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??Objective To investigate the clinical characteristics and treatment of hypereosinophilic syndrome??HES?? in children. Methods The clinical manifestations?? laboratory examinations??gastroscopy and imaging features??pathological results and therapy experience in 13 HES children admitted in Beijing Children’s Hospital??Capital Medical University from January 2009 to February 2016 and related literatures were analyzed retrospectively. Results Of the 13 patients evaluated?? 7 were male??54%?? and 6 were female??46%??. The median age at diagnosis was 9.6 years old??ranging 3 to 14 years old??. The median course of disease was 23 months??ranging 1 to 72 months??. The peripheral eosionophil counts ranged ??4.5—29.2??×109/L??mean 13.5×109/L??. Gastrointestinal tract was the most commonly involved organ?? and was reported in 92%??12/13?? of patients. It was followed in frequency by urinary system??84%????pulmonary??53%????cardiac??23%????and skin??8%?? and liver??8%??. A total of 2 sites were involved in 6 patients??3 sites were involved in 5 patients and 4 sites were involved in 2 patients. Treatment of oral prednisone therapy was given and follow-up of 10 patients had no clinical symptoms??2 patients had stopped prednisone??. But eosionophil counts still increased to varying degrees. Three patients were lost to follow-up. Conclusion HES in children is more common in school age and adolescent children. Gastrointestinal tract??urinary system and pulmonary involvement are more common. Glucocorticoid treatment is effective??which requires to be maintained in small dose in the long term.     

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??Efficacy of FOLFOX4 regimen systemic chemotherapy in treating advanced hepatocellular carcinoma: An analysis of 22 cases YIN Xiao-yu*??CHEN Jie??PENG Jian-xin??et al. *Department of Hepatobiliary Surgery??the First Affiliated Hospital of Sun Yat-sen University??Guangzhou 510080??China
Corresponding author??YIN Xiao-yu??E-mail??yinxy@21cn.com
Abstract Objective To evaluate the efficacy of FOLFOX4 regimen systemic chemotherapy in treating advanced hepatocellular carcinoma (HCC). Methods The clinical data of 22 cases of advanced HCC were treated by FOLFOX4 regimen systemic chemotherapy between July 2007 and July 2013 in the First Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. The chemotherapy was given each two weeks??with a maximum of 8 cycles. The therapeutic responses were evaluated each 3 cycles and end of treatment. Results A total of 85 cycles were administered in 22 cases??with a mean of ??3.7±2.0?? cycles /case. There were no complete response??5 partial responses??5 static diseases and 12 progressive diseases. The objective response rate was 22.7% (5/22)??and disease control rate was 45.4% (10/22)??with a one-year survival rate of 12.1% and median survival time of 5.8 months in the follow up of 2-34 ??8.5±1.9??months . In 10 cases of disease control after chemotherapy??the median survival time reached up to 9.5 months. Conclusion FOLFOX4 regimen systemic chemotherapy is effective in part of advanced HCC??and represented as an effective modality.     

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??Abstract??The purpose of the present study was to show the different choices of periodontal surgeries in resolving various clinical problems. There were both demands of restoration in bilateral posterior areas of the patient??but their remaining of local dental tissue was different. In order to immediately restore the function and esthetic of the patient's dentition??the crown-lengthening surgery was applied on the side of more dental tissue available??the tooth was extracted on the other side of less dental tissue available and cureless apical lesion??also??implant surgery was applied electively. Soft and hard tissue augmentation was finished in implantation synchronously. The effect of final restorations was good and the patient was satisfied. The periodontal surgery played the key role in multidisciplinary treatment??therefore??its indications should be carefully and comprehensively chosen in overall treatment design.     

术前TAGM联合弹簧圈门静脉栓塞根治肝门胆管癌1例报告

正右侧侵犯为主的肝门胆管癌根治术多需要联合右半肝切除,可能会导致术后肝衰竭。近年来,计划性肝切除的策略备受关注,采用门静脉栓塞(portal vein embolization,PVE)的介入技术能诱导未来残余肝(future liver remnant,FLR)术前增生、降低肝衰风险~([1-3])。使用三丙烯酸酯明胶微球(tris-acryl gelatin microspheres,TAGM)作为末梢栓塞剂,联合近侧弹簧圈的PVE在国内鲜有报道。笔者单位1例尝试采用此技术治疗1例。报告如下。     

罹患重度牙周病变磨牙采取微创拔牙和微翻瓣位点保存术后种植修复效果观察（附1例3年随访报告）

种植治疗因其临床长期效果稳定,逐渐成为牙列缺损或缺失后的常规修复方法,而充足的骨量和良好的软组织条件对种植治疗方案的实施至关重要。罹患重度牙周病变的磨牙不但在拔牙之前已经存在牙槽骨吸收,而且在拔牙窝愈合过程中所发生的不同程度牙槽骨吸收均会增加种植治疗的难度。文章完整展示了1例磨牙牙周-牙髓联合病变病例从病情分析、采取微创拔牙和微翻瓣技术在拔牙窝实施位点保存创造良好硬组织条件、按照标准化流程完成种植修复到追踪观察3年的具体实施过程,为评价此类病例微创拔牙和微翻瓣位点保存术后种植修复的长期效果提供了依据。     

B cell apoptosis accelerates the onset of murine lupus

To investigate whether the increased rate of lymphocyte apoptosis in systemic lupus erythematosus is involved in the onset of the disease, apoptotic or necrotic T or B lymphocytes from various cell lines were injected intraperitoneally into pre-autoimmune (NZBxNZW)F1 mice (BW) and non-autoimmune BALB/c mice. The intraperitoneal production of cytokines and chemokines, the specific T cell response in the spleen, and the production of anti-histone and anti-dsDNA Ab were investigated. The onset of the disease was characterized by creatinine levels and evaluation of glomerular IgG deposits. In BW, but not in BALB/c mice, injection of apoptotic and not necrotic cells up-regulated IL-6 and IL-10 in resident macrophages. Administration of apoptotic cells augmented the number of Th2 and B lymphocytes recruited in the peritoneal cavity. Only the treatment with apoptotic B cells promoted a systemic Th2 autoimmune response to H2 histones, associated with earlier occurrence of high levels of anti-dsDNA autoantibodies, higher creatinine levels and more numerous glomerular IgG deposits than in BW controls not injected with apoptotic B cells. In genetically susceptible mice exposure to apoptotic of B, but not T, lymphocytes can elicit a Th2 response to H2 histones that helps B cell production of anti-dsDNA Ab and finally triggers the onset of lupus.     

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??Ultrasound characteristics of thyroid microcarcinoma PAN Fu-shun*??XIE Xiao-yan??LI Xiao-xi??et al. *Department of Ultrasound, the First Affiliated Hospital of Sun Yat-sun University, Guangzhou 510080,China
Corresponding author??XIE Xiao-yan??E-mail??xxy1992@live.cn
Abstract Objective To investigate the ultrasound characteristics of thyroid microcarcinoma. Methods The ultrasound imaging of thirty-four cases of thyroid microcarcinoma confirmed by surgery and pathology between January 2003 and January 2009 at the First Affiliated Hospital of Sun Yat-sun University was analyzed retrospectively. Results Thirty-two (94.1%) cases were detected as hypo-echo nodules. Twenty-eight (85.3%) cases were with irregular shape. Twenty-six (76.5%) cases were with irregular edges calcification. Blood flow was detected in 7 cases with CDFI and lymph node metastasis was found in 4 cases. Conclusion Hypo-echo nodules, regular shape, irregular edges and calcification are the ultrasound characteristic. Comprehending the characteristics may improve the pre-operation diagnosis efficacy.