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Objective:To explore the impacts of postoperative radiotherapy on long-term survival of the patients with resectable locally advanced (T 3-4and/or N +) biliary tract cancers (BTCs) and to analyze the prognostic factors. Methods:The patients with locally advanced gallbladder cancer ( n=1 922) and the patients with extrahepatic biliary duct cancer ( n=3 408) who received surgical resection during 2006-2016 were selected from the Surveillance, Epidemiology, and End Result (SEER) database. They were grouped according to different treatment schemes (only surgery and surgery + radiation). The propensity score matching (PSM) method was employed to adjust the differences in baseline prognostic characteristics between patients who received only surgery and those treated with surgery+ radiation. The role of the two treatment schemes on the survival of the patients was analyzed using the Kaplan-Meier method and the prognosis factors were assessed using the Cox regression. Results:The 1 174 patients with gallbladder cancers and the 2 144 patients with extrahepatic biliary duct cancer were respectively matched according to propensity scores. The postoperative radiotherapy showed a significant advantage in 5-year cancer-specific survival (CSS) compared to only surgery for both the patients with gallbladder cancer ( χ2=35.73, P< 0.001) and those with extrahepatic biliary duct cancer ( χ2=9.878, P=0.002). After adjusting related covariates, independent prognostic factors for all the patients included pathological grading, T status, N status, treatment pattern, and age. For the patients with extrahepatic biliary duct cancer, independent prognostic factors also included race and year of diagnosis. The benefits of postoperative radiotherapy were observed in various clinicopathologic characteristics except for the patients with T 1-2 gallbladder cancer and the extrahepatic biliary duct cancer patients with a pathological grade of Ⅰ-Ⅱ and N 0 status or with age ≥ 70. Conclusions:Long-term survival benefits can be gained through postoperative radiotherapy for the patients with resectable locally advanced (T 3-4 and/or N+ ) BTCs. However, adjuvant radiation should be cautiously adopted for the patients with T 1-2 gallbladder cancer and the extrahepatic biliary duct cancer patients with a pathological grade of I-Ⅱ and N 0 status or with age ≥70.
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Objective To investigate the effect of chaihu-shugan-san ( CSS) on the behaviors and Notch1 signal pathway in depression model rats. Methods Thirty-two SD rats with similar behavioral scores were divided into control group (CON),model group (CUMS),positive control group (FLU) and interven-tion group (CSS).The depression model was established by stimulating with chronic unpredictable mild stress (CUMS),and the behaviors evaluation was assessed by sugar water consumption and forced depression.Im-munofluorescence was used to detect the proliferation of hippocampus neurons in rats,at the same time,real- time PCR and Western blot were used to detect the mRNA and protein expression levels of each factor (Notch1,Hes1,Hes5 and Jagged1) of Notch1 signal pathway respectively. Results Compared with CON group,the percentage of sugar water preference and swimming length of rats decreased significantly in CUMS group (P＜0.05 and P＜0.01).Compared with CUMS group,the percentage of sugar water preference and swimming length of rats increased significantly in CSS group(P＜0.05).Compared with CON group,there was a significant increase in the inactivity length of rats between CUMS group,FLU group and CSS group,and the difference was statistically significant (P＜0.01).Compared with CUMS group,the swimming length of rats in CSS group was significantly reduced,and the difference was statistically significant (P＜0.01).Compared with CON group((750.00±27.51)/mm2),the number of BrdU positive cells in the substratum or granulocyte lay-er of the hippocampus dentate gyrus of rats in CUMS group ((338.75±29.61)/mm2),FLU group ((545.00 ±17.73)/mm2) and CSS group ((529.38±13.74)/mm2) was significantly reduced(P＜0.01).Compared with CUMS group ((338.75±29.61)/mm2),there was a significant increase in the number of BrdU positive cells in the substratum or granulocyte layer of the hippocampus dentate gyrus of rats in CSS group ((529.38 ±13.74)/mm2),and the difference was statistically significant (P＜0.01).Compared with CON group,the mRNA and protein expression levels of Notch1,Hes1,Hes5,and Jagged1 in the hippocampus of rats in CUMS group were significantly reduced(P＜0.05 or P＜0.01).Compared with CUMS group,the mRNA and protein ex-pression levels of Notch1,Hes1,Hes5 and Jagged1 in the hippocampus of rats in FLU group and CSS group were significantly increased,and the differences were statistically significant (P＜0.05 or P＜0.01). Conclu-sion Notch1 signal pathway may be related to the obstacle during the hippocampus nerve regenerating in the model rat under chronic unpredictable mild stress.CSS may play an anti-depressant role by regulating Notchl to improve hippocampus nerve regeneration.
