Diagnosis and treatment of malignant mesothelioma of the tunica vaginalis testis: a series of 7 cases / 中华外科杂志

Objective: To investigate the clinical features, diagnosis, prognosis of malignant mesothelioma of the tunica vaginalis testis (MMTVT). Methods: The clinicopathological data of 7 patients with MMTVT who treated at Sun Yat-sen University Cancer Center between January 2010 and October 2022 were retrospectively reviewed. Cases were first diagnosed at (M (IQR)) 49 (23) years old (range: 27 to 64 years old). The main clinical manifestations were scrotal enlargement (7 cases) and hydrocele (2 cases). Results: Three patients underwent radical orchiectomy as initial treatment, 2 cases underwent hydrocelectomy due to diagnosis of hydrocele, followed by radical orchiectomy at Sun Yat-sen University Cancer Center, and 2 cases underwent transscrotal orchiectomy. Common tumor markers of testicular cancer were not significantly elevated in MMTVT. The expression of tumor PD-L1 was positive in 2 out of the 3 cases. One patient received adjuvant chemotherapy and 2 patients received first-line chemotherapy after tumor recurrence. Chemotherapy regimens used include cisplatin+pemetrexed. Up to October 2022, 3 cases relapsed, of which 2 cases died. The median overall survival was 35 months (range: 4 to 87 months) and the median progression-free survival was 6 months (range: 2 to 87 months). Conclusions: MMTVT at early stage should be treated with early radical orchiectomy and followed up closely after surgery. The cisplatin+pemetrexed regimen is a common option for the treatment of metastatic MMTVT, while whether immune checkpoint inhibitors could serve as a second-line treatment option deserves further research.

Detection of Pseudorabies Virus Antibodies in Human Encephalitis Cases / 生物医学与环境科学（英文）

Pseudorabies virus (PRV), a veterinary pathogen that infects domestic animals as well as wild animals such as wild boar and feral swine, was recently reported to infect human and led to endophthalmitis and encephalitis. A retrospective seroepidemiologic survey was conducted using 1,335 serum samples collected from patients with encephalitis and ELISA positive rates were 12.16%, 14.25%, and 6.52% in 2012, 2013, and 2017, respectively. The virus neutralizing antibody titers of positive samples correlated well with ELISA results. The pseudorabies virus antibody positive rate of patients with encephalitis were higher than that of healthy people in 2017. The above results suggest that some undefined human encephalitis cases may be caused by PRV infection.

Diagnostic value of (18)F-FDG PET/CT for solitary nodular-type bronchoalveolar carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of (18)F-FDG PET/CT in the diagnosis of solitary nodular-type bronchoalveolar carcinoma (BAC).</p><p><b>METHODS</b>The clinical and radiographic data were analyzed retrospectively in 30 patients with pathologically confirmed solitary nodular-type BAC who underwent (18)F-FDG PET/CT examinations between August, 2005 and December, 2006. The morphological and radioactive findings of the lesions were reviewed, and the maximum standard uptake values (SUVmax) were measured. The diagnostic accuracy of PET, PET/CT, and HRCT were analyzed.</p><p><b>RESULTS</b>The (18)F-FDG SUV was markedly lower in BAC than in other well differentiated adenocarcinoma. In 19 of the BAC cases, PET showed a SUVmax of no less than 2.5, demonstrating positive changes. Of the total of 30 cases, 5 had ground glass opacity (GGO) changes, 3 exhibited mixed nodules with GGO changes around the lesions, and 22 cases presented with solid nodules. HRCT showed that BAC located often in the superior lobes of the bilateral lungs, mostly below the pleura in the surrounding lung field; the lesions were patchy or nodular with irregular shapes, showing lobulation in 22 cases, spiculation in 15 cases, pleural indentation in 21 cases, and vacuolar changes in 4 cases. The diagnostic accuracy of PET, PET/CT and HRCT for solitary nodular-type BAC was 36.67%, 93.33%, and 93.33%, respectively.</p><p><b>CONCLUSION</b>The SUVmax of BAC provides only limited value for defining the nature of the lesions, but can serve as a general reference for assessing the disease activity. PET/CT, which allows both functional and imaging assessment, can be a valuable modality to reduce the misdiagnosis rate of BAC.</p>

