Coccidioides ; Coccidioidomycosis ; pathology ; Humans ; Infant ; Male

Objective To evaluate the impacts of the two different gastrectomy methods on the quality of life,complication and prognosis in proximal gastric cancer.Methods One hundred and two cases of proxi-mal gastric cancer in Tung Wah Hospital were collected for retrospective analysis.They were divided into proxi-mal gastrectomy/gastroesophagostomy (PG)group (n =50)and total gastrectomy/esophagojejunostomy (TG) group (n =52),according to the methods of gastrectomy and reconstruction.The postoperative complications, nutritional status and prognosis of the two groups were compared.Results The incidence of reflux esophagitis was obviously higher in PG group than that in TG group (38.0% vs 1 9.2%,χ2 =4.464,P =0.035).No sig-nificant differences were found between the two groups in the incidences of postoperative infection,bleeding and anastomotic leakage (χ2 =0.063,P =1 .000;χ2 =0.001 ,P =0.978;χ2 =0.31 1 ,P =0.577).There were no significant differences between PG and TG group in total plasma protein [(65.26 ±4.1 0)g/L vs (65.33 ± 3.75)g/L,t =-0.402,P =0.688],albumin [(39.76 ±2.1 7)g/L vs (39.59 ±2.04)g/L,t =1 .778,P =0.076],hemoglobin [(1 07.33 ±1 1 .1 0)g/L vs (1 08.09 ±1 1 .1 7)g/L,t =-1 .502,P =0.1 33]and weight loss [1 .00 ~8.00 kg vs 0.50 ~8.20 kg,t =-1 .622,P =0.1 05]in one year postoperatively.All cases were followed-up for 7 months to 1 0 years.No significant differences were found between PG and TG group in the incidences of anastomotic tumor recurrence (4.0% vs 5.8%,χ2 =0.1 71 ,P =0.679),metastasis (24.0% vs 28.8%,χ2 =0.308,P =0.579)and median survival time (53.6 months vs 49.8 months,χ2 =2.564,P =0.1 09).Conclusion Compared with PG group,the incidence of postoperative reflux esophagitis is effectively reduced,and the incidences of malnutrition,tumor recurrence and metastasis and death are not increased in TG group.Hence,TG should be a safe and effective surgery strategy.

OBJECTIVETo investigate the safe and effective treatment for painful venous malformation (VM) in limbs.

METHOD(1) 97 cases with painful VM underwent MRI to detect the location of VM, as well as its size and structure, its relationship with the surrounding tissue. Statistical analysis was also performed. (2) The embolic agent (ethanol) was first injected to embolize the draining vessels of VM, then the Polidocanol plus Methotrexate (MTX) was followed to keep the embolization effect on VM. The therapeutic effect was observed and analyzed.

RESULTSFrom January 2010 to January 2012, 97 patients with painful VM were treated. A Spearman correlation analysis showed no significant correlation between symptoms of pain and lesion growth, volume, or MRI grades (P > 0.05). The lesions in the muscle space are more likely to have the symptoms of pain (P < 0.01), followed by the lesions in the muscle, then the lesions in the joint and subcutaneous tissue. The pain relieve percentage was 95.9% (93/97) after one time embolic sclerotherapy. No severe complication, such as distant embolization, nerve damage, or muscle atrophy happened. No pain reoccurrence happened after 0.5-1.5 years of follow-up period.

CONCLUSIONSThe treatment of embolic scleratherapy is minimal invasive, safe and effective for painful VM with stable results.

Ethanol ; therapeutic use ; Extremities ; blood supply ; Humans ; Methotrexate ; therapeutic use ; Pain ; etiology ; Pain Management ; methods ; Polyethylene Glycols ; therapeutic use ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; methods ; Statistics, Nonparametric ; Vascular Malformations ; complications ; pathology ; therapy ; Veins ; abnormalities

Objective To study the changes of the transient outward K+ current (Ito),delayed rectifier K+ current(IkDR) and the inward rectifier K+ current(Ik1) of the rat bone mesenchymal stem cells (MSCs) induced by 5-Azacytidine(5-Aza) during proliferating and differentiating process in vitro. Methods MSCs were cultured according to related articles for two weeks and then some of the cells were induced by 5-Azacytidine.The experiment was divided into uninduced(cultured for 6w) and induced(1,2,3 and 4w) cell groups. Each week had twenty cells random tested by the whole-cell patch clamp technology and the K+ currents were identified by corresponding ionic blockers.Results The detection rate of the same type of K+ current during test weeks had no significant deviation;The three types of K+ current intensity were gradually augmented after being inducing cultured for 1,2,3 and 4 weeks(P

Recently the maintenance therapy of non-small-cell lung cancer (NSCLC) patients who completed required treatment cycles has caused widespread interests in the medical field. Traditional Chinese medicine may be a useful complement in maintenance treatment of mid-to-late stage NSCLC.

OBJECTIVETo summarize the management of infant vascular tumors with Kasabach-Merritt phenomenon (KMP) and to evaluate the effect of drug combined with sclerotherapy.

