Analysis of therapeutic effects on endovascular recanalization of symptomatic non-acute middle cerebral artery occlusion / 中国综合临床

Objective:To investigate the preoperative evaluation, safety and clinical efficacy of intravascular recanalization for patients with symptomatic non-acute middle cerebral artery occlusion .Methods:Twenty-six patients with symptomatic non-acute middle cerebral artery occlusion admitted between January 2018 to June 2021 were retrospectively analyzed. The clinical symptoms, cerebral perfusion, occlusive site, occlusive length, collateral circulation and distal capillary were evaluated. There were 17 cases accorded with intravascular recanalization. The cerebral blood flow , cerebral blood volume, MTT, peak time and scores of 17 patients before and after revascularization were compared by paired t test.Results:Endovascular recanalization was performed in 17 patients and extracranial-intracranial artery bypass grafting was performed in 9 patients. Among the 17 cases, there were 7 cases of hemiplegia of contralateral limbs, 6 cases of recurrent cerebral infarction, 4 cases of paroxysmal contralateral limb numbness or weakness, 3 cases of cognitive dysfunction and 3 cases of headache. The cerebral perfusion of the occluded side of the middle cerebral artery in 17 cases was significantly lower than that of the healthy side. One patient failed to pass through the occlusion with micro guide wire, and gave up the operation after repeated attempts. The occluded vessels were successfully recanalized in 16 cases (thrombolytic grade of cerebral infarction=2b-3), and recanalized in 16 cases, including 9 cases of simple balloon dilatation and 7 cases of stent implantation. Three months after the operation, the National Institute of Health Stroke Scale (NIHSS) score of 17 patients decreased from (9.57±2.32) to (3.75±1.42). The cerebral blood flow, cerebral blood volume, mean transit time and peak time were also significantly improved compared with those before the operation（ t value was 9.08，5.54，4.26，8.56，6.00，respectively，all P<0.001）. The Montreal Cognitive Assessment (MoCA) score of cognitive function was (22.70±1.70) before the operation, and there months after operation (26.30±2.30) points ( t=6.66, P<0.001) were statistically significant. After operation, CT cerebral angiography or whole cerebral angiography showed that 1 case was occluded, 15 cases had good recanalization, no intracranial hemorrhage occurred during the perioperative period, and no new stroke occurred during the 6-month follow-up period. Conclusion:For patients with symptomatic non acute middle cerebral artery occlusion, the patients who may benefit from multi-dimensional evaluation are selected for intravascular recanalization treatment. There are few complications and high recanalization rate. The short-term follow-up clinical effect is good, but the long-term effect needs to be further observed.

KIF2C: a novel link between Wnt/β-catenin and mTORC1 signaling in the pathogenesis of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is the fourth-leading cause of cancer-related deaths worldwide. HCC is refractory to many standard cancer treatments and the prognosis is often poor, highlighting a pressing need to identify biomarkers of aggressiveness and potential targets for future treatments. Kinesin family member 2C (KIF2C) is reported to be highly expressed in several human tumors. Nevertheless, the molecular mechanisms underlying the role of KIF2C in tumor development and progression have not been investigated. In this study, we found that KIF2C expression was significantly upregulated in HCC, and that KIF2C up-regulation was associated with a poor prognosis. Utilizing both gain and loss of function assays, we showed that KIF2C promoted HCC cell proliferation, migration, invasion, and metastasis both in vitro and in vivo. Mechanistically, we identified TBC1D7 as a binding partner of KIF2C, and this interaction disrupts the formation of the TSC complex, resulting in the enhancement of mammalian target of rapamycin complex1 (mTORC1) signal transduction. Additionally, we found that KIF2C is a direct target of the Wnt/β-catenin pathway, and acts as a key factor in mediating the crosstalk between Wnt/β-catenin and mTORC1 signaling. Thus, the results of our study establish a link between Wnt/β-catenin and mTORC1 signaling, which highlights the potential of KIF2C as a therapeutic target for the treatment of HCC.

Preliminary study on the a novel individualized 3D printing artificial vertebral body in spine reconstruction / 中华骨科杂志

