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ObjectiveTo establish an integrated method of fingerprint qualitative, multi-component quantitative analysis and chemometrics, and to evaluate the quality attributes and differences of Aurantii Fructus from different production areas and origins. MethodAnalysis was performed on COSMOSIL 5C18-MS-Ⅱ column (4.6 mm×250 mm, 5 μm) with the mobile phase of acetonitrile-0.2% phosphoric acid solution for gradient elution (0-4 min, 19%A; 4-5 min, 19%-21%A; 5-18 min, 21%A; 18-19 min, 21%-28%A; 19-27 min, 28%A; 27-28 min, 28%-40%A; 28-36 min, 40%A; 36-37 min, 40%-50%A; 37-42 min, 50%-60%A; 42-46 min, 60%-95%A; 46-55 min, 95%-100%A), the flow rate was 1 mL·min-1, the column temperature was 30 ℃, the detection wavelength was set at 320 nm, and the injection volume was 10 μL. High performance liquid chromatography (HPLC) fingerprints of Aurantii Fructus from different production areas and origins were established. Then, the quality of 26 batches of samples was evaluated by cluster analysis (CA), principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). A method for the determination of 12 components was developed and verified, and a thermal map-based CA of Aurantii Fructus from different production areas and origins was carried out based on the content difference of samples. ResultThe fingerprint and determination methods were well verified. The similarity of HPLC fingerprint of 12 batches of Aurantii Fructus was 0.85-0.996, 20 common peaks were calibrated and 14 of them were assigned. The resolution and linear relationship of 12 components in quantitative analysis were good. The recovery rates were 99.2%-101.0% with RSD≤2.0%. The results of CA, PCA and OPLS-DA indicated that the differentiation of Aurantii Fructus in different production areas was great, and there were differences among different cultivars. ConclusionThe qualitative analysis of fingerprint and quantitative analysis of multiple indexes based on the same chromatographic analysis conditions are convenient, accurate and reliable, and combined with chemometrics, the identification and quality analysis of Aurantii Fructus from different production areas and origins can be realized, which can provide reference for quality control and evaluation of Aurantii Fructus.
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OBJECTIVE@#To evaluate systematically the efficacy and safety of COVID-19 vaccines.@*METHODS@#PubMed, Embase, Cochrane Library, Clinicaltrial.gov, CNKI, Wanfang Data, China Biomedical Literature Service System, and China Clinical Trial Registry were searched for randomized controlled trials of COVID-19 vaccines published up to December 31, 2020. The Cochrane bias risk assessment tool was used to assess the quality of studies. A qualitative analysis was performed on the results of clinical trials.@*RESULTS@#Thirteen randomized, blinded, controlled trials, which involved the safety and efficacy of 11 COVID-19 vaccines, were included. In 10 studies, the 28-day seroconversion rate of subjects exceeded 80%. In two 10 000-scale clinical trials, the vaccines were effective in 95% and 70.4% of the subjects, respectively. The seroconversion rate was lower than 60% in only one study. In six studies, the proportion of subjects who had an adverse reaction within 28 days after vaccination was lower than 30%. This proportion was 30%-50% in two studies and > 50% in the other two studies. Most of the adverse reactions were mild to moderate and resolved within 24 hours after vaccination. The most common local adverse reaction was pain or tenderness at the injection site, and the most common systemic adverse reaction was fatigue, fever, or bodily pain. The immune response and incidence of adverse reactions to the vaccines were positively correlated with the dose given to the subjects. The immune response to the vaccines was worse in the elderly than in the younger population. In 6 studies that compared single-dose and double-dose vaccination, 4 studies showed that double-dose vaccination produced a stronger immune response than single-dose vaccination.@*CONCLUSIONS@#Most of the COVID-19 vaccines appear to be effective and safe. Double-dose vaccination is recommended. However, more research is needed to investigate the long-term efficacy and safety of the vaccines and the influence of dose, age, and production process on the protective efficacy.
