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1.
Article in Chinese | WPRIM | ID: wpr-928072

ABSTRACT

Panax notoginseng is a perennial Chinese medicinal plant, which has serious continuous cropping obstacles and is prone to a variety of diseases and insect pests during the growth process. At present, the prevention and control of pests and diseases is mainly carried out through chemical pesticides, and the consequent pesticide residues of P. notoginseng have attracted much attention. This study reviewed the types and detection methods of pesticide residues in P. notoginseng from 1981 to 2021, and compared the limits of pesticide residues in P. notoginseng in China and abroad to provide a reference for rational application of pesticides in P. notoginseng and quality control of medicinal materials, thereby promoting the sustainable development of the P. notoginseng industry in China. Currently, there are only 40 published papers on pesticide residues of P. notoginseng, which is indicative of a serious problem of insufficient research. At present, hundreds of pesticide residues in P. notoginseng can be detected simultaneously by using chromatography-tandem mass spectrometry. The pesticides detected have gradually changed from early prohibited ones, such as dichlorodiphenyl trichloroethane(DDT), benzene hexachloride(BHC), and parathion, to low toxic ones(e.g., dimethomorph, procymidone, propicona-zole, and difenoconazole). The dietary risk from pesticide residues in P. notoginseng is low, which would not cause harm to consu-mers. This study concluded that in the future, the development of the quality standard for pesticide residues of P. notoginseng should be actively carried out. To increase the pesticides used in actual production in the quality standard based on the existing ones and to guide farmers to use pesticides scientifically will be the focus of future work.


Subject(s)
China , Panax notoginseng , Pesticide Residues/analysis , Pesticides/analysis , Plants, Medicinal
2.
Article in English | WPRIM | ID: wpr-922259

ABSTRACT

: To investigate the protective effect of (FD) against ethanol-induced gastric ulcer and its mechanism. : Human gastric epithelial GES-1 cells were divided into normal control group, model control group, FD 95% alcohol extract group, FD 50% alcohol extract group and FD decoction extract group. Gastric ulcer was induced by treatment with 1% ethanol in GES-1 cells. The cell proliferation was detected with MTT method in each group. Sixty SD rats were randomly divided into normal control group, model control group, ranitidine group and low-dose, medium-dose, high-dose FD 95% alcohol extract groups (150, 300, 600 mg/kg). The corresponding drugs were administrated by gavage for The gastric ulcer model was induced by intragastric administration of anhydrous ethanol. The gastric ulcer area and ulcer inhibition rate of rats were measured in each group; the degree of gastricmucosal damage was observed by scanning electron microscopy; the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-1β in serum and the content of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), catalase (CAT) in gastric tissues were detected by ELISA method. : 95% alcohol extract of FD had the strongest protective effect on proliferation of GES-1 cells. In animal experiments, compared with the normal control group, a large area of ulcers appeared on the gastric mucosa in the model control group, while the ulcer areas of the FD groups and ranitidine group were significantly smaller than that of the model control group (all <0.05). Compared with the model control group, FD groups and ranitidine group significantly reduced the levels of TNF-α, IL-1β, IL-6 in serum and the MDA content in the gastric tissues, and increased the activity of SOD, CAT and GSH in gastric tissues (all <0.05). : The 95% alcohol extract of FD can reduce the levels of TNF-α, IL-1β and IL-6 in serum and the content of MDA in gastric tissues, and increase the activity of SOD, CAT and GSH in gastric tissues to achieve the protective effect against gastric ulcer.


Subject(s)
Animals , Ethanol/toxicity , Gastric Mucosa , Malondialdehyde , Rats , Rats, Sprague-Dawley , Stomach Ulcer/prevention & control , Superoxide Dismutase
3.
Article in Chinese | WPRIM | ID: wpr-884547

