Biallelic mutations in spermatogenesis and centriole-associated 1 like (SPATC1L) cause acephalic spermatozoa syndrome and male infertility / 亚洲男科学杂志(英文版)

Acephalic spermatozoa syndrome is a rare type of teratozoospermia that severely impairs the reproductive ability of male patients, and genetic defects have been recognized as the main cause of acephalic spermatozoa syndrome. Spermatogenesis and centriole-associated 1 like (SPATC1L) is indispensable for maintaining the integrity of sperm head-to-tail connections in mice, but its roles in human sperm and early embryonic development remain largely unknown. Herein, we conducted whole-exome sequencing (WES) of 22 infertile men with acephalic spermatozoa syndrome. An in silico analysis of the candidate variants was conducted, and WES data analysis was performed using another cohort consisting of 34 patients with acephalic spermatozoa syndrome and 25 control subjects with proven fertility. We identified biallelic mutations in SPATC1L (c.910C>T:p.Arg304Cys and c.994G>T:p.Glu332X) from a patient whose sperm displayed complete acephalia. Both SPATC1L variants are rare and deleterious. SPATC1L is mainly expressed at the head-tail junction of elongating spermatids. Plasmids containing pathogenic variants decreased the level of SPATC1L in vitro. Moreover, none of the patient's four attempts at intracytoplasmic sperm injection (ICSI) resulted in a transplantable embryo, which suggests that SPATC1L defects might affect early embryonic development. In conclusion, this study provides the first identification of SPATC1L as a novel gene for human acephalic spermatozoa syndrome. Furthermore, WES might be applied for patients with acephalic spermatozoa syndrome who exhibit reiterative ICSI failures.

Effect of laparoscopic surgery for pancreatic cancer after neoadjuvant chemotherapy / 中华外科杂志

Objective: To evaluate the safety and feasibility of laparoscopic surgery after neoadjuvant chemotherapy for pancreatic cancer. Methods: Clinical data of 8 patients underwent laparoscopic surgery after neoadjuvant chemotherapy for pancreatic cancer at Fudan University Shanghai Cancer Center from September 2019 to June 2020 were reviewed retrospectively. There were 5 males and 3 females,aged from 47 to 72 years old. All patients underwent abdominal enhanced CT and PET-CT before operation to accurately evaluate the tumor stage and exclude distant metastasis. Results: Neoadjuvant chemotherapy with AG regimen(gemcitabine 1 000 mg/m2 and albumin bound paclitaxel 125 mg/m2) was received for 2 to 6 cycles before surgery. All 8 patients successfully completed the operation,including 5 cases of pancreaticoduodenectomy,2 cases of radical antegrade modular pancreatosplenectomy(RAMPS),and 1 case of total pancreatectomy. No conversion to laparotomy or laparoscopic assisted surgery. The operation time was 240 to 450 minutes,the blood loss was 100 to 500 ml,the postoperative length of stay was 10 to 16 days. During the follow-up period up to December 31, 2020, there was 1 case suffered grade B pancreatic leakage and abdominal infection. The numbers of resected lymph nodes were 9 to 31. All patients received R0 resection. The follow-up times were 4.5 to 9.5 months. One patient underwent RAMPS was diagnosed as liver metastasis after 2 months of the operation,and the other 7 patients still survived without tumor recurrence. Conclusion: Minimally invasive surgery of pancreatic cancer after neoadjuvant chemotherapy is safe and feasible in experienced pancreatic minimally invasive centers.

A single nucleotide polymorphism in the Epstein-Barr virus genome is strongly associated with a high risk of nasopharyngeal carcinoma / 癌症

