The effect of sonic activated device used for different time on intracanal smear layer removal: An SEM analysis / 口腔医学

Objective @#To observe the clearance of smear layer on the root canal wall in different action time by scanning electron microscope (SEM), and to determine the optimal amount of time using sonically activated irrigation to wash root canal in clinic. @*Methods@# Fifty-six ex vivo human anterior teeth with single straight root canal were selected. After routine mechanical preparation, they were divided into two experimental groups according to different irrigating agents: saline group and EDTA group. Each group was assisted by VDW sonic activation EDDY. The saline group was divided into three subgroups according to the irrigating time: 5 s, 30 s and 50 s; EDTA group was divided into six subgroups according to the irrigating time: 5 s, 10 s, 20 s, 30 s, 40 s and 50 s. The control group did not undergo root canal irrigation. After irrigation, the root was cut longitudinally. The smear layer of crown, middle and apical of root canal wall was observed by SEM.@* Results@# After irrigating for 30 seconds, there was a significant difference between the normal saline group and the control group and the 5 second group (P<0.05), and there was no difference in the middle and apical part (P>0.05). After 50 seconds, there was a significant difference in the score of the smear layer between the apical area and the other groups (P<0.05). After irrigating for 5 seconds or 10 seconds in EDTA group, there was a significant difference between the scores of the crown and middle area of the root canal and the control group (P<0.05), and there was no significant difference in the apical area (P>0.05). There was a significant difference between the 20-40 second group and the first two groups (P<0.05). There was a significant difference between the 50 second group and the other groups (P<0.05). Comparing the cleaning effect on the smear layer after 50 seconds of irrigating between the two experimental groups, the whole root canal showed significant statistical difference (P<0.05). @*Conclusion @#The EDTA-assisted sonic activated device used for 50 seconds has the best cleaning effect.

Limited internal fixation combined with a hinged external fixator in treatment of peri-elbow bone infection / 中国修复重建外科杂志

OBJECTIVE@#To evaluate the effectiveness of limited internal fixation combined with a hinged external fixator in the treatment of peri-elbow bone infection.@*METHODS@#The clinical data of 19 patients with peri-elbow bone infection treated with limited internal fixation combined with a hinged external fixator between May 2018 and May 2021 were retrospectively analyzed. There were 15 males and 4 females with an average age of 44.6 years (range, 28-61 years). There were 13 cases of distal humerus fractures and 6 cases of proximal ulna fractures. All the 19 cases were infected after internal fixation of fracture, and 2 cases were complicated with radial nerve injury. According to Cierny-Mader anatomical classification, 11 cases were type Ⅱ, 6 cases were type Ⅲ, and 2 cases were type Ⅳ. The duration of bone infection was 1-3 years. After primary debridement, the bone defect was (3.04±0.28) cm, and the antibiotic bone cement was implanted into the defect area, and the external fixator was installed; 3 cases were repaired with latissimus dorsi myocutaneous flap, and 2 cases were repaired with lateral brachial fascial flap. Bone defects repair and reconstruction were performed after 6-8 weeks of infection control. The wound healing was observed, and white blood cell (WBC), erythrocyte sedimentation rate (ESR), and C-reaction protein (CRP) were reexamined regularly after operation to evaluate the infection control. X-ray films of the affected limb were taken regularly after operation to observe the bone healing in the defect area. At last follow-up, the flexion and extension range of motion and the total range of motion of the elbow joint were observed and recorded, and compared with those before operation, and the function of the elbow joint was evaluated by Mayo score.@*RESULTS@#All patients were followed up 12-34 months (mean, 26.2 months). The wounds healed in 5 cases after skin flap repair. Two cases of recurrent infection were effectively controlled by debridement again and replacement of antibiotic bone cement. The infection control rate was 89.47% (17/19) in the first stage. Two patients with radial nerve injury had poor muscle strength of the affected limb, and the muscle strength of the affected limb recovered from grade Ⅲ to about grade Ⅳ after rehabilitation exercise. During the follow-up period, there was no complication such as incision ulceration, exudation, bone nonunion, infection recurrence, or infection in the bone harvesting area. Bone healing time ranged from 16 to 37 weeks, with an average of 24.2 weeks. WBC, ESR, CRP, PCT, and elbow flexion, extension, and total range of motions significantly improved at last follow-up ( P<0.05). According to Mayo elbow scoring system, the results were excellent in 14 cases, good in 3 cases, and fair in 2 cases, and the excellent and good rate was 89.47%.@*CONCLUSION@#Limited internal fixation combined with a hinged external fixator in the treatment of the peri-elbow bone infection can effectively control infection and restore the function of the elbow joint.

