1.Dynamic hip screw and proximal femoral nail anti-rotation,in the treatment of femoral intertrochanteric fracture of 90 cases
Gang LIU ; Jinxing LIU ; Zhongfa ZHANG
Clinical Medicine of China 2013;(6):622-625
Objective To compare the treatment effects of senile intertrochanteric fracture with the dynamic hip screw(DHS),proximal femur locking compression plate (LCP),anti-spin femur proximal femoral nail(PFNA).Methods Ninety cases of femoral rotor fracture patients were treat in our hospital from September 2010 to March 2012 by DHS(n =30),LCP(n =30) and PFNA(n =30) treatment of femoral intertrochanteric fractures.We compared the surgical time,blood loss,fracture healing time,postoperative complications and hip function scores.Results In DHS,LCP and PFNA group,the blood loss ((287.1 ± 72.0) ml,(214.9 ± 65.8)ml,(85.0 ± 33.6) ml,F =88.7,P < 0.05),the operative time ((1.51 ± 0.07) h,(1.49 ± 0.04) h,(0.70 ±0.10) h,F =445.8,P < 0.05),and both were significant difference.But the fracture healing time ((15.2 ±1.7) weeks,(17.0 ± 1.4) weeks,(15.9 ± 1.8) weeks,F =1.4,P > 0.05),there was no significant difference.The PFNA group had a good hip Sander' score of 96.7%,better than other two groups (87.5%、96.8%) (x2 =39.06,P <0.05).The weight-beating time of PFNA group is earlier than the other two groups ((1.00±0.36) cm,(0.80±0.12) cm,(0.60±0.19) cm,F=30.4,P<0.05).Conclusion PFNAinthe treatment of femoral intertrochanteric fracture has advantages in minimally invasive,less blood loss,and help patients go through the perioperative period.
2.Progress of Study on the Relationship between Indoor Air Formaldehyde Pollution and Leukemia
Zhongfa JIANG ; Wenju YUAN ; Benyan ZHANG
Journal of Environment and Health 1993;0(03):-
Leukemia is one of the common tumors,and it seriously harms to the health.The more serious environmental pollutions become,the more people pay attention to the relationship between environmental exposures and leukemia,especially children leukemia.To discuss the progress of study on formaldehyde and leukemia,this study states the characteristics of formaldehyde,the resources of formaldehyde indoor air and the harms to health,toxicity and human cancinogenicity,and reviews the researches on the relationship between formaldehyde and leukemia.It concludes that there is "strong but not sufficient evidence for a causal association between leukemia and occupational exposure to formaldehyde".
3.Effects on DNA-Protein Crosslinks Induced by Formaldehyde in A549 Cell Lines
Zhongfa JIANG ; Jianguo HU ; Ling ZHANG
Journal of Environment and Health 2007;0(10):-
0.05).Conclusion The study suggests that the coefficient of DNA-protein crosslinks can be increased significantly by higher concentrations of FA in A549 cell lines.DPC induced by FA could be repaired.
4.The follow-up study of image guided 125I seed permanent brachytherapy for the treatment of unresectable pancreatic cancer
Hongxin NIU ; Xikun ZHANG ; Zhongfa XU ; Zhao ZHOU
Chinese Journal of General Surgery 2015;30(6):432-435
Objective To explore the clinical efficacy of image-guided 125I radioactive seed interstitial implantation therapy for unresectable pancreatic cancer.Methods 25 patients with unresectable pancreatic cancer evaluated by retrospective follow-up were enrolled in this study,13 patients received radioactive seeds implantation while 12 patients were given non-surgical treatment.We observe and compare the clinical benefits,objective curative effect,complications,adverse reaction,survival between the two groups of patients.Results Compared with the non-surgical treatment group,the clinical benefit rate in the radiotherapy seed implantation group was 92% (12/13) while that of the non-surgical group was 42% (5/12),the difference was of statistically significance.The numbers of cases evaluated as effective were 6 (46%) and 4 (33 %) respectively,the difference was not statistical significant (x2 =0.427,P > 0.05);The radioactive seed implantation group had no serious postoperative complications;3 cases who received subsequent chemotherapy in radioactive seed implantation group(23%,3/13) and 3 cases in non-surgical treatment group(25%,3/12)suffered from serious adverse reactions,the difference was of no statistical significance(x2 =0.013,P >0.05);Comparing the survival rate between the two groups,x2 =0.001,P =0.969,the difference was of no statistical significance.Conclusions The therapy of 125I radioactive seed implantation for unresectable pancreatic cancer significantly relieves cancer caused pain and improves quality of life.
