Adult ; Antineoplastic Agents ; toxicity ; CD4-Positive T-Lymphocytes ; drug effects ; Female ; Humans ; Killer Cells, Natural ; drug effects ; Middle Aged ; Nurses ; statistics & numerical data ; Occupational Exposure ; T-Lymphocyte Subsets ; drug effects

Objective To investigate the prognostic factors of survival time of the Uygur and Han nation-ality elderly patients( over 60 years) with pancreatic cancer in Xinjiang.Methods We carried on a retrospective study of 313 aged patients diagnosed with pancreatic cancer in The First Affiliated Hospital of Xinjiang Medical University from January 1st,2003 to May 30th,2015.We used Kpalan-Meier method for calculation of survival, used Log-rank method for those factors which could affect the prognosis of patients,at last we used Cox propor-tional risk model for those multiple factors which match the role.Results Three hundred and thirteen cases with pancreatic cancer had a median survival of 157 days,and survival rates of half a year,1 and 2 year were 34.8%, 18.5%,7.0%.There was a statistic difference between Uygur patients′and Han patients′survival time(P<0.05).Single factor analysis showed the nationality,tumor size,surgery,ZPS(ECOG),Clinical stage(TNM), chemotherapy and radiotherapy,carcino-embryonic antigen(CEA)level and cancer antigen 199(CA199)level before treatment with outcome(P<0.05).Multiple factor analysis showed that the clinical stage,surgery(P<0.05)can be regarded as independent prognostic decision factors.Conclusion The clinical staging,surgical treatment could be regarded as independent prognostic factors for the elderly prognosis of pancreatic cancer.Both of the Han and Uygur patients,earlier discovered and more appropriate surgery treatment are the key for the elder-ly patients with pancreatic cancer.

Objective To observe the normal structures of arteria circumflexa femoris lateralis (ACFL) and to establish digitized visible models of anterolateral thigh(ALT) flap,which can be used in clinical training and operation design.Methods The cross-sectional images from the VCH Male 3 dataset were reviewed to study ACFL structures on a section-by-section basis.Next,one adult fresh cadaver specimen was perfused with lead ox- ide-gelatine mixture to be subject to radiographic CT scanning on its lower limbs.Likewise,the cross-sectional images from the CT images were reviewed to study ACFL structures on a section-by-section basis.Three-dimensional computerized reconstructions of ACFL structures and their adjacent struetures were conducted from the two sets of data using Amira 3.1 (TGS) software respectively.Results The three-dimensional reconstructed visible models established by the above two methods perfectly displayed the anatomic relationships of ACFL structures and their adjacent structures.Conclusions Since the digitized images of ACFL structures can offer section by section in- sights into the ACFL anatomy,their 3D reconstructive models ean be applied in clinical training,pre-operative designing and virtual operation procedures.

OBJECTIVETo investigate the outcomes of surgical treatment and the prognostic factors of long-term survival for obstructing left colorectal cancer.

METHODSClinicopathological and follow-up data of 93 patients with obstructing left colorectal cancer undergoing surgical treatment from January 2001 to December 2006 in the Affiliated Hospital of Medical College of Qingdao University were analyzed retrospectively.

RESULTSThere were 53 males and 40 females. The median age was 61 years old. Fifty-one patients had concurrent medical condition. Radical resection was performed in 67 patients, including one-stage resection (n=21), Hartmann procedure (n=35), and Miles procedure (n=11). Surgery was palliative in 26 patients, including diverting stoma (n=14), bypass surgery (n=7), and palliative resection (n=5). All the 93 patients were followed up. The 1-, 3-, and 5-year survival rates were 94%, 59%, and 38%, respectively. Univariate and multivariate analyses showed that radical resection, TNM staging, and preoperative level of carcinoembryonic antigen were independent prognostic factors (all P<0.05).

