ABSTRACT
Objective To establish a stable strain of H9c2 cardiomyocytes overexpressing Cx40 and preliminarily investigate the effect of lentiviral vector-mediated Cx40 protein overexpression on the proliferation of H9c2 cells and its related mechanisms. Methods The Cx40 gene fragment was cloned from H9c2 cells by PCR and linked with lentivirus vector pLVX-IRES-Puro to obtain the recombinant plasmid pLVX-Flag-Cx40. Recombinant lentiviral particles carrying Flag-Cx40 were obtained by cotransfection with packaging plasmids into HEK293T cells. A stable expression strain (H9c2-Flag-Cx40 cell) was screened from infected H9c2 cells by purinomycin. The expression of Cx40 protein was detected by Western blot analysis, and the effect of Cx40 on H9c2 cells proliferation was determined by CCK-8 assay; cell cycle changes were measured by flow cytometry; the expression of the cell cycle protein cyclin D1 was detected by qRT-PCR and Western blot analysis. Co-immunoprecipitation (Co-IP) immunoprecipitation and Western blot analysis were used to identify the binding of Cx40 and Yes associated protein (YAP) in H9c2 cells; cytoplasmic and cytosolic proteins were isolated to detect the effect of Cx40 on the localization of YAP using Western blot analysis. Results Sequencing results showed that the recombinant pLVX-Flag-Cx40 expression vector was successfully established. A stable transfected cell line containing recombinant Flag-Cx40 lentivirus (H9c2-Flag-Cx40 cell) was successfully constructed from H9c2 cells. Compared with the control group, overexpression of Cx40 significantly reduced the proliferation of H9c2 cells, arrested the cell cycle at G0/G1 and reduced cyclin D1 expression. A significant increase in YAP expression was observed in the cytoplasm of the H9c2-Flag-Cx40 stable cell line, while the expression in the nucleus was significantly reduced. Cx40 bound to YAP in the cytoplasm and prevented it from entering the nucleus to play the role of transcriptional coactivation. Conclusion Overexpression of Cx40 induces cell-cycle arrest at G0/G1 phase and inhibits the proliferation in H9c2 cells.
Subject(s)
Rats , Humans , Animals , Cyclin D1/genetics , Transfection , Myocytes, Cardiac , HEK293 Cells , Cell Cycle Checkpoints/genetics , Cell Proliferation/genetics , Lentivirus/genetics , Genetic Vectors/genetics , Gap Junction alpha-5 ProteinABSTRACT
OBJECTIVE@#To explore the mechanism of Haitongpi Prescription extract in the treatment of knee osteoarthritis based on transcriptome.@*METHODS@#Total of 12 SPF grade rats were divided into control group(group C), model group(group M), and Haitongpi prescription group(group HP). The knee osteoarthritis rat model was established using the Panicker method for group M and group HP, and group HP was intervened by local topical application of Haitongpi Prescription extract for 4 weeks. Total RNA from mouse knee cartilage was extracted and three sets of differential genes were obtained through sequencing.Differential genes were prediction and analysis through GO function and KEGG pathway enrichment analysis.@*RESULTS@#A total of 109 differentially expressed genes were identified in Group C versus Group M, while 118 differentially expressed genes were identified in Group M versus Group HP, resulting in a total of 28 genes. GO functional enrichment analysis showed that the mechanism of HP extract in treating knee osteoarthritis mainly involved immunoglobulin mediated immune response, immunoglobulin complexes, and antigen binding; KEGG pathway enrichment analysis showed correlation with tumor necrosis factor (TNF) signaling pathway, interleukin 17(IL-17) signaling pathway, and estrogen signaling pathway.@*CONCLUSION@#HP extract can exert therapeutic effects on knee osteoarthritis through mechanisms such as immunoglobulin mediated immune response, immunoglobulin complexes, and antigen binding, as well as signaling pathways such as TNF signaling pathway, IL-17 signaling pathway, and estrogen signaling pathway.