METHODSFrom Feb. 2007 to Nov. 2014, 25 cases with KMP, who underwent drug therapy combined with sclerotherapy, were retrospectively studied. Oral corticosteroids (2 mg/kg per day) was used as the first-line therapy on all of the patients and intravenous vincristine (1.5 mg/m2 every week) was added when the platelet counts didn't recover obviously after 2-3 weeks. After the recovery of the platelet counts, the patients were admitted for sclerotherapy (average, 4.56 sessions per case) with 100% alcohol (1-3 ml per session), Lauromacrogol (1.25-5 ml per session) and betamethasone (0.25-1 ml per session). All the patients were followed up for 42 months ( range, 9 months to 6.5 years). Therapeutic outcomes were assessed by evaluating platelet counts, size of lesion, function of trunk and limb.

RESULTSAll the 25 cases got obvious recovery in the platelet counts [average, (94.3 ± 18.5) x 10(9)/L] after drug therapy, of which 16 were treated by single oral corticosteroids for 4-7 weeks and 9 were treated by corticosteroids plus intravenous vincristine for 2-5 weeks. Meantime, 11 cases received platelet transfusions, of which 3 were coupled with gamma globulin intramuscularly. During the first admission, each of the 25 cases received 1-4 sessions of sclerotherapy (average, 2.6 sessions each case). One week after the sclerotherapy, the platelet counts returned to (167-312) x 10(9)/L (average, (258.5 ± 34.4) x 10(9)/L). The hemoglobin and blood coagulation function returned to normal within 1-5 weeks. Meanwhile the mental condition, appetite, body weight, sleeping were greatly improved. The size of the lesions decreased gradually after the combined therapy including 13 cases within 3-12 months and 13 cases within 13-36 months. Long term follow-up indicated that only 1 case need treatment for recurrent decrease of platelet counts, and all of the 25 cases kept the normal weight, height, immunity as well as the growing development.

CONCLUSIONSOral corticosteroids plus intravenous vincristine combined with sclerotherapy is a reliable management with high cure rate, short course and minor side-effect.

Administration, Oral ; Betamethasone ; administration & dosage ; Combined Modality Therapy ; methods ; Ethanol ; administration & dosage ; Glucocorticoids ; administration & dosage ; Humans ; Infant ; Injections, Intravenous ; Kasabach-Merritt Syndrome ; blood ; therapy ; Platelet Count ; Polyethylene Glycols ; administration & dosage ; Retrospective Studies ; Sclerotherapy ; methods ; Vincristine ; administration & dosage

BACKGROUND:Three-dimensional (3D) printing technology is currently one of the most advanced industrial manufacturing technologies. The surgical template prepared based on the 3D printing technology is mainly made of resin, and a great improvement in its accuracy is required. However, the clinical application of the surgical template made of metal is rarely reported. OBJECTIVE:To evaluate the clinical value of 3D-printing implant template in the restoration of free-end missing teeth.METHODS:A prospective study was conducted in 64 enrolled patients with free end-tooth defects. All the patients were randomly assigned to receive traditional implant template (control group,n=32) or 3D-printing implant template (study group,n=32), and 3-6 months later, the patients were subjected to crown restoration. At 6 months after crown restoration, cone beam computed tomography was performed to compare the deviation of the implant tip and neck (including vertical, buccolingual, mesial-distal). Success rate and chewing rate were compared between the two groups at 6 months after crown restoration; patient satisfaction assessment was done and compared between the two groups at 1 year after crown restoration. RESULTS AND CONCLUSION:There were no significant differences between the two groups in the success rate and chewing rate (98.7％ vs. 95.6％; 97.4％ vs. 97.1％,P>0.05). The vertical, buccolingual, mesial-distal deviations of the implant tip were significantly lower in the study group than the control group (P<0.05), while there was no difference in the vertical and buccolingual deviations of the implant neck between the two groups (P>0.05), and the mesial-distal deviation of the implant neck was significantly lower in the study group than the control group (P<0.05). In addition, there was no difference in the patient satisfaction between the study and control groups (94％vs. 91％, P>0.05). To conclude, the 3D printing implant template can effectively reduce implant excursion based on the assurance of therapeutic efficacy and patient satisfaction, which is of great significance in the restoration of free-end tooth loss.