ABSTRACT

Objective:To identify the population who can obtain clinical benefit from concurrent chemoradiotherapy through the survival analysis during concurrent chemoradiotherapy in different subgroups.Methods:All data from a phase Ⅲ randomized controlled clinical trial were collected to compare the efficacy between preoperative concurrent chemoradiotherapy and preoperative radiotherapy from 2002 to 2012 in Cancer Hospital of the Chinese Academy of Medical Sciences. A total of 222 patients received radiation therapy with a median dose of 69.96 Gy (27.56-76.00 Gy). The cisplatin chemotherapy regimen was adopted and the median dose was 250 mg (100-570 mg). In total, 98 patients received intensity-modulated radiotherapy (IMRT). The survival analysis was conducted with Kaplan- Meier method and univariate analysis was performed with log-rank test. The multivariate prognostic analysis was conducted with Cox’s regression model. Results:The median follow-up time was 59 months (7-139 months). Among them, 104 patients were assigned in the chemoradiotherapy group and 118 patients in the radiotherapy alone group. The local and regional recurrence rates did not significantly differ between two groups (both P>0.05), while chemoradiotherapy tended to decrease the distant metastasis rate compared with the radiotherapy alone (14.4% vs. 24.6, P=0.058). Univariate analysis showed that concurrent chemoradiotherapy significantly increased the local recurrence-free survival in the early N stage subgroup ( P=0.009), and there was an increasing trend in patients aged≤55 years and female patients ( P=0.052, 0.066). The distant metastasis-free survival was significantly improved in T 4( P=0.048), N 3( P=0.005), non-IMRT treatment ( P=0.001) and hypopharyngeal carcinoma ( P=0.004) subgroups, there was an increasing trend in male ( P=0.064), high-and moderate-grade squamous cell carcinoma ( P=0.076) and non-surgical treatment subgroups ( P=0.063). Multivariate analyses showed that concurrent chemoradiotherapy significantly prolonged the progression-free survival and overall survival in patients aged≤55 years ( P=0.017 and 0.039), women ( P=0.041 and 0.039), high-and moderate-grade squamous cell carcinoma ( P=0.006 and 0.022), N 3 stage ( P=0.001 and 0.017), non-surgical treatment ( P=0.007 and 0.033) and non-IMRT treatment subgroups ( P=0.030 and 0.024), and it significantly increased the progression-free survival in patients with hypopharyngeal carcinoma ( P=0.022). Conclusion:Concurrent chemoradiotherapy can be actively delivered for young age, female, high-and moderate-grade squamous cell carcinoma, N 3 stage, non-surgical treatment and non-IMRT treatment patients.

4.
Article in Chinese | WPRIM | ID: wpr-884526

ABSTRACT

Objective:To evaluate the psychological pain of patients with head and neck cancer aged ≥60 years old before and after intensity-modulated radiotherapy (IMRT).Methods:Distress Thermometer (DT)(Chinese version) was used to investigate the degree and problems of psychological pain before and after IMRT for 85 elderly patients with head and neck cancer. The results before and after IMRT were compared by paired t-test. Relevant factors were identified by Logistic regression analysis. Results:The median age in the cohort was 66 years old (60-85 years old). The incidence rates of psychological pain were 73% and 87% before and after IMRT ( P<0.001). The corresponding incidence rates of severe distress were 6% and 34%( P<0.001). The main distress problems before IMRT were memory loss/attention deficit, worry, oral pain, economic problems, stress, sleep problems, and dry nose. The significantly-increased distress problems after IMRT were oral pain, constipation, eating, nausea, and dry nose. Logistic regression analysis showed gender ( OR=5.520, 95% CI 1.437-21.212, P=0.013), pre-treatment PG-SGA score ( OR=1.220, 95% CI 1.048-1.421, P=0.010) and medical insurance ( OR=0.230, 95% CI 0.053-0.995, P=0.049) were the relevant factors of the severe psychological distress before IMRT. Occupation ( OR=2.286, 95% CI 1.291-4.050, P=0.005) and medical insurance ( OR=0.089, 95% CI 0.029-0.276, P<0.001) were the relevant factors of severe psychological distress after IMRT. Conclusion:The incidence rate of distress is high in elderly patients with head and neck cancer before IMRT, which can be aggravated after IMRT, primarily the treatment-related physical pain problems.

5.
Article in Chinese | WPRIM | ID: wpr-879328

ABSTRACT

OBJECTIVE@#To explore clinical and radiographic effects of percutaneous pie-crusting deep medial collateral ligament release in patients with posterior horn tear of medial meniscus combined with tight medial compartment.@*METHODS@#From January 2012 to December 2016, 35 patients with medial meniscus posterior horn injury were treated with percutaneous pie crusting deep medial collateral ligament release technique, including 21 males and 14 females, aged from 21 to 55 years old with an average of (39.1±6.5) years old. Degree of meniscus extrusion were recorded before and 24 months after operation. The knee valgus stress test was performed to evaluate stability of medial collateral ligament, and compared difference between healthy and affected side. Lysholm and IKDC functional scores were compared before and 24 months after operation.@*RESULTS@#All patients were followed up from 27 to 60 months with an average of (36.7±6.8) months. All patients were underwent operation, the wound healed well without complications. Operative time ranged from 0.5 to 1.2 h with an average of (0.8±0.4) h. Nineteen patients were performed partial meniscectomy, 16 patients were performed repair suture. Convex of meniscus before operation was (1.5±0.7) mm, and (1.7±0.4) mm after operation;had no statistical difference(@*CONCLUSION@#For patients with medial meniscus tear of posterior horn combined with tight medial compartment, percutaneous pie-crusting deep medial collateralligament release could improve medial compartment space, and Knee valgus instability and meniscus extrusion are not affected.


