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Polysaccharide is a recognized immunomodulator that has been shown to have inhibitory effects on a variety of cancer cells and has the potential to be developed as an anti-cancer drug. Pancreatic cancer， one of the cancers with the highest mortality rate， is treated with long-term chemotherapeutic drugs and is prone to a variety of side effects such as immune deficiency， fatigue， and neurological lesions. The polysaccharide anti-pancreatic cancer research landscape both domestically and internationally is summarized in this publication. By regulating nuclear factor-κB， Hippo-Yes-associated protein， integrin and other signaling pathways， polysaccharide components play an anti-pancreatic cancer role by multi-target ways， such as inducing apoptosis and autophagy， inhibiting proliferation， migration and invasion of cancer cells， and regulating the cancer cell cycle.
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In the past two decades, the survival of HER2-positive early-stage breast cancer patients has significantly improved with the development of HER2-targeted therapies. The focus has been placed on maximizing the clinical benefit of HER2-positive early-stage breast cancer by optimizing the treatment frameworks and therapeutic strategies in this field. In this paper, several important clinical studies of HER2-positive early-stage breast cancer in the neoadjuvant or adjuvant settings will be summarized and analyzed to provide clues for the development of personalized treatment strategies in the future.
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ObjectiveTo analyze factors related to the suspected allergic reaction of elememe emulsion injection based on hospital information system. MethodData on cases that used elememe emulsion injection were collected from the information systems of 60 first-class hospitals nationwide. The nested case-control design method was adopted. Finally， 30 cases were included in the suspected allergy group and 120 cases in the control group. SAS 9.3 was employed for descriptive analysis of the gender， age， occupation， admission route， conditions of patients at the admission， and the diagnosis with frequency and percentage. The factors affecting the occurrence of suspected allergic reaction were analyzed by conventional logistic regression and propensity score weighted logistic regression. In the case that the number of independent variables was larger than the sample number， MCP （minimax concave penalty） was used to screen the key variables and the conditions of patients at admission， conditions of patients during hospitalization， hospital stay， diagnostic information， and medication information were compared between two groups. ResultThe male-to-female ratio was about 2∶1 in both groups and most of the patients were 46-65 years old. Patients in the control group were mainly "professional and technical personnel"， and the majority in the suspected allergy group were "business and service personnel" and "clerks and related personnel". They were mainly admitted at the outpatient and conditions of patients were average at the admission. Compared with the control group， suspected allergy group showed severe conditions during the hospitalization， short average hospital stay， large proportion with intravenous infusion， and low cure rate and effective rate. The results of logistic regression analysis showed no statistical difference in conditions of patients at admission， hospital stay， combined diseases， medicine dosage， and treatment course. ConclusionThe suspected allergic reaction of elememe emulsion injection mainly occurs in the first administration with rapid onset even with the dose lower than the commonly used one. The occurrence is related to the intravenous infusion and the severe conditions of patients during hospitalization and has nothing to do with the conditions of patients at admission， hospital stay， treatment course， use of other medicines， and diagnostic information. In summary， it is mainly related to the constitution and immune status of patients.
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Objective:To evaluate the outcomes of posterior-column dominating three-column tibial plateau fractures treated by raft-nailing and cannulated screwing via the posteromedian approach.Methods:From October 2017 to June 2019, 15 patients with posterior-column dominating three-column tibial plateau fracture were surgically treated at Department of Orthopedics, The First Affiliated Hospital to Harbin Medical University. They are 11 males and 4 females, aged from 26 to 65 years (average, 41.2 years). All patients were operated on under general anesthesia or spinal anesthesia. After full exposure via the posteromedian approach using a popliteal S-shaped incision, their fractures were treated with raft-nailing and cannulated screwing. Wound healing and neurovascular injury were observed after operation. X-ray films were taken regularly to monitor fracture union and measure the tibial plateau angle (TPA) and posterior slope angle (PA) of the tibial plateau. The knee function was assessed using The Hospital for Special Surgery (HSS) scoring system at 12 months after operation.Results:Incisions healed by the first intention after surgery in 14 patients but the healing was delayed due to fat liquefaction in one patient. No symptoms of neurovascular injury were observed in the 15 patients who were followed up for 12 to 29 months (average, 16.5 months). All fractures united after 12 to 20 weeks (average, 15.4 weeks). At 3 days and 12 months after operation, respectively, their PA was 9.3°±2.1° and 9.7°±1.6° and their TPA 4.3°±1.2° and 4.1°±1.1°, showing no significant difference ( P>0.05). At 12 months after operation, their HSS scores ranged from 84 to 95 (average, 89.3), their knee flexion from 105° to 138° (average, 126.5°) and their knee extension from 0° to 8° (average, 3.4°). Conclusions:In the treatment of posterior-column dominating three-column tibial plateau fractures, raft-nailing combined with cannulated screwing via the posteromedian approach can achieve not only full exposure by a single incision but also stable plateau fixation, reduce operative invasion, and simplify operative procedures, leading to fine surgical outcomes.
