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BACKGROUND@#Family clustering of esophageal cancer (EC) has been found in high-risk areas of China. However, the relationships between cancer family history and esophageal cancer and precancerous lesions (ECPL) have not been comprehensively reported in recent years. This study aimed to provide evidence for identification of high-risk populations.@*METHODS@#This study was conducted in five high-risk areas in China from 2017 to 2019, based on the National Cohort of Esophageal Cancer. The permanent residents aged 40 to 69 years were examined by endoscopy, and pathological examination was performed for suspicious lesions. Information on demographic characteristics, environmental factors, and cancer family history was collected. Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.@*RESULTS@#Among 33,008 participants, 6143 (18.61%) reported positive family history of EC. The proportion of positive family history varied significantly among high-risk areas. After adjusting for risk factors, participants with a family history of positive cancer, gastric and esophageal cancer or EC had 1.49-fold (95% confidence interval [CI]: 1.36-1.62), 1.52-fold (95% CI: 1.38-1.67), or 1.66-fold (95% CI: 1.50-1.84) higher risks of ECPL, respectively. Participants with single or multiple first-degree relatives (FDR) of positive EC history had 1.65-fold (95% CI: 1.47-1.84) or 1.93-fold (95% CI: 1.46-2.54) higher risks of ECPL. Participants with FDRs who developed EC before 35, 45, and 50 years of age had 4.05-fold (95% CI: 1.30-12.65), 2.11-fold (95% CI: 1.37-3.25), and 1.91-fold (95% CI: 1.44-2.54) higher risks of ECPL, respectively.@*CONCLUSIONS@#Participants with positive family history of EC had significantly higher risk of ECPL. This risk increased with the number of EC positive FDRs and EC family history of early onset. Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.@*TRIAL REGISTRATION@#ChiCTR-EOC-17010553.
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Humans , Case-Control Studies , China/epidemiology , Esophageal Neoplasms/pathology , Precancerous Conditions/pathology , Risk Factors , Stomach NeoplasmsABSTRACT
Objective:To assess the association between the different prehospital transfer pathways to the hospital and reperfusion delay in patients with ST segment elevation myocardial infarction (STEMI).Methods:We retrospective collected 320 STEMI patients aged 18 years or older who underwent primary percutaneous coronary intervention (PPCI) from June 1, 2016 to July 31, 2018. They were divided into three groups according to different prehospital transfer pathways: patients directly transferred from the field by ambulance to PCI-capable center hospital (field transfer group, n=29); patients transferred by ambulance from PCI-incapable hospitals to PCI-capable center hospital (inerhospital transfer group, n=111); patients transferred by friends or relatives to PCI-capable center hospital (self-transfer group, n=180). The basic characteristic attributes, reperfusion time and fatal complications such as acute left heart failure cases (ALHF) cases, ventricular fibrillation (VF) cases, and in hospital death were collected and compared. In addition, logistic regression analysis was used to analyze uni- and multivariate of door-to-balloon (D2B) time less than 90 min. Results:The S2FMC interval were 118 min (50, 377) min , FMC-to-balloon interval were 87 min (66, 120.5) min and the onset-to-balloon time were 221 min (135, 482.5) min. The above three interval in the interhospital transfer group were longer than those in the field transfer and self-transfer groups ( P<0.05). S2FMC accounted for 51.14% of onset-to-balloon time in the field transfer group, 63.29% in the interhospital transfer group and 55.26% in the self transfer group. The door-to-catheter room interval were 33 min (9, 53.5) min. The interval in the interhospital transfer group were shorter than those in the field transfer and self-transfer groups ( P<0.05). The interval in the self-transfer group were longer than those in the interhospital transfer and field transfer groups ( P<0.05). Multiple regression analysis showed that the interhospital transfer group ( OR=15.251, 95% CI: 5.328-43.657, P<0.01), field transfer group ( OR=8.219, 95% CI: 1.861-36.307, P=0.005), FMC2ECG time ( OR=0.975, 95% CI: 0.962-0.989, P<0.01), and smoking ( OR=2.099, 95% CI: 1.015-4.341, P=0.045) were independent predictor of goal time less than 90 min ( P<0.05 for all variables). Adverse events in STEMI patients mainly occurred within 6 h of the initial symptoms. The incidence of VF was 3.75% (95% CI: 3.73%-3.77%), ALHF was 10.94% (95% CI: 7.52%-14.36%) and in-hospital mortality was 2.5% (95% CI: 0.79%-4.21%). There was no significant difference in the incidence of adverse events among the three groups ( P>0.05). Conclusions:The symptoms of STEMI patients are at risk in the early stage. Ambulances can shorten the reperfusion time, but the ambulance system is less used by patients. It is necessary to further optimize the treatment process of non-PCI hospitals and strengthen the popularity of emergency knowledge related to chest pain among residents, so as to shorten the reperfusion time.
