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@#Objective To explore whether surgery combined with adjuvant chemotherapy can bring survival benefits to patients with cervical and upper thoracic esophageal squamous cell carcinoma (ESCC). Methods The clinical data of patients with cervical and upper thoracic ESCC who underwent R0 resection and neck anastomosis in our department from 2006 to 2010 were retrospectively analyzed. Patients received neoadjuvant therapy or adjuvant radiotherapy were excluded. The adjuvant chemotherapy group was given a combination of taxanes and platinum based chemotherapy after surgery; the surgery alone group did not receive adjuvant chemotherapy. The Kaplan-Meier method was used to analyze the survival difference between the adjuvant chemotherapy group and the surgery alone group. Results A total of 181 patients were enrolled, including 141 (77.9%) males and 40 (22.1%) females, with an average age of 61.0±8.2 years (80 patients aged≤61 years, 101 patients aged>61 years). There were 70 (38.7%) patients of cervical ESCC, and 111 (61.3%) patients of upper thoracic ESCC. Eighty-seven (48.1%) patients underwent postoperative adjuvant chemotherapy, and 94 (51.9%) patients underwent surgery alone, and the basic clinical characteristics were well balanced between the two groups (P>0.05). The median survival time of patients in the adjuvant chemotherapy group and the surgery alone group was 31.93 months and 26.07 months, and the 5-year survival rate was 35.0% and 32.0%, respectively (P=0.227). There was no statistical difference in median survival time between the cervical ESCC and upper thoracic ESCC group (31.83 months vs. 29.76 months, P=0.763). For cervical ESCC patients, the median survival time was 45.07 months in the adjuvant chemotherapy group and 14.70 months in the surgery alone group (P=0.074). Further analysis showed that the median survival time of lymph node negative group was 32.53 months, and the lymph node positive group was 24.57 months (P=0.356). The median survival time was 30.43 months in the lymph-node positive group with adjuvant chemotherapy and 17.77 months in the lymph-node positive group with surgery alone. The survival curve showed a trend of difference, but the difference was not statistically significant (P=0.557). Conclusion There is no statistical difference in the long-term survival of cervical and upper thoracic ESCC patients after R0 resection. Postoperative adjuvant chemotherapy may have survival benefits for patients with cervical ESCC and upper ESCC with postoperative positive lymph nodes, but the differences are not statistically significant in this setting.
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Objective@#To investigate the clinical features of childhood epilepsy with occipital paroxysms.@*Methods@#The clinical data of 33 children admitted to our hospital from 2015 to 2019 were retrospectively analyzed.@*Results@#The children were divided into three groups: idiopathic group (n=20), structural group (n=10) and genetic group (n=3). Among the structural etiology group, there were 1 case of megagyrus malformation, 1 case of focal cortical dysplasia type Ⅱ (FCDⅡ), 1 case of gestational age infant with enlarged ventricle, and 7 cases of perinatal ischemic-hypoxic encephalopathy (HIE). In the genetic group, there were 1 case of PCDH19 gene mutation, 1 case of cyclin-dependent kinase like 5 (CDKL5) deficiency disorder and 1 case of Wolf-Hirschhorn syndrome. All three groups had ocular motor symptoms and secondary motor symptoms. Compared with the structural group, patients of the idiopathic group had more autonomic symptoms, less visual symptoms, longer ictal duration, less episodes, less abnormal background rhythm, and more epileptic discharges in the frontal lobe or Rolandic area. The genetic group had frequent seizures and the CDKL5 deficiency disorder patient had slowed background and spasms. Compared with the other two groups, patients of the idiopathic group had fewer MRI abnormalities, better seizure control effect, and better prognosis.@*Conclusions@#There are many causes of childhood epilepsy with occipital paroxysms. The idiopathic group accounts for a large proportion. The visual symptoms and autonomic symptoms are different between groups. Background abnormalities are detected more often in the structural group and the genetic group, which is also helpful for differential diagnosis. The treatment options and prognosis of different groups vary greatly. The overall therapeutic effect and prognosis of the idiopathic group are better than those of the structural group and the genetic group.
