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Objective: To examine the feasibility and technical considerations of thorough debridement using uniportal thoracoscopic surgery for tuberculous empyema complicated by chest wall tuberculosis. Methods: A retrospective analysis was conducted on 38 patients who underwent comprehensive uniportal thoracoscopy debridement for empyema complicated by chest wall tuberculosis in the Department of Thoracic Surgery, Shanghai Pulmonary Hospital, from March 2019 to August 2021. There were 23 males and 15 females, aged (M(IQR)) 30 (25) years (range: 18 to 78 years). The patients were cleared of chest wall tuberculosis under general anesthesia and underwent an incision through the intercostal sinus, followed by the whole fiberboard decortication method. Chest tube drainage was used for pleural cavity disease and negative pressure drainage for chest wall tuberculosis with SB tube, and without muscle flap filling and pressure bandaging. If there was no air leakage, the chest tube was removed first, followed by the removal of the SB tube after 2 to 7 days if there was no obvious residual cavity on the CT scan. The patients were followed up in outpatient clinics and by telephone until October 2022. Results: The operation time was 2.0 (1.5) h (range: 1 to 5 h), and blood loss during the operation was 100 (175) ml (range: 100 to 1 200 ml). The most common postoperative complication was prolonged air leak, with an incidence rate of 81.6% (31/38). The postoperative drainage time of the chest tube was 14 (12) days (range: 2 to 31 days) and the postoperative drainage time of the SB tube was 21 (14) days (range: 4 to 40 days). The follow-up time was 25 (11) months (range: 13 to 42 months). All patients had primary healing of their incisions and there was no tuberculosis recurrence during the follow-up period. Conclusion: Uniportal thoracoscopic thorough debridement combined with postoperative standardized antituberculosis treatment is safe and feasible for the treatment of tuberculous empyema with chest wall tuberculosis, which could achieve a good long-term recovery effect.
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OBJECTIVE@#In order to solve the problem of inadequate CT screening ability in emergency medical rescue in remote mountainous areas, high-altitude areas, other public health events and sudden natural disasters, a vehicle-mounted mobile CT suitable for emergency medical rescue is studied.@*METHODS@#A vehicle chassis system suitable for long-distance transportation and a cabin system suitable for epidemic prevention and control was designed. A domestic 32-slice CT with small volume, light weight and high stability was selected to design a vehicle-mounted mobile CT suitable for emergency medical rescue.@*RESULTS@#The high-performance vehicle-mounted mobile CT can provide rapid support, and provide large-scale screening, emergency medical rescue, a supplement to daily CT scanning in peacetime and wartime.@*CONCLUSIONS@#The vehicle CT has high stability, fast scanning speed and high social and economic value.
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【Objective】 To retrospectively analyze the serological and nucleic acid testing(NAT) data of voluntary blood donors from six blood banks in Tibet, in order to explore the positive impact of NAT on reducing the risk of infective transfusion in a regional scope. 【Methods】 From 2018 to 2022, 38 718 voluntary blood donors from blood centers of Tibet, Shannan, Shigatse, Naqu, Nyingchi and Ngari were tested for hepatitis B virus surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), human immunodeficiency virus antigen (HIV) and antibody (Ag/Ab1+2) serological determination by enzyme-linked immunosorbent assay (ELISA). At the same time, Haoyuan and Daan nucleic acid detection systems were used for the combined detection of HBV-DNA, HCV-RNA and HIV-RNA. The results of NAT of reactive ELISA samples were statistically analyzed. 【Results】 A total of 178 ELISA-/NAT+ samples were detected in Tibet over the past five years, including 170 HBV-DNA positive cases, 8 HCV-RNA positive cases, and 0 HIV-RNA positive cases, with the positive rate at 0.460%.The detection rate of 624 ELISA+/NAT+ samples was 1.61%.The age of blood donors with hepatitis B in Shigatse area was slightly higher than that in other areas, and the difference was statistically significant(P<0.05) . 【Conclusion】 The centralized detection of viral nucleic acid in Blood Center of Tibet Autonomous Region can effectively reduce the missed detection of transfusion transmitted diseases and guarantee the blood safety in the region.
