Malignant tumors are currently seriously endangering human health and life， which has become one of the main causes of death in China. In modern Western medicine， they are mainly tackled by surgery， chemotherapy， and radiotherapy， but the death toll continues to rise year by year. At present， most of the anti-tumor chemotherapeutics used in clinical practice have toxic and side effects， affecting the anti-tumor efficacy and the conditions after treatment. Long-term medication will also induce drug resistance， making the good anti-tumor effect difficult to be achieved. With the vigorous development of traditional Chinese medicine （TCM）， it has played a crucial role in the fight against tumors. It is believed in TCM that "heat toxin" is one of the important causes of tumors. Therefore， the methods of clearing away heat and removing toxin are often emphasized in the treatment of tumors， and the resulting outcomes are satisfactory. There are many Chinese herbs and Chinese herbal compounds classified into the heat-clearing and toxin-removing type. Xihuangwan， a classic heat-clearing prescription， is composed of Calculus Bovis， Moschus， Olibanum， and Myrrh and has the effects of clearing away heat， removing toxin， eliminating edema， and dissipating mass， which is mainly used to treat carbuncle， pustule， scrofula， multiple abscess， and cancer caused by heat-toxin obstruction. In modern clinical practice， it has been employed in patients with lung cancer， breast cancer， gastric cancer， liver cancer， colorectal cancer， and other malignant tumors， especially during the advanced stage， as a routine or adjuvant treatment for alleviating their clinical symptoms and improving their quality of life. The main active components of Xihuangwan are pentacyclic triterpenoids （such as masticinic acids）， volatile oils， steroids （like porcine deoxycholic acid）， and bilirubin， which have been proved effective in anti-tumor. This paper reviewed the prescription source， pharmaceutical research， clinical anti-tumor research， and pharmacological mechanisms of Xihuangwan， which has provided reference for further expanding the anti-tumor applications of Xihuangwan and enhancing its secondary development.

OBJECTIVE: To explore the efficacy of a novel sternoclavicular hook-plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint. METHODS: Retrospective analysis of 13 cases of proximal clavicle fracture with dislocation of sternoclavicular joint treated with sternoclavicular hook-plate from June 2011 to January 2019 in our department. There were 9 males and 4 females, aged 26 to 78 years old, with an average age of (54.08±13.91) years old. All the patients had closed injuries without damage of blood vessels and nerves. The patient's operation time, intraoperative blood loss, hospital stay time, and postoperative complications were recorded. Fracture healing and reduction were evaluated according to X-ray and CT after operation. Constant-Murley score and Rockwood sternoclavicular joint score were used to evaluate limb function at 12 months after operation. RESULTS: All the patients were treated with sternoclavicular hook-plate. The operation time ranged from 50 to 76 min, with a mean of (54.08±13.91) min. The intraoperative blood loss ranged from 20 to 56 ml, with a mean of (46.08±11.15) ml. The hospital stay time ranged from 6 to 14 d, with a mean of (8.31±2.32) d. X-ray and CT examination on the second day after operation showed that all fractures and dislocations were anatomically reduced, and shoulder joint function exercise was performed early. All patients were followed up, and the duration ranged from 12 to 24 months, with a mean of (16.77±4.63) months. The healing time ranged from 9 to 13 d, with a mean of (11.00±1.75) d;and the bone healing time ranged from 3 to 4 months, with a mean of (3.65±0.46) months. There were no complications such as infection, internal fixation failure and nerve injury. At 12 months follow-up, the constant Murley score ranged from 78 to 100, with a mean of 87.83± 11.26; and Rockwood score ranged from 9 to 15, with a mean of 13.70±1.85. Among them, 11 cases were excellent, 1 case was good, and 1 case was general. CONCLUSION The use of the novel sternoclavicular hook-plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint is an effectively internal fixation with high safety, allowing early functional exercise for patients.
Adult ; Aged ; Bone Plates ; Clavicle ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; Humans ; Joint Dislocations ; Male ; Middle Aged ; Retrospective Studies ; Sternoclavicular Joint ; Treatment Outcome

OBJECTIVETo investigate the effect of metronomic chemotherapy of low dose phosphoramide combined with prednisolone (CP metronomic chemotherapy) on proliferation and apoptosis of RPMI 8226 cells, and to explore its regulating effect on Notch1/NF-κB signaling pathways.