Biocontrol of Dendrobium candidum damping-off disease with endophytic fungi / 中国药学杂志

OBJECTIVE: To screen out endophytic fungi isolates with good biological control against damping-off in Dendrohium candidum seedlings among the isolates owned by our laboratory, thus to lay a foundation on developing biological control technique and field application. METHODS: Eighteen isolates of endophytic fungi identified by the PDA Petri dish confrontation experiment and athogen of damping-off were used in the biological control experiment. Co-incubation in bottles was conducted to screen out isolates with weak pathogenic and growth promoting effect on Dendrobium candidum seedlings. The chosen isolates were then enrolled in the potted seedlings experiment to determine their biological control effect. RESULTS: Isolates 4829 and 3952 were confirmed to have good biological control effect by statistical analysis. The survival rates of Dendrobium candidum seedlings reached 66.7% and 60.5% respectively. CONCLUSION: Endophytic fungi isolated from Dendrobium sp. shows good biological control against Dendrobium candidum damping-off.

Protein kinase A-mediated cardioprotection of Tongxinluo relates to the inhibition of myocardial inflammation, apoptosis, and edema in reperfused swine hearts / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Our previous studies have demonstrated that Tongxinluo (TXL), a traditional Chinese medicine, can protect hearts against no-reflow and reperfusion injury in a protein kinase A (PKA)-dependent manner. The present study was to investigate whether the PKA-mediated cardioprotection of TXL against no-reflow and reperfusion injury relates to the inhibition of myocardial inflammation, edema, and apoptosis.</p><p><b>METHODS</b>In a 90-minute ischemia and 3-hour reperfusion model, minipigs were randomly assigned to sham, control, TXL (0.05 g/kg, gavaged one hour prior to ischemia), and TXL + H-89 (a PKA inhibitor, intravenously and continuously infused at 1.0 µg/kg per minute) groups. Myocardial no-reflow, necrosis, edema, and apoptosis were determined by pathological and histological studies. Myocardial activity of PKA and myeloperoxidase was measured by colorimetric method. The expression of PKA, phosphorylated cAMP response element-binding protein (p-CREB) (Ser(133)), tumor necrosis factor α (TNF-α), P-selectin, apoptotic proteins, and aquaporins was detected by Western blotting analysis.</p><p><b>RESULTS</b>TXL decreased the no-reflow area by 37.4% and reduced the infarct size by 27.0% (P < 0.05). TXL pretreatment increased the PKA activity and the expression of Ser(133) p-CREB in the reflow and no-reflow myocardium (P < 0.05). TXL inhibited the ischemia-reperfusion-induced elevation of myeloperoxidase activities and the expression of TNF-α and P-selectin, reduced myocardial edema in the left ventricle and the reflow and no-reflow areas and the expression of aquaporin-4, -8, and -9, and decreased myocytes apoptosis by regulation of apoptotic protein expression in the reflow and no-reflow myocardium. However, addition of the PKA inhibitor H-89 counteracted these beneficial effects of TXL.</p><p><b>CONCLUSION</b>PKA-mediated cardioprotection of TXL against no-reflow and reperfusion injury relates to the inhibition of myocardial inflammation, edema, and apoptosis in the reflow and no-reflow myocardium.</p>

Effect of pre-procedural statin therapy on myocardial no-reflow following percutaneous coronary intervention: a meta analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Successful revascularization of coronary artery disease, especially ST-elevation myocardial infarction (STEMI), does not always mean optimal myocardial reperfusion in a portion of patients because of no-reflow phenomenon. We hypothesized that statins might attenuate the incidence of myocardial no-reflow when used before percutaneous coronary intervention (PCI). The purpose of this study was to summarize the evidence of pre-procedural statin therapy to reduce myocardial no-reflow after PCI.</p><p><b>METHODS</b>We searched the MEDLINE, Cochrane, and clinicaltrials.gov databases from inception to October 2012 for clinical trials that examined statin therapy before PCI. We required that studies initiated statins before PCI and reported myocardial no-reflow. A DerSimonian-Laird model was used to construct random-effects summary risk ratios.</p><p><b>RESULTS</b>In all, 7 studies with 3086 patients met our selection criteria. The use of pre-procedural statins significantly reduced post-procedural no-reflow by 4.2% in all PCI patients (risk ratio (RR) 0.56, 95% confidence interval (CI) 0.35 to 0.90, P = 0.016), and attenuated by 5.0% in non-STEMI patients (RR 0.41, 95% CI 0.18 to 0.94, P = 0.035). This benefit was mainly observed in the early or acute intensive statin therapy populations (RR 0.43, 95% CI 0.26 to 0.71, P = 0.001).</p><p><b>CONCLUSIONS</b>Acute intensive statin therapy before PCI significantly reduces the hazard of post-procedural no-reflow phenomenon. The routine use of statins before PCI should be considered.</p>

