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Zwitterionic sulfobetaine-based monolithic stationary phases have attracted increasing attention for their use in hydrophilic interaction chromatography.In this study,a novel hydrophilic polymeric monolith was fabricated through photo-initiated copolymerization of 3-(3-vinyl-1-imidazolio)-l-propanesulfonate(SBVI)with pentaerythritol triacrylate using methanol and tetrahydrofuran as the porogenic system.Notably,the duration for the preparation of this novel monolith was as little as 5 min,which was significantly shorter than that required for previously reported sulfobetaine-based monoliths prepared via conventional thermally initiated copolymerization.Moreover,these monoliths showed good morphology,permeability,porosity(62.4％),mechanical strength(over 15 MPa),column efficiency(51,230 plates/m),and reproducibility(relative standard deviations for all analytes were lower than 4.6％).Mechanistic studies indicated that strong hydrophilic and negative electrostatic interactions might be responsible for the retention of polar analytes on the zwitterionic SBVI-based monolith.In particular,the resulting monolith exhibited good anti-protein adhesion ability and low nonspecific protein adsorption.These excellent features seem to favor its application in bioanalysis.Therefore,the novel zwitterionic sulfobetaine-based monolith was successfully employed for the highly selective separation of small bioactive compounds and the efficient enrichment of N-glycopeptides from complex samples.In this study,we prepared a novel zwitterionic sulfobetaine-based monolith with good performance and developed a simpler and faster method for preparation of zwitterionic monoliths.
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The principle of total mesorectal excision (TME) standardizes the resection range and surgical dissection plane in radical rectal cancer surgery, reduces the local recurrence rate and improves the long-term survival. TME is the "gold standard" in radical rectal cancer surgery. However, with the progress of laparoscopic surgical instruments and techniques in recent years, further understanding of pelvic membrane anatomy and autonomic nervous system has been gained, which makes the surgical plane of TME more accurate and the autonomic nervous system better preserved. According to anatomical discovery and histological confirmation, there is a fascia between the mesorectal fascia and pelvic parietal fascia, called pre-hypogastric nerve sheath, in which autonomic nervous system courses, including the superior hypogastric plexus, left and right hypogastric nerves, pelvic plexus and the neurovascular bundles, from the abdominal to the pelvic cavity behind the mesorectal fascia. It fuses with the end of the mesorectum at the superior border of musculi puborectalis, and goes around the mesorectum to join with Denonvillier fascia. On the basis of anatomical studies and empirical anatomical observations, we put forward the concept of network preservation of the autonomic nervous system: the main trunk as well as the nerve branches of the pelvic autonomic nervous system and accompanying blood vessels should be preserved to ensure the integrity of the nerve reflex arc. The concept allows the radical resection of rectal cancer to follow the principle of TME, and meanwhile, protect patient's urination function and sexual function to the greatest extent, improving the quality of life of patients after surgery.
Subject(s)
Humans , Autonomic Nervous System , Neoplasm Recurrence, Local , Pelvis , Quality of Life , Rectal Neoplasms/surgery , RectumABSTRACT
To evaluate the efficacy and safety of traditional Chinese medicine injections( CMI) in the treatment of acute exacerbation of chronic obstructive pulmonary disease( AECOPD). PubMed,Cochrane Library,CNKI,CBM,Wan Fang and VIP database( since the date of database establishment to July 2018) were retrieved through computer for controlled randomized trials( CRTs) of 3 kinds of traditional Chinese medicine injections( Chuankezhi Injection,Tanreqing Injection,Xuebijing Injection) for AECOPD. After the methodological quality of included researches were evaluated,and the valid data were extracted,statistical analysis was performed with Stata 14,RevMan 5.3 is used for risk bias map. There were including 4 RCTs and 20 quasi-RCTs,which involving 579 patients.The results of network Meta-analysis showed that: ①there were significant differences in the forced expiratory volume in the first second between the 3 CMI and control groups,and there was no significant difference between CMI; ②3 kinds of CMI adjuvant therapy AECOPD,According to the forced expiratory volume in the first second of the probability ranking results,Tanreqing Injection is more effective,followed by Xuebijing Injection and Chuankezhi Injection. Based on the present evidence,3 kinds of CMI can improve the forced expiratory volume in the first second on the basis of Western medicine routine treatment of AECOPD,having better safty. In addition,the conclusion of this study still needs a large number of RCTs with reasonable design and proper method to confirm it.
