Carcinoma, Hepatocellular ; pathology ; therapy ; Humans ; Liver Neoplasms ; pathology ; therapy ; Neoplasm Metastasis ; Neoplasm Recurrence, Local

China ; Combined Modality Therapy ; Evidence-Based Medicine ; Humans ; Liver Neoplasms ; diagnosis ; pathology ; prevention & control ; therapy ; Medicine, Chinese Traditional ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Remission Induction ; Survival Rate

Humans ; Integrative Medicine ; trends ; Medical Oncology ; trends ; Medicine, Chinese Traditional ; trends ; Neoplasms ; therapy

Carcinoma, Hepatocellular ; Humans ; Liver Neoplasms

Objective:To investigate the value of biopsies on diagnosing cervical intraepithelial neoplasia of grade 2 or worse (CIN Ⅱ +), and optimize biopsy procedures of risk-based colposcopy practice. Methods:A prospective study was performed on 346 women referred to colposcopy following abnormal cervical cancer screening results at the First Affiliated Hospital of Nanjing Medical University, from April 2017 to December 2019. Up to 4 cervical biopsies were taken during colposcopy and each biopsy specimen was evaluated separately in histology. CIN Ⅱ + identified by any biopsy was the reference standard of disease used to evaluate the diagnostic value of targeted biopsy and random biopsy, and to quantify the improved detection of CIN Ⅱ + by taking multiple biopsies. Cervical cytology, HPV genotyping, and colposcopic impression were used to establish different risk strata to select various multiple biopsies procedures during colposcopy to improve accuracy and efficiency of CIN Ⅱ + detection. Results:In total 346 women, 190 (54.9%, 190/346) cases of them were diagnosed as CIN Ⅱ +. (1) In total 346 women, 96.8% (184/190) CIN Ⅱ + were detected by targeted biopsies, 27.9% (53/190) CIN Ⅱ + were detected in biopsies targeted grade 1 abnormal colposcopic findings (G1) on the cervix, and 68.9% (131/190) CIN Ⅱ + were detected in biopsies targetrd grade 2 abnormal colposcopic findings (G2) on the cervix. Colposcopy had a sensitivity of 68.9% when the biopsy threshold was G2, sensitivity increased to 96.8% when the biopsy threshold was defined to be G1. Among women with G1, adding 2 targeted biopsies to the first biopsy were sufficient to detect all CIN Ⅱ +, among women with G2, adding 1 targeted biopsy was sufficient. (2) Among 270 women, random biopsies targeted normal colposcopic findings on the cervix were performed in addition to targeted biopsies and in total 3.2% (6/190) additional CIN Ⅱ + were detected. As the number of cervical quadrants involved by abnormal colposcopic images increased, random biopsy detected fewer CIN Ⅱ + that would have otherwise been missed by targeted biopsies ( P=0.010). (3) Women with atypical squamous cells,cannot exclude high grade squamous intraepithelial lesion (ASC-H), high grade squamous intraepithelial lesion (HSIL) or atypical glandular cell (AGC) referral cytology, HPV 16-positive, G2 were more likely to have CIN Ⅱ +( P<0.01); for those meeting only one category, the yield of CIN Ⅱ + increased from 34.0% for one biopsy to 51.0% for two biopsies, the absolute increase in CIN Ⅱ + yield increased from the first to the second biopsy was 17.0%, two biopsies were sufficient to detect all CIN Ⅱ +; for those meeting at least two categories, the yield of CIN Ⅱ + increased from 90.7% for one biopsy to 92.6% for two biopsies, the absolute increase in CIN Ⅱ + yield increased from the first to the second biopsy was 1.9%, two biopsies were sufficient to detect all CIN Ⅱ +; for those not meeting any category, the yield of CIN Ⅱ + increased from 8.8% for one biopsy to 17.6% for two biopsies, to 23.5% for three biopsies, the absolute increase in CIN Ⅱ + yield increased from the first to the second biopsy, from the second to the third biopsy was 8.8%, 5.9%, three biopsies were sufficient to detect all CIN Ⅱ +. Conclusions:Performing multiple targeted biopsies could improve efficiency of CIN Ⅱ + detection. Adding random biopsies to multiple targeted biopsies showed very limited additional benefit for detection of CIN Ⅱ +. The biopsy procedures undertaken during the colposcopy visit could be modified based on various colposcopic impressions and reasons for referral.

Objective:To investigate the clinical value of emergency cervical cerclage combined mesh patch suture in the treatment of cervical incompetence.Methods:From January 2011 to August 2016 in our hospital 65 cases of pregnant women with inevitable abortion,32 cases of they had carried out emergency cervical cerclage combined mesh patch suture(group A),33 cases of they had carried out cervical cerclage only(group B),The prolongation of gestation time,delivery gestational age,neonatal outcome,delivery mode and postoperative complications were compared between the two groups.Results:The operation time of A group was higher than that of group B,surgical complications of cervical laceration in group A was less than B group,the difference was statistically significant(P ＜ 0.05);there was no significant difference in the incidence of chorioamnionitis between the two groups(P＞0.05);the gestational age of group A was extended to 84.45 ±35.77 days,and the gestational age of B group was extended to 51.86 ±29.93 days,there was statistically significant difference between the two groups(P＜0.05);there was more than 28 weeks delivery in 23 cases(71.88％) in group A,and 17 cases (51.52％) in group B,the difference was statistically significant(P ＜ 0.05);there were no statistically significant differences in the delivery mode between the two groups(P ＞ 0.05);neonatal birth weight,birth Apgar 1 minutes score of group B were significantly lower than those of group A,the difference was statistically significant (P ＜0.05).Conclusions:Emergency cervical cerclage combined mesh patch suture can effectively prolong the gestational age,improve neonatal outcome,no obvious complication and has certain clinical applicative value.

