RESUMO
@#（正）目前对于可切除食管癌的治疗方式是以手术为主的综合治疗[1]。微创食管癌手术经过多年的发展和普及，其远近期疗效已被广泛认可。目前对于中、下段食管癌，胸腹腔镜联合 Ivor-Lewis 已是主流术式[2]。相对微创 McKeown 手术，全腔镜下Ivor-Lewis 食管癌根治术在近期疗效（特别是在吻合口瘘、吻合口狭窄和喉返神经损伤）方面具有明显优势[3]。本视频旨在展示全腔镜下 Ivor-Lewis 食管癌根治术的手术入路及操作要点。
RESUMO
Objective To investigate the indications and clinical outcomes of total knee arthroplasty or osteotomy for knee osteoarthritis subsequent to previous femur fractures.Methods Six patients (three male and three female) with knee osteoarthritis subsequent to previous femur fractures were analyzed retrospectively between February 2006 and February 2017.The average age of patients was 58.2± 10.3 years old,ranged from 51 to 79 years.Four patients underwent total joint replacement and two underwent osteotomy.The average age of patients in joint replacement group was 60.5±12.3 years old.The age of the two patients in the osteotomy group was 51 and 55 years old,respectively.The extra-articular deformity angle of the coronal plane of the femur,lateral distal femur angle of mechanical axis,hip-knee-ankle angle (HKA) of preoperative and postoperative were determined on long-standing radiography.The mean angle of the extra-articular deformity in the joint replacement group was 17.0±7.7 degrees.The angle of the extra-articular deformity in the osteotomy group was 34 and 20 degrees.Lateral distal femur angle of mechanical axis in the joint replacement group was within the range of 87±7 degrees.Lateral distal femur angle of mechanical axis in the osteotomy group was out of the range of 87±7 degrees.The mean preoperative HKA of the joint replacement group was 161.8±8.0 degrees.The preoperative HKA of the osteotomy group was 155 and 160 degrees,respectively.Knee function was estimated according to knee range of motion and Knee Society Score (KSS).The results of postoperative hip-knee-ankle angle,knee range of motion (ROM) and knee society score were compared between the two groups.Results The mean HKA of the joint replacement group reached 176.0±2.8 degrees at one year postoperatively.The HKA of the osteotomy group improved to 177 and to 175 degrees at one year postoperatively.The average preoperative knee ROM improved significantly from 71 ± 16 degrees preoperatively to 113 ±5degrees postoperatively.The mean knee ROM of the joint replacement group was 113.0±6.8 degrees.The knee ROM of two patients in the osteotomy group was 110 and 115 degrees,respectively.The average preoperative KSS score improved significantly from 46±3 preoperatively to 88±3 postoperatively.The mean KSS of the joint replacement group was 88.8±3.0,while the KSS of the osteotomy group was 85 and 82.No bone nonunion was observed in the two patients in osteotomy group.Conclusion For patients with knee osteoarthritis subsequent to previous femur fractures,satisfactory short-term clinical outcomes could be obtained by total knee arthroplasty or osteotomy with the strict selection of proper operative indications.
RESUMO
Objective To assess the effects of pre-operative measurement of proximal tibia varus angle (PTA) on predicting condylar twist angle (CTA) in total knee arthroplasty (TKA).Methods The CT-scan of lower limb was performed in sixty-one health female volunteers aged 31.5 (18-38) years with 160 (153-170) cm heights from March 2016 to August 2016.The PTA,medial proximal tibial angle (MPTA) and CTA were determined.The PTA was defined between a line perpendicular to the mechanical axis of the tibia and the tangent on the internal tibial plateau.The MPTA was the medial angle between the mechanical axis of the tibia and the tangent on the internal tibial plateau.The CTA was the angle between the sTEA and the posterior condylar line.The correlations between these parameters were analyzed statistically by linear regression.Results The PTA,MPTA and CTA parameters were conformed to the normal distribution.The PTA was 2.30°± 1.86°,ranged from 1.40° to 6.50°.The MPTA was 87.7°± 1.86°,ranged from 83.50° to 88.60°.The CTA was 3.4°± 1.27°,ranged from 0.50° to 5.80°.The linear regression analysis showed a strong positive correlation between the CTA and PTA in health female knees (r=0.58,P=0.048),while negative correlation was found between the CTA and MPTA in health female knees (r=-0.58,P=0.048).There were fifty-two (85.2％) volunteers with PTA that was more than 2° and less than 4°.Six (9.8％) volunteers had PTA less than 2°,while three (4.9％) had PTA more than 4°.There were eight (13.1％) volunteers with CTA less than 3°.Forty-three (70.5％) volunteers had CTA more than 3° and less than 4°.CTA more than 4° was found in ten volunteers (16.4％).Based on these above results,two formulas were demonstrated for predicting the CTA:CTA=2.52+0.395PTA,CTA=38.06-0.390MPTA.Conclusion The CTA can be predicted by calculating the PTA by CT-scan and standard long-leg standing radiographs before TKA.Using the present method could reduce the risk of femur component malrotation and the flexion gap balancing during TKA.