Subject(s)
Mice , Rats , Animals , Osteoarthritis, Knee/genetics , Transcriptome , Interleukin-17 , Ointments , Estrogens , ImmunoglobulinsABSTRACT
OBJECTIVE@#To summarize the application experience and clinical effect of radial artery in total arterial coronary revascularization (TAR) in elderly patients.@*METHODS@#Retrospectively analyzed the clinical data of patients who underwent TAR at the University of Hong Kong Shenzhen Hospital from July 1, 2020 to May 30, 2022. Patients were divided into ≥ 65-year-old group and < 65-year-old group according to age. The radial artery blood flow, diameter, intimal integrity and Allen test were evaluated by ultrasound before operation. The distal ends of radial artery were collected for pathological examination during operation. Coronary artery CT angiography (CTA) was examined postoperatively and follow up. The safety and reliability of ultrasonic assessment of radial artery and application of radial artery in elderly patients with TAR were summarized and analyzed.@*RESULTS@#A total of 101 patients received TAR, including 35 cases aged ≥ 65 years old, 66 cases aged < 65 years old; 78 cases used bilateral radial arteries, and 23 cases used unilateral radial arteries. 4 cases of bilateral internal mammary arteries. All the proximal ends of the radial artery were anastomosed to the proximal end of the ascending aorta, 34 cases were performed of "Y" grafts, and 4 cases were sequential anastomoses. There was no in-hospital death and perioperative cardiovascular events. Perioperative cerebral infarction occurred in 3 patients. 1 patients was reoperated for bleeding. Intra-aortic balloon pump (IABP) assistance was used in 21 patients. Poor wound healing occurred in 2 cases and healed well after debridement. Follow-up of 2 to 20 months after discharge showed no internal mammary artery occlusion and 4 radial artery occlusions; no major adverse cardiovascular and cerebrovascular event (MACCE) occurred, and the survival rate was 100%. There was no significant difference in the above perioperative complications and follow-up endpoints between the two age groups.@*CONCLUSIONS@#By adjusting the order of bypass anastomosis and optimizing the preoperative evaluation method, radial artery combined with internal mammary artery can obtain better outcome early in TAR, and can be safely and reliably applied to elderly patients.
Subject(s)
Aged , Humans , Radial Artery/transplantation , Coronary Vessels , Coronary Artery Bypass/methods , Retrospective Studies , Reproducibility of Results , Treatment OutcomeABSTRACT
Objective:To study the basic situation of Yunnan Province Suncus murinus carrying plague phage and to explore its epidemiological significance. Methods:From 2015 to 2018, a survey of plague host animals was carried out in 10 investigation sites in the historical plague foci, new plague foci (after 1982) and stubborn plague foci of domestric mouse in Yunnan Province. The plague phage was isolated and cultured from the intestinal specimens of Suncus murinus. The growth of plaque was observed by double-layer plate method, and the morphology and structure of plague phage were observed under electron microscope. At the same time, intestinal samples were taken to detect the structural gene caf1 of F1 antigen of Yersinia pestis. Results:In this study, a total of 157 Suncus murinus were captured and 16 strains of plague phage were isolated, with a total isolation rate of 10.19%. There was no difference in plague phage isolation rate between historical plague foci (10.00%, 1/10) and stubborn plague foci (16.22%, 12/74), new plague foci (4.11%, 3/73, χ 2 = 0.00, P = 0.965; Fisher test, P = 1.000). However, there was a difference in plague phage isolation rate between stubborn plague foci and new plague foci (χ 2 = 5.88, P = 0.015). There was no significant difference in the isolation rate of plague phage among different sex, growth period and habitat ( P > 0.05). The plaque morphology of the isolated plague phage was diverse, of which four strains were myotavirus phages; and all samples were negative for F1 antigen structural gene caf1. Conclusions:Suncus murinus is widely distributed in the domestic mouse plague foci in Yunnan Province, and the animals carry a certain number of plague phage. Regular surveillance of Suncus murinus and their plague phage has a certain guiding significance for the surveillance and early warning of plague in Yunnan Province.