Subject(s)
Humans , Drugs, Chinese Herbal , Therapeutic Uses , Injections , Medicine, Chinese Traditional , Network Meta-Analysis , Pulmonary Disease, Chronic Obstructive , Drug Therapy , Randomized Controlled Trials as TopicABSTRACT
Proper evaluation and management of surgical specimens of colorectal cancer,such as standardizing the macroscopic evaluation criteria of colorectal cancer specimens,standard processing procedure of specimens,decision criteria of routine histologic types,the method for determination of the resection specimen infiltration distance and curative degree,are of important clinical significance for surgical quality control,assessment of local lesion infiltration and diffusion,pathological classification and stage,which is able to predict prognosis and guide postoperative treatment.
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The inflammatory response is involved in the pathogenesis of the most common types of heart disease.Sanguinarine (SAN) has various pharmacological properties such as anti-inflammatory,antioxidant,antibacterial,antitumor,and immune-enhancing properties.However,few studies have investigated the effects of SAN on lipopolysaccharide (LPS)-induced inflammatory and apoptotic responses in H9c2 cardiomyocytes.Therefore,in this study,H9c2 cells were co-treated with SAN and LPS,and the mRNA levels of pro-inflammation markers and the apoptosis rate were measured to clarify the effect of SAN on cardiac inflammation.The underlying mechanism was further investigated by detecting the activation of Toll-like receptor (TLR)4/nuclear factor-κB (NF-κB) signaling pathways.As a result,increased mRNA expression of interleukin (IL)-1 β,IL-6,and TNFα induced by LPS was attenuated after SAN treatment;LPS-induced apoptosis of H9c2 cardiomyocytes and cleaved-caspase 8,9,3 were all significantly reduced by SAN.Further experiments showed that the beneficial effect of SAN on blocking the inflammation and apoptosis of H9c2 cardiomyocytes induced by LPS was associated with suppression of the TLR4/NF-κB signaling pathway.It was suggested that SAN suppressed the LPS-induced inflammation and apoptosis of H9c2 cardiomyocytes,which may be mediated by inhibition of the TLR4/NF-κB signaling pathway.Thus,SAN may be a feasible therapy to treat sepsis patients with cardiac dysfunction.
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The inflammatory response is involved in the pathogenesis of the most common types of heart disease.Sanguinarine (SAN) has various pharmacological properties such as anti-inflammatory,antioxidant,antibacterial,antitumor,and immune-enhancing properties.However,few studies have investigated the effects of SAN on lipopolysaccharide (LPS)-induced inflammatory and apoptotic responses in H9c2 cardiomyocytes.Therefore,in this study,H9c2 cells were co-treated with SAN and LPS,and the mRNA levels of pro-inflammation markers and the apoptosis rate were measured to clarify the effect of SAN on cardiac inflammation.The underlying mechanism was further investigated by detecting the activation of Toll-like receptor (TLR)4/nuclear factor-κB (NF-κB) signaling pathways.As a result,increased mRNA expression of interleukin (IL)-1 β,IL-6,and TNFα induced by LPS was attenuated after SAN treatment;LPS-induced apoptosis of H9c2 cardiomyocytes and cleaved-caspase 8,9,3 were all significantly reduced by SAN.Further experiments showed that the beneficial effect of SAN on blocking the inflammation and apoptosis of H9c2 cardiomyocytes induced by LPS was associated with suppression of the TLR4/NF-κB signaling pathway.It was suggested that SAN suppressed the LPS-induced inflammation and apoptosis of H9c2 cardiomyocytes,which may be mediated by inhibition of the TLR4/NF-κB signaling pathway.Thus,SAN may be a feasible therapy to treat sepsis patients with cardiac dysfunction.
