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OBJECTIVE To compare the efficacy ，safety and immunogenicity of bevacizumab biosimilars and original drugs for non-small cell lung cancer （NSCLC），and to provide evidence-based reference for clinical use. METHODS PubMed，Embase， Web of Science ，Cochrane Library ，CBM，CNKI，VIP，Wanfang database ，ClinicalTrials.gov，and Clinical Trial Center of China were searched from the establishment of the database to September 25，2021，randomized controlled trials （RCTs）about bevacizumab biosimilars（trial group ）versus bevacizumab original drugs （control group ）for NSCLC were collected. After literature screening ， data extraction and quality evaluation of included RCTs with bias risk assessment tool recommended by Cochrane Handbook 5.1.0， meta-analysis，sensitivity analysis and publication bias analysis were performed by using RevMan 5.3 software. RESULTS A total of 11 RCTs were included ，involving 6 596 patients in total. Meta-analysis showed that there was no statistical significance in the difference of overall response rate [RR＝0.97，95％CI（0.92，1.02），P＝0.22]，the total incidence of adverse reaction [RR＝1.00， 95％CI（0.99，1.01），P＝0.79]，the incidence of severe adverse reaction [RR＝1.04，95％CI（0.96，1.13），P＝0.38]，positive rate of anti-drug antibody [RR ＝1.10，95％CI（0.88，1.36，P＝0.41] and the incidence of common adverse reactions （except for vomiting）among 2 groups（P＞0.05）. The sensitivity analysis results showed that the obtained results were robust. The results of publication bias analysis showed that there was little possibility of publication bias. CONCLUSIONS The efficacy ，safety and immunogenicity of bevacizumab biosimilars used for NSCLC are equivalent to those of bevacizumab original drugs.
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OBJECTIVE:To systematically review the effectiveness and safety of combination prescription of lidocaine with ropivacaine for anesthesia,and provide evidence-based reference for developing new compound preparation. METHODS:Retrieved from CJFD,Wanfang Database,VIP,PubMed and EBSCO,randomized controlled trials (RCT) about lidocaine combined with ropivacaine versus lidocaine alone or ropivacaine alone for anesthesia were collected. Meta-analysis was performed by using Rev Man 5.0 software provided by the Cochrane Collaboration after data extracting and quality evaluating. RESULTS:Totally 30 RCT were included,involving 2 442 patients. Results of Meta-analysis showed,lidocaine+ropivacaine vs. lidocaine:onset time was 6.77 min vs. 7.11 min [MD=-0.29,95%CI(-0.43,-0.16),P<0.001],maintenance time was 5.11 h vs. 2.11 h [MD=3.13,95%CI (3.02,3.25),P<0.001] and the incidence of adverse reactions was 28.6% vs. 44.6% [MD=0.43,95%CI(0.31,0.62),P<0.001];lidocaine+ropivacaine vs. ropivacaine:onset time was 9.49 min vs. 15.85 min [MD=-4.43,95%CI(-4.63,-4.22),P<0.001];maintenance time was 4.84 h vs. 6.79 h [MD=-0.61,95%CI(-0.71,-0.51),P<0.001];the incidence of adverse reac-tions was 44.8% vs. 48.1% [MD=0.82,95%CI(0.56,1.19),P=0.30]. Sensitivity analysis showed that the results were in stabili-ty. CONCLUSIONS:Lidocaine combined with ropivacaine shows rapid onset and long duration in anesthesia,and it can reduce ad-verse reactions play their respective advantages.
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The application of nuclear energy and nuclear technology has brought great convenience to human beings, but also greatly increases the potential risk of people exposed to radiation injury. Radioprotectants could reduce morbidity or mortality produced by ionizing irradiation. Substantial efforts to develop medically effective radioprotectant were initiated for a long time. The research of radioprotectant with good protection effect and low toxicity has become the focus, and some candidate drugs have been found. The biological agents, as the preventive and therapeutic medical measures for the acute radiation syndrome, have exhibited a good prospect. This review is an attempt to provide vital information about the current status of some representative biological radioprotectants and their future perspective.
