Purpose:To study the efficacies and adverse effects of three different regimens in treatment of patients with gastrointestinal adenocarcinoma, which consisted of two doses of CF(20 mg/m 2, 200 mg/m 2) and two methods of administration of 5-Fu (continuous intravenous infusion and two hours per day intravenously) and DDP 20 mg/m 2. Methods:We selected 36 cases with GI adenocarcinoma and randomizedly divided them into A and B groups, who were hospitalized from January 1999 to November 2000. At the same time, 29 cases hospitalized from April 1997 to December 1998 with the same disease were designated as C group (control) . A group: CF 200 mg/(m 2.d) for 5 days, 2 hours intravenously ; 5-Fu 3 g/m 2 , continuous intravenous infusion during 5 days; DDP 20 mg/(m 2.d) for 5 days, 2 hours IV. B group: CF 20mg/(m 2.d) for 5 days, 2 hours, IV.; the dosage and usage of 5-Fu and DDP as A group. C group: CF 200 mg/m 2, usage as A, B groups; 5-Fu 600 mg/(m 2.d) for 5 days, 2 hours; dosage and usage of DDP as A, B groups. One cycle of these regimens consisted of three weeks and they were evaluated after three cycles. Results:There were 8 cases of gastral cancer and 12 of rectal cancer in A group whose response rates were 50% and 41.7% respectively. B group had 7 cases of gastric cancer and 9 cases of rectal cancer, their response rates were 42.9% and 44.4%. C group consisted of 14 cases of gastric cancer and 15 cases of rectal cancer, whose response rates were 35.7%and 40%, respectively. Adverse effects included hematological, renal and bladder and gastrointestinal toxicity. A group was similar to B group. C group had more renal and bladder toxicities(27.5%) and incidence of phlebitis was 34.5%. Conclusions:Combination regimen of low dose of CF, continuous intravenous infusion of 5-Fu and DDP is of better efficacy, tolerance and relative economy, especially suitable for to the elderly patients.

AIM: To analyze the bacterial resistance of clinical isolates in a hospital. METHODS: Susceptibility of 285 strains of G - bacillus and 133 strains of G + bacillus was observed in 18 kinds of antibiotics. RESULTS: Resistance increased in most G - bacilli to the third generation cephalosporin. The resistance rate was 28.4 % in the 74 strains of staphylococcus aureus, and 3.4 % in enterococci to vancomycin. No vancomycin resistant strain was found. Extend spectrum ? lactamases of E.coli and klebsiella (ESBLs) accounted for 34.0 % and 29.7 %, respectively. CONCLUSION: The drug resistance is severe in antibiotics, indicating that susceptibility determination is important in selection of antibiotics.

The outcome of diffuse.Large B-cell lymphoma (DLBCL) has been improved in the last decades and will be raised further with the development of novel agents in the future.Personalized treatment for DLBCL is based on its molecular heterogeneity.Except for concurrent translocation of myc and bcl-2,neither clinical nor biological factor is sufficiently available to be used to guide the deviation of R-CHOP therapy in DLBCL.Gene expression profiling and whole genomic analytic techniques are expected to be important approaches at present to determine personalized treatment for DLBCL.The advance in the field being reported by Laurie H.Sehn from University of British Columbia in the 54 ASH meeting was summarized in the paper.

Proteomics is a new field of research in the post-genomic era,which aims at the expression and functional study of proteins in cells,tissues and organisms.It analyses the vital changes of pathological and physiological processes of life by examining proteins.It can detect low-abundance or low molecular weight proteins and polypeptides which contain rich information about diagnosis,treatment and prognosis of diseases,leading to important breakthrough in the field of basic and clinical researches.It has achieved great progress and displayed a promising future in orthopedic researches.This article reviews the development,the present status of proteomic research and its application in orthopedics.