<p><b>BACKGROUND</b>Epstein-Barr virus (EBV) commonly infects the general population and has been associated with nasopharyngeal carcinoma (NPC), which has a high incidence in certain regions. This study aimed to address how EBV variations contribute to the risk of NPC.</p><p><b>METHODS</b>Using logistic regression analysis and based on the sequence variations at EBV-encoded RPMS1, a multi-stage association study was conducted to identify EBV variations associated with NPC risk. A protein degradation assay was performed to characterize the functional relevance of the RPMS1 variations.</p><p><b>RESULTS</b>Based on EBV-encoded RPMS1 variations, a single nucleotide polymorphism (SNP) in the EBV genome (locus 155391: G>A, named G155391A) was associated with NPC in 157 cases and 319 healthy controls from an NPC endemic region in South China [P < 0.001, odds ratio (OR) = 4.47, 95% confidence interval (CI) 2.71-7.37]. The results were further validated in three independent cohorts from the NPC endemic region (P < 0.001, OR = 5.20, 95% CI 3.18-8.50 in 168 cases vs. 241 controls, and P < 0.001, OR = 5.27, 95% CI 4.06-6.85 in 726 cases vs. 880 controls) and a non-endemic region (P < 0.001, OR = 7.52, 95% CI 3.69-15.32 in 58 cases vs. 612 controls). The combined analysis in 1109 cases and 2052 controls revealed that the SNP G155391A was strongly associated with NPC (P(combined) < 0.001, OR = 5.27, 95% CI 4.31-6.44). Moreover, the frequency of the SNP G155391A was associated with NPC incidence but was not associated with the incidences of other EBV-related malignancies. Furthermore, the protein degradation assay showed that this SNP decreased the degradation of the oncogenic RPMS1 protein.</p><p><b>CONCLUSIONS</b>Our study identified an EBV variation specifically and significantly associated with a high risk of NPC. These findings provide insights into the pathogenesis of NPC and strategies for prevention.</p>

Management and prognostic factors for 119 patients with follicular thyroid carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the optimal management and analyze the prognostic factors for follicular thyroid carcinoma.</p><p><b>METHODS</b>The clinicopathological data of 119 patients with well-differentiated follicular thyroid carcinoma treated in our hospital from 1970 to 2008 were retrospectively reviewed. The overall survival (OS) rate was estimated by Kaplan-Meier method. Log rank and Cox regression analyses were used to identify the prognostic factors.</p><p><b>RESULTS</b>The 5- and 10-year OS rates were 81.1% and 66.7%, respectively. The 3- , 5- and 10-year cumulative distant metastasis rates were 27.4%, 29.6% and 35.9%, respectively. The age of ≥ 45 years old was one of the most important factors affecting survival rate (P < 0.05) and an independent factor for distant matastasis.</p><p><b>CONCLUSIONS</b>Follicular thyroid carcinoma has some special features such as diffuse growth and vascular tumors thrombosis and with a relatively poor prognosis. The key measure to improve local control and prognosis is radical resection. Some aggressive management such as total thyroidectomy combined with (13)1I therapy and regular follow-up should be performed to improve the survival rate and to control postoperative distant metastasis for patients ≥ 45 years old.</p>

Primary squamous cell carcinoma of the thyroid: retrospective analysis of 28 cases / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological features, treatment outcomes and prognosis of patients with squamous cell carcinoma of the thyroid (SCCT).</p><p><b>METHODS</b>Retrospective review of SCCT cases in our hospital from January 1999 to May 2012. Demographic data and clinical charts, including presenting symptoms, histologic grade of tumor, treatment, and outcome of 28 consecutive patients were obtained. Survival rates and prognostic factors were calculated with SPSS 13.0 software using the Kaplan-Meier method and multivariate Cox model survival analysis.</p><p><b>RESULTS</b>SCCT accounted for only 0.36% of all types of thyroid malignancy. There were 15 males and 13 females, and the median age was 63 years. The presenting symptoms were neck masses (26/28) and hoarse voice (18/28). The 28 SCCTs included 15 high grade tumors, eight intermediate grade tumors and five low grade tumors. According to the UICC 2002 staging criteria, 16 patients were stage IVa, and 12 were stage IVb. Of the 28 patients, 19 underwent surgery plus postoperative radiotherapy, seven underwent surgery alone, and two received radiotherapy alone. The rates of lymph node metastasis and distant metastasis were 60.7% and 25.0%, respectively. The 1-year, 2-year and 5-year overall survival (OS) rate were 50.4%, 25.8% and 19.3%, respectively, and the median overall survival time was 12.2 months. Kaplan-Meier univariate survival analyses indicated that the sizes of the tumors, esophageal invasions and treatment policies are prognostic factors, and multivariate Cox model survival analyses confirmed that the sizes of the tumors and treatment policies were independent factors for OS. Multivariate survival analyses confirmed that the sizes of the tumors and treatment policies were independent factors for OS.</p><p><b>CONCLUSIONS</b>SCCT is a rare malignant tumor with strong invasive ability, high malignancy and poor prognosis. Combined modality therapy was strongly recommended, and surgical resection plus postoperative radiotherapy may be the main treatment protocol for patients with SCCT.</p>