[Objective]To compare the osteoinductive activity of calcium sulfate(CS),allogenetic demineralized bone materials(ADBM) and heterogenetic demineralized bone materials(HDBM) by observing their efficiency in inducing bone formation.[Method]CS,ADBM and HDBM were transplanted into thigh muscle pouches of mice.Thirty-six mature Sprague-Dawly mice were divided into 2 groups at random.CS was transplanted into the left(group A 1,n=9) and ADBM into the right(group A2,n=9) thigh muscle pouches.HDBM was transplanted into the left thigh muscle pouches(group B 1,n=9) and the right sites were taken as blank controls(group B2,n=9).Experiments were done to induce ectopic bone formation.At 2,4,6 weeks postoperatively,specimen were collected to evaluate gross and tissue structures and biochemical tests for alkaline phosphatase(ALP) and Ca2+ so that osteoinductive activities of different bone graft materials could be assessed.[Result]At 2 weeks postoperativly,ADBM and HDBM were wrapped up by fibrous tissues and stromal cells gathering around the DBM slices.At 4 weeks postoperativly,formation of cartilage and osteoblasts were observed,and at 6 weeks,materials like cartilage matrix were observed to grow.The concentration of ALP and Ca2+ in study groups was higher than that of control group,which meant that 2 types of DBM had osteogenic potential and that the differences of osteogenetie potential in ADBM and HDBM relied on the donors,whereas CS could be degraded and absorbed fast with light inflammatory reaction and no ectopic bone formation was observed in CS graft.[Conclusion]Both ADBM and HDBM have osteoinductive potential.ADBM is better in inducing ectopic bone formation than HDBM.Differences in donors and preparation of ADBM and HDBM have impacts on their abilities of inducing ectopic bone formation.CS is good at biocompatibility and could be used as bulking agents to repair bone defects.

Brain metastasis is among the most common complications of non-small celllung cancer (NSCLC) and may obviously influence the survival and quality of life in the NSCLC patients. Recently, the development in traditional treatments, the widely-used micro-molecular targeted drugs, and the combined treatment have improved the overall survival and the quality of life of these patients. In addition, the exploration of new therapeutic targets and cognitive function protective methods for current treatments also deserves at-tention. This review emphasizes the relevant clinical and basic problems and the therapeutic strategies in NSCLC with brain metastases.

OBJECTIVETo compare the difference in the clinical efficacy on post-stroke insomnia between the low-frequency electric stimulation at the acupoints and the conventional western medication.

METHODSOne hundred and twenty patients of post-stroke insomnia were randomized into a low-frequency electric stimulation group, a medication group and a placebo group, 40 cases in each one. In the low-frequency electric stimulation group, the low-frequency electric-pulsing apparatus was used at Dazhui (GV 14) and Shenshu (BL 23), once a day; the treatment of 15 days made one session and 2 sessions were required. In the medication group, estazolam was taken orally, 1 mg each time. In the placebo group, starch capsules were taken orally, 1 capsule each time. All the drugs were taken before sleep every night, continuously for 15 days as one session, and 2 sessions were required. PSQI changes and clinical efficacy were observed before and after treatment in each group.

RESULTSPitlsburgh sleep quality index (PSQI) score was reduced in every group after treatment (all P < 0.01). In the low-frequency electric stimulation group and medication group, the score was reduced much more significantly as compared with the placebo group (both P < 0.01). In the placebo group, 1 case was rejected. The total effective rates were 95.0% (38/40), 92.5% (37/40) and 17.9% (7/39) in the low-frequency electric stimulation group, medication group and placebo group separately. The efficacy in the low-frequency electric stimulation group and medication group was better apparently than that in the placebo group (both P < 0.01).

CONCLUSIONThe low-frequency electric stimulation at the acupoints effectively and safely treats post-stroke insomnia and the efficacy of it is similar to that of estazolam.

Acupuncture Points ; Aged ; Aged, 80 and over ; Electric Stimulation ; Female ; Humans ; Male ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; etiology ; therapy ; Stroke ; complications ; Treatment Outcome

According to the causes and pathogenesis of lung cancer in traditional medicine,the principle of syndrome differentiation and treatment,the research achievements of modern medicine,we discuss the idea and method of syndrome differentiation and treatment of lung cancer by integrated traditional and western medicine.We believe the treatment of lung cancer can be taken from several aspects:strengthening body essence and eliminating pathogen;individualized treatment according to the principle of syndrome differentiation and treatment;combining differential symptoms and diagnosis of diseases according to achievements of lung cancer treatment in traditional medicine;choosing suitable treatment by integrated traditional and western medicine considering the different stage of lung cancer.