Objective To explore a more reasonable and effective therapeutic regimen and evaluate prognostic factors in hepatoblastoma patients after combined therapy.Methods Sixteen patients diagnosed on hepatoblastoma between Jan.2000 and Nov.2007 were reviewed and followed-up.Resection with chemotherapy was taken among 16 cases.Chemotherapy included pre-operation and post-operation.Five cases were cured by transcatheter arterial chemombolization(TACE).Six cases were cured by single chemotherapy(both TACE and single chemotherapy were taken in 2 cases).Five cases weren't cured by pre-operation chemotherapy.Nine cases were subjected to curative resection,3 cases to alleviative resection,2 cases with single chemotherapy,1 case with single TACE,and 1 case refused operation and left hospital.Their mean survival duration was 13.5 months(3-98 months).SPSS 13.0 software was used to analyze the data.Results The total survival rate of cases as stage Ⅳ as lower than cases as stage Ⅰ,Ⅱand Ⅲ.Both alpha-fetoprotein(AFP)100 000 ?g/L cases had worse survival rate.The prognosis of mixed type was better than fetal type,embryonal type and anaplasia type.The survival rate of cases with standard chemotherapy was higher than cases with unstandard chemotherapy.And the surgical resection cases had better survival chance than non-surgical resection cases.The survival rate of surgical residual cases was worse than non-surgical residual cases.Conclusions Chemotherapy can improve the total survival rate and long-term survival rate of hepatoblastoma patients.TACE is a safe and effective choice for hepatoblastoma patients.We need to be alert and make the diagnosis as early as possibe,and treat it early and properly.

Objectives To observe the changes of apoptosis-related proteins during the development of sarcopenia and to explore the effect and mechanism of long-term aerobic exercises and heat shock protein 70 (HSP70) on those changes for the natural aging C57BL/6 mice.Methods After 1 week of acclimatization,50 27-week-old male C57BL/6 mice were randomly divided into a young sedentary control (YS) group,an old sedentary control (OS) group and an old exercises (OE) group.After the gripstrength was measured the mice from group YS were sacrificed at the age of 28 weeks.The mice from group OE exercised on a fiat treadmill at 12rn/minute for 50 min 3 or 4 times a week for 30 weeks with the intensity of 75％ VO2max.At the age of 60 weeks,the mice of group OS and OE were killed after their grip-strength was measured.The gastrocnemius muscle of each group were isolated and weighted,and the sarcopenia index (SI) was measured.Then the total protein of the gastrocnemius muscle was extracted.HSP70 and cleaved caspase-9 expression were examined.The binding rate of HSP70 and Apaf-1 was measured using Co-Immunoprecipitation.TUNEL staining was performed to detect the apoptosis of the gastrocnemius muscle.Results (1) Compared with group YS,SI of group OS decreased significantly by 23.09％,but significant increase was observed in group OE compared to group OS by 30.48％.(2) The grip strength per gram of body weight of group OS decreased significantly by 42.74％ compared to group YS,while that of group OE increased significantly by 21.51％ compared to group OS.(3) The apoptosis index increases by 475.28％ with age.However,the index decreased by 46.41％ in group OE over group OS.(4) Western blotting showed that the expression of cleaved caspase-9 increased significantly by 45.4％ in group OS compared to group YS,while that of group OE decreased significantly by 33.4％ compared to group OS.(5) The binding rate of HSP 70 with Apaf-1 of group OS decreased significantly by 67.11％ compared to group YS,while that of group OE increased significanlty by 306.31％ compared to group OS.Conclusions (1) Gastrocnemius atrophy occurring to mice of 60 weeks can be significanlty delayed through 30-week exercises training.(2) The increasing apoptosis may be involved in the development of age-related sarcopenia and 30-week exercises can significantly attenuate such apoptosis in rodent skeletal muscle.(3) Aerobic exercises increases HSP70/Apaf-1 interaction,which might play an important role in reducing age-related cellular damage and cell death in the skeletal muscle of rats.

Objective To explore the methodology of skin flap muscle flap (double flaps) and and effect of the double flaps on eyelid bag blepharoplasty.Methods Through lower eyelid incision,skin flap and muscle flap were formed,orbicularis muscle and orbital septum separated between the skin and flaps,direct access to the inferior orbital rim depression.Arcuate edge of the orbicularis muscle was fully stripped and released,especially the orbicularis muscle at the inferior orbital rim periosteal surface.The orbital fat was released,sutured below the inferior orbital rim periosteal surface.The orbicularis muscle flap was designed,lift and fixed to enhance midface to achieve the rejuvenation effect in the lower eyelid region.Results The 36 patients treated had no hematoma and flinch in the lower eyelid.Within 3 to 18 months follow-up,there were no ectropion,and facial nerve damage and other complications.Conclusions Double-flap is a feasible method as it can effectively enhance midface rejuvenation and correct eyelid bags deformity.