Clinical analysis of squamous cell carcinoma of the subglottis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics, pattern of lymph node metastasis, optimal management and relative prognostic factors of subglottic squamous cell carcinoma.</p><p><b>METHODS</b>A retrospective review was conducted in 36 cases with subglottic squamous cell carcinoma from 1970 to 2005. TNM staging showed 6 patients with stage I, 9 stage II, 8 stage III and 13 stage IV (AJCC 2010). Eight of these 36 cases were treated with radiotherapy alone, 18 with surgery alone and 10 with surgery plus perioperative radiotherapy. The overall 5-year survival rate was estimated by the Kaplan-Meier method according to different clinical stages and treatments. Log-Rank analysis was used to identify the prognostic factors.</p><p><b>RESULTS</b>The overall 5-year survival rate was 58.2%, and 5-year survival rates were 66.7%, 66.7%, 62.5% and 30.8% for patients with stage I, II, III and IV, respectively, and the rates were 43.8%, 66.7% and 51.9% for radiotherapy alone, surgery alone, surgery plus perioperative radiotherapy, respectively. The 5-year survival rate of patients with stage I-III was significantly higher than that of patients with stage IV (χ(2) = 3.955, P < 0.05). Pathologically confirmed positive rate of cervical lymph node was 25.0% (9/36), and the positive cervical lymph nodes were mainly distributed in level VI, followed by level II. The 5-year survival rate of patients with negative cervical lymph node was significantly higher than that of patients with positive cervical lymph node (χ(2) = 6.466, P < 0.05).</p><p><b>CONCLUSIONS</b>The prognosis of subglottic squamous cell carcinoma was relatively poor. Total laryngectomy was the the main therapeutic management, and only part of the early cases could be treated with radiotherapy alone or partial laryngectomy. For locally advanced cases, the typical neck dissection including level II-IV and VI should be performed.</p>

Interleukin-1 receptor antagonist gene polymorphism in patients with multidrug-resistant Acinetobacter baumannii-associated pneumonia

Multidrug-resistant Acinetobacter baumannii [MDRAB]-associated pneumonia has been a common disease and a therapeutic problem in hospitals. Interleukin-1 receptor antagonist [IL-1ra] has been considered a required role for host immune defense in pneumonia disease. The aim of this study was to investigate whether the variable nucleotide tandem repeat polymorphism of the IL-1ra gene was associated with MDRAB-related pneumonia. Sixty-six pneumonia patients were enrolled in the study: 36 subjects had MDRAB-related pneumonia and 30 controls had non-MDRAB pneumonia. Polymerase chain reaction, restriction fragment length polymorphism, and agarose gel electrophoresis techniques were used to determine the IL-1ra genotype. The frequencies of the IL-1ra genotype in the MDRAB-related pneumonia cases were A1/A1, 0.889 and A1/A2, 0.111; the frequencies of the IL-1ra genotype in the controls were A1/A1, 0.333 and A1/A2, 0.667. A statistically significant difference was determined [P < 0.05]. We also observed an increase in the frequency of IL-1ra A1 allele in the MDRAB-related pneumonia group. A statistically significant difference was determined [P<0.05]. We suggested that IL-1ra polymorphism was associated with the risk of MDRAB-related pneumonia

Association of genetic polymorphisms of glutamate decarboxylase 2 and the dopamine D2 receptor with obesity in Taiwanese subjects

It has been proposed that glutamate decarboxylase 2 and the dopamine D2 receptor are involved in the brain reward cascade to increase carbohydrate craving and cause eating disorders. We investigated the association between the polymorphisms of the CAD2 and DRD2 genes and obesity with a higher body mass index [BMI] in Taiwanese patients. A retrospective, case-control study at Antai Tian-Sheng Memorial Hospital from 1 January to 31 December 2009. Of 300 subjects enrolled in the study, 132 were obese [BMI>30 kg/m[2]] and 168 controls were not obese [BMI