Efficacy analysis of three therapeutic modes on clinical stage Ia nonseminomatous germ cell testicular tumors / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate the oncologic outcomes of surveillance, retroperitoneal lymph node dissection (RPLND) and primary chemotherapy in patients with clinical stage Ia nonseminomatous germ cell testicular tumors (CS Ia NSGCT) and to analyze risk factors for relapse.</p><p><b>METHODS</b>Patients with CS Ia NSGCT were retrospectively reviewed. Totally 72 patients were enrolled and grouped according to three different treatment after orchiectomy, among them 33 cases in surveillance group, 24 cases in RPLND group and 15 cases in primary chemotherapy group. Disease progressive free survival and disease specific survival were compared using Kaplan-Meier analysis. Cox regression analysis was used to confirm variables those were associated with disease progression.</p><p><b>RESULTS</b>All 72 patients were followed-up at mean 62 months (12 - 175 months), 6 patients had evidence of relapse. Both the 5-year disease specific survival and 5-year overall survival rate were 100%. For surveillance, chemotherapy and RPLND, cumulative 5-year PFS rates were 84.0%, 93.3% and 100%, respectively. Relapse rate was higher in surveillance group than in RPLND group (17.8% vs. 0, χ² = 3.99, P = 0.04). Patients with the history of cryptorchidism also have higher relapse rate than without (37.5% vs. 4.7%, χ² = 10.02, P = 0.01). In the surveillance cohort, relapse rates were significantly higher in patients with a predominant component of embryonal carcinoma (3/6 vs. 7.4%, χ² = 6.93, P = 0.04) and for those over 13 years of age (23.1% vs. 5.3%, χ² = 4.33, P = 0.04). On multivariate analysis, treatment mode of patients (OR = 0.08, 95% CI: 0.06-0.36, P = 0.03) and patients with a history of cryptorchidism (OR = 25.3, 95% CI: 6.57-78.42, P = 0.04) were independent predictors of relapse.</p><p><b>CONCLUSIONS</b>Surveillance, RPLND and adjuvant chemotherapy could be reliable strategies in compliant stage Ia nonseminoma patients and achieve satisfactory overall survival. Relapse rate is relatively higher for patients with surveillance. Those who are older or have a history of cryptorchidism experience a higher risk of relapse.</p>

Intraoperative microvascular Doppler monitoring in intracranial aneurysm surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Surgical treatment of intracranial aneurysms is often compromised by incomplete exclusion of the aneurysm or stenosis of parent vessels. Intraoperative microvascular Doppler (IMD) is an attractive, noninvasive, and inexpensive tool. The present study aimed to evaluate the usefulness and reliability of IMD for guiding clip placement in aneurysm surgery.</p><p><b>METHODS</b>A total of 92 patients with 101 intracranial aneurysms were included in the study. IMD with a 1.5-mm diameter, 20-MHz microprobe was used before and after clip application to confirm aneurysm obliteration and patency of parent vessels and branching arteries. IMD findings were verified postoperatively with digital subtraction angiography (DSA) or dual energy computed tomography angiography (DE-CTA). Ninety consecutive patients, harboring 108 aneurysms, who underwent surgery without IMD was considered as the control group.</p><p><b>RESULTS</b>The microprobe detected all vessels of the Circle of Willis and their major branches. Clips were repositioned in 24 (23.8%) aneurysms on the basis of the IMD findings consistent with incomplete exclusion and/or stenosis. IMD identified persistent weak blood flow through the aneurismal sac of 11 of the 101 (10.9%) aneurysms requiring clip adjustment. Stenosis or occlusion of the parent or branching arteries as indicated by IMD necessitated immediate clip adjustment in 19 aneurysms (18.8%). The mean duration of the IMD procedure was 4.8 minutes. The frequency of clip adjustment (mean: 1.8 times per case) was associated with the size and location of the aneurysm. There were no complications related to the use of IMD, and postoperative angiograms confirmed complete aneurysm exclusion and parent vessel patency. About 8.3% (9/108) aneurysms were unexpectedly incompletely occluded, and 10.2% (11/108) aneurysms and parent vessel stenosis without IMD were detected by postoperative DSA or DE-CTA. IMD could reduce the rate of residual aneurysm and unanticipated vessel stenosis which demonstrated statistically significant advantages compared with aneurysm surgery without IMD.</p><p><b>CONCLUSION</b>IMD is a safe, easily performed, reliable, and valuable tool that is suitable for routine use in intracranial surgery, especially in complicated, large, and giant aneurysms with wide neck or without neck.</p>

