Cochlear Implantation ; adverse effects ; Female ; Humans ; Infant ; Meningitis ; etiology ; Postoperative Complications

Objective To investigate the efficacy of emodin in the treatment of acute pancreatitis in rats.Methods Forty-five SD rats were divided into control group,pancreatitis group and treatment group.The apoptotic index of pancreatic acinar cells.the expression of NF-κB mRNA and Bax mRNA,the apoptosis rate of peripheral polymorphonuclear neutrophil(PMN),and the expression of PMN caspase-3 and PMN caspase-8 were detected.Results Compared with the panereatitis group,the apoptotic index of pancreatic acinax cells and PMN,and the expressions of NF-κB mRNA,Bax mRNA.PMN caspase-3 and PMN caspase-8 in pancreas tissue were significantly increased in the treatment group(F=853.199,327.126,143.586,48.857,231.750,96.552,P＜0.05).The histopathologic score of panereatitis Was negatively correlated with the apoptotic index of the pancreatic acinar cells and PMN(r=-0.96,-0.94,P＜0.05).The apeptotic index ofthe pancreatic acinar cells Was positively correlated with the expression of NF-κB mRNA,Bax mRNA in pancreas tissue(r=0.73,0.76,P＜0.05).The expression of NF-κB mRNA was positively correlated withthat of Bax mRNA(r=0.94,P＜0.05).The apoptotie index of PMN was positively correlated with the expression of PMN caspase-3 and PMN caspase-8 (r=0.99,0.99.P＜0.05).Conclusions Emodin alleviates acute pancreatitis via regulating the apoptosis of pancreatic acinar cells through Bax pathway,and regulating the PMN apoptosis through caspase pathway.

Objective To study the accuracy and the clinical significance of sentinel lymph node biopsy (SLNB)after neoadjuvant chemotherapy for breast cancer.Methods A total of 90 patients with StageⅡorⅢbreast cancer and negative axillary node after neoadjuvant chemotherapy were enrolled in the study.Mapping proce- dure and SLNB were performed using methylene blue injected at the site of the primary breast cancer,followed by the axillary lymph node dissection.Results The sentinel lymph node(SLN)was successfully identified in 82 out of 90 patients(91.1%).The number of sentinel harvested nodes ranged from 1 to 4(average 1.6).The accuracy of SLNB to predict the axillary lymph node status was 93.9 %(77/82),the sensitivity,positive predictive value,nega- tive predictive value and false negative rate were 87.5 %(40/45),100 %,88.1% and 11.1%(5/45),respectively. The SLN identification rate tended to be higher and false negative rate tended to be lower in patients with T2 prima- ry tumor before neoadjuvant chemotherapy.Conclusion Our study indicated that SLNB after neoadjuvant chemotherapy in patients with StageⅡorⅢbreast cancer had a similar effect as SLNB in non-neoadjuvant studies. SLNB was considered to be able to accurately predict the axillary lymph node status in patients with T2 primary tu- mor before neoadjuvant chemotherapy.

Objective To investigate whether the percutaneous ethanol injection (PEI)under sedation and analgesia can in-crease the energy deposition and curative efficiency of the high intensity focused ultrsound(HIFU)in treating unresectable middle and advanced stages of primary liver cancer.Methods Thirty-six cases of clinically diagnosed unresectable middle and advanced sta-ges of primary liver cancer were randomly divided into the PEI+ HIFU group(combination group,n = 23)and the simple HIFU group (HIFU group,n=13);10mL of the mixture of 99.7% ethanol and iodized oil (9:1)was given by intratumoral injection at 30 min before ablation in the PEI+HIFU group,while 0.9% physiological saline 10mL was replaced in the simple HIFU group.The ablation energy efficiency factor(EEF)and irradiation time were compared between the two groups.Results The ablation EEF in the PEI+HIFU group and the simple HIFU group were (13.82+4.26)J/mm3 and (25.63+6.31)J/mm3 respectively,the PEI+HIFU group was significantly lower than the simple HIFU group (P <0.05);the irradiation time were (1 468.28+253.21)s and (2 352.56+463.34)s respectively;which in the PEI+ HIFU group was significantly shortened (P <0.05).Conclusion PEI can enhance the HIFU ablation energy deposition and improve the efficiency of HIFU for treating unresectable primary liver cancer.