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Nasal spray can treat local diseases such as rhinitis, it also plays an important role in the treatment of systemic diseases including vaccine immunity. As a drug-device combination product, spray pattern is often used as the quality indicator of nasal spray to ensure its quality, plume geometry can not only be combined with the spray pattern to evaluate the performance of the nasal spray, but also can predict the deposition of the nasal spray in the nasal cavity. This article systematically reviews the definition and measurement methods of the spray pattern and plume geometry of nasal spray and their correlation with nasal deposition behavior. The measurement parameters of spray pattern and plume geometry are defined. The influence of formulation, device and trigger parameters on spray pattern and plume geometry is clarified. The correlation between various parameters and nasal deposition is analyzed. The measurement parameters are classified according to the size and shape of the spray. Plume angle is closely related to the deposition of drugs in the nasal cavity. Jet-like plume with a smaller plume angle can increase the navigation ability of the nasal spray in the curved anatomical structure of the nasal cavity, which is conducive to increase drug deposition. This makes it possible to increase deposition of the nasal spray in the nasal cavity via appropriately increasing viscosity and thixotropy of the nasal spray formulation. This review provides the theoretical basis for the high quality nasal spray product development.
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Objective: To examine the safety and feasibility of uniportal video-assisted thoracoscopic (VATS) decortication in patients presenting with stage Ⅲ tuberculous empyema. Methods: From August 2017 to July 2020, 158 patients of stage Ⅲ tuberculous empyema underwent uniportal VATS decortication with partial rib resection and customized periosteal stripper in Department of Thoracic Surgery, Shanghai Pulmonary Hospital. There were 127 males and 31 females, aged (M(IQR)) 32(28) years (range:14 to 78 years). Follow-up was performed in the outpatient clinic or via social communication applications, at monthly thereafter. If there was no air leak and chest tube drainage was less than 50 ml/day, a chest CT was performed. If the lung was fully re-expanded, chest tubes were removed. All patients received a follow-up chest CT 3 to 6 months following their initial operations which was compared to their preoperative imaging. Results: There was one conversion to open thoracotomy. The operative time was 2.75 (2.50) hours (range: 1.5 to 7.0 hours), and median blood loss was 100 (500) ml (range: 50 to 2 000 ml). There were no perioperative mortalities. There were no major complications except 1 case of redo-VATS for hemostasis due to excessive drainage and 1 case of incision infection, The incidence of prolonged air leaks (>5 days) was 80.3%(126/157). The postoperative hospital stay was 5.00 (2.25) days (range: 2 to 15 days). All patients were discharged with 2 chest tubes, and the median duration drainage was 21.00 (22.50) days (range: 3 to 77 days). Follow-up was completed in all patients over a duration of 20 (14) months (range: 12 to 44 months). At follow-up, 149 patients(94.9%) recovered to grade Ⅰ level, 7 patients to grade Ⅱ level, and 1 patient to grade Ⅲ level. Conclusion: Uniportal VATS decortication involving partial rib resection and a customized periosteal stripper is safe and effective for patients with stage Ⅲ tuberculous empyema.
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Aged , Female , Humans , Male , China , Empyema, Tuberculous/surgery , Retrospective Studies , Thoracic Surgery, Video-Assisted , ThoracotomyABSTRACT
Objective:To investigate the method and application experience of nasolabial subcutaneous pedicled flap in the repair of skin defect after resection of nasolabial mass.Methods:From December 2016 to December 2020, a total of 58 patients (43 cases of nevus, 12 cases of seborrheic keratosis and 3 cases of keratinacanthoma) were admitted to the Facial Neck Center of Plastic Surgery Hospital of Chinese Academy of Medical Sciences, including 24 males and 34 females. They ranged from 17 to 55 years old, with an average age of 33 years. The minimum facial tumor area was 0.8 cm×0.8 cmand the maximum was 2.2 cm×2.0 cm. A local skin flap with a subcutaneous pedicle was designed preoperatively in the nasolabial groove area, and the subcutaneous pedicle was transferred to the defect area through subcutaneous tunnel or by disconnecting the surrounding tissue. The tumor was removed and the skin defect was closed at one stage. Postoperative complications were summarized and patient＇s satisfaction was investigated.Results:Follow-up period ranged from 6 to 48 months. All the 58 patients had primary healing of the transfer incisions, and all the flaps survived. The blood supply of the flaps was good, and the scar of the operative area was smooth. After resection of peri-lip mass, there was 1 case with obvious scar in the donor area of nasolabial groove, and the overall satisfaction rate was 98.3%.Conclusions:The application of nasolabial subcutaneous pedicled skin flap to repair the skin defect after resection of nasolabial tumor has the advantages of preventing the pulling deformation of the organ, it can be completed in one stage and repair the facial skin defect from a distant position. In addition, the thickness and color of the skin flap are similar to the defect site, and the scar of the donor site is not obvious, and so the appearance and function of the surgery can be satisfied.