ABSTRACT
Objective@#To investigate the role of miR-199a-3p in children with severe mycoplasmal pneumonia (MP) and to study its effect on Th17 cells.@*Methods@#Sixty children with severe MP (severe group), 50 children with recovery MP (recovery group) and 40 healthy children (control group) were enrolled. Venous blood samples were collected from all subjects, and the expression of miR-199a-3p in the peripheral blood leukocytes was detected by RT-PCR. The levels of IL-17a, IL-13, GM-CSF and IL-6 in serum were determined by enzyme-linked immunosorbent assay (ELISA). The effect of miR-199a-3p on the differentiation of Th17 cells was investigated by inducing differentiation of Th17 cells and transfecting miR-199a-3p mimics or inhibitors in vitro.@*Results@#Compared with the control group, the expression of miR-199a-3p in peripheral blood leukocytes of children with severe MP was significantly decreased (P<0.05). The levels of IL-17a, IL-13, GM-CSF and IL-6 in serum were significantly higher than those in the control group (all P<0.05). High expression of miR-199a-3p inhibited the differentiation of Th17 cells in vitro.@*Conclusions@#The expression of miR-199a-3p is decreased in the pathogenesis of MP. Th17 cells are the target cells of miR-199a-3p, and their differentiation is regulated by miR-199a-3p. The high expression of miR-199a-3p significantly inhibites the differentiation of Th17 cells.
ABSTRACT
Objective: To observe the effect of Bushen Kangshuai tablets combined with abdominal massage on chronic fatigue syndrome (CFS) with syndrome of spleen and kidney deficiency, and investigate its antioxidant stress and immune regulation effects. Method: One hundred and sixty patients were randomly divided into control group and observation group by random number table, 80 cases in each group. Patients in control group got abdominal massage, 1 time/day, 5 times/week, for a total of 3 treatment courses, 15 times in one course. Based on the treatment in control group, patients in observation group also received Bushen Kangshuai tablets, 6 tablets/time, 3 times/days, for a total of 12 weeks in treatment. Before and after treatment, symptom scores of spleen and kidney deficiency, fatigue scale-14 (SF-14), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Pittsburgh sleep quality index (PSQI) were graded; and levels of serum immunoglobulin (IgG, IgA and IgM), natural killer cells (NK), T lymphocyte subsets (CD3+, CD4+, CD8+ and CD4+/CD8+), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were detected. Result: In the rank sum test, the clinical efficacy in observation group was better than that in control group (Z=1.982, PPPP+, CD4+, CD4+/CD8+ were also higher then those in control group (PP+ (PPConclusion: Bushen Kangshuai tablets combined with abdominal massage to CFS with syndrome of spleen and kidney deficiency can significantly relieve fatigue, improve spleen and kidney deficiency, and improve immune function and antioxidant stress, superior to abdominal massage therapy alone in the clinical Efficacy.