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Objective To investigate the clinical features of childhood epilepsy with occipital paroxysms.Methods The clinical data of 33 children admitted to our hospital from 2015 to 2019 were retrospectively analyzed.Results The children were divided into three groups:idiopathic group (n =20),structural group (n =10) and genetic group (n =3).Among the structural etiology group,there were 1 case of megagyrus malformation,1 case of focal cortical dysplasia type Ⅱ (FCD Ⅱ),1 case of gestational age infant with enlarged ventricle,and 7 cases of perinatal ischemic-hypoxic encephalopathy (HIE).In the genetic group,there were 1 case of PCDH19 gene mutation,1 case of cyclin-dependent kinase like 5 (CDKL5) deficiency disorder and 1 case of Wolf-Hirschhorn syndrome.All three groups had ocular motor symptoms and secondary motor symptoms.Compared with the structural group,patients of the idiopathic group had more autonomic symptoms,less visual symptoms,longer ictal duration,less episodes,less abnormal background rhythm,and more epileptic discharges in the frontallobe or Rolandic area.The genetic group had frequent seizures and the CDKL5 deficiency disorder patient had slowed background and spasms.Compared with the other two groups,patients of the idiopathic group had fewer MRI abnormalities,better seizure control effect,and better prognosis.Conclusions There are many causes of childhood epilepsy with occipital paroxysms.The idiopathic group accounts for a large proportion.The visual symptoms and autonomic symptoms are different between groups.Background abnormalities are detected more often in the structural group and the genetic group,which is also helpful for differential diagnosis.The treatment options and prognosis of different groups vary greatly.The overall therapeutic effect and prognosis of the idiopathic group are better than those of the structural group and the genetic group.
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Objective To observe 100 video-electroencephalogram (EEG)-cases of intellectual disability (ID) children,to analyze their EEG features of different degrees of ID,to explore the relationship between EEG changes and ID.Methods We performed a retrospective analysis of long-range video-EEGs of 100 children with an unexplained reason of ID from July 2016 to May 2018 in the department of pediatrics of Xiangya Hospital of Central South University,sumnarized their EEG manifestations,and compared their differences among different degrees of ID.We carried out x2 test according to the degree of ID,and discussed the relationship between the degree of ID and EEG.Results Among 100 cases of ID children with unexplained pathogenic factor,67 cases (67％) of them were males,33 cases (33 ％) of females,38 cases (38％)of mild ID,27 cases (27％) of moderate ID and 35 cases (35％) of severe ID.The EEG background of ID patients showed fast waves (11％),slow waves (15％),generalized discharges (14％) and focal discharges (36％),etc.Focal sharp and spike-wave were the most common in children with moderate ID,while background changes and multifocal sharp spike wave were more common in severe ID children.Conclusions The EEG background changes in children with severe ID have significant differences than mild and moderate degree ones.The specific features of EEG in mild and moderate degree ones is focal discharges,while multiple discharges in severe ID patients.Changes in the EEG may be related to the extent of intellectual disability.
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Objective To establish the solid phase extraction (SPE) with GC/MS technology for fish poi-soning cases to determine five pesticides in fishpond. Methods By three solid phase extraction column including Oasis HLB cartridge, Bond Elut C18 and SampliQ C18, the recovery rate was compared to ex-tract and purify five pesticides in fishpond. The effects of different kinds and dosages of eluents on ex-tract rate were also reviewed. Results Using Bond Elut C18 as solid phase extraction column and 3 mL benzene as eluent, the linear range of mass concentration of five pesticides in fishpond was 1-50 μg/mL, and the correlation coefficient was 0.996 2-0.999 6. The limit of detection was 3.4-26 μg/L and the re-covery was 61.49%-102.48%. The relative standard deviations was less than or equal to 3.01%. Conclu-sion With high sensitivity, good accuracy and precision, SPE -GC/MS has simple and quick operation and less solvent. It can be applied to determination of five pesticides in fishpond.