Objective:To explore the advantages of the novel individualized 3D printing artificial vertebral body in spine reconstruction and to evaluate its clinical effect.Methods:From January 2017 to December 2018, the 15 patients who underwent total vertebrectomy and spine reconstruction with individualized 3D printing artificial vertebral body were analyzed retrospectively. There were 8 males and 7 females, with the mean age 39.5 years (range: 20-57), including 12 primary tumors and 3 metastatic tumors. According to tumor location and surrounding soft tissue invasion range, simple posterior or combined anterior and posterior approach were used for total vertebral resection, and the defection was reconstructed by 3D printing artificial vertebral body. The operation time, intraoperative bleeding volume, postoperative stability of artificial vertebral body and bone ingrowth of adjacent vertebral body, preoperative and postoperative neurological changes, preoperative and postoperative VAS score, local control and survival of patients were analyzed.Results:The mean operation time was 412.0 min (range: 135-740 min), and the mean blood loss was 4 140.0ml (range: 100-14 000 ml). The mean follow-up time was 23.2 months (range: 12-35 months), and no one loss to follow-up. One case had pleural rupture, one case had cerebrospinal fluid leakage and one case had L5 nerve root palsy. All patients recovered after active symptomatic treatment. Compare with the preoperative VAS score (4.7±1.1), the differences of VAS score at 7 d postoperative and last follow-up (1.6±0.6 and 1.0±0.5) were significantly reduced ( P<0.001). Three patients with Frankel grade C gradually recovered to grade D, and no change were found in grade D and Grade E patients, there was no significant improved at last follow-up. Preliminary bone growth was found between the artificial vertebral body and the adjacent vertebral body 3 months after operation. The bone growth was more obvious at 12 months post-operation, and the artificial vertebral body fused with the adjacent vertebral bodies to form bone integration. At 24 months post-operation, the integration of the artificial vertebral body was more accurate. During the follow-up period, there was no loosening or displacement of the artificial vertebral body and no failure of internal fixation. A case of hemangioendothelioma and a case of epithelioid angiosarcoma died at 33 months and 35 months postoperatively. One patient with chondrosarcoma had local recurrence at16 months post-operation. After treated with arotinib, the tumor did not progress. The other 12 patients had no tumor recurrence or distant metastasis. Conclusion:After spinal tumor resection, individualized 3D printing artificial vertebral body can be used to accurate restoration of spinal continuity, and provide nice interface matching and bone growth between artificial vertebral body and the adjacent vertebral endplates. Moreover, the immediate and long-term stability of the artificial vertebral body can meet the needs of spinal reconstruction.

Effect of radiotherapy for primary orbital lymphoma: analyses of 28 cases / 白血病·淋巴瘤

Objective@#To analyze the effect and adverse reactions of radiotherapy in patients with primary orbital lymphoma.@*Methods@#A total of 28 patients with primary orbital lymphoma from Tianjin Union Medical Center, the First Central Hospital of Tianjin and Tianjin Dagang Oil Company Hospital between March 2006 and August 2012 were retrospectively analyzed. All the patients received orbital tumor dissection or biopsy, then received radiation therapy. Three patients received chemotherapy with CHOP protocol before radiotherapy. Radiotherapy was delivered routinely with 3D-conformal radiation therapy (CRT) technique with daily 2-2.5 Gy for 5 times per week and 3-5 fields. Total dosage was 20-50 Gy. There were 18 cases of 30 Gy, 1 case of 22 Gy, 1 case of 25 Gy, 1 case of 20 Gy, 1 case of 28.8 Gy, 3 cases of 40 Gy, 1 case of 42 Gy, 1 case of 46 Gy and 1 case of 50 Gy.@*Results@#All the patients had complete remission (CR) after radiotherapy during follow-up. One patient recurred after radiotherapy of 4 months and received CR with radiotherapy again. One patient died of lung infiltration. Acute complications during radiotherapy were conjunctivitis (28 cases, 100.0%) and keratitis (1 case, 3.6%), long-term complications with ophthalmoxerosis (10 cases, 35.7%) and decreased visual acuity (1 case, 3.6%).@*Conclusion@#Radiotherapy is an effective method for primary orbital lymphoma, and the adverse reactions can be tolerated for most patients.

Effect of Solitaire stent-assisted coils on endovascular embolization of intracranial wide-necked aneurysms / 中国综合临床

Objective To investigate the effect of Solitaire stent combined with coils on endovascular embolization of intracranial wide-necked aneurysms.Methods Twenty-six cases with intracranial wide-necked aneurysms from June 2009 to December 2011 in the NO.264 Hospital of the Chinese People's Liberation Army were treated with Solitaire stent-assisted coils,and anticoagulation and antiplatelet therapy were done among peri operation period.The effect of endovascular embolization was evaluated after 3 months cerebral angiography.Results A total of 27 solitaire stent were used in the 26 patients,one of which used 2 stents.The stents were successfully put in place,and the placement effect were satisfaction.The immediate angiography showed that 24 cases were dense embolism,2 cases of subtotal embolization.Stent were placed at right position.Twenty-three patients were followed with DSA for 3 months,and no aneurysm evidence of recurrence was found.Conclusion Solitaire stent-assisted coil embolization of intracranial wide-necked aneurysms is simple to perform and embolism rate is high and the recurrence rate is low.

