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1.
Infection ; 52(2): 403-412, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37651077

RESUMO

PURPOSE: Donor-derived infection (DDI) has become an important factor affecting the prognosis of lung transplantation patients. The risks versus benefits of using donor organs infected with multidrug-resistant organisms (MDRO), especially carbapenem-resistant organisms (CRO), are frequently debated. Traditional microbial culture and antimicrobial susceptibility testing at present fail to meet the needs of quick CRO determination for donor lungs before acquisition. In this study, we explored a novel screening method by using Xpert® Carba-R assay for CRO in donor lungs in a real-time manner to reduce CRO-associated DDI mortality. METHODS: This study was registered on chictr.org.cn (ChiCTR2100053687) on November 2021. In the Xpert Carba-R screening group, donor lungs were screened for CRO infection by the Xpert Carba-R test on bronchoalveolar fluid (BALF) before acquisition. If the result was negative, donor lung acquisition and subsequent lung transplantation were performed. In the thirty-five potential donors, nine (25.71%) with positive Xpert Carba-R results in BALF were declined for lung transplantation. Twenty-six recipients and the matching CRO-negative donor lungs (74.29%) were included in the Xpert Carba-R screening group. In the control group, nineteen recipients underwent lung transplants without Xpert Carba-R screening. The incidence and mortality of CRO-associated DDI were collected and contrasted between the two groups. RESULTS: Multivariate analysis showed that CRO-related death due to DDI within 60 days was significantly lower in the Xpert Carba-R screening group than that in the control group (OR = 0.05, 95% CI 0.003-0.74, p = 0.03). CONCLUSION: Real-time CRO screening of donor lungs before transplantation at the point of care by the Xpert Carba-R helps clinicians formulate lung transplantation strategies quickly and reduces the risk of subsequent CRO infection improving the prognosis of lung transplantation.


Assuntos
Carbapenêmicos , Transplante de Pulmão , Humanos , Carbapenêmicos/farmacologia , Carbapenêmicos/uso terapêutico , Transplantados , Pulmão , Programas de Rastreamento , Transplante de Pulmão/efeitos adversos
2.
Orthop Surg ; 14(2): 422-426, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34904392

RESUMO

OBJECTIVE: Explore an accurate transosseous tunnel drilling method based on three-dimensional (3D) printing technology for acromioclavicular joint reconstruction (ACD), design a guide design, and evaluate its accuracy. METHODS: Using Mimics software to reconstruct 100 cases of acromioclavicular joint computed tomography (CT) data. In design 2, the non-collinear tunnel is superimposed on the 3D model, and a virtual drilling is performed between the clavicle and the coracoid using a triple inner gusset. Then, in the Geomagic Studio software model, an elliptical plane is calculated and extracted as a guide design for precise drilling. Then put the design and the 3D shoulder model together for 3D printing. Ten lengths were measured, and the effects of the virtual model, the actual model, and the guide rail design were compared. RESULTS: We successfully compared 10 parameters of 3D virtual model and actual model. There was no significant difference between actual and virtual bone tunnels in 10 measurements (P > 0.05). CONCLUSIONS: The accuracy of ACD combined with 3D printing guidance design technology in the transosseous tunnel of adult shoulder is reliable.


Assuntos
Articulação Acromioclavicular , Artroplastia de Substituição , Luxações Articulares , Articulação Acromioclavicular/diagnóstico por imagem , Articulação Acromioclavicular/cirurgia , Adulto , Placas Ósseas , Clavícula/diagnóstico por imagem , Clavícula/cirurgia , Humanos , Luxações Articulares/cirurgia , Impressão Tridimensional
3.
Onco Targets Ther ; 13: 9701-9719, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33061450