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Objective To observe the effects of Bufei Yishen Huoxue Prescription combined with Western routine treatment on bone metabolism in patients with chronic obstructive pulmonary disease (COPD). Methods Totally 60 patients with COPD (GOLD level 2/3, comprehensive evaluation B/C group) were randomly divided into observation group and control group through randomized and parallel method, with 30 cases in each group. Patients of the control group were treated with COPD Western routine treatment. Patients of the observation group were treated with Bufei Yishen Huoxue Prescription on the basis of the control group, one dosage per day, twice a day, orally. The treatment for both groups lasted for 12 weeks. TCM symptom scores, levels of P1 NP and β-CTX, and bone mineral density in both groups were observed before and after treatment. Results Compared with before treatment, the total score of TCM symptom scores, scores of wheezing, expectoration, chest tightness, weakness of waist and knees, and frequent night urination in the observation group decreased significantly, with statistical significance (P＜0.05). After treatment, the total score of TCM symptom scores in the observation group was significantly lower than that in the control group (P＜0.05). After treatment, the decline degree of total score of TCM symptom scores, scores of wheezing, chest tightness, fatigue, weakness of waist and knees in the observation group were better than the control group, with statistical significance (P＜0.05). After treatment, the increase of P1 NP in the observation group was significantly higher than that in the control group (P＜0.05). β-CTX showed a downward trend after treatment, without statistical significance (P＞0.05). After treatment, there was 1 case of dry mouth in each group and 1 case of loss of appetite in the observation group. There was no obvious adverse reaction. Conclusion Bufei Yishen Huoxue Prescription combined with Western routine treatment can effectively relieve the clinical symptoms of patients with COPD, restore the functional state of osteoblast, and improve bone metabolism.
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<p><b>BACKGROUND</b>Antiplatelet therapy (APT) was prevalently being used in the prevention of vascular disease, but the influence of prior APT on the prognosis of patients with intracerebral hemorrhage (ICH) remains controversial. This meta-analysis was to explore the effects of prior APT on the prognosis of patients with primary ICH.</p><p><b>METHODS</b>PubMed and Embase were searched to identify the eligible studies. The studies comparing the mortality of ICH patients with or without prior APT were included. The quality of these studies was evaluated by the Newcastle-Ottawa quality assessment scale. The adjusted or unadjusted odds ratio (OR) for mortality between ICH patients with and without prior APT were pooled with 95% confidence interval (95% CI) as the effect of this meta-analysis.</p><p><b>RESULTS</b>Twenty-two studies fulfilled the inclusion criteria and exhibited high qualities. The pooled OR was 1.37 (95% CI: 1.13-1.66, P = 0.001) for univariate analysis and 1.41 (95% CI: 1.05-1.90, P = 0.024) for multivariate analysis. The meta-regression indicated that for each 1-day increase in the time of assessment, the adjusted OR for the mortality of APT patients decreased by 0.0049 (95% CI: 0.0006-0.0091, P = 0.026) as compared to non-APT patients.</p><p><b>CONCLUSION</b>Prior APT was associated with high mortality in patients with ICH that might be attributed primarily to its strong effect on early time.</p>
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Objective To analyze the genetic phenotypes of Nantong Han population and evaluate the application value of 17 Y-STR loci in Nantong population.Methods The peripheral blood samples were collected from 343 unrelated Nantong Han males and the genomic DNA were extracted by Chelex-100 method.Genotyping was performed using the AmpF(l)STR YfilerTM Kit.The results were compared with other 12 Han populations,including Anhui,Jiangsu,Jiangxi,Shandong,Shanghai,Zhejiang (1),Lanzhou,Nanyang,Luzhou,Mudanjiang,Shanxi and Zhejiang (2),and 9 minority populations (Mongol,Xibe,Tibetan in Lhasa,Tibetan in Qinghai,Kazak,Uighur,Manchu,Paiwan in Taiwan and Tujia).Results A total of 327 different haplotypes were found in 17 Y-STR loci in Nantong Han population.The haplotype diversity (HD) was 0.999 7.The R,value between Nantong Han and other Chinese populations ranged from-0.000 6 to 0.263 5.The multidimensional scaling results showed that Nantong Han population had no significant differences between most of the Han populations,but had significant differences between most of Chinese minority populations.Conclusion Seventeen Y-STR loci can be a powerful tool for forensic application because of its high polymorphism in Nantong Han population.