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Objective:To evaluate the efficacy of individualized preoperative planning combined with various fixations in the treatment of complex multiplanar deformities at lower extremity.Methods:Four patients with complex multiplanar deformities at lower extremity were treated at Department of Orthopedics, The First Affiliated Hospital to Harbin Medical University from January 2018 to May 2019. They were one male and 3 females, aged from 12 to 65 years (average, 28.8 years). All patients underwent thin-layer (1 mm) CT scan before surgery. Individualized preoperative planning and surgical simulation were conducted using the CT data. 3D printing technology was used to fabricate individualized surgical templates to facilitate osteotomy. Recorded were operation time, frequency of intraoperative fluoroscopy, fracture healing time, Lysholm scores before and after operation, Hospital for Special Surgery (HSS) knee function scores, pain scores of visual analogue scale (VAS) and postoperative complications in this cohort.Results:The operation time averaged 160.0 min, the frequency of intraoperative fluoroscopy 5.0 times, the follow-up duration for the 4 patients 8.8 months, the fracture healing time 6.3 months, the Lysholm scores before and after operation 55.8 and 80.5 points respectively, the HSS scores before and after operation 61.0 and 80.8 points respectively, and the VAS scores before and after operation 3.8 and 1.0 points respectively. Accurate osteotomy was achieved with assistance of the templates and no deformation or breakage of the templates was observed. Follow-ups showed fine alignment of the lower extremities by the full-length X-ray films and no recurrence of deformity, infection, implant breakage, or delayed union or non-union of the osteotomy sites.Conclusions:For patients with multiplanar deformities at lower extremity, individualized preoperative planning can be made before surgery to obtain the accurate parameters relevant to the osteotomy. In combination with various fixations, a patient-specific template made by 3D printing can be used to achieve accurate osteotomy, ensuring good efficacy, safety, efficiency and accuracy of the surgery.
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BACKGROUND: Salvia injection and needle-knife therapy are commonly used techniques in the treatment of osteoarthritis in clinical practice. At present, there is no research on the combination of the two methods. OBJECTIVE: To compare the effects of needle-knife therapy and salvia injection and their combinations in the treatment of osteoarthritis in rabbit models. METHODS: The study was approved by the Laboratory Animal Ethical Committee of Heilongjiang University of Chinese Medicine. Fifty New Zealand white rabbits were divided into five groups: Blank control, model, salvia injection, needle-knife, and combination groups. The rat models of osteoarthritis were established in all groups except for blank control group. After successful modeling, medial and lateral patellar retinaculums, medial and lateral knee eyes, suprapatellar bursa, muscle belly of each quadriceps femoris, muscle belly and ending point of gracilis, muscle belly and ending point of adductor and area surrounding the tibial plateau of rats in the needle-knife group received needle-knife release. The rabbits in the blank control and model groups underwent the intra-articuiar injection of normal saline (0.3 mL). The rabbits in the salvia injection group were given the intra-articuiar injection of salvia (0.3 mL). The rabbits in the combination group received needle-knife release, followed by intra-articuiar injection of salvia (0.3 mL). All interventions were conducted weekly, for 5 consecutive weeks. The knee articular cartilage underwent gross observation and histological observation. The levels of interleukin-1 and tumor necrosis factor-alpha in synovial fluid were detected by ELISA. RESULTS AND CONCLUSION: (1) Gross observation: The worn artificial knee in the model group was serious, and was slight in the salvia injection, needle-knife, and combination groups. (2) Pathological scores: The scores in the salvia injection group were slightly higher than those in the needle-knife and combination groups. (3) ELISA results: The levels of interleukin-1 and tumor necrosis factor-alpha in the combination group were significantly lower than those in the salvia injection and needle-knife groups (P < 0.05). (4) In summary, needle-knife therapy combined with intra-articuiar injection of salvia is superior to needle-knife therapy alone or intra-articuiar injection of salvia in reducing the levels of interleukin-1 and tumor necrosis factor-alpha in rabbit models of osteoarthritis.
