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Gallbladder cancer is a highly malignant tumor of the biliary tract with a poor prognosis. Early diagnosis and timely radical surgery are the only ways to cure gallbladder cancer. However, due to the lack of specific clinical manifestations and the early symptoms of gallbladder cancer are similar to cholecystitis, most gallbladder cancer is diagnosed only in the late stage of onset, and traditional chemotherapy and radiotherapy have very limited treatment efficacy for gallbladder cancer, and have little effect on overall survival. As the current research on the molecular biological mechanism of gallbladder cancer is becoming more and more perfect, the use of molecular biology methods to treat gallbladder cancer has shown more effective treatment strategies and development prospects. This article reviews the progress of molecular biology in gallbladder cancer in recent years, hoping to provide prognostic molecular markers and therapeutic targets for gallbladder cancer, and improve the chemotherapy effect of gallbladder cancer.
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Objective:To evaluate iliac vein balloon dilation for the treatment of superficial varicose veins of grade C3 and beyond.Methods:A total of 568 patients with superficial varicose veins of C3 or above at our department were enrolled and divided into interventional ball expansion group, the stretch socks treatment group and the ablation surgery group. The VCSS score was used to evaluate the treatment efficacy.Results:Forty out of 47 cases in the interventional ball expansion group were evaluated as effective while the other 7 cases were ineffective; 39 out of 82 cases in the elastic socks treatment group were effective while the other 43 cases were ineffective. 280 out of 439 cases in the ablation surgery group were effective while the other 159 cases were ineffective. The improvement degree of the interventional ball expansion group was statistically better than that of the other two groups ( P<0.05). Conclusion:Interventional balloon dilatation of iliac vein is better than traditional treatment to improve the subjective feelings of patients with superficial varicose veins above grade C3.
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Objective To study the effect of dynamic pressure on the expression of parathyroid hormone-related protein (PTHrP)mRNA in metaphyseal cartilage stem cells of rats so as to further explore whether fiber actin (F-actin)is involved in the mechanical signal transduction process.Methods We isolated and cultured metaphyseal cartilage stem cells of rats by immunomagnetic beads.The third-generation rat metaphyseal cartilage stem cells were randomly divided into four groups:0%,3%,6%,and 12% deformed groups according to the size of dynamic pressure strength.We used a self-prepared dynamic tonic culture device to exert different intensity of pressure on each group of cells for 24 hours.Flow cytometry was used to detect the cell cycle distribution and apoptosis rate.The expression of PTHrP mRNA in each group was detected by Rea-l time quantitative PCR. Furthermore,the third-generation rat metaphyseal cartilage stem cells were randomly divided into four groups:control group,simple pressure group (6% deformation),pressure+cytoskeleton relaxin D group,and simple cytoskeleton relaxin D group according to whether or not to apply pressure and cytoskeleton relaxin D.F-actin fibers in each group of cells were stained with phalloidin and placed under a laser scanning confocal microscope.The expression of PTHrP mRNA in each group was detected by Real-time quantitative PCR.Results The results of flow cytometry showed no significant difference in G0/G1,G2/M and S phases between 0%,3%,6% and 12% deformed groups (P＞0.05).There was no significant difference in the apoptosis rate between 3% and 6% deformed groups compared with 0% deformed group (P＞0.05).The apoptosis rate was significantly higher in 1 2 % deformed group than in control group (P＜0.05).The results of laser confocal microscopy showed that the arrangement of F-actin fibers in the pressure group was neat and parallel compared with that in the control group, which was consistent with the direction of force.The intracellular F-actin fiber structure in pressure+cytoskeleton relaxin D group and simple cytoskeleton relaxin D group was destroyed and aggregated into clusters.Real-time quantitative PCR results showed that PTHrP mRNA expression did not significantly differ between 3% and 0% deformed groups (P＞0.05).The expression of PTHrP mRNA in 6% and 12% deformed groups was significantly higher than that in 0% group (P＜0.05).The expression of PTHrP mRNA in the cells of simple pressure group was significantly higher than that in the control group (P＜0.05).There was no significant difference in the expression of PTHrP mRNA between simple cytoskeleton relaxin D group and control group (P＞0.05).The mRNA expression of PTHrP was higher in pressure+cytoskeleton relaxin D group than that in control group,but lower than in simple pressure group (P＜0.05).Conclusion The dynamic pressure of proper intensity can increase the mRNA expression of PTHrP in chondrocytes of metaphyseal hypertrophy in rats,and F-actin is involved in the mechanical signal transduction process.