Adenoid cystic carcinoma of maxillary sinus: diagnosis, treatment and prognostic factors / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the clinical characters, the outcomes of treatments and the factors affecting long-term treatment results of adenoid cystic carcinoma (ACC) of the maxillary sinus.</p><p><b>METHODS</b>The clinical data of 80 patients with ACC of the maxillary sinus treated initially were analyzed retrospectively. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Prognosis factors were analyzed by Log-rank test and Cox regression.</p><p><b>RESULTS</b>The 5-, 10- and 15-year cumulative overall survival rates were 65.2%, 37.1%, 26.3% respectively and 5-, 10-, and 15-year disease-free survival rates 50.7%, 30.7% and 24.5% respectively. The 5-, 10- and 15-year cumulative local control rates were 68.5%, 47.3% and 47.3% respectively and the cumulative distant metastasis rate were 32.8%, 48.8% and 48.8% respectively. Prognostic factors affecting survival included T stage, pathologic grade and the modes of treatment (P < 0.05). Patients with combined therapy composed of surgery and radiation had a better local control, compared with surgery or radiation alone (χ(2) = 18.33, P < 0.01), and surgery combined with postoperative radiation was prior to preoperative radiation combined with surgery (χ(2) = 6.64, P < 0.05). Patients treated with surgery combined with preoperative radiation, either with doses of ≥ 60 Gy or with negative margins, had a better local control, compared with doses < 60 Gy and with positive margins (χ(2) = 5.06, P < 0.05). The most of patients (62.8%) died of local recurrence.</p><p><b>CONCLUSIONS</b>The most of failure was due to recurrence. Combined therapy composed of surgery and radiation improves the local control and survival in patients with ACC of the maxillary sinus, compared with surgery or radiation alone. Surgery combined with postoperative radiation provides the best overall survival and local control and should be the first choice of treatments.</p>

Salvage surgery after failure of partial laryngectomy for laryngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study surgical managements, outcomes and the factors affecting prognosis of the primary recurrence following partial laryngectomy for laryngeal carcinoma.</p><p><b>METHODS</b>The clinical data of 77 patients with salvage surgery for primary recurrence following partial laryngectomy for laryngeal carcinoma were analyzed retrospectively. Fifty-one patients underwent salvage total laryngectomy and other 26 patients with salvage partial laryngectomy. Of them, 19 patients without previous radiotherapy received a combined therapy of surgery and radiotherapy. Survival rates were analyzed using Kaplan-Meier method. Prognosis factors were analyzed by Log-rank test and Cox regression.</p><p><b>RESULTS</b>After salvage surgery, the 3-and 5-year cumulative overall survival rates were 59.1% and 52.7% respectively, and both the 3- and 5-year local recurrence rates were 30.7%. Most patients (48.4%) died of the failure at the primary sites. Multivariate analysis revealed the advanced T stage at initial presentation and the extra-laryngeal invasion of recurrent tumor were adverse prognostic factors for survival rate and also the advanced T stage at initial presentation influenced local recurrence rate.</p><p><b>CONCLUSIONS</b>Salvage surgery for the primary recurrence following conservation treatment for laryngeal carcinoma can achieve promising results. Salvage total laryngectomy is the main therapeutic management in most recurrent patients. Salvage partial laryngectomy can achieve sound results in the patients selected carefully.</p>