RESUMO

BACKGROUND: The immune environment of lung cancer is complex, and the critical immune factors that promote lung cancer progression need to be explored. Granulocytic myeloid-derived suppressor cells (G-MDSCs) are regarded as immune suppressing cells. However, they also promote tumor progression through other ways, which needs to be explored further. Therefore, we sought to study the regulatory mechanisms underlying the cancer promoting function of G-MDSCs in lung cancer. METHODS: G-MDSCs were isolated from lung cancer tissues using flow cytometry. Exosomes were separated from the G-MDSCs supernatant by ultracentrifugation and verified using flow cytometry, Western blot, and transmission electron microscopy (TEM). RNA sequencing was used to identify the differential miRNAs and genes. Real-time quantitative real-time PCR (RT-qPCR) confirmed these results. The proliferation rate was assessed using the CCK-8 assay. Lentiviral vectors were used to alter the expression of the miRNAs and genes to analyze their effects on lung cancer progression. RESULTS: G-MDSCs secreted more exosomes in the lung cancer tissues, which promoted cancer progression by accelerating proliferation. Micro RNA-143-3p (miR-143-3p) increased in G-MDSCs derived exosomes and downregulated integral membrane protein 2B (ITM2B) by targeting the 3'-untranslated region (UTR) region. Overexpression of miR-143-3p enhanced proliferation by inhibiting transcription of ITM2B to activate the PI3K/Akt signaling pathway, which can be blocked by deguelin. This phenomenon was further confirmed by accelerated tumor growth and worse prognosis in mice. CONCLUSION: The key findings of this study highlight the potential of the G-MDSC-derived exosomes and the miR-143-3p/ITM2B axis as therapeutic targets and clinical indicators of lung cancer.

4.
Biomed Res Int ; 2020: 5679629, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32596331

RESUMO

Plantar heel pain is a common disease with a high incidence in different races. It significantly reduced the quality of life of patients. However, the cause of PHP is still controversial and there were varieties of physiological factors associated with PHP. The most common pathological factor in the population was plantar fasciitis. Some existing research studies had found a correlation between calcaneal spurs and plantar fasciitis, and this study had found the correlation in Chinese population. It is invaluable not only to understand the relationship between different types of plantar calcaneal spurs and plantar fasciitis but also to identify the most appropriate treatment strategies. A total of 71 patients with calcaneal spurs were chosen from the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. All 71 patients had completed X-rays and MRI scans; then, surgeons had removed their plantar calcaneal spurs. After surgery, all patients were followed up for 12 months; their prognosis was tested by the VAS and AOFAS scores. Type II (29, 40.8%) had the highest incidence in Chinese population, followed with type I (24, 33.8%) and type III (18, 25.4%). Preoperative VAS scores showed that type II (7.72 ± 1.10) was significantly higher than the other two types (P < 0.001). Postoperative VAS scores of type II were higher than those of type I and type III (P < 0.001). Postoperative AOFAS scores of type II were the lowest (P < 0.001). Researchers had proved that type II was more likely to cause PF.


Assuntos
Fasciíte Plantar/patologia , Esporão do Calcâneo/patologia , Adulto , Povo Asiático , China , Fasciíte Plantar/complicações , Feminino , Esporão do Calcâneo/complicações , Esporão do Calcâneo/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia
5.
Biomed Res Int ; 2019: 6095315, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080826

RESUMO

Due to the calcaneal osteoarthritis, patients had a lower quality of life. This research was to study which type of calcaneus was more likely to cause osteoarthritis and then to guide the clinical prevention and treatment in Chinese population. All 505 intact Chinese calcaneus facets were reconstructed by CT-3D reconstruction scanner and classified into five types based on the calcaneal talar facet (CTF) configuration. CTF's morphology parameters (osteophyte, cortical thickness of calcaneus, GIssane's and Bohler's angle, and long and short axis) were measured and recorded by PACS CT system. Researchers used the length of long and short axis to calculate the CTF area. By comparing the morphology parameters of five types of calcaneus, the differences among different types of calcaneus in Chinese people were statistically different. The study showed that Type II and Type IV had the highest percentage of osteophytes. After being compared and analyzed, the CTF pressure and the subtalar joint stability were closely related to the occurrence of osteoarthritis. Based on the measurement and comparison of morphological parameters in this study, Types II and IV were the most likely to develop osteoarthritis in Chinese population.


