Long-term outcome of transcatheter repair of paravalvular leak post surgical mitral valve replacement / 中华心血管病杂志

Objective: To explore the long-term clinical efficacy of transcatheter repair of mitral paravalvular leak (PVL) post surgical mitral valve replacement. Methods: This study is a retrospective study. Patients who completed transcatheter repair of paravalvular leak after surgical mitral valve replacement at Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine from March 2010 to December 2018 were included. Technical success was defined as the occluder being stably implanted in the paravalvular leak site without affecting the function of the mitral valve and surrounding tissues; and there were no intervention-related complications, such as new hemolysis or aggravated hemolysis, and echocardiography confirmed mitral paravalvular regurgitation reduced by more than 1 grade. Patients were followed up at 30 days, 1, and 3 years after the intervention. The main endpoints were all-cause death and re-surgery due to interventional failure or serious complications. The occurrence of occluder-mediated hemolysis and chronic renal insufficiency was recorded, and patients were monitored with echocardiography during follow up. Results: A total of 75 patients were included, aged (54.3±22.9) years old, and 38 patients were males. All patients had decreased cardiac function and/or hemolysis before intervention. Procedural success was achieved in 54 patients (72.0%). Incidence of device-mediated hemolysis was 18.7% (14/75). During the follow-up period, all-cause death occurred in 7 patients (9.3%), and 3 were cardiac deaths.The 3-year event-free survival rate was 81.3% (61/75). The need for cardiac surgery was 9.3% (7/75): 3 cases due to severe device-mediated hemolysis, 2 cases due to prosthetic valve failure and 2 cases due to moderate to severe residual regurgitation. The echocardiography follow-up results showed that the position of the occluder was stable, there was no impact on the artificial valve function and surrounding structures, and the residual regurgitation was stable without progressive increase in event-free patients. Compared with pre-intervention, the left ventricular end systolic diameter ((33.9±7.4)mm vs. (38.3±8.9) mm, P=0.036), end diastolic diameter ((53.7±8.3) mm vs. (58.4±9.1) mm, P=0.045) and left atrial diameter (59.3 (44.5, 90.7) mm vs. 64.3 (44.8, 96.6) mm, P=0.049) were significantly reduced, pulmonary artery systolic pressure was also significantly decreased ((36.5±15.8) mmHg vs. (46.3±14.9) mmHg, P=0.022, 1 mmHg=0.133 kPa). There was no significant difference between 3 years and 1 year after transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement (all P>0.05). Conclusion: Transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement is an effective treatment option in selective patients.

Clinical analysis of 5 cases of systemic juvenile idiopathic arthritis with coronary artery dilatation / 中华儿科杂志

Objective: To investigate the clinical characteristics of systemic juvenile idiopathic arthritis combined with coronary artery dilatation. Methods: A retrospective analysis was performed on the clinical data, including clinical manifestations, blood routine, inflammatory factors, echocardiography, vascular ultrasound and CT angiography, treatment and outcomes, etc, of 5 cases with systemic juvenile idiopathic arthritis combined with coronary artery dilation admitted to Department of Rheumatology in the affiliated Children's Hospital of Capital Institute of Pediatrics from May 2019 to June 2021. Results: There were 2 males and 3 females among 5 cases. The onset age ranged from 7 months to 4 years 7 months.The diagnostic time ranged from 1.5 months to 3.0 months.Four cases were diagnosed as atypical Kawasaki disease. Three cases showed unilateral coronary artery dilation.Two cases showed bilateral coronary artery dilation.Four cases developed multiple organ injuries.Three cases developed macrophage activation syndrome.Three cases developed lung injury.Two cases developed pericardial effusion.One case developed pulmonary hypertension.As for treatment, 3 cases treated with methylprednisolone pulse therapy and methotrexate combined with cyclosporine, improved after the final application of biological agents, and have stopped prednisone. The other 2 cases were treated with adequate oral prednisone and gradually reduced, and methotrexate was added at the same time, 1 case relapsed in the process of reduction. No other vascular involvement was found in 5 cases. Coronary artery dilation recovered completely after 1 to 3 months of treatment. Conclusions: Systemic juvenile idiopathic arthritis combined with coronary artery dilatation has the clinical characteristics of small onset age, long diagnostic time, prone to multiple organ injuries. Corticosteroids and conventional immunosuppressive agents are not sensitive, and biological agents should be used as soon as possible.The prognosis of coronary artery dilation is good after timely treatment.