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Objective: By building database model, to put forward measures to solve the shortage of basic drugs. Methods: There were five factors influencing medicine shortage have been researched, collecting data, using SPSS 18.0 software to build the database model of different parts, and then analyzed the existing problems and inner link, scientifically came up with the basic framework and main solutions of guarantee measures on shortages of essential medicines. Results: The database model of country and six areas in it have been built, and the influence factors of drug shortage in different region have been analyzed, and raised five aspects measures to secure reliable supplies of drugs, including selection, bid and procurement; production and flow; reserve and adjust;pricing and pay;use training. Conclusion: This study extends the application of database, enriches research ideas of drug policy, and the policy put forward to avoid drug shortages to a certain extent.
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Objective To explore the value of anatomical liver resection in the treatment of bilateral intrahepatic biliary lithiasis. Methods We collected the clinical data of 32 patients with bilateral intrahepatic biliary lithiasis who received anatomical liver resection and 25 patients who recevied non-anatomical liver resection from May 2010 to May 2012 in our hospital and Sun Yat-sen Memorial Hospital. We comapred the therapeutic efficacy of these two operative modalities in the diagnosis and treatment of bilateral intrahepatic biliary lithiasis. Results The intraoperative blood loss was 436 ±48.162 mL in patients who received anatomical liver resection, and was significantly less than that in the control group (763 ± 37.645ml) ( 0.05 ), but there 1 patients died of liver failure in the control group. Conclusions Anatomical liver resection is a favorable method to completely remove the lesions under the premise of retaining the residual liver function as much as possible. The rate of remnant biliary lithiasis and recurrence is lower and the recovery is quicker in these patients after anatomical liver resection. Thus, anatomical liver resection is worthy of promotion.
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Objective To investigate the value of modified T staging system in the diagnosis and treatment of hilar cholangiocarcinoma (HCCA).Methods The clinical data of 95 patients with HCCA who were admitted to the Memorial Sun Yat-Sen Hospital from December 1995 to January 2010 were retrospectively analyzed.Based on the results of imaging examination,preoperative staging was determined according the modified T staging system.The prognosis of the patients in difference T stages were compared.The data were analyzed by using the chi-square test and Fisher exact test.The survival curve was drawn by Kaplan-Meier method and the survival rate was compared by using the Log-rank test.Results The diagnostic rates of ultrasound + magnetic resonance cholangiopancreatography (MRCP),ultrasound + computed tomography (CT) or spiral CT were 93％ (37/40) and 66％ (23/35),respectively.The diagnostic rates of ultrasound + CT or spiral CT and endoscopic retrograde cholangiopancreatography (ERCP),ultrasound + CT or spiral CT and MRCP were 14/15 and 15/15,respectively.Of the 95 patients,44 received operation (including 28 cases of radical resection and 16 cases of palliative resection),16 received exploratory laparotomy,and 35 received simple internal or external drainage.For patients in T1,T2 and T3 stages,the resection rates were 71％ (30/42),50％ (12/24) and 7％ (2/29),respectively,with significant differences (x2 =30.182,P ＜0.05).The negative rates of the resection margins of patients in T1 and T2 stages were 77％ (23/30) and 5/12,respectively,2 patients in T3 stage were found with tumor residuals at the resection margin.There was a significant difference in the radical resection rate among patients in different T stages (x2 =8.204,P ＜ 0.05).Of the 44 patients who received surgical treatment,30 (68％) received concomitant partial hepatectomy.The ratios of patients in T1 and T2 stages who received concomitant partial hepatectomy were 70％ (21/30) and 9/12,respectively,with no significant difference (x2 =0.101,P ＞ 0.05).Fourteen (32％) patients received tumor resection.The incidences of complications and perioperative mortalities were 53％ (16/30) and 10％ (3/30) for patients who received concomitant partial hepatectomy,and 5/14 and 1/14 for patients who received tumor resection,with no significant differences between the 2 groups (x2 =1.188,0.094,P ＞ 0.05).The median survival time of patients who received concomitant partial hepatectomy was 29 months,which was significantly longer than 19 months of patients who received tumor resection (x2 =11.317,P ＜0.05).Eighty-six patients were followed up,and the median time of follow up was 15.6 months (range,3-70 months).The 1-year cumulative survival rates of patients in T1,T2 and T3 stages were 73.8％,58.0％ and 9.2％,respectively,and the 3-year cumulative survival rates of patients in T1,T2 and T3 stages were 33.5％,12.1％ and 0,respectively.The median survival time of patients in T1,T2 and T3 stages were 24,16 and 7 months,respectively.The prognosis of patients was getting poor as the increase of the T stages (x2 =37.07,P ＜ 0.05).Conclusions The modified T-staging system is beneficial to preoperative evaluation of patients with HCCA.Concomitant partial hepatectomy could improve the radical resection rate and prolong the median survival time of HCCA patients.