A study on the association of postprandial hypotension with insulin and neurotensin in very old adults / 中华老年医学杂志

Objective:To investigate the association of postprandial hypotension(PPH)with insulin and neurotensin(NT)in very old adults.Methods:In this retrospective study, 22 people with PPH and 21 without non-PPH, aged ≥80, were enrolled from patients hospitalized at the First Division of the Health Department of China-Japan Friendship Hospital between September 2015 and October 2021.The levels of blood pressure, blood glucose, insulin and NT at fasting and 30, 60, 90 and 120 minutes after a meal were monitored.Changes in values of each parameter before and after a meal were compared between the two groups, and the correlation of the maximum decrease in postprandial blood pressure with the maximum increase in blood glucose, insulin and neurotensin was analyzed.Results:The maximum decrease in postprandial systolic blood pressure(SBP)in the PPH group was significantly higher than that in the non-PPH group[(35.5±13.2)mmHg(1 mmHg=0.133 kPa) vs.(16.0±8.6)mmHg, t=4.135, P<0.01)]. The maximum increase in postprandial insulin was significantly higher than that in the non-PPH group[(20.9±4.2)mU/L vs.(12.1±4.1)mU/L, t=3.949, P<0.01)]. There was no statistically significant difference between the PPH and non-PPH groups in the maximum increase in postprandial blood glucose[(3.6±1.8)mmol/L vs.(2.5±0.5)mmol/L, t=1.912, P>0.05)]or NT[65.7(22.0, 110.1)ng/L vs.112.2(47.2, 270.2)ng/L, Z=1.817, P>0.05)]. There was a significant positive correlation between the maximum decrease in postprandial systolic blood pressure and the maximum increase in insulin( r=0.907, P<0.05). There was no correlation between the maximum decrease in postprandial systolic blood pressure and the maximum increase in blood glucose( r=0.016, P>0.05). There was no correlation between the maximum decrease in postprandial systolic blood pressure and the maximum increase in NT( r=0.396, P>0.05). Conclusions:The PPH is related to abnormal increases in postprandial insulin secretion.

Data Analysis of the Risks of Abnormal Female Reproductive System Haemorrhages Induced by Novel Oral An- ticoagulants Based on FAERS / 中国药房

OBJECTIVE：To eva luate the risk of abno rmal female reproductive system haemorrhage induced by novel oral anticoagulants （NOACs）. METHODS ：The abnormal female reproductive system haemorrhage reports induced by 4 kinds of NOACs as “dabigatran etexilate ”，“rivaroxaban”，“apixaban”and“edoxaban”were used as the first suspected dugs to collected from FDA adverse event reporting system （FAERS）database during Jan. 1st，2004-May 31st，2019. The report odd ratio （ROR） method was used to detect the signal of abnormal female reproductive system haemorrhage induced by NOACs. RESULTS ：A total of 2 658 adverse events related to abnormal female reproductive system haemorrhage were collected from FAERS database ， involving 330 reports of dabigatran etexilate ，2 049 reports of rivaroxaban ，267 reports of apixaban ，and 12 reports of edoxaban. The abnormal female reproductive system haemorrhage caused by dabigatran etexilate ，apixaban and edoxaban mainly occurred in patients aged 75 and older ，accounting for 37.27％，36.70％ and 58.33％ respectively；that of rivaroxaban mainly occurred in patients with 45-64 years old ，accounting for 33.04％. The incidence of severe adverse events （SAE）induced by dabigatran etexilate，rivaroxaban，apixaban and edoxaban were 96.36％，84.53％，47.19％ and 58.33％，respectively. All of patients in the included reports were mainly hospitalized and hospitalization stay wa s prolonged ，accounting for 64.78％，90.01％，86.51％ and 71.43％ ，respectively. A total of 12 suspected signals were detected，involving cervix uteri ，fallopian tube ，ovary，pelvis cavity，uterus，vagina，urinary tract ，etc. Among them ，there were 11 positive signals of rivaroxaban ，and the bleeding events were concentrated in vaginal hematoma [ROR ＝12.07， 药。95％CI（8.51，17.12）]，postmenopausal hemorrhage [ROR ＝ 9.89，95％CI（8.31，11.77）]，pelvic hematoma [ROR ＝7.68，95％CI（5.66，10.43）]. There were 4，4 and 2 suspicious signals for dabigatran etexilate ，apixaban and edoxaban. The main bleeding events of both apixaban [ ROR＝5.18，95％CI（1.81，5.85）] and edoxaban [ROR ＝48.19，95％CI（6.76，343.77）] were vaginal hematoma ；dabigatran etexilate-induced pelvic hematoma [ROR ＝ 12.56，95％CI（8.92，17.70）] had the strongest signal ，followed by urinary tract bleeding [ROR ＝5.41，95％CI（3.34，8.76）] and pelvic hemorrhage [ ROR＝2.53，95％CI（1.88，3.40）]. CONCLUSIONS ：Totally 4 kinds of NOACs can cause abnormal female reproductive system haemorrhage ，and the incidence of SAE is high ，of requiring hospitalization or prolonging hospitalization time. The risk of haemorrhage in rivaroxaban is the highest ，usually manifesting as vaginal hematoma ，postmenopausal hemorrhage and pelvic hematoma. Dabigatran etexilate mainly induce pelvic hematoma ，while apixaban and edoxaban are mainly cause vaginal hematoma.