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Objective:To investigate the killing effect of radiation on echinococcus in vitro culture and its effect on the mRNA expression of growth arrest and DNA damage 45 alpha (Gadd45α) gene. Methods:Echinococcus from naturally infected sheep liver was cultured in vitro and divided into 7 groups. The echinococcus was irradiated with 6 MeV at doses of 0 (control), 20, 40, 60, 80, 100, and 120 Gy, respectively. The growth of echinococcus was observed under light microscope at 1, 3, 5 and 7 d after the radiation. The expression of Gadd45α mRNA in control, 20, 40 and 60 Gy groups of echinococcus was detected by RT-PCR technique at 7 d after the radiation. Results:The disintegration and exfoliation of echinococcus were observed under light microscope at 1, 3, 5 and 7 d after the radiation, and the death rate of echinococcus was positively correlated with the radiation dosages ( r = 0.81, P < 0.05). After the radiation at 7 d, compared with the control group (100.00 ± 0.00), the mRNA expression levels of Gadd45α in echinococcus of 20, 40, and 60 Gy groups were significantly increased (279.74 ± 80.08, 759.38 ± 160.98, 1 666.68 ± 316.36, P < 0.01), and it was positively correlated with the radiation dosages ( r = 0.93, P < 0.01). Conclusion:Radiation has a certain killing effect on echinococcus cultured in vitro, and there is a certain dose-effect relationship with the radiation dosages, and Gadd45α gene may be involved in the molecular mechanism of radiation-induced killing of echinococcus in vitro.
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The surface hydrophobicity of nanoparticles plays an important role in drug delivery process. The aim of this study was to verify the feasibility of using self-assembly method to prepare drug-loaded nanoparticles with tunable surface hydrophobicity. Here, Soluplus was selected as the polymeric carrier to prepare panobinostat (PNB) loaded micelles. Three different monoglycerides, glycerly monooleate (GMO), glycerly linoleate (GML) and glycerly linolenate (GMLO), were used to modify the surface of PNB-Soluplus micelles to prepare polymer-lipid hybrid nanoparticles (PLHNs). The effect of monoglyceride type and amount on the physico-chemical properties of PNB-loaded PLHNs was investigated, and the surface hydrophobicity of PLHNs was characterized by Rose Bengal (RB) binding method and mucin particle method. The results suggested that compared with the PNB-Soluplus micelles (particle size 77.97 ± 0.78 nm, zeta potential 0.44 ± 0.29 mV, entrapment efficiency 99.45% ± 1.47%, the RB binding constant (K) value 0.008 ± 0.002, the increased particle size after mixing with mucin particles 7.90 ± 1.41 nm), surface hydrophobicity of the PLHNs increased significantly when modified by GMO, GML, GMLO, with K values of 0.055 ± 0.010, 0.050 ± 0.011 and 0.058 ± 0.008, respectively. The increased particle sizes after mixing with mucin particles were 17.37 ± 4.48 nm, 22.60 ± 2.10 nm and 25.13 ± 3.89 nm, respectively. Among them, the physico-chemical properties of the GMLO modified PNB-loaded PLHNs (particle size 81.60 ± 4.52 nm, zeta potential 0.77 ± 0.03 mV, entrapment efficiency 99.59% ± 0.20%) kept constant, thus GMLO was selected to further investigate the effect of GMLO mass ratio (1%-3%) to Soluplus on the properties of the nanoparticles. While no statistical significant difference in particle size, zeta potential, entrapment efficiency or in vitro release behavior was found when GMLO ratio increased, the surface lipophilicity of the PLHNs, as characterized by K values and the increased particle sizes after mixing with mucin particles, increased almost linearly with the increase of GMLO amount. In conclusion, we demonstrated that drug-loaded PLHNs based on Soluplus and GMLO can be prepared by self-assembly method, and the surface hydrophobicity was tunable by modifying the mass ratio of GMLO to Soluplus. This approach could be used for related basic science research aiming to elucidate the effect of surface hydrophobicity on in vivo behavior of drug-loaded system.