Malignant minor salivary gland tumors of the larynx / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the clinical features, treatment and prognosis of malignant minor salivary gland tumors of the larynx.</p><p><b>METHODS</b>Treatment and outcome were retrospectively analyzed in a consecutive series of 15 patients with malignant minor salivary gland tumors of the larynx treated in this hospital from 1959 to 2005. Ten patients (66.7%) had adenoid cystic carcinoma and 2 (13.3%) had adenocarcinoma. The other three patients had mucoepidermoid carcinomas, polymorphic adenocarcinoma and base cell carcinoma respectively. Eleven (73.3%) were located in the supraglottis and 4 (26.7%) in the subglottis. Fourteen had surgery (7 with adjuvant radiotherapy) and one was treated with radiotherapy plus chemotherapy. Five patients were found to have recurrent disease, 4 of whom underwent salvage surgery, 1 of whom had palliation radiotherapy.</p><p><b>RESULTS</b>With a median follow-up of 8 years (ranging from 2 to 16 years), 7 patients are alive. Five patients have no evidence of disease, 1 of whom had surgery alone, 4 of whom were treated with surgery plus radiotherapy. Four patients died of distant metastases in a range of 2 to 10 years. The other 4 patients were lost to follow-up after treatment (ranging from 2 years to 16 years). Seven patients developed recurrent disease, 1 of whom had local recurrence alone, 1 had regional recurrence alone, 2 had distant metastases alone, and 3 had local and distant metastases.</p><p><b>CONCLUSIONS</b>Minor salivary gland carcinomas of the larynx are rare and they are prone to the local recurrence and the distant metastasis in advanced stage. Distant metastases remain the principal cause of treatment failure. Surgery is the primary treatment modality used in most cases and the radiotherapy combining surgery has better local and regional control rate.</p>

Comparative study on risk factors and family history of familial and sporadic nasopharyngeal carcinoma patients / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the difference between familial and sporadic nasopharyngeal carcinoma patients on risk factors and family history and provide evidence on genetic counseling and screening strategy for relatives of nasopharyngeal carcinoma patients in Guangdong province.</p><p><b>METHODS</b>The Cantonese nasopharyngeal carcinoma patients diagnosed in Cancer Center, Sun Yat-sen University from October, 2005 to October, 2007 were recruited as subjects. 1877 patients were collected, including 181 familial nasopharyngeal carcinoma patients and 1696 sporadic nasopharyngeal carcinoma patients. The demographic characteristics, clinical characteristics, risk factors and family history between two groups were compared. Moreover, the distribution of nasopharyngeal carcinoma patients in first-degree relatives and the time interval between proband and the affected first-degree relatives in familial nasopharyngeal carcinoma patients was analyzed.</p><p><b>RESULTS</b>All 9.64% of 1877 nasopharyngeal carcinoma patients had affected relatives in first-degree relatives, among them, 58.49% (124/212) were siblings and 41.51% (88/212) were parents. The mean time interval between siblings and proband were (7.40 +/- 5.41) years while the mean time interval between parents and proband were (15.55 +/- 10.61) years when nasopharyngeal carcinoma occurred, and the difference was statistically significant (t = -5.78, P < 0.01). More than 80% patients of the two group were at advanced stage when they were diagnosed. There were no difference (P values were all > 0.05) both in adulthood and childhood in salted fish (OR = 1.01; 95% CI: 0.59 - 1.75 vs OR = 1.31; 95% CI: 0.92 - 1.86), preserved vegetables (OR = 0.93; 95% CI: 0.58 - 1.49 vs OR = 1.12; 95% CI: 0.80 - 1.57), fermented pastes (OR = 0.37; 95% CI: 0.14 - 1.01 vs OR = 1.61; 95% CI: 0.99 - 2.48), fresh fruits (OR = 0.87; 95% CI: 0.60 - 1.26 vs OR = 0.65; 95% CI: 0.20 - 2.12) and cured meat (OR = 1.26; 95% CI: 0.87 - 1.83 vs OR = 1.28; 95% CI: 0.71 - 2.30) diet. No significant difference (P > 0.05) was obtained on smoking (OR = 0.99; 95% CI: 0.68 - 1.45) and incidence of other cancers in first-degree relatives (OR = 0.85; 95% CI: 0.56 - 1.28) in the two groups.</p><p><b>CONCLUSION</b>Familial nasopharyngeal carcinoma was 9.64% in the observed subjects. In the familial nasopharyngeal carcinoma, the time interval at diagnosis was shorter between proband and siblings as compared with parents. Most of the patients were at advanced stage. So, we recommend the first-degree relatives of nasopharyngeal carcinoma patients, especially siblings, should be screened regularly according to the specific conditions.</p>