A sequential conditional mean model for assessing total effects of exposure in longitudinal data / 中华流行病学杂志

In prospective cohort study, multi follow up is often necessary for study subjects, and the observed values are correlated with each other, usually resulting in time-dependent confounding. In this case, the data generally do not meet the application conditions of traditional multivariate regression analysis. Sequential conditional mean model (SCMM) is a new approach that can deal with time-dependent confounding. This paper mainly summarizes the basic theory, steps and characteristics of SCMM.

Treatment of Retroperitoneal Cavernous Lymphangioma: A Case Report / 中国医学科学杂志(英文版)

A 32-year-old man who complained of recurrent nauseat and vomiting was admitted to our hospital. The contrast-enhanced computed tomography revealed a cystic mass located behind the duodenum which was suggestive of lymphangioma. Laparoscopic resection of the retroperitoneal mass was successfully performed. The postoperatively pathological examination confirmed the diagnosis of cavernous lymphangioma. Ultrasound and enhanced CT can be used for making a preoperative diagnosis. Once symptoms of the disease develop, complete surgical resection should be performed.

Prognostic analysis of recurrence in children and adolescents with differentiated thyroid cancer / 中华医学杂志(英文版)

BACKGROUND@#The standard treatment for pediatric differentiated thyroid carcinoma (DTC) still requires consideration because of a lack of clinical evidence. The purpose of this study was to summarize the clinical experiences and explore the risk factors for post-operative recurrence through a retrospective analysis to develop better clinical strategies for pediatric DTC.@*METHODS@#This study retrospectively analyzed children and adolescents with DTC who were treated between January 1999 and December 2014 at the Cancer Hospital, Chinese Academy of Medical Sciences. Clinicopathological results and outcomes were collected. A log-rank test of Kaplan-Meier curves and the Cox regression model were used to determine the factors associated with recurrence.@*RESULTS@#Data of 150 patients were collected in this study. During the follow-up, there was only one disease-related death. The recurrence rates at 3, 5, and 10 years were 13.6%, 18.7%, and 28.6%, respectively. There was a significant difference in the rate of recurrence according to age (P < 0.001), extrathyroidal extension (P < 0.001), lymph node metastasis (P = 0.023), and invasion of the trachea and esophageal wall (P = 0.004). Cox regression analysis demonstrated that age (P = 0.006) and extrathyroidal extension (P = 0.013) were significant dependent factors of post-operative recurrence.@*CONCLUSIONS@#The prognosis of DTC in children and adolescents is favorable. A close follow-up is recommended because of the high recurrence rate. A comparatively higher recurrence rate was observed in the younger age group, and new age-based divisions may be needed to conveniently evaluate the possibility of recurrence.

Surveillance of schistosomiasis in a national surveillance site of Jurong City, 2015–2017 / 中国血吸虫病防治杂志

