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Novel Application of Vacuum Sealing Drainage with Continuous Irrigation of Potassium Permanganate for Managing Infective Wounds of Gas Gangrene

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2015年第4期35卷 563-568页

作者：胡宁吴星火刘融杨述华黄玮蒋电明吴强夏天邵增务叶哲伟 department of orthopaedic Surgery Institute for Orthopaedic Research and EducationThe First Affiliated Hospital of Chongqing Medical University department of orthopaedic Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and Technology department of orthopaedic Surgery Wuhan Puren HospitalWuhan University of Science and Technology

Summary： Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputa- tion. The aim of the present study was to use vacuum sealing drainage （VSD） with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical effi- cacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Am- putations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol （PVA） foam dress- ing and polyurethane （PU） film, with continuous irrigation of 1：5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one pa- tient who suffered from severe septic shock. Emergent resuscitation was performed and the patient re- turned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenviroument and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection.

关键词： vacuum sealing drainage potassium permanganate irrigation gas gangrene trauma

LRP5 polymorphism—A potential predictor of the clinical outcome in advanced gastric cancer patients treated with EOF regimen

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Chinese Journal of Cancer Research 2014年第4期26卷 478-485页

作者： Xin Liu Ming-Zhu Huang Zhi-Yu Chen Xiao-Yin Zhao Chen-Chen Wang Wei Peng Ji-Liang Yin Jin Li Xiao-Dong Zhu department of Medical oncology Fudan University Shanghai Cancer Center department of oncology Shanghai Medical CollegeFudan University

Purpose： Wnt pathways control key biological processes that potentially impact on tumor progression and patient survival. The present study analyzed the polymorphism of lipoprotein-related receptor 5 （LRPS）（gene with key functions in Wnt signaling） and its impact on the response to chemotherapy and survival of patients with advanced gastric cancer （AGC）. Methods： A total of 107 consecutive patients with AGC treated with first-line chemotherapy of EOF regimen were enrolled in the present retrospective study. The association between single nucleotide polymorphism （SNP） of rs3736228 in LRP5 and the clinical outcomes of the patients was studied. Results： The CC genotype of rs3736228 was significantly correlated with a higher disease control rate when compared to the CT and TT genotypes （89.3% and 61.8%, respectively, P〈0.001）. A univariate survival analysis also showed that the progression free survival （PFS） and overall survival （OS） for the patients with the TC and TF genotypes of rs3736228 were worse than for the patients with the CC genotype （PFS： 3.3 and 6.7 months, respectively, HR =0.454, P〈0.001; OS： 8.1 months and 18.8 months, respectively, HR =3.056, P〈0.001）. A multivariate Cox model incorporates rs3736228 and clinical features, also identified rs3736228 was significantly associated with the PFS and OS. Conclusions： Our results firstly highlight the importance of LRPY gene of Wnt pathway in the treatment of AGC and identify polymorphism of rs3736228 as independent predictor of disease control rate, PFS and OS in AGC patients treated with first-line chemotherapy of EOF regimen in the Chinese Han population.

关键词： Gastric cancer chemotherapy biomarker lipoprotein-related receptor 5 (LRP5) rs3736228

Anterolateral rotatory instability in vivo correlates tunnel position after anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft

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World Journal of Orthopedics 2017年第12期8卷 913-921页

作者： Yasutaka Tashiro Ken Okazaki Koji Murakami Hirokazu Matsubara Kanji Osaki Yukihide Iwamoto Yasuharu Nakashima department of orthopaedic Surgery University of Pittsburgh department of orthopaedic Surgery Kyushu University

