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Objective:To compare the efficacy and safety of gemcitabine and epirubicin curing for patients with non-muscle invasive bladder cancer (NMIBC).Methods:From October 2014 to October 2017, 86 patients with NMIBC diagnosed by transurethral resection of bladder tumor (TURBT) in Wenling Hospital Affiliated to Wenzhou Medical University were analyzed retrospectively. Among them, 42 were treated with gemcitabine (gemcitabine group) and the other 44 with epirubicin (epirubicin group). In gemcitabine group, there were 37 males and 5 females. The average age was 63.9 (48-81) years old. 30 cases were single tumor while 12 cases were multiple. 35 cases with tumor diameter less than 3cm and 7 cases with tumor diameter greater than 3cm. There were 28 cases in T a stage and 14 cases in T 1 stage. 13 patients’ tumor were high grade and 29 patients’ tumor were low grade. In the epirubicin group, there were 36 males and 8 females. The average age was 65.4 (48-88) years. 31 cases were single tumor while 13 cases were multiple. 36 cases with tumor diameter less than 3cm and 8 cases with tumor diameter greater than 3cm. There were 30 cases in T a stage and 14 cases in T 1 stage. 15 patients’ tumor were high grade and 29 patients’ tumor were low grade. There was no significant difference in the above general information between the two groups ( P > 0.05). The two groups were treated with epirubicin or gemcitabine within 24 hours after operation, and bladder perfusion once a week was performed continuously after the first week of operation, a total of 8 times, and after that once a month till one year after operation. The clinical efficacy and adverse reactions were compared between the two groups. Kaplan-Meier was used to compare the recurrence free survival time of tumor after operation. The prognostic factors were analyzed by Cox proportional hazards model. Results:The adverse reactions of the two groups were mainly bladder irritation, gross hematuria, fever, nausea and vomiting. The incidence of bladder irritation and gross hematuria in epirubicin group was 25.0% (11 / 44) and 18.2% (8 / 44), which were significantly higher than those in gemcitabine group [7.1% (3/42) and 2.4% (1/42)], and the difference was statistically significant ( P<0.05). There was no significant difference in other adverse reactions between the two groups ( P> 0.05). Kaplan-Meier survival analysis showed that the median tumor recurrence free survival time of gemcitabine group was 29.7 (6.3-58.8) months, and the 1-year and 2-year tumor recurrence free survival rates were 71.4% (30/42) and 45.2% (19/42), respectively; the median tumor recurrence free survival time of epirubicin group was 28.8 (4.5-57.8) months, and the 1-year and 2-year tumor recurrence free survival rates were 70.5% (31/44) and 47.7% (21/44), respectively. There was no difference in the tumor recurrence free survival rates between the two groups( P>0.05). Cox analysis showed that age ( HR=1.1, 95% CI 1.034-1.113) and tumor grade ( HR=12.2, 95% CI 5.776-25.680) were independent risk factors for prognosis. Conclusions:The efficacy of bladder perfusion chemotherapy with gemcitabine and epirubicin in patients with NMIBC was not significantly different, but the incidence of adverse reactions with gemcitabine was lower, which was safe and reliable. The risk factors affecting postoperative survival rates of NMIBC were patient's age and tumor grade.
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Acid-sensing ion channels are a class of extracellular H+ activated cation channels, belonging to the amiloride-sensitive epithelial Na+ channel/degenerin (ENaC/DEG) superfamily. During extracellular acidification, the channels are activated and produce corresponding action potential. Acid-sensing ion channels are extensively expressed in the peripheral and central nervous system. It plays an important in synaptic plasticity, mechanical sensation, injury sensation related to acidosis of local tissues, acid reception and retinal regulation. This article reviews the expression, biological characteristics and functions of acid-sensing ion channels in cochlea, vestibular tissue and auditory center, so as to improve the understanding of physiology and pathophysiology of auditory system.