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Objective To explore the expression and clinical significance of serum cystatin C (CysC) and complement-C1q/TNF-related protein 9 (CTRP9) levels in patients with essential hypertension with with different blood pressure grades.Methods 80patients with essential hypertension who were treated in our hospital were selected as the observation group.According to the difference of blood pressure level, the patients in the observation group were divided into 1grade hypertension group (24cases) , 2grade hypertension group (36cases) and 3grade hypertension group (20cases) .In addition, 50healthy volunteers who were received physical examination in our hospital were selected as the control group.The levels of CysC, CTRP9, ankle brachial pulse wave velocity (baPWV) , carotid intima media thickness (cIMT) , mean arterial pressure (MAP) , high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected in all subjects.The correlation between CysC, CTRP9and baPWV, cIMT, MAP, HDL-C and LDL-C in patients with essential hypertension was analyzed.Results The level of CysC was positively correlated with baPWV, cIMT and MAP (r=0.556, 0.488, 0.369, P<0.05) , and the level of CTRP9was negatively correlated with baPWV, cIMT, MAP and LDL-C (r=-0.437, -0.397, -0.296, -0.203, P<0.05) .Conclusion The expression level of CysC and CTRP9in the serum of patients with essential hypertension is related to blood pressure classification and atherosclerosis related indexes, serum levels of CysC and CTRP9can be used to assess blood pressure and atherosclerosis.
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The objective of this study is to develop an in vitro screening method for nasal absorption of insulin. First, the adaptability of in situ rat nasal perfusion test for the study of insulin was investigated. It was found that insulin was liable to be absorbed on the silicone tube and the traditional method is not suitable. However, addition of 0.001% Labrasol into the perfusate can effectively solve this problem. A modified method suitable for in situ rat nasal perfusion of insulin was established with the addition of 0.001% Labrasol into the perfusate. Using the modified method, effect of pH and drug concentration on the absorption of insulin in the nasal cavity was further investigated. The results suggest that compared with pH 4.5 and pH 7.4, the drug absorption rate was the lowest at pH 6.0. The intranasal absorption mechanism of insulin may be passive diffusion.
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Innate immune cells are highly represented in the tumor microenvironment,and among the most abundant of these are macrophages.However,macrophages are broadly categorized as"classically activated"pro-inflammatory M1 macrophages and"alter-natively activated"anti-inflammatory M2 macrophages,which might be too simplified to describe the various phenotypes and func-tions of tumor-associated macrophages(TAMs).Most TAMs are now reclassified into CD68+TAM,CD163+TAM,CD204+TAM,CD169+TAM,and CCL18+TAM,among others,according to the different expression of surface proteins.These surface proteins have different types of ligands and regulate different signaling pathways and cytokines.Therefore,even if these subtypes of TAMs have similar ef-fects of promoting or inhibiting tumors,the mechanisms involved and the induced clinical manifestations are different.In this paper, the effects of various phenotypes of TAMs on tumor growth,metastasis,prognosis,and clinical relevance are reviewed.
