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Objective:To investigate the difference in efficacy between transsylvian-transinsular approach and transcortical-transtemporal approach for hematoma evacuation in the treatment of severe basal ganglia intracerebral hemorrhage in young adults.Methods:Young adult patients with severe intracerebral hemorrhage in the basal ganglia region underwent craniotomy hematoma removal in Ankang Central Hospital from February 2012 to February 2021 were retrospectively enrolled. The Glasgow Outcome Scale score was used to evaluate the outcome at 6 months after onset. 4-5 were defined as good outcome and 1-3 were defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of the poor outcomes. Results:A total of 51 patients were enrolled. Their median age was 41 (interquartile range 39-43) years, and 29 were men (56.8%). The median Glasgow Coma Scale score at admission was 6.0 (interquartile range 5.5-7.0), and the median baseline hematoma volume was 38.0 ml (34.5-47.5 ml). Twenty-one patients (41.2%) were in the transsylvian-transinsular approach group and 30 (58.8%) were in the transcortical-transtemporal approach group. There were no significant differences in demographics, vascular risk factors and baseline clinical data between the transsylvian-transinsular approach group and the transcortical-transtemporal approach group. Compared with the transcortical-transtemporal approach group, the amount of intraoperative bleeding and hematoma residue in the transsylvian-transinsular approach group were less, the proportion of patients requiring decompressive craniectomy was lower (33.3% vs. 63.3%; χ2=4.449, P=0.035), and the duration of dehydration medication and hospital stay were shorter (all P<0.05). However, there was no significant difference in the good outcome rate between the two groups (66.7% vs. 56.7%; χ2=0.518, P=0.472). Multivariate logistic regression analysis showed that lower scores of Glasgow Coma Scale at admission (odds ratio 0.128, 95% confidence interval 0.017-0.977; P=0.047) and longer hospital stay (odds ratio 1.402, 95% confidence interval 1.065-1.844; P=0.016) were independently associated with the poor outcomes. Conclusion:For young adult patients with severe basal ganglia intracerebral hemorrhage who underwent hematoma removal, although there was no significant difference between the outcomes of patients with transsylvian-transinsular approach and transcortical-transtemporal approach, the former had more advantages.
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Objective:To investigate the effectiveness of postoperative radiotherapy using shrinking field for patients with extremity soft tissue sarcoma (STS), mainly focusing on the local control rate and adverse events.Methods:Clinical data of 49 extremity STS patients who received postoperative intensity-modulated radiotherapy in the First Hospital of Tsinghua University from October 2017 to March 2021 were retrospectively analyzed. Target volumes were contoured on CT and MRI fusion images. The tumor bed was defined as GTV tb, with 3 cm expansion in the longitudinal direction and 1.5 cm expansion in the radial direction to construct CTV (the target volume should be properly repaired according to the anatomical barrier, and the edema area around the tumor should be included). GTV tb and CTV were expanded in all directions by 0.5 cm to construct PTV1 and PTV2 respectively, at a dose of 95%PTV1 63-66 Gy, 95%PTV2 50-56 Gy,1.8-2.0 Gy/f. The dose of surgical volume should be given at 70 Gy for patients who had a microscopic positive margin. Results:The median follow-up time was 32.1 months (7.9-45.6 months). The 3-year local failure-free survival (LFFS), overall survival (OS)and distant metastasis-free survival (DMFS) were 91.7%,77.6% and 71.5%, respectively. Univariate analysis showed that patients with a microscopic positive margin were more likely to develop local recurrence ( P<0.05). The incidence of grade 2 or above wound complications, joint stiffness, fracture, edema and skin fibrosis were 2%, 4.1%, 2%, 8.2% and 26.5%, respectively. Conclusion:Postoperative radiotherapy with shrinking field provides excellent local control rate and low incidence of late adverse events in patients with extremity STS.
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Objective@#To explore the prognostic value of human mitochondrial transcription termination factor 3 (hMTERF3) and forkhead box protein 3 (Foxp3) in non-small cell lung cancer (NSCLC).@*Methods@#The clinical data of 88 patients with NSCLC who were admitted to the Third Medical Center of PLA General Hospital from March 2017 to March 2018 were retrospectively analyzed. All patients were diagnosed by pathological puncture. The patients were followed-up by telephone for 12 months, and according to the prognosis, the patients were divided into good prognosis group and poor prognosis group. The pathological tissues were taken from all patients, and the expressions of hMTERF3 and Foxp3 proteins were detected by immunohistochemistry. The expressions of hMTERF3 and Foxp3 in the good prognosis group and the poor prognosis group were compared. Logistic regression model was used to analyze the risk factors of poor prognosis in patients with NSCLC.@*Results@#Of 88 patients, 61 patients (69.3%) had good prognosis and 27 patients (30.7%) had poor prognosis. The positive expression rate of hMTERF3 in the good prognosis group was 57.4% (35/61), which was significantly lower than that in the poor prognosis group (81.5%, 22/27) (χ 2= 4.766, P= 0.029). The positive expression rate of Foxp3 in the good prognosis group was 55.7% (34/61), which was significantly lower than that in the poor prognosis group (85.2%, 23/27) (χ 2= 7.113, P= 0.008). The proportions of patients with medium and high differentiation or stage Ⅰ- Ⅱ in the good prognosis group were 82.0% (50/61) and 68.8% (42/61), respectively, which were significantly higher than those in the poor prognosis group [48.15% (13/27) and 25.93% (7/27)] (both P < 0.05). Logistic regression analysis showed that the poor differentiation, stage Ⅲ-Ⅳ, hMTERF3-positive and Foxp3-positive were the risk factors for poor prognosis in NSCLC patients (all P < 0.05).@*Conclusions@#The positive expression rates of hMTERF3 and Foxp3 in patients with good prognosis are lower. The hMTERF3-positive and Foxp3-positive are risk factors for poor prognosis in NSCLC patients.
