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OBJECTIVES@#Neoadjuvant chemotherapy combined with radical surgery has become the treatment model for locally advanced rectal cancer. The purpose of this study was to evaluate the safety and efficacy of postoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer.@*METHODS@#This was a prospective study. A total of 82 patients with locally advanced rectal cancer admitted to Affiliated Nanhua Hospital, University of South China from February 2015 to December 2017 were selected as the subjects. The patients received 4 courses of mFOLFOX6 chemotherapy and underwent surgery within 4-6 weeks after chemotherapy. The incidences of chemotherapy-related adverse reactions, postoperative complications, and clinical pathological reactions were analyzed.@*RESULTS@#In the period from mFOLFOX6 chemotherapy to preoperative, 82 patients with locally advanced rectal cancer was reported chemotherapy-related adverse reactions, including Grade 4 neutropenia (2.4%), catheter related infection (2.4%), and anorexia (2.4%), Grade 3 nausea (2.4%) and anorexia (2.4%), Grade 2 neutropenia (14.6%) and peripheral neuropathy (7.3%). Finally, 76 patients with locally advanced rectal cancer completed surgery, including 56 (73.7%) with anterior rectum resection, 16 (21.1%) with abdominal perineal resection, and 72 (94.7%) with pelvic nerve preservation. A total of 22 (28.9%) patients had surgical complications, including 8 (10.5%) with complications of Grade 3 or above. The complications with high incidence were intestinal obstruction, anastomotic leakage, and sepsis. Among the 76 patients who completed chemotherapy and surgery, T stage was decreased in 28 (36.8%) and N stage was decreased in 44 (57.9%); forty-two (55.3%) were in pathological Stage I, 20 (26.3%) in Stage IIA, 12 (15.8%) in Stage IIB, and 2 (2.6%) in Stage IIIA. Ten patients were suspected of tumor invasion of surrounding organs before chemotherapy, of which 4 patients did not need to extend the resection of surrounding organs after chemotherapy and achieved R0 resection of tumor; 2 in T@*CONCLUSIONS@#Preoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer is a safe and feasible treatment strategy, and it is worthy of clinical application.
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Humans , Antineoplastic Combined Chemotherapy Protocols/adverse effects , China , Fluorouracil/adverse effects , Neoadjuvant Therapy , Neoplasm Staging , Prospective Studies , Rectal Neoplasms/surgery , Treatment OutcomeABSTRACT
OBJECTIVE@#To explore the clinical features and genetic basis for a patient with hereditary hypophosphatemic rickets with hypercalciuria(HHRH).@*METHODS@#Clinical data of the patient was collected. The patient was subjected to whole exome capture and next generation sequencing (NGS). Suspected variants were verified by Sanger sequencing.@*RESULTS@#The patient presented with hypophosphatemic rickets, short stature, hypercalciuria, and renal stones. NGS showed that he has carried compound heterozygous variants of the SLC34A3 gene, namely c.532_533delCA(p.Q178Vfs*6) and c.894_925+69del(splicing). His parents were asymptomatic heterozygous carriers of one of the variants. Based on ACMG guidelines, both variants were classified as pathogenic.@*CONCLUSION@#The compound heterozygous variants c.532_533delCA (p.Q178Vfs*6) and c.894_925+69del(splicing) of the SLC34A3 gene probably underlie the disease in this child. Above finding has enriched the variant spectrum for HHRH. Based on the results, prenatal diagnosis may be provided for the family.
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Extrarenal Wilms′ tumor is extremely rare and has no characteristic clinical manifestations. Diagnosis is difficult before surgery, and is often confirmed by histopathology. Comprehensive treatment by surgery, chemotherapy and radiotherapy is currently adopted for such patients, and the overall survival rate can reach about 90%. Here we report a 2-year-old child with Wilms′ tumor in the left scrotum.
