Objective We searched and reviewed medical evidence to find the guide of treatment for local advanced nasopharyngeal carcinoma. Methods Firstly, we put forward clinical questions. Secondly, we searched medical evidence from Medline (1985-2002), Embase (1984-2000), Cochrane library (2002.1) and ACP. And then we reviewed the results. The key words we used were "nasopharyngeal carcinoma, chemotherapy and radiotherapy randomized" and "meta analysis or randomized control trial". Results Through searching, we got 17 papers including 1 systematic review and 16 randomized control trials, in which there were 8 prospective randomized phase Ⅲ trials. Most of these trials concluded that combination chemo-radiotherapy were better than radiotherapy alone. We think these results were suitable for our patient’treatment decision. Conclusion To treat our patients,we choosed the method of the mutimodality of squeitial neoadjuvant chemotherapy, concurrent chemo-radiotherapy and adjuvant chemotherapy with the drug doses down-adjusted.
ObjectiveTo study the advance of malignant anorectal melanoma. MethodsThe literature in recent years about risk factors,clinical characteristic,early diagnosis,treatment and the prognosis of the anorectal melanoma were reviewed.ResultsMalignant anorectal melanoma was very rare.The history of pigment naevus,human immunodeficiency virus infection and sunlight exposure might be the risk factors.Clinic characteristics were rectal bleeding,anorectal mass and changing in bowel habits.Early diagnosis mainly depended on performing routine examination on patients between the ages of 45-80 years.The staining for polycolnal CEA in anorectal melanoma has a role on diagnostic pathology.The treatment is controversial and the combined treatments of chemotherapy with radiation therapy and immunotherapy which were based on surgery (abdominoperineal resection or wide local excision) are introduced.Conclusion Early diagnosis of malignant anorectal melanoma is difficult and the prognosis is poor.It is necessary to pay more attention to this disease and the most successful therapeutic approaches need to be developed.
ObjectiveTo review the nomenclature, functional unit construction, technical essentials, and prevention and treatment of complications of functional perforator flaps, so as to provide references for the structural and functional reconstruction of composite tissue defects. MethodsBy retrieving and analyzing domestic and foreign literature on anatomical research, technical innovation and clinical application of functional design and application of perforator flaps, combined with the clinical practice of our team, the methods for harvesting and integrating functional units of perforator flaps were summarized. ResultsFunctional perforator flap refers to a perforator flap that, on the basis of perforator blood supply, carries one or more tissue functional units (such as muscles, nerves, lymphatic vessels, lymph nodes, bones, mucous membranes, joints or articular cartilages, etc.) with sufficient blood supply located in the supra-fascia and/or sub-fascia, and is used to reconstruct one or more functions of the recipient site. The design and transfer of functional perforator flaps should not only meet the needs of precise coverage of the wound, but also reconstruct the functions of the recipient site such as muscle contraction, flap sensation, lymphatic drainage, blood flow bridging, bone growth, glandular secretion or joint movement, while avoiding iatrogenic dysfunction in the donor site. ConclusionFunctional perforator flaps have broken through the limitation of “wound coverage” and realize the integrated reconstruction of “structure-function-aesthetics”.
Tibetan population has been living in Tibet plateau for more than thousands of years ago. Although, the environment is unlikely to be an ideal place for residence. They have evolved genetical and physiological adaptions living in Tibetan highlands. In recent several years, foreign scientists have noticed that lung cancer mortality is reduced at high altitude. Many in vitro and in vivo experiments explored the mechanism of this phenomenon. In this review we discuss the lung cancer incidence and mortally of Tibetan population, as well as the possible underlying mechanism including oxygen level, radiation, inhalable particulate matter, metabolism, hypoxic induced factor pathway and immune system. But, the clinical data as well as basic researches of Tibetan population remain insufficient, which required further investigation.