Subject(s)
Adult , Arthroscopy , Collateral Ligaments , Female , Humans , Joint Instability , Knee Joint/surgery , Male , Menisci, Tibial/surgery , Middle Aged , Young Adult
6.
Article in Chinese | WPRIM | ID: wpr-868727

ABSTRACT

Objective:Continuous acquisition of swallowing images of head and neck cancer patients by using MRI technique was performed to observe and measure the movement regularity and maximum displacement of the soft palate, tongue and larynx.Methods:From July 2018 to October 2018, 20 patients with primary head and neck cancer were chosen randomly, 17 male and 3 female. The median age was 58.5 years (28 to 78 years). Among the 20 patients, 7 patients were diagnosed with nasopharyngeal carcinoma, 3 patients with oral cancer, 5 patients with oropharyngeal cancer, 3 patients with hypopharyngeal cancer, and 2 patients with nasal and paranasal sinuses cancer. Two patients were classified as stage Ⅰ-Ⅱ, 8 patients as stage Ⅲ and 10 patients as stage Ⅳ according to the eighth edition of AJCC.Results:The displacement of the upward movement of the soft palate during swallowing was (1.06±0.31) cm and followed the pattern normal distribution. The displacement of backward movement of the soft palate was (0.83±0.24) cm, which also almost normally distributed. The displacement of backward tongue movement was (0.77±0.22) cm and followed the normal distribution pattern. The displacement of upward tongue movement was 0 in patients with tongue depressor for image acquisition. The mediandisplacement of upward tongue movement in patients without tongue depressor was 1.23 cm (0.59 to 1.41 cm). The displacement of upward laryngeal movement was (1.14±0.22) cm and followed the normal distribution pattern, and the median displacement of forward laryngeal movement was 0.4 cm (0.27 to 0.90 cm).Conclusions:Swallowing movement may occur in head and neck cancer patients during radiotherapy. It can also cause the movement of gross tumor volume (GTV) and surrounding normal tissues. Therefore, extensive attention should be paid to the individual distance between GTV and planning gross tumor volume (PGTV) when making radiotherapy plans, aiming to ensure the prescription dose of cancer.

7.
Article in Chinese | WPRIM | ID: wpr-868696

ABSTRACT

Objective:To investigate the patterns of regional lymphatic spread and the value of elective neck treatment (ENT) in oral mucosal melanoma (OMM).Methods:In this retrospective analysis, 61 OMM patients with no distant metastasis treated in Cancer Hospital of Chinese Academy of Medical Sciences between 1984 and 2016 were recruitred. The regional lymph node distribution of cN+ disease, the value of ENT in cN 0 disease, the failure patterns and prognostic factors were retrospectively analyzed. Results:Overall, 55.7% of the patients were clinical/pathological cN+ . The most frequently involved locations were the level Ⅰ b (76%), followed by level Ⅱ and level Ⅲ. For cN 0 patients, the 5-year regional failure-free survival rate was 91.7% in patients who received at least ipsilateral level Ⅰ b-Ⅲ ENT and 52.4% in patients who did not receive at least ipsilateral level Ⅰ b-Ⅲ ENT ( P=0.036). The regional failure rate was 6% for patients treated with at least ipsilateral leve Ⅰ b-Ⅲ ENT, while in their counterparts who did not receive at least ipsilateral level Ⅰ b-Ⅲ ENT was 46%( P=0.035). For the regional failure pattern, the most frequently failure sites were level Ⅰ b (93%), level Ⅱ(50%) and level Ⅲ(36%). Conclusions:The cervical lymph node metastasis rate is relatively high in OMM patients. The pathway of regional LN spread follows a regular pattern. The most frequently involved regions for clinical/pathological cN+ and regional failure are both level Ⅰ b-Ⅲ. Elective treatment including at least ipsilateral level Ⅰ b-Ⅲ ENT should be recommended for OMM patients with cN 0.