AIM To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone(BTB) autografts, and to clarify the influence of tunnel positions on the knee *** Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial(TT)(n = 20) and trans-portal(TP)(n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3 D-CT bone models two weeks after surgery. Anterolateral rotatory translation was examined using a Slocum anterolateral rotatory instability test in open magnetic resonance imaging(MRI) 1.0-1.5 years after surgery, by measuring anterior tibial translation at the medial and lateral compartments on its sagittal images. Anterior-posterior stability was evaluated with a Kneelax3 *** A total of 40 patients(80%) were finally followed up. Femoral tunnel positions were shallower(P < 0.01) and higher(P < 0.001), and tibial tunnel positions were more posterior(P < 0.05) in the TT group compared with the TP group. Anterolateral rotatory translations in reconstructed knees were significantly correlated with the shallow femoral tunnel positions(R = 0.42, P < 0.01), and the rotatory translations were greater in the TT group(3.2 ± 1.6 mm) than in the TP group(2.0 ± 1.8 mm)(P < 0.05). Side-to-side differences of Kneelax3 arthrometer were 1.5 ± 1.3 mm in the TT, and 1.7 ± 1.6 mm in the TP group(N.S.). Lysholm scores, KOOS subscales and reinjury rate showed no difference between the two *** Anterolateral rotatory instability significantly correlated shallow femoral tunnel positions after ACL reconstruction using BTB autografts. Clinical outcomes, rotatory and anterior-posterior stability were overall satisfactory in both techniques, but the TT technique located femoral tunnels in shallower and higher positions, and tibial tunnels in more p

关键词： Anterior cruciate ligament Patellar tendon Bone-patellar tendon-bone Rotatory instability Magnetic resonance imaging Tunnel position Anatomic Singlebundle

Expert consensus on maintenance treatment for metastatic colorectal cancer in China

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Chinese Journal of Cancer 2016年第1期35卷 20-25页

作者： Rui-Hua Xu Lin Shen Jin Li Jian-Ming Xu Feng Bi Yi Ba Li Bai Yong-Qian Shu Tian-Shu Liu Yu-Hong Li Chun-Mei Bai Xiang-Lin Yuan Jun Zhang Gong Chen Ai-Ping Zhou Ying Yuan Xi-Jing Wang Xiao-Ping Qian Yan-Hong Deng Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center of Cancer Medicine department of Medical oncology Sun Yat-sen University Cancer Center department of Gastrointestinal Medical oncology Peking University Cancer Hospital department of oncology Tongji University Tianyou Hospital department of Medical oncology The 307th Hospital of Chinese People's Liberation Army department of Medical oncology West China Hospital of Sichuan University department of Gastrointestinal Medical oncology Tianjin Medical University Cancer Institute and Hospital department of Medical oncology The 301 th Hospital of Chinese People's Liberation Army department of Medical oncology Jiangsu Provincial Hospital department of Medical oncology Fudan University Zhongshan Hospital department of Medical oncology Peking Union Medical College Hospital department of Medical oncology Tongji Hospital of Tongji Medical CollegeHuazhong University of Science and Technology department of oncology Rui Jin HospitalShanghai JiaoTong University School of Medicine department of Colorectal Surgery Sun Yat-sen University Cancer Center department of Medical oncology Cancer Hospital Chinese Academy of Medical Sciences department of Medical oncology The Second Hospital of Zhejiang University School of Medicine department of oncology The Second Affiliated Hospital of Xi'an Jiaotong University department of Medical oncology Nanjing Drum Tower Hospital department of Medical oncology The Sixth Affiliated Hospital of Sun Yat-sen University

The impact of maintenance therapy on progression-free survival and overall survival as well as quality of life of Chinese patients with metastatic colorectal cancer has long been under ***,some phase III clinical trials have revealed that maintenance therapy can significantly prolong the progression-free survival while maintain an acceptable safety *** on this evidence and common treatment practice in China,we now generated one Expert Consensus on Maintenance Treatment for Metastatic Colorectal Cancer in China to further specify the necessity of maintenance therapy,suitable candidates for such treatment,and appropriate regimens.