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If heart function is normal, the atrial cells are excited in a stable rhythm. But this would change during atrial fibrillation. In this paper, after comparing with the method of characteristic point, we use the dominant frequency method to analyze the activation pattern under sinus and atrial fibrillation rhythm in different parts of atria based on epicardial mapping system. It is found that the activation rhythm changes a lot in different parts of atria, and the automaticity of atrial cells change obviously in somewhere. The result shows that dominant frequency method is very suitable for the analysis of atrial fibrillation signal. What's more, we also roughly discuss the role of this method in exploring the driving sources during atrial fibrillation.
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Humans , Atrial Fibrillation , Epicardial Mapping , Heart AtriaABSTRACT
Objective To develop the accelerated solvent extraction (ASE ) for determ ining pesticides pre-sent in blood sam ples. Methods Pesticides were extracted by ASE with optimized param eters to study recovery rate affected by extraction tem perature, time and agent. GC/MS was used to perform quantita-tive analysis.Results The recovery rates of eight pesticides were 70.6%-92.4%. The coefficient of variation was less than 5.0%. Agood linear relationship was obtained at the concentration range of 0.5-5.0μg/m L . Conclusion The m ethod was fast and sim ple with high recovery rate and good repeatability. It can be applied to analyze pesticides present in the blood specimen.
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Objective To investigate the curative effect of photodynamic therapy on acnes and summarize the nursing measures.Methods Twenty-four acne patients were treated with photodynamic therapy from our hospital.The nursing experience was summarized.Result Nineteen had complete recovery,3 significant improvement,and 2 mild improvement,with a total effective rate of 91.7%.Conclusion Health education on acnes,keeping the patients away from strong sunlight and instructing them to clean skin in a right way and timely treatment of complications are critical for the improvement of curative effect.
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Objective To investigate the clinical significance of plasma adrenocorticotropic hormone and cortisol changes at different time in acute cerebral infarction.Methods The clinical data of 62 patients with acute cerebral infarction (acute cerebral infarction group) were analyzed retrospectively,and 60 healthy cases in the same period were recruited as control group.The plasma adrenocorticotropic hormone and cortisol levels at 8:00,16:00 and 24:00 of two groups were detected by electrochemiluminescence immunoassay.Results Plasma adrenocorticotropic hormone and cortisol levels at 8:00,16:00 and 24:00 in acute cerebral infarction group were significantly higher than those in control group [(20.5 ± 4.2) pmol/L vs.(10.4 ±2.6) pmol/L,(18.9 ±4.9) pmol/L vs.(8.5 ± 2.1) pmol/L,(18.1 ±3.8) pmol/L vs.(7.1 ±2.4) pmol/L and (542 ± 76) nmol/L vs.(469 ± 65) nmol/L,(528 ±43) nmol/L vs.(341 ± 33) nmol/L,(499 ± 32) nmol/L vs.(196 ±27) nmol/L](P＜0.05); plasma adrenocorticotropic hormone and cortisol levels of severe degree acute cerebral infarction at different time were higher than those of light conditions (P＜0.05 ); plasma adrenocorticotropic hormone and cortisol levels at different time of acute cerebral infarction patients with good prognosis were significantly lower than those of the persons with poorprognosis(P＜0.05).Conclusion Plasma adrenocorticotropic hormone and cortisol testing at different time has clinical significance in determining the condition and prognosis of patients with acute cerebral infarction.