8.
Article in Chinese | WPRIM | ID: wpr-868667

ABSTRACT

Objective:To analyze the incidence and high-risk factors of lymph node metastasis in the retropharyngeal region of hypopharyngeal squamous cell carcinoma based on magnetic resonance imaging (MRI), aiming to guide the delineation of clinical target area.Methods:Clinical data of patients who were pathologically diagnosed with hypopharyngeal carcinoma from January 2012 to September 2018 in our center were retrospectively analyzed. All patients received head and neck MRI before treatment. The diagnosis of lymph node metastasis and the delineation of primary gross target volume (GTV p) and lymph nodes target volume (GTV nd) were determined by all the radiation oncologists in head and neck group through twice weekly general round discussion. The cut-off points of GTV p and GTV nd were defined by establishing the receiver operating characteristic curve. All patients were divided into the high GTV p, low GTV p and high GTV nd and low GTV nd groups. Chi-square test was used for univariate analysis and logistic regression was utilized for multivariate analysis to analyze the high-risk factors of patients with retropharyngeal lymph node metastasis. Results:A total of 326 patients were included in this study, 295 of whom were diagnosed with cervical lymph node metastasis, accounting for 90.5%. The most common involved area was Level Ⅱ a, followed by Level Ⅲ, Level Ⅱ b, Level IV, Level Ⅶ a (retropharyngeal), Level V a, and Level V b. The incidence of retropharyngeal lymph node metastasis was 21.5%, and the incidence was 53.1% in patients with primary tumor located in the posterior pharyngeal wall. Univariate and multivariate analyses showed that patients with tumor originated from the posterior pharyngeal wall ( P=0.002), bilateral cervical lymph node metastasis ( P=0.020), larger GTV p (greater than 47 cm 3, P=0.003), and larger GTV nd (greater than 22 cm 3, P=0.023) were significantly associated with the occurrence of retropharyngeal lymph node metastasis. Conclusions:The incidence of retropharyngeal lymph node metastasis is high in hypopharyngeal carcinoma, especially in patients with primary tumors in the posterior pharyngeal wall, bilateral cervical lymph node metastasis and larger primary burden. Therefore, for patients with these risk factors, it is highly recommended that the clinical target area should be delineated to include the retropharyngeal lymph node drainage area.

9.
Article in Chinese | WPRIM | ID: wpr-868636

ABSTRACT

Objective:To compare the effects of comprehensive treatment with different combinations of radiotherapy, chemotherapy and surgery on the survival of patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC).Methods:From September 2002 to May 2012, 222 patients were enrolled in a randomized controlled clinical trial to compare the clinical efficacy between preoperative radiotherapy and preoperative concurrent chemoradiotherapy. The chemotherapy was performed at the beginning of the radiotherapy, with cisplatin 30 mg/m 2 every week. Conventional radiotherapy or intensity-modulated radiotherapy (IMRT) was adopted. Clinical efficacy was evaluated during radiotherapy to 50 Gy in all patients. Whether surgery or original treatment regime was given was determined according to the clinical efficacy. The survival of different therapeutic methods was analyzed by Kaplan- Meier method. Results:The median follow-up time was 59 months (7-139 months). All patients were divided into four groups: radiotherapy group (R group, n=84), concurrent chemo-radiotherapy group (R+ C group, n=67), preoperative radiotherapy group (R+ S group, n=34) and preoperative concurrent chemoradiotherapy group (R+ C+ S group, n=37). The 5-year overall survival rates were 32%, 44%, 51%, and 52%, respectively (R+ C+ S group vs. R group, P=0.047). The 5-year progression-free survival rates were 34%, 48%, 49%, and 61%, respectively (R+ C Group vs. R group, P=0.081; R+ C+ S group vs. R group, P=0.035). The 5-yeal distant metastasis-free survival rates were 70%, 85%, 65%, and 73%, respectively (R+ C group vs. R+ S group, P=0.064; R+ C group vs. R+ S group, P=0.016). Conclusions:Compared with radiotherapy alone, comprehensive treatment with different combinations can improve the long-term survival of LA-HNSCC patients. Radiotherapy combined with chemotherapy has a tendency to improve the distant metastasis-free survival rate, The optimal comprehensive treatment modality that improves the overall survival of LA-HNSCC patients remains to be explored.

10.
Article in Chinese | WPRIM | ID: wpr-868538

ABSTRACT

Objective To investigate the pattern of lymph node metastasis (LNM) in patients with locally advanced (T3,T4) laryngeal squamous cell carcinoma (LALSC) and provide reference for the delineation of clinical target volume.Methods Clinical data of 272 patients with LALSC treated in our hospital from 2000 to 2017 were retrospectively analyzed.All patients underwent bilateral neck dissection (at least level Ⅱ-Ⅳ).The LNM ratio of each node level was calculated.The risk factors of LNM were identified by univariate and multivariate logistic regression analyses.Results LNM was found in 156 of 272 patients (57.1%).According to the location of primary lesions,all patients were divided into group A (n=72;unilateral without midline involvement),group B (n=86;unilateral with midline involvement) and group C (n=114;giant or central).In group A,the LNM ratio at ipsilateral level Ⅱ,Ⅲ and Ⅳ was 36.3%,26.4% and 6.9%,whereas 13.9%,8.3% and 1.4% at the contralateral level,respectively.In group B,the LNM ratio at ipsilateral level Ⅱ,Ⅲ and Ⅳ was 1.9%,29.1% and 11.6%,whereas 18.6%,14.0% and 1.2% at the contralateral level,respectively.In group C,the LNM ratio at the left neck level Ⅱ,Ⅲ and Ⅳ was 24.6%,23.7% and 2.6%,whereas 21.9%,26.3% and 6.1% at the right neck,respectively.Bilateral LNM ratio did not significantly differ between group A and group B/C (15.3%,25.0%,P=0.093).Ipsilateral level Ⅲ metastasis (OR=2.929,95%CI 1.041-8.245,P=0.042) and clinical N stage (OR=0.082,95%CI 0.018-0.373,P=0.001) were associated with contralateral LNM.Ipsilateral level Ⅱ(P=0.043) or Ⅲ(P=0.009)metastasis were risk factors of the ipsilateral level Ⅳ metastasis.Conclusions Neck levels Ⅱ and Ⅲ are the high-risk LNM regions,whereaslevels Ⅳ and Ⅴ are the low-risk areas.Ipsilateral level Ⅱor Ⅲ metastases are the risk factors of ipsilateral level Ⅳ and contralateral cervical LNM.Contralateral neck LNM rarely occurs in cN0 stage patients.