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Objective@#To establish a new scoring system based on the clinicopathological features of hepatocellular carcinoma (HCC) to predict prognosis of patients who received hepatectomy.@*Methods@#A total of 845 HCC patients who underwent hepatectomy from 1999 to 2010 at Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. 21 common clinical factors were selected in this analysis. Among these factors, the cut-off values of alpha-fetoprotein (AFP), alkaline phosphatase (ALP) and intraoperative blood loss were evaluated by using a receiver operating characteristic (ROC) curve analysis.The Kaplan-Meier method and Cox regression model were used to evaluate the independent risk factors associated with the prognosis of HCC patients after hepatectomy. HCC postoperatively prognostic scoring system was established according to the minimum weighted method of these independent risk factors, and divided the patients into 3 risk groups, including low-risk, intermediate-risk and high-risk group. The relapse-free survival (RFS) and overall survival (OS) were compared among these groups.@*Results@#The univariate analysis showed that clinical symptoms, preoperative α-fetoprotein (AFP) level, serum alkaline phosphatase (ALP) level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with median RFS of these HCC patients (P<0.05). Alternatively, clinical symptoms, preoperative AFP level, serum ALP level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological lymphocyte invasion, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with the median OS of these HCC patients (P<0.05). The multivariate analysis showed that AFP ≥20 ng/ml, clinical symptoms, tumor diameter ≥5 cm, multiple tumors, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, moderate and severe liver cirrhosis, non- anatomic resection were the independent risk factors of RFS and OS (P<0.05). The independent risk factor of RFS was intraoperative bleeding loss ≥325 ml (P<0.05); The independent risk factors of OS were abdominal lymph node metastasis and pathological tumors thrombus (P<0.05). The respective weight of 11 independent factors was used to establish the scoring system (scores range from 0 to 26). In the score system, 0 to 5 points were defined as the low-risk group (286 cases), 6 to 12 points were determined as the intermediate-risk group (503 cases), more than 13 points were classified as the high-risk group (56 cases). The median RFS of the low-risk, intermediate-risk and high-risk group were 80, 27 and 6 months, respectively. The differences were statistically significant (P<0.001). The median OS of the three groups were 134, 51 and 15 months, respectively, and the differences were statistically significant (P<0.001).@*Conclusion@#This new score system provides effective prediction of postoperative prognosis for HCC patients.
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Objective@#To investigate the effect of different mechanisms of liver-protection drugs in clinic and compare which one is best for the proliferation of irradiated HL-7702, laying the basis of liver-protection drugs choose in clinic on theory and practice.@*Methods@#Human liver parenchyma cells HL-7702 were given single 6 MV X ray irradiation at a dose of 10Gy, the cells’ morphology were detected under an inverted microscope at 24h, 48h and 72h. Then, MTT was used to assess the survival rate of the cells to evaluate the effect of the X ray. The representive medicines which mechanism may relate to RILD were chosen and diluted into various concentrations with culture medium according to clinical and relative reports. Different concentrations of medicines were used to protect the cells damaged by the X ray. Comparing the effect with MTT and measure SOD, MDA for the best one. Further research on its protection of oxidative damage. T-test, F test and non- paramiter test were used for statistical analysis.@*Results@#2.5 mg/ml and 1 mg/ml of magnesium isoglycyrrhizinate both have an effect on the proliferation of liver cells, especially the concentration of 1 mg/ml. The injection of polyene phosphatidyl choline show trivial effect at the concentrations of 250 μmol/L and reduced glutathione(GSH) did not demonstrate relative functions. Further research on the magnesium isoglycyrrhizinate, found its protection at 48h to oxidative damage (P < 0.05), but the effect is weak at 24h and 48h.@*Conclusions@#In three kinds of representing medicines, magnesium isoglycyrrhizinate has preferable effects on liver parenchyma cells and show a bright future in the treatment of RILD.
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Objective@#To investigate the clinical value of intraoperative radiofrequency ablation (RFA) in the treatment of colorectal liver metastasis (CLM).@*Methods@#A retrospectively analysis of 187 patients with CLM who underwent liver resection with or without RFA from January 2009 to August 2016 in Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences was performed. According to whether RFA was used intraoperatively, patients were divided into resection only group and combined treatment group. The clinical and pathological characteristics of the two groups were compared to explore factors influencing survival and recurrence. Imbalance of background characteristics between the two groups was further overcome by propensity score matching method (PSM).@*Results@#The number of liver metastases (267), simultaneous liver metastases (100%), bilobar involvement (73.3%) and preoperative chemotherapy (93.3%) rates were significantly higher in the combined treatment group than those in the resection only group(471, 74.7%, 42.0% and 63.1%)(all P<0.05). In the combined treatment group, median overall survival (OS) was 25.7 months; and 3-year and 5-year OS were 47.9% and 28.8%, respectively. In the resection only group, the median survival time was 46.9 months; and 3-year and 5-year OS rate was 59.1% and 42.4%, respectively (χ2=4.579, P=0.034). Median disease-free survival (DFS) was 5.4 months in the combined treatment group, and 10.1 months in the resection only group (χ2=5.399, P=0.023). In multivariate analysis, intraoperative RFA was not an independent prognostic factor for OS and DFS (HR=0.98, 95%CI: 0.47-2.08, P=0.965; HR=1.21, 95%CI: 0.71-2.07, P=0.465). After PSM, the median OS of the resection only and the combined treatment groups were 30.2 and 25.7 months (χ2=0.876, P=0.350). The median DFS in the two groups was 5.3 and 4.2 months, respectively (χ2=0.199, P=0.650).@*Conclusion@#In patients with similar tumor burden, liver resection combined with intraoperative RFA for unresectable CLM can achieve long-term outcomes similar to hepatectomy alone for resectable CLM.