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Anciano , Humanos , COVID-19 , Vacunas contra la COVID-19 , China , SARS-CoV-2 , VacunasRESUMEN
Objective:To establish a high performance liquid chromatography (HPLC) fingerprint of the substance benchmark of Xiao Chengqitang and evaluate its quality with chemical pattern recognition method. Method:Diamonsil C<sub>18</sub> column (4.6 mm×150 mm, 5 μm) was used, mobile phase was consisted of methanol (A)-0.1% phosphoric acid solution (B) for gradient elution (0-60 min, 20%-90%A; 60-70 min, 90%-100%A), the flow rate was 1 mL·min<sup>-1</sup>, the column temperature was 25 ℃, and the detection wavelength was 254 nm. The similarity evaluation system of chromatographic fingerprint of traditional Chinese medicine (2012 edition) was used to evaluate the similarity of HPLC fingerprint of 15 batches of substance benchmark of Xiao Chengqitang, and the chromatographic data were analyzed by cluster analysis, principal component analysis and orthogonal partial least squares-discriminant analysis, in order to evaluate the quality difference between different batches of substance benchmarks of Xiao Chengqitang and find out the main chemical components that caused the quality difference. Result:The HPLC fingerprint of Xiao Chengqitang substance benchmarks was established, 31 common peaks were identified, and 18 components were identified by comparing with the reference substances. The similarities of 15 batches of HPLC fingerprint of Xiao Chengqitang substance benchmarks were >0.92. The samples could be divided into two categories by three chemical pattern recognition methods. Nine main components leading to the quality discrepancy of samples between batches were screened out, including rhein, chrysophanol-8-<italic>O</italic>-<italic>β</italic>-<italic>D</italic>-glucoside, aloe-emodin-8-<italic>O</italic>-<italic>β</italic>-<italic>D</italic>-glucoside, sennoside A, chrysophanol-1-<italic>O</italic>-<italic>β</italic>-<italic>D</italic>-glucoside, rhein-8-<italic>O</italic>-glucoside and others. Conclusion:The established fingerprint analysis method is accurate, stable and reproducible, which basically reflects the overall chemical composition characteristics of Xiao Chengqitang, and can be used for the quality control of Xiao Chengqitang preparations.
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Organ transplantation is an effective treatment for end-stage organ failure. However, organ shortage has always been a common problem faced by countries around the world. The recognition and active participation of intensive care unit (ICU) medical staff in organ donation contributes to promoting the development of organ donation, thereby alleviating the shortage of donor organ. In this article, the key strategies of ICU donor management to promote organ donation and the key strategies of ICU medical staff management to promote organ donation were summarized, aiming to provide reference for organ donation practitioners (especially ICU medical staff) and jointly facilitate the professional development of organ donation.
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OBJECTIVE@#To explore the clinical efficacy of C expanded half lamina excision combined with unilateral open door laminoplasty for multiple segmental cervical spinal cord compression syndrome.@*METHODS@#The clinical data of 58 patients with multiple segmental cervical spinal cord compression syndrome underwent surgical treatment between September 2014 and May 2018 were retrospectively analyzed. There were 34 males and 24 females with a mean age of 64.4 years old (ranged from 46 to 78 years old). Among them, 28 cases received the surgery of C expanded half lamina excision combined with C-C unilateral open-door laminoplasty (improvedgroup), and 30 cases received a single C-C unilateral open-door laminoplasty (traditional group). Operation time, intraoperative blood loss, complications including C nerve root palsy and axial symptoms were compared between two groups. To evaluate the situation of the imaging indicators by measuring the space available for the spinal cord through cross sectional MRI of cervical spine at the narrowest segment of C (including intervertebral disc levels of C). Pre- and post-operative Japanese Orthopedic Association(JOA) score, Neck Disability Index(NDI) score, and improvement rate of neurological function, were recorded and analyzed between the two groups.@*RESULTS@#All the patients were followed up for 12 to 18 months with an average of(14.5±1.8) months for improved group and (14.5±1.9) months for traditional group, and no significant difference was found between the two groups (>0.05). There was no significant difference in intraoperative blood loss and C nerve root palsy between the two groups (>0.05). The operation time (119±10) min vs (126±12) min and axial symptoms 7.1%(2/28) vs 26.6%(8/30) was significant difference between the two groups (0.05).@*CONCLUSION@#C expanded half lamina excision combined with unilateral open-door laminoplasty is an effective method to treat multiple segmental cervical spinal cord compression syndrome, for it can not only fully relieved spinal cord compression, but also achievedgood effect in preventing complications such as axial symptoms by reducing stripping of muscles from C2 spinous process.