Objective To understand the endemic situation and control effect of schistosomiasis through the surveillance in a national surveillance site of Jurong City, so as to provide the evidence for formulating the prevention and control measures. Methods According to the National Schistosomiasis Monitoring Scheme (2014 Edition), the surveillance of schistosome infection in Oncomelania hupensis snails, residents and livestock was performed in the Kongqing Village, a national surveillance site of Jurong City, from 2015 to 2017. Results The areas with snails were 0, 0, and 0.63 hm2 in 2015, 2016, and 2017 respectively; the average densities of living snails were 0, 0, and 0.19 snails/0.1 m2 in 2015, 2016, and 2017 respectively. No schistosome-infected snails were found. The positive rates of blood tests for schistosomiasis in the local residents were 7.72%, 7.45% and 3.45%, and the positive rates of blood tests in the floating population were 4.90%, 3.47% and 0.97% in 2015, 2016 and 2017, respectively. No positives were found in the schistosome etiology detection in the crowd and livestock. Conclusions The effect of schistosomiasis prevention and control is obvious in Jurong City, but O. hupensis snails are still of recurrence. Therefore, the monitoring and control efforts should be strengthened to consolidate the achievements of schistosomiasis prevention and control.

Surveillance of schistosomiasis in a national surveillance site of Jurong City, 2015–2017 / 中国血吸虫病防治杂志

Objective To understand the endemic situation and control effect of schistosomiasis through the surveillance in a national surveillance site of Jurong City, so as to provide the evidence for formulating the prevention and control measures. Methods According to the National Schistosomiasis Monitoring Scheme (2014 Edition), the surveillance of schistosome infection in Oncomelania hupensis snails, residents and livestock was performed in the Kongqing Village, a national surveillance site of Jurong City, from 2015 to 2017. Results The areas with snails were 0, 0, and 0.63 hm2 in 2015, 2016, and 2017 respectively; the average densities of living snails were 0, 0, and 0.19 snails/0.1 m2 in 2015, 2016, and 2017 respectively. No schistosome-infected snails were found. The positive rates of blood tests for schistosomiasis in the local residents were 7.72%, 7.45% and 3.45%, and the positive rates of blood tests in the floating population were 4.90%, 3.47% and 0.97% in 2015, 2016 and 2017, respectively. No positives were found in the schistosome etiology detection in the crowd and livestock. Conclusions The effect of schistosomiasis prevention and control is obvious in Jurong City, but O. hupensis snails are still of recurrence. Therefore, the monitoring and control efforts should be strengthened to consolidate the achievements of schistosomiasis prevention and control.

Analysis of clinical effects of anterior segmental decompression for multi-segment cervical spondylotic myelopathy / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of anterior segmental decompression for the treatment of multi-segment cervical spondylotic myelopathy.</p><p><b>METHODS</b>The clinical data of 84 patients with multi-segment cervical spondylotic myelopathy treated between August 2005 to March 2016 were retrospectively analyzed. According to different operative methods the patients were divided into control group and observation group, with 42 cases in each group. In the control group, including 26 males and 16 females, the age was (56.87±11.89) years old and course of disease was(7.91±3.71) years on average, the lesion segment occurred on C₃-C₆ of 36 cases and on C₄-C₇ of 6 cases. There were 24 males and 18 females in observation group, with the mean age of (54.58±12.56) years old, and the course of disease was(8.03±3.52) years, the lesion segment occurred on C₃-C₆ of 34 cases, and on C₄-C₇ of 8 cases. The patients in control group were treated with posterior laminoplasty, and the patients in observation group underwent anterior segmental decompression. Operation time, intraoperative blood loss, hospitalization time, bone graft fusion time and complication rate were observed between two groups. JOA scores and Cobb angle of fusion segment were compared before operation and 3, 6, 9 months after operation.</p><p><b>RESULTS</b>Operation time, intraoperative blood loss, hospitalization time and complication rate in observation group were significantly lower than in control group(<0.05); the bone fusion time in observation group was significantly lower than in control group(<0.01);3, 6, 9 months after surgery, JOA score and the segment Cobb angle in observation group were significantly higher than in control group(<0.01).</p><p><b>CONCLUSIONS</b>Anterior segmental decompression for the treatment of multi-segment cervical spondylotic myelopathy has obvious advantages of less vertebral resection, thorough decompression, good stability, less postoperative complications, which can effectively promote the recovery of the spinal cord function and vertebral stability.</p>