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Objective:To explore the prognostic value of human mitochondrial transcription termination factor 3 (hMTERF3) and forkhead box protein 3 (Foxp3) in non-small cell lung cancer (NSCLC).Methods:The clinical data of 88 patients with NSCLC who were admitted to the Third Medical Center of PLA General Hospital from March 2017 to March 2018 were retrospectively analyzed. All patients were diagnosed by pathological puncture. The patients were followed-up by telephone for 12 months, and according to the prognosis, the patients were divided into good prognosis group and poor prognosis group. The pathological tissues were taken from all patients, and the expressions of hMTERF3 and Foxp3 proteins were detected by immunohistochemistry. The expressions of hMTERF3 and Foxp3 in the good prognosis group and the poor prognosis group were compared. Logistic regression model was used to analyze the risk factors of poor prognosis in patients with NSCLC.Results:Of 88 patients, 61 patients (69.3%) had good prognosis and 27 patients (30.7%) had poor prognosis. The positive expression rate of hMTERF3 in the good prognosis group was 57.4% (35/61), which was significantly lower than that in the poor prognosis group (81.5%, 22/27) (χ 2= 4.766, P= 0.029). The positive expression rate of Foxp3 in the good prognosis group was 55.7% (34/61), which was significantly lower than that in the poor prognosis group (85.2%, 23/27) (χ 2= 7.113, P= 0.008). The proportions of patients with medium and high differentiation or stage Ⅰ- Ⅱ in the good prognosis group were 82.0% (50/61) and 68.8% (42/61), respectively, which were significantly higher than those in the poor prognosis group [48.15% (13/27) and 25.93% (7/27)] (both P < 0.05). Logistic regression analysis showed that the poor differentiation, stage Ⅲ-Ⅳ, hMTERF3-positive and Foxp3-positive were the risk factors for poor prognosis in NSCLC patients (all P < 0.05). Conclusions:The positive expression rates of hMTERF3 and Foxp3 in patients with good prognosis are lower. The hMTERF3-positive and Foxp3-positive are risk factors for poor prognosis in NSCLC patients.
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Objectives: To study the changes of blood levels of soluble semaphorin 4D (sSema4D) and matrix metalloproteinases-14 (MMP-14);to explore the correlation between sSema4D and ventricular remodeling in patients of dilated cardiomyopathy with chronic heart failure. Methods: Our research included in 2 groups:Dilated cardiomyopathy group, n=86 patients and Control group, n=32 healthy subjects. Blood levels of sSema4D, MMP14, Pro-BNP and hs-CRP were examined by ELISA. Left atrial diameter (LAD), right ventricular diameter (RVD), ejection fraction (EF), left ventricular end diastolic diameter (LVEDD), left ventricular fractional shortening (LVFS) were measured by echocardiography. Correlation analysis between blood levels of sSema4D, MMP-14 and the parameters for left ventricular remodeling was conducted. Results: Blood levels of sSema4D and MMP14 were different between 2 groups, P Conclusion: Serum level of sSema4D might be related to ventricular remodeling in patients with dilated cardiomyopathy which could be used as risk factor for predicting the prognosis of heart failure in relevant patients.
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Objective To observe the therapeutic effect of the new plan of concurrent capecitabine (CAP) and radiation therapy for hu-man cervical adenocarcinoma in nude mice. Methods The nude mice were injected with CAC-1 cells for the modelization of cervical ade-nocarcinoma. Before treatment,all mice with tumors were randomly divided into control group,CAP group,5-FU group,radiation group,CAP+ radiation group,5-FU+radiation group. According to the tumor size,mice were furtherly divided into large-size and small-size groups in the control group,CAP group,radiation group, CAP+radiation group. The change of tumor size,tumor growth percentage and the delay time of tu-mor growth were evaluated. Results The therapeutic effect of combining 2/3MTD CAP with 6 Gy radiation or fractionation 2 Gy × 8 times radiation was better than that of the control group,chemotherapy group and the radiation group. The difference was significant (P < 0.05). The restraint effect of the combining 2/3MTD CAP with 6 Gy radiotherapy was better than that of the combining 2/3MTD 5-FU with 6 Gy radiotherapy. Combining 2/3MTD CAP with fractionation 2 Gyx8 times radiation therapy was more efficient than Combining 2/3MTD CAP with fractionation 6 Gy radiation therapy. In combining therapy groups,the response of large-size tumors was more significant than that of the small-size tumors (P < 0.05),which had almost no obvious response. Conclusion Concurrent CAP and radiation therapy has obvious restraint effect on CAC-1 cervix adenocarcinoma in nude mice. The CAP and radiation therapy can promote the therapeutic effect to each oth-er. The therapeautic effect of the concurrent CAP and radiation therapy is affected by the radiation dose, radiation method and the tumor size.