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By analysing the similarity between defense qi and leukocytes in terms of function， site of action， and circadian rhythm， it is proposed that in traditional Chinese medicine （TCM）， the pathogenesis of leukopenia is defense qi deficiency. By analyzing the relevant discussions on the generation and transmission of defense qi in TCM classics， it is believed that the original qi in lower jiao （焦） is the source of defense qi， while the water and grain qi in middle jiao enriches defense qi， and the upper jiao transmits and distributes defense qi to the whole body. Therefore， when treating leukopenia after chemotherapy with TCM， Guilu Erxian Gelatin （龟鹿二仙胶） and Yougui Pill （右归丸） are often used to tonify the kidney and supplement essence， and moxibustion at Guanyuan （CV 4） and Qihai （CV 6） is usually accompanied to replenish the original qi in lower jiao and enrich the source of defense qi. Guipi Decoction （归脾汤）， Buzhong Yiqi Decoction （补中益气汤）， Shenling Baizhu Powder （参苓白术散）， and Sijunzi Decoction （四君子汤） are often suggested to strengthen spleen and replenish qi， in combination with moxibustion at Zhongwan （CV 12） and Zusanli （ST 36） to transport the spleen and stomach in the middle jiao to enrich the defense qi. Modified Guizhi Decoction （桂枝汤） to harmonize nutrient and defensive aspects is often used， and moxibustion at Dazhui （GV 14） and Feishu （BL 13） or scraping is added to dredge the striae and interstice in the upper jiao and promote transmission and dissemination of the defense qi. Considering the whole process of generation and distribution of defense qi， it is suggested to choose the most appropriate treatment modality flexibly， and combine internal treatment with external treatment， in order to provide ideas for the treatment of leukopenia in tumour patients.
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Objective:To investigate the anatomy of rectus femoris muscle flap and the anterolateral thigh muscle flap and their clinical application in reconstruction of large soft tissue defects after the removal of oral malignant tumour.Methods:From December 2006 to June 2009, 8 specimens of Chinese adult cadavers fixed in 10% formaldehyde were dissected to perform anatomy of anterolateral thigh region at the School of Basic Medical Sciences, Kunming Medical University. Anatomical images were analysed using Image-Pro Plus 6.0. Then, a retrospective study was performed on 19 patients who had postoperative defects after oral malignant tumour surgery and the defects were reconstructed with the rectus femoris muscle flap and the anterolateral thigh muscle flap from March 2020 to July 2022 at the Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital, Kunming Medical University. The postoperative defects of the 19 patients ranged from 3.0 cm×6.0 cm to 5.0 cm×10.0 cm. Ten rectus femoris muscle flaps, 8 anterolateral thigh muscle flaps and 1 combined rectus femoris muscle flap and anterolateral thigh muscle flap were used. The muscular flaps sized from 4.0 cm × 8.0 cm to 6.0 cm × 11.0 cm. Regular postoperative outpatient follow-ups were conducted.Results:The lengths of vessels of the harvested rectus femoris muscle flap and anterolateral thigh muscle flap were 63.4 mm± 12.9 mm and 112.5 mm± 19.6 mm, respectively. The starting outer diameters of the lateral circumflex thigh artery, the oblique branch of the lateral circumflex thigh artery and the descending branch of the lateral circumflex thigh artery were 2.92 mm±0.72 mm, 1.88 mm±0.23 mm and 2.29 mm±0.43 mm, respectively. Postoperative follow-up lasted for 7 to 32 months, with 17.5 months in average. Seventeen flaps were completely survived and the rectus femoris muscle flap was completely mucosalised 5 weeks after surgery. However, 2 rectus femoris muscle flaps had necrosis of which one was changed to a tongue flap reconstruction and the other encountered flap necrosis during postoperative radiotherapy and healed after debridement and dressing changes. There was no postoperative complication in the donor sites. Other than the 2 patients, all other 17 patients had satisfactory clinical outcomes.Conclusion:Both of the starting outer diameters and length of vessels of the femoris muscle flap and the anterolateral thigh muscle flap meet the requirements for reconstruction of maxillofacial defects, and both muscular flaps are simple to prepare, in good reconstructive results with few complication, as well as an excellent outcome. They are feasible approaches for reconstruction of large soft tissue defects left after the removal of an oral malignant tumour.
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Objective To explore the method and clinical efficacy of microsurgical reconstructive surgery af-ter malignant tumors radical resection on the surface. Methods From June, 2015 to March, 2017, a total of 32 pa-tients in this group underwent radical resection of malignant tumors. All of them resulted in a large area of soft tissue defect with loss of function.The average defect area was 10.0 cm×12.0 cm.All types of free flap and pedicle flap were selected. Myocutaneous flaps or local flaps were used to repair large areas of soft tissue defect on the basis of micro-surgical techniques to protect the blood supply of the flaps and to reduce the damage to the donor area by evaluating the defect size, surrounding anatomical characteristics, and other factors. Results Thirty-two flaps survived com-pletely. After 4 to 18 months of followed-up, the color of flap was close to that of the surrounding skin. The texture was good. There was no bloated swelling, and the skin protective sensation was restored. There was no obvious scar hyperplasia, no chills, no pain and no other complications in the donor site. Conclusion After the radical mastec-tomy of the body surface, different types of flaps can be selected for the first-stage microsurgery according to the characteristics of the different parts and the tumor excision wounds to obtain a good clinical efficacy.
