Invasive fungal infections in children should not be underestimated / 中华实用儿科临床杂志

With the increasing number of people with immune deficiency in recent years, fungal infections become an important factor threatening human health.Likewise, the number of children who are immunosuppressed due to hematological diseases, malignancies, use of immunosuppressants and spectrum antibacterial drugs has increased, leading to a high mortality of fungal infections.Moreover, infections of the non-candida albicans and aspergillu are prevalent, serving as important causes for the death of critically ill children. Therefore, this review aims to introduce and summarize the epidemiological characteristics, diagnosis and treatment of pediatric invasive fungal infections, thus yielding the concern of pediatric invasive fungal infections, reducing the occurrence of pediatric fungal infections and improving the prognosis.

Regulatory effect of Ganoderma lucidum polysaccharides on H2O2-induced apoptosis and mitochondrial dysfunction in SH-SY5Y cells / 中国组织工程研究

BACKGROUND:Current studies have confirmed that Ganoderma lucidum polysaccharides can promote nerve regeneration in neurodegeneration-related diseases.The occurrence of neurodegenerative diseases is closely related to mitochondrial dysfunction,but the role of Ganoderma lucidum polysaccharides on the regulation of apoptosis and mitochondrial function in neurodegenerative diseases is not yet clarified. OBJECTIVE:To explore the regulatory effects and mechanisms of Ganoderma lucidum polysaccharides on apoptosis and mitochondrial dysfunction in H2O2-induced SH-SY5Y cells. METHODS:SH-SY5Y cells were divided into three groups:control group,H2O2 group,and Ganoderma lucidum polysaccharides group.Cells in the control group were normally cultured.Cells in the H2O2 group were treated with 300 μmol/L H2O2 for 24 hours.In the Ganoderma lucidum polysaccharides group,the intervention with 300 μg/L Ganoderma lucidum polysaccharides was conducted first for 1-2 hours,followed by the addition of 300 μmol/L H2O2 for 24 hours.The mitochondrial membrane potential was detected by JC-1 kit.Apoptosis was detected by TUNEL staining kit.The activities of malondialdehyde and superoxide dismutase were detected by malondialdehyde test kit and superoxide dismutase test kit,respectively.The apoptosis and expression of mitochondrial dynamics-related proteins were detected by immunofluorescence staining and western blot assay. RESULTS AND CONCLUSION:(1)Compared with the control group,the mitochondrial membrane potential and superoxide dismutase activity were significantly reduced,as well as apoptotic rate and malondialdehyde levels were significantly increased in the H2O2 group(P<0.05).After treatment with Ganoderma lucidum polysaccharides,the membrane potential and superoxide dismutase activities were significantly increased,and apoptotic rate and malondialdehyde levels were significantly reduced compared with the H2O2 group(P<0.05).(2)The expression levels of pro-apoptotic proteins Bax and Caspase-3 were significantly increased,but the expression of anti-apoptotic protein Bcl-2 was significantly decreased in the H2O2 group compared with the control group(P<0.05).Compared with the H2O2 group,the levels of Bax and Caspase-3 were significantly decreased,but the expression of anti-apoptotic protein Bcl-2 was significantly increased in the Ganoderma lucidum polysaccharides group(P<0.05).(3)Compared with the control group,the expression of mitochondrial splitting proteins Fis1 and p-Drp1 was significantly increased,but the expression of mitochondrial fusion proteins OPA1,Mfn1,and Mfn2 was decreased in the H2O2 group(P<0.05).Compared with the H2O2 group,Fis1 and p-Drp1 expression was significantly reduced,but the expression levels of OPA1,Mfn1,and Mfn2 were significantly increased in the Ganoderma lucidum polysaccharides group(P<0.05).(4)The above results confirm that Ganoderma lucidum polysaccharides can attenuate H2O2-induced oxidative stress damage and apoptosis in SH-SY5Y cells by ameliorating mitochondrial dysfunction.