CONCLUSIONSRadical resection, TNM stage, and preoperative CEA level are prognostic factors of obstructing left colorectal cancer. Early diagnosis, radical resection, and selection of appropriate surgical procedure are helpful to prolong survival time of patients with obstructing left colorectal cancer.

Adult ; Aged ; Colorectal Neoplasms ; diagnosis ; surgery ; Colorectal Surgery ; Female ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Retrospective Studies

OBJECTIVETFo compare the efficacy and complications rate of intramedullary (IM) nailing or K-wire versus plating fixation for clavicular fractures.

METHODSPubmed, Embase, Cochrane Library databases, CNKI, VIP and Wangfang databases were searched to find all randomized or quasi-randomized controlled trials of clavicle fractures using plating versus IM nailing or K-wire. The methodologic quality of the studies was assessed. After independent study selection by 2 authors ,data were collected and extracted independently. Outcomes of postoperative shoulder functional measurement, the efficacy and information of the operation and complications rate were meta-analyzed using RevMan 5 software.

RESULTSNine hundreds and seventy-six patients in 10 randomized controlled trials (RCTs) and 3 quasi-RCTs were involved in the meta-analysis,of which 5 studies compared the K-wire and the plating fixations and 8 studies compared the IM nailing and the plating fixations. The overall odds ratio(OR) (with 95% CI) of the operation efficacy for K-wire versus the plating was 3.79 (1.93, 7.46). The overall weighted mean difference (with 95% CI) of Constant Shoulder score for plating versus IM fixation was -1.39 (-3.43, 0.65) in 6 studies. The overall OR of the plating versus IM nailing was 9.34(2.70, 32.32) for the overall major complications in 5 studies and 5.04 (1.52,16.77) for the revision rate in 5 studies.

CONCLUSIONThe current limited evidences suggested that the IM fixation could reduce the incidences of the overall major complications and the revision surgery, while the post-operative efficacy of the plating was superior to the K-wire. More high quality RCTs are still needed in the future.

Bone Nails ; Bone Wires ; Clavicle ; injuries ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Randomized Controlled Trials as Topic

Long-tem culture initiating cells(LTC-IC), and in vitro assay of hematopoietic stem/progenitor cells, still represent a heterogeneous population in terms of proliferative capacity and sensitivity to different growth factors. Human umbilical cord (CB) is rich of hematopoietic progenitor cells measured by clonogenic assays and stem cells capable of reconstituting the marrow after transplantation. The influence of culture conditions on the in vitro behavior of LTC-IC from CB was evaluated. First, by using IRES sequence, FL and TPO cDNA were recombined with retroviral vector pLXSN by gene recombination technology. The recombinant plasmid pLFSN, pLTSN, pLFTSN were transfected into human stromal cell line HFCL. Then, LTC-IC were evaluated in long term cultures, comparing five types of stromal feeder layers: human bone marrow stromal cell, human stromal cell line HFCL, and stromal cell lines HDF tranfected with FL gene, HLT transfected with TPO gene or HFT co-transfected with FL and TPO genes. The results were demonstrated that after 8 weeks of coculture, three types of stromal cell lines that supported the maintenance of CFU-C for up to 3 weeks in vitro were identified. However, cocultivation of human bone marrow stromal cell and CB CD34(+) cells on HFT, CFU-C production continued up to 6 weeks or longer on these stroma. The absolute LTC-IC frequency in CD34(+) cells on human bone marrow stromal cell (2.65 +/- 0.76/1 000 cells) was no significant difference with on HFT (3.65 +/- 0.58/1 000 cells). Thus, HFT acts by direct contact to maintain the phenotype and function of the most primitive and quiescent human progenitors. Furthermore, HFT cell line was selected as the optimal one for supporting long-term culture feeder. It was concluded that LTC-IC progenitors from cord blood maintain growing upon the FL/TPO gene-modified stromal feeder layers in vitro.

OBJECTIVEObserving the dynamic change characteristics of serum liver function indexes in occupational dermatitis medicamentosa-like of trichloroethylene patients with liver damage, we can underlie for guiding therapy, prognosis and mechanism of dermatitis medicamentosa-like of trichloroethylene patients with liver damage.