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Objective To discuss the X-ray and CT findings of pulmonary air leak in neonates and to improve the early diagnostic ability.Methods The supine anteroposterior chest films of 33 neonates with pulmonary air leak were retrospectively analyzed.A-mong them,spiral CT scanning was performed in 5 cases.Radiographic follow-up was made in 30 cases.Results Pulmonary intersti-tial emphysema was found in 2 cases,pneumomediastinum in 4 cases,simple pneumothorax in 14 cases.Pulmonary interstitial em-physema combined with pneumomediasfinum was detected in 2 cases,with pneumothorax in 4 cases.Pneumomediastinum combined with pneumothorax was displayed in 3 cases.Pulmonary interstitial emphysema combined with pneumomediastinum and pneumotho-rax was found in 4 cases.Among them,medial pneumothorax was shown in 26 side,lateral pneumothorax in 9 side.Conclusion X-ray radiography is the main method for the diagnosis of pulmonary air leak in neonates,and CT can further define the location,range and extent of the disease.
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The physiological and bio-marker function of D-acidic amino acids is now becoming the hot topic on metabolomics study and new drug discovery. A fully automated two-dimensional high performance liquid chromatography (2D-HPLC) system was established by using monolithic ODS column as the first dimension column, acetonitrile-trifluoro acetic acid-water (9: 0. 05: 92, V/ V) as the mobile phase; micro Chiralpak QD-1-AX column as the enantiomer separation column, 10 mmol/ L citric acid in methanol-acetonitrile (50: 50, V/ V) as the mobile phase for the second dimension, 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F) as the fluorometrical derivative reagent. The separation efficiency ( Rs > 2. 5), determination sensitivity ( LOD =1 fmol) of acidic amino acids enantiomers were higher than those of existing methods, and an online confirmation of the enantiomers amounts was also achieved using this system. The recoveries were around 97-104% , RSD values for intra-day and inter-day precision were less than 5% for the acidic amino acids enantiomers in the biological samples. Furthermore, by analyzing the aging model senescence accelerated mouse prone 1 (SAMP1) mice which have low immunocompetence, the amounts of D-aspartic acid in thymus and spleen were determined as (206±18) and (264±21) nmol/ g, respectively. It is the first time that an obvious trend of the increasement of D-aspartic acid (p<0. 01) was observed in thymus and spleen of SAMP1 mice compare to senescence accelerated mouse resistant 1 (SAMR1) mice.