11.
Article in Chinese | WPRIM | ID: wpr-826632

ABSTRACT

The research progress of acupuncture analgesia in recent years is analyzed to summarize the analgesic mechanism of acupuncture on neuropathic pain. The analgesic mechanism of acupuncture on neuropathic pain is discussed from peripheral level and central level, including peripheral sensitization and immune inflammatory response, changes of ion channel, central sensitization, regulation of cell signal pathway, activation of spinal glial cells, etc. It is suggested that the focus of future research should include conducting in-vitro studies with the help of multi-omics technology to detect the changes of metabolic substances and signal pathway molecules in patients with neuropathic pain before and after acupuncture to further clarify the mechanism of acupuncture analgesia.

12.
Article in Chinese | WPRIM | ID: wpr-798797

ABSTRACT

Objective@#To investigate the pattern of lymph node metastasis (LNM) in patients with locally advanced (T3, T4) laryngeal squamous cell carcinoma (LALSC) and provide reference for the delineation of clinical target volume.@*Methods@#Clinical data of 272 patients with LALSC treated in our hospital from 2000 to 2017 were retrospectively analyzed. All patients underwent bilateral neck dissection (at least level Ⅱ-Ⅳ). The LNM ratio of each node level was calculated. The risk factors of LNM were identified by univariate and multivariate logistic regression analyses.@*Results@#LNM was found in 156 of 272 patients (57.1%). According to the location of primary lesions, all patients were divided into group A (n=72; unilateral without midline involvement), group B (n=86; unilateral with midline involvement) and group C (n=114; giant or central). In group A, the LNM ratio at ipsilateral level Ⅱ, Ⅲ and Ⅳ was 36.3%, 26.4% and 6.9%, whereas 13.9%, 8.3% and 1.4% at the contralateral level, respectively. In group B, the LNM ratio at ipsilateral level Ⅱ, Ⅲ and IV was 1.9%, 29.1% and 11.6%, whereas 18.6%, 14.0% and 1.2% at the contralateral level, respectively. In group C, the LNM ratio at the left neck level Ⅱ, Ⅲ and Ⅳ was 24.6%, 23.7% and 2.6%, whereas 21.9%, 26.3% and 6.1% at the right neck, respectively. Bilateral LNM ratio did not significantly differ between group A and group B/C (15.3%, 25.0%, P=0.093). Ipsilateral level Ⅲ metastasis (OR=2.929, 95%CI 1.041-8.245, P=0.042) and clinical N stage (OR=0.082, 95%CI 0.018-0.373, P=0.001) were associated with contralateral LNM. Ipsilateral level Ⅱ(P=0.043) or Ⅲ(P=0.009) metastasis were risk factors of the ipsilateral level Ⅳ metastasis.@*Conclusions@#Neck levels Ⅱ and Ⅲ are the high-risk LNM regions, whereaslevels Ⅳ and V are the low-risk areas. Ipsilateral level Ⅱ or Ⅲ metastases are the risk factors of ipsilateral level Ⅳ and contralateral cervical LNM. Contralateral neck LNM rarely occurs in cN0 stage patients.