Assuntos
Calcâneo/anatomia & histologia , Articulações/anatomia & histologia , Osteoartrite/classificação , Osteoartrite/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Povo Asiático , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/epidemiologia , Osteoartrite/terapia , Osteófito/patologia , Qualidade de Vida , Tomografia Computadorizada por Raios X , Adulto Jovem
6.
Ann Anat ; 221: 173-178, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30248401

RESUMO

BACKGROUND: The variable of the suprascapular notch (SSN) is a common cause in suprascapular nerve (SN) entrapment. Hence, knowledge of SSN variations may be predictive valuable for the predisposition to compression of SN. The aim of this study was to propose the classification of SSN in Chinese population and took this complex morphology into account. MATERIAL AND METHODS: 308 human dry scapulae were analyzed thoroughly and systematically in this study. Morphological variations of the SSN were observed by visual inspection and the classification of SSN was determined by geometrical measurements. Then measurement results were averaged and recorded. RESULTS: Chinese dry scapulae were measured, we found seven types of SSN. Type Ⅰ (√, 44.8%) was the most common, followed by type Ⅱ (U, 41.9%) to Ⅶ (double O, 0.6%). Right scapulae were larger in depth of SSN and thickness of A and C. Type Ⅶ (double O) had the deepest SSN and type Ⅰ (√) was widest among five types. For BC, type Ⅰ (√) was shorter than type Ⅲ (V). For thickness of A, type Ⅶ (double O) was greater than type Ⅰ (√). For thickness of C, type Ⅰ (√) and type Ⅱ (U) were shorter than type Ⅲ (V). There were no significant differences in other measurements between types and sides of body. Seven types of SSN in Chinese population were defined in our study. CONCLUSION: These anatomical variations of the SSN may improve the diagnostic rate and success rate of the surgical for the suprascapular nerve entrapment.


Assuntos
Síndromes de Compressão Nervosa/fisiopatologia , Escápula/anatomia & histologia , Articulação do Ombro/anatomia & histologia , Povo Asiático , China , Feminino , Humanos , Masculino , Síndromes de Compressão Nervosa/genética , Escápula/inervação , Articulação do Ombro/inervação
7.
Biomed Pharmacother ; 104: 145-150, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29772434

RESUMO

Pancreatic cancer (PC) is one of the most aggressive malignancies in humans. Despite advances in early detection and treatment of PC, the prognosis is still limited. LncRNA myocardial infarction-associated transcript (MIAT) is found abnormally expressed in a variety of cancers. However, the role of MIAT in PC is still unknown. This study aimed to explore whether MIAT was related to the progression of PC and the underlying mechanism. Bioinformatics analysis and luciferase reporter assay validated that miR-133 may target MIAT 3'-UTR. MIAT expression was found remarkably increased and miR-133 expression was significantly decreased in PC tissues and PC cell lines (PATU-8988, BxPC-3, PANC-1, SW1990 and AsPC-1 cells). PC patients with high MIAT level had poor prognosis than that with low MITA level. Besides that, PATU-8988 cells transfected with siMIAT and/or miR-133 inhibitor. The results exhibited that the inhibition of miR-133 expression reversed the inhibition effect of MIAT down-regulation in the growth, migration and invasion of PC cells. Moreover, tumor growth was tremendously suppressed in nude rats received injection of PATU-8988 cells transfected with siMIAT. Taken together, our results suggest that the interaction of MIAT and miR-133 play a role in the proliferation and metastasis of pancreatic carcinoma.


