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Objective:To compare the clinical efficacy, prognosis and complications between intravenous chemotherapy (IVC) combined with intra-arterial chemotherapy (IAC) and single IAC in the treatment of children retinoblastoma (RB).Methods:A cohort study was performed.A 4-year follow-up of 300 children (352 eyes) with intraocular RB enrolled in the Children's Hospital Affiliated of Zhengzhou University from June 2015 to June 2019 was conducted.According to the different treatment methods, the children were divided into IAC group (140 cases, 160 eyes) treated with IAC combined with local laser photocoagulation/cryotherapy and IVC+ IAC group (160 cases, 192 eyes) receiving IVC combined with IAC treatment.The clinical efficacy (eye salvage rate), survival and complication incidence of the two groups were compared.The survival analysis was performed by Kaplan-Meier method.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Children's Hospital Affiliated of Zhengzhou University (No.20150503). Written informed consent was obtained from custodians of each child prior to their entering into the cohort.Results:All of the children were followed up for 2-60 months.Within the follow-up, the eye retention rate of the IAC group and IVC+ IAC group was 85.62%(137/160) and 81.21%(154/192) respectively, without statistically significant difference ( P>0.05). The recurrence rate and metastasis rate of IAC group were 18.75%(30/160) and 8.57%(12/140), which were significantly higher than 10.94%(21/192) and 3.13%(5/160) of IVC+ IAC group ( χ2=4.299, P=0.038; χ2=4.143, P=0.042). There was no significant difference in one-year survival rate between the two groups ( χ2=1.766, P=0.184), but the overall survival rate of IVC+ IAC group was 95.00%(152/160), significantly higher than 88.57%(124/140) of IAC group ( χ2=4.193, P=0.041). Kaplan-Meier analysis showed that the overall recurrence-free, metastasis-free and survival rate of IVC+ IAC group were better than those of IAC group, and the differences were statistically significant (all at P<0.05). There was no significant difference in the incidence of eyelid edema and/or ptosis, fundus hemorrhage, enophthalmos and cataract between the two groups (all at P>0.05). The incidence of myelosuppression was 32.14%(45/140) in IAC group, significantly lower than 43.75%(70/160) of IVC+ IAC group ( χ2=4.255, P=0.039). Conclusions:Compared with single IAC treatment, IVC combined with IAC can reduce the metastasis rate, recurrence rate in RB child patient and improve the survival rate, but it is with relatively high incidence of systemic complications.
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Objective To study the clinical efficacy and advantages of tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy for the treatment of impacted upper ureteral calculi.Methods We retrospectively analyzed 75 cases of impacted upper ureteral calculi treated in our hospital between September 2015 and December 2017.There were 45 males and 30 females,aged from 35 to 65 years,mean (42.5 ± 3.5)years.All patients were diagnosed by B-ultrasound and CT with impacted upper ureteral calculi.The mean stone diameter was (1.6 ± 0.3) cm.The CT value of stone was (1 025.3 ± 215.4) HU.Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy were performed in all of the cases,which were under general anesthesia with lithotomy position,to observe the successful rate of lithotripsy,operation time,intraoperative and postoperative complications,postoperative hospitalization time and stone-free rate.Results All 75 cases were successfully operated.The operation time was (38.5 ± 11.2) min.Three cases had postoperative fever.No severe perioperative complications such as septic shock,ureteral perforation or avulsion occurred.The mean hospital stay of the patients was (2.7 ± 0.4) d.A follow up by non-contrast CT scan was done 4 weeks after the procedure to evaluate the result.Sixty seven cases had stone clearances at the primary operation and the stone clearance rate was 89.3％ (67/75).Eight cases undergone ESWL and physical vibration lithecbole,the CT examination showed that the stones were cleared after 1 month.Conclusions Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy in the treatment of impacted upper ureteral calculi had a definite effect,safe and comfortable for doctors.
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Objective To investigate the relationship between the genetic polymorphisms, which played roles in the pathogenesis of metabolic syndrome (MS), and susceptibility of non-alcoholic fatty liver disease (NAFLD) in Han people in Guangdong province. Methods The subjects were selected from an epidemiologie survey in Guangdong province. Fifty to 117 adult NAFLD patients, who met the criteria of Chinese guideline for diagnosis of NAFLD and had typically clinical, biochemical signs and abdominal ultrasonography, were recruited in the study. By using 1 : 1 matched method of nested case-control study, same numbers of people without NAFLD were included as controls. The genetic analyses was performed by using genomic DNA extracted from peripheral blood. Polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) was applied to detect the single nucleotide polymorphisms (SNPs) at 9 sites in 7 candidate genes. Results Most SNPs of the genes were related to the susceptibility of NAFLD. Some of them had positive relation (increasing the risk) such as tumor necrosis factor (TNF)-α-238, adiponectin-45, leptin-2548, peroxisome proliferator-activated receptors (PPAR) γ-161 and phosphatidylethanolamine N-methyltransferase (PEMT)-175. Some had negative relation (decreasing the risk) including adiponectin-276 and hepatic lipase-514. And some had no relation (TNF-α-380 and PPAR g coactivator-1α-482). Conclusion Most cytokines' SNPs of candidate genes discovered in MS patients are related to the susceptibility of NAFLD.