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Our previous study introduced a barley protein microparticle for encapsulation of hydrophobic drug/nutraceutical, which could release nanoparticles upon gastric digestion and deliver encapsulated compound to a simulated intestinal environment intact. This work focused on evaluating the potential of liberated nanoparticles to improve the absorption of encapsulated compounds (., -carotene) using Caco-2 cell and small intestine models. Nanoparticles obtained from gastric digestion of barley protein microparticles had a spherical shape and an average size of 351 nm. Nanoparticles showed low cytotoxicity in Caco-2 cells and their cellular uptake was dependent on time, concentration and temperature. In a Caco-2 cell monolayer model, significantly greater uptake and transport of -carotene were observed when it was delivered by nanoparticles (15%), compared to free -carotene suspension (2.6%). In an rat jejunum model, nanoparticles showed the capacity to retain in small intestinal tissue. Approximately 2.24 and 6.04 μg nanoparticle were able to permeate through each cm intestinal tissue and translocate to the serosal side after 60 and 90 min, respectively. Results from this study demonstrated the absorption improving effect of the barley protein nanoparticles and suggested their potential as vehicles for hydrophobic compounds.
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Objective To retrospectively investigate the characteristics of background parenchymal enhancement(BPE)in the contralateral breast following neoadjuvant chemotherapy(NAC)and whether BPE could help predict tumor response in early stage of advanced breast cancer. Methods Data from 161 patients who were diagnosed with unilateral breast cancer and then underwent NAC before surgery were analyzed retrospectively from August 2014 to December 2016.All the patients underwent both bilateral breast MRI scan with contrast enhancement. Two experienced radiologists independently categorized the patients' levels of BPE into four categories (1=minimal, 2=mild, 3=moderate, 4=marked) at baseline and after the 2nd cycle of NAC. All the patients were divided in to pathologic complete response (pCR) group and non-pCR group according to the histopathologic tumour response.The status of estrogen receptor(ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) were recorded before underwent NAC.The t test and Pearson chi-squared test were used to compare the baseline characteristics of the pCR and Non-pCR groups.The kappa test was used to test the inter-observer agreement.The Wilcoxon test was used to test for changes of BPE categories after NAC.The Mann-Whitney U test was used to test the difference of BPE between pre-and post-menopausal status. Associations were evaluated using Binary logistic regression models. Results Fifty nine patients achieved pCR, and 102 patients had residual disease (non-pCR). Age, tumor size, distribution of size, menopausal status and lymph node showed no significance between pCR and non-pCR groups(all P>0.05),while only ER/PR status and HER2 status had a significant difference (P>0.05 in both). Inter-observer agreement regarding BPE categorization was moderate and substantial before and after NAC(Kappa value 0.644 and 0.708).The level of BPE was higher in premenopausal than post-menopausal women both at baseline and after the 2nd cycle of NAC(P<0.01). Decreased BPE was observed in 106 cases(premenopausal 60 cases and postmenopausal 46 cases),and no change in BPE were observed in 55 cases (premenopausal 27 cases and postmenopausal 28 cases). A significant reduction in BPE was observed after the 2nd NAC cycle in the overall cases, pre-and post-menopausal cases (all P<0.01). Logistic model showed that hormonal receptor (HR) negative and HER-2 receptor at baseline and the change of BPE after NAC were the independent factors for predicting pCR. Conclusions Regardless of the menopausal status, BPE showed a reduction after NAC, and it can serve as an additional imaging biomarker of tumour response at an early stage of NAC.