A novel heterozygous missense mutation of Trp1220Gly in the insulin receptor gene associates with type A insulin resistance syndrome: A case report / 中华内分泌代谢杂志

We report a case of type A insulin resistance syndrome. A 16-year-old girl with BMI of 19.1 kg/m 2 presented with primary amenorrhea and hyperglycemia for two years. Baseline HbA 1C was 10.8%, along with severe hyperinsulinemia, increased total testosterone and free androgen index(FAI). Ultrasonography showed polycystic ovaries. Next generation sequencing identified a novel and de novo heterozygous missense mutation of Trp1220Gly in the insulin receptor gene. Short-term intensive insulin pump treatment was initiated, followed by insulin glargine, pioglitazone and acarbose combination regiment. Fasting blood glucose and insulin levels decreased significantly, but post-load hyperglycemia and hyperinsulinemia remained unsatisfactory. HbA 1C dropped to 7.6% at 1-year follow up. Patients with polycystic ovarian syndrome who are adolescent-onset and with lean body type should be taken into account of type A insulin resistance syndrome. Currently, there is no standardized treatment protocol, and therapy should be individualized based on the specific gene mutation of each patient.

Plantar approach for Lisfranc injury: an anatomical study and preliminary clinical application / 中华创伤骨科杂志

Objective:To explore the safety, efficacy and preliminary clinical application of the single plantar approach or in combination with the dorsalis pedis approach in the treatment of Lisfranc injury with poor dorsalis pedis soft tissue, metatarsal avulsion fracture or complicated multi-column lesions.Methods:(1) Six fresh cadaveric specimens of adult foot were collected and dissected through the plantar approach in order to determine the skin incision of the plantar approach and the safe area for plate-screw internal fixation, including start-stop points and courses of plantar nerves, blood vessels, tendons and ligaments, followed by plate-screw fixation on the specimens. (2) After feasibility of the plantar approach was confirmed by our anatomical study, it was used to treat the 3 patients who were admitted to Department of Orthopedics, The Third Hospital Affiliated to Southern Medical University between September 2020 and November 2021 for Lisfranc injury with severe necrosis due to dorsalis pedis skin contusion or metatarsal base avulsion fracture. They were 2 males and one female, with an average age of 51 years (from 34 to 68 years). The preliminary clinical efficacy was evaluated in terms of visual analogue scale (VAS), midfoot score of American Orthopaedic Foot and Ankle Surgeons (AOFAS), Maryland score, Kofoed score, fracture healing at the last follow-up and postoperative complications.Results:(1) Regarding the anatomical exposure range, the metatarsal side of the first metatarsal wedge joint was exposed medially and the metatarsal side of the third metatarsal wedge joint was exposed laterally; the peroneus longus tendon, Lisfranc plantar ligament and interosseous ligament were explored. X-ray films after the simulated operation showed satisfactory plate positions. (2) As for the preliminary clinical application, all patients were followed up for 6 to 14 months (mean, 11 months). At the last follow-up, the VAS score ranged from 0 to 1 (mean, 0.5), AOFAS score from 85 to 92 (mean, 89), Maryland score from 93 to 96 (mean, 95), and Kofoed score from 92 to 95 (mean, 94). There were no early complications such as fascial compartment syndrome, skin necrosis or infection. All fractures got united, with no complications like traumatic arthritis, muscle atrophy or screw loosening.Conclusion:Testified by the anatomical study, the plantar approach can be used to treat Lisfranc injury with poor dorsalis pedis soft tissue, metatarsal avulsion fracture or complicated multi-column lesions, leading to safe, effective and satisfactory clinical outcomes.

Series interpretation to Chinese Expert Consensus on the Diagnosis and Treatment of Acromegaly(2020)(Part 3): Pharmaceutical treatments / 中华内分泌代谢杂志

Acromegaly is an endocrine and metabolic disease with insidious onset. Delays in its diagnosis and treatment significantly increase the incidence of complications. Early detection, diagnosis, and treatment are extremely important for the prognosis of patients with acromegaly. Based on a large quantity of evidence in recent years, Chinese Expert Consensus on the Diagnosis and Treatment of Acromegaly(2020) has standardized the diagnosis and the treatment strategies of acromegaly. In the non-surgical treatment section, according to the categories of drugs used to treat acromegaly, the indications, selection, administration, dosage and precautions of pharmaceutical treatment have been clarified with specific recommendations. It is hoped that the new consensus can further guide and standardize the clinical management of acromegaly.