ABSTRACT
Objective@#To investigate whether plague phages were present in the indicator animals of plague foci in Yunnan Province, and to explore their epidemiological significance.@*Methods@#Anus swabs were collected from indicator animals (dogs or cats) of the 41 plague affected villages in 26 towns of 10 cities (counties, districts) of Yunnan plague foci from November of 2015 to March of 2018. The Yersinia pestis phages were isolated by plague vaccine strain EV76. The isolation of plague phages from different plague foci, the isolation of plague phages from different canine species (cats), the polymorphism of plaque and the host spectrum of phages were analyzed.@*Results@#A total of 1 014 indicator animals (1 003 dogs and 11 cats) were studied, and 102 of plague phages were isolated. In the 10 cities (counties, districts), plague phages were only not isolated from Lancang County, and the plague phages were isolated from the other 9 cities (counties, districts). The separation rates from high to low were as follows: Yiliang County (21.00%, 21/100), Menghai County (19.23%, 25/130), Yuanjiang County (11.63%, 10/86), Midu County (11.50%, 13/113), Wenshan County (10.10%, 10/99), Mile Country (7.07%, 7/99), Lianghe County (6.67%, 7/105), Baoshan Longyang District (4.90%, 5/102) and Gengma County (3.81%, 4/105). Of the 102 plague phages, 75 were isolated from the native dogs (Chinese pastoral dogs, 9.32%, 75/805), 20 from the pug dogs (13.70%, 20/146), 5 from the wolf dogs (17.24%, 5/29), 1 from Samoye (1/4) and 1 from Alaska dog (1/2). The plaque of the phage was divided by five appearance of complete lysis (the plate was clear), large (2.5-4.0 mm), big (1.5-< 2.5 mm), middle (0.5-< 1.5 mm) and small (< 0.5 mm). The representative phages were all of the Myoviridae family. Most of the phages could lysis the strains of Yersinia pestis, and some phages could lysis Shigella and type 5 Yersinia pseudotuberculosis (PST5).@*Conclusion@#The plague phages are present in the plague foci of Yunnan, and the phages are polymorphic.
ABSTRACT
Objective To investigate whether plague phages were present in the indicator animals of plague foci in Yunnan Province,and to explore their epidemiological significance.Methods Anus swabs were collected from indicator animals (dogs or cats) of the 41 plague affected villages in 26 towns of 10 cities (counties,districts) of Yunnan plague foci from November of 2015 to March of 2018.The Yersinia pestis phages were isolated by plague vaccine strain EV76.The isolation of plague phages from different plague foci,the isolation of plague phages from different canine species (cats),the polymorphism of plaque and the host spectrum of phages were analyzed.Results A total of 1 014 indicator animals (1 003 dogs and 11 cats) were studied,and 102 of plague phages were isolated.In the 10 cities (counties,districts),plague phages were only not isolated from Lancang County,and the plague phages were isolated from the other 9 cities (counties,districts).The separation rates from high to low were as follows:Yiliang County (21.00％,21/100),Menghai County (19.23％,25/130),Yuanjiang County (11.63％,10/86),Midu County (11.50％,13/113),Wenshan County (10.10％,10/99),Mile Country (7.07％,7/99),Lianghe County (6.67％,7/105),Baoshan Longyang District (4.90％,5/102) and Gengma County (3.81％,4/105).Of the 102 plague phages,75 were isolated from the native dogs (Chinese pastoral dogs,9.32％,75/805),20 from the pug dogs (13.70％,20/146),5 from the wolf dogs (17.24％,5/29),1 from Samoye (1/4) and 1 from Alaska dog (1/2).The plaque of the phage was divided by five appearance of complete lysis (the plate was clear),large (2.5-4.0 mm),big (1.5-＜ 2.5 mm),middle (0.5-＜ 1.5 mm) and small (＜ 0.5 mm).The representative phages were all of the Myoviridae family.Most of the phages could lysis the strains of Yersinia pestis,and some phages could lysis Shigella and type 5 Yersinia pseudotuberculosis (PST5).Conclusion The plague phages are present in the plague foci of Yunnan,and the phages are polymorphic.