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The excel statistical software and standard research methods were applied to account the application and approval rates of NSFC of Xiyuan Hospital of CACMS in the recent 3 years. The application and feedback issued by NSFC were collated and analyzed in this paper. From the foundation management, all departments had higher enthusiasm on project application, but departments applied were relatively centralized. The approval rates had risen steadily in the past 3 years. And approved projects mainly focused on departments of cardiovascular, hematology, spleen and stomach, geriatrics and basic medicine. However, no higher level projects were not supported successful by NSFC. And research awards for Xiyuan Hospital were mainly supported by the Ministry of Science and Technology and NSFC. In order to enhance successful rates of application and guarantee development of science research more sustainable, rapid and healthy, enthusiasm of researchers should be stimulated; quality of declaration should be improved; new mechanism of scientific research management need be perfected; and a good research environment should be built.
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Background and purpose: Many factors have impacts on the surgery approach of breast cancer. The purpose of this study was to analyze the influence factors of breast reconstruction for patients with breast cancer, focusing on the relationship between travel distance and breast reconstruction. Methods: Retrospective review of all female breast cancer patients staging 0-Ⅱ who underwent unilateral or bilateral mastectomy with or without breast reconstruction at Fudan University Shanghai Cancer Center from 1999 to 2015 was conducted in the study. Analysis of travel distance and breast reconstruction rate was performed. Results: Non-Shanghai patients have higher breast reconstruction rate after mastectomy compared with Shanghai patients (6.1％ vs 4.5％, P＜0.001). Travel distance may have an influence on the breast reconstruction rate (P=0.035). Univariate regression analysis showed that the increase of travel distance was the predictor of breast reconstruction, and that the increase of age or body mass index (BMI), or the later TNM stage had a negative correlation with breast reconstruction (P＜0.001). Multiple regression analysis demonstrated that the increase of age or BMI, or the later TNM stage was the independent predictor of the refusal of breast reconstruction (P＜0.001), but travel distance was not (P＞0.05). No significant correlation between the travel distance and breast reconstruction types was indicated. Negative correlation was observed between age and travel distance (P＜0.001). Conclusion: Age, BMI and tumor stage are the main influence factors of breast reconstruction, while travel distance shows a linear correlation with it.
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Objective To investigate the diagnostic value and characteristics of breast lesion in digital breast tomosynthesis (DBT) in combination with synthesized two-dimensional (2D) images. Methods The prospective study enrolled women older than 18 years with clinically suspected breast lesion.One hundred and sixty seven patients with 177 lesions confirmed by biopsy or surgery were included. All the patients underwent full-field digital mammography(FFDM)and DBT examinations,and synthesized 2D images(V-preview)were reconstructed from DBT.The images of FFDM,V-preview images and DBT plus FFDM, V-preview images were analyzed. The breast imaging reporting and data system (BI-RADS) and characteristic for predicting benign and malignant lesion were also evaluated.The average glandular dose for a single mammographic view between FFDM and DBT was recorded.The Nonparametric Z test was used to compare the differences among four different mammographic images in BI-RADS.The differential diagnostic performance among different mammography was evaluated by ROC analysis.Independent t test was used to compare the average glandular dose between FFDM and DBT.Results One hundred three benign lesions and 74 malignant lesions were confirmed. Compared with FFDM images alone or plus DBT,the diagnostic values of V-preview images alone/or plus DBT were not significantly different(Z=0.187 and 0.226,P=0.851 and 0.821), but compared with V-preview, the diagnostic values of V-preview images plus DBT revealed significant difference(Z=3.546,P<0.01).The area under ROC for V-preview plus DBT were 0.899,and the sensitivity,specificity,and accuracy were 90.5%,89.3%,and 89.3%,separately.For the average glandular dose, there was no significant difference between FFDM (1.48 ± 0.52) mGy and DBT (1.56 ± 0.39) mGy examination(t=1.714,P=0.087).Conclusion Synthesized 2D images from DBT,which may eliminate the need for FFDM,in combination with DBT can improve the diagnostic efficiency.