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vértebras Cervicales , Cirugía General , Estudios Transversales , Laminectomía , Laminoplastia , Estudios Retrospectivos , Compresión de la Médula Espinal , Resultado del TratamientoRESUMEN
Purpose@#This study was performed to establish and validate a nomogram for predicting the overall survival in children with neuroblastoma. @*Methods@#The latest clinical data of neuroblastoma in Surveillance, Epidemiology, and End Results (SEER) database was extracted from 2000 to 2016. The cases included were randomly divided into training and validation cohorts. The survival curves were drawn with a Kaplan-Meier estimator to investigate the influences of certain single factors on overall survival. Also, least absolute shrinkage and selection operator regression was applied to further select the prognostic variables for neuroblastoma. Additionally, receiver operating characteristic (ROC) curves and calibration curves were used to evaluate the accuracy of the nomogram. @*Results@#In total, 1,262 patients were collected and 8 independent prognostic factors were achieved, including patients’ age, sex, race, tumor grade, radiotherapy, chemotherapy, tumor site, and tumor size. Then we constructed a nomogram by using the data of the training cohort with 886 cases. Subsequently, the nomogram was validated internally and externally with 886 and 376 cases, respectively. The internal validation revealed that the area under the curves (AUC) of ROC curves of 1-, 3-, and 5-year overall survival were 0.69, 0.78, and 0.81, respectively. Accordingly, the external validation also showed that the AUC of 1-, 3-, and 5-year overall survival were all ≥0.69. Both methods of validation demonstrated that the predictive calibration curves were consistent with standard curves. @*Conclusion@#The nomogram possess the potential to be a new tool in predicting the survival rate of neuroblastoma patients.
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Objective:To study the serum pharmacochemistry of Aurantii Fructus (AF), and to investigate the pharmacological material basis of AF extract in rats. Method:Rapid identification and speculation of the prototype constituents and their metabolites in vivo were carried out according to the relative retention time, accurate relative molecular mass, cleavage fragments of MS/MS and neutral loss of metabolites with ultrahigh performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry (UPLC-Q-TOF/MS) technique by comparing the differences between different samples such as AF extracts, blank plasma, and administered plasma under the same chromatographic and mass spectrometric conditions. Result:After oral administration of the AF extract, 74 transitional constituents absorbed into the blood were detected in serum, in which 49 compounds were prototype constituents and the other 25 were metabolites. The prototype constituents could be divided into dihydroflavones, polymethoxyflavonoids, limonins, coumarins and alkaloids. The identified metabolites included glucuronic acid conjugates, sulfuric acid conjugates, hydroxylated products of flavonoid glycosides and polymethoxyflavonoids, as well as the simultaneous glucuronidation and sulfation products. Conclusion:The constituents absorbed into the blood and their metabolites may be the pharmacodynamic components of AF. Among them, alkaloids, polymethoxyflavonoids and coumarins are mainly introduced into the blood in the prototype form, while naringin and neohesperidin (the index components) exert effect mainly through hydrolysis into aglycones. This work will help to further elucidate the material basis of AF.