METHODSExperiment was divided into the DMSO control group, and the phosphoramide mustard (PM) group, the prednisolone group, the phosphoramide mustard plus prednisolone group (the CP group). RPMI 8226 cells were treated with different drugs, CCK-8 method was used to detect cell proliferation, flow cytometry was used to detect the cell cycle and apoptosis, reverse transcription PCR was used to detect Notch1 and NF-κB mRNA expression level.

RESULTSCompared with DMSO control group, RPMI8226 cell proliferation inhibition rate in all the PM, prednisolone and CP groups increased significantly with prolonging of time (r of 0.994,0.996,0.999, respectively, P<0.001). And at the same time, the inhibitory rate of cell proliferation was significantly different; the cell inhibitory rate in PM group was lowest, that in CP group was highgest, that in prednissone group was intermediate (P<0.01). After 48 hours, compared with the DMSO control group, the G/Gcell proportion in treatment group increased significantly, S phase cell proportion decreased significantly, especially in PM and CP groups. The G/M phase cell proportion increased in PM group, while reduced in the prednisolone and the CP groups. After 48 hours, compared with the DMSO control group, RPMI 8226 cell apoptosis rate increased as follow: in PM, pre-dnisolone and CP group(P<0.01). After 48 hours, compared with the DMSO control group, Notch1 and NF-κB mRNA expression in the prednisolone, the PM and the CP group decreased significantly(P<0.001).

CONCLUSIONCP metronomic chemotherapy can significantly reduce RPMI 8226 cell proliferation, promote RPMI 8226 cell apoptosis, arrest RPMI 8226 cells mainly in the G/Gphase, and significantly reduce Notch1 and NF-κB expression levels. It is suggested that Notch1/NF-κB signaling pathways is involved in CP metronomic chemotherapy for MM.

OBJECTIVETo evaluate the impact of the factors of perceived male infertility on men's penile erectile function.

METHODSUsing the 5-item version of the International Index of Erectile Function (IIEF-5), we investigated the penile erectile function among 245 infertile men (infertility group) and another 52 males having physical checkup for planned conception (checkup group), the former further divided into four subgroups according to the factors of infertility: male factor, female factor, bilateral factor, and unknown factor. We compared the total and item scores of IIEF-5 among different groups.

RESULTSMild or mild-moderate ED was found in 50.61% of the infertile men, with a total IIEF-5 score of 21.24 +/- 2.58. The total and item scores of IIEF-5 were markedly higher in the male factor than in the female factor subgroup (P < 0.01), but with no significant difference between the male factor subgroup and the bilateral and unknown factor subgroups (P > 0.05), except the score on confidence. The scores were significantly lower in the bilateral and unknown factor subgroups than in the female factor subgroup (P < 0.05), with no remarkable difference between the former two. In the infertility group, the total and item scores of IIEF-5 were markedly higher in those with education above high school than in those with high school or lower education (P < 0.01), but not correlated with age and infertility duration. After adjustment for education background, the total IIEF-5 score and the scores on confidence and satisfaction were significantly lower in the infertility than in the checkup group (P < 0.05), and 15.38% of the men in the latter group had mild ED, dramatically lower than in the former (P < 0.01).

CONCLUSIONPerceived infertility may cause ED in males, and a higher incidence rate is associated with lower education background of the men.

Adult ; Erectile Dysfunction ; epidemiology ; Humans ; Infertility, Male ; physiopathology ; Male ; Penile Erection ; Penis ; physiopathology ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo investigate effects of low-dose cyclophosphamide and prednisone (CP) metronomic chemotherapy on microvessel density of bone marrow, serum vascular endothelial growth factor (VEGF) and platelet derived growth factor BB (PDGF-BB)in multiple myeloma (MM) patients.