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Objective Obese patients with type 2 diabetes mellitus ( T2DM) characterized by hyperglycemia are li-able to more severe myocardial infarction .Semen Cassiae is proved to reduce serum lipid level .This study was to investigate whether the Semen Cassiae extract (SCE) reduces myocardial ischemia and reperfusion (MI/R) injury with or without diabetes and the underlying mechanisms .Methods The high-fat diet-fed streptozotocin ( HFD-STZ) rat model was used as T2DM model.Normal and DM rats received SCE treatment orally (10 mg/kg/day) for 1 week.Subsequently these animals were subjected to MI /R.Results Compared with the normal animals , DM rats showed increased plasma total cholesterol ( TC) and triacylglycerol ( TG) , more severe MI/R injury and cardi-ac functional impairment .SCE treatment significantly reduced the plasma TC and TG , improved the instantaneous first derivation of left ventricle pressure and reduced infarct size , decreased plasma creatine kinase and lactate dehydrogenase levels, and reduced apoptosis index at the end of reperfusion in diabetic rats .Moreover, SCE treat-ment increased the antiapoptotic protein Akt and stimulated ERK 1/2 phosphorylation .Pretreatment with a PI3 K in-hibitor wortmannin or an ERK1/2 inhibitor PD98059 not only blocked Akt and ERK1/2 phosphorylation, but also inhibited the cardioprotective effects of SCE .However , SCE treatment did not show any effects on the MI/R injury in the normal rats.Conclusions SCE effectively improves myocardial function and reduces MI/R-induced injury in diabetic but not normal animals , which is potentially attributable to the reduced TC/TG levels and the triggered cell survival signaling Akt and ERK 1/2 .
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BACKGROUND:MRI characterized as non-invasion, high resolution, high sensitivity and specificity to injury has become another important means for diagnosis of knee joint disease folowing the arthroscopy. OBJECTIVE: To explore the effective evaluation on the knee meniscus injury diagnosis, by comparing the results of MRI and arthroscopy of the knee meniscus. METHODS: Clinical data of 206 patients with meniscus injury were retrospectively analyzed. Every case was subjected to MRI and the arthroscopy. The findings of arthroscopy were considered as the golden standard. Then, the sensitivity, specificity and coincidence rate of MRI in the diagnosis of meniscus injury were calculated. The chi-square analysis was used to evaluate the MRI and arthroscopy in the diagnosis of meniscus injury. The Kappa values were used to test the consistency of MRI with arthroscopy in the diagnosis of meniscus injury. RESULTS AND CONCLUSION:For levels 0 and I meniscus injury, the coincidence rate of MRI was 97%; for level II meniscus injury, the coincidence rate of MRI was 91.1%, and there was no significant difference (P > 0.05). For level III meniscus injury, the sensitivity, specificity, concordance rate and Youden index of MRI were 92.9%, 94.4%, 93.7% and 87.3%, respectively. By the consistency checking, the value of Kappa was 0.874 and χ2 so there was a high consistency checking between the data of MRI and arthroscopy (P=0.000). MRI is a noninvasive diagnostic method for meniscus injury. For patients with levels I and II meniscus injury on MRI, arthroscopy should be cautiously adopted; however, for patients with level III meniscus injury on MRI, arthroscopy should be done as early as possible. Arthroscopic observation is more intuitive that enables to make accurate judgments of meniscus injury to reduce the rate of misdiagnosis.
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BACKGROUND:Undergoing femoral head replacement in senile osteoporosis patients with intertrochanteric fracture is a chal enging problem. OBJECTIVE:To explore the clinical effect of the use of joint instal ation and fracture reduction on the treatment of unstable intertrochanteric fractures in elderly patients. METHODS:A total of 21 elderly patients with unstable intertrochanteric fractures underwent femoral head replacement. Simultaneously, we col ected clinical data of 20 elderly patients with unstable intertrochanteric fractures undergoing internal fixation of dynamic hip screw. Operation time, blood loss amount, time of walking practice after replacement, complications, and Harris score were compared between the two groups. Clinical effects in patients with femoral head replacement were observed. RESULTS AND CONCLUSION:Al patients were fol owed up for averagely 20 months (ranged from 6 months to 36 months). After replacement, the incision was first healing. The operation time of femoral head replacement was short;blood loss amount was less;the time of walking practice was early. However, no significant difference in Harris score was detected between the two groups (P>0.05). After femoral head replacement, no infection, inversion and shift, or hip joint loose occurred. Results suggested that correct anteversion angle, eccentricity and femoral calcar size should be identified before the implementation of artificial joint replacement for the elderly femoral intertrochanteric fracture. After implantation of the prosthesis, reduction and fixation of trochanter and femoral calcar bony landmarks are simple easily operated surgery. It can reduce blood loss amount, shorten operation time and elevate clinical effects.