ABSTRACT
Objective To investigate the role of miR-199a-3p in children with severe mycoplasmal pneumonia (MP) and to study its effect on Th17 cells. Methods Sixty children with severe MP (severe group), 50 children with recovery MP (recovery group) and 40 healthy children (control group) were enrolled. Venous blood samples were collected from all subjects, and the expression of miR-199a-3p in the peripheral blood leukocytes was detected by RT-PCR. The levels of IL-17a, IL-13, GM-CSF and IL-6 in serum were determined by enzyme-linked immunosorbent assay (ELISA). The effect of miR-199a-3p on the differentiation of Th17 cells was investigated by inducing differentiation of Th17 cells and transfecting miR-199a-3p mimics or inhibitors in vitro. Results Compared with the control group, the expression of miR-199a-3p in peripheral blood leukocytes of children with severe MP was significantly decreased (P<0.05). The levels of IL-17a, IL-13, GM-CSF and IL-6 in serum were significantly higher than those in the control group (all P<0.05). High expression of miR-199a-3p inhibited the differentiation of Th17 cells in vitro. Conclusions The expression of miR-199a-3p is decreased in the pathogenesis of MP. Th17 cells are the target cells of miR-199a-3p, and their differentiation is regulated by miR-199a-3p. The high expression of miR-199a-3p significantly inhibites the differentiation of Th17 cells.
ABSTRACT
The objective of this study was to investigate Babesia infection among domestic animals in Western Yunnan Province and provide scientific evidence for developing control measures.A total of 1 073 domestic animals blood samples (274cattle,395 sheep,354 dogs,33 horses and 17 donkeys) were collected in 12 counties in Western Yunnan Province.Genomic DNA was extracted and a near full-length 18S rRNA gene sequence of Babesia was amplified by using nested PCR.Babesia species was identified by Blast program and phylogenetic tree.It was indicated that 50 samples were infected with Babesia,belonging to 5 species and with the infection rate of 4.66％.Among 274 cattle blood samples,11 were infected with Babesia (4.01％).Four of them were Babesia bovis and seven of them were Babesia bigemina.Among 395 sheep blood samples,38 were infected with Babesia (9.62 ％),37 of them were Babesia odocoilei-like parasites and 1 of them was Babesia capreoli-like parasites.Horses and donkeys were negative.In conclusion,domestic animals in Western Yunnan Province are infected with many kinds of Babesia,which threaten stock raising development and human health.It is necessary to strengthen prevention of babesiosis and investigate infection rate of babesiosis in human.
ABSTRACT
<p><b>OBJECTIVE</b>Interferon-γ (IFN-γ) plays an important role in apoptosis and was shown to increase the risk of diabetes. Visfatin, an adipokine, has anti-diabetic, anti-tumor, and regulating inflammatory properties. In this study we investigated the effect of visfatin on IFN-γ-induced apoptosis in rat pancreatic β-cells.</p><p><b>METHODS</b>The RINm5F (rat insulinoma cell line) cells exposed to IFN-γ were treated with or without visfatin. The viability and apoptosis of the cells were assessed by using MTT and flow cytometry. The expressions of mRNA and protein were detected by using real-time PCR and western blot analysis.</p><p><b>RESULTS</b>The exposure of RINm5F cells to IFN-γ for 48 h led to increased apoptosis percentage of the cells. Visfatin pretreatment significantly increased the cell viability and reduced the cell apoptosis induced by IFN-γ. IFN-γ-induced increase in expression of p53 mRNA and cytochrome c protein, decrease in mRNA and protein levels of anti-apoptotic protein Bcl-2 were attenuated by visfatin pretreatment. Visfatin also increased AMPK and ERK1/2 phosphorylation and the anti-apoptotic action of visfatin was attenuated by the AMPK and ERK1/2 inhibitor.</p><p><b>CONCLUSION</b>These results suggested that visfatin protected pancreatic islet cells against IFN-γ-induced apoptosis via mitochondria-dependent apoptotic pathway. The anti-apoptotic action of visfatin is mediated by activation of AMPK and ERK1/2 signaling molecules.</p>