BACKGROUND: Proximal femoral nail anti-rotation is widely used to treat various intertrochanteric fractures. Although its operation trauma is small, and the blood loss of perioperative period is still large. Tranexamic acid has been gradually used to reduce the bleeding of intertrochanteric fracture. The effectiveness and safety of reducing blood loss during perioperative period were not reported. OBJECTIVE: To explore the safety and efficacy of tranexamic acid on perioperative blood loss in patients with intertrochanteric fracture undergoing proximal femoral nail anti-rotation. METHODS: One hundred and eight patients with intertrochanteric fracture undergoing proximal femoral nail anti-rotation were selected from First Affiliated Hospital, Guangzhou University of Chinese Medicine between January 2015 and January 2017. Among all the subjects, 52 patients who received the operation before January 2016 served as the control group and 56 patients who received the operation after January 2016 were selected as the treatment group. Half an hour before operation, patients in the treatment group received 1 g tranexamic acid dissolved in 250 mL normal saline by intravenous dropping; patients in the control group just received 250 mL normal saline by intravenous dropping. The bleeding volume, blood transfusion volume, hemoglobin, hematocrit, coagulation index, D-dimer levels and complications were compared between the two groups. RESULTS AND CONCLUSION: (1) During perioperative period, actual blood loss, intraoperative blood loss, dominant blood loss, recessive blood loss, volume of drainage, blood transfusion volume and blood transfusion rate were lower in the treatment group than in the control group (P < 0.05). (2) There was no statistically significant difference in the hemoglobin and hematocrit between the two groups before operation (P > 0.05). The hemoglobin and hematocrit of the two groups gradually decreased after the operation, and there was a slight improvement in the fifth day after surgery. At postoperative 2 hours, 1, 3 and 5 days, the hemoglobin and hematocrit of the treatment group were higher than in the control group (P < 0.05). At preoperation and each time point postoperation, prothrombin time, activated partial thromboplastin time, and fibrinogen levels were not statistically significant between the two groups (P > 0.05). Postoperative D-dimer levels in the two groups were significantly higher than preoperation, and there was a return on the fifth day. There was no statistically significant difference between groups at preoperation and each time point of postoperation (P > 0.05). (3) The results suggest that the tranexamic acid can effectively reduce the dominant and recessive blood loss in patients with the intertrochanteric fracture, and it is safe and effective.

OBJECTIVE: To study the effect of glutamine-supplemented enteral nutrition in regulating the apoptosis of intestinal mucosal cells and promoting mucosal healing in young rats with inflammatory bowl disease (IBD). METHODS: A total of 80 male Sprague-Dawley rats aged 4-5 weeks were randomly divided into 4 groups: blank control, IBD model, short peptide, and short peptide+glutamine (n=20 each). The IBD model was prepared by a single colon perfusion of 3-nitrobenzene sulfonic acid. At 3 days after modeling, the rats in the short peptide group were fed with short peptide formula (100 mL/kg), and those in the short peptide+glutamine group were fed with short peptide formula (100 mL/kg) and glutamine (0.5 g/kg). The course of intervention was 1 week. General conditions were observed after the experiment and their intestinal mucosal tissue was obtained. Hematoxylin-eosin staining was used to observe the pathological change of the intestinal mucosa. RT-PCR was used to measure the expression of apoptosis-regulating genes (bax and bc1-2) and apoptotic signal transduction factors (Caspase-3 and Caspase-9) in the intestinal mucosa. Western blot was used to measure the expression of insulin-like growth factor-1 (IGF-1) in the colonic mucosa. RESULTS: The IBD model group had poorer general conditions than the other three groups (blank control, short peptide and short peptide+glutamine), and the short peptide+glutamine group had better general conditions than the IBD model and short peptide groups. The IBD model group had significantly higher mRNA expression of bax than the other three groups (P<0.05). There was no significant difference in the mRNA expression of bcl-2, Caspase-3 and Caspase-9 among the 4 groups (P>0.05). The short peptide group had a significantly higher level of IGF-1 than the short peptide+glutamine, blank control and IBD model groups (P<0.05). CONCLUSIONS Glutamine-supplemented enteral nutrition can effectively improve the general nutritional status of young rats with IBD, but it is not better than exclusive enteral nutrition in inhibiting the apoptosis of colonic mucosal cells and stimulating the synthesis of IGF-1 in the intestinal mucosa.
Animals ; Apoptosis ; Enteral Nutrition ; Glutamine ; Intestinal Mucosa ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the efficacy of the combination of gemcitabine with capecitabine in the chemotherapy for patients with relapsed or metastatic biliary tract carcinoma.

METHODSForty-one patients with unresectable relapsed or metastatic carcinoma of the biliary tract were treated from March 2000 to December 2004. The regimen consisted of intravenous administration of gemcitabine plus oral intake of capecitabine every 3 weeks for more than 2 cycles. The parameters including tumor response, clinical benefit rate,survival and safety were observed.

RESULTSThirty-six patients were valuable and 5 patients were excluded from this series due to various reasons. Eleven patients (30.1%) had a partial response and another 11 patients (30.1%) experieced stable disease with a clinical benefit rates of 61.1%. The median overall survival time and time to progression were 10 months and 6 months, respectively. The one-year survival rate was 40.0%. The adverse events including nausea, diarrhea and hand-foot syndrome, fatigue, neutropenia, thrombocytopenia were frequently observed, which were usually in grade I or II, rarely in grade III and none in grade IV (NCI-CTC).

CONCLUSIONOur results show that the regimen of gemcitabine combined with capecitabine is effective and well tolerated in patients with unresectable relapsed or metastatic carcinoma of the biliary tract.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Bile Duct Neoplasms ; drug therapy ; pathology ; Bile Ducts, Intrahepatic ; Capecitabine ; Cholangiocarcinoma ; drug therapy ; pathology ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Diarrhea ; chemically induced ; Female ; Fluorouracil ; administration & dosage ; analogs & derivatives ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nausea ; chemically induced ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neutropenia ; chemically induced ; Remission Induction ; Survival Rate