Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Benzamides ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; drug therapy ; surgery ; Gastrointestinal Stromal Tumors ; drug therapy ; secondary ; surgery ; Humans ; Imatinib Mesylate ; Liver Neoplasms ; secondary ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use

Objective To invstigate the diagnostic value of the detection of telomerase activity in the specimen obtained from CT guided percutaneous transthoracic needle biopsy of lung nodules.Methods The techniques of TRAP silver staining were performed to detect telomerase activity in 43 cases. Results 43 mass cases were studied includirg 32 proved to be primary lung cancer, and 11 benign lesions cytologically and clinically. Telomerase activity was detected as 28(87.5%) of 32 lung carcinomas, whereas in benign lung lesions was 1(9.1%) in 11 cases.Conclusions Detection of telomerase activity in the specimen of lung nodules by CT guided percutaneous transthoracic needle biopsy may be an effective method in the diagnosis of lung cancer and also as tumor marker.

Objective To evaluate the preoperative diagnosis and treatment of primary non-specific ureteritis,and to better understand this disease.Methods Three cases of primary non-specific ureteritis (1 man and 2 women)were reported.Their age was 28,38,68 years,respectively.One ease was found to have hydronephrosis on B-ultrasound at physical examination with no symptoms,and 2 had abdominal pain. The lesions were detected in lower part of the ureter in 2 cases,and in middle in I.The patients were diag- nosed preoperatively with combined use of MRU and ureteroscopy.Partial resection of the diseased part of the ureter was performed in all the cases.Results Pathological findings confirmed the diagnosis of non-spe- cific ureteritis.Microscopy showed necrotic tissue and inflammatory cell infiltration of ureteral mucosa,dilated and congested blood vessels,hypertrophic muscular layer,and proliferation of fibrous tissue.During the fol- low-up of 2 years,the patients had no symptoms and were free from hydronephrosis.Conclusions The eti- ology of primary non-specific ureteritis is unclear,and no typical symptoms can be found clinically.Combined use of MRU and ureteroscopy is helpful for definite diagnosis of the disease.Partial resection of the diseased part of the ureter has good results.

Objective To systematically review the existing evidence about the effect of medial and lateral (crossed) entry pins versus only lateral entry pin fixation on the supracondylar fractures of the humerus in children.Methods Eligible studies were identified in Cochrane library,the Cochrane Bone,Joint and Muscle Trauma Group (till March 2011 ),Medline (from 1966 to March 2011 ),EMbase (from 1966 to 2011 ),CBM (from January 1979 to March 2011 ),PubMed,Wanfang Data (from 2000 to March 2011 ) and CNKI and the references of the included studies and several Chinese orthopedic journals were manually searched.Then,the randomized controlled trials (RCTs) and quasi-randomized controlled trials (CCTs) about two entries (crossed and only lateral pinning) for supracondylar fractures of humerus in children were collected.After evaluation of methodology with the enrolled studies,available data was extracted and systematic review was conducted via the method recommended by the Cochrane Collaboration.Results In total,five RCTs involving 311 patients were involved.Compared with the preoperative data,the meta-analysis results showed no significant difference in reduction stability in terms of change in Baumann angle and Carrying angle between the two groups.For the postoperative function outcome including complete reduction,Flynn grade and full return to function,no significant difference was found between the two groups.For the postoperative complications,there was no difference in the infection of pin tract,though lateral entry resulted in a significant lower incidence of the iatrogenic nerve injury compared with the medial and lateral entry.Conclusions With the Kirschner wire fixation for supracondylar fractures of humerus in children,current existing evidences indicate that the lateral entry of pinning has similar results in reduction stability,function outcome and incidence of pin tract infection compared with medial and lateral entry.Nevertheless,lateral entry,as a safe pinning technique,may effectively decrease the risk of iatrogenic nerve injury

