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Objective:To compare the long-term prognosis between open versus closed reduction and internal fixation in the treatment of unstable pelvic fractures.Methods:The data of 402 consecutive patients with unstable pelvic fracture were retrospectively analyzed who had been treated at The First Medical Center and The Fourth Medical Center, PLA General Hospital, and Strategic Support Force Specialty Medical Center from March 2011 to March 2017. This cohort was divided into 2 groups according to the reduction methods. In the open group of 194 cases subjected to open reduction and internal fixation, there were 133 males and 61 females with a median age of 43.0 (30.7, 51.0) years, and 35 cases of type B and 159 cases of type C by the Tile classification. In the closed group of 208 cases subjected to closed reduction and internal fixation, there were 115 males and 93 females with a median age of 45.5 (32.0, 56.0) years, and 40 cases of type B and 168 cases of type C by the Tile classification. The 2 groups were compared in terms of 12-items Short Form Health Survey (SF-12) scores [physical component summary (PCS) and mental component summary (MCS)] at the last follow-up, time from injury to operation, frequency of intraoperative X-ray fluoroscopy, intraoperative and postoperative blood transfusion, operation time, and quality of postoperative fracture reduction.Results:There was no statistically significant difference between the 2 groups in the preoperative general data except for the gender, showing the 2 groups were comparable ( P>0.05). This cohort of 402 patients was followed up for 7.8(6.2, 8.8) years. At the last follow-up, the PCS [49.9 (45.4, 55.4) points] and MCS [53.1 (46.4, 57.6) points] in the closed group were significantly higher than those in the open group [48.2 (41.4, 52.7) and 46.5 (40.6, 53.6) points] ( P<0.05). The closed group incurred significantly shorter time from injury to operation [6 (5, 8) d] and operation time [180 (126, 260) min] than the open group [9 (6, 13) d and 240 (165, 334) min], significantly less intraoperative and postoperative blood transfusion [1.5 (0, 4.0) U] than the open group [5.0 (2.9, 8.0) U], significantly higher frequency of intraoperative X-ray fluoroscopy [104.5 (85.0, 132.0) times] than the open group [21.0 (18.0, 26.0) times], and a significantly higher excellent and good rate of postoperative fracture reduction (92.8%, 193/208) than the open group (86.6%, 168/194) (all P<0.05). Conclusion:In the treatment of patients with unstable pelvic fractures, compared with open reduction and internal fixation, closed reduction and internal fixation can not only significantly shorten the waiting time and operation time of patients, reduce the transfusion during operation, but also achieve better fracture reduction to ultimately improve the quality of life of patients.
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Objective:To introduce a novel clinical classification that can be applied to osteoradionecrosis treatment in an easy and considerably acceptable manner through a retrospective analysis of patients with osteoradionecrosis of the mandible (ORNM). Methods:The clinical data of 99 ORNM patients admitted to shanghai Ninth People's Hospital between 2000 and 2013 were summa-rized. A novel classification was established based on bone necrosis and soft tissue lesions. The new staging system was developed based onBandSclassifications. Corresponding strategies and methods of ORNM treatment at different stages were also proposed. Results:A new staging system with four different stages (i.e., stage 0:8 cases;stageⅠ:14 cases;stageⅡ:65 cases;and stageⅢ:12 cases) was proposed. Conservative treatment was applied to stage 0 patients, whereas sequestrectomy was performed in stageⅠcases. Marginal or segmental resection of the mandible was selected for stageⅡpatients;osteocutaneous flap or just soft tissue flap was also reconstructed. Conclusion:This new classification and staging system is easier to use and more acceptable for clinical evaluation than other systems.