5.Clinical analysis of female occult breast cancer with axillary neck node metastasis and literature reviews
Mei ZHANG ; Zhongfa XU ; Yang TAO ; Liansheng NING ; Yang YU ; Wenchuan ZHAO
Chinese Journal of Postgraduates of Medicine 2008;31(35):13-15
Objective To investigate the characteristic,diagnosis,clinical staging, treatment and clinical prognosis of occult breast carcinoma (OBC). Method Forty-six cases of OBC were analyzed retrospectively with the clinical and follow-up information that were confirmed by postoperative pathologic diagnosis from November 1981 to November 2005. Results All patients showed axillary node enlargement as the first sign and were operated.The operation included axillary node excision in 2 patients,radical mastec-tomy or modified radical mastectomy in 44 patients. Forty-five cases got follow-up for 1-22 years,33 cases had existed 3 years,18 cases had existed 5 years,8 cases had existed 10 years. Conclusions For axillary mass which causes are uncertain ,the possibility of OBC should be considered .Meanwhile excision and pathological examination is necessary.The metastatic histological structure and immunohistochemical index of the axillary nodes usually provide important clue for the source of this tumor.Radical or modified mastectomy is the best method, and pest-operative chemotherapy and/or radiotherapy should be done. It has been showed that targeted therapy is very important to breast cancer with C-erbB-2 positive recently.To the cases that neck lymphatic metastasis is M4G3 positive by immunohistochemical examination and no primary focus clinically, the diagnosis of OBC should be considered. The cases without primary focus have better prognosis than those with primary focus.
6.Evaluation of clinical efficacy of single-unit unrelated umbilical cord blood transplantation based on umbilical cord blood provided by China's public cord blood bank
Jianjun LI ; Huilan LIU ; Xiaoyu ZHU ; Baolin TAO ; Kaidi SONG ; Changcheng ZHENG ; Liangquan GENG ; Juan TONG ; Lei ZHANG ; Xuhan ZHANG ; Wei WEI ; Wei LU ; Feng ZHOU ; Jieying WU ; Qiang CHEN ; Yasheng YU ; Zhongfa JIANG ; Junye YANG ; Zimin SUN
Chinese Journal of Organ Transplantation 2017;38(2):84-89
Objective To study the curative efficacy and safety of single-unit umbilical cord blood transplantation (sUCBT) for malignant hematologic diseases,which is provided by China's public cord blood bank.Methods We retrospectively analyzed 409 cases of malignant hematologic diseases who accepted myeloablative single-unit unrelated donor UCBT without ATG at our center between May 2008 and December 2016.A comparative analysis was made on the total nuclear cells (TNC) of the umbilical cord blood before freezing and after thawing,the cells of CD34+,the recovery rate of cells and the clinical effect of UCBT.Result 409 units of umbilical cord blood used in UCBT respectively came from eight China's public cord blood banks.The average TNC of 409 units of umbilical cord blood before freezing and after the tubular recovery were respectively 18.5 × 108 and 16.34 × 108 (p =0.000).The average recovery rate of the tubular recovery was 88.5%,and there was significant difference among cord blood banks (P =0.000).The average TNC of umbilical cord blood before freezing and transfusion were respectively 18.5 × 108 and 15.86 × 108 (p =0.000).The average recovery rate of umbilical cord blood transfusion was 85.9%,with the difference being significant among cord blood banks (P =0.000).The average number of CD34+ cells before freezing and after the tubular recovery was 11.18 × 106and 8.68 × 106 (p =0.000).The average recovery rate of CD34+ cells after the tubular recovery was 80.75 %,with the difference being significant among the cord blood banks (P =0.000).At 42nd day after UCBT,the cumulative incidence of neutrophil engraftment was 95.4%,and the median time of the engraftment was 17 days (11-38 days).The cumulative incidence of platelet engraftment at 120th day was 84.6%,and the median time of the engraftment was 36 days (14-93 days).The cumulative incidence of erythrocyte engraftment at 60th day was 92%,and the median time of engraftment was 22 days (9d-60 days).After the umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of engraftment.The P values for cumulative incidence of neutrophil,platelet and erythrocyte engraftment were respectively 0.004,0.01 and 0.000 2,with the differences being statistically significant.At 100th day after UCBT,the cumulative incidence of Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees of acute graft-versus-host disease (aGVHD) was respectively 28.63% and 15.7%.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of aGVHD.There was no significant difference between Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees (P =0.809 and 0.68 respectively).At 3rd year after UCBT,the cumulative incidence of relapse was 15.89%.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the cumulative incidence of relapse (P =0.898).At 3rd year after UCBT,the overall survival (OS) rate and disease free survival (DFS) rate were respectively 66.7% and 59%.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in OS and DFS.There was no significant difference in OS and DFS (P =0.566 and 0.703 respectively).At 3rd year after sUCBT,the rate of graft-versus-host diseases/relapse-free survival (GRFS) was 54.3%.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the rate of GRFS (P =0.449).Conclusion The umbilical cord blood provided by China's public cord blood bank was used in UCBT.It has a high safety and good efficacy in treating malignant hematologic diseases.But it needs to set up the standardized and normalized quality-control system of umbilical cord blood for China's public cord blood bank.