METHODS54 refractory or relapsed MM patients were treated with CP metronomic chemotherapy consisted of oral cyclophosphamide (CTX, 50 mg/d) and prednisone (Pred, 15 mg/d). Bone marrow and peripheral blood of each patient were collected before and 2, 4, 6 months after treatment. Among the 37 assessable patients, 30 cases were responsive with the response rate of 81.08%. Another 17 cases were follow-uped less than 6 months or failure to obtain serum samples or lost to follow-up. Microvessel density of bone marrow was measured by immunohistochemistry and serum VEGF/PDGF-BB expression was analyzed by ELISA in the 37 assessable patients.

RESULTS2, 4, 6 months following CP metronomic chemotherapy, microvessel densities of bone marrow in the responders were 33.1 ± 4.8/HP, 24.8 ± 3.7/HP, 19.7 ± 2.1/HP respectively; the expressions of VEGF were (394 ± 57) ng/L, (268 ± 32) ng/L and (217 ± 20) ng/L respectively; the expressions of PDGF-BB were (304 ± 31) ng/L, (274 ± 31) ng/L and (196 ± 22) ng/L respectively. After CP metronomic chemotherapy, there were significantly lower of microvessel density, VEGF and PDGF-BB levels than pretreatment \[MVD 48.5 ± 5.9/HP, VEGF (517 ± 60) ng/L, PDGF-BB (484 ± 60) ng/L\]in the responders (P < 0.01). While in the non-responders, after treated by CP metronomic chemotherapy for 2 months, microvessel density, the expression of VEGF and the expression of PDGF-BB were 32.5 ± 4.7/HP, 512 ± 39 ng/L and (452 ± 39) ng/L respectively. There were no significant changes of MVD, VEGF and PDGF-BB levels compared with pretreatment \[MVD 33.2 ± 5.6/HP,VEGF (498 ± 55) ng/L, PDGF-BB (488 ± 44) ng/L\] (P > 0.05).

CONCLUSIONSOur findings suggested that continuous low-dose CP metronomic chemotherapy could decrease microvessel density of bone marrow in MM patients. Furthermore, it down-regulated expression of serum VEGF and PDGF-BB to exert its anti-angiogenesis in MM.

Aged ; Aged, 80 and over ; Angiogenesis Inhibitors ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; administration & dosage ; Female ; Humans ; Male ; Microvessels ; drug effects ; Middle Aged ; Multiple Myeloma ; blood ; blood supply ; drug therapy ; Prednisone ; administration & dosage ; Proto-Oncogene Proteins c-sis ; blood ; Vascular Endothelial Growth Factor A ; blood

Objective To investigate the clinical effect of low-dose cyclophosphamide plus prednisone (CP regimen) in treatment of multiple myeloma (MM) and its influence on serum levels of vascular endothelial growth factor (VEGF) and platelet-derived growth factor BB (PDGF-BB). Methods Totally 54 patients with refractory or relapse MM were continuously treated with CP regimes oral cyclophosphamide (CTX, 50 mg/d) and prednisone (Pred, 15 mg/d). The peripheral blood samples were collected from each group 0, 2, 4, and 6 months after treatment. Serum VEGF and PDGF-BB levels were analyzed by ELISA. Results The overall effective rate was up to 69% (36/52) in our study. The treatment was effective in 30 patients, including 2 complete response (CR) cases, 4 very good partial response (VGPR) cases and 24 partial response (PR) cases, and their serum samples were examined for 4 times. The serum levels of VEGF and PDGF-BB were significantly decreased in the 30 patients at 2, 4, and 6 months after treatment (P<0. 01); while their levels were not significantly change in the 7 invalid patients 2 months after treatment compared with before treatment. Conclusion Low-dose cyclophosphamide plus prednisone has noticeable effect in treatment of MM patients; it can also greatly down-regulate serum VEGF and PDGF-BB levels. The mechanisms of CP regimen in MM patients may be associated with the inhibition of new blood vessel generation.