Outcome analysis of 71 patients with laryngeal squamous cell carcinoma / 中国基层医药

Objective To investigate the prognosis relevant factors of laryngeal squamous cell carcinoma (LSCC).Methods From January 2013 to December 2013,the clinical data of 71 patients with LSCC who were initially treated in Zhejiang Cancer Hospital were retrospectively analyzed.Results Univariate analysis showed that there were statistically significant differences in survival rate between the group of supraglottic type and glottic type (60.0% vs.86.3% ,χ2 =6.284,P<0.05),the group of N0 and N+(41.7% vs.86.4% ,χ2 =16.803,P<0.01), the group of early and late stage(93.6% vs.50.0% ,χ2 =19.854,P<0.01).There were no statistically significant differences in survival rate between the group of age ≤50,>50-60,>60-70 and >70(88.9% vs.88.2% vs. 79.3% vs.62.5% ,χ2 =3.909,P>0.05),the group of T1+T2 and T3+T4(83.6% vs.62.5% ,χ2 =3.623,P>0.05),the group of high,medium,low differentiated and unsigned(75.0% vs.69.7% vs.83.3% vs.91.7% ,χ2 =3.780,P>0.05),the group of surgery,radiotherapy and surgery+radiotherapy (74.3% vs.90.9% vs.71.4% , χ2 =2.437,P>0.05).Multivariate analysis showed that age( P =0.003),treatment( P =0.048) had significant effect on the prognosis of patients,but tumor location(P=0.766),T stage(P=0.677),N stage(P=0.482),clinical stage(P=0.825),the degree of pathological differentiation(P=0.206) had no significant effect on the prognosis of patients.Conclusion More aggressive treatment should be supplied for patients with N+,advanced clinical stage and age whom the prognosis are usually poor. In addition, the proportion of tracheal tube extraction should be appreciated.

Progress of circulating tumor DNA detection in cancer / 中国基层医药

Peripheral blood circulating tumor DNA(ctDNA) is a kind of DNA that is released into the blood circulation system after the tumor cell somatic cell DNA is exfoliated or when the cell apoptosis is released.ctDNA is a characteristic tumor biomarker, known as " liquid biopsy" . It can reflect the invasion and metastasis of the tumor, and can monitor the effect and prognosis of the tumor.The current research is mainly focused on relatively mature breast cancer, lung cancer and other diseases.In this study, the development of ctDNA inspection technology and its current research status at home and abroad are reviewed.

Practice of Standardizing Rational Use of Ribavirin in Children by PDCA Cycle Management Method in Our Hospital / 中国药房