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<p><b>OBJECTIVE</b>To explore the relationship of inflammation and endothelial dysfunction with risks to cardiovascular disease (CVD).</p><p><b>METHODS</b>Blood pressure, body weight, body height, waist circumference and lifestyle risk factors were measured and studied among 2589 participants in Inner Mongolia of China, and biomarkers of inflammation and endothelial dysfunction including high-sensitivity C-reactive protein (hsCRP), soluble inter-cellular adhesion molecule-1 (sICAM-1), soluble E-selectin (sE-selectin), and angiotensin II were investigated.</p><p><b>RESULTS</b>Subjects with metabolic risk factors for CVD had higher levels of hsCRP, sE-selectin and sICAM-1 than those without such risk factors (all P<0.05). Levels of all biomarkers positively and significantly increased with aggregation of the metabolic risk factors among the subjects (all P for trend <0.001). Data from the multivariate analysis showed that participants with high levels of hsCRP [odds ratio (OR): 1.96, 95% confidence interval (CI): 1.52-2.53], sE-selectin (OR: 1.35, 95% CI: 1.05-1.72), and angiotensin II (OR: 1.81, 95% CI: 1.40-2.33) were more likely to develop hypertension; participants with high levels of hsCRP (OR: 2.33, 95% CI: 1.85-2.94), sE-selectin (OR: 1.24, 95% CI: 1.00-1.54), and sICAM-1 (OR: 1.70, 95% CI: 1.30-2.22) were more likely to develop dyslipidemia, and those with high levels of hsCRP (OR: 2.95, 95% CI: 2.27-3.83) and sICAM-1(OR: 2.80, 95% CI: 2.06-3.80) were more likely to develop hyperglycemia.</p><p><b>CONCLUSION</b>Biomarkers of inflammation and endothelial dysfunction were separately associated with relevant metabolic risk factors for CVD. And appropriate measures should be taken to control inflammation and improve endothelial function among individuals with different metabolic risk factors for CVD.</p>
Subject(s)
Humans , Biomarkers , Blood , C-Reactive Protein , Metabolism , Cardiovascular Diseases , China , Endothelium, Vascular , Metabolism , InflammationABSTRACT
<p><b>BACKGROUND</b>Acute gout is an intensely painful, inflammatory arthritis. Although the non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for this condition, the efficacy is based on only a few studies, particularly in China. We tried to assess the safety and efficacy of etoricoxib in the treatment of acute gouty arthritis in China.</p><p><b>METHODS</b>A randomized, double-blind, active comparator study was conducted at 10 sites in China. Patients (n = 178; ≥ 18 years of age) with acute gouty attack (< 48 hours) were treated for 5 days with etoricoxib (120 mg/d; n = 89) or indometacin (75 mg twice daily; n = 89). The primary efficacy end point was self-assessed pain in the affected joint (0-4 point Likert scale) from days 2 - 5. Secondary end points included investigator assessments of tenderness and swelling, patient/ investigator global assessments of response to therapy, and patients discontinuing treatment. Safety was assessed by adverse events (AEs).</p><p><b>RESULTS</b>Etoricoxib and indometacin had comparable primary and secondary end points. Mean change difference from baseline from days 2 - 5 was 0.03 (95% confidence interval (CI) -0.19 to 0.25; P = 0.6364), which fell within the prespecified comparative bounds of -0.5 to 0.5. No severe AEs were associated with etoricoxib use. Non-severe AEs were mainly digestive and general, and most (73.7%) were mild, although they caused withdrawal of two subjects in the etoricoxib group, due to bilateral renal calculi and uronephrosis of the left kidney (unrelated to etoricoxib) and fever and chills (potentially etoricoxib-related). Overall, AEs were similar, although the absolute number of AEs in the etoricoxib group (n = 31) was less than the indometacin group (n = 34).</p><p><b>CONCLUSIONS</b>Etoricoxib (120 mg once daily) is effective in treating acute gout, is generally safe and well-tolerated, and is comparable in efficacy to indometacin (75 mg twice daily).</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Arthritis, Gouty , Drug Therapy , Cyclooxygenase Inhibitors , Therapeutic Uses , Double-Blind Method , Indomethacin , Therapeutic Uses , Pyridines , Therapeutic Uses , Sulfones , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and clinical significance of 64-multislice spiral computed tomography angiography(MSCTA) with image fusion for the anatomy of perigastric arteries.