVETo investigate whether exposure to 900 MHz GSM wireless communication signals enhances mammary tumor development and growth induced by low dose dimethylbenz (a) anthracene (DMBA).

METHODSFive hundred female Sprague Dawley (SD) rats were treated with a single dose of 35 mg/kg. DMBA and then divided into 5 groups: one control group without exposure, and 4 groups with exposure in blinded fashion. The specific absorption rates (SAR) were 0, 0.44, 1.33 and 4.00 W/kg for the 4 exposure groups, respectively. Exposure started on the next day after DMBA administration and lasted 4 hours/day, 5 days/week for 26 weeks. Rats were weighted and palpated weekly for the presence of tumors, and killed at the end of 26-week exposure period. All mammary glands were examined histopathologically.

RESULTSThe incidence of mammary carcinoma in sham-exposure group was 37% (37/100). And mammary carcinoma incidences in the other groups of the exposure dose (0.44, 1.33 and 4.00 W/kg) were 25% (25/100), 34% (34/99) and 38% (38/100) respectively. There were no statistically significant differences between sham- and mobile phone microwave-exposed groups. In addition, the histopathological morphology of mammary tumor model in SD rats was observed. By microscopical examination two types of mammary tumor in this model were found, that was malignant or benign one. The former included adenocarcinoma and squamous cell carcinoma, and the latter included adenoma, fibroadenoma and cyst. Sometimes the histopathological morphology of mammary tumor appeared various since several kinds of histopathological features existed in the same individual.

CONCLUSIONThis study does not provide the evidence that 900 MHz GSM microwave exposure might promote DMBA-induced mammary tumor development in rats.

9,10-Dimethyl-1,2-benzanthracene ; Animals ; Cell Phone ; Female ; Mammary Neoplasms, Experimental ; chemically induced ; Microwaves ; adverse effects ; Radiation Dosage ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo inquire into the relationship between lipoprotein lipase (LPL) gene D9N, N291S and S447X polymorphisms and the development of cardiovascular diseases in children with obesity.

METHODSThe polymerase chain reaction (PCR) and restriction fragment length polymorphism (RLFP) techniques were used to detect three common mutations of LPL gene exon D9N, N291S and S447X in 157 obese children and 175 normal controls. Plasma lipid and lipoprotein levels between children with different genotypes were compared.

RESULTSThe D9N and N291S gene mutations were not detected in either the obese or the control groups. There were no significant differences in the frequency of S447X gene mutation between the two groups. There were no significant differences in the levels of plasma lipid and lipoprotein between children with S447 and X447 genotypes.

CONCLUSIONSD9N and N291S gene mutations may not be risk factors associated with cardiovascular diseases in children with obesity. S447X gene mutation might not play an important role in the development of cardiovascular diseases in childhood.

Adolescent ; Cardiovascular Diseases ; etiology ; genetics ; Child ; Female ; Humans ; Lipoprotein Lipase ; genetics ; Male ; Mutation ; Obesity ; genetics ; Risk Factors

Objective To evaluate the safety and efficacy of Viabahn covered stent in treatment of hepatic artery pseudoaneurysm (HAPA) caused by surgery.Methods Clinical data of 7 patients with postoperative massive intra-abdominal hemorrhage and diagnosed as HAPA with emergency angiography were collected from November 2015 to May 2016.All the patients underwent Viabahn covered stent implantation.Perioperative and postoperative clinical data of the patients were recorded,and with 1-month follow-up.Results All the 7 cases were diagnosed as extrahepatic HAPA and successfully completed Viabahn covered stent procedure,and curative rate was up to 100％.One case experienced transient vasospasm in the hepatic artery proximal to the stent.All the patients repeated hepatic artery CT angiography scans one week after surgery,with no evidence of bleeding.With 1-month follow-up,all the patients were in stable conditions.Conclusion Viabahn covered stent is minimally invasive,simple and effective interventional approach for HAPA.