RESUMO
Objective To assess the effects of pre-operative measurement of proximal tibia varus angle (PTA) on predicting condylar twist angle (CTA) in total knee arthroplasty (TKA).Methods The CT-scan of lower limb was performed in sixty-one health female volunteers aged 31.5 (18-38) years with 160 (153-170) cm heights from March 2016 to August 2016.The PTA,medial proximal tibial angle (MPTA) and CTA were determined.The PTA was defined between a line perpendicular to the mechanical axis of the tibia and the tangent on the internal tibial plateau.The MPTA was the medial angle between the mechanical axis of the tibia and the tangent on the internal tibial plateau.The CTA was the angle between the sTEA and the posterior condylar line.The correlations between these parameters were analyzed statistically by linear regression.Results The PTA,MPTA and CTA parameters were conformed to the normal distribution.The PTA was 2.30°± 1.86°,ranged from 1.40° to 6.50°.The MPTA was 87.7°± 1.86°,ranged from 83.50° to 88.60°.The CTA was 3.4°± 1.27°,ranged from 0.50° to 5.80°.The linear regression analysis showed a strong positive correlation between the CTA and PTA in health female knees (r=0.58,P=0.048),while negative correlation was found between the CTA and MPTA in health female knees (r=-0.58,P=0.048).There were fifty-two (85.2％) volunteers with PTA that was more than 2° and less than 4°.Six (9.8％) volunteers had PTA less than 2°,while three (4.9％) had PTA more than 4°.There were eight (13.1％) volunteers with CTA less than 3°.Forty-three (70.5％) volunteers had CTA more than 3° and less than 4°.CTA more than 4° was found in ten volunteers (16.4％).Based on these above results,two formulas were demonstrated for predicting the CTA:CTA=2.52+0.395PTA,CTA=38.06-0.390MPTA.Conclusion The CTA can be predicted by calculating the PTA by CT-scan and standard long-leg standing radiographs before TKA.Using the present method could reduce the risk of femur component malrotation and the flexion gap balancing during TKA.
RESUMO
Background and purpose:High expression of excision repair cross-complementing 1 (ERCC1) is related to resistance in patients treated with platinum-containing regimens. The ERCC1 antibody 8F1 was usually used in past studies, but it was found to have no-speciifcity recently. This study aimed to investigate the predictive role of a new ERCC1 antibody 4F9 to platinum chemotherapy in non-small cell lung cancer (NSCLC) patients. Methods:Expression of ERCC1 was detected using antibody 4F9 by immunohistochemistry (IHC) in 72 NSCLC tissues. The relationship between the expression of ERCCl and the clinical pathological parameters, the efficacy of platinum chemotherapy and overall survival of patients were explored by statistical analysis. Results: The high expression of ERCCl protein was 55.5%in 72 cases. There was no signiifcant correlation between the ERCC1 expression with gender, age, pathological type, clinical stage and lymphatic metastasis (P>0.05). Patients with low expression of ERCC1 had signiifcantly higher response rates to platinum chemotherapy, longer median survival time and 2-years survival rate comparing with those with high expression of ERCC1 (62.5%vs 37.5%;22.9 vs 18.4 month;46.9%vs 37.5%), respectively (P<0.05). Conclusion:The expression analysis of ERCC1 using new ERCC1 antibody 4F9 by IHC method is helpful to assign chemotherapeutic regimen, and guide individual platinum chemotherapy for post-operation patients.
RESUMO
<p><b>OBJECTIVE</b>To study the protective effects of astragaloside (AST) on memory impairment and the expression levels of amyloid precursor protein (APP) and its mRNA, alpha secretase and beta secretase mRNA in the brain of mice induced by dexamethasone (DEX).</p><p><b>METHOD</b>Mice were randomly divided into six groups: control group, model group, AST ( 10, 20, 40 mg x kg(-1)) groups and ginsenoside Rg1 (6.5 mg x kg(-1)) group. The animal models of dysmnesy mice were established by intragastrical administration of DEX (5 mg x kg(-1)) for 21 days. Subsequently, the dysmnesy mice were treated by intragastrical administration of ginsenoside Rg1 and different doses of AST (10, 20, 40 mg x kg(-1)), respectively. Morris water maze was applied to evaluate the learning and memory function in mice. The expression of APP, alpha secretase and beta secretase mRNA were analysed by RT-PCR, and immunohistochemistry was used to evaluate the expression levels of APP in cerebral cortex, hippocampus CA1 and CA3.</p><p><b>RESULT</b>AST (20, 40 mg x kg(-1)) could improve the learning and memory function in mice (P<0.05, P<0.01), decrease the expression levels of APP and beta secretase mRNA (P<0.05), increase the expression level of alpha secretase mRNA (P<0.05), and decrease the expression level of APP in cerebral cortex and hippocampus CA1 (P<0.05).</p><p><b>CONCLUSION</b>AST could improve the learning and memory function in mice, which mechanism may contribtuted to the expression inhibition of APP and APP mRNA, beta secretase mRNA, and promotion of the expression of alpha secretase mRNA.</p>