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Objective@#To analyze the related factors of esophageal squamous cell carcinoma and precancerous lesions among residents aged 40-69 years old in rural areas of Shandong Province. @*Methods@#In October 2018, 300 villages in 13 counties of the Shandong upper gastrointestinal cancerearly diagnosis and treatment projectin 2017 were selected as research areas, and 30 400 residents aged 40-69 were recruited in this study. The demographic characteristics, health status and lifestyle information were collected through the questionnaire survey, and endoscope iodine staining and indicative biopsy methods were used for cancer screening among eligible people.The multivariate logistic regression model was used to analyze the risk factors for esophageal cancer and precancerous lesions. @*Results@#The subjects in this study were (56.42±7.24) years old, including 13 193 males (43.40%).There were 936 cases of esophageal cancer and precancerous lesions (3.08%), including 521 males and 415 females.Compared with women, 40-49 years old, high level education, drinking tap water, regular intake of meat, eggs and milk, and family average annual income more than 30 000 RMB, men (OR=1.90, 95%CI: 1.65-2.19), 60-69 years old (OR=5.28, 95%CI: 4.11-7.30), primary school education or below (OR=1.50, 95%CI: 1.20-1.89), drinking groundwater (OR=1.71, 95%CI: 1.38-2.13), never eating meat, eggs and milk (OR=1.48, 95%CI: 1.22-1.80), and family average annual income less than 30 000 RMB (OR=1.41, 95%CI: 1.16-1.70) would increase the risk of esophageal cancer and precancerous lesions. @*Conclusion@#The gender, age, educational level, annual household income, drinking water source, the frequency of eating meat, egg and milk were related to the occurrence of esophageal cancer and precancerous lesions among 40-69 years old residents in rural areas of Shandong Province.
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Objective To evaluate the performance of the Sendai Guidelines,Fukuoka Guidelines and Pancreatic Cystic Lesions Management Guidelines (Chinese guidelines) in predicting malignant mucinous pancreatic cystic neoplasms (PCN).Methods A retrospective analysis of 196 patients,who received surgery and were pathologically identified as PCN or intraductal papillary mucinous neoplasms (IPMN),underwent surgical resection in Ruijin Hospital affiliated with Shanghai Jiao Tong University from January 2003 to April 2017 was performed.The differences on clinical and pathological parameters between malignant mucinous and benign mucinous PCN were compared.The accuracy,sensitivity,specificity,positive predictive value (PPV)and negative predictive value (NPV) of the indications for surgery in the Sendai,Fukuoka and Chinese Guidelines in predicting malignant mucinous PCN were calculated.Results Of 196 patients,39 patients (19.9％) were confirmed as malignant tumors and 157 patients (80.1％) were confirmed as benign tumors by pathology.There were significant differences on age,symptoms (abdominal pain,jaundice or pancreatitis),tumor solid composition,pancreatic duct diameter,tumor site,tumor diameter ＞3 cm,and serum CA199 level between malignant and benign patients (all P ＜0.05).But there were no significant differences on gender distribution,tumor diameter,mural nodules and the proportion of mucinous cystic neoplasm (MCN)and intra-ductal papillary mucinous neoplasm (IPMN).165 patients (84.2％) met the Sendai Guidelines,153 patients (78.1％) met the Chinese guideline,and only 61 patients (31.1％) met the Fukuoka Guidelines.All 39 patients with malignant tumors met the indications in Sendai Guidelines and Chinese guidelines,and only 35 patients had the indication for surgery in the Fukuoka Guidelines.The accuracy,sensitivity,specificity,PPV and NPV of the Fukuoka Guidelines for predicting the malignancy were 84.7％,89.7％,83.4％,57.4％ and 97.0％,compared to 35.7％,100％,19.8％,23.6％ and 100％ for the Sendai and 41.8％,100％,27.4％,25.5％ and 100％ for the Chinese guidelines,respectively.Conclusions The performance of the Chinese guideline is slightly better than the Sendai Guidelines,while both of them can lead to a larger number of patients undergoing unnecessary surgical resection.Though the rate of missed diagnosis could reach 10.3％,the Fukuoka Guidelines gets the highest accuracy.