Objective To explore the association between ACTN3 gene R577X polymorphism and serum lipid levels in an elderly Chinese Han population.Methods This study was based on the ageing arm of The Rugao Longevity and Ageing Study (RtLAS).Genotyping was performed by Taqman MGB method.Lipids includedtotal cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C).Cut points of dyslipidemia were based on that reported in the NCEP ATPIII.We explored the associations between R577X polymorphism loci and dyslipidemia by using analysis of covariance and logistic regression analysis.Results Overall 1 618 samples was included (741 males and 877 females) in this study.Covariance analysis found that TC level of RR,XX and RX genotype in the general population were 1.34,1.37,1.43 mmol/L with an increasing trend (P =0.024);TC and LDL-C levels of RR,XX and RX genotype (TC:5.13,5.29,5.43 mmol/L,P =0.004;LDL-C:2.76,2.88,3.00 mmol/L,P =0.004) were significantly different in females.Logistic regression analysis showed that the increased copies of X allele were significantly associated with increased TC and LDL-C levels in the general population and females.For the general population,TC:OR=1.184,95％CI:1.030-1.361,P =0.018;LDL-C:OR =1.334,95％CI:1.101-1.588,P=0.003;For females,TC:OR=1.332,95％ CI:1.102-1.616,P =0.003;LDL-C:OR =1.549,95 ％CI:1.208-1.986,P =0.001.After adjusting for other covariates,the above associations remained significant.Conclusions ACTN3 gcnc R577X polymorphism is associated with plasma TC and LDL-C levels in elderly woman of Han populations in Rugao,China.

In the areas of prevention and life skills counseling for breast cancer, risk assessment and prediction can assist clinicians to decide if chemoprevention or prophylactic surgery is needed or suggestions on improving the quality of life for their clients. Several mathematical models, namely Gail Model, Claus Model, BRCAPRO Model and Cuzick-Tyrer Model etc. have been developed to make predictions, clinically. This paper has reviewed the development, operation, advantage versus disadvantage and areas of application for the four models. Having family history of breast cancer, one subject was calculated on the risks by the four models and different results were found. Up to 45 years old, the accumulative risks from the four models and population risk were 1.9%, 11.8%, 2.5%, 5.0% and i.6%, respectively. To 75 years old, they were 20.2%,32.5%, 13.1%, 25.0% and 8.5%, respectively. The subject had a relatively high breast cancer risk during her lifetime. A new model is supposed to include a variety of important risk factors and to be validated by large scale of case-control samples. Incidence of breast cancer in China had significantly increased during the last ten years, but the research on developing assessment methods of breast cancer risk had never been reported, suggesting that the development of models for Chinese population is necessary.

OBJECTIVETo explore whether there exists coincidence of the most appearing time of clinical features of liver cancer at different longitude and latitude, according to the law of field equation and the theory of warpage of space time by Einstein.

METHODSThree regions with different longitude and latitude were selected randomly and sampled. There were 36 items altogether, including 12 clinical items, which were used to imitate the yearly cycle cosine curve. The acorphases and the ratioes of amplitudes and means were compared to justifying whether they were in the same range.

RESULTSAll the acorphases of 36 items appeared between -90.1degrees to -207.5 degrees (from april to july), existing in one third of the same range, in which 13 items occurred rhythmly (P<0.05). The image acorphases of liver cancer at the early and middle stage and gamma-glutamyl transpeptidase acorphase appeared between -98.5 degrees to -148.2 degrees (from april to may), in which 5 items occurred rhythmly (P<0.05).

CONCLUSIONIt is the same mode of the yearly biologcal cycle for liver cancer malignant growth within the most appearing time (from april to july). It will increase the detecting rate of liver cancer at the early and middle stage during this time (especially from april to may).

Carcinoma, Hepatocellular ; pathology ; Cell Cycle ; physiology ; Chronobiology Phenomena ; Hepatocytes ; physiology ; Humans ; Liver Neoplasms ; pathology ; Mathematical Computing ; Periodicity

OBJECTIVETo prepare the nasal thermosensible gels of Chinese medicine Xingbi and study the release mechanism.