Subject(s)
Animals , Rats , Adenylate Kinase , Metabolism , Apoptosis , Physiology , Cell Line , Cytokines , Physiology , Flow Cytometry , Interferon-gamma , Physiology , Islets of Langerhans , Cell Biology , MAP Kinase Signaling System , Nicotinamide Phosphoribosyltransferase , Physiology , Real-Time Polymerase Chain Reaction , Signal TransductionABSTRACT
<p><b>OBJECTIVE</b>A phase II study was conducted to test the efficacy and toxicity of the combination of cisplatin, 5-Fu and nimotuzumab, as induction treatment of resectable head and neck squamous cell carcinoma (HNSCC).</p><p><b>METHODS</b>Forty cases of resectable HNSCC were treated with nimotuzumab (400 mg on day 1) combined with PF regimens (cisplatin 75 mg/m² on days 1 and 5-Fu 750 mg/m² on days 1-5 q3wks). After 2 cycles, an organ-preservation local therapy (surgery or radiotherapy) was recommended. The primary endpoints of this study were overall response rate, pathologic complete response and safety of the induction treatment. Mean age of 40 patients was 54 years old, of them 9 patients with oropharyngeal cancer (22.5%), 16 hypopharyngeal cancer (40.0%), 10 laryngeal cancer (25.0%), and 5 oral cancer (12.5%).</p><p><b>RESULTS</b>With a 2-cycle induction treatment, 34 (85.0%) patients achieved complete or partial response. Twenty-four patients (60.0%) got downstage, with T downstage in 21 (52.5%) patients and N downstage in 8 (20.0%) patients. Totally 27 patients got surgery after the induction treatment, of them 20 patients (74.1%) preserved organ functions. Four patients' primary tumors (10.0% in all 40 patients and 14.8% in operated 27 patients) showed pathologically complete responses. The toxicity was mild and manageable. The most common grade 3/4 toxicities were neutropenia (5.0%), nausea/vomiting (2.5%), stomatitis (2.5%) and thrombocytopenia (2.5%). One patient got grade 2 renal insufficiency and one patient got grade 1 skin rash.</p><p><b>CONCLUSION</b>For resectable HNSCC, nimotuzumab plus PF regimen as induction treatment is highly effective for preserving the organ function and the toxicities are well tolerable.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antibodies, Monoclonal, Humanized , Therapeutic Uses , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Carcinoma, Squamous Cell , Therapeutics , Cisplatin , Combined Modality Therapy , Fluorouracil , Head and Neck Neoplasms , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To observe the efficacy of retention enema with Huchang Jiedu Decoction (, HJD) in treating chronic severe hepatitis B (CSHB).</p><p><b>METHODS</b>Sixty patients of CSHB were equally randomized into the treated group and the control group. Both groups were treated with conventional integrative medicine, but to patients in the treated group, retention enema with HJD was given in addition, once every day for 3 weeks. The dominant symptoms, physical signs, and related biochemical indices, as well as the incidence of complications in patients before and after treatment, were observed.</p><p><b>RESULTS</b>Good therapeutic effects were shown in the treated group, with a total effective rate better than that in the control group (83.3% versus 60.0%, P<0.05), superior in terms of lowering alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), globulin (Glb), and endotoxin (ET) levels and increasing prothrombin activity (PTA), total cholesterol (TC), and calcium (Ca) levels, as well as eliminating ascites and preventing hepatic encephalopathy (P<0.05); especially in treating middle/early stage patients with Chinese medicine syndrome differentiated as water-toxin accumulation pattern.</p><p><b>CONCLUSION</b>Retention enema with HJD is surely effective in treating CSHB, and its primary mechanism may be related to the mitigation of enterogenous endotoxemia.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Ascites , Metabolism , Drugs, Chinese Herbal , Therapeutic Uses , Endotoxins , Blood , Enema , Hepatitis B, Chronic , Blood , Drug Therapy , Phytotherapy , Treatment OutcomeABSTRACT