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ObjectiveTo review our experience in the diagnosis and surgical treatment of solid pseudopapillary neoplasm (SPN) of the pancreas which can be used as a reference for other doctors to avoid misdiagnosis and to provide a better treatment.MethodThe clinical,laboratory,radiological,pathological and operative data of 24 patients with SPN of the pancreas operated between February 2001 to December 2009 were collected and retrospectively analyzed.Results23 of 24 patients were female and the mean age was 31 years.The most common clinical presentations were vague abdominal pain and abdominal mass.In most cases,abdominal imaging showed a solid or a solid-cystic mass in the tail or head of pancreas.All patients received surgery.20 of 22 patients who received curative resection were alive with no evidence of tumour recurrence.One patient who had a R1 resection died 42 months after surgery.The remaining patient was alive after a second operation.ConclnsionsSPN of the pancreas is a tumour with low malignancy.A correct diagnosis of SPN of the pancreas is made on its clinical,radiological and histopathological characteristics.Radical surgical resection is the treatment of choice.For patients with an advanced disease,palliative resection is beneficial.
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Objective To evaluate perioperative portal hemodynamic alterations in cirrhotic patients undergoing subtotal splenectomy,podicled spleen remnant retroperitoneal transplantation plus lower esophagus transection in the treatment of portal hypertension.Method Forty patients with cirrhotic portal hypertension were randomly allocated into 2 groups:splenic transplantation group (n = 20),in which patients underwent subtotal splenectomy with pedicled remnant spleen retroperitoneal transplantation and cardia-esophageal devascularization and transection,and control group (n = 20),in which splenectomy and cardia-esophageal devascularization and transection were performed.The cross section area,blood velocity and flow and collateral circulation of portal parameters were comparatively evaluated by 3D DEC MRA,and the size of remnant spleen,blood flow and collateral circulation of retroperitoneal transplanted spleen were comparatively assessed.Results At 6-month after operation,the disappearance of esophageal-gastric varices in two groups was similar,and the cross section areas of main portal vein (MPV) in two groups all decreased postoperatively,in study group it was (1.81±0.73) cm~2 vs.(1.20±0.52) cm~2,P ＜ 0.01;in control group it was (1.78±0.52) cm~2 vs.(1.30±0.12) cm~2,p ＜0.01.The mean blood velocity of MPV decreased postoperatively,in study group it was (9.86±0.10) cm/s vs.(7.06±1.92) cm/s,P ＜0.01;In control group it was (10.0 ±0.6)cm/s vs.(8.2±2.4) cm/s,P ＜0.01.The mean blood flow velocity of MPV in study group was lower postoperatively than that in control group(P＜0.01).The mean blood flow volume of MPV decreased postoperatively from (15.0±1.9) ml/s to (10.5 ±2.7)ml/s,P ＜0.01 in study group;and from (14.9±2.1) ml/s to (11.6±2.1) ml/s,P ＜ 0.01 in control group.The mean blood flow volume of MPV in study group was lower postoperatively than that in control group(P＜0.05).A significant collateral formation was observed around the retroperitoneally translocated pedicled remnant spleen.Conclusions Compared with splenectomy,subtotal splenectomy,retroperitoneal translocation of the pedicled remnant speen helps to preserve splenic function as well as to increase retroperitoneal collateral formation which is conducive to further decreasing the portal veinous pressure.
