Pyriform sinus fistula in children: A comparison of endoscopic-assisted surgery and endoscopic radiofrequency ablation

BackgroundPyriform sinus fistula (PSF) is a rare congenital anomaly, and the preferred definitive treatment is yet to be verified. In this study, we investigated the treatment outcomes of PSF specifically comparing endoscopic-assisted surgery and endoscopic radiofrequency ablation (RA).MethodsThe medical records of patients treated for PSF at the Shanghai Children's Hospital between October 2016 and September 2019 were retrospectively evaluated.ResultsThere were 93 girls and 98 boys. The median age at onset and operation was 3 years and 5 years, respectively. Endoscopic-assisted surgery was performed in 143 patients. During the same period, RA was performed in 48 patients, and 10 of them concurrently underwent incision and drainage of neck abscesses. Longer hospital stay was found in the endoscopic-assisted surgery group than in the RA group (10.50 ± 3.93 vs. 5.02 ± 3.30 days, P < 0.001). Postoperative complications were not significantly different between the two groups, except for neck infection (0 vs. 8.3%, P = 0.004). After a median follow-up period of 21 months, no significant difference was found between the two groups in terms of recurrence (1.4% vs. 0, P = 0.560).ConclusionPatients treated with RA had a significantly shorter hospital stay than those treated with endoscopic-assisted surgery. Outcomes of endoscopic-assisted surgery and RA were not significantly different for the management of PSF and treatment method should be tailored to the patient.Level of evidenceIV.     

Clinicopathological characteristics,prognosis, and chemosensitivity in patients with metastatic upper tract urothelial carcinoma

PurposeTo investigate the clinical characteristics, chemosensitivity, and outcome of metastatic upper tract urothelial carcinoma (UTUC).Patients and MethodsRecords of patients with metastatic UTUC since January 2005 were retrieved from a database that included clinical and survival data. Statistical analyses including survival and multivariate analyses of factors were respectively performed by the Kaplan-Meier method and Cox proportional hazard model.ResultsA total of 250 consecutive UTUC cases were evaluated. There were 56 patients (22.4%) with initially diagnosed stage IV disease. The most common metastatic sites were lung (39.6%), distant lymph nodes (39.2%), bone (19.6%), liver (18.0%), and adrenal gland (7.2%), respectively, and the local recurrence rate was 10.4%. Two hundred thirteen patients received first-line chemotherapy. The overall response rate was only 28.7% and the median progression-free survival time was only 5.0 months. The overall survival time of the cohort was 18.0 months. Multivariate analyses showed that initially diagnosed stage IV disease, number of metastatic organs ≥3, no response to chemotherapy and cycles of chemotherapy ≤2 were adverse prognosticators for overall survival.ConclusionUTUC presented to be more prone to metastasize than locally recur and thought to have low chemosensitivity. Stage IV disease at initial diagnosis, number of metastatic organs, response and cycles of chemotherapy were independent prognosticators for metastatic UTUC.     

Bacterial expression of immunoglobulin VH proteins

A bacterial expression system in Escherichia coli has been developed that produces as much as 10 mg/l of culture of the VH protein associated with monoclonal antibodies specific for the 5-dimethylaminonaphthalene-2-sulfonyl (Dns) group. This system has been applied to the expression of the VH genes derived from a low-affinity, IgM-producing hybridoma and from a high-affinity, IgG-producing cell line. The plasmid vectors (contributed by Dr William F. Studier) utilize a T7 expression cassette whose activity is initiated by infection with a lambda phage derivative carrying the T7 RNA polymerase gene. The VH proteins were extracted from the bacterial pellet in 8 M urea and purified by chromatography in 8 M urea. Recombinants with the homologous light (L) chains were prepared to yield VHL molecules. These were used to measure intrinsic affinity for Dns-lysine by resonance energy transfer. The association constants were 7 x 10(6) M-1 and 7 x 10(9) M-1 for the low- and high-affinity systems, respectively. These values are not significantly different from those observed with monoclonal antibodies secreted from the corresponding cell lines. This system lends itself to the quantitative evaluation of the binding properties of the VH protein itself as well as the modulation of affinity by site-directed mutagenesis.     

Primary study of iontophoresis of zinc ion in treatment of retinitis pigmentosa

We report here the preliminary effects of zinc iontophoresis in treatment of 26 Rp patients who had decreased zinc serum level or abnormal ratio of serum copper to zinc. Through more than 20 to 30 times of therapy, the vision of 15.38% eyes increased more than "3 lines", 4% eyes increased more than 5 degrees in the visual field, 13.46% eyes improved in dark adaptation threshold (greater than 1.0), the visual functions of the rest eyes were slightly improved or unimproved. The fundus didn't change before & after treatment. There were no changes of ERG in 8 eyes of 4 cases. In addition, the advantages and disadvantages between Zn iontophoresis and Zn compound taken orally, the improvement of vision by direct electric current therapy, the relationship between the metabolism of Zn element and Vit A and influence of Zn over the mechanism of dark adaptation were also briefly discussed.     

P~(53)蛋白在口腔扁平苔藓癌变诊断中的意义

目的 :探索口腔粘膜扁平苔藓 (OLP) P53蛋白的表达及其在癌变诊断中的应用价值。方法 :采用 S- P免疫组化方法 ,观察在 2 5例 OLP、2 0例鳞癌 (OSCC)中 P53蛋白的表达。结果 :1 P53蛋白的阳性表达在 OLP早期已出现 ,各组间 P53阳性表达率间有显著性差异。2在 OSCC中其阳性表达率高达 80 % ,随着细胞异常增生程度的增高而增高。结论 :1在 OSCC的形成过程中 ,抑癌基因 P53的失活可能参与调节作用 ;2 P53蛋白作为判断 OLP癌变的辅助性参考指标 ,具有一定的可行性     

Studies of β-lactamase production in ampicillin resistant Haemophilus influenzae

In 1972, HaelnOPhilus influenzae (HI) was firstlydiscovend being resistant against alnpicillin by producing5-lac~e, since then, studies on the rests~ mechamsms and the moleCular basis of 5-lactalnaSe Pwhctionhave been increasing year by yeax abroadll]. In 1978,Bryan et .l[2] first reported sabins of HI Producing 0-lactamaSe, which was mediated by plaaed, from then on,many stUdies foeused on 3-lactamase encoded by PlaSnddin HI and its relation with ampicillin resisboce. In ourco~, few st…     

4-硒硫酸酯多糖的体内抗瘤作用

目的　观察 4-硒硫酸酯多糖 (Se-carra)的体内抗瘤作用。方法　于小鼠右腋皮下接种瘤细胞 2 4h后开始给药 ,连续 10天 ,观察其抑瘤率 ;小鼠腹腔接种肿瘤细胞前或接种后连续给药 10天 ,观察动物的生存时间。结果　 4-硒硫酸酯多糖能明显抑制肿瘤细胞的生长 ,延长小鼠的生存期。结论　 4-硒硫酸酯多糖体内给药有良好的抗瘤效果 ,值得进一步研究。     

医学大学生对医德认知的调查研究

采用抽样研究方法,对４３８名不同专业、不同层次的大学生进行了医德认知调查,以了解大学生对医德基本知识掌握的情况,结果表明,大学生对开设医学伦理学课必要性认识均率为６２．９％,课外经常阅读医德书籍均率为２２．７５％,对中外基德发展史各朝代典型的人物及代表作了解的均率为３１．１％,文中对调查结果进行了分析。