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Objective To investigate the effect of group feedback and formative assessment respectively on teaching effectiveness of endotracheal intubation (ETI).Methods After atheoretical lecturing and theoretical test,eighty three undergraduates were randomized into concurrent-feedback group and groupfeedback group.ETIsimulation training was given respectively by providing concurrent or group feedback in the two groups,and then undergraduates received a skill assessment.After atheoretical lecturing and theoretical test,other 91 undergraduates were randomized into final-assessment group and formative-assessment group.ETIsimulationtraining and skill assessment were given in final-assessment group.Before training,first skill assessment was performed in formative-assessment group,and then feedback was delivered based on the assessment.After training,second skill assessment was given again.Skill assessment was evaluated using the criterion-based task specific checklist combined with global rating scale.t-test was used for comparison between groups.Results There was no statistical difference (P=0.212) in theoretical scores between group-feedback group,and concurrent-feedback group.Skill assessment score of group-feedback group (39.4 ± 4.9) was higher than that in concurrent-feedback group (35.4 ± 4.7),with statistical difference (P=0.000).There was no statistical difference (P=0.395) in theoretical scores between formative-assessment group and final-assessment group.Score of formative-assessment group (39.3 ± 6.2) was higher than that in final-assessment group (32.2 ± 2.4),with statistical difference (P=0.000).Conclusion Terminal feedback or formative assessment could enhance teaching effectiveness of endotracheal intubation among medical students.
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Objective To determine the most cost-effective modality for breast cancer screening in women living in Shanghai.Methods A Markov model for breast cancer was redeveloped based on true effect which was derived from a project for detection of women at high risk of breast cancer and an organized breast cancer screening program conducted simultaneously in Minhang district,Shanghai,during 2008 to 2012.Parameters of the model were derived from literatures.General principles related to cost-effectiveness analysis were used to compare the costs and effects of 12 different screening modalities in a simulated cohort involving 100 000 women aged 45 years.Incremental cost-effectiveness ratio (ICER) was used to determine the most cost-effective modality.Sensitivity analysis was conducted to evaluate how these factors affected the estimated cost-effectiveness.Results The modality of biennial CBE followed by ultrasonic and mammography among those with positive CBE was observed as the most cost-effective one.The costs appeared as 182 526 Yuan RMB per life year gained and 144 386 Yuan RMB per quality adjusted life-year (QALY) saved,which were within the threshold of 2-3 times of local per capita Gross Domestic Product.Results from sensitivity analysis showed that,due to higher incidence rate of breast cancer in Shanghai,the cost per QALY would be 64 836 Yuan RMB lower in Shanghai than the average level in China.Conclusion Our research findings showed that the biennial CBE program followed by ultrasonic and mammography for those with positive CBE results might serve as the optimal breast cancer screening modality for Chinese women living in Shanghai,and thus be widely promoted in this population elsewhere.
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Objective To determine the most cost-effective modality for breast cancer screening in women living in Shanghai.Methods A Markov model for breast cancer was redeveloped based on true effect which was derived from a project for detection of women at high risk of breast cancer and an organized breast cancer screening program conducted simultaneously in Minhang district,Shanghai,during 2008 to 2012.Parameters of the model were derived from literatures.General principles related to cost-effectiveness analysis were used to compare the costs and effects of 12 different screening modalities in a simulated cohort involving 100 000 women aged 45 years.Incremental cost-effectiveness ratio (ICER) was used to determine the most cost-effective modality.Sensitivity analysis was conducted to evaluate how these factors affected the estimated cost-effectiveness.Results The modality of biennial CBE followed by ultrasonic and mammography among those with positive CBE was observed as the most cost-effective one.The costs appeared as 182 526 Yuan RMB per life year gained and 144 386 Yuan RMB per quality adjusted life-year (QALY) saved,which were within the threshold of 2-3 times of local per capita Gross Domestic Product.Results from sensitivity analysis showed that,due to higher incidence rate of breast cancer in Shanghai,the cost per QALY would be 64 836 Yuan RMB lower in Shanghai than the average level in China.Conclusion Our research findings showed that the biennial CBE program followed by ultrasonic and mammography for those with positive CBE results might serve as the optimal breast cancer screening modality for Chinese women living in Shanghai,and thus be widely promoted in this population elsewhere.