METHODThe gels were prepared by using P407 as the gel matrix and P188 and PEG 6000 were used to adjust the gelatination temperature. The formulations were screened by the method of orthogonal test. Mathematic models were used to imitate the drug release.

RESULT20% poloxmar 407, 2% poloxmar 188 and 2% PEG 6000 were suitable to Chinese medicine Xingbi thermosensitive gel in situ. Nasal thermosensible gels of Chinese medicine Xingbi was gelated at the temperature between 32-34 degrees C and the dissolution curves in vitro showed that the drug release could be best described by the Higuchi equation.

CONCLUSIONThe formulation of the nasal thermosensible gels of Chinese medicine Xingbi is reasonable and it is worth doing further research.

Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Gels ; chemistry ; Humans ; Nose Diseases ; drug therapy ; Temperature

Objective: To observe the clinical effects of recombinant human growth hormone (rhGH) on children with severe burn. Methods: Clinical data of 94 children with severe burn, hospitalized in our burn unit from April 2012 to December 2016, conforming to the study criteria, were retrospectively analyzed. According to the use of rhGH, children were divided into rhGH group (n=50) and control group (n=44). Children in control group received conventional treatment, while children in rhGH group received both conventional and rhGH treatment. The rhGH treatment was started 3 to 5 days post injury in dosage of 0.2-0.4 U·kg^-1·d^-1, by way of subcutaneous injection, and the course of treatment was (11±5) d. The plasma albumin and prealbumin levels, heart rate, alanine aminotransferase (ALT), and serum creatinine level in 2 weeks post injury, times of skin grafting operation, hospitalization time, total hospitalization treatment cost, and sepsis and death of children were compared between the 2 groups. Data were processed with independent sample t test, Mann-Whitney U test, and Fisher′s exact test. Results: (1) In 2 weeks post injury, the plasma albumin level [(36±4) g/L] and prealbumin level [(94±34) g/L] of children in rhGH group were significantly higher than those in control group [(33±4) and (73±20) g/L, t=3.666, 3.401, P<0.05]. (2) In 2 weeks post injury, the heart rate of children in rhGH group was (123±11) times per minute, which was slower than (130±14) times per minute of children in control group (t=2.839, P<0.05). There was no significant difference in ALT level of children between the 2 groups (Z=0.868, P>0.05). The blood creatinine levels of children in the 2 groups were within normal range. (3) The times of skin grafting operation of children in rhGH group was 0.3±0.5, which was significantly less than 0.5±0.6 in control group (Z=2.234, P<0.05). The hospitalization time of children in rhGH group was (22±8) days, which was shorter than (28±10) days in control group (t=2.837, P<0.05). The total hospitalization treatment cost of children in rhGH group was (41±15) thousand yuan, which was significantly less than (53±25) thousand yuan in control group (t=2.878, P<0.05). (4) There were 2 cases of sepsis in control group and 1 case of sepsis in rhGH group, with no significant difference between the 2 groups (P>0.05). No children died in the 2 groups. Conclusions rhGH treatment of children with severe burn can correct post-injury hypoproteinemia, improve cardiac function, reduce the times of skin grafting operation and hospitalization treatment cost, shorten hospitalization time, with no significant effect on kidney and liver function, sepsis, and death.