Modified pararectus abdominis approach for anterior plate fixation of sacral fracture: a clinical anatomy study / 中华创伤骨科杂志

Objective:To investigate the safety and feasibility of modified pararectus abdominis approach in the anterior plate fixation of sacral fractures.Methods:In 5 fresh adult cadavers (3 males and 2 females), gross anatomy was performed on one pelvic side using a modified pararectus abdominis approach to clarify the anatomical structures around the approach. On the other side of the pelvis, the anterior structures of the sacrum were exposed in simulated anterior plate fixation of sacral fracture via the modified pararectus abdominis approach. The exposed anatomic range of the approach, and the locations and courses of lumbosacral trunk nerve and iliac vessels were observed and recorded.Results:(1) The modified pararectus abdominis approach exposed the whole S1 vertebral body from the sacroiliac joint to the medial side, the L5 vertebral body cephalally, the S1 foramina in the true pelvis, and the same structures laterally as a traditional pararectus abdominis approach did. (2) Via the modified pararectus abdominis approach, exploration and decompression of the lumbosacral plexus (from L4 to S1) (including S1 foraminoplasty) were performed under direct vision to decompress the nerve entrapment from anterior compressed fracture fragments and hyperplastic callus. (3) There was a safe surgical area in anterior L5 and S1 where a plate could be safely fixed to the S1 vertebral body. (4) Since the maximum vertical distance from the lumbosacral trunk nerve lifted above the periost to the sacral ala was 1.4 cm (range, from 1.2 to 1.5 cm), a plate could be safely placed from the subperiosteum to the S1 vertebral body to fix the fracture.Conclusions:The modified pararectus abdominis approach is safe and feasible for exploration and decompression of lumbosacral nerves in the anterior sacral region (from L4 to S1) because it has significant advantages in vision and operation. It also broadens the range of anterior sacral plate fixation because a sacral fracture displacement can be reduced under direct vision and a plate can be fixated to the S1 vertebral body along the alae sacralis and across the sacroiliac joint to the iliac bone.

Whole-process ultrasound-guided percutaneous portal vein puncture islet transplantation for diabetes: a report of 16 cases / 中华器官移植杂志

Objective:To explore the application value of whole-process ultrasound-guided percutaneous portal vein puncture islet transplantation.Methods:From October 2018 to May 2021, 16 diabetics underwent whole-process ultrasound-guided percutaneous portal vein puncture islet transplantation at First Affiliated Hospital of Sun Yat-sen University.The whole process was guided by ultrasound for completing percutaneous portal vein puncture catheterization, islet infusion monitoring, bleeding prevention and ablation hemostasis after bleeding.Results:Ten patients [8 males and 2 females with a mean age of(45.9±21.1)years]underwent 16 islet transplants, including one islet(5 cases), two islets(4 cases)and three islets(1 case). A single puncture was successfully performed without damage to other extrahepatic organs, persistent portal hypertension, portal vein embolism or infection.Bleeding at liver puncture site occurred in 3 cases and ultrasound radiofrequency ablation was performed for immediate hemostasis.Among them, postoperative blood glucose stabilized at 4~12 mmol/l post-operation.And 5 cases(31.3%)achieved insulin independence for>2 months and 10 cases(62.5%)lowered insulin dosage by>50% as compared with preoperative level.The level of fasting C-peptide recovered or was higher than normal in 10 cases(62.5%)and became obviously elevated in the remainders.In 11 cases(68.8%)of them, liver transaminase was briefly and mildly elevated post-operation, and no other complications were observed.Conclusions:The whole-process ultrasound-guided percutaneous portal vein islet transplantation is both safe and feseasible.It avoids the injury of transplanted kidney caused by contrast agent and radiological radiation to operator and patient.It is a method of islet transplantation worth a wider popularization.

Tripodalsporormielones A-C, unprecedented cage-like polyketides with complex polyvdent bridged and fused ring systems

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Progress in clinical application of 3D printed navigational template in orthopedic surgery / 南方医科大学学报

Orthopedic 3D printed surgical navigational template is an instrument that is prepared by 3D reconstruction based on preoperative radiological data of the patient using computer-aided design (CAD) and 3D printing techniques. The 3D printed navigational template allows accurate intra-operative assessment of the relative spatial distance, angular relationship, direction and depth. The application of 3D printed navigational template technique in orthopedics surgeries achieves the conversion of preoperative planning from 2/3D graphics to 3D models, and provides a new method for individualized and precise treatment. Herein we review the evolution, clinical application, and basic classification of 3D printed navigation template technique, analyze its advantages and disadvantages, and discuss the current problems and the future development of this technique.