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In this study, the standard research methods were applied to account the awards and applications of scientific research achievements of Xiyuan hospital from 2010 to 2014. As for the scientific research awards, each department from Xiyuan hospital was active, but the awards application offices were relatively few, thus the quantity of the awards was decreasing year by year. And the distribution was relatively uneven. The basic characteristics of scientific research awards showed that the National Science and Technology Award was the most difficult award. And other characteristics of scientific research award showed that it was often based on a project with high social recognition and high authority, and with the first researchers were high rank professors. This work cast light on that scientific research management should improve the quality of projects and strengthen exchanges, propaganda and introduction of each project achievement, enhance team establishment as support, and establish a reasonable assessment system for scientific research achievements.
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Breast cancer is the most common cancer in women. Compared with older patients, young breast cancer has unique clinicopathological characteristics, with lower detective rate and worse prognosis. Multidisciplinary individual-based therapy is of great significance in maximizing therapeutic benefits, as well as minimizing their side effects. Today more and more young patients are eager to reserve reproductive functions at the same time. This article reviews the progress on screen?ing and diagnostic measures, comprehensive treatments, and reproductive endocrine problems brought by therapies in early young breast cancer.
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Objective To analyze the correlation between the metal components and MRI signal intensities of gallstones, to investigate the causes of gallstone signal features on MRI. Methods The MRI data and the metal components of the gallstones in vivo and in vitro of 30 patients were retrospectively analyzed. The MR sequences, namely 3D fast spoiled gradient-echo with fat saturation T1-weighted imaging (3D-FSPGR-FS T1WI), fast spoiled gradient-echo with fat saturation T1-weighted imaging(FSPGR-FS T1WI), fast imaging employing steady-state acquisition(FIESTA)and fast spin-echo T2-weighted imaging with fat saturation(FSE-FS T2WI), were performed on the gallstones in vivo and in vitro. According to the characteristics of the surface and cross section, gallstones were divided into pigment gallstones( n=16) and cholesterol gallstones(n=14). The MR signal characteristics of the gallstones were observed and the signal intensity rates of the gallstones were calculated. Preoperatively, the signal intensity rates of cholesterol and pigment stones of each MR sequence were compared by using t test and Mann-Whiteney U test. Postoperatively,the signal intensity rates of the fresh,dried and re-soaked gallstones were compared by using paired t test and Wilcoxon test. The correlation between the signal intensity rates of gallstones on the 3D-FSPGR-FS sequence and their metal components was analyzed by using Linear Regression analysis. Results The pigment gallstones showed high signal intensity on the 3D-FSPGR-FS T1WI. The signal intensity rates of the pigment gallstones were higher than the rates of the cholesterol gallstones on the 3D-FSPGR-FS T1WI, which were 2.02 ± 0.53 and 0.51 ± 0.24 (t=10.26,P< 0.01), respectively. On the 3D-FSPGR-FS T1WI, the signal intensity rates of the drying pigment stones were significantly lower than the rates of the fresh ones, the rates of the two states of the pigment gallstones were 0.21±0.06 and 1.42±0.35(t=13.49,P<0.01),respectively. The signal intensity rates of pigment gallstones showed significant rebound after re-soaking, the rates of the two states of the pigment gallstones were 0.21±0.06 and 1.68±0.86(t=-6.63,P<0.01),respectively. The metal components of pigment gallstones were significantly higher than the cholesterol stones. In the pigment gallstones and cholesterol gallstones, the medians of the Calcium were 28.186 and 2.347 mg/g(Z =-4.66,P< 0.01),respectively.For pigment gallstones, there was a significant correlation between the calcium and the signal intensity rate on 3D-FSPGR-FS T1WI. The regression equation of linear regression analysis was SI=65.40 logCa-166.67. Conclusions The pigment gallstones containing much more water and metal showed high signal intensity on 3D-FSPGR-FS T1WI. The Calcium in the pigment gallstones may be the main cause for this MR appearance.