Objective To systematically review the effectiveness of Yindan Xinnaotong capsule for cardiovascular and cerebrovascular diseases. Methods We electronically searched databases including PubMed, MEDLINE, CBM, CNKI, VIP, WanFang Data for published articles of randomized controlled trials (RCTs) of Yindan Xinnaotong capsule plus conventional drugs versus conventional drugs for cardiovascular and cerebrovascular diseases from inception to April, 2016. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 62 RCTs involving 6 306 patients with cardiovascular and cerebrovascular diseases were included. The results of meta-analysis showed that the improvement of symptoms, such as the total clinical effective rate of cerebrovascular disease indications (stroke) (RR=1.25, 95% CI 1.19 to 1.31,P<0.000 01), and the total clinical effective rate of cerebrovascular disease (ischemic headache) indications (RR=1.27, 95% CI 1.17 to 1.38,P<0.000 01), and the total clinical effective rate of coronary heart disease and angina pectoris (RR=1.21, 95% CI 1.17 to 1.25,P<0.000 01), were superior in the combination arm to the conventional drugs alone arm. Conclusion The current evidence shows that the combination of Yindan Xinnaotong capsule and conventional drugs may significantly improve the effectiveness. Due to the limited quality and quantity of the included studies, the above conclusions need more high quality studies to verify.
Objective To compare the clinicopathological features of hilar cholangiocarcinoma (HCCA) and hilar benign diseases, and then explore the value of carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) in the differential diagnosis between them. Methods Clinical data of 65 patients (54 patients with HCCA and 11 patients with hilar benign diseases) who were diagnosed as HCCA and received treatment from January 2011 to October 2015 in our hospital were retrospectively analyzed. Comparison of clinical data of HCCA patients and patients with hilar benign diseases in age, gender, disease duration, clinical manifestation, laboratory examination, and imaging examination was performed, and the receiver operating characteristic curve (ROC) was used to explore the value of CA19-9 and CEA in differential diagnosis between hilar benign diseases and HCCA. Results The age, levels of serum CA19-9, CEA, alanine aminotransferase (ALT), total bilirubin (BILT), and direct bilirubin (BILD) of HCCA group were significantly higher than that in benign group (P<0.05). However, the gender, disease duration, clinical manifestations (including jaundice, abdominal discomfort, fever, and weight loss), serum aspartate aminotransferase (AST), serum alkaline phosphatase (ALKP), and imaging findings (including hilar mass, intrahepatic bile duct dilatation, thickening of the bile duct wall, lymph node enlargement, vascular invasion, and gallbladder invasion) had no significant difference between the 2 groups (P>0.05). The ROC curve results showed that, when cut-off point for CA19-9 was 233.15 U/mL, the sensitivity was 56% and specificity was 91%; when cut-off point for CEA was 2.98 ng/mL, the sensitivity was 61% and specificity was 90%. Conclusions For the differential diagnosis between HCCA and hilar benign diseases, the elderly patients with high levels of serum transaminase and bilirubin were more likely to be malignant. It is more likely to be malignant when the serum CA19-9>233.15 U/mL or CEA>2.98 ng/mL.
Objective To fabricate a nanohydroxyapatite-chitosan(nano-HA-CS) scaffold with high porosity by a simple and effective technique and to evaluate the physical and chemical properties and the cytocompatibility of the composite scaffold. Methods The threedimensional nano-HA-CS scaffolds with high porosity were prepared by the in situ hybridization-freeze-drying method. The microscopic morphology and components of the composite scaffolds were analyzed by the scanning electron microscopy (SEM), the transmission electron microscopy（TEM）, the X-ray diffraction（XRD）examination, and the Fourier transformed infrared spectroscopy（FTIR）. The calvarial osteoblasts were isolated from the neonatal Wistar rats. The serial subcultured cells (3rd passage) were respectively seeded onto the nanoHACS scaffold and the CS scaffold, and then were cocultured for 2, 4, 6 and 8 hours. At each time point,four specimens from each matrix were taken to determine the celladhesion rate. The cell morphology was observed by the histological staining and SEM. Results The macroporous nanoHACS scaffolds had a feature of high porosity with a pore diameter from 100 to 500 μm (mostly 400500 μm). The scaffolds had a high interval porosity; however, the interval porosity was obviously decreased and the scaffold density was increased with an increase in the contents of CS and HA. The SEM and TEM results showed that the nanosized HA was synthesized and was distributed on the pore walls homogeneously and continuously. The XRD and FTIR results showed that the HA crystals were carbonatesubstituded and not wellcrystallized. The cytocompatibility test showed that the seeded osteoblasts could adhere the scaffolds, proliferating and producing the extracellular matrix on the scaffolds. The adherence rate for the nanoHACS scaffolds was obviously higher than that for the pure CS scaffolds. Conclusion The nano-HA-CS scaffolds fabricated by the in situ hybridization-freeze-drying method have a good physical and chemical properties and a good cytocompatibility; therefore, this kind of scaffolds may be successfully used in the bone tissue engineering.
