ABSTRACT
Objective:To explore the risk factors affecting central lymph node metastasis in cN0 isthmus papillary thyroid carcinoma and the significance and feasibility of preventive dissection, so as to provide reference for clinical treatment.Methods:The clinical data of 108 patients with cN0 stage isthmus papillary thyroid cancer who underwent surgery in the General Surgery Department of Lianyungang Oriental Hospital from January 2014 to December 2021 were retrospectively analyzed. There were 32 males and 76 females, with an age range of 24 to 70 years, with a mean age of (46.0±12.7) years. Statistical analysis was performed using the SPSS 22.0 statistical software. Chi-square test and logistic regression were used to analyze the relationship between central lymph node metastasis and patients Relationship between clinical case factors.Explore the feasibility of preventive cleaning.Results:The positive rate of lymph node metastasis in central region of isthmic papillary thyroid carcinoma was 37.9% (41/108). Univariate analysis showed that central lymph node metastasis was associated with tumor diameter ( χ2=5.36, P=0.021), capsular infiltration ( χ2=7.69, P=0.006), and elevated thyroglobulin ( χ2=7.73, P=0.005). Multivariate analysis showed that capsular infiltration ( HR=2.75, P=0.037) and tumor diameter ( HR=4.454, P=0.004) were independent risk factors for central lymph node metastasis. The ROC curve of tumor diameter to predict central lymph node metastasis was drawn, and the AUC value of the area under the curve was calculated to be 0.720. When the diameter was 0.695 cm, the Youden index was 0.326, the sensitivity was 0.878, and the specificity was 0.448. 6 cases (5.56%) had temporary recurrent laryngeal nerve palsy, 13 cases (12.04%) had temporary hypoparathyroidism, no permanent complications occurred. Conclusions:cN0 stage PTCI has the risk of early occult lymph node metastasis. Prophylactic CLND can clarify the stage of the tumor, assess the risk, and guide the follow-up treatment of patients. CLND should be routinely performed for patients with tumor diameter >0.695 cm and capsular invasion.
ABSTRACT
OBJECTIVES@#To investigate the roles of cytoskeleton-associated protein 2 (CKAP2) in proliferation, apoptosis, and migration in liver cancer cells and the potential mechanisms.@*METHODS@#Human normal hepatocyte L02 and liver cancer cell lines HepG2, Huh7, and SMMC-7721 were cultured. The CKAP2 expression was detected by real-time PCR and Western blotting. HepG2 cells were randomly divided into a control group, a negative control (NC) group, and a CKAP2 silencing (siCKAP2) group. CCK-8 and BrdU assays were used to evaluate cell viability and proliferation, respectively. Transwell assay was employed to determine cell migration and invasion. The protein levels of cleaved-caspase 3, Bax, E-cadherin, N-cadherin, Vimentin, phosphorylated Janus kinase 2 (p-JAK2), and phosphorylated signal transducer and activator of transcription 3 (p-STAT3) were determined by Western blotting.@*RESULTS@#Compared with normal hepatocyte L02, CKAP2 was highly expressed in liver cancer cell lines HepG2, Huh7, and SMMC-7721 (all <0.05). Compared with the NC group, cell viability and proliferation rate of the siCKAP2 group were decreased (both <0.05). The apoptotic rate, protein expression of cleaved-caspase 3 and Bax in the siCKAP2 group were significantly higher than those in the NC group (all <0.05). Compared with the NC group, cell migration and invasion rates of the siCKAP2 group were significantly attenuated (both <0.05). Compared with the NC group, E-cadherin protein expression in siCKAP2 group was increased, while protein expression levels of Vimentin, N-cadherin, p-JAK2, and p-STAT3 were decreased (all <0.05).@*CONCLUSIONS@#CKAP2 gene silence inhibits proliferation, migration, and invasion, and promotes apoptosis in liver cancer cells, while JAK2/STAT3 signaling pathway may be involved in these processes.