Objective To evaluate the effect of digital subtraction angiography and transcatheter embolization for gastrointestinal hemorrhage.Methods Twenty patients with gastrointestinal hemorrhage received celiac arteries,superior mesenteric arteries and inferior mesenteric arteries angiography. Superselective angiography were performed when the arteries were suspicious by clinic or angiogrraphy.Ten patients with definite diagnosis and manifestation of hemorrhagic arteries by angiography were embolized after superseleetive catheterization with gelfoam particles,gelfoam particles and coils,polyvinyl alcohol particles. Results The positive signs were observed in 13 cases.The DSA features including contrast medium accumulation in the gastrointestinal tract outside vascular,aneurysm,tumorous vascularization and staining, artery affect and local vasospasm.The bleedings were stopped immediately in 8 patients.No rebleeding and intestinal ischaemia or necrosis were observed in 30 days.One patient died in the second day after embolization from multiple organ failure.Rebleeding occurred 3 days after embolization in another patient, and was recovered after surgical operation.Conclusion DSA is more effective for the diagnosis of gastrointestinal vascular malformation and tumors complicating acute bleeding.Transcatheter embolization is effective and safe to control the hemorrhage.

Objective To improve the recognition of meconium ileus and pseudohypoaldosteronism type Ⅰ and to explore the relationship between neonatal meconium ileus and cystic fibrosis.Methods The clinical and follow-up data of a premature infant with meconium ileus and pseudohypoaldosteronism type Ⅰ was analyzed.Relevant literature was reviewed.Results The child was a very low-birth weight premature infant who didn′t pass meconuim within 24 hours of birth and persistent abdominal distention was noted.Laparotomy was performed on day 4.Thick and inspissated meconium was found in the ileum with perforation.The atretic intestine was resected,and a double-barreled enterostomies was performed.On day 30,the child presented hyponatremia,hyperkalemia,high levels of plasma renin and aldosterone and was given 9 g/L salt supplementation.At 6-month age,9 g/L salt supplementation was discontinued.Anastomosis was performed at 8-month age.The child recovered with a good prognosis whose catch-up growth was obtained at 18-month age and didn′t pre-sent manifestations of cystic fibrosis.Conclusions This case could be diagnosed as meconium ileus and pseudohypoaldosteronism type Ⅰ.The relationship between neonatal meconium ileus and cystic fibrosis is different in China and the regions of Caucasian.

Objective To study the anti-tumor effects of pEgr-1-endostatin-TNF-α generadiotherapy on mice bearing Lewis lung carcinoma, and to explore the mechanism involved. Methods 240 mice with Lewis lung carcinoma were randomly divided into four groups, including control group,irradiation group, liposome group, and liposome combined irradiation group. The plasmids packed by liposome were injected locally into the tumors of the mice, and the tumors of liposome combined irradiation group were irradiated with 10 Gy γ-rays 24 h later. The expression levels of TNF-α and endostatin in mouse serum were measured by ELISA. Then the tumor growth rates at different time were observed. Tumor angiogenesis density were estimated on frozen sections stained with CD31 by using the Chalkley counting method to vessel hot-spots. The tumor inhibition rates were also calculated. Results Radiation induced the expression of pEgr-1-endostatin-TNFα. The endostatin and TNF-α were expressed steadily for about 4 weeks. The highest levels of expression of the endostatin and TNF-α were (52. 64 ±4. 19)and( 12. 01 ±0. 87 ) ng/ml at 2 week. The expression levels of TNF-α and endostatin were higher in combined therapy group than those in other groups( F = 29. 726,P ＜ 0.05 ). Compared with the control group, the density of tumor angiogenesis were depressed [ (4.7 ± 0. 8 ) vs ( 10.0 ± 1. 2)/field, t = 14. 063, P ＜ 0.05 ] and tumor growth were significantly inhibited compared to the control group and irradiation group [ (5907. 2 ±78.6), (4653.4±32.8) and (763.5 ± 12.3) mm3, F= 16.415,P ＜0.05)]. Conclusions The expression of pEgr-1-endostatin-TNFα could be induced by irradiation in dose- and time-dependent manner. The effect of antitumor and angiogenesis inhibition may be more significant than irradition.