Collapsin Response Mediator Protein-2-induced Retinal Ischemic Injury in a Novel Mice Model of Ocular Ischemia Syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Collapsin response mediator protein-2 (CRMP2) has been shown to be involved in ischemia/hypoxia (IH) injury. We determined whether CRMP2 modulates ischemic injury in the retinal of Ocular ischemic syndrome (OIS). This study was to explore the molecular mechanisms underlying OIS in a novel mice model.</p><p><b>METHODS</b>Experiments were performed on adult male C57/BL6 mice that received bilateral internal carotid arteries ligation for 1, 2, or 4 weeks. The mice received injection of calpeptin group before occlusion for 4 weeks or not. The expression of CRMP2 in the retinal was examined by western blotting (WB) analysis and immunohistochemical analysis (IHC). The effects of ischemic injury on retinal were evaluated by fundus examination, fundus fluorescein angiography, electroretinogram, cell counting of retinal ganglion cell (RGC), and measurement of the thickness of the retina.</p><p><b>RESULTS</b>The veins dilated after chronic ischemia. In the electroretinography, the amplitudes of a- and b-waves kept diminishing in an ischemia time-dependent manner. Moreover, the tail vein-retinal circulation time prolonged in the 1- and 2-week group. In comparison, thickness of the retina decreased gradually with the ischemia time elapsed. WB analysis showed the CRMP2 and p-CRMP2 levels decreased in the 2- and 4-week groups. The results of IHC analysis were compatible with our results of WB. The loss of RGCs, decrease of the total reaction time and reduction of CRMP2 was alleviated by intravitreal injection of calpeptin.</p><p><b>CONCLUSIONS</b>These results revealed that bilateral ligation of the internal carotid artery causes retinal ischemia in mice. Moreover, CRMP2 might play a pivotal role during the ischemic injury in the retina and inhibit the cleavage of CRMP2 can ameliorate the IH injury.</p>

Epidemiological survey of Haemophilus influenzae-positive hospitalized children: a retrospective analysis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the basic clinical characteristics and drug resistance of Haemophilus influenzae (Hi) infection in hospitalized children in the past two years.</p><p><b>METHODS</b>A retrospective cross-sectional study was conducted to analyze Hi strains isolated from the sputum and pharyngeal swabs of children aged 0-17 years who were hospitalized in the Third People's Hospital of Chengdu between June 2011 and May 2013.</p><p><b>RESULTS</b>A total of 117 strains were isolated from 111 hospitalized children. There were 102 cases (91.9%) of respiratory infection and 9 cases (8.1%) of other diseases. The positive rates of Hi in children with bronchopneumonia or pneumonia (50.8%, 30/59) and in children with acute laryngotracheobronchitis (50.0%, 2/4) were relatively high, followed by in children with capillary bronchitis (34.6%, 9/26), in children with acute bronchitis (24.2%, 32/132), in children with herpangina (19.0%, 4/21), in children with asthmatoid bronchitis (17.9%, 5/28), in children with acute upper respiratory tract infection (11.8%, 9/76), in children with acute tonsillitis (8.2%, 7/85), and in children with neonatal pneumonia (5.6%, 3/54). There were significant differences in the rates of resistance to amoxicillin-clavulanate (15% vs 23%; P=0.010) and chloramphenicol (25% vs 8%; P=0.015) between the two survey years. The frequencice of β-lactamase-nonproducing-ampicillin-resistant (BLNAR) strains and β-lactamase-producing-amoxicilli/clavulanate-resistant (BLPACR) strains increased from 12% to 21% and from 13% to 19% respectively during the two survey years (P>0.05).</p><p><b>CONCLUSIONS</b>Hi plays an important role in the respiratory tract infection of children aged 0-17 years. The increasing trend of BLNAR and BLPACR rates makes it harder for antibiotic selection in clinical practice.</p>