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BACKGROUND:Microfracture technique and osteochondral transplantation are one of the methods for the treatment of articular cartilage defects with broad application prospects. OBJECTIVE:To investigate the effect of microfracture technique and autologous and al ogeneic osteochondral transplantation in the treatment of knee osteoarthritis complicated with articular cartilage defects. METHODS:The articular cartilage defects were treated with arthroscopic debridement combined with microfracture surgery in the cartilage defect region, and then the clinical effect, clinical symptoms and Tenger sport score were detected. The patients were fol owed-up for 3-24 months. The articular cartilage defects patients treated with autologous osteochondral transplantation were fol owed-up. The effect of autologous osteochondral transplantation was evaluated through assessing the range of motion after transplantation, improvement of clinical symptoms and joint imaging examination. The animal experiment of al ogeneic osteochondral transplantation for the treatment of articular cartilage defects was conducted to evaluate the effect of al ogeneic osteochondral transplantation through general observation of transplantation site, histological and immunohistochemical staining. RESULTS AND CONCLUSION:For the patients treated with arthroscopic microfracture technique, the total efficiency of joint debridement combined with microfracture surgery in the cartilage defect region was 89.7%. For the articular cartilage defects patients treated with autologous osteochondral transplantation, the symptoms of joint pain and swel ing were improved, and the range of motion was normal with rest pain and slight pain after movement occasional y. Radiographic examination showed the transplanted osteochondral was in good position with good healing. In the experiment animals with articular cartilage defects after treated with al ogeneic osteochondral transplantation, the range of motion was normal, transplanted articular surface was finishing, the articular cartilage was covered with hyaline cartilage, and the cells were arranged in order;there was cartilage matrix secretion, and the col agen type II in the repaired articular cartilage was strongly positive with immunohistochemical staining.
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The breakdown voltage plays an important role in evaluating residual life of stator insulation in generator. In this paper, we discussed BP neural network that was used to predict the breakdown voltage of stator insulation in generator of 300 MW/18 kV. At first the neural network has been trained by the samples that include the varieties of dielectric loss factor tanδ, the partial discharge parameters and breakdown voltage. Then we tried to predict the breakdown voltage of samples and stator insulations subjected to multi-stress aging by the trained neural network. We found that it's feasible and accurate to predict the voltage. This method can be applied to predict breakdown voltage of other generators which have the same insulation structure and material.