13.
Article in Chinese | WPRIM | ID: wpr-755090

ABSTRACT

Objective To analyze the clinical features,diagnosis and prognosis of patients with primary lymphoepithelial carcinoma of the parotid gland.Methods Clinical data of 13 patients diagnosed with lymphoepithelial carcinoma of the parotid gland in our hospital from 2009 to 2017 were retrospectively analyzed.The median follow-up time was 38.5 months.All patients received radiotherapy after operation.Results Of 13 patients,9 cases were male and 4 female.The median age was 33 years.At the initial diagnosis,9 cases had primary lesions limited to the parotid gland,and 4 cases of lymph node metastases located in Ⅰb and Ⅱ regions of the neck.According to UICC2010 staging,1 case was classified as stage Ⅰ,Ⅰ as stage Ⅱ,6 as stage Ⅲ and 5 as stage Ⅳ,respectively.Eleven surgically pathological specimens were tested with EBER in-situ,and 10 cases were positive for EBER.No patient died in the whole group.The 3-year overall survival rate was 100%.The 3-year progression-free survival rate was 76%.The 3-year local control rate was 92%.The 3-year metastasis-free survival rate was 84%.Conclusions The incidence of lymphoepithelial carcinoma of the parotid gland is relatively low.The pathological features are associated with EB virus.It is prone to present with cervical lymph node metastasis.The possibility of lymph node metastasis of nasopharyngeal carcinoma to the parotid gland should be excluded before treatment.At present,surgery combined with postoperative radiotherapy is the main treatment.The overall survival is favorable.Local recurrence and distant metastasis are the main causes of treatment failure.

14.
Article in Chinese | WPRIM | ID: wpr-755056

ABSTRACT

Objective To analyze the clinical treatment modalities and clinical prognosis of patients diagnosed with primary nasopharyngeal adenoid cystic carcinoma (NACC).Methods The medical records of 46 patients with NACC between March 1971 and November 2015 were retrospectively analyzed.Among them,22 patients were male and 24 female.The median age of all patients was 47 years (range:23-74 years).Among them,34 patients received radiotherapy alone including 25 patients treated with conventional radiotherapy and 9 receiving intensity-modulated radiation therapy (IMRT).Five patients underwent salvage surgery for the residual tumors after radiotherapy.Twelve patients were treated with a comprehensive treatment modality (surgery combined with radiotherapy).Results The median follow-up time was 66.0 months (range:11.0-270.6 months).The 5-and 10-year overall survival,locoregional failure-free survival,and distant metastasis failure-free survival rates were 70% and 40%,64% and 47%,70% and 62%,respectively.In the radiotherapy alone group,12(35%) cases obtained complete response,13 had partial response and 9 remained stable after radiotherapy.The 5-year overall survival and locoregional failure-free survival rates in the radiotherapy alone and combined therapy groups were 69% and 74%,63% and 66%,respectively (all P> 0.05).Conclusion The course of NACC is relatively slow.Radiotherapy is recommended for patients with high sensitivity towards radiotherapy.Salvage surgery is feasible for those who are insensitive to radiotherapy or with residual tumor after radiotherapy.

15.
Article in Chinese | WPRIM | ID: wpr-797676

ABSTRACT

Objective@#To analyze the clinical features, diagnosis and prognosis of patients with primary lymphoepithelial carcinoma of the parotid gland.@*Methods@#Clinical data of 13 patients diagnosed with lymphoepithelial carcinoma of the parotid gland in our hospital from 2009 to 2017 were retrospectively analyzed. The median follow-up time was 38.5 months. All patients received radiotherapy after operation.@*Results@#Of 13 patients, 9 cases were male and 4 female. The median age was 33 years. At the initial diagnosis, 9 cases had primary lesions limited to the parotid gland, and 4 cases of lymph node metastases located in Ⅰb and Ⅱ regions of the neck. According to UICC2010 staging, 1 case was classified as stage Ⅰ, 1 as stage Ⅱ, 6 as stage Ⅲ and 5 as stage Ⅳ, respectively. Eleven surgically pathological specimens were tested with EBER in-situ, and 10 cases were positive for EBER. No patient died in the whole group. The 3-year overall survival rate was 100%. The 3-year progression-free survival rate was 76%. The 3-year local control rate was 92%. The 3-year metastasis-free survival rate was 84%.@*Conclusions@#The incidence of lymphoepithelial carcinoma of the parotid gland is relatively low. The pathological features are associated with EB virus. It is prone to present with cervical lymph node metastasis. The possibility of lymph node metastasis of nasopharyngeal carcinoma to the parotid gland should be excluded before treatment. At present, surgery combined with postoperative radiotherapy is the main treatment. The overall survival is favorable. Local recurrence and distant metastasis are the main causes of treatment failure.