Assuntos
Proliferação de Células/genética , MicroRNAs/genética , Metástase Neoplásica/genética , Neoplasias Pancreáticas/genética , RNA Longo não Codificante/genética , Regiões 3' não Traduzidas/genética , Animais , Regulação para Baixo/genética , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Metástase Neoplásica/patologia , Neoplasias Pancreáticas/patologia , Prognóstico , Ratos , Transfecção/métodos , Neoplasias Pancreáticas
8.
Nan Fang Yi Ke Da Xue Xue Bao ; 38(3): 346-352, 2018 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-29643043

RESUMO

OBJECTIVE: To study the effect of Shaoyangzhugu (SYZG) Formula (a formula consisting of 9 traditional Chinese drugs) in delaying the degeneration of articular cartilage and the role p19Arf-p53-p21Cip1 signaling pathway in mediating this effect. METHOD: Thirteen aged cynomolgus monkeys with degenerative knee joints were selected based on X-ray findings, and one of them was randomly selected for pathological observation. The other monkeys were randomized equally into SYZG Formula group (treated with SYZG decoction), ammonia moxime group and saline group. All the monkeys were sacrificed after 8 weeks of treatment with intragastric administration of the drugs or saline. The pathology in the knee joint articular cartilage was observed and the mRNA and protein expressions of p19Arf, p53, and p21Cip1 in the articular cartilage were detected using RT-qPCR and Western blotting. RESULTS: The pathological findings of the articular cartilage in old cynomolgus monkeys were consistent with the characteristics of knee osteoarthritis (KOA). Mankin scores of the cynomolgus monkeys were 7.38∓0.52 in SYZG Formula group, 7.88∓0.83 in ammonia moxime group, and 8.38∓0.74 in saline group, showing a significant difference between SYZG Formula group and saline group (P<0.05). The expressions of p19Arf, p53, and p21Cip1 were the lowest in SYZG Formula group and the highest in saline group with significant differences among the 3 groups (P<0.05). CONCLUSION: SYZG Formula can delay chondrocyte senescence by regulating p19Arf-p53-p21Cip1 signaling pathway to delay articular cartilage degeneration in aged cynomolgus monkeys.


Assuntos
Cartilagem Articular/efeitos dos fármacos , Medicamentos de Ervas Chinesas/farmacologia , Osteoartrite do Joelho/tratamento farmacológico , Transdução de Sinais , Animais , Inibidor de Quinase Dependente de Ciclina p19/metabolismo , Inibidor de Quinase Dependente de Ciclina p21/metabolismo , Macaca fascicularis , Distribuição Aleatória , Proteína Supressora de Tumor p53/metabolismo
9.
Nan Fang Yi Ke Da Xue Xue Bao ; 37(9): 1171-1177, 2017 Sep 20.
Artigo em Chinês | MEDLINE | ID: mdl-28951357

RESUMO

OBJECTIVE: To study the effect of electroacupuncture on proprioception in cynomolgus monkeys after unilateral anterior cruciate ligament (ACL) injury. METHODS: Twenty-seven cynomolgus monkeys were randomized equally into 3 groups, namely unilateral ACL injury with electroacupuncture group, unilateral ACL injury model group and blank control group. One week after modeling, the monkeys in electroacupuncture group were treated daily for 12 weeks with electroacupuncture at the acupoints Wei Yang, Yin Gu, Xi Yangguan and Qu Quan. At 4, 8, and 12 weeks during the treatment, the changes in the somatosensory evoked potentials (SEPs) and motor nerve conduction velocity (MCV) of the nerves of the ACL were examined with neural electrophysiological method; the changes in the morphology and the total and variable number of the proprioceptors in the ACL were observed with gold chloride staining. RESULTS; In the mokeys in the model group, the incubation period of the SEPs and MCV on the injured side of the knee were significantly extended and the amplitudes were decreased with the passage of time (P<0.05). Intervention with electroacupuncture significantly reduced the incubation period and increased the amplitudes of the SEPs and MCV (P<0.05). The total number of the proprioceptors in the ACL was significantly decreased and the variable number of the proprioceptors in ACL was increased with time in the monkeys in the model group (P<0.05); electroacupuncture intervention obviously slowed the reduction rate of total number of the proprioceptors (P<0.05) but without affecting the variable number of the proprioceptors (P>0.05). CoONCLUSION: ACL injury causes attenuation of the proprioception on the injury side, and electroacupuncture intervention can produce a positive effect on the proprioception in cynomolgus monkeys.