<p><b>BACKGROUND AND OBJECTIVE</b>Concurrent chemoradiation therapy (CCRT) is the standard treatment for patients with locally advanced nasopharyngeal carcinoma (NPC). The effect of neoadjuvant chemotherapy followed by CCRT has not been determined. Therefore, we conducted 2 phase II studies to evaluate the efficacy and safety of neoadjuvant chemotherapy with a regimen of docetaxel, cisplatin, and 5 fluorouracil (5-Fu) (TPF) followed by radiotherapy and concurrent cisplatin in patients with stage III and IV(A - B) NPC. This article is the preliminary report on treatment related toxicities and response.</p><p><b>METHODS</b>Graded according to the 2002 American Joint Committee on Cancer (AJCC) staging criteria, only patients with stage III or IV(A-B) poorly differentiated or undifferentiated NPC (World Health Organization type II/III) were included. We planned to recruit 52 patients with stage III disease and 64 patients with stage IV(A - B) disease. All patients received neoadjuvant chemotherapy with TPF (docetaxel 75 mg/m(2), day 1; cisplatin 75 mg/m(2), day 1; 5 Fu 500 mg/(m2 x day), continuous intravenous infusion for 120 h), every 3 weeks for 3 cycles, followed by weekly cisplatin (40 mg/m(2)) concurrent with radiotherapy. Three dimensional conformal radiotherapy (3D CRT) and intensity modulated radiotherapy (IMRT) were used. Gross disease planning target volume (PTV), high risk and low risk subclinical PTV doses were prescribed at 70-76 Gy, 66-70 Gy, and 60-61.25 Gy at 1.75-2.0 Gy per fraction. The lower neck or supraclavicular fields may be treated with conventional AP/PA fields for a total of 54 Gy at 1.8 Gy per fraction. Patients were evaluated for tumor response after the completion of neoadjuvant chemotherapy, and at 3 months after radiation according to the Response Evaluation Criteria In Solid Tumors (RECIST). The latest version of the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE 3.0) was used for grading all adverse events.</p><p><b>RESULTS</b>Fifty nine patients were evaluable for treatment response. Thirty patients had stage III disease and 29 patients had stage IV(A-B). All patients completed RT to the prescribed dose and 2 cycles of neoadjuvant chemotherapy, with 51 patients (86.4%) completing 3 cycles. A total of 50 (84.7%) and 39 patients (66.1%) completed 4 weeks and 5 weeks of cisplatin during CCRT, respectively. The overall response rate in the primary site and the neck region were 94.9% [complete response (CR) in 25.4%] and 100% (CR in 19.6%) after completing neoadjuvant chemotherapy. At 3 months after RT, the CR rates increased to 96.6% and 90.2%, respectively. After a median follow up of 14.3 months, we observed 5 treatment failures and 2 deaths. The 1 year overall survival, distant metastasis free survival, and locoregional relapse free survival rates were 100%, 95.7%, and 97.7%, respectively. The rates of grade 3/4 myelosuppression and anorexia/nausea/vomiting during neoadjuvant chemotherapy were 55.9% and 16.9%, respectively. The corresponding rates were 11.9% and 23.7% during CCRT. Grade 3/4 mucositis, skin desquamation, and xerostomia occurred in 6.8%, 44.1%, and 27.1% of patients, respectively. There were no treatment related deaths.</p><p><b>CONCLUSIONS</b>Neoadjuvant chemotherapy with TPF followed by CCRT was well tolerated with a manageable toxicity profile. Preliminary results are encouraging and warrant further investigation.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Anemia , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Chemoradiotherapy , Chemotherapy, Adjuvant , Cisplatin , Therapeutic Uses , Fluorouracil , Therapeutic Uses , Follow-Up Studies , Leukopenia , Nasopharyngeal Neoplasms , Pathology , Therapeutics , Nausea , Neoadjuvant Therapy , Neoplasm Staging , Neutropenia , Radiotherapy, Conformal , Radiotherapy, Intensity-Modulated , Remission Induction , Survival Rate , Taxoids , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To discuss the method, the safety, the advantages and disadvantages of endoscopic thyroidectomy via chest and breasts.