OBJECTIVE:To evaluate the effects of PDCA cycle management on standardizing rational use of ribavirin in children,and to investigate the effectiveness and safety of ribavirin in children. METHODS:By adopting 4 times of PDCA cycle, clinical pharmacists conducted continuous intervention to ribavirin use in pediatric department;authoritative guideline and evidence-based evidence were reviewed;List of Antiviral Therapy Plans in Qutpatient Department of Prediatrics was formulated in our hospital,which provided antiviral therapy plan of common pediatric infectious disease. By compared the rationality of ribavirin prescription in the pre and post PDCA cycle management(intervention group and non-intervention group)to evaluate the effects of standard management. RESULTS & CONCLUSIONS:After 4 times of PDCA cycle,the consumption amount of ribavirin both reduced significantly. The proportion of ribavirin prescriptions decreased from 3.10％ to 0.80％(P<0.01);the proportion of suitable medication indication prescriptions increased from 56.14％ to 90.30％(P<0.01);diagnosed disease types of commonly prescribed ribavirin prescriptions decreased from 26 to 5;the proportion of suitable administration route prescriptions increased from 73.43％ to 93.75％. The proportion of ribavirin combined with antibiotics prescriptions decreased from 59.74％ to 12.91％(P<0.01). PDCA is an effective and feasible method for pediatric medication management by clinical pharmascits. Ribavirin is not recommended as routine antiviral drug for children due to its unclear clinical benefit and distinct toxicity.

Planned neck dissection in the treatment of locally advanced head and neck squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the value of planned neck dissection combined with induction chemotherapy and concurrent chemoradiotherapy in regional control and the outcome of locally advanced head and neck squamous cell carcinoma.@*Methods@#A prospective randomized controlled study totally enrolled sixty-four patients of head and neck squamous cell carcinomas(include oropharynx, hypopharynx, and larynx) in stages Ⅳa-Ⅳb with lymph node metastase was were N2-N3. All patients firstly received 2-3 cycles of induction chemotherapy(ICT), then divided into two groups randomly, according to the efficacy of ICT. Group A(the study group) received planned neck dissection(PND) and concurrent chemoradiotherapy(CCRT). Group B(the control group) received concurrent chemoradiotherapy(CCRT). The differences in clinicopathologic features, local recurrence(LR), regional recurrence(RR), disease-free survival(DFS), and overall survival(OS) between the two groups were estimated. SPSS 19.0 software was used to analyze the data.@*Results@#Group A enrolled twenty-one patients, and group B enrolled forty-three patients.The follow-up of all patients were 4-55 months, median follow-up time was 22 months. In study group, two-year OS and DFS were 80.9% and 68.3%, respectively. In control group, two-year OS and DFS were 90.7% and 67.1%, respectively. There was no significant difference in gender(P=0.215), age(P=0.828), primary tumor site(P=0.927), LR(P=0.126), DFS(P=0.710), and OS(P=0.402) between the two groups, while the RR(χ2=5.640, P<0.05) and distant metastasis(χ2=10.363, P<0.01) showed significant differences between the two groups.@*Conclusion@#The ICT+ PND+ CCRT treatment model has benefit on regional control of locally advanced head and neck squamous cell carcinoma.

Multifocal papillary thyroid microcarcinoma increases the risk of central lymph node metastasis / 中华内分泌外科杂志

Objective To investigate the predictive factors for central lymph node metastasis (CLNM) in papillary thyroid microcarcinoma(PTMC).Methods A retrospective study including 2511 cases of PTMC admitted from Jan.2013 to Jan.2016 were enrolled in our study.Chi-square test was used in univariate analysis.Logistic regression analysis was applied for multivariate analysis.The relation between age,sex,tumor size,multifocality,thyroidal extension,nodular goiter and central lymph node metastasis is analyzed.Results Univariate analysis showed that age,sex,tumor size,multifocality,thyroidal extension and nodular goiter had statistical significance.Age less than 45(P＜0.001,x2=17.442);Male gender(P＜0.001,x2=17.029);Tumor size less than 5 mm (P＜0.001,x2=70.164.);Extrathyroid extension factor (P＜0.001,x2=63.197);Nodular hyperplasia factor (P=0.017,x2=5.611).Multivariate analysis showed there was a significant relationship between multifocality and the central lymph node positivity.The odds ratio (OR) was 1.587 in patients with tumor foci ≥2(P＜0.001).While OR increased sharply near to 3 in patients withtumor foci ≥3(OR=2.730).Tumor size(OR=1.926);Extrathyroid extension(OR=1.606).Conclusions Multifocalty,tumor size and thyroidal extension are the main predicative factors for central lymph node metastasis in PTMC.Among them,tumor foci ≥ 3 is an important predictor.Besides the conventional factors such as tumor size,thyroidal extension etc,multifocalty should also be taken into consideration.