Efficacy and safety of Changsulin ? compared with Lantus ? in type 2 diabetes: a phase Ⅲ multicenter, randomized, open-label, parallel, controlled clinical trial / 中华内科杂志

Objective:To compare the efficacy and safety of Changsulin ? with Lantus ? in treating patients with type 2 diabetes mellitus (T2DM). Methods:This was a phase Ⅲ, multicenter, randomized, open-label, parallel-group, active-controlled clinical trial. A total of 578 participants with T2DM inadequately controlled on oral hypoglycemic agents were randomized 3∶1 to Changsulin ? or Lantus ? treatment for 24 weeks. The efficacy measures included changes in glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2h postprandial plasma glucose (2hPG), 8-point self-monitoring of blood glucose (SMBG) profiles from baseline, and proportions of subjects achieving targets of HbA1c and FPG. The safety outcomes included rates of hypoglycemia, adverse events (AEs) and anti-insulin glargine antibody. Results:After 24 weeks of treatment, mean HbAlc decreased 1.16% and 1.25%, FPG decreased 3.05 mmol/L and 2.90 mmol/L, 2hPG decreased 2.49 mmol/L and 2.38 mmol/L in Changsulin ? and in Lantus ?, respectively. No significant differences could be viewed in above parameters between the two groups (all P>0.05). There were also no significant differences between Changsulin ? and Lantus ? in 8-point SMBG profiles from baseline and proportions of subjects achieving the targets of HbA1c and FPG (all P>0.05). The rates of total hypoglycemia (38.00% and 39.01% for Changsulin ? and Lantus ?, respectively) and nocturnal hypoglycemia (17.25% and 16.31% for Changsulin ? and Lantus ?, respectively) were similar between the two groups (all P>0.05). Most of the hypoglycemia events were asymptomatic, and no severe hypoglycemia were found in both groups. No differences were observed in rates of AEs (61.77% vs.52.48%) and anti-insulin glargine antibody (after 24 weeks of treatment, 6.91% vs.3.65%) between the two groups (all P>0.05). Conclusions:Changsulin ? shows similar efficacy and safety profiles compared with Lantus ? and Changsulin ? treatment was well tolerated in patients with T2DM.

Effects of maximum fat oxidation intensity exercise combined with diet restriction on lipid and ferroptosis in obese college students with non alcoholic fatty liver disease / 中国学校卫生

Objective@#To compare the effects of 12week maximum fat oxidation (FATmax) intensity exercise combined with dietary restriction and FATmax intensity exercise alone on body composition, blood lipid metabolism and ferroptosis in obese college students with nonalcoholic fatty liver disease(NAFLD),so as to provide a exercise prescription reference for rehabilitation treatment of obese NAFLD college students.@*Methods@#In August 2023,a total of 45 obese NAFLD college students were divided into maximum fat oxidation intensity exercise combined with dietary restriction group (FATmax+DR, n=22) and FATmax group (n=23) by random number table method,who were recruited through online notifications and physical examinations at the Physical Examination Center of Fenyang College of Shanxi Medical University. FATmax group received FATmax intensity exercise with 3 times a week for 12 weeks (FATmax:0.51 g/min, exercise intensity:50.14% VO2max and the heart rate:136.78 times/min). FATmax+DR group underwent 12 weeks of FATmax intensity exercise combined with dietary restriction, and daily dietary energy intake was determined according to resting energy consumption. Body composition, four items of blood lipids and the indicators of oxidative stress and ferroptosis were measured before and after the intervention.The differences of indicators among each group were analyzed by using independent sample t test and paired sample t test.@*Results@#Before the intervention, there were no significant differences in body composition,four items of blood lipid, oxidative stress and iron death between FATmax+DR group and FATmax group (P>0.05). After 12 weeks of intervention, body weight , body mass index(BMI), body fat mass, trunk fat mass, visceral fat area and serum low density lipoprotein(LDL) and malondialdehyde(MDA) levels in FATmax+DR group were significantly lower than those in FATmax group, while serum high density lipoprotein(HDL) and glutathione(GSH) levels were higher than those in FATmax group (t=-2.30，-3.23,-3.97,-5.85,-3.44,-3.06,-2.03,-2.09; 2.73, 2.42, P<0.05). There were no significant differences in serum levels of total cholesterol(TC), triglyceride(TG), superoxide dismutase(SOD) and glutathion peroxidase 4(GPX4) between the two groups (t=1.49, 1.00, -0.01, 0.59, P>0.05).@*Conclusion@#Twelveweek FATmax intensity exercise combined with dietary restriction could significantly improve body composition and dyslipidemia, prevent the occurrence of ferroptosis and liver oxidative damage in obese NAFLD college students,which could serve as a timely promotion and application of intervention for obese college students with NAFLD.