10.
Ann Transplant ; 22: 75-82, 2017 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-28184034

RESUMO

BACKGROUND Ischemia-reperfusion injury (IRI) is a clinically common pathologic process defined as the inability to improve neuronal function. This study aimed to investigate the pathological mechanism of IRI and to explore effects of hyperbaric oxygenation (HBO) on autophagy and inflammatory response in IRI. MATERIAL AND METHODS Ninety Sprague-Dawley (SD) rats were randomly divided into a Sham group, a kidney transplant group (Trans), and a kidney transplant plus HBO treatment group (Trans+HBO). The kidney was harvested from the donor and transplanted to recipient rats according to a previously reported study. Rats were anesthetized using pentobarbital-natrium, and the kidney was resected and fixed in 4% paraformaldehyde. Serum creatinine (Scr) was detected using an automatic biochemical analyzer. The interleukin-6 (IL-6) level was assessed using enzyme-linked immunosorbent assay (ELISA). LC-3 was examined using indirect immunofluorescence assay and immunochemistry assay. LC-3 mRNA levels were analyzed using real-time PCR (RT-PCR). RESULTS The kidney transplant IRI model was successfully established. Scr and IL-6 levels were significantly increased in the Trans group (P<0.05). HBO significantly enhanced Scr and IL-6 levels. Scr was positively correlated with IL-6 levels (r-0.607, P<0.05). HBO increased LC-3 protein and mRNA expression in kidney-transplanted rats compared to the Sham and Trans group (P<0.05). Moreover, immunofluorescence assay also showed that LC-3 protein mainly distributes along renal tubular epithelial cells in a linear manner. CONCLUSIONS Autophagy dysfunction and inflammatory response after renal transplantation play important roles in processes of IRI. HBO treatment protects against the renal injury of IRI in renal tissues at the early stage, which may be triggered by the IL-6 pathway.


Assuntos
Autofagia/fisiologia , Oxigenoterapia Hiperbárica , Inflamação/patologia , Rim/irrigação sanguínea , Traumatismo por Reperfusão/prevenção & controle , Animais , Creatinina/sangue , Inflamação/sangue , Interleucina-6/sangue , Rim/patologia , Ratos , Ratos Sprague-Dawley , Traumatismo por Reperfusão/sangue , Traumatismo por Reperfusão/patologia
11.
Nan Fang Yi Ke Da Xue Xue Bao ; 37(12): 1592-1596, 2017 Dec 20.
Artigo em Chinês | MEDLINE | ID: mdl-29292250

RESUMO

OBJECTIVE: To explore the hemodynamic changes in cynomolgus monkeys with mild carotid atherosclerotic (CAS) plaques after therapy with pushing manipulation on Qiaogong acupoint (MPQ). METHODS: Nine cynomolgus monkeys were equally randomized into MPQ group, mild CAS model group and blank control group. Mild CAS models were established in the monkeys in MPQ and model groups, and the monkeys in MPQ group received treatment with MPQ intervention after the modeling. The conditions of the carotid artery and the hemodynamic changes in the 3 groups were evaluated after the treatment. RESULTS: Formation of CAS plaques was detected in monkeys in both MPQ and model groups. The vascular cross?sectional area, plaque cross?sectional area and stenosis rate of the plaques in the two groups all differed significantly from those in the blank control group (P<0.05), but these parameters were similar between MPQ group and the model group (P>0.05). Compared with those in the blank control group, the hemodynamic parameters showed significant changes in MPQ and the model groups (P<0.05) but remained similar between the latter two groups (P>0.05). CONCLUSION: CAS plaques can cause changes in hemodynamic parameters. Short?term therapy with MPQ does not affect the stability of the plaques or cause adverse effects on hemodynamics in cynomolgus monkeys with mild CAS plaques.