ObjectiveTo investigate the effect of concomitant tricuspid valve repair during mitral valve surgery on the early and mid-term prognosis of the tricuspid valve and right heart function in the patients with moderate or less tricuspid regurgitation. MethodsA retrospective study of 461 patients with mitral valve disease requiring cardiac surgery combined with moderate or less tricuspid regurgitation in our hospital from 2011 to 2014 was done. They were 309 males and 152 females with a median age of 53.00 (44.00, 60.00) years. According to whether they received tricuspid valve repair (Kay’s annuloplasty, DeVega’s annuloplasty or annular ring implantation), the patients were divided into a mitral valve surgery only group (a nTAP group, n=289) and a concomitant tricuspid valve repair group (a TAP group, n=172). At the same time, 43 patients whose tricuspid valve annulus diameter was less than 40 mm in the TAP group were analyzed in subgroups. ResultsThe median follow-up duration was 3.00 years (range from 0.10 to 9.30 years). There was no perioperative death. Three months after surgery, the anteroposterior diameter of the right ventricle in the TAP group was significantly improved compared with that in the nTAP group [–1.00 (–3.00, 1.00) mm vs. 0.00 (–0.20, 2.00) mm, P=0.048]. Three years after surgery, the improvement of right ventricular anteroposterior diameter in the TAP group was still significant compared with the nTAP group [–1.00 (–2.75, 2.00) mm vs. 2.00 (–0.75, 4.00) mm, P=0.014], and the patients in the TAP group were less likely to develop moderate or more tricuspid regurgitation (3.64% vs. 35.64%, P<0.001). Annuloplasty ring implantation was more effective in preventing regurgitation progression (P=0.044). For patients with a tricuspid annulus diameter less than 40 mm, concomitant tricuspid valve repair was still effective in improving the anteroposterior diameter of the right ventricle in the early follow-up (P=0.036). Conclusion Concomitant tricuspid valve repair for patients with moderate or less tricuspid regurgitation during mitral valve surgery can effectively improve the tricuspid valve and right heart function in the early and mid-term after surgery. Annuloplasty ring implantation is more effective in preventing regurgitation progression. Patients whose tricuspid annulus diameter is less than 40 mm can also benefit from concomitant tricuspid repair.
Recently, World Health Organization/International Agency for Research on Cancer (WHO/IARC) published the World Cancer Report 2020. This report described the cancer burden of the world, the risk factors of cancer, biological process in cancer development and the prevention strategies of cancer. Based on current status of China’s cancer burden and prevention strategies, this paper briefly interpreted the key points of cancer prevention and control in the report.
Methylcellulose is a semi-flexible cellulose ether derivative, whose hydrogels are thermosensitive and reversible, with good biocompatibility and adjustable function, and its application has attracted much attention in the biomedical field. In this paper, the application of methylcellulose-based thermo-sensitive hydrogels in biomedical field was reviewed. Based on the mechanism of gelation and influencing factors of methylcellulose, this paper focused on the recent advances in biomedical applications of methylcellulose-based hydrogels, including drug delivery, regenerative medicine, and other related fields. The current achievements in these fields were summarized in the form of lists in this paper to provide ideas and tendencies for future research. Finally, the future development of multifunctional methylcellulose-based hydrogel materials with improved performance was also discussed.