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BACKGROUND: There are pressure sensors in carotid-sinus, which are very sensitive to blood pressure regulated by ions and play an important role in the regulation of blood pressure. But it is yet not very clear how different ions regulate the blood pressure through pressure sensors in carotidsinus.OBJECTIVE: To observe the effect of different ions at various concentrations outside the carotid-sinus.DESIGN: Self-control experiment.SETTING: Preclinical Experiment Center, Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was accomplished in the Preclinical Experiment Center, Fourth Military Medical University of Chinese PLA from December 2000 to June 2001. Totally 18 New Zealand pure strain rabbits were provided by the Aninal Experimenting Center of Fourth Military Medical University of Chinese PLA. They were standard grade Ⅱ, of either gender and body mass was (2.0±0.2) kg.METHODS: The rabbits were divided into Na+, K+ and Ca2+ groups according to random numbers, and each group consisted of 6 rabbits. After anaesthesia, tracheal intubatton was performed on the rabbit, and bilateral carotid arteries were separated with carotid-sinus separated on one side and vessel intubatton performed in the other side for blood pressure measurement. Then various concentrations of Na+, K+ and Ca2+ ions were added outside the carotid-sinus with the pipette to make the carotid-sinus completed immersed in the ion solutions. The basal blood pressure and the peak value after ions addition were recorded respectively.MAIN OUTCOME MEASURES: The basal blood pressure and the peak value after ions addition.RESULTS: After Na+ (0.15, 1.5 mol/L) was added the blood pressure was(97±12), (83±17) mm Hg. It was decreased significantly compared with the basal value (106±14), (105±12) mm Hg (t=2.946, P ＜ 0.05). K+ (0.4 mol/L)decreased the blood pressure significantly [(106±12), (64±13) mm Hg, (t=13.496, P ＜ 0.01)], but other concentrations of K+ were not effective. Ca2+(0.07 mol/L) increased the blood pressure to (113±16) mm Hg compared with the basal value (103±12) mm Hg (t=-3.627, P ＜ 0.01).CONCLUSION: Na+, K+ and Ca2+ regulate the blood pressure by acting on the carotid-sinus directly. High concentrations of Na+ and K+ possess the effect of decreasing the blood pressure, while high concentrations of Ca2+increases it, which may be an important mechanism of blood pressure regulation.
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BACKGROUND: Sleep deprivation cannot only cause learning and memory impairment of animal and human, but also lead to increased content of nitric oxide in brain tissue of rats. Melatonin has the effects of antifreeradical and antioxidation. It has been reported that melatonin can improve aluminum chloride and morphine abstinence induced learning and memory impairment of animal, however, whether it has influence on sleep deprivation induced learning and memory impairment is not very clear. OBJECTIVE: To observe the effect of melatonin on memory of rats after sleep deprivation and analyze its possible mechanism. DESIGN: Randomized controlled trial.SETTING: Teaching and Experiment Center of Basic Medicine and Department of Nursing, the Fourth Military Medical University.MATERIALS: The experiment was performed in Teaching and Experiment Center of Basic Medicine of the Fourth Military Medical University in January 2005. A total of 24 adult male Sprague Dawley rats were selected and randomly divided into 3 groups, namely, control group, small dosage of melatonin group and large dosage of melatonin group, with 8 in each group on the basis of random digits table.METHODS: To rats in small dosage of melatonin group and large dosage of melatonin group, the dosage of melatonin was 5 mg/kg and 15 mg/kg respectively, which was made into 2 mL solution and intraperitoneally injected into the rats at 17:00 o'clock every day, while rats in control group were injected with 2 mL physiological sodium at the same time, once a day for continuous 7 days. Then a 3-day sleep deprivation was given to the rats; melatonin or physiological sodium were also given according to different groups during these days. Rat model of sleep deprivation was established by "Flower Ppot" technique; water maze was used for detecting the memory of rats after 48-hour and 72-hour sleep deprivation; took escape latency (s) as indicator of changes of learning and memory of rats; the shorter the escape latency, the better the spacial memory of rats. When sleep deprivation was finished, all the rats were put to death and hippocampus and cerebral cortex were taken out in ice bath. The content of nitric oxide in cerebral cortex and hippocampus was detected with the method of nitrate reduction, and malondialdehyde (MDA) with the method of thiobarbital acid.MAIN OUTCOME MEASURES: Results of escape latency after 48hour and 72-hour sleep deprivation. Contents of nitric oxide and MDA in cerebral cortex and hippocampus of rats.There was significant difference in escape latency in water maze after 48-hour and 72-hour sleep deprivation among each group (F=11.886, P=0.000)and (F=5.440, P=0.012); the escape latency after 48-hour and 72-hour sleep deprivation remarkably decreased both in small and large dosage of melatonin groups as compared with control group, and the latency after 48-hour sleep deprivation was shorter in large dosage group than that in small ide and MDA in brain of rats among each group, namely, nitric oxide in cerebral cortex (F=14.038, P=0.000), MDA in cerebral cortex (F=27.414,P=0.000), nitric oxide in hippocampus (F=22.692, P=0.000), MDA in hippocampus (F=14.316, P=0.000). Compared with control group, the contents of nitric oxide and MDA in cerebral cortex and hippocampus in the two experimental groups decreased significantly, and there was obvious difference in the content of nitric oxide in hippocampus between large and small dosage groups, which showed a dose-effect relationship.CONCLUSION: Melatonin can improve memory impairment of rats after sleep deprivation, which may be closely related to the effect of inhibiting the increase of nitric oxide and MDA in their cerebral cortex and hippocampus.