Assuntos
Pontos de Acupuntura , Estenose das Carótidas/terapia , Hemodinâmica , Placa Aterosclerótica/terapia , Animais , Macaca fascicularis , Distribuição Aleatória
12.
Acupunct Med ; 33(6): 465-71, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26245584

RESUMO

BACKGROUND: Based on a description of acupuncture to treat a bone disease resembling osteoporosis in the ancient text of Huangdi Neijing, we aimed to assess the effects of electroacupuncture (EA) at GB points in ovariectomised (OVX) rats. METHODS: 40 female Wistar rats were randomly divided into four groups (n=10 each): ovariectomised model group (OVX); ovariectomised group treated with EA at GB points (OVX+GB); ovariectomised group treated with EA at non-GB points (OVX+N) in the hindlimb; and a sham surgery group (Sham). Three months after ovariectomy, rats in the OVX+GB and OVX+N groups received EA treatment for 3 months. Urine, blood and femur samples were collected from each animal for analysis. RESULTS: Bodyweight (BW) in the OVX+GB group decreased after EA treatment, reaching a minimum of ∼12% below the OVX and OVX+N groups at 1 month. Concentrations of urine deoxypyridinoline, a bone resorption marker, were significantly elevated in the OVX and OVX+N groups but not the OVX+GB group. Concentrations of serum bone specific alkaline phosphatase, a bone formation marker, were significantly higher in the OVX+GB group versus the Sham and OVX groups. Bone mineral density (BMD) did not differ between the OVX, OVX+GB and OVX+N groups, but was ∼10% lower than the Sham group. However, BMD/BW in the OVX+GB group was significantly higher than in the OVX and OVX+N groups and similar to the Sham group. Histological assessment of the femur showed that EA at GB points improved the bone architecture. CONCLUSIONS: EA treatment at GB points had anti-osteoporotic effects in a rat model of osteoporosis.


Assuntos
Pontos de Acupuntura , Eletroacupuntura , Osteoporose/metabolismo , Fosfatase Alcalina/metabolismo , Aminoácidos/urina , Animais , Biomarcadores , Peso Corporal , Densidade Óssea , Reabsorção Óssea , Feminino , Fêmur/patologia , Osteoporose/patologia , Ovariectomia , Ratos , Ratos Wistar
13.
Zhonghua Wei Chang Wai Ke Za Zhi ; 15(9): 893-6, 2012 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-22990917

RESUMO

OBJECTIVE: To compare the differences in biological behavior and clinical features between adenocarcinoma of the esophagogastric junction (AEG) and lower thoracic esophageal squamous cell cancer (LESC), and to explore reasonable procedures for each cancer. METHODS: Clinical data of 111 patients with AEG and 126 patients with LESC who underwent surgery from January 2004 to April 2012 were retrospectively reviewed. Data pertaining to resection rate, lymph node metastasis, and postoperative complication rate were analyzed. RESULTS: The resection rate was 94.6% for AEG and 97.6% for LESC, and the difference was not statistically significant (P<0.05). The rate of lymph node metastasis in the mediastinum in patients with AEG was significantly lower [6.3%(7/111) vs. 32.5%(41/126), P<0.01], while the rate of lymph node metastasis in the abdomen was significantly higher [57.7%(64/111) vs. 34.1%(43/126), P<0.01]. The rate of lymph node metastasis in mediastinum of AEG was 12.5%(4/32) for Siewert I and 4.7%(3/64) for Siewert II, and there was no lymph node metastasis in Siewert III (n=15). For AEG patients who underwent trans-abdominal surgery, the rate of positive lymph node in the middle and lower mediastinum was significantly lower than trans-thoracic surgery [0/22 vs. 7.9% (7/89), P<0.05]. LESC via right thorax with two-field or three-field lymph node dissection was associated with a significantly higher rate of positive lymph node metastasis in the upper mediastinum than that of single incision via left thorax [17.9%(12/67) vs. 0/59, P<0.01]. The postoperative complication rates were 23.4%(26/111) and 27.0%(34/126) respectively, and the difference was not statistically significant(P>0.05). CONCLUSIONS: AEG and LESC show different lymph node metastasis pattern and should be operated differently. Lymphadenectomy in mid-lower mediastinum should be emphasized in Siewert I and Siewert II type cancers.


