Efficacy of raltitrexed combined with transcatheter arterial chemoembolization in treatment of advanced colorectal cancer with liver metastasis / 临床肝胆病杂志

ObjectiveTo investigate the efficacy of raltitrexed combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced colorectal cancer with liver metastasis. MethodsA total of 80 patients with liver metastasis of advanced colorectal cancer who were admitted to Central Hospital of China National Petroleum Corporation and underwent surgery from January 2012 to June 2015 were enrolled and randomly divided into study group and control group, with 40 patients in each group. The patients in the study group underwent hepatic arterial infusion chemotherapy with raltitrexed combined with TACE, and those in the control group were treated with intravenous infusion of raltitrexed alone. The above treatment was performed once every 4 weeks for 3-6 cycles. The response rate (RR), disease control rate (DCR), median time to disease progression, survival rate, and reductions in carcinoembryonic antigen (CEA), CA19-9, aminotransferases, and bilirubin were observed in the two groups. The chi-square test was used for comparison of categorical data between groups. ResultsRR, DCR, and the median time to disease progression showed significant differences between the study group and the control group (45.0% vs 22.5%, χ2=4.528, P=0.033; 70.0% vs 47.5%, χ2=4.178, P=0.041; 17.9 months vs 10.5 months, χ2=2408, P＜0.001). The study group had significantly higher 1- and 2-year survival rates than the control group (80.0% vs 57.5%, χ2=4.713, P=0.030; 55.0% vs 32.5%, χ2=4.114, P=0.043). The study group had a significantly higher number of patients with more than 50% reductions in CA19-9, CEA, aminotransferases, and bilirubin at 2 months after TACE than the control group (χ2=5333, 4528, 5051, and 5.013, P=0.021, 0.033, 0.025, and 0.025). ConclusionRaltitrexed combined with TACE is of good value in the treatment of advanced colorectal cancer with liver metastasis and holds promise for clinical application.

Atlanto-axial pedicle screw fixation through posterior approach for treatment of atlanto-axial joint instability / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the therapeutic effects of the atlantoaxial pedicle screw system fixation in treatment of atlantoaxial instability.</p><p><b>METHODS</b>From June 2003 to March 2010, 32 patients with atlantoaxial instability were treated by atlantoaxial pedicle screw system fixation, included 21 males and 11 females wiht an average age of 42.5 years old ranging from 28 to 66 years. Among them, 18 cases were odontoid process fractures, 7 were congenital dissociate odontoid process, 4 were Jefferson fracture combined with odontoid fracture, 3 were rheumatic arthritis causing atlantoaxial instability. All patients suffered from the atlantoaxial subluxation and atlantoaxial instability. The JOA score ranged from 4 to 14 (means 9.1 +/- 0.3) before operation. The patients had some image examination including the X-ray of cervical vertebrae (include of dynamic position film), spiral CT 3D reconstruction and/or MRI. The position of pedicle screw system implantation,the angle of pedicle screw system implantation and screw length were measured. Operating skull traction. Operation undewent general anesthesia, implanted the pedicle screw, reduction and bone fusion under direct vision. The bone was fixated between posterior arch of atlas and lamina of axis by the lateral combination bended to posterior.</p><p><b>RESULTS</b>One hundred and twenty-eight atlantoaxial pedicle screws were implanted in 32 patients. No patient had the injure of spinal cord, nerve root and vertebral artery. All patients were followed-up from 6 to 48 months (averaged 16 months). After operation, the JOA score ranged from 11 to 17 (averaged 15.9 +/- 0.2), improvement rate was 86.1%. The fracture of odontoid process were healing completely. All fusion bone were combinated. The internal fixation wasn't loosening and breaking.</p><p><b>CONCLUSION</b>The atlantoaxial pedicle screw system fixation was effective method to treat atlantoaxial instability. The method had many advantages, such as provide rigid and short segment fixation, safe and simple, high fusion rate. The method was worth in clinical application.</p>

Semen quality of the men from six districts in Chongqing / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the quality and spatial distribution features of semen and to evaluate the reproductive health of the males in the Chongqing section of the Three-Gorge Reservoir area.</p><p><b>METHODS</b>We collected semen samples by masturbation after 2 -7 days of abstinence from the men in Nan'an, Shapingba, Zhongxian, Wanzhou, Yunyang and Wushan of Chongqing, which are geographically and demographically representative of the Three-Gorge Reservoir area. We analyzed the semen quality of all the samples and evaluated the reproductive health of the men.</p><p><b>RESULTS</b>The mean value of the five semen parameters of the male subjects from the six districts was within the normal range, including semen volume, sperm concentration, total sperm count, rapid progressive motile sperm, and total motile sperm. Those from Shapingba, Yunyang and Zhongxian exhibited abnormal sperm motility. According to the WHO criteria, normal value of all the semen parameters was found in less than 50% of the semen samples from the six districts, in 47% of those from Yunyang, and only 16% of those from Wanzhou. Spatial distribution maps of the semen parameters revealed significant spatial differences in seminal quality among the six districts, the highest in Yunyang, and the lowest in Wanzhou and Wushan that are located in the middle and lower reaches of the Three-Gorge Reservoir area.</p><p><b>CONCLUSION</b>The mean value of semen parameters was low in a large proportion of men in the Chongqing section of the Three-Gorge Reservoir area, with spatial differences along the Changjiang river.</p>