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Objective To study the short-term curative effect of total parathyroidectomy (t-PTX) and cinacalcet therapy for treating refractory secondary hyperparathyroidism (SHPT).Methods The clinical data of 118 patients with refractory SHPT admitted in our hospital from January 2012 to September 2015 wereretrospectively analyzed,and according to different therapeutic methods the patients were divided into the group A (receiving the conventional medical treatment after poor effect by the impact therapy,n=62),B(performing t-PTX,n=26) and C (oral cinacalcet,n=30).All patients were given the conventional medical treatment.The calcium,phosphorus and calcium-phosphorus product,and parathyroid hormone (iPTH) follow-up on 0,1 d,and at 1,3,6 months was finished in 3 groups.Results The gender,age,dialysis time,calcium,phosphorus,calcium-phosphorus product and iPTH level on 1 d had no statistically significant difference among 3 groups(P＞0.05).the pain relief rates of the group A,B and C were 0,92.31 ％ and 60.00 ％ respectively;compared with the group A,phosphorus,calcium-phosphorus product and iPTH at various time points after processing in the group B and C were significantly decreased(P＜0.01);compared with the group C,calcium,phosphorus,calcium-phosphorus product and iPTH at various time points after processing in the group B were significantly reduced(P＜0.05).Conclusion If the patients with refractory SHPT are tolerable for surgery,t-PTX therapy should be taken as the first choice;oral cinacalcet treatment provides the possibility of non-operative therapy for the patients with refractory SHPT.
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Objective To analyze the clinical features of Hashimoto thyroiditis with thyroid cancer, and provide scientific basis for clinical diagnosis and treatment. Methods The clinical data of 87 patients of Hashimoto thyroiditis with thyroid cancer and 105 patients of Hashimoto thyroiditis were retrospectively analyzed. Results The rates of Hashimoto thyroiditis with thyroid cancer in age 0.05). There were statistical differences in total thyroxine (TT4), thyroid stimulating hormone (TSH), thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) levels between Hashimoto thyroiditis with thyroid cancer and Hashimoto thyroiditis, there were statistical differences (P<0.05 or <0.01). Multiariable Logistic regression analysis result showed that the decreased serum level of TT4 and the increased levels of TSH, TgAb and TPOAb were the correlated factors of Hashimoto thyroiditis with thyroid cancer (P<0.05 or <0.01). Conclusions Low level of TT4 and high levels of TSH, TgAb and TPOAb may increase the risk of Hashimoto thyroiditis with thyroid cancer. The 30-49 years male patients with Hashimoto thyroiditis should be highly suspected of the possibility of merger thyroid cancer.
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BACKGROUND:The limb ischemia model in rats has been widely applied in China to study the pathological process and treatment method of limb ischemia, but there are some controversies on the model construction and evaluation, so a reliable, convenient and economical disease model is needed for the related research. OBJECTIVE:To compare limb ischemia degree, duration and changing rule of acute hind limb ischemia models prepared by different ways in Sprague-Dawley rats, and find a method to prepare models that have moderate and stable limb ischemia and maintain a longer time. METHODS: 72 Sprague-Dawley rats were randomly divided into four groups, with 18 rats in each group. Group A: sham operation group, abdominal aorta below renal artery and iliolumbar artery, right superficial femoral artery, popliteal artery, saphenous artery were separated. Group B: the right superficial femoral artery, popliteal artery, saphenous artery were cut off, and the right femoral artery was resected to establish acute hind limb ischemic model. Group C: abdominal aorta and bilateral abdominal perineal artery were ligated to establish acute hind limb ischemic model. Group D: abdominal aorta, iliolumbar artery and lumbar artery were ligated to establish acute hind limb ischemic model. RESULTS AND CONCLUSION:Right hind limb muscle strengths of rats in groups B, C, D were weaker than that in group A at weeks 2, 4, 6 after operation; muscle strengths in group D was weaker than that in groups B, C at week 4 after operation; muscle strengths in groups B, D was stil weaker than that in group C at week 6 after operation. The partial venous oxygen pressure of right hind limbs in groups B, C, D was lower than that in group A at weeks 2, 4, 6 after operation; the partial venous oxygen pressure in group D was lower than that in groups B and C at weeks 2, 4 after operation; and group D was stil lower than group C at week 6 after operation. At weeks 2, 4 after operation, some muscle cels in the right hind limb muscle tissue were disrupted, fibrous connective tissue hyperplasia and capilary hyperplasia were detected, inflammatory cels infiltrated in the groups B, C, D. These pathological findings were more apparent in group D. Fiber connective tissue hyperplasia was attenuated, capilary hyperplasia, expansion and congestion were found in each group at week 6 postoperatively. The method of ligating abdominal aorta, iliolumbar artery and lumbar artery below renal artery for hind limb ischemia model can obtain moderate and stable ischemia conditions, maintain a long time, and is convenient to prepare.