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Objective To observe the effects of Coix seed injection on the cell viability and radiosensitivity of human hepatoma cell line Bel-7402.Methods Bel-7402 cells were irradiated by X-rays,or treated with Coix seed injection,or treated with both of them.The cells proliferation and apoptosis were detected by MTT and by flow cytometry respectively.Cell cloning was used to observe the number of viable cells and to draw the cell survival curve.The mRNA and protein level of Bax,Bcl-2 were detected by RT-PCR and Western blot respectively.Results It was found that the Coix seed injection group (12 μmol/L) and X-ray group (8 Gy) had a significant inhibitory effect on the growth of hepatocellular carcinoma cells (t =17.03,11.26,P ＜ 0.05).And compared with Coix group and irradiation group,the combined treatment group showed higher inhibition rate (t =24.80,20.19,P ＜0.05).The mRNA and protein levels of Bax were gradually elevated (F =437.92,67.91,P ＜ 0.05),while the expressions of Bcl-2 reflected a decreased trend (F =31.18,48.50,P ＜ 0.05).The D0 values of pure irradiation group and combined treatment group were 4.27 and 3.34,respectively,and the sensitization enhancement ratio was 1.27.Conclusions The Coix seed injection inhibit cell growth and induce apoptosis,as well as increase radiative sensitization may via the apoptosis related factors Bax and Bcl-2 in hepatocellular carcinoma.
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Objective: To establish an HPLC method for the determination of three bacteriostatic agents ( methylparaben, eth-ylparaben, propylparaben) in taurine eye drops. Methods:The HPLC method was conducted on a Phenomenex Gemini C18 column ( 250 mm × 4. 6 mm, 5 μm ). The mobile phase was 1％ acetic acid-methanol(40 :60). The flow rate was 1. 0 ml·min-1 and the de-tection wavelength was 254 nm with the injection volume of 20 μl and the column temperature of 25℃. Results:Methylparaben, eth-ylparaben and propylparaben showed good linear relationship (r>0. 999)within the range of 1. 00-19. 94μg·ml-1,2. 01-20. 08μg· ml-1 and 0. 21-10. 46 μg·ml-1,respectively. The average recoveries were 99. 20％-99. 90％, and the RSDs were 1. 34％-1. 54％(n=9). Conclusion:The method is accurate, reproducible and stable without interference, which can be used for the determination of three bacteriostatic agents in taurine eye drops.
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<p><b>BACKGROUND</b>The liver is the most common site for colorectal cancer (CRC) metastases. Their removal is a critical and challenging aspect of CRC treatment. We investigated the prognosis and risk factors of patients with CRC and liver metastases (CRCLM) who underwent simultaneous resections for both lesions.</p><p><b>METHODS</b>From January 2009 to August 2016, 102 patients with CRCLM received simultaneous resections of CRCLM at our hospital. We retrospectively analyzed their clinical data and analyzed their outcomes. Overall survival (OS) and disease-free survival (DFS) were examined by Kaplan-Meier and log-rank methods.</p><p><b>RESULTS</b>Median follow-up time was 22.7 months; no perioperative death or serious complications were observed. Median OS was 55.5 months; postoperative OS rates were 1-year: 93.8%, 3-year: 60.7%, and 5-year: 46.4%. Median DFS was 9.0 months; postoperative DFS rates were 1-year: 43.1%, 3-year: 23.0%, and 5-year 21.1%. Independent risk factors found in multivariate analysis included carcinoembryonic antigen ≥100 ng/ml, no adjuvant chemotherapy, tumor thrombus in liver metastases, and bilobar liver metastases for OS; age ≥60 years, no adjuvant chemotherapy, multiple metastases, and largest diameter ≥3 cm for DFS.</p><p><b>CONCLUSIONS</b>Simultaneous surgical resection is a safe and effective treatment for patients with synchronous CRCLM. The main prognostic factors are pathological characteristics of liver metastases and whether standard adjuvant chemotherapy is performed.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Colorectal Neoplasms , Mortality , General Surgery , Disease-Free Survival , Hepatectomy , Liver Neoplasms , Mortality , General Surgery , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