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Objective: To analyze the trend of lung cancer incidence rate among rural residents in Feicheng city between the years 2000 and 2012,and predict the incidence rate between the years 2013 and 2018,and subsequently provide baseline data for lung can-cer control and prevention.Methods:With the cancer registration data in Feicheng rural areas,the time trend of lung cancer inci-dence rate and the annual percentage change(APC)were calculated by the Joinpoint model,while the incidence of lung cancer from 2013 to 2018 were predicted by the ARIMA(p,d,q)model.Results:A total of 3,908 new cases of lung cancer were diagnosed be-tween 2000 to 2012.The incidence rate was 40.77/105,the age-specific cancer incidence rate in the Chinese population(ASRC)and world population(ASRW)were 32.95/105 and 32.97/105,respectively.The incidence was 2.14 times higher among males than females (P<0.001).The incidence of lung cancer which apparently rose from 25.13/105to 64.92/105 with an APC value of 9.74%(P<0.001),was increasing every year.The change in the trend of lung cancer with respect to age could be divided into three segments,the incidence rate in the 0 to 59 years group showed a rapid upward trend(APC=113.38,P<0.001),which was lower in the 60 to 79 years group (APC=20.39,P<0.05)and began to decline in the 80 years or older group(APC=-21.20,P>0.05).The incidence of lung cancer was also observed to be increasing yearly from 2013 to 2018,and with an average annual growth rate of 4.92%,was predicted to reach 87.92/105 in 2018.Conclusions:The occurrence of lung cancer was closely related to population aging,unhealthy habits,and environmental risk factors.Due to the increasing aging population,the incidence of lung cancer will continue to increase.In order to formulate specif-ic strategies,the control and prevention of lung cancer must be based on its incidence features.
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BACKGROUND:Mechanical, inflammatory, and biochemical factors, particularly matrix metaloproteinases and reactive oxygen lead to chondrocyte degeneration in osteoarthritis. Curcumin has been shown to be a potent antioxidant; however, its protective effects against chondrocyte degeneration in osteoarthritis remain unclear. OBJECTIVE:To investigate the potential molecular mechanisms underlying the protective effects of curcumin on articular cartilage of osteoarthritis in rats. METHODS:A total of 30 Sprague-Dawley rats were used and randomly divided into model group (positive control,n=15) and normal group (negative control,n=15). Rat models of traumatic osteoarthritis were established, and then cartilage cels were isolated from articular cartilage and culturedin vitro. Chondrocytes were treated with curcumin (curcumin group) or PDTC (an inhibitor of nuclear factor-kappa B) for 24 hours. The expression level of nuclear factor-kappa B P65 in nucleus and cytoplasm in chondrocytes were determined by western blot assay and immunofluorescence. Moreover, mRNA expressions of type II colagen, matrix metaloproteinase-1 and -13 were analyzed using RT-qPCR. RESULTS AND CONCLUSION: Nuclear factor-kappa B P65 protein was mainly expressed in nucleus, but few in cytoplasm in positive control group; the reversed results were found in the curcumin group. Nuclear translocation of nuclear factor-kappa B P65 was observed mainly in nucleus in the positive control group; however, that was observed mainly in cytoplasm in the negative control, curcumin, and PDTC groups. Matrix metaloproteinase-1 and -13 mRNA expressions were significantly decreased, while type II colagen mRNA expression was significantly increased in the curcumin group compared with the positive control group. These findings indicated that curcumin protect chondrocytes against degeneration through inhibiting the activation of nuclear factor-kappa B signaling pathway, suppressing nuclear translocation of nuclear factor-kappa B P65 and inhibiting the expressions of matrix metaloproteinase-1 and -13, which are responsible for upregulation of type II colagen expression.