Ischemic preconditioning attenuates myocardial no-reflow and reperfusion injury after revascularization of acute myocardial infarction by reducing myocardial edema via the protein kinase A pathway / 中华心血管病杂志

<p><b>OBJECTIVE</b>Myocardial edema plays an important role in the development of myocardial no-reflow and reperfusion injury after the revascularization of acute myocardial infarction (AMI). The present study investigated whether the effect of ischemic preconditioning (IPC) against myocardial no-reflow and reperfusion injury was related to the reduction of myocardial edema through the protein kinase A (PKA) pathway.</p><p><b>METHODS</b>Twenty-four minipigs were randomized into sham, AMI, IPC, and IPC + H-89 (PKA inhibitor, 1.0 µg · kg(-1) · min(-1)) groups. The area of no-reflow (ANR), area of necrosis (AN), and water content in left ventricle and ischemic-myocardium and non-ischemic area were determined by pathological studies. Microvascular permeability was determined by FITC-labeled dextran staining. Cardiomyocyte cross-sectional area (CSA) and mitochondria cross-sectional area (MSA) were evaluated by histological analysis. Myocardial expression of aquaporins (AQPs) was detected by Western blot.</p><p><b>RESULTS</b>Compared with the MI group, the sizes of no-reflow and infarct were reduced by 31.9% and 46.6% in the IPC group (all P < 0.01), water content was decreased by 5.7% and 4.6% in the reflow and no-reflow myocardium of the IPC group (all P < 0.05), microvascular permeability and cardiomyocytes swelling in the reflow area were inhibited by 29.8% and 21.3% in the IPC group (all P < 0.01), mitochondrial water accumulation in the reflow and no-reflow areas of the IPC group were suppressed by 45.5% and 34.8% respectively (all P < 0.01), and the expression of aquaporin-4, -8, and -9 in the reflow and no-reflow myocardium were blocked in the IPC group. However, these beneficial effects of IPC were partially abolished in the IPC + H-89 group.</p><p><b>CONCLUSIONS</b>The cardioprotective effects of IPC against no-reflow and reperfusion injury is partly related to the reduction of myocardial edema by inhibition of microvascular permeability and aquaporins up-regulation via PKA pathway.</p>