Survival Outcome of Squamous Cell Carcinoma Arising from Sinonasal Inverted Papilloma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sinonasal inverted papilloma (IP) is a rare benign tumor of the nasal cavities and paranasal sinuses. It is destructive or bone-remodeling, tends to recur after surgical resection, and has a significant malignant potential. The present study aimed to perform a retrospective analysis of patients with squamous cell carcinoma (SCC) arising from IP, including characteristics, survival outcome, and predictors of associated malignancy.</p><p><b>METHODS</b>The medical records of 213 patients diagnosed with IP from January 1970 to January 2014 were retrospectively reviewed. Eighty-seven patients were diagnosed with SCC/IP; their clinical characteristics, treatments, and survival outcomes were analyzed.</p><p><b>RESULTS</b>Of the 87 patients with SCC/IP, the 5- and 10-year overall survival outcomes were 39.6% and 31.8%, respectively. Twenty-nine of these patients received surgery and 58 received combined surgery and radiation. Of the patients with stages III-IV, the 5-year survival rate was 30.7% for those treated with surgery only and 39.9% for those given the combination treatment (P = 0.849). Factors associated with significantly poor prognosis were advanced-stage, metachronous tumors, or with cranial base and orbit invasion. Age, synchronous or metachronous tumors, and pathological stage were independent risk factors for mortality, shown by multivariate analysis.</p><p><b>CONCLUSION</b>Patients with SCC/IP had low overall survival outcomes. Advanced age, stage, and metachronous tumors are the main factors affecting prognosis. Treatment planning should consider high-risk factors to improve survival outcome.</p>

Association between toll-like receptors 2 and 5 polymorphisms and neonatal sepsis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the association between single nucleotide polymorphisms(SNP) in toll-like receptors (TLR) 2 and 5 genes and the susceptibility to neonatal sepsis.</p><p><b>METHODS</b>One hundred and fourteen newborn infants who were diagnosed with clinical sepsis (case group) between May 2011 and January 2014 and 172 newborn infants without infection(control group) were enrolled in this study. The polymorphisms of TLR2 (rs5743708 and rs3804099) and TLR5 (rs5744105) were analyzed using a SNaPshot multiplex reaction to compare the genotypic and allelic frequencies between two groups. The relationship between TLR genotypes and susceptibility to sepsis was analyzed by logistic regression models.</p><p><b>RESULTS</b>Significant differences in genotypic frequencies of TLR2 rs3804099 (C/T) and TLR5 rs5744105 (C/G) were found between the two groups (P<0.05), but there was no significant difference in allelic frequencies of all the SNPs above between the two groups (P>0.05). The genotype on TLR2 rs5743708 was GG and no mutation was found in both groups. In regression models, birth weight (OR=3.065; P<0.05) and gestational age (OR=3.301; P<0.05) were closely associated with neonatal sepsis. Sex (OR=1.107, P>0.05), polymorphisms in rs3804099 (OR=0.876; P>0.05) and polymorphisms in rs5744105 (OR=0.820; P>0.05) genes were not risk factors for neonatal sepsis.</p><p><b>CONCLUSIONS</b>TLR2 and 5 polymorphisms (rs5743708, rs3804099 and rs5744105) may not serve as the susceptible gene for sepsis in newborn infants.</p>

Simultaneous determination of four effective components in Jishengshenqi tablets by HPLC / 中国药学杂志

OBJECTIVE: To establish an HPLC method for simultaneous determination of the contents of loganin, paeoniflorin, cinnamaldehyde, and paeonol in Jishengshenqi tablets traditional Chinese medicines. METHODS: SHISEIDO MG II C18 column(4.6 mm × 250 mm, 5 μm) was used. The mobile phase was acetonitrile and water with gradient elution. The detection wavelengths were set at 238 nm for loganin and paeoniflorin and 280 nm for cinnamaldehyde and paeonol. The column temperature was 30°C and the flow rate was 1.0 mL · min-1. RESULTS: Loganin, paeoniflorin, cinnamaldehyde, and paeonol showed good linear relationships within their respective linear ranges. The average recoveries were 97.6%, 100.5%, 101.9%, and 102.8%, respectively. CONCLUSION: The method is simple, accurate, repeatable, and can be used to control the quality of Jishengshenqi tablets.