To investigate factors influencing the intranasal absorption of rivastigmine hydrogen tartrate (RHT), we studied the pharmacokinetics of RHT after intranasal administration and evaluated its brain targeting behavior. In situ rat nasal perfusion model was used in the study and pH impact was examined on the intranasal absorption of RHT. High performance liquid chromatography (HPLC) method was established to measure RHT concentration in the plasma and brain tissue after intranasal and intravenous administration. The pharmacokinetic parameters, drug targeting index (DTI), and nose-to-brain direct transport percentage (DTP) were calculated. It was demonstrated that the intranasal absorption mechanism of RHT was passive diffusion. The absorption rate was highest at pH 6.0. The absolute bioavailability of intranasally administrated RHT was 73.58%. Compared with that of intravenous administration, RHT absorption into the brain was faster and more efficient after intranasal delivery, and the DTI value was 195.27% of intravenous injection. Moreover, 48.79% of the drug can be absorbed directly from the nose into the brain without systematic circulation. Meanwhile, drug elimination half-time in the brain was prolonged by 1.4 fold compared to that of intravenous injection. In conclusion, intranasal administration of RHT not only improves drug absorption into the system, but also enhances drug absorption rate and content in the brain remarkably, which is an advantage in the treatment of central nervous system-related diseases.
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Objective To investigate the prognostic factors of survival time of the Uygur and Han nation-ality elderly patients( over 60 years) with pancreatic cancer in Xinjiang.Methods We carried on a retrospective study of 313 aged patients diagnosed with pancreatic cancer in The First Affiliated Hospital of Xinjiang Medical University from January 1st,2003 to May 30th,2015.We used Kpalan-Meier method for calculation of survival, used Log-rank method for those factors which could affect the prognosis of patients,at last we used Cox propor-tional risk model for those multiple factors which match the role.Results Three hundred and thirteen cases with pancreatic cancer had a median survival of 157 days,and survival rates of half a year,1 and 2 year were 34.8%, 18.5%,7.0%.There was a statistic difference between Uygur patients′and Han patients′survival time(P<0.05).Single factor analysis showed the nationality,tumor size,surgery,ZPS(ECOG),Clinical stage(TNM), chemotherapy and radiotherapy,carcino-embryonic antigen(CEA)level and cancer antigen 199(CA199)level before treatment with outcome(P<0.05).Multiple factor analysis showed that the clinical stage,surgery(P<0.05)can be regarded as independent prognostic decision factors.Conclusion The clinical staging,surgical treatment could be regarded as independent prognostic factors for the elderly prognosis of pancreatic cancer.Both of the Han and Uygur patients,earlier discovered and more appropriate surgery treatment are the key for the elder-ly patients with pancreatic cancer.
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Objective To analyze the clinical epidemiology of primary hepatocellular carcinoma (PHC) in the Xinjiang region. Methods Clinical data of the patients with PHC were collected at First Affiliated Hospital of Xinjiang Medical University from 5 577 cases from January 2002 to December 2014, their gender, race, age, household distribution, hepatitis virus-positive rate were analyzed retrospectively. Results Among the 5 577 eases, the men/women gender ratio was 3.45∶1;the proportion of Han, Uighur, Kazakh, and other ethnic groups (Hui, Mongolian, Manchu, Xibo) was 79.67%, 9.86%, 4.55%, 3.31%and 2.61%, respectively. The Constituent ratio difference between Uighur and Han was significant (P<0.05);4 232 patients had hepatitis B surface antigen (HBsAg) detection, and 3 833 patients had HCV antibody (HCV-Ab) detection. HBsAg was positive in 2 560 cases (60.49%), HCV-Ab was positive in 490 cases (12.78%). Hepatitis B virus detection positive rate in Uygur was 35.52%, in Kazak was 40.00%, which was lower than the Han's (65.68%, P<0.05). Urban and rural population had 3589 cases (64.35%) and 1988 cases (35.65%). Conclusion An increased risk for PHC was found in hepatitis virus-positive patients, the Xinjiang Uygur and Kazak people had significantly lower prevalence of HBV infection than the Han's. Appropriate measures should be taken for clinical diagnosis, treatment and prevention of PHC.