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BACKGROUND: Undergraduates from military medical universities face many psychological stresses. Poor coping style might affect the status of mental health. Mental health might also be associated with social support and personality.OBJECTIVE: To investigate the correlation of social support and coping style with mental health among undergraduates from military medical universities.DESIGN: Cluster sampling and questionnaire investigation.SETTING: The Center of Basic Medicine Eexperiment, School of Basic Medicine and School of Preventive Medicine of Fourth Military Medical University of Chinese PLA, and Xi'an Hospital of Sports Trauma.PARTICIPANTS: Totally 352 freshmen of a military medical university were chosen by cluster sampling in October 2004 as the subjects.METHODS: Investigationwas performed on subjects with Symptom checklist-90 (SCL-90), social support rating scale (SSRS), coping style questionnaire (CSQ) and revised Eysenck's personality questionnaires short scale for Chinese (EPQ-RSC).SCL-90 consists of 90 items, including 10 factors. SSRS consists of subjective support, objective support and the utilization of support 3 factors as well as total score of social support. CSQ consists of problem solving, self-reproach, asking for help, keeping out of the way, fancy, rationalization 6 factors. EPQ-RSC mainly consisted of extraversion-introversion (E), neuroticism (N), psychoticism/tough mindedness (P) and lie/social diserability (L) 4 dimensions. Data were performed statistical management with t test and correlation analysis.MAIN OUTCOME MEASURES: ①Comparison of the scores of various factors of social support, coping style and personality among undergraduates with different mental health levels from military medical universities. ② Correlation of different social supports, copying styles and personalities with SCL-90. ③ Comparison of scores of mental health,coping style and personality of military medical undergraduates under different social supports.RESULTS: Totally 352 questionnaires were handed out and all of them were retrieved and eligible, with responding rate of 100%. ① The total scores of SRSS were taken as the grouping index, and 25% of the undergraduates who had the highest scores and the lowest scores were respectively chosen as severe symptom group and mild symptom group.Total scores of social support, subjective support and the utilization of support were higher in the mild symptom group than in the severe symptom group, but no difference in the objective support existed between two groups; Compared with mild symptom group, self-reproach, fancy, keeping out of the way and other immature coping styles were more significantly used, but asking for help was less, the scores of E were lower, but those of N were higher in the severe symptom group. ② Various factors of mental health were significantly negatively correlated with the total scores of support, the utilization of support, asking for help, E and L (r=-0.131 to -0.306 ,P ＜ 0.05 or P ＜ 0.01 ), but positively correlated with self-reproach,fancy, keeping out of the way, rationalization and N (r=0.141-0.450, P＜ 0.05 or P ＜ 0.01). ③ Total scores of support was used as the grouping index, 27% of the subjects who had the highest scores and lowest scores were chosen respectively as high support group and low support group.Mental health level was superior in the high support group to in the low support group; Most of the undergraduates of high support group preferred active coping styles, and those of low support group preferred passive coping styles; Scores of E of high support group were higher than those of low support group, and the scores of N and P were lower than those of low support group (P ＜ 0.05).CONCLUSION: Social support, coping style and EPQ-RSC interact and co-influence mental health.
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In recent years dendritic cell tumor vaccine has been of great interest in medical research.In this paper,the author introduces the theory of immunotherapy on the basis of dendritic cell the development of the research in dendritic cell tumor vaccine and the clinical effect.The conclusion is that the clinical application of dendritic cell tumor vaccine should follow the principle of medical ethics.