Application value of sentinel node biopsy in early stage oral tongue cancer with clinically negative neck / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the liability of sentinel node biopsy in the treatment of early stage oral tongue carcinoma with clinically negative neck.</p><p><b>METHODS</b>Eighteen patients with T1 or T2 oral tongue carcinoma were enrolled in the prospective study. Preoperative lymphoscintigraphy and intra-operative hand-held gamma probe techniques were used to detect the sentinel lymph nodes. The sentinel lymph node biopsies were sent to frozen section pathology and the results were compared with specimen of routine selective neck dissection (I ∼ III or I ∼ IV). The accuracy of cervical metastasis prediction was compared between sentinel node biopsy and tumor thickness.</p><p><b>RESULTS</b>Sentinel lymph nodes were identified in all 18 cases. The numbers of sentinel lymph nodes of level Ib, IIa and III were 6, 22 and 2, respectively. In this series, positive sentinel lymph nodes were revealed in 4 cases, which were also positive in the postoperative routine histology.In other cases, both sentinel lymph nodes and routine histology were negative. Both the sensitivity and specificity were 100%. Sentinel lymph node biopsy obviously improved the specificity of predicting cervical metastasis comparing with the tumor thickness. (100% vs. 36.4%).</p><p><b>CONCLUSION</b>Sentinel node biopsy is effective and reliable in the treatment of early stage oral tongue cancer, and deserves clinical application.</p>

Prognostic value of the number of lymph nodes retrieved after selective neck dissection in hypopharyngeal squamous carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To discuss the influence of the number of lymph nodes retrieved after selective neck dissection on the prognosis of hypopharyngeal squamous carcinoma.</p><p><b>METHODS</b>A retrospective review was performed on 96 patients with hypopharyngeal squamous carcinoma between January 1995 and December 2009, and all cases were accepted initial treatment for selective neck dissection. t test was used for analysis of normally distributed and Mann-Whitney U test for non-normally distributed continuous data in two groups. Comparisons were made by χ(2) analysis for categorical variables. Overall survival, disease-free survival and neck-control rate were calculated by the Kaplan-Meier method.</p><p><b>RESULTS</b>The mean number of lymph nodes retrieved in all patients with hypopharyngeal squamous carcinoma was 19.0 ± 11.3. Preoperative radiotherapy significantly decreased the number of retrieved lymph nodes and positive lymph nodes (t = -4.45, P < 0.001 and U = 568, P < 0.001, respectively). The number of nodes retrieved ≤ 15 was associated with 3-year overall survival of 37.7% compared with 71.3% in those with nodes retrieved > 15 by using Kaplan-Meier analysis (χ(2) = 8.214, P < 0.01). 3-year disease-free survival rates were 34.8% in those with ≤ 15 nodes and 61.7% in patients with > 15 nodes (χ(2) = 7.345, P < 0.01). The 3-year neck-control rates were 97.4% and 76.7% (> 15 nodes vs. ≤ 15 nodes;χ(2) = 5.539, P < 0.05), respectively. After adjusting for the effect of T stage and N stage on multivariate analysis, the number of nodes retrieved > 15 was an independent prognostic factor in patients undergoing selective neck dissection for hypopharyngeal squamous carcinoma (P < 0.05).</p><p><b>CONCLUSIONS</b>The number of lymph nodes retrieved is a valuable prognostic factor in patients received selective neck dissection for hypopharyngeal squamous carcinoma. These results suggest that at least 15 nodes should be examined in this setting.</p>

