[Evaluation of CT angiography vascular localization combined with refined three-dimensional printing in guiding the resection and reconstruction of complex oral cancer].

Objective: To evaluate the effect of vascular localization using computerized tomography angiography (CTA) combined with refined three dimensional (3D) printing in guiding the resection and reconstruction of complex oral cancer. Methods: From December 2013 to July 2017, the clinical data of 30 patients with complex oral cancer enrolled in the Hunan Cancer Hospital were retrospectively analyzed. 15 patients received CTA+ 3D assisted surgery, while the other 15 patients underwent traditional surgery. In CTA+ 3D assisted surgery group, CT and Magnetic Resonance Imaging (MRI) data were combined with CTA to print refined solid 3D model and surgical guide plate. The preoperative and intraoperative virtual surgical system and the operative experience were combined for preoperative evaluation and surgery. In traditional surgery group, preoperative evaluation and surgery were performed according to imaging data and surgeons' clinical experience. Operative time, intraoperative blood loss, hospital stay and local recurrence rate were compared between the two groups. Results: In CTA+ 3D assisted surgery group, one patient gave up surgical treatment after intuitively watching the lesion through the 3D model, and the remaining 14 patients underwent surgery as planned. All the 15 patients in traditional surgery group received surgery. But the preoperative plans of three patients were temporarily and passively modified due to insufficient preoperative evaluation. The average intraoperative blood loss was(320.1±27.2)ml in CTA+ 3D assisted surgery group and(430.2±30.3)ml in traditional surgery group. Mean operation time was(440.3±19.2)min and(552.2±23.3)min, respectively. Mean hospitalization time was (20.4±3.2)d and (25.1±3.7)d, respectively. The differences were all statistically significant (all P<0.05). 1 year and 3 years local recurrence rates were 9.1% and 28.6% in CTA+ 3D assisted surgery group, as well as 14.3% and 50.4% in traditional surgery group with statistical significance (P<0.05). Conclusion: For complex oral cancer patients with difficulty in opening the mouth or postoperative recurrence, CTA vascular localization combined with fine 3D printing technology has significant advantages in the surgical process, surgical effect and postoperative evaluation index compared with traditional method using imaging data and clinical experience.

[Clinicpathological features and survival of patients with AIDS related non-Hodgkin's lymphoma].

Objective: To analyze the clinical characteristics, pathological features and survival of patients with AIDS related non-Hodgkin's lymphoma (ARL) . Methods: The clinical data of 53 ARL cases diagnosed and received care at Zhongnan hospital of Wuhan University were retrospectively studied, and 106 controls were enrolled as control group according to 1∶2 for paired cases and control. SPSS 13.0 package was used for statistical analysis. Kaplan-Meier was applied to assess the survival probability. Results: The mean age of patients with ARL was 43 (11-67) years. Male versus female was approximately 4∶1. The median CD4(+) T cell count was (146±20) /ml. The Ann Arbor clinical classification showed that 52.8% of the cases were of stage Ⅲ and Ⅳ. Approximately 54.7% of the patients had elevated serum lactate dehydrogenase (LDH) . According to international prognosis index score, 64.2% of the patients were in high risk group. Diffuse large B-cell lymphoma (DLBCL) was the predominant histological subtype. Among 53 cases, 33 cases (62.3%) received combination of anti-HIV therapy and anti-NHL (CHOP) chemotherapy regimen, 8 cases (15.1%) only received anti-HIV therapy, and 12 cases (22.6%) asked for alleviative treatment. Median survival time was (6.0±1.3) months for ARL cases versus (48.0±10.0) months for controls (P<0.05) . After eliminating cases who did not receive anti-lymphoma treatment, ARL cases showed a lower 1-year OS rates than control group (60.6% versus 83.0%) , but no difference about 2-, 3- and 5-year OS rates (53.5% versus 60.5%, 48.1% versus 45.9%, and 39.1% versus 27.5%, respectively) . Conclusions: ARL is more common in young adults; one-year mortality rate is high. Anti-HIV therapy combined with anti-NHL therapy could significantly improve the prognosis of ARL patients. CHOP regimen may be more suitable for ARL patients.

[The detection and significance of HBV-DNA in serum and liver of advanced schistosomiasis patients].

Hepatitis B virus deoxyribonucleic acid (HBV-DNA) and surface antigen (HBsAg) in the serum and liver specimens from 31 patients with advanced schistosomiasis were investigated. The patients have been followed up for six years. The presence of HBsAg and HBcAb in serum among patients with advanced schistosomiasis were significantly more frequent than that in the control group (P < 0.05), but the prevalence of HBV-DNA and HBeAg in the patients were not significantly different from that in the controls (P > 0.05). The positive rate of HBV-DNA and HBsAg in liver was 19.4% and 48.4% respectively, which were greater than that in serum. The presence of HBV-DNA in patients with advanced schistosomiasis was associated with high mortality and the cause of death was either hepatic failure or hepatocellular carcinoma. The results suggest that it is important to detect HBV-DNA both in surum and liver. Antiviral therapy for patients with advanced schistosomiasis who had detectable HBV-DNA may improve the prognosis.