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<p><b>OBJECTIVE</b>The objective of this study is to investigate the effect of epidermal growth factor receptor (EGFR) monoclonal antibody MAb225 on repair of DNA double strand break (DNA-DSB) after radiation in tongue squamous cell carcinoma cell.</p><p><b>METHODS</b>The single cell gel electrophoresis (SCGE) was performed to estimate the repair of DNA-DSB induced by radiation in human tongue carcinoma cells Tca8113 treated with or without MAb225. Expression of Ku70 and Ku80 were detected by semiquantitative reverse transcription polymerase chain reaction and Western bolt.</p><p><b>RESULTS</b>Comet tail moment of MAb225 treated cell was significantly higher than untreated cell (P < 0.05). The expression of Ku70 and Ku80 were inhibited by MAb225.</p><p><b>CONCLUSION</b>MAb225 can inhibit repair of DNA-DSB induced by down-regulated expression of Ku70 and Ku80.</p>
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Humanos , Anticorpos Monoclonais , Antígenos Nucleares , Reparo do DNA , Proteínas de Ligação a DNA , Autoantígeno Ku , Receptores ErbB , Neoplasias da LínguaRESUMO
Objective To prospectively assess the influence of intensity-modulated radiotherapy (IMRT) and conventional radiotherapy on quality of life (QOL) in patients with head and neck cancer (HNC) for clinical guidance. Methods From May 2007 to May 2008, 102 HNC patients were enrolled in this study. Fifty-two patients were treated with IMRT and 50 with conventional radiotherapy. In patients with IMRT, at least one parotid gland was spared, and the contralateral submandibular gland was spared in 24 patients. The parotid and submandibular gland were not spared in patient with conventional radiotherapy.QOL was assessed using EORTC QLQ C30 and HN35 questionnaires at 4 time points (before radiotherapy,end of radiotherapy, 2 months and 6 months after radiotherapy). A change of 10% in scores of the instru-ment range had been previously demonstrated to be clinically significant. Results In the study, 94% (31/33) of the QOL domains were worse after IMRT or conventional radiotherapy, including 49% (16/33) with significant difference (U=2.72-5.98, all values of P<0.01) and 33% (11/33) with clinical signifi-cance. At 2 months after radiotherapy, 12% (4/33) of the domains showed clinically significant improve-ment, however, 15% (5/33) of the domains did not show any improvement (U=3.10-5.93,all value of P < 0.01). Continuous improvement in most domains of QOL was shown at 6 months after radiotherapy. Clini-cally and statistically significant improvement were shown in 21% (7/33) of the domains, and some were even better than pretreatment except in dry mouth and sticky saliva scales (U=4.49 , P<0.01 and U=4.87 ,P <0.01). Compared with conventional radiotherapy, the dry mouth and sticky saliva caused by IM-RT were milder (U=4.57,P <0.01 and U=5.57, P < 0.01) and continuous improvement were shown over time after radiotherapy (U=7.23, P <0.01 and U = 7.57, P < 0.01). Similar improvement weren't shown in patients with conventional radiotherapy. Conclusions QOL in HNC patients is significant worse after ra-diotherapy. QOL can be improved continuously over time after treatment except dry mouth and sticky saliva which are the main factors affecting QOL. IMBT, causing less dry mouth and sticky saliva when compared with conventional radiotherapy, has benefits for the preservation of QOL.
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Objective To obstor.e analgesic effect of cancer pain by radiation of acupoint with HPD millimeter-wave. Methol One 100patlents with serious cancer pain were treated by HPD millmeter-wave instrument (MW group) 30 minuies each time once a day. The radiatnt heads were put on the acupoints according to channeis. 40 patients with serious cancer pain accepting drug treamtment as control groud. The patieuts were evaluated one week after the treatment. Result Pain was signficantly relieved in 27 patients(27%)and decreased in 40 cases(40%) in millimeter wave group. Total analgesic rate was 67% (67/100)in MW group. Pain was relieved in 4 cases(10%) in control group(P＜0.001) Conclusion Radiation of acupoint with millimeter-wave is a safe, effective, and prompt method for cancer pain.
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Objective: To observe the effect of superior technology using three dimension radiation treatment plans (3D-RTPS) in the reduction of postradiation xerostomia in patients with head and neck cancer. Methods: 3D-RTPS of conventional radiation and new superior technique were applied in the patients of 3 kinds of head and neck cancer (tumor in middle, lateral, between middle and lateral area of head and neck). Superior technology including superior ray entrance, multi fields, conformal irradiation and application of wedges. Analysis of 3D dose distributions and dose volume histograms (DVH) was used to evaluate the dose and volume in tumor, parotids and spinal cord in the patients. Tumor dose of 55.6～68.6 Gy (average 58.8 Gy) was given to the patients in conventional radiation group in 8 patients, 53.5～68.5 Gy (average 58.3 Gy) to new radiation technique group in 12 patients. Whole saliva flow rate and subjective xerostomia scores were assessed in patients during radiation course and follow-up. Results: The dose in contralateral parotids in patients with tumor in lateral area, between lateral and middle area in conventional radiation and new radiation technique groups were 51.8～64.3 Gy and 0.4～1.4 Gy, respectively. The dose in parotids in patients with tumor in middle area in conventional radiation and new radiation technique groups were 51.8 and 24.7 Gy respectively. The rate of xerostomia at the end of radiotherapy and in 4～6 months follow-up after radiotherapy in patients of new radiation technique group were 8.3 % (1/12) and 0 respectively. Those in patients in conventional radiation group were 87.5 % (7/8) and 50 % (4/8) respectively. Conclusion: Superior technology using 3D-RTPS can reduce the rate of postradiation xerostomia in patients with head and neck cancer.
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Purpose: To measure the distribution of radiation dose on neighboring tissue of the mandible metallic. Materials and Methods: The stainless steel and tantalum prothesis of mandible were inserted in the phantoms. The percent radiation dose distributions of 60 Co ?-ray were measured by Lithium fluoride thermo-luminsence method. Results: Using unidirectional beam, the radiation dose was increased in the front of metallic and decreased at the back of it in 3mm thickness. Stainless steel gave higher changes than tantalum. Using opposite beams irradiation, these changes were compensated each other. Conclusion: Tantalum prothesis is advised to mandible when 60 Co is used.