7.Risk factors for bleeding events in patients with cirrhosis-associate esophageal and gastric varices
Xue Bai ; Xiaoyan Liu ; Wenjun Du ; Zhongfa Zhang
Acta Universitatis Medicinalis Anhui 2024;59(1):149-153
Objective :
To detect the risk factors for bleeding in patients with cirrhosis and esophageal and gastric varices (EGV) and better understand the potentially life-threatening complications.
Methods :
Retrospectively, and a total of 309 patients with cirrhosis and EGV were enrolled in this study and were divided into the observation group and control based on EGV bleeding or not.Meanwhile,the patients'epidemiological,clinical,laboratory, and radiological characteristics were collected and analyzed to construct a prediction model.The bootstrap method could be used to validate predictive models and the ROC curves to evaluate its forecasting ability.
Results :
High- density lipoprotein (HDL) (P<0. 001,OR = 0. 131,95% CI = 0. 049-0. 350) ,C-reactive protein ( CRP) (P = 0. 010,OR = 2. 657,95% CI = 1. 269-5. 563) ,the width of portal vein (PVW) (P = 0. 050,OR = 1. 156,95% CI = 1. 000 -1. 336) ,the thickness of spleen (P = 0. 035,OR = 1. 492,95% CI = 1. 028 -2. 165) ,Child-Pugh grade B (P = 0. 003 ,OR = 11. 320,95% CI = 2. 232 -57. 407 ) and Child-Pugh grade C ( P = 0. 002 ,OR = 3. 888,95% CI = 1. 659-9. 114) were significantly associated with the occurrence of EGV bleeding.The AUC of the predictive risk model in the modeling group was 0. 802,and the validation group was 0. 836.
Conclusion
The lower HDL and higher CRP,PVW,the thickness of the spleen,Child-Pugh grade B and C are the risk factors for the occurrence of EGV bleeding.
8.Clinical Observation of Bevacizumab Combined with S-1 in the Treatment of Pretreated Advanced Esophageal Carcinoma.
Keke NIE ; Chuanxin GENG ; Ling ZHANG ; Shichao LIU ; Zhongfa ZHANG ; Rong WANG ; Xiao ZOU ; Youxin JI
Chinese Medical Sciences Journal 2016;31(4):221-227
Objective To investigate the clinical effects and safety of bevacizumab combined with S-1 as the second-line treatment of recurrent and/or metastatic esophageal cancer after chemoradiation. Methods Patients with recurrent or metastatic esophageal cancer after chemoradiation were treated with bevacizumab and S-1. Bevacizumab was used by intravenous infusion, 7.5mg/kg body weight on day 1; S-1 was used by oral at 80mg/m·d on day 1-14, 21 days as a cycle of treatment and repeated until either pro- gressive disease or intolerable toxicity occurred. Chest CT were performed and RECIST 1.1 was used for response evaluation. Kaplan-Meier method was used for survival analysis. Side effects were recorded and analyzed. Results Totally 78 patients were enrolled in the study, including 67 squamous cell carcinoma and 11 adenocarcinoma histologically. The overall response (CR+PR) rate was 22.4% (17/76) and disease control (CR+PR+SD) rate was 61.8% (47/76) respectively. The median follow-up time was 20 months (range from 9 to 44 months). The median progression-free survival (PFS) was 4.9 months (95% CI 4.4-5.5) and the median overall survival (OS) was 8.1 months (95% CI 7.6-9.2). The median PFS and OS of patients with metastasis diseases were 6.2 months (95% CI 3.3 to 6.3) and 8.5 months (95% CI 5.8 to 11.2), where PFS was longer than that of patients with local regional recurrence (median 5.0 months, 95% CI 3.0 to 5.5, P=0.017) and OS was longer than that of patients with regional disease and metastasis (median 8.0 months, 95% CI 4.6 to 9.5, P=0.010). The common adverse effects were mild to moderate neutropenia (84.2%), grade I-II hand and foot syndrome (51.3%), grade I-II nausea (48.7%), mild epistaxis (30.1%) and mild vomiting (14.5%). Esophageal bleeding occurred in 7.9% of patients. One patient (1.3%) died from massive bleeding which was caused by esophageal perforation. Conclusion Bevacizumab combined with S-1 was effective and safe for esophageal cancer patients who had recurrent or metastatic diseases after chemoradiation.
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9.Severe acute interstitial lung disease induced by crizotinib therapy in a patient with c-Met amplification non-small cell lung cancer.
Youxin JI ; Zhongfa ZHANG ; Keke NIE ; Ketao LAN ; Chuanxin GENG ; Shichao LIU ; Ling ZHANG ; Zongchun ZHANG ; Lei SUN ; Xiao ZOU
Chinese Medical Journal 2014;127(8):1600-1600