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Xiao Chengqitang, derived from Treatise on Febrile Diseases, is composed of Rhei Radix et Rhizoma, Magnoliae Officinalis Cortex and Aurantii Fructus Immaturus. It is often used to treat Yangming Fushi light syndrome. This formula was included in the Catalogue of Ancient Classical Prescription (The First Batch), which has a high clinical application value. Current researches on the chemical composition, pharmacological effect and clinical application of Xiao Chengqitang have been carried out, but the history of Xiao Chengqitang is unclear and the dose conversation method is vague. It has great difficulties in clinical rational applications of Xiao Chengqitang and the research and development of its compound preparations. In this article, the literature reports on Xiao Chengqitang were summarized from the aspects of historical evolution, literature researching of Chinese herbs, dosage conversation method, modern research in case to clarify the historical context of Xiao Chengqitang and to provide basis for the clinical application and modern scientific research of this formula.
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Purpose@#This study was performed to establish and validate a nomogram for predicting the overall survival in children with neuroblastoma. @*Methods@#The latest clinical data of neuroblastoma in Surveillance, Epidemiology, and End Results (SEER) database was extracted from 2000 to 2016. The cases included were randomly divided into training and validation cohorts. The survival curves were drawn with a Kaplan-Meier estimator to investigate the influences of certain single factors on overall survival. Also, least absolute shrinkage and selection operator regression was applied to further select the prognostic variables for neuroblastoma. Additionally, receiver operating characteristic (ROC) curves and calibration curves were used to evaluate the accuracy of the nomogram. @*Results@#In total, 1,262 patients were collected and 8 independent prognostic factors were achieved, including patients’ age, sex, race, tumor grade, radiotherapy, chemotherapy, tumor site, and tumor size. Then we constructed a nomogram by using the data of the training cohort with 886 cases. Subsequently, the nomogram was validated internally and externally with 886 and 376 cases, respectively. The internal validation revealed that the area under the curves (AUC) of ROC curves of 1-, 3-, and 5-year overall survival were 0.69, 0.78, and 0.81, respectively. Accordingly, the external validation also showed that the AUC of 1-, 3-, and 5-year overall survival were all ≥0.69. Both methods of validation demonstrated that the predictive calibration curves were consistent with standard curves. @*Conclusion@#The nomogram possess the potential to be a new tool in predicting the survival rate of neuroblastoma patients.
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Excessive pro-inflammatory cytokines result in adverse pregnancy outcomes, including preeclampsia-like phenotypes, and fetal growth restriction. Anti-inflammation might be an effective therapy. The aim of this research was to investigate whether Uncaria rhynchophylla alkaloid extract (URE), a highly safe anti-inflammation constituent of the herb, can inhibit inflammation and improve clinical characteristics of preeclampsia in a lipopolysaccharide (LPS)-induced preeclampsia rat model. The rat model was established by daily administration of LPS (1 μg/kg body weight per day) from gestational day (GD) 14 to 19. Different doses of URE (35, 70, and 140 mg/kg body weight per day) were administered from GD 14 to GD 19. The effects of URE on proteinuria, maternal hypertension, pregnancy outcomes, as well as pro-inflammatory cytokines levels in serum and placenta were measured. High-dose URE (HURE) treatment decreased LPS-induced mean 24-h proteinuria and systolic blood pressure, and increased fetal weight, placental weight, and the number of live pups (P<0.05). Moreover, increased serum and placental levels of interleukin (IL)-6, IL-1β, tumor necrosis factor-α, and interferon-γ in the LPS-treated group were obviously inhibited after HURE administration (P<0.01). URE improved preeclampsia symptoms and mitigated inflammatory responses in the LPS-induced preeclampsia rat model, which suggests that the anti-inflammation effect of URE might be an alternative therapy for preeclampsia.
