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??Abstract??Objective To study the clinical effect on patients with generalized aggressive periodontitis who accepted periodontal systematic therapy for 5 years. Methods Ten patients with generalized aggressive periodontitis were selected in the Periodontology and Oral Mucosa Department??Stomatological Hospital of Dalian from January 2006 to January 2007. These patients accepted periodontal systematic therapy for 5 years??including??periodontal initial therapy??periodontal surgical therapy??and periodontal supportive therapy. Clinical parameters of probing depth(PD)??clinical attachment level(CAL)??tooth mobility(TM)and bleeding on probing(BOP)were recorded by Florida electronic probe at baseline and 1-5 years after therapy??then analysis was carried out. Panoramic tomogram and the first molar intraoral radiography were detected before and 5 years after therapy. Results PD and CAL were decreased 1-5 years after periodontal systematic therapy??the positive sites of BOP were reduced and TM was improved. The statistical differences were detected(P < 0.01). The positive sites of BOP were reduced in the 5th year than in 1-3years??and the statistical differences were detected(P < 0.05). Conclusion To generalized aggressive periodontitis??the effect of periodontal systematic therapy of 5 years is effective and stable.     

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??Analysis on the evaluation criteria for therapeutic effect of imatinib in GIST WANG Chun-meng*, SHI Ying-qiang, WU Jiang-hong, et al. *Department of Gastric and Soft Tissue Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Corresponding author: SHI Ying-qiang, E-mail: yingqingshi@126.com
Abstract Objective To explore a new evaluation on target therapy in GIST patients. Methods The clinical data of 4 cases of GIST obtained complete remission after using imatinib between August 2004 and October 2010 at Fudan University Shanghai Cancer Center was analyzed. The imaging by CT or PET-CT scan before operation and pathology results after resection of 4 cases were compared. Results In 4 cases of GIST, 2 cases were evaluated only by imaging ( case 1 was evaluated by both CT and PET-CT), and another 2 cases were evaluated by both imaging and pathology. CT scans of cases performed resection after imatinib therapy was in contradiction of the findings of histopathological examination. Conclusion The Choi response criteria are superior to the RECIST criteria, and may become the mainstay in the evaluation of imatinib response in GIST cases.     

胃癌病人淋巴结转移nomogram图预测模型构建及评价

目的 探讨胃癌淋巴结转移的影响因素并构建nomogram图预测模型预测淋巴结转移概率。 方法 回顾性分析2013-01-01-2020-01-01上海交通大学医学院附属新华医院收治的879例未发生远隔转移及腹膜转移且经手术治疗的胃癌病人临床资料，利用单因素logistic回归、lasso回归筛选等统计学方法筛选变量，建立nomogram图并用ROC曲线进行评价模型。结果 CA242、肿瘤病灶大小、肿瘤浸润深度以及肿瘤分化程度被纳入构建nomogram图预测模型，内部验证评价模型AUC值为0.802（95%CI 0.766~0.838），外部验证评价AUC值0.791（95%CI 0.699~0.883）。 结论 构建胃癌淋巴结转移nomogram图预测模型，纳入变量在术前易于获得，模型具有较好的预测效果和较低的泛化误差，或可为临床医生在胃癌术前分期及治疗决策选择上提供参考。     

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??Individualized treatment of advanced pancreatic carcinoma with special reference to liquid biopsy LOU Wen-hui*??LIU Xiao-yu. *Department of General Surgery??Zhongshan Hospital??Fudan University??Shanghai 200032??China
Corresponding author??LOU Wen-hui??E-mail??lou.wenhui@
zs-hospital.sh.cn
Abstract The advantage of liquid biopsy in pancreatic cancer lies in minimal invasive, repeatable, and coherent to pathological diagnosis. Circulating tumor cells (CTCs) and Circulating cell-free DNA (cfDNA) are the major parts of liquid biopsy, there will be good perspertive in the personalized therapy of pancreatic cancer. Standardized technique, reasonable interpretation of the result will be the fundation of liquid biopsy in pancreatic cancer. Dynamically monitoring the change of CTC and cfDNA will provide clue for discovering new markers of recurrence and metastasis, as weill as new target of treatment.     