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Objective To investigate the efficacy of recombinant activated factor Ⅶ (γFⅦa)in the management or prevention of intraoporative bleeding in general surgery. Methods A retrospective analysis was made to investigate the effect of FⅦa in 56 surgical cases.There were 56 cases including 53 hepatobiliary cases,3 gastrointestinal surgical cflses.γFⅦa was used intraoperatively when bleeding was difficult to control in 12 patients,and in 30 liver transplant cases before a skin incision was made.γFⅦa was used in the other 14 cases postoperatively to control intraabdominal bleeding. Results Massive bleeding stopped in 11 out of 12 cases who used γFⅦa during the operation as a rescue regimen,though two of them eventually died intraoperatively for deteriorating hemedynamics,one died of intraoperative intractable bleeding in spite of the Use of γFⅦa.All the 30 liver transplant cases used γFⅦa in the prevention of intraoperative bleeding had a successful surgery.After γFⅦa was administered in 11 out of the 14 cases of postoperative bleeding,the drainage decreased by 50%.In 3 cases γFⅦa failed and hemodynamic and vital signs were still unstable.In brief,γFⅦa were safely used in bleeding control or prophylaxis.Its Successful rate reached 89% in 56 patients.No thrombus complication was found. Conclusion γFⅦ a controls perioperative hemorrhage complications.
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Objective To compare the effect of pericardial devascularization with that of the modified Sugiura procedure in management of portal hypertension. Methods From 1990 to 2008, 236patients with portal hypertension underwent operations including pericardial devascularization in 147and modified Sugiura in 89 in our hospital. Results There were 12 perioperative deaths (8.2 % ), and 2 rebleedings (2 % ) in the pericardial devascularization group, and 7 perioperative deaths (7.9 % ) and 2 rebleedings(3.4 % ) in the modified Sugiura group. The follow-up rate was 91.9 % in the pericardial devascularization group and 87.8% in the modified Sugiura group respectively, in a period from 6 months to 19 years. The 1-, 3-and 5-year rebleeding rates were 5.7%,15.2% and 25.5% in the pericardial devascularization group and 6.9%, 16.3%, 29.5 % in the modified Sugiura group, respectively. The 1-, 3- and 5-year survival rates were 87.8% ,79.1% and 69.7% in the pericardial devascularization group and 95.8 %,85.0%, 76.9 % in the modified Sugiura group, respectively. Conclusion Modified Sugiura procedure and pericardial devascularization have differences in perioperative mortality as well as rebleeding and survival rates.
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BACKGROUND: In vitro differentiation of embryonic stem cells into hepatocytes has been successfully reported to a certain degree; however, whether embryonic stem cells are able to effectively enter hepatic plate of host after intrahepatic transplantation, whether embryonic stem cells can further differentiate into hepatocytes and express hepatocyte function, and risk factors for neoplastic formation are still unclear at present. OBJECTIVE: To study the intrahepatic transplantation of embryonic stem cells-derived hepatic stem cells in therapeutic liver repopulation models, and to investigate the liver tissue replacement, growth and differentiation in vivo, and neoplastic formation.DESIGN: Randomized controlled animal study.SETTING: Department of Pediatric Surgery, the Second Hospital affiliated to Sun Yat-sen University. MATERIALS: Twenty-four BALB/c mice, 6-8 weeks old, weighing 20-35 g, irrespective of gender, were provided by Guangzhou Experimental Animal Center. Embryonic stem cells-derived hepatic stem cells were differentiated from embryonic stem cells. E14 was provided by Stem cell Center of our hospital. METHODS: This study was performed at the Stem Cell Center, the Second Hospital affiliated to Sun Yat-sen University from July 2006 to June 2007. Twenty-four mice were randomly divided into a liver repopulation model + stem cell transplantation group (group A) and a liver resection + stem cell transplantation group (group B), with 12 mice in each group. Mice in the group A were intraperitoneally injected with 50 mg/kg retrorsine once every two weeks for totally twice. Four weeks after the second injection, about 70% liver was resected. And then, the embryonic stem cells-derived hepatic stem cells, labeled by 1×105 carboxy fluoresce in diacetate succinimidyl ester (CFDA-SE), were transplanted into mouse liver through portal vein. On the other hand, 70% liver of mice in the group B was resected and embryonic stem cells-derived hepatic stem cells were transplanted into mouse liver. MAIN OUTCOME MEASURES: The distribution, incorporation, and proliferation of transplanted cells were observed under fluorescent microscopy. Two weeks later, hepatic function was stained with albumin fluorescence immunoassay (double fluorescence staining) and assayed by level of serum albumin. Embryonic stem cells-derived hepatic stem cells were poured into liver of remedial liver regeneration mice, and undifferentiated embryonic stem cells were transplanted into subcutaneous tissue in axillary region as the controls to observe neoplastic formation in embryonic stem cells-derived hepatic stem cells. RESULTS: ① Growth of hepatic stem cells in recipient mice: One week after transplantation of CFDA-SE-labeled embryonic stem cells-derived hepatic stem cells, some scattered region was green under fluorescent microscopy. The area of green region increased apparently in 2 weeks, and cord-like structure could be observed. ② Liver function: Immunofluorescent staining of albumin (double fluorescence staining) demonstrated that labeled cells expressed positive albumin (yellow fluorescence) in liver tissue of recipient mice, but there was not significant difference in serum albumin level between group A and group B (P > 0.05). ③ Reliability of hepatic stem cell transplantation: Teratoma did not form over 6 months; however, transplantation of undifferentiated embryonic stem cells in the axillary region could cause formation of teratoma after 6 weeks. CONCLUSION: The transplantation of embryonic stem cells-derived hepatic stem cells in therapeutic liver repopulation model mice can effectively and further grow and differentiate, or even partially express hepatocyte function; in particular, the transplantation is safe.