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BACKGROUND:The assessment for long-term efficacy of chronic ischemic disease is more important than the short-term efficacy assessment, which associates with patient’s long-term quality of life and long-term survival rate. OBJECTIVE:To observe the 5-year folow-up outcomes of autologous bone marrow stem cel transplantation for the treatment of thromboangitis obliterans. METHODS:This study enroled 43 patients of thromboangitis obliterans who underwent autologous bone marrow stem cel transplantation from August 2007 to January 2010 in the Department of Thyroid Vascular Surgery, the First Affiliated Hospital of Xinjiang Medical University. At 1, 2, 3, 4 and 5 years after transplantation, pain, cold sensation, and intermittent claudication distance were folowed up by telephone; changes in limb ulcers were observed. At 1 year after transplantation, venous oxygen partial pressure and oxygen saturation of limbs were reviewed. RESULTS AND CONCLUSION:A total of 38 thromboangitis obliterans patients with complete folow-up data were included in the final analysis. Compared to the preoperation, pain, cold sensation, and intermittent claudication significantly improved. The difference was statisticaly significant (Z values:-4.277,-5.086,-3.574, P 0.05). Intermittent claudication distance had increased. Differences in terms of intermittent claudication distance was statisticaly significant (Z=43.898,P < 0.001). Significant differences in venous oxygen partial pressure and oxygen saturation were detected between preoperation and 1-year posttransplantation (tvalues: 36.790, 43.964,P values: 0.040, 0.037). Above results suggest that autologous bone marrow stem cel transplantation for thromboangitis obliterans obtained stable long-term outcomes.
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BACKGROUND:With the development of surgical techniques and endovascular treatment techniques, the therapeutic efficacy on arteriosclerosis obliterans of the lower limbs has been improved greatly. As the long-term prognosis is stil not clear, how to treat arteriosclerosis obliterans of the lower limbs is stil a problem for vascular surgery. OBJECTIVE:To observe the long-term clinical efficacy of autologous bone marrow stem cel transplantation in the treatment of arteriosclerosis obliterans of the lower limbs. METHODS:Thirty-nine patients with arteriosclerosis obliterans who had undergone autologous bone marrow mesenchymal stem cels (totaly 56 times of cel transplantation) from September 2007 to July 2013 were enroled in this study. As of February 2015, the folow-up time was 7.5 years. After treatment, regular telephone folow-up about limb pain, cold sensation, intermittent claudication distance, resting ankle-brachial index and limb ulcer size and depth was done annualy; at 1 year after treatment, limb arteriography and venous blood gas analysis were reviewed. RESULTS AND CONCLUSION: Of the enroled 39 patients, 4 patients were subjected to amputation because of poor efficacy, 2 patients died of acute myocardial infarction, and 2 patients died of not timely amputation. There were 31 patients who had been folowed up for over 3 years. After treatment, the resting ankle-brachial index and limb ulcer size and depth limb pain were both improved significantly. There were significant differences in 1-year limb blood oxygen partial pressure and oxygen saturation before and after treatment, and the postoperative number of capilaries also increased significantly. These findings indicate that autologous bone marrow stem cel transplantation is a safe treatment for arteriosclerosis obliterans of the lower limbs with better and stable long-term curative effects. This method is a good choice for patients who have poor blood vessels and poor efficacy of traditional methods.
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<p><b>OBJECTIVE</b>To study the clinical characteristics of ecotopic viral integration site-1 (EVI1) and BCR/ABL positive childhood leukemia.</p><p><b>METHODS</b>Clinical data of four children with EVI1 and BCR/ABL positive leukemia and eight children with BCR/ABL positive but EVI1 negative chronic myeloid leukemia (CML) were retrospectively analyzed.</p><p><b>RESULTS</b>In the four children with EVI1 and BCR/ABL positive leukemia, two were initially diagnosed with chronic phase of CML, one with accelerated phase of CML and one with high-risk acute lymphoblastic leukemia (ALL). There were no significant differences in clinical characteristics at diagnosis between the patients with EVI1 and BCR/ABL positive leukemia and BCR/ABL positive but EVI1 negative leukemia. CD33 and CD38 were highly expressed and t(9;22) abnormality was present in all patients with EVI1 and BCR/ABL positive leukemia. Two of the 3 children with EVI1 and BCR/ABL positive CML achieved complete remission one or three months after treatment. Acquired negative status conversion occurred for EVI1 but not BCR/ABL in one CML case. The 3 children with EVI1 and BCR/ABL positive CML survived 20, 13 and 14 months, respectively, without recurrence. The child with EVI1 and BCR/ABL positive ALL failed to achieve complete remission after the first course of treatment and discontinued further treatment.</p><p><b>CONCLUSIONS</b>Co-expression of EVI1 and BCR/ABL fusion gene can be found in childhood CML and ALL. The relatively rare leukemia has not significant difference respect to clinical characteristics. Prognosis of the disease needs to be determined by clinical studies with a larger sample size.</p>