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??Application and evaluation of fine needle aspiration biopsy and eluate detection for cervical lymph node dissection decision in patients with thyroid carcinoma ZHOU Le*, ZHANG Guang, ZHANG Da-qi, et al. *Department of Thyroid Surgery, China-Japan Union Hospital, Jilin University, Changchun 130033,China
Corresponding author: SUN Hui, E-mail??sunhui1229@163.com
Abstract Objective To investigate the value of ultrasound-guided fine needle aspiration biopsy and technology of elution detection in strategy of cervical lymph node dissection in thyroid cancer patients. Methods The retrospective study included all thyroid papillary carcinoma patients who underwent primary surgical treatment in Department of Thyroid Surgery China-Japan Union Hospital from January 2013 to May 2017. The patients who received both fine needle aspiration cytology ??FNAC??and thyroglobulin detection in eluate??FNA-Tg?? were further analyzed. The diagnostic results of the above mentioned were compared with preoperative ultrasound image and postoperative paraffin pathology?? and some health economics indexes were also analyzed. Results Totally 9923 patients were enrolled in the study?? of whom 2609 patients were evaluated by ultrasound guided combined FNAC and FNA-Tg ??FNAC-Tg???? and then 254 patients among them underwent lateral cervical lymph node dissection and paraffin pathological examination. For the diagnosis of the lateral cervical lymph node?? the sensitivity?? specificity and accuracy of ultrasonography and FNAC-Tg were 67.57% vs. 97.30%?? 71.01% vs. 82.61% and 68.38% vs.93.81%?? respectively. No neck hematoma?? postoperative infection or needle-related metastasis occurred. The average hospitalization days of patients performed operation were 7.9, 7.3, 7.0, 6.5, 6.3 days each year from 2013 to 2017. The lateral cervical lymph node dissection accounted for the proportion of patients were 52.6%, 34.2%, 30.8%, 14.7%, 12.4%, respectively. Lymph node metastasis rate in lateral cervical lymph node dissection samples were 35.8%, 67.1%, 60.4%, 78.0%, 80.1%, respectively. Conclusion The combination of FNAC and FNA-Tg can increase the diagnostic accuracy of lymph node metastasis in thyroid carcinoma. It provides strong basis of evidence-based medicine for the development of the strategy of lateral cervical lymph node dissection?? which is helpful to reduce the proportion of prophylactic lateral cervical lymph node dissection and then save medical resources.     

甲状腺癌颈部淋巴结清扫术后双侧乳糜胸及乳糜腹1例报告

正颈侧区淋巴结清扫术后发生乳糜胸的情况少见,尤其是双侧乳糜胸更为罕见~([1]),大量乳糜液压迫肺和纵膈可导致呼吸循环功能障碍而危及生命。甲状腺癌颈部淋巴结清扫术后发生双侧乳糜胸及乳糜腹文献尚无报道。笔者单位近期诊治1例甲状腺癌双侧颈侧区淋巴结清扫术后发生双侧乳糜胸及乳糜腹的病例。报道如下。     

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??Objective??To study the anesthetic effect of infiltration anesthesia and block anesthesia in the treatment for irreversible pulpitis. Methods??Seven electronic databases were searched including Pubmed??Cochrane Library and CNKI??which were updated until April 1st??2017. Two researchers finished the screenings??data extraction and bias risk evaluation separately. RevMan 5.2 was utilized to finish the data processing and statistical analysis. Results??There was no significant difference in the success rate of anesthesia in the treatment of irreversible pulpitis ??RR = 0.96??95% CI = 0.85??1.09??P =0.56?? comparing infiltration anesthesia with block anesthesia. Infiltration anesthesia was less painful at the time of injection ??RR = 0.41??95% CI = 0.19??0.88??P = 0.02??. Conclusion??There is no significant difference in anesthesia effect between infiltration anesthesia and block anesthesia in the treatment of irreversible pulpitis. Infiltration anesthesia is less painful than block anesthesia at injection.     

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??Recognition and management of mesenteric vascular diseases in emergency SUN Bei*??HUANG Ren-ping. *Department of Pancreatobiliary Surgery??the First Affiliated Hospital of Harbin Medical University??Harbin 150001??China
Corresponding author??HUANG Ren-ping??E-mail??cup521@163.com
Abstract It is hard to diagnose early and give appropriate management for the patients who get mesenteric vascular disease. The prognosis of all types of acute mesenteric vascular disease is grave??and the mortality is high. Diagnosis of acute mesenteric vascular disease before the occurrence of permanent tissue damage is the best way to improve patients’ survival??and patients who receive the effective treatment in a timely manner are much more likely to recover.     

DNA连接酶4缺乏症致反复肺炎1例报告

正DNA连接酶4缺乏症(DNA ligase IV syndrome,LIG4),又称LIG4综合征(OMIO#606593),是一种与联合免疫缺陷相关的罕见常染色体隐性遗传病。临床主要表现为小头畸形、鸟样面容、生长发育迟缓、皮肤异常和全血细胞减少~([1])。本文报告1例LIG4综合征患儿的临床资料,并回顾国内外相关病例的临床特征,以提高临床医师对该疾病的认识。1病历资料患儿女,2岁1月龄,因咳嗽伴喘息半个月入院。咳嗽无明显诱因,伴喘息,起病6 d后咳嗽渐加重,偶可呕出大量黄色及白色黏痰。至当地门