Effect of neoadjuvant hormonal therapy in different time combined with intensity modulated radiotherapy for locally advanced prostate cancer / 中华泌尿外科杂志

ObjectiveTo investigate the ideal method of neoadjuvant hormonal therapy (NHT) for locally advanced prostate cancer.MethodsSixty cases of patients diagnosed with locally advanced ( T3 -T4 N0M0) prostate cancer were treated with NHT combined with intensity modulated radiotherapy (IMRT),They were randomly divided into 3 groups with 20 cases in each group.Group A with NHT 2 weeks,Group B with NHT 3 months,Group C with NHT 6 months.Endocrine duration began with NHT until 12 months after the end of IMRT.The PSA and prostate volumes were detected by transrectal ultrasound and Qmax was tested after NHT and every 3 months after IMRT.Results After NHT,the median PSA of different groups were decreased to 24.88,0.20 and 0.07 μg/L,respectively.There was significant difference ( P ＜ 0.05 ).The prostate volume in groups B and C reduced significantly ( P ＜ 0.05 ).The group B reduced 20.8％ and the group C reduced 39.5％.The Qmax of group B and C were ( 11.70 ± 2.81 ) and ( 14.45 ±2.61 ) ml/s respectively.After 12 months of endocrine combined with IMRT:(①)PSA.There was significant difference (P ＜0.01 ) with group C ＜ group B ＜ group A.②The prostate volume.The reducing of groups B and C were more obvious than group A ( P ＜ 0.01 ).There was no significant difference between group B and group C ( P ＞ 0.05).③Qmax.There was significant difference (P ＜ 0.01 ) among the 3 groups with group C ＞ group B ＞ group A.ConclusionsNHT combined with IMRT is an ideal method for locally advanced prostate cancer.The NHT time before IMRT treatment should last at least 3 months.

Effect of different time neoadjuvant hormornal therapy for locally advanced prostate cancer / 肿瘤研究与临床

Objective To investigate ideal solution of neoadjuvant hormomal therapy (NHT) for locally advanced prostate cancer.Methods 60 patients diagnosed with locally advanced (T3-4N0M0) prostate cancer were treated with NHT.They were randomly divided into 3 groups of 20 cases.A group:NHT 2 weeks,B group:NHT 3 months,C group:NHT 6 months.Results The median PSA of A,B and C group after NHT were 24.88 (6.62-55.86),0.20 (0.05-12.07) and 0.07 (0.01-2.01) ng/ml,respectively.There was statistically significance compared with those in untreatment ( all P =0.00).There was statistically significant (P =0.00)among groups.The prostate volume of A,B and C group were (49.50+14.19),(47.35±17.99) and (36.15±7.17)ml,respectively.There was statistically significance in the B and C group compared with that in untreatment (P =0.04,0.00).There was statistically significant between A and C group and between B and C group (P =0.00,0.01).The Qmax of A,B and C group were (8.75±2.15),(11.7±2.81) and (14.45±2.61) ml/s,respectively.There was statistically significance in the B and C group compared with untreatment (both P =0.00).There was statistically significance among groups (all P =0.00).Conclusion The NHT time should last at least 3 months in order to reduce PSA and prostate volume and to increase the Qmax.

Analysis of short-term efficacy of 3D conformal radiotherapy for late-stage pancreatic cancer / 中华肝胆外科杂志

Objective To investigate the efficacy of 3D conformal radiotherapy for late-stage pancreatic cancer and determine relavent prognostic factors.Methods Fifty patients with advanced pancreatic cancer were divided into 3 groups according to treatment planning: palliative radiotherapy (group A) at 10.8-56 Gy, radiotherapy alone (group B) at 8-60.5 Gy and concurrent chemoradiother-apy (group C) at 10-64 Gy.All patients received 3D-conformal radiotherapy, and smaller multiple ports were used for palliative treatment whereas large fields including pancreatic tumors and adjacent lymph node drainage system were adopted in the beginning of radiotherapy.Concurrent chemotherapy with gemcitabine (200-600 mg/m~2) alone was used with weekly protocol.Results The duration of follow-up was 3-35 months.Forty three patients died during the follow-up for multiple metastasis, de-teriation, secondary infection and hemorrhage.Among the seven surviving patients, 3 received concur-rent radiotherapy, 3 radiotherapy alone and 1 palliative radiotherapy.Only 1 patient was alive in group A.However, the symtoms were relieved in 46% of the patients.The median survival time was 5.07 months whereas it was 4.33 months for patients received less than 45 Gy and 7.33 months for patients received 45 Gy or more.Three patients were alive in group B and the symptoms were relieved in 81% of the patients.The median survival time was 6.65 months whereas it was 4.36 months for patients received less than 45 Gy and 8.33 months for patients received 45 Gy or more.Three patients were a-live in group C and the symptoms were relieved in 89% of the patients.The median survival time was 9.89 months.One patient survived for 3 months after 8 Gy irradiation.The median survival time was 10.73 months for patients received 45 Gy or more.Conclusion 3D-conformal radiotherapy is safe and effective in treatment of advanced pancreatic cancer.The symptom relieving rate and median survival time seem to be related to patient's status, extent of disease, choice of treatment and irradiation dos-age.3D-confromal concurrent chemoradiotherapy leads to the longest survival time in some patients.