Clinicopathological analysis of thyroid nodules with preoperative recurrent laryngeal nerve palsy / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the clinical significance of preoperative recurrent laryngeal nerve palsy (RLNP) for thyroid nodules with regard to the incidence of malignancy,recurrent laryngeal nerve involvement and histopathological character.METHODS Eighty patients with preoperative RLNP treated in Zhejiang Cancer Hospital between Jan 2007 to Dec 2014 were enrolled,their clinicopathological data were recorded and retrospectively analyzed.RESULTS Of 80 patients,16 patients had benign thyroid disease,while the other 64 had malignancies (80.0％).The preoperative RLNP incidence of benign and malignant lesions was 0.3％ and 0.9％ respectively.Poorly differentiated and anaplastic thyroid cancer had the higher incidence of preoperative RLNP comparing with other pathology types (25.93％,P＜0.05).The RLN did not preserved intraoperatively in 2 patients with benign lesions (2/16,12.5％) and in 42 patients with malignancy lesions (42/48,87.50％).All nerves were sacrificed in poorly differentiated and anaplastic thyroid cancer patients.The RLN could be isolated from 14 benign lesions and 6 malignancies,with or without adhesion,and the nerve function was recovered postoperatively.CONCLUSION The probability of preoperative RLNP is significantly higher in malignant lesions than benign lesions.Thyroid tumors with RLNP are strongly suggested of malignancy,with higher rate of intraoperative nerve sacrifice.The RLN should be preserved if it has not been invaded by the tumor,which offers a chance of functional recovery postoperatively.

Risk factors for central lymph node metastasis in papillary thyroid microcarcinoma:an analysis of 855 patients / 中国基层医药

Objective To investigate the clinical features of papillary thyroid microcarcinoma(PTMC) and the risk factors of central lymph node metastasis (CLNM) in PTMC patients.Methods The clinical data of 855 patients with PTMC who underwent prophylactic central lymph node dissection were retrospectively reviewed.Results In the present study,the rate of CLNM was 21.9％ (187/855) in PTMC patients.In the univariate analysis,the incidence of CLNM was significantly higher in male patients,age ＜ 45 years,tumor size ＞ 5 mm,capsular invasion,multiple tumor and intracapsular spread (31.4 ％ vs.19.5 ％,x2 =11.429,P =0.001;29.3 ％ vs.15.9 ％,x2 =22.416,P =0.000;30.0％ vs.14.3％,x2 =30.669,P=0.000;29.4％ vs.16.8％,x2 =19.233,P =0.000;30.0％ vs.19.9％,x2 =8.205,P =0.004;42.9％ vs.21.3 ％,x2 =5.549,P =0.018,respectively).Multivariate analysis showed that male gender,age ＜ 45 years,tumor size ＞ 5mm,multiplicity and capsular invasion were independent risk factors for CLNM in PTMC patients (95％ CI:0.380-0.834,0.349-0.693,1.450-3.060,1.078-2.229,1.024-2.373,respectively).Conclusion A routine prophylactic central lymph node dissection should be considered particularly in male PTMC patients with age ＜45 years,tumor size ＞5 mm,capsular invasion and tumor multiplicity.

Analysis of Intervention Effects by Clinical Pharmacist on the Use of Antibacterials during Perioperative Period of Hysteroscopic Surgery / 中国药房

OBJECTIVE:To explore the intervention effects by clinical pharmacist on the use of antibacterials during periopera-tive period of hysteroscopic surgery. METHODS:250 medical records of hysteroscopic surgery were collected from July to Septem-ber in 2014(before intervention)and from October to December in 2014(after intervention). The rationality of antibacterials dur-ing perioperative period was retrospectively analyzed before and after intervention. RESULTS:After intervention by clinical pharma-cists,the antibacterial use density decreased from 47.02 DDDs/(100 persons·day)to 23.30 DDDs/(100 persons·day),and the rate of perioperative use of antibacterial decreased from 82.40% to 57.20%,with significant difference(P<0.01). The rationality of medication indicators for perioperative application of antibacterials for hysteroscope increased from 56.80%to 82.52%;the rational-ity of medication duration increased from 49.51% to 79.02%,with significant difference(P<0.05). CONCLUSIONS:Clinical pharmacist's intervention is effective and feasible to perioperative application of antibacterials for hysteroscopic surgery. It could ef-fectively promote the rational use of antibacterials.