Correlation between transient elastography controlled attenuation parameter and metabolic syndrome components / 中华内分泌代谢杂志

Objective To investigate the relationship between Fibroscan? data controlled attenuation parameter(CAP), liver stiffness measurement(LSM), and the risk of metabolic syndrome(MS). Methods A total of 817 subjects in this year's staffs physical checkup screening for fatty liver were recruited. Questionnaires were filled, anthropometries including neck and waist circumferences were collected, and fasting glucose, lipid profiles, insulin, adiponectin levels were measured, CAP and LSM were recorded using FibroScan? . The subjects were divided into MS and control groups. Clinical characteristic parameters were compared, and independent predictors for MS were analyzed. Results There were 231 subjects(28.3％) in the MS group and 586(71.7％) in the control group. As compared to the controls, MS group had significantly higher CAP, LSM, neck circumference, and fasting insulin levels[(277±48vs237±44)dB/m,(4.9±2.2vs4.1±1.0)kPa,(37.1±3.3vs34.1±3.0)cm,(9.3±4.7vs5.7± 2.9)μIU/ml, all P<0.01], whereas adiponectin levels were lower [(10.6 ± 8.8 vs 18.7 ± 14.9) ng/ml, P<0.01] . With the accumulation of MS components, CAP and LSM increased. When CAP and LSM were divided into quartiles, the number of MS components increased with increasing quartiles, along with proportions and odds ratios for the occurrence of MS, and CAP showed a stronger correlation with MS than LSM. Binary Logistic regression analysis revealed that CAP, age, neck circumference, adiponectin, and fasting insulin levels were independent predictors for MS. Even with no MS component, subjects with CAP≥248 dB/m had elevated body mass index, neck and waist circumference, waist to hip ratio, increased fasting insulin, triglyceride, uric acid and reduced adiponectin levels. Conclusion CAP showed a close relationship with MS. Increased CAP was associated with increased body weight, dyslipidemia, elevated uric acid, and fasting insulin, whereas reduced adiponectin even before the occurrence of MS.

Diagnostic strategy of primary aldosteronism based on CT scan and serum potassium level / 中华全科医师杂志

One hundred and forty-five patients with primary aldosteronism (PA) admitted from 2006 to 2013 were enrolled in the study. The diagnosis of PA was confirmed by upright furosemide test and all patients met the following criteria: ① round-or oval-shaped lesion of low density with diameter>1 cm in one adrenal gland shown in contrast CT scan; ② no lesion or abnormality in contralateral adrenal gland; ③serum potassium level<3.5 mmol/L. Of 145 patients, 106 underwent total adrenalectomy, 36 partial adrenalectomy and 3 tumor enucleation. Serum potassium was (2.75±0.55) mmol/L before and (4.03±0.46) after surgery. Potassium was normalized after treatment in 141 cases (97.2％) with correction or improvement in hypertension; 4 patients (2.8％) remained hypokalemic and received spironolactone. Patients with normalized potassium were followed up for a medium period of 74 months (22—103 months), of whom 32 (22.7％) dropped off; the remaining 109 (77.3％) patients did not have hypokalemia. Multivariate linear correlation analysis showed that serum potassium level was negatively correlated with tumor diameter (r=?0.273,95％ CI:?0.086—?0.564, P=0.026) and basal serum aldosterone level (r=?0.261,95％ CI:?0.047— ?0.514, P=0.036). In PA patients with unilateral adrenal macroadenoma and hypokalemia, satisfactory surgical resolution can be achieved without adrenal venous sampling in majority of patients.

