Objective:To evaluate the efficacy of postoperative radiotherapy (PRT) for dermatofibrosarcoma protuberans (DFSP).Methods:A systematic review and meta-analysis of articles published before February 23, 2019 were conducted. A total of 655 studies were retrieved consisting of 195 DFSP patients. Among them, 50 cases were assigned into the PRT group and 145 cases in the surgery alone (SA) group. The recurrence rate was statistically compared between two group.Results:Meta-analysis showed that the recurrence rate in the PRT group was significantly lower than that in the SA group (8% vs. 24.1%, OR=0.28, P=0.010). The recurrence rate of patients with positive margins in the PRT group was significantly lower compared with that in the SA group (8% vs. 61.5%, P=0.002). The recurrence rate of patients with negative margins in the PRT group had a decreasing trend than that in the SA group (6% vs. 21.6%, P=0.205). Conclusions:The recurrence rate of surgery combined with PRT is lower than that of SA. The recurrence rate of patients with positive margins is higher than that of those with negative margins. For patients with positive margins, PRT can decrease the recurrence rate. The recurrence rate trends to decline in patients with negative margins after receiving PRT.

Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected. Six hundred and fifteen patients who were more than 18 years old and less than or equal to 65 years old were included in young and middle-aged group (YM). Eighty-two patients aged more than 65 years old were included in elderly group (E). Data of age, gender, residence, education level, cause of injury, location of injury, season of injury, total burn area, occurrence and area of full-thickness burn injury, wound site, inhalation injury incidence and severity, post burn admission time, proportion of delayed resuscitation, proportion of escharectomy or tangential excision and skin grafting, preinjury systemic disease, system complication during hospitalization, length of hospital stay, outcome of treatment, and reason of abandoning treatment of patients were analyzed. Data were processed with chi-square test and Mann-Whitney U test. The odds ratios of preinjury systemic disease, system complication during hospitalization, and adverse outcome of patients in group YM were compared with those in group E. Results: (1) The majority of patients in the two groups were male, but the proportion of male patients in group YM was higher. There was statistically significant difference in gender distribution of patients between the two groups (χ²=18.727, P<0.001). The majority of patients in the two groups were from rural areas, but the proportion of rural patients in group E was higher. There was statistically significant difference in residence distribution of patients between the two groups (χ²=9.306, P=0.002). Patients in group YM mainly had secondary education, while patients in group E mainly had primary education. There was statistically significant difference in distribution of education level of patients between the two groups (χ²=146.797, P<0.001). (2) The most common causes of injury of patients in the two groups were both flame, but the proportion of patients with flame burn injury in group E was higher. There was statistically significant difference in distribution of cause of injury of patients between the two groups (χ²=25.063, P<0.001). The main locations of injury of patients in groups YM and E were respectively public place and private residence. There was statistically significant difference in location distribution of injury of patients between the two groups (χ²=46.313, P<0.001). The main seasons of injury of patients in groups YM and E were respectively summer and winter. There was statistically significant difference in season distribution of patients between the two groups (χ²=23.143, P<0.001). There was statistically significant difference in distribution of total burn area of patients between the two groups (χ²=25.799, P=0.002). The occurrences of full-thickness burn injury of patients in the two groups were similar (χ²=2.685, P=0.101), while there was statistically significant difference in area of full-thickness burn injury of patients between the two groups (χ²=26.702, P=0.002). There was no statistically significant difference in distribution of wound site of patients between the two groups (χ²=3.954, P=0.785). There were no statistically significant differences in incidence and severity distribution of inhalation injury of patients between the two groups (with χ² values respectively 0.425 and 0.672, P values above 0.05). (3) There was statistically significant difference in distribution of admission time of patients between the two groups (χ²=6.632, P=0.036), but there was no statistically significant difference in proportion of delayed resuscitation of patients between the two groups (χ²=1.261, P=0.261). The proportion of escharectomy or tangential excision and skin grafting of patients in group YM was 72.0% (443/615), which was significantly higher than 35.4% (29/82) of group E (χ²=44.498, P<0.001). The incidence of preinjury systemic disease of patients in group YM was 13.2% (81/615), which was significantly lower than 61.0% (50/82) of group E (χ²=108.337, P<0.001). The risk of preinjury systemic disease of patients in group E was 10.30 times of that of patients in group YM [with 95% confidence interval (CI) of 6.24-17.01, P<0.001]. During hospitalization, 59.8% (49/82) of patients in group E suffered from system complications, which was significantly higher than 36.6% (225/615) of group YM (χ²=16.282, P<0.001). The risk of system complication of patients in group E was 2.57 times of patients in group YM (with 95% CI of 1.61-4.12, P<0.001). The length of hospital stay of patients in group E was significantly shorter than that of group YM (U=36 735, P<0.001). There was statistically significant difference in treatment outcome of patients between the two groups (χ²=106.251, P<0.001). The risk of adverse outcome of patients in group E was 7.52 times of group YM (with 95% CI of 4.40-12.88, χ²=67.709, P<0.001). The proportion of abandoning treatment of patients in group E was significantly higher than that of group YM (χ²=150.670, P<0.001). The risk of abandoning treatment of patients in group E was 15.86 times of that of group YM (with 95% CI of 9.36-26.88, P<0.001). There was no statistically significant difference in distribution of reason of abandoning treatment of patients between the two groups (χ²=4.178, P=0.243). Conclusions There were significant differences in the epidemiological characteristics of patients in groups E and YM. In elderly burn patients, the proportion of rural population was higher and the education level was lower. Flame burn was common and burns mostly occurred in private residences and in winter. The total burn area was slightly lower but the area of full-thickness burn injury was larger. The length of hospital stay was shorter and the proportion of surgical treatment was lower. The incidences of preinjury systemic disease and system complication during hospitalization were higher, and therefore the risks of adverse outcome and abandoning treatment were higher.