Treatment of pelvic Ewing's sarcoma in children and the effect on the skeletal growth and development / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the effect of neo-adjuvant chemotherapy and computer-assisted surgery on children and adolescents with primary pelvic Ewing's sarcoma, and assess the therapeutic effect on the pelvic skeletal growth and development.</p><p><b>METHODS</b>This is a retrospective analysis of 10 children with primary pelvic Ewing's sarcoma treated between Jan 2001 and Oct 2010 at the Department of Oncologic Orthopaedics at Xijing Hospital. There were 3 girls and 7 boys in the age of 7 to 16 years (average 12.7 years). All patients were pathologically diagnosed as Ewing's sarcoma. There were two cases in the sacroiliac joint, one in the ilium, one in the pubic bone, and 6 cases in peri-acetabular area including 5 below the triradiate cartilage and one above the triradiate cartilage, without cartilage invasion. All patients underwent neo-adjuvant chemotherapy, resection and reconstruction surgery and postoperative chemotherapy. CDP, ADM and IFO regimen chemotherapy were given as the main treatment. Five cases were treated by traditional resection and reconstruction, and after 2008, five cases were treated by computer-assisted surgery. During the reconstruction, the hip rotation center was put at a depressed location. All of the 10 cases underwent postoperative radiotherapy in a dose of 45-55 Gy.</p><p><b>RESULTS</b>All patients were followed-up for 12-72 months (mean: 37.8 months). One child had tumor recurrence and lung metastasis and 9 patients had no evidence of disease (NED). After neo-adjuvant chemotherapy, the oncologic statuses (RECIST) were: 1 CR, 8 PR and 1 SD. The functional recoveries after surgery (Enneking's) were: 4 cases excellent, 4 good, 1 fair and 1 poor. Five cases who underwent computer-assisted surgery achieved a good reconstruction without local recurrence. There were no effects on skeletal growth in 8 cases. An unbalanced hip rotational center occurred in one case, and a compemsatory scoliosis was found in another case. There were no serious complications in all patients.</p><p><b>CONCLUSIONS</b>The comprehensive treatment including neo-adjuvant chemotherapy, resection-reconstruction surgery and postoperative chemoradiotherapy may give a good control to primary pelvic Ewing's sarcomas in children and adolescents. The computer-assisted surgery used for accurate tumor resection and pelvic reconstruction is a good alternative when treating young patients with malignant pelvic tumors. The triradiate cartilage in children's acetabulum could be a natural barrier resistant to the invasion of Ewing's sarcomas.</p>

Action mechanisms of complementary and alternative medicine therapies for rheumatoid arthritis / 中国结合医学杂志

Rheumatoid arthritis (RA) is characterized as a chronic inflammatory disease in joints and concomitant destruction of cartilage and bone. Cartilage extracellular matrix components, such as type II collagen and aggrecan are enzymatically degraded by matrix metalloproteinases (MMPs) and aggrecanases in RA. Currently, treatments targeting cytokines, including anti-tumor necrosis factor (TNF) α antibodies, soluble TNF receptor, anti-interleukin (IL)-6 receptor antibody, and IL-1 receptor antagonist, are widely used for treating RA in addition to antiantiinflammatory agents and disease-modifying antirheumatic drugs (DMARDs), such as inflmethotrexate, but these treatments have some problems, especially in terms of cost and the increased susceptibility of patients to infection in addition to the existence of low-responders to these treatments. Therefore, therapeutics that can be safely used for an extended period of time would be preferable. Complementary and alternative medicines including traditional Chinese medicines (TCM) have been used for the arthritic diseases through the ages. Recently, there are many reports concerning the anti-arthritic action mechanisms of TCM-based herbal formulas and crude herbal extracts or isolated ingredients. These natural herbal medicines are thought to moderately improve RA, but they exert various actions for the treatment of RA. In this review, the current status of the mechanism exploration of natural compounds and TCM-based herbal formulas are summarized, focusing on the protection of cartilage destruction in arthritic diseases including RA and osteoarthritis.

The clinical study of epithelioid angiosarcoma in deep soft tissue / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the histopathology of, surgery for, and prognosis (survival rate, local recurrence rate, metastases rate, function) of epithelioid angiosarcoma (EA).</p><p><b>METHODS</b>Seven patients diagnosed as EA were received treatment in our department from May 2001 to May 2011. According Enneking staging, 3 patients were classified as IIA, 3 for IIB, and 1 for III. Wide excision was performed in 3 patients and amputation in 4 patients. Seven patients were followed up from 3 to 20 months.</p><p><b>RESULTS</b>One patient had local recurrence 3 months after wide excision. Five patients had metastases at 4 to 20 months postoperatively. The cumulative survival rate at 0.5, 1 and 2 years postoperatively were 67%, 22% and 0. The function of 3 patients after limb salvage operation was good in 2 cases and poor in 1 case. The tumor site, surgical staging, and safe margin were crucial factors affecting survival rate.</p><p><b>CONCLUSIONS</b>The prognosis of EA in deep soft tissue was poor. Customized, multimodality treatment and safe margin in operation may increase the survival rate as well as decrease recurrence and metastasis.</p>