Assuntos
Adenocarcinoma/cirurgia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica , Idoso , Esofagectomia/métodos , Junção Esofagogástrica/patologia , Junção Esofagogástrica/cirurgia , Esôfago/patologia , Esôfago/cirurgia , Feminino , Humanos , Excisão de Linfonodo/métodos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
14.
Zhonghua Wei Chang Wai Ke Za Zhi ; 15(4): 373-6, 2012 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-22539385

RESUMO

OBJECTIVE: To compare outcomes of left and right thoracic incision for middle and lower thoracic esophageal squamous cancer, and to determine reasonable surgical approach for thoracic esophageal squamous carcinoma. METHODS: One hundred and twenty patients with middle or lower thoracic esophageal squamous cancer who received esophagectomy plus lymphadenectomy between January 2004 and December 2007 were divided into two groups including left(n=60) and right thoracic(n=60) approach. Clinical data were analyzed including the results of surgical resection, lymphadenectomy, postoperative complication, recurrence, and survival. RESULTS: The rate of surgical resection was 91.7%(55/60) in the left approach group and 95%(57/60) in the right approach group. There was no significant difference(P>0.05). But the average number of lymph nodes resected (4.60 vs. 8.32) and metastatic lymph nodes(0.57 vs. 1.33) were both significantly higher in the right approach group(P<0.01). There was no statistical difference in postoperative complications[26.7%(16/60) vs. 31.7%(19/60), P>0.05] between the two groups. However, the incidence of local recurrence was lower[43.3%(26/60) vs. 23.3%(14/60), P<0.05] in the right approach group than that in left-approach group. There was no significant difference in distant metastasis(P>0.05). CONCLUSIONS: The resection rate is comparable between left and right approach for thoracic esophageal cancer. However, it is easier to perform systemic lymphadenectomy via right thoracic approach and therefore the local recurrence is reduced and long-term survival improved.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Esofágicas/cirurgia , Adulto , Idoso , Esofagectomia , Feminino , Humanos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
15.
Zhonghua Zhong Liu Za Zhi ; 33(9): 687-91, 2011 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-22340051