Objective To evaluate comprehensive therapy in the treatment of keloid effect and the patients' satisfaction.Methods From 2002 to 2015,a total of 523 patients with comprehensive treatment,according to the treatment the patients were divided into group A (surgery combined radiotherapy group) and group B (operation with corticosteroid hormone therapy group),group C (corticosteroids in combination with radiotherapy group),and the therapeutic effect of patients with satisfaction was evaluate.Results Total effective rate of three groups of patients were 85.7％,84.0％,64.9％;the efficiency in group A was higher than that of group B and group C;there was statistically significant difference between group A and C (P＜0.05),but there were no significant difference between the group A and group B (P＞0.05).All the patients were follow up for one years and the adverse reaction in the three groups was slight and happened in the 2 month after cure.And the adverse reaction was all self-cure in the final follow up.Difference was statistically significant between three groups of patients' satisfaction,group B better than in group A and group C;there was no significant difference between group A and group B (P＞0.05);the difference between group B and C group was statistically significant (P＜0.05).Conclusions Three kinds of comprehensive therapy effect are obvious,among which surgical adjuvant radiotherapy effect is best,being worth to recommend for clinical use.

Toxoplasmosis, a neglected tropical disease caused by the protozoan parasite Toxoplasma gondii, occurs throughout the world. Human T. gondii infection is asymptomatic in 80% of the population; however, the infection is life-threatening and causes substantial neurologic damage in immunocompromised patients such as HIV-infected persons. The major purpose of this study was to investigate the seroprevalence of T. gondii infection in subjects infected with HIV/AIDS in eastern China. Our findings showed 9.7% prevalence of anti-T. gondii IgG antibody in HIV/AIDS patients, which was higher than in intravenous drug users (2.2%) and healthy controls (4.7%), while no significant difference was observed in the seroprevalence of anti-Toxoplasma IgM antibody among all participants (P>0.05). Among all HIV/AIDS patients, 15 men (7.7%) and 10 women (15.9%) were positive for anti-T. gondii IgG antibody; however, no significant difference was detected in the seroprevalence of anti-Toxoplasma IgG antibody between males and females. The frequency of anti-Toxoplasma IgG antibody was 8.0%, 13.2%, 5.5%, and 0% in patients with normal immune function (CD4+ T-lymphocyte count ≥500 cells/ml), immunocompromised patients (cell count ≥200 and <500 cells/ml), severely immunocompromised patients (cell count ≥50 and <200 cells/ml), and advanced AIDS patients, respectively (cell count <50 cells/ml), while only 3 immunocompromised patients were positive for anti-T. gondii IgM antibody. The results indicate a high seroprevalence of T. gondii infection in HIV/AIDS patients in eastern China, and a preventive therapy for toxoplasmosis may be given to HIV/AIDS patients based on CD4+ T lymphocyte count.
Acquired Immunodeficiency Syndrome/complications ; Antibodies, Protozoan/*blood ; China/epidemiology ; Female ; HIV Infections/*complications ; Humans ; Immunocompromised Host ; Male ; Seroepidemiologic Studies ; Toxoplasma ; Toxoplasmosis/*complications/*epidemiology