</p><p><b>METHODS</b>From Mar. 2002 to Dec. 2006, endoscopic thyroidectomy via anterior chest and breast approach was performed in 500 patients, including 76 cases of Grave's disease (1 case had an opened operation history), 111 cases of thyroid adenoma, 291 cases of nodular goiter (10 cases have 1-2 opened thyroidectomy history, 2 cases secondary of hyperthyroidism), and 22 cases of thyroid carcinoma.</p><p><b>RESULTS</b>The endoscopic thyroidectomy was successfully carried out in 492 cases, including tumor enucleation in 50 cases, partial lobectomy in 210 cases, subtotal thyroidectomy in 212 cases (including 73 cases of Graves' disease), and lobectomy in 16 cases of thyroid carcinoma. The operative time length ranged from 40 to 270 min (mean 74.5 min). Mean operative blood loss was 5.5 ml (3-250 ml), no cases underwent blood transfusion. The drainage was taken out in the second or third days postoperatively. Postoperative hospital stay ranged from 3 to 8 days (mean 4.2 days). There were some complications including subcutaneous bleeding (3 cases), burn of the epidermal (1 case), inflammation of the incision (2 cases), subcutaneous bruising (3 cases), subcutaneous effusion (6 cases), thyroid crisis (1 case), and temporarily hoarseness of 2 cases. There were no complications such as permanence damage to recurrent laryngeal nerve or parathyroid glands. The complication rate was 3.6% (18/492). The hospital charges ranged from 7600 to 13,500 RM yuan. The average cost of endoscopic thyroidectomy was 10,510 RM yuan, in contrast to 5700 RM yuan for the open thyroidectomy patients. The post-operative following-up was 3 to 57 months (mean 27 months). All the patients were satisfied with the cosmetic results and the same curative effects as conventional surgery were obtained. However, 3 cases of nodular goiter, 1 case of thyroid carcinoma, and 1 case of Grave's disease were recurrence. The operations were converted into open surgery in 8 cases. The 22 cases with carcinoma were survival until now.</p><p><b>CONCLUSIONS</b>Endoscopic thyroidectomy is a safe and effective method of thyroid surgery. Since all the minimal incisions are on concealed parts of the body, the obvious cosmetic effect of this method is guaranteed. Some disadvantages such as complications and more costs are needed to be improve.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Breast , General Surgery , Endoscopy , Thoracic Wall , General Surgery , Thyroidectomy , Methods , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the incidence, MRI characteristics and invasion route of nasopharyngeal carcinoma (NPC) infiltrating the cavernous sinus.</p><p><b>METHODS</b>The data of 141 patients with histologically proven NPC collected from May 2003 to June 2004 were reviewed. All patients were examined by 1.5-tesla superconducting MR unit to evaluate the tumor extent. MR FSE technique was used for T1 WI and T2WI images in the axial plane, followed by FSPGR fat-suppressed gadolinium-enhancement for T1WI images in the axial and coronal sections. All MR images were interpreted and evaluated by two diagnostic radiologists, paying particular attention to the nasopharynx and cavernous sinus infiltration.</p><p><b>RESULTS</b>MR imaging showed infiltration of 49 cavernous sinuses in 39 patients (27.7%). The most common MRI features were enlargement of cavernous sinus with unconventional enhancement (22/49, 44.9%), even with formation of mass inside the sinus (9/49, 18.4%). The other MRI image features were local or diffuse dura mater thickening of cavernous sinus and presence of obscure structure as intra-sinus blurs and hazies inside. The most common infiltration route is through the foramen ovale (18/49, 36.7%), or through both the foramen ovale and foramen lacerum (6/49, 12.2%).</p><p><b>CONCLUSION</b>In NPC patients, MRI invasion is characteristically and clearly shown as changes in the cavernous sinus. Possession of this information is crucial for giving correct treatment. The main infiltrtion route is through foramen ovale.</p>