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Increasing scientific evidence supports the positive relationship between inflammation and cancer development. The immune response initiated by pattern recognition receptors is critical to triggering of tumor-associated inflammation. Triggering receptor expressed on myeloid cells (TREM) is an immunoglobulin of the super transmembrane glycoprotein family, which is mainly expressed on select groups of myeloid cells. The most important members of TREM comprise TREM-1 and TREM-2. Activation of TREM-1 and TREM-2 signaling is initiated upon binding of their ligands. Subsequently, cross-linking reactions of downstream effectors occur, resulting in inflammation regulation. Recently, the connection between TREM and malignant tumors has been widely noticed and studied. This review summarizes studies of association between TREM-1, TREM-2, and malignant tumors in the medical field to provide new ideas for study on the correlation between periodontitis and oral cavity cancer.
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Ameloblastic carcinoma is a highly malignant tumour and requires aggressive treatment. This case report describes an aggressive ameloblastic carcinoma that infiltrated the mandible. Mandibulectomy with right functional radical neck dissection and left supra omohyoid dissection was followed by primary reconstruction with a single free vascularised fibula flap. The post-operative course was uneventful. The 2 year regular follow up revealed no signs of recurrent tumour or metastasis. Future reporting of this rare condition is encouraged in lieu of limited information in its clinical course and prognosis.
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Background: The impact of diagnostic immunohistochemistry for the surgical pathology is legendary especially when it provides true identity of undifferentiated tumours. This not only is important for prognostication & therapy but also provide further insights into the pathobiology of these tumours. Aims & Objective: This study was undertaken to determine the role and significance of immunohistochemistry for accurate diagnosis and subtyping of undifferentiated malignant tumours as it is essential in guiding therapy and prognosis. Material and Methods: Immunohistochemical staining (IHC) performed was based on Peroxidase Antiperoxidase (PAP) method on paraffin sections, using appropriate mono/polyclonal antibodies. Total 74 cases including six consultation cases were studied from August 2008 to November 2011, which were reported as undifferentiated or poorly differentiated malignant tumor using routine hematoxylin- eosin stains. Results: The histopathology and IHC reports of 74 tumours were reviewed and assigned to appropriate categories. It was possible to arrive at a diagnosis in 73 cases (98.65%) with the help of IHC. Carcinoma was the commonest diagnosis (27 cases, 36.50%) followed by lymphoma (18 cases, 24.32%), sarcoma (14 cases, 18.92%), malignant melanoma (3 cases, 4.05%) and neuroblastoma (3 cases, 4.05%). Conclusion: Immunohistochemistry is helpful in the majority of difficulties arising during histological diagnosis of undifferentiated malignant tumours and serves as a diagnostic, prognostic, and predictive tool.
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Objective To explore the clinical efficacy of treating pains suffered from metastatic bone cancer with composite kushen injection and pamidronate disodium injection.Methods The clinical information of 60 cases of metastatic bone cancer patients suffered with pains was collected retrospectively.Thirty patients were assigned to the treatment group and 30 to the control group according to the treatment they underwent.The control group were treated with pamidronate disodium injection for 3 cycle,the treatment group were additionaly treated with composite kushen injection.The differences of two groups cases were compared in respect of the relief of pains and the changes of performance status (PS) and the incidence of adverse effects after treatment for 3 cycles.Results The objective remission rate of bone pain was 60.0％ (18/30) in the treatment group,which was significantly higher than that of 30.0％ (9/30) in the control group was higher( x2 =5.455,P=0.020 ).The incidence of adverse effect was 40.0％ (12/30) in the treatment group and 46.6％ (14/30) in the control group,with no significant difference between the two groups( x2 =0.271,P =0.602).In the treatment group the performance status of patients was( 2.30 ± 0.70 ) after treatment,which was better than that of( 1.80 ± 0.80 )before treatment(t =15.000,P =0.042),wheras there was no significant difference on performance status in the control group.Conclusion Kushen injection has synergistic effect with pamidronate disodium injection in treating pains with matstatic bone cancer.It could improve the short term efficacy,and significantly relief the pain and improve the quality of life.