关键词： Metastatic colorectal cancer, Maintenance therapy, Consensus

Protein tyrosine phosphatases in skeletal development and diseases

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Bone Research 2022年第1期10卷 1-19页

作者： Huiliang Yang Lijun Wang Christian Shigley Wentian Yang department of orthopaedic Surgery and orthopaedic Research Institute West China Hospital of Sichuan UniversityChengdu 610041SichuanChina department of orthopaedic Surgery Rhode Island Hospital and Brown University Alpert Medical SchoolProvidenceRI 02903USA

Skeletal development and homeostasis in mammals are modulated by finely coordinated processes of migration, proliferation,differentiation, and death of skeletogenic cells originating from the mesoderm and neural crest. Numerous molecular mechanisms are involved in these regulatory processes, one of which is protein posttranslational modifications, particularly protein tyrosine phosphorylation(PYP). PYP occurs mainly through the action of protein tyrosine kinases(PTKs), modifying protein enzymatic activity, changing its cellular localization, and aiding in the assembly or disassembly of protein signaling complexes. Under physiological conditions, PYP is balanced by the coordinated action of PTKs and protein tyrosine phosphatases(PTPs).Dysregulation of PYP can cause genetic, metabolic, developmental, and oncogenic skeletal diseases. Although PYP is a reversible biochemical process, in contrast to PTKs, little is known about how this equilibrium is modulated by PTPs in the skeletal ***-genome sequencing has revealed a large and diverse superfamily of PTP genes(over 100 members) in humans, which can be further divided into cysteine(Cys)-, aspartic acid(Asp)-, and histidine(His)-based PTPs. Here, we review current knowledge about the functions and regulatory mechanisms of 28 PTPs involved in skeletal development and diseases;27 of them belong to class Ⅰ and Ⅱ Cys-based PTPs, and the other is an Asp-based PTP. Recent progress in analyzing animal models that harbor various mutations in these PTPs and future research directions are also discussed. Our literature review indicates that PTPs are as crucial as PTKs in supporting skeletal development and homeostasis.

关键词： harbor supporting Whole

Safety and efficacy of Tongkuaixiao ointment in reliving cancer-induced pain: a multicenter double-blind placebo-controlled randomized trial

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Journal of Traditional Chinese Medicine 2016年第6期36卷 695-700页

作者： Tan Huangying Zhu Shijie Li Tong Feng Li Zhang Xia Li Yuan Lou Yanni Liu Meng Wan Donggui Li Peiwen Jia Liqun Deng Bo oncology department of Integrated Chinese-Western Medicine China-Japan Friendship Hospital oncology department the Third Affiliated Hospital of Beijing University of Chinese Medicine oncology department Wangjing Hospital of China Academy of Chinese Medical Science oncology department the General Hospital of Beijing Military Region

OBJECTIVE: To evaluate the safety and efficacy of Tongkuaixiao ointment(TKXO) in treating moderate-to-severe cancer induced ***: Totally 130 patients with moderateto-severe cancer induced somatalgia were randomly divided into a TKXO group and a control *** patients were treated with either TKXO applied externally or placebo, with opioid analgesics orally at the same time. Observation parameters were included numerical rating scale(NRS) scores,analgesic efficacy, initiation effective time, persistent analgesic time, equivalent morphine dose,National Comprehensive Cancer Network(NCCN)grade in Impact of Pain Measurement Scores, and safety and satisfaction extent ***: NRS scores and NCCN grade in Impact of Pain Measurement Scores decreased significantly after 5-days' treatment in the two groups(P <0.0001). Compared to the control group, initiation effective time was significantly shorter(P < 0.05)and persistent analgesic time was significantly longer(P < 0.01), equivalent oral morphine doses of the first day and the whole treatment course were significantly decreased in the TKXO treatment group(P < 0.01 or P < 0.05). No obvious adverse effects were found in the TKXO ***: TKXO combined with opioid analgesics possesses the advantages of high efficacy,fast action, long persistent action, safety and convenience in use, and it can reduce the dose of opioid.