16.
Article in Chinese | WPRIM | ID: wpr-745989

ABSTRACT

Objective To explore the effects of whole-stage labor analgesia on maternal and neonatal outcomes after the implementation of the new partogram.Methods A retrospective cohort study was performed in Peking University First Hospital.From June to December 2016,907 nulliparae with full-term singleton cephalic pregnancies that were expected to deliver vaginally and adhered to the new partogram were selected as the study group,and 982 cases that adhered to the old partogram (Friedman standard) from June to December 2012 were selected as the control group.Maternal basic characteristics and analgesic,obstetric and neonatal data were collected.Maternal and neonatal outcomes between the two groups were analyzed with independent sample t-test,rank sum test or Chi-square test (Fisher's exact test).Results (1) Maternal age and the proportion of gravidas of advanced maternal age in the study group were both higher than those in the control group [(30.2±3.0) vs (29.64-2.9) years,t=3.823;8.2% (74/907) vs 4.2% (41/982),x2=13.087;both P<0.001].No statistically significant difference in the other basic characteristics was found between the two groups.(2) Women in the study group had significantly smaller cervical dilatation [M(P25-P75)] than that in the control group when analgesia was commenced [2(1-2) vs 2(1-3) cm,Z=-3.752].The intensity of pain quantified with numerical rating scale (NRS) before analgesia,and during the second stage of labor in the study group were less than that in the control group [8(8-9) vs 8(8-10) points,Z=-14.441;5(4-5) vs 6(5-7) points,Z=-16.495].The study group had longer median duration of analgesia than the control group [520(340-750) vs 300(200-453) min,Z=-17.801,P<0.001].The overall dose of analgesics in injection pump in the study group was significantly higher compared with that used in the control group [68 (35-84) vs 30 (18-48) ml,Z=-18.004,P<0.001].However,there was no significant difference in the incidence of analgesia-related complications (hypotension,accidental dura puncture,lower extremity numbness,pruritus and urinary retention) between the two groups.(3) The study group showed a higher percentage of spontaneous vaginal delivery,and a lower rate of converted cesarean section compared with the control group [71.8% (651/907) vs 63.2% (621/982),x2=15.623;13.6% (123/907) vs 20.5% (201/982),~=18.831;both P<0.001].The study group had lower forceps-assisted vaginal delivery rate than the control group without statistically significant difference [14.8% (133/907) vs 15.3% (150/982),x2=0.093,P=0.797].The duration of the first,second and third stage of labor in the study group were all significantly longer than that of the control group [680 (470-900) vs 480 (360-660) min,Z=-12.490;56 (31-89) vs 37 (24-58) min,Z=-9.964;7 (5-10) vs 6 (5-8) min,Z=-6.673;all P<0.001].Women in the study group had a lower rate of artificial rupture of membranes when comparing with the control group [55.2% (501/907) vs 63.2% (621/982),x2=12.516,P<0.001].The incidence of fever,pathologically confirmed infection and postpartum hemorrhage were significantly higher in the study group than that in the control group [10.8% (98/907) vs 6.4% (63/982),x2=11.652;9.6% (87/907) vs 3.7% (36/982),x2=27.201;12.6% (114/907) vs 5.7% (56/982),x2=27.144;all P<0.05].There was no significant difference in the rate of oxytocin use during labor or blood transfusion between the two groups.(4) Compared with the control group,the proportion of cesarean section due to arrested active stage of labor in the study group was significantly lower [5.7% (7/123) vs 50.2% (101/201),x2=68.173,P<0.05],but the incidences of cesarean section due to intrauterine infection and relative cephalopelvic disproportion were higher in the study group [61.0% (75/123) vs 30.8% (62/201),x2=2.680;20.3% (25/123) vs 8.0% (16/201),x2=10.555;both P<0.05].There was no significant difference in the proportion of fetal distress or other indications for cesarean section between the two groups.(5) There was no significant difference between the two groups in birth weight,macrosomia,fetal distress,neonatal asphyxia,or the proportion of neonatal intensive care unit admission.Conclusions After the implementation of the new partogram,analgesic pain relief covering the whole labor prolongs the average analgesic time and reduces the rate of cesarean section due to arrested active stage of labor.Although the risk of postpartum hemorrhage is slightly increased,analgesia itself does not pose additional risks on forceps-assisted delivery,maternal blood transfusion and neonatal asphyxia.

17.
Article in Chinese | WPRIM | ID: wpr-745987

ABSTRACT

As one of the most effective and commonly used analgesic methods during labor and delivery,epidural analgesia has been widely accepted in terms of its safety.Neurological complications following childbirth,which are most related to pregnancy and childbirth factors rather than labor analgesia,has not been well studied or recognized in China.Therefore,there are some confusions and misunderstandings of reasons for these neurological complications,and,to a certain extent,have affected the clinical implementation of epidural labor analgesia.This review analyzed the etiology and prognosis of this problem in order to help the clinicians in identifying the risk factors and causes and also to improve clinical awareness,prevention,and management for these conditions.