Value of positron emission tomography-computed tomography in the diagnosis of mediastinal lymph node metastasis of non-small cell lung cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the value of positron emission tomographic-computed tomographic scanning (PET/CT) in the diagnosis of mediastinal lymph node metastasis in patients with non-small cell lung cancer and the application of PET/CT in the clinical staging of NSCLC.</p><p><b>METHODS</b>A hundred and fifty-eight patients with NSCLC undergoing surgical resection and mediastinoscopy received preoperative examinations with PET/CT. All the patients underwent mediastinal lymph node dissection or sampling, and the pathological results were compared with the imaging findings. The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy of CT and PET/CT were compared.</p><p><b>RESULTS</b>Final histology was available for 937 lymph node samples (N1, N2, and N3) from 158 patients during mediastinoscopy or surgical resection. The sensitivity, specificity, and positive and negative predictive values of CT for identifying mediastinal lymph node involvement were 51.0%, 76.1%, 49.0%, and 77.6%, respectively, with an diagnostic accuracy of 68.4%. The sensitivity, specificity, and positive and negative predictive values of PET/CT were 83.7%, 89.0%, 77.4%, and 92.4%, respectively, with a diagnostic accuracy of 87.3%.</p><p><b>CONCLUSION</b>Mediastinoscopy is essential for patients with positive findings of mediastinal lymph node involvement by PET/CT, but might not be necessary in negative patients.</p>

Detection of malignant lymphoma with invasion in liver and spleen using PET/CT imaging / 中华核医学杂志

Objective The detection of malignant lymphoma with invasion in liver and spleen using PET/CT has not been well documented in the literature. This study aimed to investigate the usefulness of PET/CT in this regard and to compare it with plain CT. Methods Forty-one pathologically confirmed malignant lymphoma patients with liver and spleen invasion were recruited into this study. Among all patients, there were 38 non-Hodgkin's lymphoma (NHL), 2 Hodgkin's lymphoma (HL) and 1 gastric mucosa associated lymphoma. PET/CT imaging was recorded 1h after injection of 296～444 MBq 18F-fluorodeoxyglucose (FDG). Results (1) There were 30(30/41) patients with liver invasion, including hepatic nodules, mass and portal nodes. The mass was large to invade surrounding liver parenchyma. (2) There were 23(23/41) patients with spleen invasion. The spleen was enlarged and demonstrated diffused hyper-metabolism. (3) Other invasion included: lung (n=13), cortical bone and marrow (n=12), stomach (n=9), pleural (n=6), and subcutaneous soft tissue (n=5) and so on. Conclusion PET/CT could accurately diagnose the invasion in liver and spleen of malignant lymphoma, which was of potential role on the diagnosis and staging of lymphoma.

Reconstruction with a new type of combined reconstruction following excision of periacetabular tumors / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the reconstructive effect of a new pattern of combined reconstruction after periacetabular tumor resections.</p><p><b>METHODS</b>Between March 2001 and March 2007, tumor resections and new pattern of combined reconstructions which consisted of screw-rod system, acetabular reinforcement shell, antibiotic cement and total hip arthroplasty techniques were performed in 23 patients with periacetabular tumors. There were 7 females and 16 males. The mean age was 43 years (range, 16-78 years). Seventeen patients had primary malignant tumors including 7 chondrosarcomas, 4 osteosarcomas, 2 Ewing sarcomas, 2 malignant fibrohistiocytomas, 1 malignant Schwannomas, and 1 synovial sarcoma. Other primary tumors were 2 giant cell tumors and 1 aggressive osteoblastoma. Three metastatic bone tumors were also included in this study, and the original sites were thyroid, breast, and ovary.</p><p><b>RESULTS</b>According to Enneking's staging system, there were 1 case in IA, 5 cases in IB, 3 cases in IIA, and 8 cases in IIB. Three primary benign bone tumors belonged to stage III. The average follow-up was 36. 8 months (range, 9-73 months) in the patients with primary tumors. The survival time in 3 patients with metastatic disease were between 9.6 months and 36. 6 months. There were 4 patients who had local recurrence, 5 patients had pulmonary metastases, and 5 patients died of disease. No wound complication was encountered. The postoperative complications included 3 cases of screw loosening, 2 cases of prosthetic dislocation, 3 cases of leg length discrepancy, 2 cases of deep vein thrombosis, 1 case of partial neuropraxia of sciatic nerve. The complication rate related to implants was 21.7%. The average MSTS functional score was 68% for all patients at 6 months postoperatively, and 62% for 6 patients with follow-up time more than 5 years.</p><p><b>CONCLUSIONS</b>This new combined reconstruction is an effective way to rebuild pelvic ring and maintain hip function with low complication rate after periacetabular tumor resections.</p>