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Animales , Femenino , Embarazo , Ratas , Preeclampsia/prevención & control , Extractos Vegetales/administración & dosificación , Uncaria/química , Inflamación/prevención & control , Antiinflamatorios/administración & dosificación , Preeclampsia/inducido químicamente , Lipopolisacáridos , Citocinas/efectos de los fármacos , Citocinas/sangre , Modelos Animales de EnfermedadRESUMEN
BACKGROUND:The vascular endothelial growth factor (VEGF) plays an important role in the development and formation of blood vessels.Up to now,there are few reports about the treatment of postoperative complications of vascular anastomosis surgery by mcrosutures with VEGF in China.OBJECTIVE:To synthesiize microsutures with VEGF and to evaluate its effect in revascularization following small vessel anastomosis.METHODS:The method of emulsification-diffusion was use to produce biodegradable polymer polylactic acid/glycolic acid (PLGA) copolymer microparticles containing VEGF,and then,the microparticles were added into microsutures to prepare microsutures with VEGF.Ninety Sprague-Dawley rats were enrolled to make animal models of caudal artery anastomosis using microsutures with VEGF in experimental group and microsutures alone in control group.Complications and VEGF level in the peripheral blood were detected and hematoxylin-eosin staining at the anastomotic site was performed at 2,12 hours,1,3,7 days after anastomosis.RESULTS AND CONCLUSION:(1) Postoperative complications:The postoperative incidence of skin necrosis was significantly lower in the experimental group than the control group (P < 0.05).(2) VEGF level:Compared with the control group,the peripheral blood VEGF level was significantly higher in the experimental group at each time point after operation (P < 0.05).(3) Hematoxylin-eosin staining:In the experimental group,proliferated endothelial cells were seen near the anastomotic site at 1 day after anastomosis;there were a large number of proliferated endothelial calls and subcutaneous tissues covering the sutures completely at 3 days after anastomosis;and endothelial cells and internal elastic lamina were completely repaired,smooth muscle cells proliferated further,and the outer membrane returned to normal at 1 week after anastomosis.In the control group,cell degeneration and necrosis were seen near the anastomotic suture,and only adventitial cells infiltrated and exhibited a traumatic proliferative response at 1 day after anastomosis;neonatal endothelial cells appeared in the exfoliated area of the endothelial cells,grew and migrated,and there was a few endothelial cells covering the anastomotic site at 3 days after anastomosis;and newborn endothelial cells got over the anastomotic crack and covered the suture.To conclude,microsutures with sustained-release VEGF microparticles can promote endothelial cell regeneration in rats at the anastomotic site.
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Objective Endometrial cancer (EMC) is a most common malignancy in the female reproductive system. The purpose of this study was to investigate the relationship of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with the prognosis of EMC. Methods We retrospectively analyzed the clinical and follow-up data about 153 EMC patients surgically treated in the Second Affiliated Hospital of Zhengzhou University. Based on the cutoff values of NLR and PLR, we divided the patients into a high and a low value group,and analyzed the relationships of NLR and PLR with clinical pathological features and prognosis of the patients. Results There were statistically significant differences between the high value group(NLR>3.40) and the low value group (NLR≤3.40) in the FIGO stage,pathological grade,invasion depth,and lymph node metastasis(P<0.05). No sig-nificant correlation was found between the PLR and the prognosis EMC (P>0.05). COX regression analysis showed that FIGO stageⅢ-Ⅳ (P<0.001),pathological grade G3(P=0.022) and NLR>3.4(P=0.004) were independent risk factors for the overall surviv-al and disease-free survival of the EMC patients. Conclusion High preoperative NLR was closely related with the FIGO stage, pathological grade,invasion depth,and lymph node metastasis in pa-tients with endometrial cancer.