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Objective To evaluate the efficacy of splenic autotransplantation plus lower esophagus transaction for the treatment of portal hypertension(PTH).Methods Thirty patients were divided into study group(15 cases)and control group(15 cases).Patients in study group Underwent splenic autotransplantation after splenectomy and cardia-esophageal devascularization plus lower esophagus transaction,and those in control group had all except splenic autotransplantation.The cross section area,blood velocity,blood flow of MPV(main portal vein)and changes of cardia-esophageal varices were evaluated by 3D DCE MRA at 1 week before operation and 6 months after,and blood flow and collateral circulation of transplanted spleen in the retroperitoneal space were assessed.Results In both groups,the cross section areas(cm2),mean blood velocity(cm/s)and mean blood flow(ml/s)of MPV decreased postoperatively(P＜0.05).The postoperative cross section areas(cm2)and mean blood velocity(cm/s) of MPV in study group were smaller than that in control group(P＜0.05).Esophageal and fundal variceal veins disappeared or improved equally in both groups.There was no difference in the postoperative and preoperative liver function between the two groups(P＞0.05).In study group,the planted spleen grew well in the retroperitoneal space,and with a formation of extensive collateral circulation.The postoperative serum hyaluronic acid decreased in this group(t=2.929,P＜0.05).Conclusion Splenic autotransplantation after splenectomy plus lower esophagus transection was effective for the treatment of PHT without adverse impact on liver function.
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BACKGROUND: The immature dendritic cell (imDC) can induce immunological tolerance and has widely application in the field of organ transplant. At present, the methods of inducing imDC are insufficient, so the new induction method is demanding.OBJECTIVE: To investigate the effect of sodium butyrate (SB) on the maturation and immunological function of human peripheral blood-derived imDC.DESIGN: Controlled observation and in vitro cytological trial.SETTING: Department of Hepatobiliary Surgery in the Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: Five samples of human peripheral blood were obtained from the healthy volunteers (aged 20-23 years) of Sun Yat-sen University, totally 500 mL. Then peripheral blood mononuclear cells (PBMCs) and lymphocytes were isolated within 2 hours.METHODS: The experiment was carried out in the Medical Research Center of the Second Hospital Affiliated to Sun (1 mmol/L) was added for induction, while those supplemented with maturation promoting factor lipopolysaccharide (LPS)the beginning of induction, while LPS was added on the sixth day for second stimulation.MAIN OUTCOME MEASURES: Cell morphological change, flow cytometry was used to detect DC phenotype,FITC-labeled Dextran was used to detect the endocytosis of DC, the production of IL-12 was determined by means of enzyme-linked immunosorbent assay, and the proliferation of lymphocyte induced by DC was assayed with mixed lymphocyte reaction.expressions of CD80, CD83 and HLA-DR were significantly lower in the imDC of routine induction group following SB maturity promoting, compared with LPS group (P＜0.01). On the sixth day, LPS was added into the SB-induced imDC,Endocytosis of DC: The imDC of routine induction group possessed a significantly lower endocytic activity after induced by LPS, and there were extremely significant differences compared with blank control group and SB maturation Production of IL-12: The production of IL-12 in the mDC induced by LPS was significantly higher than that in control group, SB maturation promoting group and SB induction group, the mDC induced by LPS in routine induction group stimulated significantly stronger proliferation of lymphocyte (P＜0.01).