METHODSWe collected serum of 10 cases of occupational dermatitis medicamentosa-like of trichloro-ethylene patients with liver damage from different time points since they were hospitalized, using automatic biochemistry analyzer to detect total protein (TP), albumin (ALB), total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), albumin/globulin ratio etc 11 liver function biochemical indicators. We used Excel to establish database, professional drawing software gnuplot to draw dynamic variation diagram of each index.

RESULTSThe variation range of 11 liver function indexes of 10 cases was TP 43.2-74.2 g/L, ALB 24.6-44.6 g/L, A/G 0.77-2.10, TBIL 3.7-268.2 umol/L, DBIL 1.0-166.0 umol/L, IBIL 2.4 -167.5 umol/L, ALT 11-5985 U/L, AST 14-5586 U/L, GGT 15-1500 U/L, ALP 35-309 U/L, S/L 0.07-1.94, respectively. TBIL, DBIL, ALT, AST, GGT, ALP concentration significantly increased, especially ALT, AST, GGT, ALT topped 5985 U/L, AST topped 5586 U/L, GGT topped 1500 U/L. But TP, ALB and S/L significantly decreased, TP lowest to 43.2 g/L, S/L lowest to 0.07. A/G basically remained unchanged, but IBIL didn't change regularly.

CONCLUSIONThe early liver damage in dermatitis medicamentosa-like of trichloroethylene patients was serious, and repeatedly attacked, so we should lead to enough attention to the clinical work and prevention. This also provided the basis for studying the mechanism of trichloroethylene poisoning.

Adolescent ; Adult ; Bilirubin ; blood ; Dermatitis, Occupational ; blood ; physiopathology ; Female ; Humans ; Liver ; enzymology ; physiopathology ; Liver Function Tests ; Male ; Trichloroethylene ; Young Adult

OBJECTIVE:To observe the effects of dexmedetomidine combined with ulinastatin on stress reaction indexes,ex-travascular lung water value(EVLW)and pulmonary vascular permeability indexes(PVPI)and other parameters in one-lung venti-lation(OLV)lobectomy patients. METHODS:A total of 80 patients underwent OLV lobectomy selected from the Affiliated Hospi-tal of Southwest Medical University during Nov. 2015-Nov. 2016 were divided into control group (group N),ulinastatin pretreat-ment group(group U),dexmedetomidine continuous pump group(group D),ulinastatin pretreatment+dexmedetomidine continu-ous pump group(group U+D),with 20 cases in each group. Thirty min before anesthesia induction,all patients were given atro-pine sulfate 0.5 mg intramuscularly and received catheterization of right internal jugular vein and ipsilateral femoral artery under lo-cal anesthesia. Based on that,group N was given 0.9％ Sodium chloride injection 100 mL intravenously;group U was given sodi-um chloride mixed solution 100 mL containing Ulinastatin for injection 200000 U intravenously;group D was given continuous in-travenous pump of Dexmedetomidine hydrochloride injection 2 μg/mL mixed with sodium chloride mixed solution at 1 μg/(kg·h), and after induction intravenous pump at 0.5 μg/(kg·h)until the end of surgery;group U+D was given Sodium chloride mixed so-lution containing 200000 U ulinastatin 50 mL and 4 μg/mL dexmedetomidine sodium chloride mixed solution 50 mL intravenously (same dose as above during induction period and maintenance period). The levels of blood glucose,partial pressure of oxy-gen [p(O2)],adrenocorticotropic hormone (ACTH),norepi-nephrine (NE),heart rate (HR),cardiac output (CO),sys-temic vascular resistance(SVR),EVLW and PVPI were com-pared among 4 groups 30 min before anesthesia induction(T1),2 h after the beginning of surgery(T2),immediately after extuba-tion(T3)and 12 h after surgery(T4). Liquid intake and output volume were recorded during T2-T4. The occurrence of ADR among 4 groups was observed. RESULTS:There was no statistical significance in each index among 4 groups at T1 (P>0.05). During T2-T4,the levels of blood glucose,ACTH,NE,SVR,EVLW and PVPI in group N were significantly higher than other 3 groups, and group U and D were significantly higher than group U+D,with statistical significance(P<0.05);there was no statistical sig-nificance between U and D(P>0.05). The levels of p(O2)and CO in groups U+D were significantly higher than other 3 groups, with statistical significance (P<0.05);there was no statistical significance among other 3 groups (P>0.05). HR of group N and U were significantly higher than other 2 groups,with statistical significance (P<0.05). There was no statistical significance be-tween group N and U,between group D and U+D(P>0.05). There was no statistical significance in liquid intake or output vol-ume among 4 groups (P>0.05). No obvious ADR was found in 4 groups. CONCLUSIONS:Dexmedetomidine combined with ulinastatin can significantly relieve stress reaction,and reduce the levels of part blood flow and respiratory dynamics indexes as EV-LW,PVPI in patients with OLV lobectomy so as to play lung protective effect.