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Objective To explore the relationship between levels of serum 25-(OH) D3 and changes in Th1/Th2 cell balance in infants with recurrent wheezing.Methods Sixty cases of infants with recurrent wheezing were involved and 60 cases of healthy children were selected as controls.Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of serum 25-(OH) D3 and double-antibody sandwich (ABC-ELISA) was used to detect the serum levels of interferon-γ(IFN-γ),interleukin (IL)-4,IL-13,and then the relationship between the levels of serum 25-(OH) D3 and changes in Th1/Th2 balance in infants with recurrent wheezing were explored.Results Serum 25-(OH) D3 levels decreased significantly in the infants with recurrent wheezing group compared with those of the healthy control group [(18.24 ± 5.64) μg/L vs (37.85 ± 7.78) μg/L] (t =15.810,P =0.000).Serum IFN-γ levels decreased significantly in the infants with recurrent wheezing group compared with those of the healthy control group [(11.20 ± 2.08) ng/L vs (20.68 ± 3.87) ng/L] (t =16.700,P =0.000).In contrast,serum IL-4,IL-13 levels increased significantly in the infants with recurrent wheezing group compared with those of the healthy control group[IL-4:(28.61 ±6.44) ng/L vs (22.14±5.29) ng/L;IL-13:(20.02±4.83) ng/L vs (17.72± 4.06) ng/L] (t =6.201,P =0.000 ; t =2.829,P =0.006).Th1/Th2 in the infants with recurrent wheezing group were lower than that those of the healthy control group,and there was statistically significant difference between two groups(0.41 ± 0.12 vs 1.00 ± 0.36) (t =11.796,P =0.000).Serum 25-(OH) D3 levels were negatively correlated with Th1/Th2 in the infants with recurrent wheezing(r =-0.649,P =0.000).There were no correlation between serum 25-(OH) D3 levels and Thl/Th2 in the healthy control group(r =-0.217,P =0.096).Conclusions Low serum 25-(OH) D3 may be the risk factor for recurrent wheezing in infants.Serum 25-(OH) D3 levels were negatively correlated with Th1/Th2 in the infants with recurrent wheezing group,which show that recurrent wheezing in the infants is closely related to allergic reaction.
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OBJECTIVE@#To raise awareness of granulomatosis with polyangiitis by summarizing its nasal mani- festations and treatment experience.@*METHOD@#Retrospective studies were done to the nasal clinical manifestations and treatment processes of 21 GPA patients in this study. All were treated by the combined treatment of glucocorticoid, cyclophosphamide as well as tripterygium wilfordii, and 4 of them who had much heavier nasal symptoms were treated by endoscopic sinus operation at the same time.@*RESULT@#Eighteen cases were effective treated by medical treatments besides 3 were died of all 21 cases. The nasal symptoms of those 4 patients were obviously improved, and still had effective drainage of sinus after operation with 8-22 months follow up, although the sinus ostiums were reduced comparing to themselves intraoperation at different degree.@*CONCLUSION@#GPA is always been ignored which will lead to delay treatment due to the lack of specificity of its clinical manifestations. So, enough attention is the key point of avoiding misdiagnosis as well as providing timely treatment for these patients.