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Child , Female , Humans , Male , DNA-Binding Proteins , Genetics , Genes, abl , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Genetics , MDS1 and EVI1 Complex Locus Protein , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Genetics , Prognosis , Proto-Oncogenes , Genetics , Retrospective Studies , Transcription Factors , GeneticsABSTRACT
BACKGROUND:Large randomized trials have demonstrated carotid endarterectomy or stenting for symptomatic and asymptomatic extracranial carotid stenosis is effective. OBJECTIVE:Using the meta analysis method, to evaluate efficacy and safety of carotid stenting and carotid endarterectomy for the treatment of carotid stenosis. METHODS:Computer-based retrieval of databases both at home and abroad was performed for randomized control ed trials related to carotid stenting and carotid endarterectomy for the treatment of carotid stenosis. According to exclusion criteria, literature screening was done fol owed by quality evaluation. Then, the enrol ed literatures were analyzed by Cochrane col aboration with RevMan5.0 Meta analysis software. RESULTS AND CONCLUSION:There were 14 enrol ed studies, including 7 693 patients among whom, 3 835 cases were in stenting group and 3 858 in carotid endarterectomy group. Compared with the carotid endarterectomy group, the stroke event rate within 30 days postoperatively, death and stroke event rate within 30 days postoperatively, myocardial infarction event rate within 1 year postoperatively and non-disabling stroke event rate within 30 days postoperatively were higher in the stenting group (P ≤0.000 1);the myocardial infarction event rate within 30 days postoperatively was lower in the stenting group (P=0.001 0). There were no significant differences in the death event rate and disabled stroke event rate within 30 days postoperatively between the two groups. These two treatments are complementary rather than antagonistic. We should optimize the treatment choice based on the comprehensive analysis of each patient's condition.
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Objective To investigate the effect of progressive decompression elasticity socks therapy on life quality of the lower extremity deep vein thrombosis patients.Methods 50 qualified patients were divided into 2 groups receiving respectively compression therapy or not.Analysis and comparison were made based on results of SF36 questionnaire.Results There were no demographic differences between the two groups.Average follow-up time was (5.6 ± 2.4) months,the cronbach α coefficient was 0.8652 in compression therapy group,there was significant improvement on every evaluated stage and in every dimension after standard treatments (P ＜ 0.01),while in control group,only 4 dimensions (PF,RP,RE,BP) improved (P ＜ 0.05),there were statistical differences on every dimension between the two groups (P ＜ 0.01).Conclusions Progressive decompression elasticity socks therapy helps make the recovery of patients of acute deep vein thrombosis of the lower extremities.
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Objective To investigate the effect of pre- hospital emergency care programs in children with febrile seizures,in order to reduce damage by febrile seizures and obtain the best firstaid effect. Methods 112 cases of children with febrile seizures were treated in pediatric department of our hospital from April 2009 to February 2011.The parents of 75 children patients were given guidance of prehospital emergency care,they were set as the pre-hospital emergency care group.The other 37 cases were set as the non-pre-hospital emergency care group,routine emergency care was given until the medical personnel arrived at the spot.The conditions of aspiration,tongue bite injury,another episode of febrile seizures and brain damage were recorded in two groups of children. Results Only one case of aspiration and three cases of febrile seizures occurred in the pre-hospital emergency care group by misoperation of parents.Non brain damage and tongue bite injury occurred.The incidence rate of improper consequences was 5.3％in the pre-hospital emergency care group,lower than that of the non-pre-hospital emergency care group,51.4％. Conclusions To give pre-hospital emergency care guidance to parents of children patients by mobile phones before the health care workers reach the spot can significantly reduce accidental injury of children,stabilize the emotion of parents,decrease the impact of seizures on children,all the above has a positive effect on follow-up treatment.
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ObjectiveTo study prognostic factors and surgical extent of papillary thyroid microcarcinona (PTMC). MethodsLiteratures about PTMC were searched. Relationship between prognostic factors and recurrence after initial operation was analyzed by meta analysis. The surgical extent of PTMC was discussed. Results A total of 12 retrospective studies were included. Meta analysis results showed that factors such as male, tumor size ＞ 5 mm, nonincidental, positive lymphnode, multifocus, and capsular invasion were related to recurrence after initial surgery. Age above 45 years had nothing to do with the recurrence rate of PTMC. There was no signifi.cant difference in recurrence rate between prophylactic neck dissection groups and the groups without prophylactic neck dissection. ConclusionsMany factors are related to the prognosis of PTMC. The surgical extent depends on prognostic factors. Prophylactic neck dissection is not supposed to be conventional surgical procedure for PTMC. Bilateral central lymph node dissection is appropriate to PTMC with positive lymph node.