Clinical analysis of 27 cases of well differentiated carcinoma of the thyroid isthmus / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Well differentiated thyroid carcinoma (WDTC) may be located in the isthmus. The guidelines now have not mentioned an appropriate procedure for WDTC in the isthmus. The aim of this study was to retrospectively analyze the outcomes in patients with WDTC in the isthmus treated at our institution.</p><p><b>METHODS</b>Twenty-seven patients with WDTC in the isthmus were managed by surgery in the Cancer Hospital of Chinese Academy of Medical Sciences from 1985-2006. Their demographic data, surgical procedures, pathological features, stages and outcomes were analyzed.</p><p><b>RESULTS</b>Five patients were men and 22 were women. The median age was 41 (range, 20-69) years. Nine patients received isthmusectomy, fourteen patients received extended isthmusectomy and four received isthmusectomy with unilateral lobectomy. There were no complications of recurrent laryngeal nerve palsy or hypocalcaemia. The median size of lesion was 1.0 cm(range, 0.5-4.0 cm). Sixteen patients had a pathologically T1a lesion (pT1a), seven patients were pT1b, two patients were pT2 and two pT3. Three patients had papillary carcinoma detected in perithyroid lymph nodes (pN1a). Among the 27 cases, 25 patients had a solitary malignant nodule confined to the isthmus, one had two malignant nodules confined to the isthmus and one had two malignant nodules located separately in the isthmus and right lobe. The patients were followed up with a median follow-up time of 85 months(range, 37-274 months). The 5-year recurrence-free survival was 95.2% and overall survival rate was 100%.</p><p><b>CONCLUSIONS</b>Our results suggest that isthmusectomy or extended isthmusectomy are feasible and efficient for the patients with WDTC located in the isthmus, and concurrent pretracheal lymph node dissection should be considered.</p>

Prognostic value of lymph node ratio in hypopharyngeal squamous cell carcinoma after chemoradiotherapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Lymph node ratio (LNR) has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell carcinoma (HPSCC) after neoadjuvant therapy in our institution.</p><p><b>METHODS</b>We performed a retrospective study of 279 patients with HPSCC who underwent radiotherapy with or without chemotherapy followed by neck dissection between November 1965 and December 2008. Patients were divided into four groups according to quartiles based on LNR.</p><p><b>RESULTS</b>The mean LNR was 10.4% (range 0-100%, median 4.3%). Males and advanced clinical N classification significantly increased the LNR (P = 0.014 and P < 0.001, respectively). Compared with those with LNR <0.14, LNR ≥0.14 was associated with reduced overall, disease-specific and disease-free survival (all at P < 0.001). Multivariate analysis revealed that LNR is an independent predictor of prognosis.</p><p><b>CONCLUSION</b>Our results suggest that LNR is a strong predictor of HPSCC after chemoradiotherapy.</p>

Association of antigen processing machinery and HLA class I defects with clinicopathological outcome in laryngeal squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the role of antigen-processing machinery (APM) component defects in HLA class I antigen down-regulation in laryngeal squamous cell carcinoma (SCC) and to assess the clinical significance of these defects.</p><p><b>METHODS</b>Fifty-one formalin-fixed, paraffin-embedded SCC specimens were examined for the expressions of APM component transporter associated with antigen processing (TAP1) and low molecular weight polypeptide (LMP-7) and HLA class I antigen by immunohistochemistry.</p><p><b>RESULTS</b>HLA class I antigens, TAP-1 and LMP-7 expressions were down-regulated in 56.9% (29/51), 39.2% (20/51) and 45.1% (23/51) of the tested specimens respectively, whereas HLA class I antigens, TAP-1 and LMP-7 expressions lost in 21.6% (11/51), 33.3% (17/51) and 27.5% (14/51) of the tested specimens respectively. TAP-1 and LMP-7 expressions were significantly correlated with HLA class I antigen expression (r=0.460, P<0.05 and r=0.685, P<0.05, respectively). HLA class I antigens down-regulation was significantly correlated with T stage (χ2=8.61, P<0.05). Both TAP-1 and LMP-7 down-regulations were significantly correlated with T stage (χ2 values were 9.72 and 8.97 respectively, P<0.05) and TNM stage (χ2 values were 9.18 and 7.70 respectively, P<0.05). TAP-1, LMP-7 and HLA class I antigen down-regulations were significantly associated with reduced patients' overall survival (P<0.05) and disease-free survival (P<0.05). Multivariate analysis showed lymph node metastasis, recurrence and HLA class I antigen down-regulation were unfavorable prognostic factors (P<0.05).</p><p><b>CONCLUSIONS</b>Down-regulated expressions of HLA class I antigen and APM component TAP-1 and LMP-7 occur frequently in laryngeal squamous cell carcinoma, by which cancer cells could avoid immune surveillance, while HLA class I antigen down-regulation is a major contributing factor to tumour progression and mortality.</p>