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Objective To evaluate the effect of neoadjuvant chemotherapy on lymph node micrometastasis and DC cell number in stage Ⅲ gastric cancer patients.Methods Lymph node micrometastases in pathologically negative lymph nodes from 76 stage Ⅲ gastric cancer patients [56 cases with neoadjavant chemotherapy (NCT) and 20 cases without],were assessed by cytokeratin-20 antibody.Dendritic cells (DC) in HE positive lymph nodes,HE negatives near tumor foci and HE negatives far foci were assessed by CD83 antibody respectively.Patients were divided into four groups:group 0 (20 cases without NCT),group 2 (two courses of NCT in 29 patients),group 3 (three courses of NCT in 16 patients),group 4 (four courses of NCT in 11 patients).Results In NCT group there were two patients with micrometastases (2/56).All the patients were with micrometastases in control group (20/20).Difference was statistically significant (P =0.000).In HE-positive lymph node group:the number of CD83-positive DC in 2 times group,3 times group,and 4 times group when compared with no chemotherapy group were statistically significant (P20 =0.001,P30 =0.000,P40 =0.000).In HE-negative lymph node near foci group:the number of CD83-positive DC in 3 times group,and 4 times group compared with 0 group were statistically significant increased (P30 =0.001,P40 =0.001).In HE-negative lymph node far foci group:the number of 4 times group was significantly higher than 0,2 and 3 group (P40 =0.000,P42 =0.000,P43 =0.001).Conclusions Neoadjuvant chemotherapy is effective in the prevention of lymph node micrometastases in stage Ⅲ gastric carcinoma and it increases the number of mature dendritic cells in lymph nodes.
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Objective To compare the efficacy and safety of modified FOLFOX4 program with docetaxel-oxaliplatin-5-fluorouracil (DOF) program as neoadjuvant chemotherapy in stage Ⅲ gastric cancer patients.Methods In 86 cases of stage Ⅲ gastric cancer patients,42 received modified FOLFOX4 chemotherapy,44 cases were treated by DOF program.After two cycles of chemotherapy,the treatment effect and adverse reactions were evaluated.Results The total effectiveness in modified FOLFOX4 group and DOF group was 60％ (25/42) and 68％ (30/44) respectively (P ＞ 0.05).Tumor control rate was 83％ (35/42) and 89％ (39/44) respectively (P ＞ 0.05).The incidence of nausea,vomiting and leukopenia was higher in DOF group than modified FOLFOX4 group (P ＜ 0.05).The D2 lymph node dissection rate between modified FOLFOX4 group and DOF group was 80％ (20/25) and 87％ (26/30) respectively (P ＞ 0.05),the R0 resection rate was 72％ (18/25) and 83％ (25/30) respectively (P ＞ 0.05).In 43 R0 resection patients using FOLFOX4 the median survival time was 38.7 months,1-,3-year survival rate was 90％,and 60％ ; while that in DOF group the median survival time was 39.6 months,1-,3-year survival rate was 95％,and 75％.Multivariate analysis showed that postoperative TNM stage only was an independent risk factor for prognosis.Conclusions TNM stage was the independent risk factor for prognosis of gastric carcinoma patients after radical gastrectomy.
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OBJECTIVE@#To discuss the method and efficacy of Wormald technique application in opening frontal recess surgery.@*METHOD@#Twenty cases with chronic frontal sinusitis underwent surgery with Wormald technique were subjected to this study. Preoperative CT scan and especially sagittal reconstructing were used to indicate the extent of lesion, source and key adjacent structure.@*RESULT@#All patients were followed up for more than half a year with an average of nine months. The effective rate was 90% and no recurrence appeared except for two cases.@*CONCLUSION@#Application of Wormald technique for frontal recess open surgery under endoscope is safe and feasible, with no intracranial, orbital, and other serious complications. All treatments including preoperative sagittal CT, that help to a clear locating the cell lead to the frontal recess obstructive lesions, awarding of the potential difficulties while frontal recess could not be identified, protecting mucous membrane in operation, and strengthening medication, washing, and oxygen spray after operation, can improve operational efficiency.
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Female , Humans , Male , Middle Aged , Axilla , General Surgery , Chronic Disease , Endoscopy , Frontal Sinus , General Surgery , Frontal Sinusitis , General Surgery , Treatment OutcomeABSTRACT
OBJECTIVE@#To explore the significance of the lacrimal bone at the lateral nasal wall in endoscopic dacryocystorhinostomy.@*METHOD@#The position, dimension and thickness of the exposed lacrimal bone at the lateral nasal wall in 10 cadaveric heads(male 5, female 5) were examined and the anatomy of uncinate process, the maxillary line and M point were studied, too.@*RESULT@#The lacrimal bone at the lateral nasal wall is always situated immediately anterior to the uncinate process. The average length and width of the lacrimal bone was 9.23 mm and 3.63 mm, respectively. The lacrimal bone was very thin with an average thickness of 0.06 mm.@*CONCLUSION@#The study indicates that the lacrimal bone is so thin that a bony rongeur is usually sufficient to nibble it away. The medial wall of the sac is then removed without the use of drill or chisel with less operative trauma. The uncinate process, the maxillary line and M point are reliable landmarks in endoscopic dacryocystorhinostomy.