To report a case of generalized lichen amyloidosis successfully treated with dupilumab in China. A 70-year-old male patient presented with extensive itchy papules on the trunk and extremities for 23 years. Skin examination revealed diffuse millet-to mung bean-sized hemispherical brown plaques on the trunk, right anterior shank, and extensor aspect of both upper arms, with a hard texture on palpation. No abnormalities were observed in the blood eosinophil count or serum IgE level. Histopathological examination of the skin lesion on the lower limb showed epidermal hyperkeratosis and homogeneous red-stained lumpy materials in the papillary dermis. Immunohistochemical study showed positive staining with Congo red. The pruritus numerical rating scale score was 10 points. The diagnosis of generalized lichen amyloidosis was confirmed. The patient received subcutaneous injection of dupilumab at an initial dose of 600 mg, followed by an every-2-week regimen at a dose of 300 mg. At week 2 after the start of treatment, pruritus was markedly relieved; at week 14, the skin lesions began to subside markedly; at week 18, the skin lesions on the chest and abdomen nearly completely subsided, and lesions on the lower back and limbs markedly regressed. No obvious adverse reactions were observed.

OBJECTIVETo study the apoptosis of facial motor neurons and the expression of apoptosis-related genes, Bcl-2 and Bax, in the animal model of viral facial paralysis.

METHODSTotal of 84 Balb/c mice were divided into viral inoculation group and nerve transaction group. The animals were executed 1, 3, 7, 10, 15, 20 and 30 days after being operated respectively. The histopathological features of facial neurons in brain stem were observed by HE and Nissl stain. The changes of facial neuronal apoptosis were observed by TUNEL. The changes of expression of Bcl-2 and Bax genes in facial neurons were observed by immunohistochemistry staining.

RESULTSAfter nerve transection, increased apoptotic cells were found in homolateral facial motor nucleus and the peak appeared at 10 and 15 days. The level of Bcl-2 expression in neurons declined while the expression of Bax increased gradually. Correspondingly, the ratio of Bcl-2/Bax declined. In the viral inoculation group, no visible change of apoptosis and Bax expression, but the level of Bcl-2 and the ratio of Bcl-2/Bax increased gradually.

CONCLUSIONSComparing to axotomy, facial motor nucleus in HSV-1 infective animal model are free of apoptosis. Both the mild form of lesion and the ability to block apoptosis of HSV-1 are likely to be involved into the phenomenon. Bcl-2 and Bax might interfere with the apoptotic response.

Animals ; Apoptosis ; Facial Paralysis ; pathology ; virology ; Female ; Herpesvirus 1, Human ; pathogenicity ; Mice ; Mice, Inbred BALB C ; Neurons ; pathology ; Proto-Oncogene Proteins ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; bcl-2-Associated X Protein ; metabolism