PET/CT-based classification of delayed radiation encephalopathy following radiotherapy for nasopharyngeal carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate positron-emission tomography-computed tomography (PET/CT) findings of radiation encephalopathy (RE) following radiotherapy for nasopharyngeal carcinoma (NPC), observe the metabolic changes of the compromised brain tissues, and postulate the clinical classification of RE to provide reference for its diagnosis.</p><p><b>METHODS</b>This study included 53 pathologically confirmed NPC patients who received previous radical radiotherapy, and the diagnosis of RE was established according to the clinical manifestations and CT/PET findings. All the patients underwent PET/CT whole-body and head scans, and the image data were evaluated along with the clinical data of the patients.</p><p><b>RESULTS</b>RE most frequently involved the lateral or bilateral inferior temporal lobes. PET identified hypometabolic changes in the bilateral temporal lobes of 35 patients (70 lobes) and in the lateral temporal lobe of 18 patients (18 lobes). According to the PET/CT findings, the lesions were classified into 3 types, namely the oedema type (56 temporal lobes), liquefactive necrosis type (10 temporal lobes), and atrophic calcification type (22 temporal lobes). One patient with oedema type lesion received neurotrophic treatment and recovered completely with normal brain tissue density and metabolism, but the oedema type lesions in 2 patients progressed into to atrophic calcification type; the liquefactive necrotic lesions in another 2 patients also progressed into atrophic calcification type.</p><p><b>CONCLUSION</b>RE patients exhibit significant hypometabolic changes in the inferior temporal lobe on PET. According to the findings by PET/CT, RE can be classified into the oedema type, liquefactive necrosis type, and atrophic calcification type, and lesions of the former two types may progress into the third type.</p>

Analysis of standard uptake values of 18F-FDG PET/CT in relation to pathological classification and clinical staging of nasopharyngeal carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the relation of the standard uptake values (SUV) of 18F-fluorodexygl-gucose (18F-FDG) PET/CT and the pathological classification and clinical staging of nasopharyngeal carcinoma (NPC).</p><p><b>METHOD</b>Whole body 18F-FDG PET imaging was performed in 32 patients with pathologically confirmed NPC, who received no previous treatment. The regions of interest (ROI) covering the pharyngeal and cervical lesions were defined along the margins of the lesion, and the lesion volume and the SUVs were calculated.</p><p><b>RESULTS</b>The SUVs in stage I, II, III, and IV patients were 4.50-/+0.42, 5.62-/+1.44, 7.33-/+1.50, and 8.24-/+2.16, respectively, showing significant differences between them (P < 0.05). In patients in stage T1, T2, T3, and T4, the SUVs increased significantly in advanced stageds (2.56-/+1.05, 3.72-/+0.60, 6.87-/+1.07, and 9.70-/+0.70, respectively, P < 0.05). The SUVs were not significantly different in patients in stages N1, N2, and N3, differed significantly between lymph nodes > 6 cm in size and those < or = 6 cm (5.92-/+1.51 vs 3.48-/+1.31, P < 0.05). The SUV in poorly differentiated squamous carcinoma was significantly lower than that in undifferentiated carcinoma (5.58-/+1.48 vs 8.41-/+1.71, F = 1.3323, P = 0.01).</p><p><b>CONCLUSIONS</b>The SUV is not associated with the clinical staging of NPC, but is correlated to the T staging of NPC. Though irrelevant to the N staging of NPC, the SUV is correlated to the size of the lymph nodes, and also related to the degree of differentiation of NPC.</p>