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<p><b>OBJECTIVE</b>To study the diagnostic value of diffusion tensor imaging (DTI) in cervical spondylotic myelopathy.</p><p><b>METHODS</b>Twenty healthy volunteers and fifty patients with cervical spondylotic myelopathy underwent DTI in the Affiliated Hospital of Medical College of Ningbo University from January 2014 to April 2015. Healthy volunteers served as controls. Fifty patients were divided into three groups (group A , B, C) according to cervical MRI scan standard. Group A (17 cases) had only the dura mater spinalis compressed; Group B (23 cases) showed the cervical spinal cord compressed, but no high signal in it; Group C (10 cases) had the cervical spinal cord compressed with high signal in the same level. The average apparent diffusion coefficients(ADC) and fractional anisotropy (FA)values in these examinee were analyzed and all subjects were performed fiber tracking.</p><p><b>RESULTS</b>There was no statistically significant differences in ADC and FA values in C2/C3, C3/C4, C4/C5, C5/C6, C6/C7 of control group (P>0.05). The average ADC and FA values in control group were (0.875 +/- 0.096) x10(3) mm2/s and 0.720 +/- 0.051, respectively; compared with group A,there was no statistically significant difference; compared with group B and C, there was significant difference; comparison among group A, B, C, there was significant differences.</p><p><b>CONCLUSION</b>DTI can early and accurately quantify the changes of microstructure in cervical spondylotic myelopathy. Fiber tracking can show the damage range of spinal cord lesions.</p>
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Estudios de Casos y Controles , Vértebras Cervicales , Diagnóstico por Imagen , Imagen de Difusión Tensora , Imagen por Resonancia Magnética , Radiografía , Enfermedades de la Médula Espinal , Diagnóstico por Imagen , Cirugía General , Espondilosis , Diagnóstico por ImagenRESUMEN
<p><b>OBJECTIVE</b>To explore the feasibility and clinical efficacy of unilateral pedicle screw fixation with transforaminal lumbar interbody fusion (TLIF) for the treatment of far lateral lumbar disc herniation.</p><p><b>METHODS</b>From January 2007 to January 2011, 18 patients with far lateral lumbar disc herniation underwent a unilateral TLIF procedure in conjunction with posterior unilateral pedicle screw fixation. There were 13 males and 5 females,ranging in age from 42 to 73 years (means 58.5 years). All cases had single segment involved 5 cases in L3, 4, 10 cases in L4,5,3 cases in LSS. The visual analog scale (VAS) of low back pain and leg pain and Oswestry Disability Index scores were observed in postoperative and followed-up period, and compared with preoperative.</p><p><b>RESULTS</b>The operation of 18 patients was successful,there were no severe complication. The average operative time was 105 min (85 to 125 min), the average amount of blood loss was 145 ml (90 to 340 ml). During the followed-up, the visual analog scale and Oswestry disability index scores were significant improved compared with preoperative (P < 0.05). All patients were followed up from 12 to 48 months with an average of 23 months, there was no implant break and displacement in postoperative X-ray.</p><p><b>CONCLUSION</b>The surgical procedure of unilateral pedicle screw fixation with transforaminal lumbar interbody fusion had the advantage including less invasion, quickly recovery, short operative time, and saving fixation cost, it may provide an alternative treatment for patients with far lateral lumbar disc herniation.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tornillos Óseos , Estudios de Seguimiento , Desplazamiento del Disco Intervertebral , Cirugía General , Vértebras Lumbares , Cirugía General , Fusión Vertebral , MétodosRESUMEN
This study is to investigate the effect of ferulic acid on learning and memory impairments of vascular dementia (VD) rats and its mechanism of action. VD rats model was replicated by permanent bilateral common carotid artery occlusion (2VO). The learning and memory capability of VD rats was evaluated by Morris water maze. The activity of acetylcholinesterase (AChE) and superoxide dismutase (SOD) and the content of glutamic acid (Glu) and malondialdehyde (MDA) in hippocampus of VD rats' brain were determined, separately. The results showed that ferulic acid could alleviate learning and memory deficits of VD rats significantly. Ferulic acid was found to inhibit the activity of AChE and increased the activity of SOD in rat hippocampus. In addition, ferulic acid could also decrease the content of Glu and MDA in rat hippocampus. These results suggested that ferulic acid could alleviate VD rats' learning and memory deficits, which might be due to antioxidation, the improvement of cholinergic system in brain, or the inhibitory of nerve injury by excitatory amino acids.