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Objective To observe the effect ofXing Nao Kai Qiao (awakening brain and opening orifice) needling method on the cognitive and motor function of patients in acute stage of cerebral infarction.Method Sixty-four patients in acute stage of cerebra infarction were recruited and randomized into a trial group and a control group, 32 cases in each group. The control group was intervened by Edaravone 30 mg plus Fibrinogenase injection 200 U mixed in 500 mL 0.9% NaCl via intravenous drip, once a day. The trial group was byXing Nao Kai Qiao needling method in addition to the intervention given to the control group, once a day, 5 times a week. The two groups were both given 2-week successive treatment. At the end of the intervention, clinical efficacy, cognitive function, motor function, nervous function, serum C-reactive protein and NO levels, and adverse reactions of the two groups were compared.Result After the treatment, the Chinese Stroke Scale (CSS) score dropped significantly, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) score, Barthel Index (BI) score and motor function score of both upper and lower limbs increased significantly in both groups (P<0.05); the total effective rate of the trial group was significantly higher than that of the control group (P<0.05); the CSS score was lower, and LOTCA score, BI score, and motor function scores of both upper and lower limbs were higher in the trial group compared with those in the control group, and the differences were statistically significant (P<0.05); on the 1st, 3rd, 7th and 14th day after the intervention, the serum CRP and NO levels were significantly lower in the trial group compared with those in the control group (P<0.05). There was no significant difference in comparing the adverse reaction incidence between the two groups (P>0.05).Conclusion Xing Nao Kai Qiao needling method can produce a significant efficacy in treating patients in acute stage of cerebral infarction, and it can improve the cognitive, motor and nervous functions with high security.
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Objective To observe the effect ofXing Nao Kai Qiao (awakening brain and opening orifice) needling method on the cognitive and motor function of patients in acute stage of cerebral infarction.Method Sixty-four patients in acute stage of cerebra infarction were recruited and randomized into a trial group and a control group, 32 cases in each group. The control group was intervened by Edaravone 30 mg plus Fibrinogenase injection 200 U mixed in 500 mL 0.9% NaCl via intravenous drip, once a day. The trial group was byXing Nao Kai Qiao needling method in addition to the intervention given to the control group, once a day, 5 times a week. The two groups were both given 2-week successive treatment. At the end of the intervention, clinical efficacy, cognitive function, motor function, nervous function, serum C-reactive protein and NO levels, and adverse reactions of the two groups were compared.Result After the treatment, the Chinese Stroke Scale (CSS) score dropped significantly, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) score, Barthel Index (BI) score and motor function score of both upper and lower limbs increased significantly in both groups (P<0.05); the total effective rate of the trial group was significantly higher than that of the control group (P<0.05); the CSS score was lower, and LOTCA score, BI score, and motor function scores of both upper and lower limbs were higher in the trial group compared with those in the control group, and the differences were statistically significant (P<0.05); on the 1st, 3rd, 7th and 14th day after the intervention, the serum CRP and NO levels were significantly lower in the trial group compared with those in the control group (P<0.05). There was no significant difference in comparing the adverse reaction incidence between the two groups (P>0.05).Conclusion Xing Nao Kai Qiao needling method can produce a significant efficacy in treating patients in acute stage of cerebral infarction, and it can improve the cognitive, motor and nervous functions with high security.
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Churg-Strauss syndrome (CSS) or allergic granulomatosis angiitis is a rare primary vasculitic disease. CSS can be diagnosed by the presence of any four or more of the six criteria, which include asthma, eosinophilia greater than 10%, paranasal sinusitis, pulmonary infiltration, histological proof of vasculitis and mono- or poly-neuropathy. We report here on a 45-year-old male who developed erythematous macules, papules and hemorrhagic vesicles on both right extremities along with a tingling sensation and sacral pain. He has been suffering from recurrent allergic rhinitis and bronchial asthma for 6 months. The laboratory findings showed severe eosinophilia (22.3%), hyper-IgE and positivity for p-ANCA. On the histological examination of the hemorrhagic vesicle on the right lower leg, leukocytoclsatic vasulitis and many neutrophils and eosinophils around the cutaneous vessels were observed in the dermis.