RESUMO

OBJECTIVE: To evaluate THE clinical significance of the 2009 UICC staging system for thoracic esophageal squamous cell carcinoma. METHODS: Two hundred and nine patients with thoracic esophageal squamous cell carcinoma undergone selective cervico-thoraco-abdominal lymphadenectomy were reviewed retrospectively and restaged according to the new 2009 UICC staging system. The relationship between individual stages and survival were analyzed accordingly. RESULTS: The five-year overall and cause-specific survivals were 35.0% and 38.8%, respectively. Depth of invasion (T, P = 0.004), number of metastatic lymph nodes (N, P < 0.001), distant lymph node metastasis (M, P = 0.003), complete resection (R, P = 0.005) were significantly related to postoperative survival. On the other hand, location of primary tumor (L, P = 0.743) and histological grade (G, P = 0.653) were not significantly related to long-term prognosis. Upon stratification, the 5-year survival for T4a (32.0%) was significantly better than that of T4b (0, P < 0.001), but was similar to that of T3 (28.4%, P = 0.288). Patients without nodal involvement (47.8%, P < 0.001) and those with single station nodal disease (37.5%, P < 0.001) had significantly better survival than patients having 2 or more stations of lymph node metastasis (11.3%). Also patients without nodal involvement and those with metastasis confined to a single field (34.2%) had significantly better survival than patients having nodal diseases in 2 fields (12.1%) and 3 fields (0, P < 0.001). The 5-year survival for cervical metastasis after complete resection was 20.0%. Upon multivariate analysis, depth of tumor invasion (P = 0.001, RR = 1.635), numbers of metastatic nodal stations (P = 0.043, RR = 1.540) and fields (P = 0.010, RR = 2.187) were revealed as independent risk factors for long-term survival. CONCLUSIONS: The new UICC staging system effectively predicts long-term prognosis for thoracic esophageal squamous cell carcinoma. Depth of tumor invasion and extent of lymph node involvement are two most important prognostic factors. To improve surgical outcomes, much effort is needed to increase the accuracy of preoperative staging and to include effective induction therapies into a multidisciplinary setting.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/patologia , Linfonodos/patologia , Estadiamento de Neoplasias/métodos , Carcinoma de Células Escamosas/cirurgia , Neoplasias Esofágicas/cirurgia , Esofagectomia , Feminino , Seguimentos , Humanos , Agências Internacionais , Excisão de Linfonodo , Linfonodos/cirurgia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estudos Retrospectivos , Taxa de Sobrevida
16.
Zhongguo Gu Shang ; 23(6): 417-20, 2010 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-20669569

RESUMO

OBJECTIVE: To study the therapeutic effects of combined anterior-posterior (small incision or micro-incision) approach for complex tibial plateau and posterior condylar fractures. METHODS: From 2000 to 2008, 79 patients (81 limbs) with complex tibial plateau and posterior condylar fractures were reviewed. There were 45 males and 34 females, ranging in age from 19 to 66 years, with an average of 40.6 years. Thirty-nine limbs were treated using small incision through combined anterior-posterior approach, in which 13 limbs were Schatzker type IV, 15 limbs were type V ,and 11 limbs were type VI. Other 42 limbs were treated using micro-incision through combined anterior-posterior approach, in which 18 limbs were Schatzker type IV, 16 limbs were type V, and 8 limbs were type VI. The Rasmussen scores for knee joint and radio scores were used to evaluate therapeutic effects after the treatment. The complications such as cutaneous necrosis and incision infection were observed. RESULTS: All the patients were followed up. According to Rasmussen criterion, in small incision group, 16 limbs got an excellent result, 13 good, 7 fair and 3 bad; in micro-incision group,above data were 19, 11, 8 and 4 respectively. Comparison between the two groups, P = 0.924. Comparison of complications such as cutaneous necrosis and incision infection: in small incision group,10 limbs had the complications, and in micro-incision group were 4 limbs; the occurrence rate of small incision group were higher than that of micro-incision group (P = 0.047). CONCLUSION: There are no significant differences between the two groups in the knee joint function rehabilitation; however, there is smaller rate for cutaneous necrosis and incision infection in micro-incision group.


Assuntos
Traumatismos do Tornozelo/cirurgia , Fixação de Fratura/métodos , Fraturas da Tíbia/cirurgia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Articulação do Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos
17.
Zhongguo Zhen Jiu ; 28(6): 469-71, 2008 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-18630551

RESUMO

To explore the theory of "Shaoyang Meridians being in charge of the bone" in Huangdi's Internal Classic, which has been buried for long time. With citation of Huangdi's Internal Classic and exposition of famous experts, speculate on the contents and meanings systematically. Results indicate that the theory of "Shaoyang Meridians being in charge of the bone" possibly first in the world recognizes osteoporosis being a general bony disease, and articulates that the Foot-Shaoyang Meradians can modulate bony strength under physiological and pathological conditions, and treat osteoporosis which mainly manifests as ostealgia and easy fracture.


Assuntos
Doenças Ósseas/etiologia , Medicina Tradicional Chinesa , Meridianos , Densidade Óssea , Doenças Ósseas/terapia , Humanos , Osteoporose/etiologia
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