Radiographic skill and clinical value of the scapula Y-position / 实用放射学杂志

Objective To illustrate and discuss the technique and clinical value of scapula Y-position radiography.Methods Scapula Y-position radiographies were performed on 110 patients with shoulder joint injury or omalgia.The patient standed in front of the panel face to face, with the affected joint closed to the panel, and the arms fell naturally and palms pronated to stick close to the body.The angle between the coronal plane and the panel was about 55 to 65 degree, put the affected caput humeri at the center of the panel,tilted the tube to foot-side by 15 degree,and aimed the axis at caput humeri.Results Among the 110 patients, 82 radiographies were successfully taken by the first time,28 failed because of the inappropriate body-tilt angle.We had exposed 5 acromion fractures cases, 20 flexural and hook-form acromion cases, 35 cases with the acomion-caput humeri distance less than 1 cm, and 2 coracoid fracture cases.Conclusion Scapula Y-position radiography has high clinical value that could expose the osseous anatomic exit of the rotator cuff and guide the clinical treatments.

CT anatomic study and 3D reconstruction of lumbar nerve roots and main adjacent structures / 局解手术学杂志

Objective To observe the positional relationship of lumbar nerve roots and its main adjacent structures with CT data, and to conduct 3D construction and measurement,so as to provide anatomical basis for percutaneous lumbar diskectomy(PLD).Methods CT serial tomography dataset of 30 healthy adults' lumbosacral portions were imported into Mimics 17.0 software to segment related structures and obtain the layers of different structures.The structures were 3D reconstructed and virtually demonstrated.The lumbar nerve roots and their main surrounding structures were observed and measured.Results The minimum distances between the lumbar nerve roots and the superior articular processes increased gradually from L3 to L4 intervertebral disc layer to L5 to S1 intervertebral disc layer.The 3D model clearly displayed the morphology and spatial relationship of the lumbar nerve roots and their adjacent structures in lumbosacral portion.The lower the lumbar intervertebral discs were,the thicker they were.The distances from the middle point of the back of lumbar intervertebral disc to the end of the superior spinous process of lumbar vertebra increased at first and decreased then,and the distance in L3 to L4 intervertebral disc layer was the farthest.Conclusion The relationship between lumbar nerve roots and superior articular processes,the intervertebral disc thickness variance and the change of the distances from lumbar intervertebral disc to the end of the superior spinous process have been analyzed in this study,and the clinic basis has been laid for percutaneous lumbar diskectomy.

Risk factors of central myocardial infarction in patients with different lipid levels / 重庆医学

Objective To investigate the incidence of miocardial infarction and risk factors in patients with different levels TG.Methods From June 2006 to October 2007,Kailuan coal mine group conducted an on-the-job and retired workers were took physical examination in Kailuan area,and their results were used in our study(n=100 271).According to different levels of TG,all cases were divided into five groups(TG1-5):TG1 group(0.0125 kg/m2,FBG≥6.1 mmol/L,HDL-C<1.5 mmol/L were all the risk factors for myocardial infarction (P<0.05).Cox proportional hazards regression model showed that after adjustment for sex,age and other factors,with the increase in TG levels.Conclusion In study of Kailuan crowd,the increased fasting triglycerides increase the risk of myocardial infarction,and the risk factors for myocardial infarction are age,BMI,FBG and HDL-C.

Value of neck circumference in diagnosis of metabolic syndrome / 实用医学杂志

Objective To estimate the value of neck circumference in diagnosis of metabolic syndrome. Methods We analyzed the neck circumference of 523 volunteers and the occurrence of metabolic syndrome among them. Then we updated and revalued their data after follow-up for 1.5 years, meanwhile, we evaulated the value of Body Mass Index (BMI) and neck circumference in predicting metabolic syndrome. Results The increase of neck circumference was closely related to the occurrence of metabolic syndrome , and this tendency continued in the follow-up. Compared with BMI , neck circumference was sensitive in identifying the patients of metabolic syndrome. Conclusion Neck circumference has great value in diagnosis and treatment of metabolic syndrome.