Distribution of cervical lymph node metastasis in well-differentiated thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the distribution of cervical lymph nodes metastases in patients with differentiated thyroid carcinoma, explore the surgical modality of the neck of cN + cervical node metastasis and evaluate the role of preoperative ultrasonography in detecting of cervical metastases of differentiated thyroid carcinoma.</p><p><b>METHODS</b>Data were reviewed retrospectively from medical records between July 2003 and July 2005, in which 93 patients (113 sides) of differentiated thyroid carcinoma patients with cN + cervical lymph nodes metastasis. Patients were divided into 2 groups: group 1, 64 cervical sides with preoperative palpable cervical lymph nodes; group 2, 49 cervical sides with impalpable node but preoperative ultrasonic positive nodal metastasis. All the pathologic specimens were reviewed by pathologists counting the numbers of pathologic positive nodes and mapping localization of positive nodes in level II, III, IV, V and VI respectively.</p><p><b>RESULTS</b>In 93 patients 21.5% (20/93) of those metastasize bilaterally. In those 113 sides specimens 92 sides (81.4%) involved multi-sites in the neck. The distribution of metastasized nodes were; level II, 60.2% (68/113); level III, 70.8% (80/113); level IV,61.9% (70/113); level VI, 58.4% (66/113); level V, 22.5% (25/113). The numbers of positive nodes of group 1 were more than the number of group 2 (10.1 vs 6.9) and the involved levels of group 1 was also more than the levels of group 2 (3.18 level vs 2.61 level). Preoperative ultrasonography could detect 43.4% (49/113) of lymph nodes metastasis that were missed by palpation in the physical examination.</p><p><b>CONCLUSIONS</b>The distribution of the cervical nodes in patients with differentiated thyroid carcinoma were multi-levels in the neck and mainly localized in level II , level III, level IV and level VI. Preoperative ultrasonography is a mainstay in detecting of cervical lymph nodes metastasis in thyroid cancer. For patients with differentiated thyroid carcinoma of cN + cervical lymph nodes should be undergone modified neck dissection, includes level II, III, IV, V, VI.</p>

Therapeutic modalities of nasopharyngeal adenoid cystic carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To grasp clinical characteristics, therapeutic methods and prognosis of the patients with nasopharyngeal adenoid cystic carcinoma, and explore the optimal therapeutic modalities.</p><p><b>METHODS</b>Twenty one cases with nasopharyngeal adenoid cystic carcinoma were retrospectively reviewed. The treatment results were compared between radiotherapy alone and combined therapy.</p><p><b>RESULTS</b>The cases with nasopharyngeal adenoid cystic carcinoma in T1, T2 phases was 28.6%, the cases in T3, T4 phases was 71.4%. The lymphatic node metastasis rate was 14.3%. The present symptoms were nasal discharge with blood, headache, nasal obstruction, deafness, double vision, facial insensibility, etc. One of 21 cases was lost follow up. Five years free-disease survival rates of the patients with nasopharyngeal adenoid cystic carcinoma was 42.9% (9/21). Five years free-disease survival rate of the patients with radiotherapy alone (RA) and the patients with radiotherapy combining surgery (R + S) were respectively 38.5% (5/12) and 50.0% (4/8), P = 0.472. Ten years free-disease survival rates of the patients was 16.7% (3/18). Ten years free-disease survival rates of the patients with RA and the patients with R + S were respectively 0/12 and 3/6, P = 0.025. The local recurrent rate was 50.0% (10/20). The local recurrent rates of the patients with RA and the patients with R + S were respectively 66.7% (8/12) and 25.0% (2/8), P = 0.085. The distant metastasis rate was 30. 0% (6/20). The distant metastasis rates of the patients with RA and the patients with R + S were respectively 25.0% (3/12) and 37.5% (3/8), P = 0.455.</p><p><b>CONCLUSIONS</b>The course of nasopharyngeal adenoid cystic carcinoma is long, and it is prone to the local recurrence and the distant metastasis in advanced stage. Comparing with the radiotherapy alone, the radiotherapy combining surgery has better 10 years free-disease survival rate.</p>

Preparation of nimodipine-loaded PLEG copolymer nanoparticles and quality evaluation / 中国基层医药