Objective To evaluate the clinic efficacy and adverse effects of four-weekly pirarubicin combined with COP (CTOP-28) regimen in aggressive non-Hodgkin lymphoma patients with bone marrow involvement. Methods 65 aggressive non-Hodgkin lymphoma cases with bone marrow involvement (BMI)from January 2002 to January 2007 were chosen, who were newly diagnosed according to 2001 World Health Organisition (WHO) classification. The response rate and adverse effects of CTOP-28 regimen were retrospectively compared with standard CHOP-21 regimen in these patients. CHOP-21 regimen:eyclophosphamide 750 mg/m2(day 1), vincristine 1.4 mg/m2 (maximum 2 rag, day 1), adrimycin 50 mg/m2 (day1), prednisene 100 nag (day 1 to 5). CTOP-28 regimen: cyclopbosphamide 750 mg/m2 (day 1, 15), vincristine 1.4 mg/m2 (maximum 2 rag, day 1,8,15,22), pirarubicin 25 mg/m2 (day 1,2 and 15,16), prednisone 40 mg/m2(day 1 to 28). Results The complete remission rate (CRR) in CHOP-21 group was less than in CTOP-28group (40 % vs 80 %, P＜0.05). The incidence of 3 and 4 degree blood toxicity in CTOP-28 was more than in CHOP-21 (100.0 % vs 50.0 %, P ＜0.05), but incidence of 1 and 2 degree cardic toxicity was similar as CHOP-21 (8.57 % vs 10.0 %, P＞0.05) and 3 and 4 degree cardic toxicity did not occurred in both groups.The gastrointestinal, hepatobiliary and renal toxicities at only 1 and 2 degree took place and no difference wasfound between two groups. No therapy-related mortality occurred in these patients. Conclusion CTOP-28regimen is more effective, safer for aggressive non-Hodgkin lymphoma patients with BMI as induction treatment.

Tissue-engineering bone with porous ,betatricalcium phosphate (3-TCP) ceramic and autologous bone marrow mesenchymal stem cells (MSC) was constructed and the effect of this composite on healing of segmental bone defects was investigated. 10-15 ml bone marrow aspirates were harvested from the iliac crest of sheep, and enriched for MSC by density gradient centrifugation over a Percoll cushion (1. 073 g/ml). After cultured and proliferated, tissue-engineering bones were constructed with these,cellS seeded onto porous f-TCP, and then the constructs were implanted in 8 sheep left metatarsus defect (25 mm in length) as experimental group. Porous ,-TCP only were implanted to bridge same size and position defects in 8 sheep as control group, and 25 mm segmental bone defects of left metatarsus were left empty in 4 sheep as blank group. Sheep were sacrificed on the 6th, 12th, and 24th week postoperatively and the implants samples were examined by radiograph, histology, and biomechanical test. The 4 sheep in blank group were sacrificed on the 24th week postoperatively. The results showed that new bone tissues were observed either radiographic or histologically at the defects of experimental group as early as 6th week postoperatively, but not in control group, and osteoid tissue, woven bone and lamellar bone occurred earlier than in control group in which the bone defects were repaired in "creep substitution" way, because of the new bone formed in direct manner without progression through a cartilaginous intermediate. At the 24th week, radiographs and biomechanical test revealed an almost complete repair of the defect of experimental group, only partly in control group. The bone defects in blank group were non-healing at the 24th week. It was concluded that engineering bones constructed with porous -TCP and autologous MSC were capable of repairing segmental bone defects in sheep metatarsus beyond "creep substitution" way and making it healed earlier. Porous ,-TCP being constituted with autologous MSC may be a good option in healing critical segmental bone defects in clinical practice and provide insight for future clinical repair of segmental defect.
Bone Marrow Cells/cytology ; Calcium Phosphates/*pharmacology ; Cells, Cultured ; Fractures, Bone/*therapy ; Implants, Experimental ; Mesenchymal Stem Cells/*cytology ; Metatarsus/*injuries ; Porosity ; Sheep ; Tissue Engineering

Recently, several scoring systems have been proposed to predict remission from type 2 diabetes mellitus (T2DM) after metabolic surgery. The ABCD score was compared to the individualized metabolic surgery (IMS) score in terms of the prediction of long-term T2DM remission; however, which of the two scoring systems is better remains controversial. Thus, Three East Asian countries Metabolic Surgery (TEAMS), which has been organized as a study group since 2016, is conducting a retrospective, international, multi-institutional study to compare the two scoring systems in East Asian obese patients after metabolic surgery. The primary study objective is to compare the ABCD score with the IMS score at 3 and 5 years after sleeve gastrectomy (SG), Roux-en-Y gastric bypass, one anastomosis gastric bypass and SG with duodenojejunal bypass. The secondary objectives include evaluating patients who were good candidates for SG, and adjusting the IMS scoring system for East Asian patients.
Asian Continental Ancestry Group ; Bariatric Surgery ; Diabetes Mellitus, Type 2 ; Gastrectomy ; Gastric Bypass ; Humans ; Retrospective Studies