Background and purpose:The incidence of hepatoma is high. The outcome of treatment on hepatoma is poor.So we investigated the effect and mechanism of a selective cyclooxygenase-2 inhibitor celecoxib on the proliferation and apoptosis of SMMC-7721 hepatoma cell line. Methods:MTT assay was used to study the inhibitive effect of celecoxib on the growth of SMMC-7721 hepatoma cell. The effect of celecoxib on cell cycle and apoptosis on cells was studied by flow cytometry(FCM).Transmission electron microscopy (TEM) was used to display the morphological change of the SMMC-7721 hepatoma cell . The biochemical character of apoptosis was viewed on the agarose gel electrophoresis.The expression of bax gene and bcl-2 gene were measured by immunohistochemistry.Results:The SMMC-7721 cells were cultured in media that contained 25,50,75,100 ?mol/L celecoxib,by means of MTT, the inhibition rate was(15?3)%,(34.6?2.4)%,56.8?1.0)%,(86.2?0.4)% respectively after 24 hours; but the inhibition rate was (33.4?0.7)%,(66.7?1.8)%,(76.1?2.4)%,(97.3?0.8)% respectively after 48 hours(P

BACKGROUND: Diabetic morbidity can predict its progress tendency. National diabetic morbidity has been increased compared with previous level at present.OBJECTIVE: To compare the diabetic morbidity between populations with impaired glucose tolerance or normal blood glucose tolerance to analyze its correlative influencing factors.DESIGN: A cluster sampling survey in two communities of Liuzhou City Guangxi Zhuang Autonomous Region based on adults.SETTING: Department of endocrinology in a university hospital.PARTICIPANTS: Diabetic morbidity was investigated in 4 relative big unit communities of Liuzhou City between July and August 1994. The resident population of the communities was 11 886, which were all adults between 20 and 75 years old and lived in Liuzhou City for more than 5 years. Populations with either impaired glucose tolerance or normal blood glucose tolerance in 2 of the 4 unit communities were followed up in October 1999. Totally 9 230 individuals should be checked and 6 020 subjects were actually checked with the response rate of 65.22% (quite a few cases lost followed up due to unemployment and retirement, etc. ) . Inclusion criteria: Finally 5 539 subjects with complete data of two surveys entered into statistics. There were 5 237 normal individuals and 266 individuals with impaired glucose tolerance. And there were 3 177 males including 110 individuals with impaired glucose tolerance with an average age of(40 ± 12) years old, and 2 362 females including 156 individuals with impaired glucose tolerance with an average age of(41 ± 10) years old. Exclusion criterion: secondary diabetes.METHODS: Totally 5 539 subjects(including individuals with normal blood glucose or impaired glucose tolerance) who confirmed without diabetes in 1994 survey for diabetic morbidity in 2 unit communities of Liuzhou City Gugangxi Zhuang Autonomous Region received recheck in 1999 including blood glucose, body mass index(BMI), blood pressure and blood fat to analyze the impacts of each factor on diabetic morbidity.bidity among correlative risk factors.RESULTS: Totally 5 539 individuals were included into statistics. A totally of 46 of 5 237 normal individuals developed diabetes with the annual percent of conversion of 0.19%, while 50 of 226 individuals with impaired glucose tolerance developed diabetes with the annual percent of conversion of 3.84%, which had 20.9 times of correlative risk significantly higher than normal individuals(x2 = 1 063.1, P < 0. 000 1).CONCLUSION: The risk of diabetes is higher in individuals with impaired glucose tolerance than normal individuals. Age, BMI, hypertension, fasting blood glucose, blood glucose, and 1 hour blood glucose in Glucose tolerance test are risk factors of diabetic morbidity.

BACKGROUNDTo evaluate the reversal effect of high dose tamoxifen on multidrug resistance to EP regimen in patients with non-small cell lung cancer.

METHODSA total of 41 patients with NSCLC were studied, who were resistant to EP regimen and were proved to have P-gp protein overexpression. All patients were randomizedly divided into two arms. Reversal group (n=21) received oral tamoxifen 100?mg, 2 times everyday on D1-5, together with EP regimen. Control group (n=20) were only given EP regimen.