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Animales , Masculino , Ratas , Acetilcolinesterasa , Metabolismo , Anticoagulantes , Farmacología , Usos Terapéuticos , Ácidos Cumáricos , Farmacología , Usos Terapéuticos , Demencia Vascular , Metabolismo , Ácido Glutámico , Metabolismo , Hipocampo , Metabolismo , Malondialdehído , Metabolismo , Aprendizaje por Laberinto , Memoria , Trastornos de la Memoria , Quimioterapia , Distribución Aleatoria , Ratas Sprague-Dawley , Superóxido Dismutasa , MetabolismoRESUMEN
<p><b>BACKGROUND</b>With a trend that renal tumors are being detected at an earlier stage, classical radical nephrectomy is being reconsidered. More conservative techniques are being proposed. To clarify the indication for synchronous adrenalectomy in radical nephrectomy for renal cell carcinoma which has been questioned since the 1980s, this study evaluates the role of adrenalectomy and recommends a new indication for adrenalectomy in renal cell carcinoma.</p><p><b>METHODS</b>A systemic search was performed, using PubMed and Google Scholar, of all English language studies published up to March 2012 that compared adrenalectomy with adrenal-sparing surgery, in surgery for renal cell carcinoma. We assessed preoperative imaging for adrenal involvement and the relationship of tumor location with adrenal metastases. Twenty-one studies (20 retrospective and 1 prospective) involving 11 736 patients were included.</p><p><b>RESULTS</b>The mean incidence of ipsilateral adrenal involvement from renal cell carcinoma was 4.5%. Synchronous adrenalectomy did not alter survival (hazard ratio (HR) = 0.89, 95% confidence interval (CI) 0.67 - 1.19, P = 0.43; odds ratio (OR) = 1.10, 95%CI 0.84 - 1.44, P = 0.49). Upper pole tumors were not associated with a higher incidence of ipsilateral adrenal metastases. Pooled preoperative imaging: sensitivity, specificity, positive predictive value and negative predictive value were 92% (95%CI 0.84 - 0.97), 95% (95%CI 0.93 - 0.96), 71.6% and 98.5% respectively.</p><p><b>CONCLUSIONS</b>Adrenal involvement from renal cell carcinoma is rare, even in advanced tumours. Synchronous adrenalectomy does not offer any benefit, even for "high risk" patients. We suggest that only patients with a positive preoperative adrenal finding on preoperative imaging for a solitary adrenal metastasis should undergo adrenalectomy as part of the radical nephrectomy.</p>
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Humanos , Neoplasias de las Glándulas Suprarrenales , Cirugía General , Adrenalectomía , Métodos , Carcinoma de Células Renales , Mortalidad , Cirugía General , Neoplasias Renales , Mortalidad , Cirugía General , Nefrectomía , Métodos , Tasa de SupervivenciaRESUMEN
Cemento-ossifying fibroma is a rare benign tumor from periodontium, which usually occurs in mandible body and mandible ramus. It consists of collagen fibrils, fibroblast, and cementoblast. This article reported a case of giant cemento-ossifying fibroma and discussed the clinical features and treatment.