</p><p><b>METHODS</b>A total of 53 patients underwent abdominal 64-MSCTA, among whom 26 patients with gastric cancer underwent gastrectomy. Using volume rendering techniques, computed tomography angiography(CTA) of perigastric arteries and the stomach were reconstructed respectively, and then the images were fused together. The branching pattern of the celiac trunk and the origins and courses along the stomach of the 10 perigastric arteries were assessed. The accuracy, sensitivity, and specificity of 64-MSCTA were determined based on intraoperative findings.</p><p><b>RESULTS</b>CTA clearly showed the celiac trunk. The most common branching pattern of the celiac trunk was Michels type I( in 46 patients(86.8%). The anatomy of perigastric arteries and stomach could be clearly demonstrated from any angle according to image fusion. The left gastric artery and the right gastroepiploic artery were shown in 100%, the left gastroepiploic artery 94.3%(50/53), the right gastric artery 83.0%(44/53), short gastric artery 58.5%(31/53), posterior gastric artery 49.1%(26/53), the replaced left hepatic artery 15.1%(8/53). The accessory left hepatic artery, accessory left gastric artery and replaced right hepatic artery were all identified in 7.5%(4/53) patients. The accuracy of preoperative CTA in term of correctly identifying perigastric arteries ranged from 84.6% to 100%, the sensitivity 82.6% to 100%, and the specificity was 100% for all the perigastric arteries.</p><p><b>CONCLUSIONS</b>64-MSCTA can clearly reveal individual perigastric arteries. The anatomy of the stomach and perigastric arteries can be shown in vivo by fused image, and can provide guidance for gastrectomy.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Angiography , Methods , Arteries , Image Processing, Computer-Assisted , Preoperative Care , Sensitivity and Specificity , Stomach , Stomach Neoplasms , Diagnostic Imaging , General Surgery , Tomography, Spiral ComputedABSTRACT
<p><b>OBJECTIVE</b>To summarize the experience and short-term clinical outcomes of hand-assisted laparoscopic surgery (HALS) in sphincter-preserving surgery for low and ultralow rectal cancer.</p><p><b>METHODS</b>Data of 49 patients with rectal cancer who underwent HALS for low or ultralow anterior resection between January 2010 and January 2011 were analyzed retrospectively.</p><p><b>RESULTS</b>The proximal resection margin was (14.3±6.9) cm and the distal margin was(4.3±1.9) cm. The mean operative time was(128.3±70.9) min. On postoperative macroscopic evaluation, the mesorectum was intact in 42 cases, nearly intact in 7 cases. The circumferential resection margin was more than 2 mm in 42 cases, and less than 2 mm in 7 cases. Forty-six patients underwent R0 resection, and 3 cases underwent R1 resection. The median retrieved lymph node (LN) was 16.20±9.23, and the median positive LN was 1.12±2.19. Postoperative pathological examination showed TNM stage was I( in 12 patients, II(A in 18, II(B in 1, III(A in 2, III(B in 8, III(C in 5, IIII( in 3. The median postoperative hospital stay was (6.25±3.87) d. There were no anastomotic leakage, ileus, intra-abdominal or anastomotic bleeding. There were two wound infections.</p><p><b>CONCLUSION</b>Low and ultralow anterior resection for rectal cancer using HALS approach is safe and feasible with favorable short-term outcome.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anal Canal , General Surgery , Hand-Assisted Laparoscopy , Methods , Rectal Neoplasms , General Surgery , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and influencing factors of imatinib in patients with advanced gastrointestinal stromal tumor(GIST).</p><p><b>METHODS</b>From April 2004 to January 2010, clinicopathological data of 73 adult patients with advanced GIST treated with imatinib at the First Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The treatment outcomes and associated factors were investigated.