Rationality Analysis of Hydroxyethyl Starch Clinical Application in A Hospital / 中国药房

OBJECTIVE:To provide reference for the clinical rational application and preventing the adverse reactions of hy-droxyethyl starch(HES). METHODS:The HES application of inpatients in a hospital in Jul. 2014 were retrospectively analyzed, the usage and dosage,indications,and the changes of renal functions and blood coagulation function before and after HES treat-ment were detected,and the application rationality was evaluated. RESULTS:The usage of HES in the hospital was hydroxyethyl starch 200/0.5 and Sodium chloride injection,which was the second generation of HES. In the 347 patients,295 patients had moni-tored the renal functions before the HES treatment,the result was normal;and 21 patients had monitored the renal functions after HES treatment,the result was normal. Meanwhile,326 patients had monitored the blood coagulation functions before and after HES treatment,the results were normal. HES was not used for the patient of severe sepsis,renal dysfunctions and coagulopathy in this hospital. CONCLUSIONS:The application of HES can induce renal damage and coagulation disorder,so relevant indicators should be closely monitored before and after treatment to prevent the incidence of adverse reactions;further more,clinicians should strictly handle indications,usage and dosage and precautions during the clinical application;in addition,it is suggested to replace the second generation of HES by the third generation,which is more safer.

The application of pectoralis major myocutaneous flap in reconstruction of surgical defect for oropharyngeal ;cancer / 中国基层医药

Objective To explore the clinical value of using pectoralis major myocutaneous flap in surgery with various adverse factors for advanced oropharyngeal cancer.Methods 15 patients who presented with advanced oropharyngeal cancer were performed for radical surgery,and pectoralis major myocutaneous flaps were applied for immediate reconstruction of surgical defect.In all cases,various adverse factors(advanced age,diabetes,cardiovascular disease,radiation damage,etc.)were existed.The effect of reconstruction was observed.Results All surgeries were successful,and all patients tided over perioperative period.The average time of operation was 5 hours with a range of 4 to 6 hours.The average time cost for flap preparation was 40 minutes with a range of 40 to 55 minutes.The completely survival rate of flaps was 93%.Partial skin necrosis occurred in 1 case(7%);and submandibular fistula occurred in another one(7%).Two patients(13%)developed wound infection.All of them were healed by symptom-atic treatment.Conclusion For the patients with advanced oropharyngeal cancer and various adverse factors of sur-gery,pectoralis major myocutaneous flap can be used as salvage measure in reconstruction of surgical defect,which is more secure than free flap.

Study on tissue distribution and pharmacokinetics of moxifloxacin in the urogenital system by orally administration with single dose in rats / 重庆医学

Objective To explore the pharmacokinetics and tissue distribution in rats with a single dose by orally administra‐tion of moxifloxacin .Methods Totally 60 rats were equally divided into 10 groups with orally administration moxifloxacin for 50 mg/kg .The lungs ,uterus ,ovaries (tube) ,kidney ,ureter and bladder tissues were collected at different time points (before give med‐icine and after 0 .25 ,0 .50 ,1 .00 ,2 .00 ,3 .00 ,4 .00 ,6 .00 ,8 .00 ,12 .00 ,24 .00 h) .The concentrations of moxifloxacin in tissues were determined by the established HPLC method and the pharmacokinetic parameters were calculated by 3p97 .Results The established HPLC methods had good specificities ,and the linear range was between 0 .001 6-50 .000 0μg/mL for tissue sample .T1/2βof moxi‐floxacin were (13 .65 ± 3 .56) ,(12 .64 ± 2 .86) ,(13 .27 ± 3 .51) ,(13 .47 ± 3 .29) ,(14 .78 ± 2 .64) ,(11 .56 ± 1 .58)h in lung ,uterus , ureterine adnexa ,kidney ,ureter and bladder ;Cmax of moxifloxac in various tissues were (15 .61 ± 3 .58) ,(12 .48 ± 4 .57) ,(16 .18 ± 4 .21) ,(12 .65 ± 3 .17) ,(26 .68 ± 7 .42) ,(1 .13 ± 0 .58)μg/mL ;Tmax of moxifloxac in above tissues were (3 .15 ± 1 .24) ,(2 .66 ± 1 .74) ,(2 .97 ± 1 .65) ,(2 .58 ± 1 .36) ,(3 .47 ± 1 .84) ,(2 .46 ± 1 .87)h;AUC0 -t of moxifloxac in above tissues were (87 .2 ± 5 .41) , (70 .89 ± 4 .56) ,(92 .41 ± 7 .65) ,(88 .26 ± 6 .94) ,(170 .59 ± 21 .48) ,(14 .57 ± 5 .47)μg · h-1 · mL -1 .Conclusion Moxifloxacin had a higher concentration in ureterine adnexa and ureter by orally administration with single dose ,and it can maintain for a long time .

