With widespread utilization of multi-slice helical computed tomography (CT) and low-dose CT in lung cancer screening, significantly greater incidence of patients with solitary pulmonary nodules (SPN) has been found. Once SPN is discovered, it is very difficult to immediately determine whether it is benign or malignant in clinical practice. In this review, SPN etiology, epidemiological characteristics of SPN patients, nodule size, morphology, location and growth rate, mathematical models for predicting malignancy of SPN, and diagnostic value of positron emission tomography (PET) and positron emission tomography-computed tomography (PET/CT) are summarized to provide reference for differential diagnosis of SPN. Current management strategies for SPN are also discussed in this review. According to whether SPN diameter is greater than 8 mm, whether SPN patients are advanced aged, have smoking or malignancy history, different follow-up and treatment strategies can be chosen. The diagnostic and treatment value of video-assisted thoracoscopic surgery for SPN is also discussed.
Objective To investigate the application value of the binding pancreaticogastrostomy in pancreatico-duodenectomy. Methods The clinical data of 13 patients that performed pancreaticoduodenectomy with binding pancr-eaticogastrostomy from Jan. 2010 to Mar. 2013 in our hospital were retrospectively analyzed. The incidence of postoper-ative complications were counted. Results There was 1 patient with pancreatic stump bleeding after operation， and then recovered after conservative treatment. There was no patient with pancreatic fistula， bile fistula， delayed gastric empt-ying， and other complications after operation in whole group. Peritoneal fluid and amylase level in peritoneal fluid were gradually reduced or degraded after operation. The gastrointestinal function was recovered better. All patients were compl-etely cured. Conclusion The binding pancreaticogastrostomy in pancreaticoduodenectomy has its own unique advantage.It could be reduce the incidence of pancreatic fistula in postoperative patients by using binding pancreaticogastrostomy reasonably.
Infectious bone defects are usually caused by trauma, surgical infections, or chronic osteomyelitis, and represent a complex and intractable clinical challenge in the field of orthopaedics. Biological scaffolds can achieve synergistic repair of defects by loading antibiotics for controlled release to inhibit bacteria, providing support for cell proliferation and differentiation to promote bone regeneration, and carrying factors or stem cells to enhance vascularization. They possess incomparable advantages over traditional treatment methods in the management of infectious bone defects, and the selection of appropriate biological scaffolds in clinical practice needs to be tailored to the type of defect and the severity of infection. Therefore, this article elaborates on the application and research progress of biological scaffolds in the treatment of infectious bone defects.
Objective To summarize the research progress of gastric schwannoma (GS). Methods GS related researches and case reports were collected to make a review on general clinical manifestations, pathology characteristics, auxiliary examinations, differential diagnosis, and treatment. Results GS is rare in clinical reports, and it is lack of tissue specificity. Diagnosis is rely mainly on the expressions of S-100 protein and glial fibrillary acidic protein (GFAP). All kinds of auxiliary examinations, such as gastrointestinal angiography, ultrasound, endoscope, CT, an so on, could not independently as a diagnostic basis. Identification between GS and other gastric tumors is difficult, and GS is not sensitive to radiation and chemotherapy, the main treatment is surgery. Conclusions GS is a kind of rare tumor which occurs in gastric mucosa, immunohistochemistry is the most main examination for the diagnosis of GS. The surgical excision is the main treatment for GS, but the safety and efficacy of combination therapy of laparoscopy and endoscopy remains to be study.
ObjectiveTo explore new mechanisms of cross-species regulation of plant microRNA (miRNA) to regulate human health and disease.MethodThe recently relevant literatures on the new mechanisms of cross-species regulation of the plant miRNA for the health and disease of human were reviewed.ResultsThe phytochemicals played an important role in the maintaining human health and regulating diseases, and the plant miRNA cross-species regulation also played an important role in it. Its possible regulatory mechanism was that the mature plant miRNA came into the animal body through the gastrointestinal tract. It firstly passed through the gastrointestinal tract and then came into the microvesicles secreted by the small intestine. It was targeted to the organ or tissue through passing of the animal circulatory system. The plant miRNA passing through the gastrointestinal tract was highly matched with the target mRNA to perform its biological regulatory role.ConclusionsAlthough studies have confirmed that plant miRNA can regulate animal specific biological functions across gastrointestinal tract and it provides an experimental basis for plants to participate in new mechanisms for regulating occurrence and development of human health and disease, whether or not miRNA in food is affected by way it is processed, transported, stored, and extent to which it is affected, remains to be explored. At the same time, content of plant miRNA in animals is very low and types of plant miRNA in different animals are not same. Although the above issues have been unresolved, it is believed that with research progresses, mastering mechanism of miRNA cross-species regulation will greatly help to prevent human diseases and maintain health of body.
