Objective To investigate the value of endoscopic retrograde appendicitis therapy ( ERAT) in the diagnosis and treatment of atypical acute appendicitis. Methods All the 48 patients suspected of atypical acute appendicitis in Jiangsu Province Hospital from January 2015 to December 2016 were randomly divided into ERAT group and conservative treatment group according to the treatment method. The final appendectomy rate of the two groups was analyzed. Results Only 17 of the 24 patients in the ERAT group received endoscopic treatment because of complex conditions or personal wishes, and 16 cases were diagnosed as acute appendicitis. Surgical resection was performed in 5 cases because of recurrence of the disease after ERAT, and the appendectomy rate was 31. 2％ ( 5/16 ) . In the conservative treatment group, all 24 patients were treated with antibiotics. Twenty of them underwent surgical resection with appendectomy rate of 83. 3％ ( 20/24) , and 1 of them had appendiceal perforation. The appendectomy rate of the ERAT group was significantly lower than that of the conservative treatment group (χ2=11. 111, P<0. 05) . Conclusion ERAT has a high diagnostic and therapeutic value for atypical acute appendicitis.

BACKGROUND:Eucommia ulmoides gum has good thermoplastics, liquidity, bondability and antimicrobial properties. However, the application of Eucommia ulmoides gum as a root canal filing material is rarely reported. OBJECTIVE: To compare the different contents of gas phase nano-silica on mechanical performance of composite material taking the gutta-percha as the matrix, and observe the effect of the root canal filing. METHODS:Four kind of root canal filing materials were prepared through adding barium sulfate (20%), nano-hydroxyapatite (10%) and different contents of gutta-percha and gas phase nano-silica (40% and 15%, 45% and 20%, 50% and 25%, 55% and 30%). PureEucommia ulmoidesgum served as the blank control. The mechanical properties (hardness, tensile strength and rupture elongation rate) of those five materials were detected. Furthermore, four kinds of composite materials, pureEucommia ulmoidesgum and Gutta-Percha Pelets were filed into the fresh extracted premolar root canal by using Obtura II technology. The effect of root canal filing was observed under X-ray and scanning electron microscopy.RESULTS AND CONCLUSION: Along with the increase of the content of gas phase nano-silica, the hardness of Eucommia ulmoides gum composite material increased, tensile strength increased firstly and then decreased, and rupture elongation rate decreased. PureEucommia ulmoides gum was transmitted to the X-ray and no image of filing material was obtained. Four kinds of composite materials were resistant to X-ray, and images showed that al composite materials were equaly filed into the root canal, without cacuole, and were in contact with the root canal inner wal, showing good filing effect. Scanning electron microscopy showed that, fingerlike projections were the longest at the surface of pureEucommia ulmoides gum; as the content of gas phase nano-silica increased, fingerlike projection length reduced at the surface of composite materials.Eucommia ulmoides gum composite materials could be developed as a canal filing material under heat flow condition.

OBJECTIVETo compare the CT image of gastrointestinal schwannomas (GIS) and gastrointestinal stromal tumors(GIST), and to find the CT features to be helpful for differentiation of GIS from GIST.

METHODSClinical and iconography data of 15 GIS patients and 50 GIST patients who underwent stomach CT scan with postoperatively confirmed histopathology between January 2000 and July 2014 in our department were collected retrospectively. CT findings of these two tumors were compared. Then the ROC curve was drawn based on the significant CT findings and area under the curve (AUC) was calculated to assess the sensibility and specificity for the differential diagnosis of GIS and GIST.

RESULTCT findings, such as the tumor size, shape, cystic change, perilesional lymph nodes, vessel seeding, enhancement pattern and degree, absolute and standardized CT value were significantly different between GIS and GIST(all P<0.05). Among the CT findings, tumor size, cystic change, perilesional lymph nodes, enhancement pattern and arterial phase standardized CT value (Sa) were better differential than others (all AUC>0.7). Tumor size showed the highest sensibility(90%), and cystic change and Sa showed the highest specificity(87%).

CONCLUSIONSGIS seems to show a homogeneous tumor more frequently, presenting light and moderate enhancement pattern and obvious enhancement of perilesional lymph nodes, while GIST seems to reveal malignant features, such as abundant blood supply, larger volume, frequent necrosis and cystic change. Cystic change and Sa value possess the better differential ability in diagnosis of these two tumors.