Objective To improve the poor water-solubility of nimodipine,nimodipine-loaded PLEG copoly- met nanopartieles were prepared to avoid the sedimentation of its crystal from water,which could also shun the blood vessel stimulation caused by ethanol,a cosolvent,in the injection.Methods Solvent evaporation method was used to prepare water-dispersing nimodipine-loaded nanoparticles,whose lyophilized powder was further prepared,with PLEG2000 as drug carrier.Particle size,Zeta potential,embedding ratio,drug loading,shape and redispersion ability of the lyophilized powder were determined.Results Concerning the lyophilized nanoparticle powders,the particle sizes were 136nm,the Zeta potentials were -29.90mV,the embedding ratio was 67.9% and the drug loading was 6.17%.Conclusion Prepared nimodipine-loaded nanoparticles solved the problem of poor water-solubility of ni- modipine basically.It also avoided the recrystallization process of the drug and reduced the blood vessel stimulation caused by ethanol in the injection.

Allograft replacement in management of giant cell tumor of bone: a report of 77 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the functional outcome and the complications of allograft replacement in management of giant cell tumors of bone.</p><p><b>METHODS</b>Seventy-seven patients who underwent bone tumor resection and massive allograft reconstruction of bone defects between 1992 and 2002 were evaluated. The length of the resected part ranged from 5 to 11 centimeters. Fresh-frozen allografts were employed as osteoarticular grafts (n = 47), hemi-condylar (n = 12), massive (n = 14) or allograft-prosthesis composite (n = 4). Most of the lesions located in proximal and distal femur, proximal tibia and humerus. The oncological parameters that were evaluated including survival of the patient, local recurrence, and metastasis. The radiographic parameters included time to union, stability of the joint, fracture of the allograft. Mankin evaluation system was used to assess functional outcome.</p><p><b>RESULTS</b>At a median of 35 months (range from 12 to 135 months) after the operation, 76 of the patients in the study group were free of disease, and one had died of disease. Eleven (14.1%) patients had local recurrence and 12 (15.4%) nonunion. Late complications included 5 (6.4%) fractures of the allograft and 5 (6.4%) infections of the graft. Instability of the joint in the form of subluxation was noted in 5 (6.4%) patients. One extremity were amputated due to local recurrence. On the basis of Mankin functional evaluation, the total satisfied rate was 83.2 percent. Osteoarticular graft got the highest score (91.5%) and hemi-condylar got the lowest (66.6%). Massive grafts and composite were at the middle (ranges from 71.4% to 75%).</p><p><b>CONCLUSION</b>Allografts offer many types of reconstruction for bony defects after tumor resection. The functional results are comparable to other methods of reconstruction, and once incorporated by the host, offer the advantage of longevity. It is also a method with high complication, and decreasing the complications could improve the functional score. Less resection could get better reconstruction and better function, less margin resulted at the same time. The risk of recurrence increases when less surgical margin achieves. The main end-result-influencing factor is local recurrence.</p>

Diagnosis, treatment and prognostic factors of adenoid cystic carcinoma of the palate / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the clinical characteristics, diagnosis, treatment and prognosis of adenoid cystic carcinoma of the palate.</p><p><b>METHODS</b>A retrospective review was conducted in 42 patients with adenoid cystic carcinoma of the palate treated in our hospital from 1967 to 1998. Statistical analysis was performed using the Kaplan-Meier method. Prognostic factors were analyzed by Log Rank test.</p><p><b>RESULTS</b>The overall 5-, 10-, 15-year accumulative survival rates were 85.0%, 61.8% and 28.1%, and the 5-, 10-, 15-year accumulative disease-free survival rates were 52.4%, 32.7% and 22.4%, respectively. The 5-, 10-, 15-year accumulative local recurrence rates were 25.2%, 50.9% and 73.1%, and the 5-, 10-, 15-year accumulative distant metastasis rates were 28.5%, 50.4% and 66.0% respectively. T stage, bone invasion, extent of tumor, local recurrence and distant metastasis were significant prognostic factors. Treatment method, dose and area covered by radiotherapy were related to the prognosis.</p><p><b>CONCLUSION</b>Surgery alone can be done for early lesions, and combination of surgery with radiotherapy should be adopted for advanced lesions in adenoid cystic carcinoma of the palate. Radiotherapic salvage could prolong the survival of the locally recurrent patients.</p>