Objective: To explore the clinical efficacy of surgical radiofrequency ablation-modified Maze procedure in treating atrial fibrillation (AF) patients with large left atrial heart valve disease. Methods: A total of 267 patients received cardiac valve replacement and radiofrequency ablation-modified Maze procedure at the same time in our hospital from 2014-01 to 2015-15 were retrospectively studied. Based on the size of left atril, patients were divided into 2 groups: Group A, patients with left atrial size<60 mm, n=182 and Group B, patients with left atrial size≥60 mm, n=85. All patients were followed-up for 6 months after operation, clinical efficacy of surgical radiofrequency ablation-modified Maze procedure in treating AF was compared between 2 groups. Results: ①All patients were successfully completed the operation, radiofrequency ablation time was similar between Group A and Group B [18-32 (24±4) min] vs [22-38 (25±6)min], P>0.05. ②The ratios for recovering to sinus rhythm at the end of operation and discharge in Group A were 156/182 (86%) and 152 (84%), in Group B were 56/85 (66%) and 54 (64%); at 3 and 6 months post-operation in Group A were 149/182 (81.6%) and 146 (80.2%), in Group B were 48/85 (56.4%) and 46 (54.1%), all P<0.05. ③No patients needed installing permanent pacemaker, no operative mortality and no ablation related complications.Conclusion: Radiofrequency ablation-modified Maze procedure was safe, simple and effective in treating heart valve disease complicated AF, the effect in patients with left atrial ≥60 mm was inferior than left atrial<60mm; it could be used in clinical practice.

Objective To evaluate the efficacy and safety of neoadjuvantchemotherapy of trastuzumab combined with paclitaxel on human epidermalgrowth factor receptor -2 (HER2) positive breast cancer.Methods A total of 36 patients with breast cancer were included in this study.Patients in this study were given trastuzumab combined with paclitaxelneoadjuvant chemotherapy.Paclitaxel 175 mg· m-2 through intravenousinjection in 3 h on day 1 followed by trastuzumab 8 mg· kg-1 (burdendosage) on day 2 for cycle 1.And for cycle 2 to 4, paclitaxel remainedthe same, followed by trastuzumab 6 mg· kg-1 .Each chemotherapycycle was 21 days.After 4 cycles of chemotherapy treatment, the data ofclinical efficacy and toxicity were evaluated.Results All of the 36 casesfinished the neoadjuvant chemotherapy.The case of completeresponse, partial response were 18 and 13 and and objective responserate (ORR) was 86.11%.There was no statistical difference in ORRamong the subgroup analysis (P >0.05).The main adverse reactionswere granulocytopenia (13.88%) and fatigue (61.11%) during thechemotherapy.Conclusion High clinical efficacy and less adversereactions are found in the treatment of trastuzumab combined withpaclitaxel for HER2 -positive breast cancer.

BACKGROUNDFrequent premature ventricular complexes from the right ventricular outflow tract (RVOT-PVCs) are associated with left ventricular dysfunction. This study adopted two-dimensional speckle tracking imaging to evaluate global and regional left ventricular myocardial function in patients with frequent RVOT-PVCs.

METHODSThis study included 30 patients with frequent RVOT-PVCs and 30 healthy subjects. Aortic systolic velocity-time integral (AoVTI) and myocardium strain in circumferential (CS), radial (RS) and longitudinal (LS) directions were evaluated by conventional echocardiography and speckle tracking imaging. All values of patients with RVOT-PVCs were recorded during sinus (PVC-S) and PVC beats (PVC-V).