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Humans , Combined Modality Therapy , Diagnostic Errors , Drainage , Endoscopy , Granulomatosis with Polyangiitis , Diagnosis , Therapeutics , Nose , Paranasal Sinuses , Retrospective StudiesABSTRACT
Patient, 30-year-old, male,was admitted to our hospital because of discontinuously spit fresh blood without any inducing factors for three days. In the course, the patient suffered mild dry sensation of pharyngeal, poor spirit condition, fatigue, poor sleep, poor appetite and was with black stool 2 times. Physical examination: T36. 6°C, R 21/min, P98/min, BP135/90 mmHg (1 mmHg = 0.133 kPa). Bilateral tonsils were III hypertrophy and with scar shape surfaces. The left tonsil's surface had longitudinal small blood vessels markedly dilated. His oropharynx, laryngopharynx and laryngeal did not be find any obvious bleeding sites. Laboratory findings: WBC 13.82 x 10(9)/L, N 0.8084, L 0.1632, Hb 81.00 g/L, HCT 25.20; PT 9.60 s, APTT 25.50 s, TT 15.80 s, FIB 1.900 g/L. After 3 hours of admission,the patient spit out fresh blood again,checked the body to see:the left peri-tonsil with fresh blood and found a slowly bleeding site at the 1/3 junction of the middle lower part of left tonsil's rear surface, the size was about 0.5 cm x 0.6 cm. We finally diagnosed spontaneous tonsillar hemorrhage and successfully managed with low-temperature radiofrequency technology.
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Adult , Humans , Male , Catheter Ablation , Hemorrhage , Therapeutics , Hypertrophy , Hypopharynx , Larynx , Oropharynx , Palatine Tonsil , Pathology , TemperatureABSTRACT
Objective To investigate the methods and effects of abdominal and pelvic shielding for pediatric chest CT examinations.Methods The 705-D phantom made by Computerized Imaging Reference Systems (CIRS) was used to replace a 5-year-old child,thermoluminescent dosimeters were set in the abdomen and pelvis to measure the organ and tissue doses.Chest scans were conducted with the routine protocol for pediatric chest CT examinations.Doses to main organs and tissues in the abdomen and pelvis were measured after chest CT scans without lead apron,with lead apron covering anterior of the abdomen and pelvis and with apron wrapping same part,respectively.Results Absorbed doses to some abdominal organs near the irradiation field were up to several mGy in a procedure of pediatric chest CT examination.There were statistically significant differences among the dose values for three different scans at the same location (x2 =16.00,P ＜ 0.05).Statistically significant difference was also found between the dose values for scans,which were measured with wrapping and covering approaches (Z =-2.52,P ＜ 0.05).Compared to the doses in the condition of no shielding,the doses in testis and colon reduced by 71.2％ and 42.3％,respectively,if the abdomen and pelvis was wrapped with a lead apron (0.35 mm Pb),and reduced by 55.9％ and 26.1％,respectively,if the same lead apron was used to cover the anterior of the abdomen and pelvis.Conclusions In pediatric chest CT examinations,the use of a lead apron can effectively shield the abdomen and pelvis,and plays an important role in protection of the gonad and colon.The wrapping measure is worth being recommended.
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BACKGROUND:Intra-articular injection of sodium hyaluronate or dexamethasone can relieve pain and increase range of motion after traumatic arthritis. OBJECTIVE:To observe the effect of dexamethasone combined with sodium hyaluronate on traumatic arthritis of rat knees. METHODS:Forty-eight Sprague-Dawley rats were randomly divided into four groups. The anterior ligament of the left knee was resected and the medial meniscus was removed to establish models of traumatic arthritis in al the rats. After 3 weeks, the four groups were respectively injected dexamethasone+sodium hyaluronate (combined group), dexamethasone, sodium hyaluronate, and nothing (control group). After 4, 8, 12 weeks of injection, the samples were obtained for gross observation, anteroposterior and lateral X-ray films and hematoxylin-eosin staining. RESULTS AND CONCLUSION:At 12 weeks after injection, X-ray films showed that there was no stenosis in the combined group, mild stenosis in the dexamethasone and sodium hyaluronate groups, and obvious stenosis in the control group (indicating severe osteoarthritis);hematoxylin-eosin staining exhibited the fibrous cartilage-like tissue grew wel in the combined group, varying degrees of proliferation of fibrous cartilage-like cells were visible in the dexamethasone and sodium hyaluronate groups, and there was a smal amount of fibrosis in the control group. These findings suggest that the combination of dexamethasone and sodium hyaluronate can improve the cartilage repair and restore the joint function.