Magnetic resonance imaging survey of the upper airway in different age non-snoring males / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the morphology characters of upper airway and its surrounding tissues in different age non-snoring males.</p><p><b>METHODS</b>Total of 114 non-snoring males, with age-range from 22 to 78 year old, were included in this study. They were divided into 3 groups: 30 in younger group (22-29 years old), 57 in middle-aged group (36-57 years old), and 31 in aged group (70-78 years old). All subjects had magnetic resonance imaging scanning.</p><p><b>RESULTS</b>(1) The nasopharynx in aged group was statistically different from that of the younger group and the middle aged group. The volume of nasopharynx in aged group (7.81 +/- 1.59) cm3 (x +/- s, same herein after) is greater than that in younger group (4.89 +/- 1.20) cm3 and middle aged groups (6.06 +/- 2.07) cm3. (2) The AP diameter/transverse diameter of velopharynx, glossopharynx and laryngopharynx in the aged group tended to be smaller. The average value of AP diameter/transverse diameter of velopharynx in aged group is 0.46 +/- 0.14, while the value is 0.59 +/- 0.14 and 0.57 +/- 0.14 in middle and young groups respectively, compared with that of the aged group, there is statistical difference (P < 0.01). Further more, the min/max section area of velopharynx, glossopharynx, laryngopharynx in aged group are smaller than that of young group and midlife groups. (3) The aged group had the thinnest thickness of posterior and lateral velopharyngeal walls, but the largest volume of soft palate and fat pads among all groups.</p><p><b>CONCLUSIONS</b>In non-snoring males, there is more fat deposition around the upper airway with aging. While the large nasopharynx and large transverse diameter of upper airway seem to balance the disadvantaged changes and to benefit the their sleep respiration.</p>

PET/CT imaging of delayed radiation encephalopathy following radiotherapy for nasopharyngeal carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>With the significant improvement in the survival of patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy and the growing availability of the sophisticated imaging modalities, the number of radiation encephalopathy (RE) cases relating to NPC radiotherapy is increasing. In this study, we investigated the metabolic and density changes of the compromised brain tissues during delayed RE using a positron-emission tomography-computed tomography (PET/CT) to provide clinical evidences for the diagnosis of delayed RE following radiotherapy for NPC.</p><p><b>METHODS</b>The PET/CT manifestations and the clinical data of 53 pathologically confirmed NPC patients with delayed RE following radical radiotherapy and 15 healthy volunteers were investigated. The standardized uptake values (SUV) of the bilateral temporal lobes, the occipital lobe and the brain stem were measured respectively; and then the metabolic reduction rate of 88 temporal lobes and 13 brain stems were calculated for a statistical comparison between the two groups.</p><p><b>RESULTS</b>The earliest case of delayed RE in the investigated patients occurred 1.5 years after radiotherapy. Delayed RE frequently involved the inferior temporal lobe. For patients with delayed RE confirmed by clinical symptoms and imaging findings, PET maintained a 100% coincidence rate with CT; however, in the 25 temporal lobes of the 35 delayed RE patients, PET revealed obvious hypometabolic changes whereas CT displayed normal density. The incidence of brain stem metabolic reductions was 24.5% (13/53) in the investigated patients, including 4 patients with hypometabolic changes shown by PET and negative finding shown by CT. The incidence of granuloma adjacent to the hypometabolic region in the temporal lobe was 12.5% (11/88).</p><p><b>CONCLUSION</b>Delayed RE patients exhibit significant hypometabolic changes in the inferior temporal lobe, captured by PET much earlier than by CT. PET/CT offers a valuable means for the diagnosis of delayed RE in subacute stages and granuloma formation.</p>

Analysis of Surveillance of Birth Defect on Perinatal Fetuses in Hubei Province during 2001-2005 / 实用儿科临床杂志

Objective To analyze the prevalence and factors of birth defect on perinatal fetuses in Hubei province.Method The prevalence of birth defect on perinatal fetuses delivered in 28 weeks or more was analyzed in Hubei surveillance hospital of birth defect during 2001-2005 year.Results The prevalence rate of birth defect on perinatal feruses from 2001 to 2005 year was 107.39 per 10 000,and increased significantly than that in 2001 year 81.07 per 10 000(?2=39.505 P