RESULTSSignificant differences were demonstrated in global CS, RS and LS between the control subjects and the PVC-V (CS: (17.46 ± 2.48)% vs. (11.52 ± 3.28)%, RS: (48.26 ± 10.20)% vs. (20.92 ± 9.78)%, LS: (19.89 ± 2.62)% vs. (11.79 ± 3.66)%, P < 0.01), and in segmental RS and LS of nearly all the left ventricular segments. Statistical differences in segmental CS between the PVC-V and the control subjects were only observed in anterior, anteroseptal and septal segments (only seen in anteroseptal and septal segments at apex). Furthermore, V/S AoVTI (AoVTI during the PVC beat divided by AoVTI during the sinus beat, then multiplied by 100%) correlated with coupling interval (r = 0.67, P < 0.001) and global strain (CS: r = 0.48, P = 0.007; RS: r = 0.65, P < 0.001; LS: r = 0.65, P < 0.001).

CONCLUSIONSFrequent RVOT-PVCs can induce global and regional left ventricular systolic dysfunction. The reduction of hemodynamic parameters relates to the coupling interval and the global systolic function.

Adult ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Ventricular Function, Left ; physiology ; Ventricular Premature Complexes ; physiopathology

OBJECTIVETo compare the anastomotic leakage rates after esophagectomy and reconstruction through different routes for esophageal cancer and analyze the causes for higher anastomotic leakage rate after esophagectomy, systemic lymph node dissection and reconstruction through retrosternal route and its prevention.

METHODSData of 1105 cases of esophagectomy were reviewed retrospectively. Patients in group A (n=229) underwent esophagectomy through left thoracotomy and intrathoracic anastomosis, patients in group B (n=716), esophagectomy through right anterio-lateral thoracotomy and cervical reconstruction through posterior mediastinal route, patients in group C (n=160) esophagectomy, systemic lymph node dissection and cervical anastomosis through the retrosternal route.

RESULTSThe leakage rate was significantly higher (19.4%) in group C than that in group B (11.9%, P< 0.05) and much significantly higher than that in group A (2.2%, P< 0.01). In group C, there was no significant difference in leakage rate between the patients with hand-sewn or mechanical anastomosis (22.2% vs.11.6%, P=0.133), between the patients who had whole stomach or tube-typed gastric reconstruction (25% vs.15.6%, P=0.146). The leakage rate was significantly decreased from 23.3% to 9.1% after prolonged nasal-gastric drainage for seven days (P< 0.05).

CONCLUSIONThe high anastomotic leakage rate after retrosternal reconstruction is mainly due to compression of the stomach in the anterior mediastinum. Prolonged nasogastric drainage is an effective way to decrease the leakage rate after systemic lymphadenectomy.

Anastomosis, Surgical ; methods ; Esophageal Neoplasms ; surgery ; Esophagectomy ; adverse effects ; Female ; Fistula ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Surgical Stomas ; pathology

OBJECTIVETo evaluate the value of normalization window of tumor vasculature (NWTV) in patients with unresectable gastric cancer undergoing neoadjuvant chemotherapy.

METHODSFrom October 2010 to March 2011, 93 patients with unresectable advanced or locally advanced gastric carcinoma were prospectively collected and randomly divided to Group A(n=30), Group B(n=29), and Group C(n=34). Group A received FOLFOX4 as conventional neoadjuvant chemotherapy. Group B received FOLFOX4 plus bevacizumab. The treatment was adjusted in Group C according to the hypothesis of NWTV with neoadjuvant chemotherapy delivered 5 days after bevacizumab treatment. The efficacy, drug toxicity and clinical outcome were assessed and compared between the three groups.

RESULTSThere were no significant differences among the 3 groups in demographics(P>0.05). All the patients completed the neoadjuvant chemotherapy. Efficacy and toxicity between the three groups were comparable(P>0.05). The rates of tumor downstaging in the three groups were 56.7%(17/30), 72.4%(21/29), 85.3%(29/34), respectively, with a significantly lower downstaging rate in Group C as compared to Group A(P<0.05). R0 resection rates were 23.3%(7/30), 27.6%(8/29), 52.9% (18/34), respectively, with significantly higher R0 resection rate in Group C as compared to Group A and Group B(All P<0.05). There was no perioperative death in this cohort. Postoperative complications were comparable among the 3 groups(P>0.05).