Objective To compare the CT image of gastrointestinal schwannomas ﹙GIS) and gastrointestinal stromal tumors ﹙GIST), and to find the CT features to be helpful for differentiation of GIS from GIST. Methods Clinical and iconography data of 15 GIS patients and 50 GIST patients who underwent stomach CT scan with postoperatively confirmed histopathology between January 2000 and July 2014 in our department were collected retrospectively. CT findings of these two tumors were compared. Then the ROC curve was drawn based on the significant CT findings and area under the curve ﹙AUC) was calculated to assess the sensibility and specificity for the differential diagnosis of GIS and GIST. Result CT findings, such as the tumor size, shape, cystic change, perilesional lymph nodes, vessel seeding, enhancement pattern and degree, absolute and standardized CT value were significantly different between GIS and GIST ﹙all P<0.05). Among the CT findings, tumor size, cystic change, perilesional lymph nodes, enhancement pattern and arterial phase standardized CT value ﹙Sa) were better differential than others ﹙all AUC>0.7). Tumor size showed the highest sensibility ﹙90%), and cystic change and Sa showed the highest specificity ﹙87%). Conclusions GIS seems to show a homogeneous tumor more frequently, presenting light and moderate enhancement pattern and obvious enhancement of perilesional lymph nodes, while GIST seems to reveal malignant features, such as abundant blood supply, larger volume, frequent necrosis and cystic change. Cystic change and Sa value possess the better differential ability in diagnosis of these two tumors.

Objective To compare the CT image of gastrointestinal schwannomas ﹙GIS) and gastrointestinal stromal tumors ﹙GIST), and to find the CT features to be helpful for differentiation of GIS from GIST. Methods Clinical and iconography data of 15 GIS patients and 50 GIST patients who underwent stomach CT scan with postoperatively confirmed histopathology between January 2000 and July 2014 in our department were collected retrospectively. CT findings of these two tumors were compared. Then the ROC curve was drawn based on the significant CT findings and area under the curve ﹙AUC) was calculated to assess the sensibility and specificity for the differential diagnosis of GIS and GIST. Result CT findings, such as the tumor size, shape, cystic change, perilesional lymph nodes, vessel seeding, enhancement pattern and degree, absolute and standardized CT value were significantly different between GIS and GIST ﹙all P<0.05). Among the CT findings, tumor size, cystic change, perilesional lymph nodes, enhancement pattern and arterial phase standardized CT value ﹙Sa) were better differential than others ﹙all AUC>0.7). Tumor size showed the highest sensibility ﹙90%), and cystic change and Sa showed the highest specificity ﹙87%). Conclusions GIS seems to show a homogeneous tumor more frequently, presenting light and moderate enhancement pattern and obvious enhancement of perilesional lymph nodes, while GIST seems to reveal malignant features, such as abundant blood supply, larger volume, frequent necrosis and cystic change. Cystic change and Sa value possess the better differential ability in diagnosis of these two tumors.

Objective Explore the relationship of ventricular late potential (VLP) and the heart function of children with viral myocarditis,and provide the evidence for their diagnosis and therapy.Methods The clinical data of 152 cases of epileptic children were collected.The patient group was divided into three groups (severe arrhythmia,heart failure,and cardiogenic shock).The patient group was also divided into two groups (cardiac dilatation,and non-cardiac dilatation) according to UCG.Serum levels of cTnI and VLP in children with viral myocarditis were detected.Results The VLP was negative in the mild and control groups,but the positive rate of VLP is 75.0 ％ in the severe group.The positive rate of VLP was 60.0％ in the severe arrhythmia group,77.78％ in the heart failure group,and 100％ in the shock group.There is one kind of negative rank correlation between LAS,RMS40 and LVFS (P ＜ 0.05),and another negative rank correlation between RMS40 and LVEF (P ＜ 0.05).Conclusions The children with viral myocarditis have a favorable prognosis.The sever patient in the minority must be diagnosed in time and treated because of the critical state of viral myocarditis children.The serum level of cTnI and VLP were increased in children with viral myocarditis,and they were sensitive parameters to reflect patients’ condition.

Target therapy is a major progress in treatment of advanced colorectal cancer. Cetuximab and bevacizumab are the most widely used target agents in colorectal cancer, which target against EGFR and VEGF respectively. The addition of target agent to chemotherapy improve efficacy and prolong survival in the first line setting, as well as in the second line setting. The increased respectability of liver metastases from colorectal cancer is of great importance, k-ras gene mutation is a definite predictor of cetuximab, however, there is no clear predictor for bevacizumab.