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Fourier transform infrared (FTIR) microspectroscopy can be considered to be a fast and non-invasive tool for distinguishing between normal and cancerous cells and tissues without the need for laborious and invasive sampling procedures. Gastric samples from four patients (age, 65±2 years) were analysed. Samples were obtained from the organs removed during gastrectomy and then classified as normal or cancerous. Classification was based on histopathological examinations at our institution. Formalin-fixed sections of gastric tissue were analysed by FTIRmicrospectroscopy. To characterize differences between sections of normal and cancerous tissue, specific regions of the spectra were analysed to study variations in the levels of metabolites. To distinguish between two conditions (normal and cancerous), changes in the relative intensity of bands in the range 600–4000 cm−1 were analysed. A FTIR spectral map of the bands in the region 2800–3100 cm–1 and 900–1800 cm–1 were created to analyse pathological changes in tissues. The limited data available showed that normal gastric tissue had stronger absorption than cancerous tissue over a wide region in the four patients. There was a significant decrease in total biomolecular components for cancerous tissue compared with normal tissue.
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Objective To study the influence of clinical nursing pathway on operative effects for patients with malignant tumout of bone. Methods 60 adult patients with malignant turnout bone were divided into the clini-cal nursing pathway gronp(32 cases) and control group(32 cases) randomly, routine nursing cares were used in con-trol group, while the clinical nursing pathway was used in the observation group. Compared the index between the two groups. Results All the indexes which had been compared between the two group were better in the clinical nursing pathway group than those in control group, the difference was significant (P < 0.05). Condusion The clinical nursing pathway can effectivly improve the compliance of patients for operation, avoid postoperative complications, and then imprpve their quality of life.
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OBJECTIVE To analyze the clinical features of nosocomial infection of malignant tumor in our hospital.METHODS The clinical material of 6967 malignant tumor patients with hospital infection was analyzed retrospectively.RESULTS From them 409 patients got nosocomial infection and the infection rate was 5.87%;respiratory infection was the main infection(57.9%),digestive tract infection was the rext(18.83%).G-pathogens accounted for 43.22%,fungi infection for 36.91%,in which the Candida were the head pathogens.The risk factors were age,antibiotic usage,invasive operation and anti-tumor treatments.CONCLUSIONS The malignant tumor is easy to cause the hospital infection.Strengthening the nosocomial infection management,controlling the risk factors,and the standardzed antibiotic usage can reduce the nosocomial infection occurrence.
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Purpose:To study the therapeutic mechanism through inducing apoptosis of tumour by protamine inhibiting angiogenesis . Methods:The vascular density and apoptotic index(AI)in the tumour were investigated by immunohistological and Tunel(terminal deoxynucletidy1 transferase-mediated dU TP nick end-labelling) methods in animal tumour model with experimental treatment. Results:The vascular density of tumour was much lower in controls. Apoptosis appeard in the treated group and AI is (7.67?1.70)%. Conclusions:Protamine could reduce the vascular density of tumour very much and induce the apoptosis of tumour cells. The therapeutic effects were achieved by inhibiting angiogenesis and inducing apoptosis of tumour.
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Purpose: To study the clinical treatment and prognosis of gastric cancer in elderly patients. Methods: From 1984 to 1995, 110 old patients with malignant tumor in stomach were treated in this hospital. All 110 patients received surgery with radical resections in 60 cases, palliative resections in 22 cases, laparotomy in 24 cases, and gastrojejunostomy in 4 cases. Results: Postoperative complication was 16. 36%, mortality was 1. 8%. The overall 3- and 5- year survivals for radical resections were 68. 4%, 55. 08%, respectively. Multivariate analyses showed that the favorable factors for prognoses were stage and radical resection. Conclusions: It is recommended that radical resection should be performed for malignant tumors of stomach in old patients. Although the risks of complication morbidity and surgery mortality are more likely to be higher after surgery for the elderly, the outcome would be better if more attention were paid, to improve patients general condition, and correct management after surgery.\;
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Objective To study the clinical efficacy of island skin flap in the repair of skin and subcutaneous soft tissue defects caused by excision of malignant tumour in the skin. Methods Island skin flaps with the main artery and its penetrating branches were used to repair the skin and soft tissue defects in different sites after malignant tumour removal. A total of 5 cases were repaired, in which 2 cases were in the face, 2 in limb and one in wall of the chest. Results Among the 5 cases, one was repaired with island skin flaps with the main artery, and another 4 were repaired with island skin flaps with the penetrating arteries. Follow-up for one to 5 years showed that the appearance and function in the repaired sites were normal without blood flow disturbance and dysfunction of the island skin flap, and no recurrence of the tumors except one case. Conclusion The island skin flap with main artery, especially one with its penetrating branches, is a good option to repair the defect caused by removal of malignant tumors with high rate of success, better appearance and minor damage to the donor site.
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Superior vena cava syndrome(SVCS) is caused by malignant tumour, often showing tumour crisis. The prognosis is bad. It will endanger the life frequently if not cured in time. It is argued which is the preferred treatment on radiotherapy, chemotherapy, surgery or colligate therapy etc. Now we introduce briefly correlated study in the near future, pointting out the colligate therapy trend of SVCS.