Salvage surgery for neck recurrence or residue of nasopharyngeal carcinoma after primary radiotherapy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the surgical procedures and prognosis for neck recurrence or residue of nasopharyngeal carcinoma(NPC) after primary radiotherapy.</p><p><b>METHODS</b>A total of 153 cases with neck recurrence or residue after radiotherapy in NPC who received salvage neck surgery between January 2001 and December 2011 were retrospectively analyzed. There were rN1 109 cases, rN2 17 cases and rN3 27 cases. Of them 17 cases received bilateral neck dissection(ND) simultaneously. The surgical procedures included the modified radical neck dissection (MRND) in 66 cases, radical neck dissection (RND) in 48 cases, selective neck dissection(SND) in 28 cases, enlarged radical neck dissection (ERND) in 16 cases, local excision in 9 cases, and parotidectomy in 3 cases. The Kaplan-Meier method was used to calculate survival curves, and the differences between groups were calculated by χ(2) tests.</p><p><b>RESULTS</b>There were 20 cases (13.1%) with lymph node(LN) metastasis in level I and 7 cases (4.6%) with parotid gland LN metastasis. The 3-year and 5-year overall survival rates were 57.2% and 40.6% respectively, and the median survival time was 49 months. Cox regression analysis revealed that rN staging, size of LN and age were the main prognosis factors for survival.</p><p><b>CONCLUSIONS</b>Salvage surgery was effective for neck recurrence or residue of NPC after primary treatment, and MRND and SND are reasonable options so as to improve functionality. Dissection of LN in level I and parotid gland should be selective. Patients with stage rN3 or LN > 6 cm or age > 50 years had poor prognosis.</p>

The clinical features and prognosis of radiotherapy associated sarcoma (RAS) following radiotherapy for nasopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features and prognosis of radiotherapy associated sarcoma (RAS) in the head and neck following radiotherapy for nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>The clinicopathologic data, diagnosis, treatment and follow-up results of 11 patients with RAS diagnosed between January 1995 and December 2011 at Zhejiang Cancer Hospital were analyzed retrospectively. Among these patients, 6 were males and 5 were females. Patients' ages ranged from 33 to 66 years (median 50 years). The latency period for development of the RAS was between 3 years and 23 years (median 7 years) after irradiation. Overall survival rate was calculated using the Kaplan-Meier method and Log rank test.</p><p><b>RESULTS</b>All cases underwent surgery, of them 6 casesachieved radical resection3 cases left with microscopic positive resection margins and 2 caseshad palliative surgery. Among 11 patients, 4 had re-surgery after recurrence, including 1 case had repeated surgeries followed by chemotherapy and radioactive seed implantation. Follow-up time ranged from 2 to 102 months, andeight patients died The 2-year, 3-year and 5-year cumulative survival rateswere 45.5%, 30.3% and 15.2%, respectively. The median survival time was 15 months. Surgical resection with clear margins achieved significantly better prognosis (P = 0.04).</p><p><b>CONCLUSIONS</b>The incidence of RAS after radiation of NPC is generally low, but the treatment of RAS is very difficult, with poor prognosis.</p>