Objective Application of the second metatarpophalangeal joint by traction prolong trans- plant repair the defects in the metacarpophalangeal joint,reconstruct the function of it.Methods By means of the apparatus to prolong finger in advance,then transplant the second metatarpophalangeal joint to recon- struct metacarpophalangeal joint for seven cases of obsolete defects in the metacarpophalangeal joint.Results The average of finger prolong was 2.6 cm,consultation from 1 to 4 years.average 2.5 years,thai the trans- plant joints have all survived and osteal concrescence.Through the criterion Chinese Medical Association,good rate was 85.7%. Conclusion It' s a good method to repair obsolete defects in the metacarpophalangeal joint by transplant traction prolong of the second metatarpophalangeal joint.

OBJECTIVETo evaluate the clinical effect of external tissue expansion in the repair of massive skin and soft tissue defects.

METHODSFrom August 1998 to January 2004, 10 patients with massive skin and soft tissue defects ( the area ranging from 10 cm x 4 cm to 24 cm x 15 cm) , including 7 with wounds in the leg, 2 with wounds in knee region, and 1 with wounds in the forearm, were enrolled in the study. All patients were subjected to external tissue expansion together with external skeletal fixation for 2 -3 weeks, then the wounds were closed with suturing or supplemented with skin flaps.

RESULTSThe defects were closed completely after external expansion in 4 cases, and in other 5 cases the wounds were significantly decreased in area, and the residual wounds were covered with free skin grafting. In I case the wound could only be reduced in size, and the residual wound was closed with a local flap. Follow-up from 1 to 12 months showed that the wounds were closed with normal cutaneous sensation and good appearance.

CONCLUSIONExternal skin expansion is a simple, economical method for repair of massive skin soft-tissue defect, which can significantly be reduced or entirely closed.

Adolescent ; Adult ; Dermatologic Surgical Procedures ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Tissue Expansion ; methods ; Wound Healing ; Young Adult

BACKGROUNDPostoperative preablative stimulated thyroglobulin (ps-Tg) has been evaluated in predicting prognosis and success of ablation regarding differentiated thyroid cancer (DTC); however, its relationship with recurrence risk and radioiodine decision-making remains uncertain, especially in Chinese DTC patients. We aimed to evaluate the association between ps-Tg and recurrence risk stratification in DTC, to provide incremental values for ps-Tg in postoperative assessment and radioiodine management.

METHODSSeven hundred and seven patients with DTC were included; low-risk (L; n = 90), intermediate-risk (I; n = 283), and high-risk (H; n = 334, 117 with distant metastasis [M1]) patients were divided according to recurrence risk stratification. The M1 group was further analyzed regarding evidence of metastasis. Cut-off values of ps-Tg were obtained using receiver operating characteristic analysis.

RESULTSPatients with more advanced disease at initial risk stratification were more likely to have higher ps-Tg levels (I vs. L: P < 0.05; H vs. I: P < 0.001; H vs. L: P < 0.001). The corresponding cut-off value of ps-Tg for distinguishing sensitivity and specificity in each of the two groups was 2.95 ng/ml (I vs. L: 61.5%, 63.3%), 29.5 ng/ml (H vs. I: 41.9%, 92.6%), 47.1 ng/ml (M1 vs. M0 in the H group: 79.5%, 88.9%) and 47.1 ng/ml (M1 vs. M0 in all patients: 79.5%, 93.7%). With the cut-off value at 47.1 ng/ml, ps-Tg was the only factor that could be used to identify distant metastases, and consequently if measured before radioiodine therapy would prevent 10.26% of patients with M1 from undertreatment.

CONCLUSIONSPs-Tg, as an ongoing reassessment marker, favors differential recurrence risk grading and provides incremental values for radioiodine treatment decision-making.

Adult ; Female ; Humans ; Iodine Radioisotopes ; therapeutic use ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Thyroglobulin ; Thyroid Neoplasms ; blood ; pathology ; radiotherapy