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Objective To retrospectively analyze the cardiovascular outcomes of the elderly patients with obstructive sleep apnea syndrome (OSAS) and the influence factors. Methods According to polysomnography examination, 79 OSAS patients and 60 patients without OSAS were selected and divided into 3 groups: elder OSAS group [39 patients older than 65 years, respiratory apnea index (AHI)≥5], non-elder OSAS group (40 patients less than 65 years old, AHI≥5) and elder control group (60 patients older than 65 years, AHK5). All patients were followed up by telephone and clinic consulting. The median follow-up duration was 25 months. All patients received the following studies: (1)Flow-mediated vasodilation (FMD), which was assessed by high-resolution ultrasound technique. (2)The sleep-related breathing events and serum biochemical indexes. (3)The death due to cardiovascular disease (CVD), angina, myocardial infarction and stroke. Results (1) FMD was significantly lower in elder OSAS group than in elder control group (P<0. 01). (2)In elder OSAS group versus elder control group, BMI was significantly higher (P<0. 01), while both lowest pulse oxygen saturation (LSpO_2 ) and mean series pulse oximeter ( MeanSpO_2 ) were significantly lower (P< 0.01 and P<0. 05, respectively). Multiple logistic regression analysis showed that impaired fasting plasma glucose was the primary injury factor for FMD (OR=1. 83, 95% CI:1. 11～3.03), and LSpO_2 was the secondary injury factor (OR = 0.92, 95% CI: 0. 85～1. 00). (3) The incidence of cardiovascular events in the 3 groups: the incidence of cardiovascular events was significantly higher in elder OSAS group than in the other 2 groups (χ~2= 7. 339, P<0. 05). Multiple logistic regression analysis showed that FMD (OR=1. 33, 95% CI:1. 06～1. 66)and hs-CRP (OR = 0.51, 95% CI: 0. 34～0.76) were closely related with prognosis. Conclusions Compared with non-elder OSAS group and elder control group, vascular endothelial function impairment is more serious and the incidence of cardiovascular events is higher in elder OSAS group. So OSAS may influence the prognosis of the patients by injuring the vascular endothelial function.
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Objective To investigate the effect of GDNF on pancreatic cancer cell proliferation and chemotaxis.Methods The cell counting, MTT and flow cytometry were employed to investigate whether the neurotrophic factor GDNF can stimulate the proliferation of pancreatic carcinoma cells.Meanwhile, the trans-well invasion chamber was used to observe the chemotactic effect of GDNF on pancreatic cancer cells.Results The cells were exposed to incremental concentrations of human re-combinant GDNF (0-120 ng/mL).We found that the proliferation of pancreatic cancer cells was stim-ulated by GDNF in a dose-dependent manner and the number of cells in "S" phenotype was increased;The count of cells was increased by GDNF in a dose-dependent manner.Conclusion GDNF can stimu-late the proliferation and invasion of pancreatic cancer cells in a dose-dependent manner.