Objective To evaluate the clinical significance of epidermal growth factor receptor EGFR) mutations in the treatment of non-small cell lung cancer ( NSCLC) . Methods Plasma DNAs solated fromblood specimens of 170 NSCLC patients, who were admitted in the First Affiliated Hospital of uangzhou Medical College from December 2005 to December 2007, were subjected to the test of EGFR utant-enriched PCR. The correlation of mutant detection with clinical characteristics was analyzed as well.Results Out of the total 170 patients, EGFR mutations were identified in 77 cases ( 77 /170, 45. 3% ) .EGFR mutations were more frequent in the patients with adenocarcinoma ( P lt; 0. 001) and in the nonsmokers P =0. 001) . In the 33 patients treated with gefitinib, those with mutations ( + ) showed a higher esponse rate and prolonged progression-free survival after the treatment compared with those with mutations( - ) ( P =0. 001 and 0. 001, respectively) . Conclusions EGFR active mutations can be specifically and ensitively detected by EGFR mutant enriched PCR assay. Plasma EGFR mutants detection is valuable in uiding clinical decision.
ObjectivesTo systematically review the safety and efficacy of intraoperative local application of platelet-rich plasma in patients with femoral neck fracture.MethodsDatabases including The Cochrane Library, PubMed, Web of Science, WanFang Data, CBM, EMbase and CNKI were searched to collect randomized controlled trials (RCTs) on operation versus operation combined with platelet-rich plasma for patients with femoral neck fracture from inception to April 30th, 2017. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 8 RCTs, including 916 patients with femoral neck fracture were enrolled in the analysis. The results of meta-analysis showed that compared with the group of internal fixation, the group of internal fixation combined with platelet-rich plasma could significantly shorten healing duration of fracture (MD=−2.18, 95%CI −3.37 to −0.99, P=0.000 3), improve the fracture healing rate (RR=1.14, 95%CI 1.03 to 1.25, P<0.000 01) and hip function score (MD=10.18, 95%CI 5.99 to 14.37, P<0.000 01), and effectively reduce the femoral head necrosis rate after operation (RR=0.35, 95%CI 0.22 to 0.57, P<0.000 1).ConclusionCurrent evidence shows that the method of internal fixation combined with platelet-rich plasma could effectively shorten healing duration, improve healing rate and hip function score, and reduce the rate of femoral head necrosis. Due to the limited quality of the included studies, more large scale, high-quality studies are required to verify the above conclusion.
Objective To investigate the feasibility of detection of epidermal growth factor receptor ( EGFR) exon 19 deletions and exon 21 L858R mutations in pleural effusion fromnon-small-cell lung cancer ( NSCLC) patients by mutant enriched PCR assay. Methods The mutations of exon 19 and 21 of EGFR gene in pleural samples fromthirty NSCLC patients were analyzed using both the mutant-enriched PCR assay and the non-enriched PCR assay. Results Ten ( 33. 3% , 10/ 30) exon 19 deletions and five ( 16. 7% , 5/30) exon 21 L858R mutation were detected by the mutant-enriched PCR assay, while only 6 cases ( 20. 0% ) and 1 case ( 3. 3% ) were detected by the non-enriched PCR assay respectively. The difference of mutation detection rate of EGFR gene between the two methods was statistically significant ( P = 0. 032) . Mutations were detected in all of partial responders ( 2 /4) among the four patients who received gefitinib therapy. Conclusions Mutant-enriched PCR assay can detect EGFR exon 19 deletions and exon 21 L858R mutation in pleural effusion from NSCLC patients effectively, economically and accurately. It may be a valuable biomarker for gefitinib therapy in advanced NSCLC.