Objective To compare the image quality of chest low dose CT (LDCT) using automatic exposure control (AEC) and constant current control (CCC) and explore a more reasonable scanning protocol. Methods Two hundred and eighty participants were examined with 64 CT scanner at 7 centers in China. All were divided into 4 groups. Two groups underwent LDCT using AEC with standard deviation set at 25 (A1) and 30 (A2) respectively and the tube current ranged from 10 mA to 80 mA. The other two groups underwent LDCT using CCC with tube current set at 40 mA (C1) and 50 mA (C2) respectively. The axial and MPR images were evaluated by two radiologists who were blinded to the scanning protocols.The radiation dose, noise and the image quality of the 4 groups were compared and analyzed statistically.Differences of radiation dose and noise among groups were determined with variance analysis and t test,image quality with Mann-Whitney test and the consistency of diagnosis with Kappa test. Results There was a significant lower DLP in AEC group than in CCC group [(82.62±40.31)vs ( 110.81±18.21) mGy·cm (F =56. 88 ,P ＜ 0. 01 )], whereas no significant difference was observed between group A2 and group A1 0. 05]. The noisy of AEC group was higher than that of CCC group both on lung window(41.50±9.58 vs 40.86±7.03) and mediastinum window (41.19±7.83 vs 40.92±9.89), but there was no significant difference( Flung =0.835, P=0.476, Fmediastinum =1.910, P=0.128).The quality score of axial image in AEC group was higher than that in CCC group (superior margin of the brachiocephalic vein level: 4.49±0.56 vs4.38±0.64,superior margin of the aortic arch: 4.86±0.23 vs 4.81±0.32,the right superior lobar bronchus Level:4.87±0.27 vs 4. 84 ± 0. 22, the right middle lobar bronchus Level: 4.90±0.25 vs 4.88±0.21) except on the right inferior pulmonary vein level(4. 92 ±0. 25 vs 4. 93 ±0. 17) and superior margin of the left diaphragmatic dome level (4. 91±0.27 vs 4.93±0.22) on lung window, but no significant differences (F=0.076-1.748, P＞0.05) were observed. A significant higher score in AEC group was observed on mediastinum window compared with CCC group on superior margin of brachiocephalic vein level (2.57±0.77 vs 2. 46 ± 0. 59, F = 8. 459, P ＜ 0. 05 ), however, the score of AEC group was lower than that of CCC group on other levels without significant differences (superior margin of the aortic arch:3.36 ±0. 63 vs 3.45 ±0. 60,the right superior lobar bronchus level: 3.94 ±0. 56 vs 3. 95 ±0. 51 ,the right middle lobar bronchus Level: 3.80 ±0. 58 vs 3. 87 ±0. 50,the right inferior pulmonary vein level: 3.72 ±0. 56 vs 3.78 ±0. 53, superior margin of the left diaphragmatic dome level: 3.58 ± 0.63 vs 3.68±0.56,F=0.083-3.380,P ＞ 0.05 ). The MPR image quality of AEC group was better than that of CCC group both on lung window and mediastinum window (Zlung =-2.258, Zmedlastinum=-1.330, P＞0.05). For all participants including the underweighted group, the normal group and the overweighted group, the image quality of A1 group was better than that of A2 group without significant differences (the underweighted group: Zlung=0.000, P=1.000, Zmedastinum= 0.000, P=1.000;the normal group: Zlung =-0.062, P=0.950, Zmediastinum =-0.746, P = 0.456; the overweighted group: Zlung = - 1.177, P = 0.239,Zmediastinum =-1.715, P=0.144) both on lung and mediastinum windows, and for the higher BMI participants, a better image quality was obtained in A1 group than in A2 group on the mediastinum window (Z = -1. 715, P = 0. 144). Conclusions The total radiation exposure dose of AEC group is significantly lower than that of CCC group, but no statistical significant differences are observed between both groups in image quality and noise level. The AEC technique is highly recommended in thoracic LDCT scan for screening program, and the SD25 ( SD value = 25) scan protocol is suggested for higher BMI population while the SD30 (SD value = 30) scan protocol for lower BMI population.

OBJECTIVETo evaluate the practical method of vacuum sealing drainage (VSD) technique combined with sural neurovascular pedicle fasciocutaneous flap to repair deep wounds in the foot near the ankle joint with exposed bone and tendons.

METHODSFrom January 2006 to January 2009, 79 patients with deep wounds in the foot near the ankle joint with exposed bone and tendons were treated by VSD technique combined with sural neurovascular pedicle fasciocutaneous flap including 58 males and 21 females with an average age of 34 years old ranging from 7 to 59 years. There were 17 cases in low 1/3 part of leg and achilles tendon, 28 in lateral malleolus and lateral dorsum of foot, 21 in medial malleolus and medial dorsum of foot, 13 in heel and pelma. Firstly the wounds were debrided and cultivated by using VSD technique, then the soft tissue defections were repaired with sural neurovascular pedicle fasciocutaneous flap.

RESULTSThe area of flap was from 6 cm x 5 cm to 18 cm x 15 cm; All patients stayed in hospital for 14 to 30 days, 18 days in average. Living flaps of all patients were followed-up from 6 months to 3 years, the flaps of 2 patients were mostly necrotic, 3 were necrotic, 5 cases appeared obstacle of venous back streaming. The others survived with no infections.

CONCLUSIONThe wound would become fresh and clean as soon as possible with VSD. The sural neurovascular pedicle fasciocutaneous flap could provide a good covering for the exposed wound. Therefore the wound healed faster with friction resistance and fine appearance. The time of hospitalization were greatly shortened after combined application.

Adolescent ; Adult ; Ankle Joint ; surgery ; Child ; Drainage ; methods ; Female ; Foot Injuries ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Vacuum