Controlled clinical trials on different surgical methods for the treatment of acromioclavicular dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical effects of clavicular hook plate fixation, coracoid transplantation, and clavicular hook plate fixation combined with modified dynamic muscle transfer for the treatment of the complete acromioclavicular dislocation.</p><p><b>METHODS</b>From January 2006 to November 2009, 65 patients with sustained complete acrominoclavicular dislocation were treated with clavicular hook plate fixation, coracoid transplantation,and clavicular hook plate fixation combined with modified dynamic muscle transfer. All the patients were divided into three groups: 22 patients in group A were treated with clavicular hook plate fixation, including 17 males and 5 females, with an average age of (31.0 +/- 10.0) years; 21 patient in group B were treated with coracoid transplantation, including 16 males and 5 females,with an average age of (33.0 +/- 6.4) years; 22 patients in group C were treated with clavicular hook plate fixation combined with modified dynamic muscle transfer,including 18 males and 4 females, with an average age of (30.0 +/- 5.3) years. Postoperative functional recovery was evaluated by Karlsson criteria.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from half to three years (averaged 1.5 years). In group A, 8 patients got half re-dislocation, 2 patients got complete re-dislocation and arthritis of acromioclavicular joint after internal fixations removal, 1 patient had clavicular hook plate broken after operation. In group B, 7 patients got half re-dislocation, 1 patient got complete re-dislocation,and 5 patients had arthritis of acromioclavicular joint with acute pain and limited shoulder function after internal fixations removal. In group C,2 patients got half re-dislocation, no complete re-dislocation and arthritis of acromioclavicular joint occurred after internal fixations removal. According to Karlsson evaluation, in group A, 12 patients obtained an excellent result, 8 good and 2 poor; in group B, the data were 9, 7 and 5 respectively; in group C, they were 20, 2 and 0 respectively. There were remarkable differences of therapeutic effects between the clavicular hook plate fixation combined with modified dynamic muscle transfer and that with either of the former two treatment methods (P < 0.05).</p><p><b>CONCLUSION</b>Clavicular hook plate combined with modified dynamic muscle transfer is a reliable and good treatment for the complete acrominoclavicular dislocation, with advantages such as easy to handle,stable fixation and early exercise.</p>

Preliminary efficacy of CyberKnife radiosurgery for locally advanced pancreatic cancer / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>CybeKnife is a newly developed technology in the field of stereotactic radiosurgery/radiotherapy (SRS/SRT). Compared with conventional SRS/SRT, there are many advantages for CyberKnife in terms of treating tumors that move with respiration, being real-time image-guidance, frameless, high accurateness, and so on. Recently, it has been used to treat different types of malignant carcinoma including intracranial and caudomedial tumors. This study was designed to evaluate the short-term efficacy and toxicity of the CyberKnife radiotherapy for locally advanced pancreatic cancer.</p><p><b>METHODS</b>A total of 20 patients with locally advanced (stage II-III) pancreatic cancer treated with CyberKnife were recruited between April 2009 and December 2009. Of 20 patients, 13 were with cancer located at the pancreatic head and 7 were located at the pancreatic body and tail. The planning target volume (PTV) was defined as gross tumor volume (GTV) plus 2-3 mm, and more than 95% PTV should be covered by 75% isodose surface. The median of PTV was 47 cm³ (26-64 cm³). The median total prescription dose was 40 Gy (32-55 Gy) at 3-6 fractions. During treatment delivery, X-Sight Spine Tracking System was used in 5 patients to track movement of the tumor. Other 15 patients were implanted fiducials in the tumors to track movement of the tumor and patient breathing patterns.</p><p><b>RESULTS</b>The median follow-up time was 7 months (3-11 months). All patients had finished the treatment and 19 were alive by the last follow-up. Slight fatigue was the most common complain. Evaluated by CT scan, 6 were complete response, 9 were partial response, 3 were stable disease, and 1 was progression; 1 was dead. There were 6 patients with grade I granulocytopenia, 7 with grade I nausea, and 5 with grade II vomiting.</p><p><b>CONCLUSIONS</b>The CyberKnife radiosurgery for the locally advanced pancreatic cancer shows a high rate of local control and minimal toxicity. Long-term follow-up is necessary to evaluate the survival and late toxicity.</p>