Enrichment and functional characterization of cancer stem cells from squamous cell carcinoma of head and neck by suspension culture / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Initiation, growth, recurrence, and metastasis of head and neck squamous cell carcinoma (HNSCC) have been related to the cancer stem cells (CSC) that can be identified by their aldehyde-dehydrogenase-isoform-1 (ALDH-1) activity. In this study, we try to prove that suspension culture can enrich ALDH-1 high expression cells within HNSCC cell lines and the enriched cells possess cancer stem cell properties.</p><p><b>METHODS</b>Cells from five HNSCC cell lines were cultured in ultra-low attachment plates in serum-free Quantum 263 medium supplemented with 10 ng/ml EGF and 10 ng/ml bFGF, and ALDH-1 expression level was evaluated by ALDEFLUOR assay. ALDH-1 high expression cells were separated by FACS sorting, and their phenotypical and functional properties were characterized.</p><p><b>RESULTS</b>Spheroids can be formed from all five HNSCC cell lines (UD-SCC1, UT-SCC22, UM-SCC11B, UT-SCC9 and UT-SCC24A) under anchorage independent culture condition. The proportion of ALDH1 high expression cells were highly increased in speroids derived cells (SDCs) compared with their monolayers (P < 0.05). The clones formed by ALDH1 high expression cells on average contained 197 (197 ± 47) cells compared with 33 (33 ± 16) cells in clones generated from ALDH1 low expression cells (P < 0.01). Single ALDH1 high expression cell could significantly better regenerate a spheroid (UT-SCC9: 17.1%, UD-SCC1:19.3%), whereas under the same conditions single ALDH1 low expression cells regenerated only in one case a spheroid (P < 0.01). SDCs from all five tested cell lines also showed a significantly increased invasion capacity (P < 0.05). We also found that the mRNA levels of Oct-4, Sox2, and Nanog were all significantly increased in the SDC. The reactive oxygen species (ROS) levels in SDCs from UD-SCC1 and UT-SCC24A were significantly increased compared with their monolayer counterpart [(26.3 ± 4.9)% vs (8.6 ± 1.7)% and (72.1 ± 6.1)% vs (23.7 ± 7.5)%, P < 0.05)].</p><p><b>CONCLUSION</b>Cancer stem cells can be enriched by suspension culture, which may be of importance in investigation of their contribution to therapy resistance, tumor recurrence and metastasis.</p>

Pedigree screening of a Chinese multiple endocrine neoplasia type 2A family and prophylactic total thy-roidectomy / 中华内分泌外科杂志

Objective To explore the clinical significance of integrated screening of RET in a Chinese multiple endocrine neoplasia type 2A(MEN 2A)family and to evaluate the feasibility and effectiveness of prophy-lactic total thyroidectomy to MEN 2A-related medullary thyroid carcinoma ( MTC).Methods Medical history was obtained from 10 family members in a 3-generation south China family .Systemic investigations including bio-chemical tests, imaging examinations and germline RET screening were performed .3 asymptomatic mutation car-riers underwent prophylactic total thyroidectomy .Results RET screening showed a heterozygous missense muta-tion of TGC to CGC at codon 634 on exon 11 in 6 members(p.C634R), which was completely consistent with the clinical manifestations.There were 4 males and 2 females.The initial mean diagnostic age of 33.5 years(ranging from 19 years to 65 years) and the mean maximum diameter of MTC was 2.3 cm(ranging from 0.7 cm to 5.2 cm). Among them 3 members had palpable neck masses (1 case with diarrhea).Right total thyroidectomy +right level Ⅵlymph-node dissection with modified right neck dissection in one case , and bilateral total thyroidectomy +bilat-eral level Ⅵlymph-node dissection in 2 were performed .In other 3 asymptomatic mutation carriers , prophylactic total thyroidectomy +bilateral level Ⅵ lymph-node dissection were also performed .Among them, 1 case of a-symptomatic pheochromocytom ( PHEO) underwent cortical-sparing adrenalectomy before MTC .After the first op-eration, 4 patients still presented a high value of calcitonin , among whom 1 patient( T3N 1bM 0-1) underwent re-operation for 3 times after the initial operation and presented metastasis to bone after 130 months, taking vandet-anib orally up to now;2 patients underwent reoperation at 6 and 7 months after initial operation respectively (T1N 1bM0 and T2N 1bM0), and the other one patient was closely monitored and followed up for 22 months(T2N 1b M0).Moreover, The calcitonin levels dropped to normal in the other 2 asymptomatic cases(T1N0M0) who were followed up for 20 months.Conclusions Pedigree screening can work up an early diagnosis and improve the prognosis of MEN 2A.Integrated screening of RET and pre-operative calcitonin level measurement and prophylac-tic thyroidectomy for asymptomatic RET mutation carriers are reasonable and effective .

Oncogene Pim-1 and tumor / 国际肿瘤学杂志

Oncogene Pim-1 has a close relationship with the occurrence and development of several tumours.It is involved in a number of signal transduction pathways and regulates the expression of the downstream biological factors or acts synergistically with other oncogenes.Pim-1 plays an important role in the clinical diagnosis,treatment and prognosis of some tumors,and provides a new potential target in the chemotherapy of tumors.Recently,Pim-1-targeting treatment strategy has be a research hotspot and it would be used for cancer clinical treatment hopefully.