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<p><b>OBJECTIVE</b>To evaluate the radical effect and postoperative anal function of total mesorectum excision (TME) combined with different intersphincter resection (ISR) in treatment of T1 and T2 stage ultra-low rectal cancer.</p><p><b>METHODS</b>Clinical data of 102 T1 and T2 stage ultra-low colorectal cancer patients who received TME combined with different ISR from January 2004 to December 2013 in our department, including 33 cases of complete internal anal sphincter excision ISR (complete ISR group), 39 cases of partial internal anal sphincter excision ISR (partial ISR), 30 cases of partial dentate line reservation ISR (dentate line group). All the operation procedures followed the principles of TME. Radical conditions were compared and similarly, postoperative anal function was evaluated by Williams classification standard among 3 groups.</p><p><b>RESULTS</b>The general information, such as gender, age, BMI, maximum diameter of tumor, distance of tumor edge to dentate line, TNM staging, degree of differentiation among 3 groups had no statistically significant differences (all P>0.05). The operation time, intraoperative blood loss, length of removed intestinal canal, resection margin, the harvested number of lymph nodes, and postoperative complications among 3 groups also had no statistically significant differences (all P>0.05). Twelve months after surgery, good anal function rate in part ISR group and dentate line group was 100%, significantly better than that in complete ISR group (75.8%) with significant difference (χ2=4.654, P=0.015).</p><p><b>CONCLUSION</b>TME combined with ISR surgery in treatment of T1 and T2 stage ultra-low rectal cancer is safe and effective, which, as far as possible to preserve partial internal sphincter and dentate line on the premise of the guarantee of radical condition, can help to improve the postoperative anal function.</p>
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Humans , Anal Canal , Digestive System Surgical Procedures , Follow-Up Studies , Lymph Nodes , Neoplasm Staging , Operative Time , Postoperative Complications , Postoperative Period , Rectal NeoplasmsABSTRACT
Neoadjuvant chemotherapy or neoadjuvant chemotherapy in combination with targeted therapy has been widely accepted as the standard treatment for locally advanced breast cancer (Ⅱb-Ⅲ). Nearly forty percent of the patients who accepted neoadjuvant chemotherapy achieved pathological complete response of axillary lymph nodes in addition to downstage the primary lesions. However, for patients with clinical complete response of lymph nodes after pre-operative systemic therapy, there are constant controversies regarding the prediction of axillary lymph nodes response and sentinel lymph nodes biopsy after the treatment. Here we design to review the latest studies about how to evaluate the axillary lymph nodes response after neoadjuvant chemotherapy and try to enlighten the treatment choices in clinical practice.
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This study was aimed to analyze the composition principles of prescriptions for sequela of apoplexy collected in the CNKI by the Traditional Chinese Medicine Inheritance Platform (TCMIP), in order to provide a reference for clinical selection of medication. Prescriptions for the sequela of apoplexy treatment in CNKI were collected. Based on the TCMIP, the medication rules of prescription were analyzed by data mining method after data entry. A total of 190 prescriptions involving 204 herbs for sequela of apoplexy treatment were screened and studied. The herbs for blood-activating andqi-tonifying were used with higher frequency. There were 36 commonly used herbal pairs. The herb pair of Dang-Gui(Radix Angelicae Sinensis) andHuang-Qi (Radix Astragali) was with the highest frequency. The herbal combination with three types of herbs wasDi-Long (Pheretima),Dang-Gui andHuang-Qi. The herbal combination with four types of herbs wasChuan-Xiong (Rhizoma Chuanxiong),Di-Long,Dang-Gui andHuang-Qi. The analysis on association rule showed thatChuan-Xiong,Dang-Gui,Tao-Ren (Semen Persicae),Hong-Hua(Flos carthami) andHuang-Qiwere often combined with each other. A total of 48 core combinations and 11 new prescriptions were mined. It was concluded that the prescriptions for sequela of apoplexy were mainly composed with herbs for blood-activating,qi-tonifying and collateral-dredging. According to the flavor and meridian tropism theory of Chinese medicine, the herbal medication selection in the prescription was mostly warm and hot in nature, sweet and pungent flavor, and the meridian tropism of the liver and spleen meridian.