RESULTSIn reversal group, complete response occurred in 1 patient, and partial response in 5; disease remained stable in 11 patients, and tumor progression occurred in 4 patients. The response rate was 28.6%(6/21). In control group, no response occurred; 9 patients had stable diseases, and the other 11 progressed. There was a significant difference in response rate between the two groups (P=0.012?1). In reversal and control groups, the median survivals were 8.4 and 4.6 months respectively (P < 0.01), and 1-year survial rates were 38.1% and 35.0% respectively. Reversal of P-gp occurred in 7 cases of reversal group (33.3%),and none in control group (P= 0.005?2) . There was no significant difference in toxicities between the two groups (P > 0.05).

CONCLUSIONSHigh dose tamoxifen can remarkably downregulate the expression of P-gp and partially reverse the multidrug resistance to EP regimen for non-small cell lung cancer.

OBJECTIVETo investigate the possibility and short-term effect of high dose chemotherapy with peripheral blood stem cell support in the preoperative therapy of breast cancer, and-its influence on the following operation and would healing.

METHODSThree patients with T(3)N(1)M(0) (III(a)), T(4)N(1)M(0) (III(b)), T(4)N(1)M(1) (IV) of breast cancer were diagnosed histopathologically. After receiving HDC/APBSCT, the 3 patients were operated on. HDC/APBSCT process included 2 cycles of FEC induction chemotherapy; PBSC mobilization, APBSC collection and cryopreservation and PBSC infusion; and high-dose chemotherapy, APBSC infusion and supportive therapy. The therapy consisted of CTX2.5 g/m(2), VP-16 600 mg/m(2), and cerboplatin 600 mg/m(2) delivered on day 1, APBSC infusion 48 h later, rhG-CSF (150 microg, BID) was administered 4 h after infusion of APBSC until WBC was higher than 10 x 10(9)/L. During HDC/APBSCT, the patients were protected in the air laminar flow room with supportive therapy of antibiotics, anti-virus and anti-fungus drugs. They left the air laminar flow room after their WBC was greater than 2 x 10(9)/L. Case 1 was treated by radical mastectomy, Case 2 by improved radical mastectomy, Case 3 by improved radical mastectomy and transplantation of skin for the large area.

RESULTSRapid recovery of bone marrow function was observed in all 3 patients. Operation was performed 4 weeks after HDC/PBSCT in Cases 1, 2 and 33 days in Case 3. No influence was seen on operative procedure and would healing, especially in Case 3 with a large area of skin transplantation. Two patients with stage III(a) and III(b) have been alive since the treatment for 30 months and the other with stage IV died of brain metastasis 16 months later.

CONCLUSIONSHDC/APBSCT as a preoperative therapy for breast cancer has no influence on the coming surgery and would healing, even on skin transplantation for a large area. It has a practical response in stage III(a) and III(b), but it is still controversial in stage IV. This method as a salvage therapy for patients with breast cancer of intemuediate or stage.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; therapy ; Combined Modality Therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Mastectomy, Radical ; Middle Aged ; Neoplasm Staging ; Preoperative Care ; Salvage Therapy

Objective To identify the putative CpG-N ODNs in adenovisus 2 DNA (Adv2 DNA) and Adv5 DNA by comparing the sequence difference among Adv2, 5, 12 DNA and E.coli (EC) DNA. Methods Sequences of Adv2, 5, 12 DNA and EC DNA were obtained from the Entrez Nucleotides database at NCBI. The specific CpG motifs of Adv2 DNA and Adv5 DNA were identified after above sequences were analyzed and compared by softwares such as DNATools, BioEdit, and so on. All the 12-ODNs with specific CpG motif core were searched from Adv2 DNA and Adv5 DNA. Results 19 specific CpG motifs were ascertained and 504 12-ODNs were detected in Adv2 DNA and Adv5 DNA. Conclusion 504 12-ODNs were putative CpG-N ODNs in Adv2 DNA and Adv5 DNA.

Bacterial DNA taken up by immune cells in a CpG motif-independent manner is translocated into endosome. Endosomal maturation is essential for subsequent bacterial DNA-mediated signal transduction. TLR9 is recruited into endosome to recognize bacterial DNA and initiate the TLR/IL-1R signal transduction pathway. As a result , transcription factors NF-?B and AP-1 are activated, which, in turn, leads to proinflammatory cytokine expression and induces a strong acute Th1-like inflammatory response.