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Humanos , Cemento Dental , Fibroblastos , Fibroma Osificante , Mandíbula , Ligamento PeriodontalRESUMEN
<p><b>OBJECTIVE</b>To explore the clinical application and therapeutic effect of open vertebroplasty for thoracolumbar metastatic tumor.</p><p><b>METHODS</b>From September 2003 to December 2009, 21 patients with thoracolumbar metastatic tumor underwent the surgical procedure of posterior spinal cord decompression and open vertebroplasty combined with short-segmental pedicle screw fixation during the same intervention. There were 14 males and 7 females, ranging in age from 48 to 73 years with the mean of 59.5 years and ranging in course of disease from 1 to 4 months with an average of 2.5 months. The primary focus of the tumor of 19 cases were established, lung carcinoma was in 8 cases, breast cancer in 4 cases, prostate carcinoma in 4 cases, hepatocarcinoma in 2 cases and thyroid carcinoma in 1 case. The primary focus of 2 cases could not be established. The spinal function according to Frankel grade, grade B was in 4 cases, C in 6, D in 5, E in 6. The lumbar-back pain, height of anterior and posterior vertebral body, Cobb angle and spinal function were recorded before and after operation.</p><p><b>RESULTS</b>The operation of all patients was successful, there were no severe complications and aggravation of spinal function. The VAS score of lumbar-back pain decreased from 8.78 +/- 0.45 preoperatively to 2.25 +/- 0.36 postoperatively. Among 16 cases combined with pathological fracture, the height of anterior spinal vertebral body increased from (12.7 +/- 2.1) mm preoperatively to (19.5 +/- 3.9) mm postoperatively; the height of posterior spinal vertebral body increased from (14.1 +/- 1.8) mm preoperatively to (20.3 +/- 2.3) mm postoperatively; Cobb angle decreased from (26.0 +/- 8.9) degrees preoperatively to (6.0 +/- 0.9) degrees postoperatively. There was significant difference above items between before and after operation (P < 0.05). The spinal function according to Frankel grade at final follow up, grade C was in 2 cases, D in 4, E in 15. All patients were followed up from 5 to 28 months with an average of 14 months, there was no loosening and breakage of internal fixity, 15 cases died during follow-up period.</p><p><b>CONCLUSION</b>The surgical intervention can effectively preserve spinal instability and alleviate the spinal cord symptoms, improve the life quality of patients. It may provide an alternative treatment for patients in poor general health and shorter life expectancy.</p>
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vértebras Lumbares , Patología , Metástasis de la Neoplasia , Terapéutica , Neoplasias de la Columna Vertebral , Patología , Cirugía General , Vértebras Torácicas , Patología , Resultado del Tratamiento , Vertebroplastia , MétodosRESUMEN
<p><b>OBJECTIVE</b>To investigate the effect of rabbit saphenous and sciatic nerve homogenates on the proliferation and calcification of rabbit osteoblasts in vitro.</p><p><b>METHOD</b>The saphenous nerves (sensory nerves) and the muscular branches of the sciatic nerve (motor nerve) were collected from 48 New Zealand white rabbits to prepare the nerve tissue homogenates. Bone marrow mesenchymal stem cells (MSCs) were isolated from the rabbits and cultured in vitro, and after 14 days of routine osteogenic induction, the resultant osteoblasts were identified by immunohistochemistry, alkaline phosphatase (ALP) and Alizarin red S staining. The osteoblasts were then incubated in the induction medium containing the saphenous (sensory nerve group) or sciatic homogenates (motor nerve group), with the cells in the dexamethasone-containing, dexamethasone-free osteogenic induction medium and control medium as the control. The proliferation, total protein and ALP activity of the osteoblasts were measured every other day until the 8th day, and Alizarin red S staining was used for quantitative analysis of calcification of the cells after two weeks.</p><p><b>RESULTS</b>The application of the saphenous nerve homogenates significantly promoted cell proliferation, total protein and ALP activity (P<0.01, P<0.05 and P<0.05), while exposure of the osteoblasts to dexamethasone inhibited the cell proliferation (P<0.001). Compared to dexamethasone-free group, the saphenous homogenates enhanced the mineralization of the osteoblasts (P<0.001).</p><p><b>CONCLUSION</b>Saphenous nerve homogenates significantly promotes the proliferation, differentiation, ALP activity and mineralization of rabbit osteoblasts, but sciatic nerve homogenates do not show osteogenic effects on the cells.</p>