关键词： Cancer pain External therapies Randomized controlled trail Double-blinded method

Perioperative chemotherapy for resectable gastric cancer:MAGIC and beyond

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World Journal of Gastroenterology 2015年第24期21卷 7343-7348页

作者： Audrey H Choi Joseph Kim Joseph Chao department of Surgical oncology City of Hope Duarte department of Medical oncology City of Hope Duarte

Over the last 15 years, there have been major advances in the multimodal treatment of gastric cancer, in large part due to several phase Ⅲ studies showing the treatment benefits of neoadjuvant and adjuvantchemotherapy and chemoradiation protocols. The objective of this editorial is to review the current highlevel evidence supporting the use of chemotherapy, chemoradiation and anti-HER2 agents in both the neoadjuvant and adjuvant settings, as well as to provide a clinical framework for use of this data based on our own institutional protocol for gastric cancer. Major studies reviewed include the SWOG/INT 0116, Medical Research Council Adjuvant Gastric Infusional Chemotherapy(MAGIC), CLASSIC, ACTS-GC, Adjuvant Chemoradiation Therapy in Stomach Cancer(ARTIST) and Trastuzumab for Gastric Cancer trials. Although these studies have demonstrated that multiple approaches in terms of the timing and therapy for gastric cancer are effective, no standard of care is widely accepted and questions regarding the optimal timing of chemotherapy, the benefit of radiotherapy, the minimum required extent of lymphadenectomy and optimal chemotherapy regimen still exist. Protocols from the upcoming ARTIST Ⅱ, CRITICS, TOPGEAR, Neo-AEGIS and MAGIC-B studies are outlined, and results from these studies will provide critical information regarding optimal timing and treatment regimen. Additionally, the future directions of gastric cancer research predicated on molecular profiling and tailored therapies based on targetable genetic alterations in individual patient's tumors are addressed.

关键词： Gastric cancer Neoadjuvant therapy Adjuvant therapy Chemotherapy Chemoradiation

A review of UHMWPE wear-induced osteolysis:the role for early detection of the immune response

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Bone Research 2016年第2期4卷 72-84页

作者： Adrese M Kandahari Xinlin Yang Kevin A Laroche Abhijit S Dighe Dongfeng Pan Quanjun Cui department of orthopaedic Surgery University of Virginia department of Radiology and Medical Imaging University of Virginia

In a world where increasing joint arthroplasties are being performed on increasingly younger patients, osteolysis as the leading cause of faiIure after total joint arthroplasty （TJA） has gained considerable attention. Ultra-high molecular weight polyethylene wear-induced osteolysis is the process by which prosthetic debris mechanicaIly released from the surface of prosthetic joints induces an immune response that favors bone catabolism, resulting in loosening of prostheses with eventual failure or fracture. The immune response initiated is innate in that it is nonspecific and self-propagating, with monocytic cells and osteoclasts being the main effectors. To date, detecting disease early enough to implement effective intervention without unwanted systemic side effects has been a major barrier. These barriers can be overcome using newer in vivo imaging techniques and modules linked with fluorescence and/or chemotherapies. We discuss the pathogenesis of osteolysis, and provide discussion of the challenges with imaging and therapeutics. We describe a positron emission tomography imaging cinnamoyl-Phe-（D）-Leu-Phe-（D）-Leu-Phe-Lys module, specific to maerophages, which holds promise in early detection of disease and localization of treatment. Further research and increased collaboration among therapeutic and three-dimensional imaging researchers are essential in realizing a solution to clinical osteolysis in TJA.

关键词： UHMWPE RANKL A review of UHMWPE wear-induced osteolysis

Presacral ganglioneuroma: A case report and review of literature Presacral ganglioneuroma: A case report and review of literature

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World Journal of Gastroenterology 2007年第14期13卷 2129-2131页

作者： Guido Cerullo Daniele Marrelli Bernardino Rampone Clelia Miracco Stefano Caruso Di Martino Marianna Maria Antonietta Mazzei Franco Roviello department of Pathology and oncology Unit of Surgical oncology University of SienaSienaItaly department of Pathology and oncology University of Siena SienaItaly department of Radiology University of Siena SienaItaly

Presacral ganglioneuromas are so rare benign tumors that only 17 cases have been reported in the literature. They are abdominal masses growing slowly and differential diagnoses have to be considered. Surgical resection is important for definitive diagnosis because it represents the only therapeutic choice. Because of the benign nature of ganglioneuroma, adjuvant chemoor radiotherapy is not indicated but regular follow-up is necessary for an early diagnosis of potential local recurrence. We report a case of a 64-year-old man with a presacral ganglioneuroma.

关键词： Ganglioneuroma Neuroblastoma Presacraltumor