Clinical outcomes of salvage surgery for nasopharyngeal carcinoma after irradiation failure / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study salvage surgery for persistent or recurrent nasopharyngeal carcinoma after irradiation failure.</p><p><b>METHODS</b>A total of 84 cases underwent salvage surgery for persistent or recurrent nasopharyngeal carcinoma after irradiation failure between 1993 and 2009 was reviewed. rTNM stage: rT1 34 cases, rT2 27 cases, rT3 12 cases and rT4 11 cases; rN0 70 cases, rN1 9 cases and rN2 5 cases; No with distance metastatic. The salvage surgeries were performed using maxillary swing approach (47 cases), transcervical-mandibulo-palatal approach (21 cases), palate nasopharyngectomy (6 cases), lateral rhinotomy (7 cases), and maxillectomy (3 cases).</p><p><b>RESULTS</b>Persistent or recurrent nasopharyngeal carcinoma after irradiation failure was resected completely in 57 patients (67.9%) and there were microscopic residual diseases in 27 patients (32.1%). The median follow-up was 27 months. Postoperative recurrence occurred in 35 cases. Thirty-six patients died of recurrence, metastasis and other diseases. The overall 5 year survival rate was 43.6%. Cox regression analysis indicated the complete resection for persistent or recurrent disease and no cervical metastasis were two independent factors affecting survival.</p><p><b>CONCLUSIONS</b>Salvage surgery for persistent or recurrent nasopharyngeal carcinoma after irradiation failure is an effective treatment.</p>

Analysis on 71 patients with polycythemia vera / 中国实验血液学杂志

The aim of this study was to analyse the clinical characteristics and laboratory data, treatment and prognosis of polycythemia vera (PV). A retrospective study was performed for 71 PV patients treated in our hospital during January 2001 to July 2011 including analysis of clinical characteristics, laboratory data, myelogram chromosome karyotypes, BCR/ABL and JAK2V617F genes, as well as lactate dehydrogenase (LDH) and neuron-specific enolase (NSE) levels in serum and so on. The results showed that 71 patients (37 males and 34 females with a average age of 57.8 years) were diagnosed. Thrombosis and embolism occurred in 34 patients (47.89%), hemorrhage in 10 patients (14.08%), splenomegaly occurred in 44 patients. The onset of the disease was insidious, 13 patients (18.31%) were found to have PV during the treatments for other diseases. The average hemoglobin at diagnosis was 206.31 (171 - 242) g/L. JAK2V617F mutation was detected in 31 (81.58%) of 38 patients studied. The average levels of serum LDH and NSE were higher than normal and both positively correlated with hemoglobin (P = 0.007, P = 0.005). The disease outcomes were myelofibrosis for 3 patients, death from cerebral hemorrhage for 1 patient, and death from ineffective chemotherapy in 1 patient with ANLL-M2. It is concluded that PV is a chronic myeloproliferative disorder characterized predominantly by thrombosis and hemorrhage. The serum LDH and NSE levels are higher than the normal values. It is inferred that the serum LDH and NSE levels can reflect the degree of malignant proliferation of bone marrow hematopoietic cells and also can be used as an indicator to judge the therapeutic effect of PV.