18.
Journal of Practical Radiology ; (12): 114-117,132, 2018.
Article in Chinese | WPRIM | ID: wpr-696769

ABSTRACT

Objective To evaluate the diagnostic value of arterial spin labeling(ASL)in gliomas grading with different post label delay(PLD)time.Methods A total 30 patients with postoperative histo-pathology confirmed gliomas were included in this study.3D ASL acquisition with PLD of 1 525 ms and 2 025 ms were analyzed retrospectively.Tumor blood flow(TBF)values,as well as the ratio between TBF and the mirror ROI CBF(M-TBF),the ratio between TBF and normal contra-lateral gray matter(G-TBF)were analyzed respectively.T test between HGG and LGG groups was performed with P<0.05 regarded as statistically significant different. Receiver operating characteristic curve(ROC curve)analyses were also conducted for all parameters to determine the sensitivity and specificity for grading.Spearman rank analysis was finally used to evaluate the correlation between these parameters and glioma grades.Results For 1 525 ms PLD,TBF,M-TBF and G-TBF were all significantly higher in HGG[(88.7 ± 22.9)mL/100 g·min, 1.66 ± 0.36,1.75 ± 0.48)]than that in LGG[(68.0 ± 11.9)mL/100 g·min,1.23 ± 0.19,1.17 ± 0.21)](all P<0.01).While for 2 025 ms, TBF,M-TBF and G-TBF also showed significantly higher in HGG[(80.9 ± 18.1)mL/100 g· min,1.68 ± 0.32,1.73 ± 0.34]than that in LGG[(58.0 ± 11.7)mL/100 g·min,1.21 ± 0.16,1.15 ± 0.17)](all P<0.001).For 1 525 ms PLD,AUC values of TBF,M-TBF and G-TBF were 0.806,0.875 and 0.921,respectively.While for 2 025 ms,AUC values of TBF,M-TBF and G-TBF were 0.866,0.949 and 0.977 respectively.TBF and M-TBF showed moderate positive correlation with tumor grade both in 1 525 ms and 2 025 PLD. While G-TBF showed strong positive correlation with tumor grade for 2 025 ms PLD comparing with 1 525 ms PLD,which was moderate positive correlation.Conclusion The normalized G-TBF in 2 025 ms PLD obtains the best diagnostic performance than other parameters, which can be used as a more accurate pre-operative imaging method in grading of gliomas.

19.
Article in Chinese | WPRIM | ID: wpr-708318

ABSTRACT

Objective To evaluate the clinical efficacy,failure pattern and prognostic factors of the malignant mucosal melanoma of the head and neck ( MMHN) in a single center. Methods The treatment pattern,clinical efficacy, failure pattern and prognostic factors of 194 M0MMHN patients admitted to our institution from 1982 to 2017 were retrospectively analyzed.Results The 5-year overall survival (OS),local recurrence-free survival ( LRFS ), regional recurrence-free survival ( RRFS ) and distant metastasis-free survival (DMFS) were 41. 4%,57. 8%,76. 5% and 46. 5%,respectively. The failure rate was calculated as 74. 6%(141/189).Among them,40% (56/141) had distant metastasis as the first pattern of treatment failure,37%(52/141) had local relapse,15%(21/141) had regional relapse,5%(7/141) had concurrent distant metastasis and local/regional relapse and 3% ( 5/141) had concurrent local and regional relapse. Multivariate analysis demonstrated that surgical margins (P=0. 001) and adjuvant radiotherapy (P=0. 000) were the independent prognostic factors for LRFS. Conclusions Surgery combined with radiotherapy can yield relatively high LRFS in the comprehensive treatment of MMHN.Distant metastasis is the major failure pattern.

20.
Article in Chinese | WPRIM | ID: wpr-708232

ABSTRACT

Objective It has been confirmed that Epstein-Barr virus ( EBV) is associated with the occurrence and development of the nasopharyngeal carcinoma ( NPC ) . We investigated the clinical significance of plasma concentrations of EBV-DNA in patients with NPC. Methods Since October,2013 to December,2016,471 patients were analyzed. The significantly associated between EBV-DNA before treatment and staging, tumor burden was analyzed. The survival rate of EBV-DNA before and after treatment was calculated. Results The median copies of pretreatment plasma EBV-DNA in patients is 137 copies,( range 0-494000) ,which is correlated with T stage,N stage,M stage,clinical stage and tumor burden load and that is statistically significant. Overall survival ( OS,P=0. 007) ,progression-free survival ( PFS,P=0. 011) and distant metastasis-free survival ( DMFS,P=0. 003) were significantly lower among patients with pretreatment plasma EBV-DNA more than 1300 copies/ml. Patients with detectable plasma EBV-DNA had significantly worse OS (P=0. 016),PFS (P=0. 000) and DMFS (P=0. 000) than patients with undetectable EBV-DNA after treatment. Cox multivariate analyze suggests that T stage and EBV-DNA after treatment were independent prognostic factors for OS,however the plasma EBV-DNA after treatment ( P=0. 006,0. 001) and N stage ( P=0. 037,0. 017) were independent prognostic factors for PFS and DMFS. Conclusions The plasma EBV-DNA level was significantly correlated with staging and tumor load before treatment in patients with NPC,and the prognosis of patients with higher copies before treatment could be worse. The plasma EBV-DNA after treatment is predictive for OS,PFS and DMFS.

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