</p><p><b>RESULTS</b>Treatment outcomes included complete response in 1(1.4%) patients, partial response in 53(72.6%), stable disease in 14(19.2%), and primary resistant in 5(6.8%). All the patients had routine followed up, the length of which ranged from 12 to 76 (median 32) months. The median progression-free survival was 45.0 months(95% confidence interval, 34.2-55.8). The progression-free survival(PFS) rate was 87.7% in 1 year, 63.6% in 3 year, and 39.6% in 5 years. On multivariate analysis, both mutation status and patient performance were independent factors influencing the efficacy of imatinib treatment(both P<0.01). PFS was significantly better in patients with c-kit exon 11 mutations than those with exon 9 mutations, and better in lower ECOG scales than in higher ones.</p><p><b>CONCLUSION</b>Imatinib is effective in treating patients with advanced GIST, c-kit exon 9 mutations and poor performance status predict an adverse survival benefit of imatinib therapy.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Agents , Therapeutic Uses , Benzamides , Therapeutic Uses , Exons , Follow-Up Studies , Gastrointestinal Stromal Tumors , Drug Therapy , Genetics , Imatinib Mesylate , Mutation , Piperazines , Therapeutic Uses , Proto-Oncogene Proteins c-kit , Genetics , Pyrimidines , Therapeutic Uses , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To report a case of rectal non-Hodgkin lymphoma with concomitant rectal adenocarcinoma.</p><p><b>METHODS</b>Clinical records of a 71 years old male patient with rectal non-Hodgkin lymphoma with concomitant rectal adenocarcinoma admitted on May 19, 2010 to the First Affiliated Hospital of Sun Yet-sen University were retrospectively reviewed. Clinical manifestations, diagnosis, and treatment as well as postoperative pathology were summarized.</p><p><b>RESULTS</b>The preoperative diagnosis of the patient was severe atypical adenomatous hyperplasia with focal carcinogenesis, and the preoperative staging was T2N0-1M0. The patient underwent a Parks procedure (rectal resection and colo-anal anastomosis) and subtotal resection of left lateral liver. The operation was successful, postoperative recovery uneventful. Postoperative pathology showed moderately differentiated tubular adenocarcinoma with deep muscular invasion, and non-Hodgkin lymphoma with marginal zone cell. Both the distal and proximal resection margins were negative and no vascular and neural invasion were seen. Immunohistochemical staining indicated L26(+), Bcl-2(+), Bcl-6(+), CD3(-), CD23(-), CK epithelial cells(+), and M-CEA luminal border(+). The pathological and immunohistochemistry results of liver specimens showed hepatic mucosa-associated marginal zone lymphoma.</p><p><b>CONCLUSIONS</b>Rectal adenocarcinoma and lymphoma occurring at the same site simultaneously is extremely rare with unique pathologic features.</p>
Subject(s)
Aged , Humans , Male , Adenocarcinoma , Pathology , Lymphoma, Non-Hodgkin , Pathology , Rectal Neoplasms , PathologyABSTRACT
<p><b>OBJECTIVE</b>To evaluate and compare the results of vagina vasorum lymph node dissection (VLND) and non-vagina vasorum lymph node dissection (NVLND) in patients with gastric cancer after radical operation.</p><p><b>METHODS</b>A total of 759 cases of evaluable patients with gastric cancer, operated from June 1994 to April 2005, were retrospectively analyzed. Of which, 627 cases underwent radical gastrectomy: 215 patients received VLND and 412 cases received NVLND. The operation time, intraoperative blood loss, operative complications and survival rate were recorded and compared between the two groups.</p><p><b>RESULTS</b>The 5- and 10-year overall accumulative survival rates of VLND group and NVLND group were 55.4% and 51.2%, 39.1%and 36.8%, respectively (all P < 0.05). No significant differences in intraoperative blood transfusion (loss), operation time, operative complication rate was found between the two groups. The 5- and 10-year accumulative survival in patients with a tumor of phase N0-N2, T2-T4, Ib-IV in VLND groups were all significant higher than those in NVLND group.</p><p><b>CONCLUSIONS</b>VLND is a safe technique in advanced gastric cancer, it dose not prolong operation time or increase operative complications but improves survival.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Follow-Up Studies , Gastrectomy , Lymph Node Excision , Methods , Lymphatic Metastasis , Retrospective Studies , Stomach Neoplasms , Pathology , General Surgery , Survival Analysis , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy of surgical treatment and the prognosis in gastric stump cancer patients.