Radiation therapy in cholangiocellular carcinomas

Cholangiocarcinoma can arise in all parts of the biliary tract and this has implications for therapy. Surgery is the mainstay of therapy however local relapse is a major problem. Therefore, adjuvant treatment with chemoradiotherapy was tested in trials. The SWOG-S0809 trial regimen of chemoradiotherapy which was tested in extrahepatic cholangiocarcinoma and in gallbladder cancer can currently be regarded as highest level of evidence for this indication. In contrast to adjuvant therapy where only conventionally fractionated radiotherapy plays a role, stereotactic body radiotherapy (SBRT) today has become a powerful alternative to chemoradiotherapy for definitive treatment due to the ability to administer higher doses of radiotherapy to improve local control. Sequential combinations with chemotherapy are also frequently employed. Nevertheless, in general cholangiocarcinoma is an orphan disease and future clinical trials will have to improve the available level of evidence.     

Anti-inflammatory effect of taurocholate on TNBS-induced ulcerative colitis in mice

Taurocholate is a natural conjugated bile acid. The aim of this study was to evaluate the anti-inflammatory effect of taurocholate in TNBS-induced ulcerative colitis in mice. The colitis were induced by rectal administration of TNBS. After 24 h, the experimental animals were treated with sulfasalazine (SASP, 500 mg/kg/day) and taurocholate (20, 40 and 60 mg/kg) for 7 consecutive days. The anti-inflammatory effects of taurocholate for colitis were assessed by body weight, colonic weight and length, macroscopic scores, and histopathological examinations. In addition, the colonic tissue levels of myeloperoxidase (MPO) activity, interleukin (IL)-1β, interferon (IFN-γ) and tumour necrosis factor-α (TNF-α) were also determined to assess the effect of taurocholate. Compared with the model group, treatment with taurocholate (20, 40 and 60 mg/kg) significantly inhibited the body weight loss, improved colonic weight and length, and decreased macroscopic and histopathological scores. Furthermore, the activity accumulation of MPO and the colonic tissue levels of IL-1β, IFN-γ and TNF-α were also decreased by administration of taurocholate. All the findings of this study suggested that taurocholate has the anti-inflammatory effect in ulcerative colitis in mice and indicated it as a good candidate to treat inflammatory bowel disease.     

暴露法在新生儿脐部护理中的应用

目的 探讨风险预测评估暴露法在新生儿脐部应用的效果.方法 采用随机分组方法将2012年7月1日至2014年1月31日在本院出生的1000例足月新生儿按双盲随机分为实验组和对照组,实验组采用风险评估暴露法对新生儿脐部的影响,评估：①新生儿营养状态和生产过程对新生儿的影响及脐部的情况;②断脐后,暴露其部位可能带来不良的影响;③家属与产妇对暴露脐部的方法接受程度等.脐部暴露方法的处理：用脐带夹结扎脐带包扎24 h后暴露脐带至脐带脱落,这期间每天用75％酒精消毒脐部一次.对照组采用传统的脐部包扎法.观察两组新生儿脐带脱落天数、脐部愈合时间、脐部红肿、出血、分泌物、新生儿呼吸改变等情况.结果 实验组脐部红肿1例（0.20％）、脐部出血2例（0.40％）、脐炎12例（2.42％）、脐带脱落时间（6.59±1.85）d、脐部愈合时间（2.14±0.59）d,对照组脐部红肿12例（2.41％）、脐部出血11例（2.21％）、脐炎80例（16.06％）、脐带脱落时间（7.52±2.21）d、脐部愈合时间（2.35±0.65）d、呼吸改变5例（1.00％）,两组比较差异有统计学意义（P＜0.05）.结论 脐部暴露法应用于新生儿可促进脐带脱落及脐部愈合,减少脐部感染的发生,是安全、有效的新生儿脐部护理方法,值得临床推广应用.     

Neo-Adjuvant Chemotherapy Followed by Surgery for Extensive Calvarial Metastases of a Neuroblastoma

Neuroblastoma is a common tumor of children. We report a patient with extensive calvarial metastases of a neuroblastoma as an initial presentation. A 2-year-old girl presented with a history of gradually increasing head size and fever. A brain CT showed a multilobulated, large, extra-axial tumor involving both frontotemporoparietal areas with a sunray-spiculated hyperostosis of the skull and marked contrast enhancement. A brain MRI demonstrated extensive calvarial lesions with simultaneous involvement of the orbits. A biopsy was performed and a ganglioneuroblastoma was diagnosed. On systemic evaluation, an enlarged abdominal mass was detected. After neo-adjuvant chemotherapy, most of the tumors disappeared except for a tumor in the left parietal area; there was a corresponding decrease in the circumference of the head. We performed surgery for the remnant mass. Intensive chemotherapy was administered and a bone marrow transplantation was performed. Adequate neo-adjuvant chemotherapy followed by surgery to the neuroblatoma with extensive metastases to the skull and orbit may be helpful.     

开腹与后腹腔镜术式治疗肾上腺良性肿瘤的比较

目的 探讨开腹与后腹腔镜术式对肾上腺良性肿瘤患者围手术期临床指标、ICU转送率及并发症的影响。方法 选取120例肾上腺良性肿瘤患者为研究对象，以随机数字表法分为对照组和观察组，每组各60例；其中对照组患者采用开腹术式治疗，观察组患者则采用后腹腔镜术式治疗；比较两组患者的手术时间、术中失血量、肛门排气时间、术后引流量、术后拔管时间、住院时间、ICU转送率及并发症发生率。结果 观察组患者手术时间、肛门排气时间、术后拔管时间及住院时间均显著短于对照组（P＜0.05）；观察组患者术中失血量和术后引流量均显著少于对照组（P＜0.05）；两组患者ICU转送率比较差异无统计学意义（P＞0.05）；同时观察组患者术中和术后并发症发生率均显著低于对照组（P＜0.05）。结论 后腹腔镜术式治疗肾上腺良性肿瘤可有效减轻医源性损伤程度，促进术后早期康复，且有助于避免术中及术后出现并发症，其临床应用价值优于开腹术式。     

中西医结合治疗口腔扁平苔藓的临床疗效观察

目的观察中西医结合治疗口腔扁平苔藓的临床效果。方法选取从2012年1月-2013年1月我院口腔科收治的40例口腔扁平苔藓患者，按就诊顺序随机分为对照组和治疗组各20例。对照组患者注射卡介菌多糖进行治疗，实验组患者在对照组基础上结合中药方剂进行治疗。结果治疗前，2组患者的疼痛评分比较，差异无统计学意义（t=0．151，P〉0．05）。采用不同方式治疗后，2组患者的疼痛评分比较，差异有统计学意义（t=9．631，P〈0．05）；对照组的总有效率为85．0％，实验组的总有效率为95．0％，实验组明显优于对照组，差异有统计学意义（P〈0．05）。结论采取中西医结合治疗口腔扁平苔藓，能使患者的疼痛情况得到缓解，有助于治疗效果的提升，具有临床应用及推广价值。