CONCLUSIONSAnti-angiogenesis agent can improve the efficacy of neoadjuvant chemotherapy in unresectable gastric cancer. Furthermore, administration according to NWTV may achieve better outcomes.

Adolescent ; Adult ; Aged ; Antibodies, Monoclonal, Humanized ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bevacizumab ; Female ; Fluorouracil ; therapeutic use ; Humans ; Leucovorin ; therapeutic use ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neovascularization, Pathologic ; drug therapy ; Organoplatinum Compounds ; therapeutic use ; Prospective Studies ; Stomach Neoplasms ; blood supply ; drug therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the influence of enteral administration of carbachol on the intestinal dysfunction of both severely burn patients and rabbits with partial intestinal ischemia/reperfusion (I/R) injury.

METHODSSeventy-five white rabbits were inflicted with I/R injury and randomized into intestinal I/R (I, n=25), carbachol [C, n=25, with 3g/L carbachol (3 mg/kg) injection into duodenum 1 h after SMA occlusion] and sham operation (SO, n=25, with SMA isolation but no occlusion) groups, and 5 other as normal controls. The blood flow of intestinal mucosa was detected before and after SMA occlusion or admission of carbachol. Changes in diamine oxidase (DAO), D-lactate, xylopyranose absorption, blue dextran discharging time were measured at 2, 4, 6, 8, 24, 48, 72 h after SMA occlusion. In addition, eight severe burn patients with TBSA of 84 +/- 12% were enrolled in the study, and carbachol (15 microg/kg) was administered to patients when abdominal distension or bowel sound was lower than 2 times/min, then the number of abdominal distension and bowel sounds per minute were observed.

RESULTSThe blood flow in intestinal mucosa of rabbits without SMA occlusion was (102 +/- 5) PU, reduced to (48 +/- 6) PU after SMA occlusion, and increased to (77 +/- 3) PU after injection of carbachol. The plasma DAO activity and D-lactic acid content in I group began to increase 4 hours after SMA occlusion, and they reached the peak 24 hours after SMA occlusion (4.63 +/- 0.27 U/ml, 7.9 +/- 2.4 mg/L) , after that they decreased gradually, but still higher than the normal value (0.89 +/- 0.14 U/ml, 2.0 +/- 1.1 mg/L, P < 0.05). In carbachol group, data showed the same trends as that in intestine I/R group with lower values, while no obvious changes were in sham operation group (P > 0.05). The content of D-lactic decreased dramatically 2 hours after D-lactic administration in both I and C groups, increased 6 hours after SMA occlusion, then decreased gradually, but it in C group was always higher than normal values, and little fluctuation was in sham operation group. There was no blue dextran discharge 2 hours after SMA occlusion. The discharging distance increased 6 hours later, but it was obviously shorter than the normal value 24 hrs after operation (P < 0.05) , then it returned to normal 48 to 72 hrs after operation. In the C group, blue dextran discharge was found immediately after its injection, with obvious increase in the discharging distance to peak value (43 +/- 6 cm) 6 hours after injury, and returning to normal (28 +/- 3 cm) gradually. In severe burned patients, the bowel sounds was (1.6 +/- 1.1) per minutes before carbachol administration, then increased dramatically to (6.9 +/- 1.7) per minutes 10 mins after administration, reached to a higher level 30 minutes after administration (8.3 +/- 2.4 ) times/min, and it maintained to (6.1 +/- 1.3) times/min 1 hour after administration. Abdominal distension was ameliorated 2 hours after carbachol administration, six patients were able to defecate.

CONCLUSIONEnteral administration of Carbachol can increase the blood flow of intestine mucosa, help to improve the movement, absorption and barrier functions of intestine, and ameliorate intestinal dysfunction in patients with severe burns.

Adolescent ; Adult ; Animals ; Burns ; drug therapy ; physiopathology ; Carbachol ; therapeutic use ; Disease Models, Animal ; Female ; Humans ; Intestinal Mucosa ; blood supply ; metabolism ; Intestines ; physiopathology ; Male ; Rabbits ; Reperfusion Injury ; drug therapy ; physiopathology