Objective To investigate the application of computer aided design-computer aided manufacture(CAD-CAM)technique in the reconstruction of mandible defect with individual titanium prosthesis. Methods Six patients with large mandibular ramus and angle tumor were spiral CT scanned preoperatively, and the CAD-CAM was used to design and make individual titanium prosthesis for reconstructing the mandibular defects after resection of the tumor. The prosthesis were assembled during operation. Postoperative follow-up period was 9-38 months.Results The design and manufacture of titanium prosthesis by use of CAD-CAM technique was convenient and the prosthesis fitted the defects very well.The outline of the face,the occlusion and function were restored. After 9-38 months of follow-up, the mandibular symmetry was good.Conclusions The application of CAD-CAM provided accurate simulation and fast manufacturing process for the titanium prosthesis in the repair of mandibular defect.

OBJECTIVETo investigate the influence of multiple sintering on wear behavior of Cercon veneering ceramic.

METHODSSamples were fabricated according to the manufacture's requirement for different sintering times (1, 3, 5, 7 times). The wear test was operated with a modified MM-200 friction and wear machine in vitro. The wear scars were characterized by scanning electron microscope (SEM) and atomic force microscopy (AFM).

RESULTSWith the sintering times increasing, the wear scar width became larger. The correlation was significant at the 0.01 level. Significant difference was observed in wear scar width among different samples (P < 0.05). SEM and AFM results showed that veneering ceramic wear facets demonstrated grooves characteristic of abrasive wear.

CONCLUSIONMultiple sintering can decrease the wear ability of Cercon veneer, and the wear pattern has the tendency to severe wear.

Ceramics ; Dental Porcelain ; Dental Veneers ; Materials Testing ; Surface Properties ; Zirconium

The aim of this study is to assess the status of treatment of chronic prostatitis (CP) in Chinese men. A population-based cross-sectional survey was performed, in which 15 000 men aged between 15 and 60 years were randomly selected to receive a questionnaire designed to assess National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI) status, therapeutic efficacy and 28 other items. A total of 12 743 men (84.95%) completed the questionnaire, of whom 1 071 (8.4%) were identified as having prostatitis-like symptoms and 517 (4.5%) were diagnosed with CP according to NIH-CPSI criteria and prostatitis-like symptomatology. Of the CP patients, 372 (65%) underwent long-term routine treatment 12 times per year. Additionally, 217 (72.8%) patients received antibiotic therapy and 215 (79.3%) men showed therapeutic effects. The treatment cost USD 1 151 (8 059 yuan) per person per year on average. Most CP patients received routine treatment, in most cases with antibiotics. Treatment was costly and most CP patients were not satisfied with its effectiveness. Antibacterial treatment might have been effective primarily in patients with bacterial disease.
Adolescent ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; complications ; drug therapy ; epidemiology ; China ; epidemiology ; Chronic Disease ; Cross-Sectional Studies ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Middle Aged ; Prevalence ; Prostatitis ; drug therapy ; epidemiology ; microbiology ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the application of double-step distraction osteogenesis in the reconstruction of mandibular segmental defects after tumor resection.

METHODSFrom January 2002 to December 2006, six cases of post-tumor unilateral mandibular segmental defects were reconstructed using distraction osteogenesis. The mandibular body was lengthened first, following by mandibular ramus distraction.

RESULTSNo infection or other complication was observed. The maximal distraction length reached 55 millimeter in the mandibular body, and 42 millimeter in the mandibular ramus. The average distraction length was 52 millimeter in the mandibular body, and 34 millimeter in the mandibular ramus. Both the aesthetic and functional result was excellent in all cases.

CONCLUSIONSDouble-step distraction osteogenesis is effective and easily performed in the reconstruction of unilateral mandibular segmental defects with less morbidities and complications. There is no need for donor site. However, the treatment period is relatively long with three staged operations.

Adolescent ; Adult ; Female ; Humans ; Male ; Mandibular Neoplasms ; surgery ; Middle Aged ; Osteogenesis, Distraction ; methods ; Reconstructive Surgical Procedures ; methods ; Young Adult