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BACKGROUND: Recently, little attention has been paid to how to induce and identify the functions of differentiated cells in the methods for embryonic stem (ES) cells differentiation into hepatocytes. Whether the differentiated cells express functional characteristics of hepatocytes should be one of the markers to identify the hepatic differentiation of ES cells.OBJECTIVE: To direct mouse embryonic stem cells in vitro differentiation into functional hepatocytes by introduction of murine cholestatic serum in hepatocyte growth factor (HGF)-induced system.DESIGN: A controlled observation and in vitro cytological trial.SETTING: Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: The experiment was carried out in the Medical Research Center of the Second Affiliated Hospital of Sun Yat-sen University from October 2004 to February 2007. The mouse E14 ES cell line was kindly provided by the Stem Cell and Tissue Engineering Center of Sun Yat-sen University. Twenty male SD rats, aged 2 weeks, were purchased from the Experimental Animal Center of Sun Yat-sen University. All animal experimental procedures were abided by the rules of animal ethnics.METHODS: The SD rats were undergone common bile duct ligation to induce cholestasis. Ten days after the operation, the whole blood of rats was collected to prepare cholestatic serum. The ES cells were cultured using hanging-drop method for 5-7 days to develop embryonic bodies (EBs). The dissociated EBs cells were then induced hepatic differentiation with spontaneous system, HGF (20 μg/L) system and cholestatic serum (5%) plus HGF (20 μg/L) system, respectively.MAIN OUTCOME MEASURES: The cellular morphologic changes were observed using transverse microscopy dynamically. (2) The cell staining for albumin, α-fetoprotein, CK18/19, glycogen, indocyanine green (ICG) and fluorescein diacetate (FDA) was done after 4 weeks differentiation. (3) The hepatocyte-specific metabolic functions of synthesizing albumin, triacylglycerol and urea nitrogen were assayed at 3 days interval.RESULTS: (1) The differentiation of ES cells cultured in spontaneous system was uncontrolled and the cells could grow into a wide range of three-germ cells. The HGF could promote ES cells differentiation into endoderm and mesoderm (myocardium). But the differentiated cells only expressed low levels of hepatic specific functions in these two induced systems. (2) Under cholestatic serum plus HGF system, the ES cells could differentiate into polygonal cells with very uniform morphology which were positive in glycogen, ICG and FDA staining and showed higher capabilities of synthesizing albumin, triacylglycerol and urea nitrogen than the differentiated cells in the other systems (P＜0.05-0.01).CONCLUSION: The cholestatic serum, a mimic pathological microenvironment in vitro, could effectively promote ES cells-derived hepatocytes induced by HGF to express high level of liver-specific metabolism functions.
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OBJECTIVE:To optimize the extraction technology of total saponins from Litchi chinensis.METHODS:The extraction technology of total saponins from Litchi chinensis was optimized by orthogonal experiment taking the content of total saponins and extraction rate as indexes with the extraction solvent,the amount of solvent,the extraction time and extraction times as factors. RESULTS:The optimal extraction technology of total saponins from Litchi chinensis was as follows:70% ethanol as solvent,1 g medicinal powder(per 8 mL solvent),extraction time of 1 hour (extraction for 1 time). CONCLUSION:The optimum extracting technology is simple,feasible and stable,and it provides theoretic basis for the further utilization of Litchi chinensis.
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OBJECTIVE:To discuss the characteristics and regularity of drug-induced deaths so as to promote the ra?tional use of drugs in the clinic.METHODS:The case reports on drug-induced deaths retrieved from Chinese medical science periodicals from1998to2004collected in CHKD periodicals knowledge base in China hospital digital library were analyzed statistically.RESULTS:Of the total drug-induced deaths,43.85%were by iv,which dominate the first place in terms of fatality rates;antimicrobials,Chinese herbal medicine,antineoplastic agent and drugs that affect blood system and hematopoietic system dominated the first5places in terms of the fatality rates;the mortality of allergic shock was higher,which made up about31.81%.CONCLUSION:An indispensable measure to reduce drug-induced disease and its fatality rate is to strictly control the indications of medication and enhance the cultivation of professional staffs'professional activities and service quali?ty.