Tissue-engineering bone with porous β-tricalcium phosphate (β-TCP) ceramic and autologous bone marrow mesenchymal stem cells (MSC) was constructed and the effect of this composite on healing of segmental bone defects was investigated. 10-15 ml bone marrow aspirates were harvested from the iliac crestof sheep, and enriched for MSC by density gradient centrifugation over a Percoll cushion (1. 073 g/ml). After cultured and proliferated, tissue-engineering bones were constructed with these cells seeded onto porous β-TCP, and then the constructs were implanted in 8 sheep left metatarsus defect (25 mm in length) as experimental group. Porous β-TCP only were implanted to bridge same size and position defects in 8 sheep as control group, and 25 mm segmental bone defects of left metatarsus were left empty in 4 sheep as blank group. Sheep were sacrificed on the 6th, 12th, and 24th week postoperatively and the implants samples were examined by radiograph, histology, and biomechanical test. The 4 sheep in blank group were sacrificed on the 24th week postoperatively. The results showed that new bone tissues were observed either radiographic or histologically at the defects of experimental group as early as 6th week postoperatively, but not in control group, and osteoid tissue, woven bone and lamellar bone occurred earlier than in control group in which the bone defects were repaired in "creep substitution" way, because of the new bone formed in direct manner without progression through a cartilaginous intermediate. At the 24th week, radiographs and biomechanical test revealed an almost complete repair of the defect of experimental group, only partly in control group. The bone defects in blank group were non-healing at the 24th week. It was concluded that engineering bones constructed with porous β-TCP and autologous MSC were capable of repairing segmental bone defects in sheep metatarsus beyond "creep substitution" way and making it healed earlier. Porous β-TCP being constituted with autologous MSC may be a good option in healing critical segmental bonedefects in clinical practice and provide insight for future clinical repair of segmental defect.

Objective:To investigate the influence of string-overalls-suture pancreaticojejunostomy on the incidence of postoperative pancreatic fistula (POPF) in pancreaticoduodenectomy (PD) .Methods:Clinical data of 70 cases receiving PD in the Affiliated Zhongshan Hospital of Dalian University from Jan. 2011 to Dec. 2018 were retrospectively studied. All cases were divided into experimental group and control group according to the different ways of pancreaticojejunostomy. Patients in experimental group received string-overalls-suture pancreaticojejunostomy, and those in control group received pancreatic duct jejunal mucosa pancreaticojejunostomy. The 70 cases were performed by the same team. Operative time and the incidence of postoperative complications between the two groups were compared and analyzed.Results:There was no statistical differences between the two groups in general data and intraoperative observations. The total operative time was (4.28±1.10) hours in the control group and (3.62±0.76) hours in the experimental group. It was significantly different between the two groups ( t=2.942, P=0.004) . There were 7 (28.0%) cases of POPF including 6 cases of grade B, and 1 case of grade C in the control group, and 3 (6.7%) cases of grade B in the experimental group. 6 (24.0%) cases had postoperative bleeding in the control group, 7 (15.6%) cases in the experimental group, 8 (32.0%) cases with abdominal infection in control group, and 8 (17.8%) cases in the experimental group. Delayed gastric emptying occurred in 3 (12.0%) cases in the control group, and 4 (8.9%) cases in the experimental group. It was significantly different for POPF between the two groups (χ 2=4.358, P=0.037) . And there were no significant differences for other postoperative complications between the two groups (all P>0.05) . Conclusion:The string-overalls-suture pancreaticojejunostomy has the advantages of simple and quick manipulation, wide indication, safe and reliable pancreaticojejunostomy, and has certain superiorities in shortening operation times and reducing POPF.

Porto-sinusoidal vascular disease (PSVD) is an entity characterized with portal hypertension (PH) in the absence of cirrhosis, the related risk factors, and imaging evidence of obstructed portal vein, hepatic vein and inferior vena cava. Its prevalence varies significantly between East and West countries. Until now, the etiologies have been classified as autoimmune, hematologic, and prethrombotic conditions, infections, toxins or drugs, and genetic or metabolic disorders. However, the definite cause remains unknown. Diagnosis is based on three histopathological features: obliterative portal venopathy, nodular regenerative hyperplasia, and incomplete septal fibrosis. The clinical manifestations of early PSVD are nonspecific, whereas those at a late stage are similar to cirrhosis. The imaging detection mainly reveals the PH signs and complications, but the liver stiffness is normal or slightly increased, necessitating a liver biopsy for PVSD diagnosis. PSVD treatment is similar to liver cirrhosis; however, the prognosis is better. In order to gain a thorough understanding of PSVD, the epidemiology, pathogenesis, clinical diagnosis, and treatment are discussed in this article.