Impact of small doses of chemotherapy for patients with early glottic carcinoma / 中国生化药物杂志

Objective To investigate the curative effect of surgery,radiotherapy and photodynamic therapy combined with chemotherapy on early glottic carcinoma and prognostic factors.Methods Clinical data of 122 cases of early glottic carcinoma with Tis ~T2 N0 M0 were analyzed retrospectively.Small doses of chemotherapy applied to single drug cisplatin (according to the surface area of 50 mg/m2 ).83 patients underwent surgical treatments combined with chemotherapy,20 cases accepted radiotherapy combined with chemotherapy and 19 cases accepted photodynamic therapy combined with chemotherapy. Results The 3 and 5 years overall survival rates (overall survival,OS ) of surgery group,radiotherapy group and photodynamic group were 92.7%,93.8% and 89.5%,89.5% and 84.4% ,89.5%,respectively.The 2-year disease free survival rate (disease-freesurvival,DFS)were 87.6%,79.4%,78.6%,respectively.The 2-year local control rate(local control,LC)were 91.9%,84.4%,83.0%, respectively.27 cases suffered from tumor recurrence or metastasis,15 cases in the surgery group,3 cases in the radiotherapy group and 5 cases in the photodynamic group,among them 19 patients accepted salvage surgery.Multifactor retrospective analysis indicated anterior commissure invasion (P=0.047),clinical stage(P =0.018)and KPS score before treatment(P =0.001)were independent adverse prognostic factors for OS.Anterior commissure invasion(P=0.027)and differentiation degree(P=0.041)were adverse prognostic factors for DFS.Anterior commissure invasion was also poor prognostic features for LC(P=0.047).Conclusion Radiotherapy and photodynamic therapy combined with chemotherapy may be the first or very important treatment on early stage glottic squamous cell cancer(Tis ~T2N0M0 ).High preservation rate of laryngeal function with radiotherapy and photodynamic therapy combined with chemotherapy can significantly improved quality of life of patients.Curative effect of three groups was similar,and three kinds of curative methods achieved good effect.KPS score before treatment,glottis impair and differentiation degree were the main adverse prognostic factors for early stage glottic carcinoma.

The application of two enterostomy in gerontal patients with obstructive carcinoma of sigmoid and high rectum / 实用医学杂志

Objective To explore the safety and efficacy of loop ileostomy and Hartmann operation in gerontal patients with obstructive carcinoma of sigmoid and high rectum. Methods sixty-two gerontal patients with obstructive carcinoma of sigmoid and high rectum from April 2008 to April 2013 were randomly divided into loop ileostomy group and Hartmann group.The operation time , length of stay and postoperative complications in the two groups were analyzed. Results The time of absolute diet in loop ileostomy group was shorter than that in Hartmann group in Stage I operation (P < 0.05). The time of operation, absolute diet, and length of stay in loop ileostomy group were shorter than that in Hartmann group in Stage II operation (P < 0.05). Conclusion The application of loop iloostomy in gerontal patients with obstructive carcinoma of sigmoid and high rectum was safe and effective.

Rapid identification and differentiation of the species of the Mycobacterium chelonae /abscessus complex by hsp65 and rpoB PCR-RFLP / 中国人兽共患病学报

The Mycobacterium chelonae/abscessus (M.chelonae/abscessus) complex belongs to the rapidly growing genus Mycobacterium (RGM).It is one of the most important pathogenic members of Mycobacterium leading to nosocomial infections and outbreaks.It includes members of M.chelonae,M.immnunogenum,M.abscessus,M.massiliense,and M.bolletii.In order to investigate the epidemiological characteristics of the M.chelonae/abscessus complex in China and to conduct the molecular methods for species identification of M.chelonae/abscessus,we collected clinical M.chelonae/abscessus complex strains identified by phenotypic tests.Members were verified by sequencing of 16S rRNA,Species and subspecies were identified by hsp65 and rpoB PCR RFLP methods.In total,27 clinical specimens were identified as Mycobacterium chelonae/abscessus complex by phenotypic tests.16s rRNA gene sequence analysis of all 27 clinical samples shared over 99.7％ similarity with M.chelonae and M.abscessus.Species identification with hsp65 PCR-RFLP and rpoB PCR-RFLP revealed that 18 specimens were M.abscessus and 4 were M.absecces.The remaining 5 samples displayed a pattern that failed to match any previously reported pattern.Thus,this might represent a novel species that is part of the Mycobacterium chelonae/abscessus complex.We identified that a majority of the chronic lung infection in China is caused by the M.chelonae/abscessus complex.Specifically,the M.abscessus species might be the most infectious,while other species in the complex can still cause infection.Interestingly,there may be a novel or previously unidentified species that is a part of the complex.Finally,we show that species identification can be carried out more accurately by combined use of hsp65 and rpoB PCR-RFLP.