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Objective To inquire the therapeutic effect of retroperitoneal splenic autotransplantation combined with lower esophageal transection in the treatment of hepatic cirrhosis induced portal hypertension with randomized comparasion.Methods The hepatic cirrhosis induced portal hypertension patients with Child A or B grade of liver function were randomly divided into splenic autotransplantation group and splenectomy group.In the splenic autotransplantation group, retroperitoneal transplantation of pedicled autosplenic tissue combined with modified lower esophageal transection was performed,while in the splenectomy group, splenectomy combined with modified lower esophageal transection was conducted.The general conduction, splenic scanning, liver function, serum tuftsin and IgM levels in patients were observed 2 to 6 months after operation, and compared with those before operation. Results One patient died in the splenectomy group on the 6th postoperative day, rebleeding occurred in one case of the splenic autotransplantation group. The levels of tuftsin and IgM in splenic autotransplantation group were higher than those of splenectomy group after operation, with significant difference ( P 0.05).Conclusion Spleen autografts could maintain the basic immune function of spleen and survive for a long time.
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<p><b>OBJECTIVE</b>To study the predictive factors that are associated with intraoperative identification of the sentinel lymph node (SLN).</p><p><b>METHODS</b>Lymphatic mapping using blue dye was performed in 108 patients with stage I and II operable primary breast cancer. Subsequently the patients received operations of breast cancer including axillary dissection. Clinical and histological factors were assessed to determine those that were associated with intraoperative identification of the SLN.</p><p><b>RESULTS</b>The sentinel node was identified at the time of surgery in 84 patients (77.78%). Of the clinical factors assessed, age(y) < 50 (chi(2) = 7.447, P < 0.01), tumour in the upper quadrant (chi(2) = 6.330, P < 0.05), diagnosis by preoperative biopsy (chi(2) = 5.509, P < 0.05), successful mapping of the lymphatic duct (chi(2) = 13.125, P < 0.01) were significant in identifying the sentinel node at operation. No histological factor was associated with intraoperative identification of the sentinel node.</p><p><b>CONCLUSION</b>There are the possibility of failure of SLN identification at sentinel lymph node biopsy. Our results suggest that the best predictor of intraoperative sentinel node identification is the visualization of the lymphatic duct on mapping by blue dye. Other factors such as age, tumour site as well as diagnostic method are also important in determining the success of the procedure.</p>
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Female , Humans , Middle Aged , Breast Neoplasms , Pathology , Intraoperative Care , Lymph Nodes , Pathology , Lymphatic Metastasis , Neoplasm Staging , Sentinel Lymph Node BiopsyABSTRACT
<p><b>OBJECTIVE</b>To investigate the cause of sentinel lymph node biopsy failure and false negative result in vital blue injection for breast cancer.</p><p><b>METHODS</b>Eight-four female breast cancer patients were injected with vital blue to find the sentinel lymph nodes during operation. All patients were treated by the traditional radical or modified radical mastectomy with axillary dissection after sentinel node biopsy. All sentinel nodes, axillary lymph nodes and dissected specimens were submitted separately to pathological examination.</p><p><b>RESULTS</b>Sentinel node was not identified at the time of operation in 11 patients, giving a failure rate of 13.1%. In 73 patients in whom sentinel nodes were identified, 32 (43.8%) revealed cancer invasion. Postoperative axillary node pathology showed cancer metastasis in all of them. Two patients who showed uninvaded sentinel nodes were demonstrated to have axillary node metastasis. These were the two false negative patients. Therefore, the prediction of axillary metastasis by the sentinel node biopsy showed a sensitivity of 90.4%, a specificity of 100% and a false negative rate of 2.7%.</p><p><b>CONCLUSION</b>Failure in identifying the sentinel nodes in vital blue injection is related to the degree of mastering the technique and the method of injection. The cause of false negative result is due to an extensive primary tumor and the variation in the position of the sentinel lymph nodes.</p>
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Adult , Aged , Female , Humans , Middle Aged , Axilla , Pathology , Breast Neoplasms , Pathology , False Negative Reactions , Lymphatic Metastasis , Pathology , Sentinel Lymph Node BiopsyABSTRACT
0 05) when E/T was 1, whereas DNA fragmentation in oligonucleotide treated cells was significantly higher as compared with non treated cells ( P