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Objective To investigate the degradation of dicalcium phosphate dehydrate-coated Mg-Zn alloy in vivo and bone formation. Methods Left femoral condyles were drilled in 72 New Zealand rabbits, and were randomly divided into experiment group (n＝24, implanted with dicalcium phosphate dehydrate-coated Mg-Zn alloy rods), Mg-Zn alloy control group (n＝24, implanted with Mg-Zn alloy rods) and poly-L-lactide acid rod group (n＝24, implanted with poly-L-lactide acid rods). Serum concentrations of Mg~(2+) were examined 1 d pre-operation, and 1 d, 1 week, 2 weeks, 5 weeks and 10 weeks post-operation in experiment group and Mg-Zn alloy control group. Operation sites were examined by X-rays at 3, 6, 12 and 18 weeks post-operation. After X-ray examination at each time point, 6 rabbits in each group were sacrificed, and subjected to histopathological observation of live and kidney tissues by HE staining. Tissues from condyles of femur were observed by HE staining and 2, 4, 6-trinitrophenol rosein staining, and mineral apposition rate of bone was calculated. Results There was no significant difference in the concentrations of serum Mg~(2+) at each time point between Mg-Zn alloy control group and experiment group (P>0.05). X-ray examination revealed gas emerged near the implants 3 weeks after surgery in Mg-Zn alloy control group. However, there was no obvious histological abnormality in liver and kidney tissues. The mineral apposition rate was higher and the degradation of material was lower in experiment group than those in the other two groups. Conclusion Dicalcium phosphate dehydrate-coated Mg-Zn alloy has a favourable biocompatibility, and degrades more slowly in vivo.
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Objective To analyze the literatures on arthroplasty treating femoral neck fracture in the elderly so as to evaluate the value of arthroplasty in treating femoral neck fracture in the elderly. Methods The literatures published from 1991 to 2007 on arthroplasty treating femoral neck fracture in the elderly were retrieved via PubMED and Ovid database to compare the mortality. Dislocation, revision and Harris score after operation. The heterogeneity was tested and the data dealt by meta-ana]ysis. Then, we talculated the OR value and 95% confidence interval. Results The study included 10 related pa-pers involving hemi-arthroplasty(HA)and total hip arthroplasty(THA)treating femoral neck fracture in the elderly. There was no statistical difference between HA and THA in aspect of mortality. No heteroge-neity existed in dislocation and revision, with the Q value of 4. 03 and 2. 78 respectively(P>0. 1). THA had a high dislocation rate but lower incidence of revision, in comparison with HA. The heterogeneity of Harris score was confirmed with the Q value of 23. 94(P<0. 1), with relative risk(RR) of 0. 79, OR of 0. 35 and 95% CI of 0. 23-0. 53. Conclusions As for hip function recovery, THA is better than he-mi-arthroplasty and THA should be the first choice for femoral neck fracture. However, for patients who can not tolerate operation or have anticipated life span less than 5 years, hemi-arthroplasty should be cho-sen.
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Objective To evaluate CT manifestations and its clinical significance of the laryngopharyngeal carcinoma.Methods CT findings of 18 cases with laryngopharyngeal carcinoma proved by surgery and pathology were analysed.Results Of 18 cases,11 cases were in the piriform fossa,5 cases were in the postcricoid region and 2 cases were in the posterior wall of laryngeal pharynx.The tumor showed isodense or mixed density and slightly enhancement.It was the characteristic feature of the laryngopharyngeal carcinoma that the tumor pushed the annular and arytenoid cartilage displacement anteriorly,the thyroarytenoid gap and cricothyroid joint were widened.Other indirect findings included invasion of the larynx and esophageal ostium,destruction of laryngeal cartilage and metastasis of lymph node of neck.Conclusion CT can reliably exhibit the location,size and extent of the tumors and metastasis of lymph node of neck.It is useful in working out the thearapeutic program and evaluating prognoses.
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ObjectiveThis study was to evaluate the effects of different pneumoperitoneum used in laparoscopy on in vitro tumor cells growth. Methods 3H-TdR incorporation was used to compare the DNA synthesis (CPM value) of tumor cells after exposure to simulated laparoscopic environments, composed of carbon dioxide, helium and room air, respectively. Results At 24 hours after pneumoperitoneum, compared with group of helium, air and control, CPM increased in group of carbon dioxide (F=47.576 5,P0.05). At 48,72 and 96 hours, pneumoperitoneum, compared with helium group, air group and control group, CPM increased significantly in carbon dioxide group (F=116.183,1082.92 and 5116.75, P0.05). Conclusion Carbon dioxide promotes tumor cells growth, while helium restrains the growth of tumor cells. [