OBJECTIVE:To study the pharmacokinetics of boanmycin and to make a clinical evaluation on which.METHODS:36patients with malignant tumor were subjected to the first stage of clinical study after injected intramuscular injection.with0.5～7.5mg/m 2 boanmycin.Of which,8patients were chosen as the subjects for the pharmacokinetic study by microbioassay.RESULTS:Boanmycin had little influence on the functions of heart,liver,kidney and lungs and which had no inhibitory action on bone marrow.After intramuscular injection with5.29～7.65mg/m 2 boanmycin,parameters of pharma?cokinetics in the patients were determined as the following:t 1/2? was(14.036?4.409)min,t 1/2? was(39.160?5.599)min,AUC was(14.697?1.826)(?g?min)/ml and CLs was(0.781?0.102)L/min.CONCLUSION:Serum clearance of boanmycin shows two-compartment model.

OBJECTIVEThe efficacies of the selective 5-hydroxytryptamine3 (5-HT3) antagonists--ramosetron (0.3 mg) and granisetron (3 mg) in treating acute chemotherapy-induced digestive system dysunction were compared.

METHODSA total of 111 patients were enrolled in a single-blind, randomised crossover study; with data from 98 were used to assess efficacy and data from 110 to assess the safety profile. Ramosetron or granisetron was given intraveneously 15 min befire chemotherpy.

RESULTSThe ability of ramosetron to prevent emesis, nausea and anorexia was similar to granisetron during the first 6 h following the administration of chemotherapy, ciplatin or doxorubicin. However, during the first 24 h after chemotherapy, significant differences between ramosetron and granisetron appeared: emetic episode (P = 0.068), nausea (P = 0.006), and anorexia (P = 0.048) remained lower in ramosetron-treated patients. The safety profile of ramosetron was similar to that of granisetron and adverse events in both groups were generally mild and transient.

CONCLUSIONRamosetron is more potent and longer-lasting than granisetron in preventing chemotherapy-induced digestive disturbances.

Adolescent ; Adult ; Aged ; Anorexia ; chemically induced ; drug therapy ; Antiemetics ; therapeutic use ; Antineoplastic Agents ; adverse effects ; Benzimidazoles ; therapeutic use ; Cisplatin ; adverse effects ; Cross-Over Studies ; Doxorubicin ; adverse effects ; Female ; Granisetron ; therapeutic use ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Nausea ; chemically induced ; prevention & control ; Serotonin Antagonists ; therapeutic use ; Single-Blind Method ; Vomiting, Anticipatory ; etiology ; prevention & control

OBJECTIVETo evaluate the efficacy of combined modality treatment and determine the prognostic factors for small cell lung cancer (SCLC).

METHODSFrom January 1974 to December 1995, 1260 patients with SCLC treated were retrospectively evaluated, with limited lesions in 732 patients, extensive lesions in 500 and stage unrecorded in 28. 553 patients were alloted into chemotherapy + radiotherapy (C + R) group, 355 into C + R + C group, 97 into R + C group, 126 into C group, 64 into R group and 65 into surgery (S + C + R) group. Patients with limited lesions received 2 - 4 cycles of chemotherapy including COMC, COMP, COMVP and CE-CAP. Radiotherapy was given to a dose of 40 - 70 Gy/4 - 7 w. Radiation portals for patients with limited lesions encompassed the primary tumor, hilar lymphatic drainage areas, partial mediastinum and bilateral supraclavicular regions. Patients with extensive lesions mainly received chemotherapy with or without palliative irradiation.

RESULTSThe overall CR and PR rates were 26.7% and 52.3%. Local recurrence and distant metastasis rates were 58.8% and 61.5%. The 1-, 3- and 5-year survival rates were 50.2%, 14.7% and 11.7%, with median survival time of 12 months. The era, sex, age, tumor stage and treatment modality were all significant prognostic factors by both uni-variate and multi-variate analyses (P < 0.05). The result of S + C + R rated the best among these modalities and the result of C + R + C was superior to C + R, though the difference of which was not significant.

CONCLUSIONSurgical resection should be considered as one part of comprehensive therapy for small cell lung cancer patients with limited lesions whenever possible. On top of routine chemotherapy early administration of radiotherapy is advisable.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; Carcinoma, Small Cell ; mortality ; therapy ; Combined Modality Therapy ; Female ; Humans ; Lung Neoplasms ; mortality ; therapy ; Male ; Middle Aged ; Radiotherapy ; Survival Rate ; Treatment Outcome