</p><p><b>METHODS</b>Between June 1994 and March 2004, 692 patients underwent radical operation for gastric cancer in our department. Among them, 22 cases were gastric stump cancer. Their surgical treatments, lymph node metastasis and survival were analyzed retrospectively.</p><p><b>RESULTS</b>Gastric stump cancer accounted for 3.2 % of all the gastric cancer cases in the same period. There were 4 cases of stage I, 2 cases of stage II, 6 cases of stage III and 10 cases of stage IIII respectively. Radical excision was 77.3% and combined evisceration was 50.0%. Total gastrectomy were performed in 21 cases and exploratory laparotomy in 1 case. Digestive tract was reconstructed with Roux-en-Y pattern after total gastrectomy. Radical gastric stump cancer excisions were finished with abdominal incision in 18 cases and with thoraco-abdominal incision in 4 cases. Lymph node metastasis rate was 63.6 %, including pN(0) 8 cases, pN(1) 6 cases, pN(2) 7 cases and pN(3) 1 case respectively. Average survival time was(80.2+/-17.2) months in stage I( and II( gastric remnant cancer; average survival time was(31.2+/-9.2) months in stage III( gastric remnant cancer, average survival time was (23.6+/-6.1) months in stage IIII( gastric remnant cancer, which were significantly different(all P<0.05). Between palliative operation group and standard radical excision, extended radical excision groups, well-moderate differentiated and poor differentiated adenocarcinoma groups, lymph node metastasis positive and negative groups, the differences were all significant.</p><p><b>CONCLUSIONS</b>Total gastrectomy and D(2) lymph node dissection are imperative for radical excision of gastric remnant cancer. On this base, extended lymphectomy and combined evisceration should be performed appropriately. Tumor stage, procedure pattern, lymph node metastasis and tumor differentiation affect the prognosis of patients with gastric stump cancer.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Gastrectomy , Gastric Stump , Pathology , General Surgery , Lymphatic Metastasis , Neoplasm Staging , Prognosis , Retrospective Studies , Stomach Neoplasms , Pathology , General SurgeryABSTRACT
<p><b>BACKGROUND</b>A novel anti-rheumatic drug, T-614, has been shown to have an anti-inflammatory effect and to improve abnormal immunological findings in rheumatoid arthritis (RA). To assess the safety and efficacy of T-614 versus placebo in patients with active RA we conducted a 24-week clinical study in 280 Chinese patients.</p><p><b>METHODS</b>In a multicenter, randomized, double blind, placebo controlled study, 280 patients were randomly assigned to receive placebo (n = 95) or T-614 at 50 mg (n = 93) or 25 mg (n = 92) daily. Active disease was defined by 4 of the following 5 criteria: >or= 5 tender joints, >or= 3 swollen joints, morning stiffness lasting for >or= 60 minutes, and Westergren erythrocyte sedimentation rate (ESR) >or= 28 mm/h, the assessment of pain at the rest by patient as moderate or severe. Clinical and laboratory parameters were analyzed at baseline, 2, 4, 6, 12, 18 and 24 weeks. The primary efficacy variable at week 24 was the American College of Rheumatology (ACR) response rate using the intent-to-treat population.</p><p><b>RESULTS</b>The ACR response rate was significantly higher in the T-614 treatment group compared with the placebo group within 8 weeks after the initiation of treatment. After 24 weeks, the 25 mg/d and 50 mg/d dosage groups and the placebo group showed 39.13%, 61.29% and 24.21% in ACR20 and 23.91%, 31.18% and 7.37% in ACR50, respectively. A time-response in ACR response was observed, with clear superiority for the 25 mg/d and 50 mg/d dosage groups compared to placebo (P < 0.0001), and the 50 mg/d dose compared to the 25 mg/d dose (P < 0.05) when using the ACR response analyses after 24 weeks. ESR and c-reactive protein (CRP) were significantly different in the treatment groups after 24 weeks. The incidence of adverse events (AEs) was not significantly higher with T-614 than with placebo, but upper abdominal discomfort, leucopenia, elevated serum alanine aminotransferase (sALT), skin rash and/or pruritus were more common in the 50 mg and 25 mg dosage groups.</p><p><b>CONCLUSION</b>T-614, a new slow-acting drug, is effective in treatment of rheumatoid arthritis and is well tolerated.</p>