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Objective The aim of this study was to evaluate the efficacy and safety of the approach of the Nuss procedure for the correction of pectus excavatum in children without thoracoscopy.Methods From Oct 2007 and May 2009,48 patients with pectus excavatum underwent Nuss procedure.Among them 22 were done under the thoracoscopic guidance,and the other 26 in a non-thoracoscopic way,in which,a bilateral extrapleural tunnel to the edge of sternum was created using a blunt dissection via a bilateral thoracic skin incision.Without introducing the thoracoscopy into the thoracic cavity,a steel bar was inserted in the entirely extrapleural tunnel and turned as the standard Nuss procedure.Results All 48 patients recovered uneventfully.There were no postoperative deaths and serious complications.A single alloy steel bar(23-40 cm)was used in all patients.In the non-video-assisted extrapleural group(n=26),no pneumothorax occurred,the operating time(after anesthesia)ranged from 24～38 minutes[mean(25.4±2.6)mins],blood loss was minimal(range,5-10 ml),and the hospital stay was ranged from 3-6 days[mean(4.5±1.1)days].In the thoracoscopic group(n=22),the corresponding figures were 40 to 60 minutes[mean(53.5±3.4)mins)],10 to 15ml,5-8days[mean(7.0±2.2)days],respectively.No recurrent of the funnel chest occurred during the 3-18 months(median 10.4 monthes)of follow-up.The bar displacement occurred in 1 case 2 months after operation,which was replaced with satisfied result.Conclusion The non-thoracoscopic approach of the Nuss procedure is a safe and less traumatic procedure for the correction of pectus excavatum.
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Objective To compare and evaluate the defect-repaired capabilities of human bone morphogenetic protein-2(hBMP-2) gene modified tissue engineered bone in the segmental bone defect model of rabbit's radius.Methods Rabbit's bone mesenchymal stem cells (BMSCs)were transferred with hBMP-2 gene through Adeno-XTM adenoviral expression systems,then seeded onto the compound scaffold of calcium phosphate cemept(CPC)and fibrin glue(FG)to construct a new kind of gene modified tissue engineered bone after proliferation in vitro for three weeks(Group A).Meanwhile,the compound scaffold of calcium phosphate cement(CPC)and fibrin glue(FG),which were seeded by rabbit's bone knesenchyrmal stem cells(BMSCs) after proliferation in vitro for three weeks(group B)and the compound scaffold without cells(Group C)acted as control groups.Then,three kinds of reconstructive modalities were implanted into segmental bone defect of donator rabbit's radius.Besides these three groups,bone defect model of rabbit's radius without treatment(Group D)represented blank group.The defect-repaired capabilities were assessed by gross observation,radiograph,Single Photo Emission Computed Topography (SPECT)and histological analysis in the 4th week,8th week and 12th week after operation.The rates of bone healing in the different groups were compared each other.Results All defects that had been treated with implants(Group A,B,C)exhibited new bone formation and could attain osseous tissue healing 12 weeks after operation,but defects in blank group(Group D)were repaired only by fibrous tissue.The defects in the Group A regenerated more new bone,bridged earlier and stronger than those in the Group B and Group C.The quantity and rate of new bone formation in the Group B and Group C had no significant difference and the rates of bone healing in different groups showed the same results.Conclusion hBMP-2 gene modified tissue engineerod bone have better potential to form new bone and the rate of bone healing in repairing bone defects is higher,so this way is an optimal kind of material for artificial bone graft.
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Objective To explore the clinical effects and safety of treatment for colorectal cancer to pulmonary metastases with percutaneous multiple electrodes radiofrequency-2000 (RF-2000) under CT-guided.Methods 26 pulmonary metastatic tumors in 11 cases were treated with RF-2000. The following extents were observed: (1) blood pressure,pulse rate and oxygen saturation during the treatment;(2)the variety of the liver function,the lung function and renal function after treatment;(3) the variety of the volume and low dense shadow of tumors after treatment;(4)the survival rate for 5 years. Results (1) The blood pressure,pulse rate and oxygen saturation were not changed during the treatment;(2) the liver function,the lung function and renal function after treatment were also not changed;(3) the volume of tumors were increased one month after treatment,three months later,23 lesions of 26 tumors were disappeared,2 decreased to more than 80% and 1 to 50%~80% in volume,and the low dense shadow within the tumors appeared as Ⅰtype (less than 50%) in one,Ⅱtype (50%~80%) in 3 and Ⅲ type (more than 80%) in 22;(4)The survival rate for 5 years was 81.82%(9/11). Conclusion The clinical effects and safety of treatment of colorectal cancer to lung metastases with percutaneous radiofrequency-2000 (RF-2000) under CT-guided is excellent.