Subject(s)
Humans , Apoptosis , Cell Line, Tumor , Cell Movement , Cell Proliferation , Cytoskeleton , Liver Neoplasms , GeneticsABSTRACT
The present study shows the case of a patient with acetabular protrusions secondary to rheumatoid arthritis progressing to femoral neck fracture.The patient,a 64 years female,had a history of rheumatoid arthtitis for 38 years.The left hip pain and abnormal sound occurred when hip flexion for picking up.She was diagnosed with rheumatoid arthritis secordary to acetabular pelvic retraction and left femoral neck fracture by medical history,physical examination and imaging.Total hip arthroplasty was performed after preoperative examination.Hip dislocation,femoral head removal,acetabular reconstruction;cup fixation,and bone mass assessment are technical challenges during surgery.Based on literature review,this case is belonging to secondary acetabular pelvic retraction,which may be related to acetabular softening caused by rheumatoid arthritis.Whenthe stress from the femoral head exceeds the endurance of the softened acetabulum,the acetabulum protrudes into the pelvis and gradually wraps around the femoral head.Based on the pathological characteristics,itis speculated that the cause of femoral neck fracture is the direct hit of the femoral neck-acetabular rim during hip flexion.In this case,spiral cup prosthesis was used to achieve both the initial stability of the prosthesis and saving bone mass around the acetabulum.The patient was followed up for 3 months with satisfactory position of prosthesis and joint function.
ABSTRACT
Objective To discuss the clinical characteristics for lateral cervical lymph node metastasis in stage cN0 papillary thyroid microcarcinoma and significance and feasibility of preventive dissection,and provide reference for clinical treatment.Methods Reviewd the clinical data of 191 patients with stage cN0 papillary thyroid microcarcinoma patients from Jul.2011 to Dec.2016 underwent surgery in the Department of General Surgery of Lianyungang Oriental Hospital.Assessed the need for preventive cervical lymph node dissection.Chisquare test and logistic regression were used to analyze the relationship between cervical lymph node metastasis and gender,age,tumor number,tumor size,capsule infiltration,single and bilateral tumors,Hashimoto's disease,and central lymph node metastasis.Results The positive rate of cervical lymph node metastasis in papillary thyroid microcarcinoma was 27.9％ (50/191).Univariate analysis showed that the metastasis of the cervical lymph nodes was associated with infiltration of the capsule,Hashimoto disease,and CLN metastasis (all P ＜ 0.05).Multivariate logistic regression analysis showed that the capsule infiltration (OR =7.563,P =0.000),Hashimoto's disease (OR =4.635,P =0.003),and central lymph node metastasis (OR =3.075,P ＜ 0.001) were able to be independent risk factors for cervical lymph node metastasis.When the positive number of lymph node metastasis in the central region was ≥ 2,the positive rate of cervical lymph nodes was significantly increased (P ＜ 0.001).Eleven patients (5.8％) had temporary recurrent laryngeal nerve palsy,29 patients (15.1％) had transient hypoparathyroidism,and no patients with permanent recurrent laryngeal nerve palsy and hypoparathyroidism.Conclusions The removal of the cervical lymph nodes helps to accurately classify the tumor and assess the risk.It is important to choose the postoperative treatment follow-up plan for patients.For patients with capsule infiltration,Hashimoto's disease,and central lymph node metastasis,cervical lymph node dissection should be routinely performed.
ABSTRACT
-Glucosidase and lipase inhibitors play important roles in the treatment of hyperglycaemia and dyslipidemia. To identify novel naturally occurring inhibitors, a bioactivity-guided phytochemical research was performed on the pu-erh tea. One new flavanol, named (-)-epicatechin-3---coumarate (), andknown analogs (-) were isolated from the aqueous extract of the pu-erh tea. Their structures were determined by spectroscopic and chemical methods. Furthermore, the water extract of pu-erh tea and its fractions exhibited inhibitory activities against-glucosidases and lipases; compoundshowed moderate inhibitory effect against sucrase with an ICvalue of 32.5 μmol/L and significant inhibitory effect against maltase with an ICvalue of 1.3 μmol/L. Compounds,,anddisplayed moderate activity against a lipase with ICvalues of 16.0, 13.6, 19.8, and 13.3 μmol/L, respectively.
ABSTRACT
Objective To study the compliance of medical care with corresponding national clinical pathways for inpatients of cholecystectomy for cholecystolithiasis with acute cholecystitis at public hospitals of China. Methods Thirty medical records of the inpatients with cholecystectomy admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding national clinical pathways. Results The average compliance rate of inpatient care of cholecystectomy at public hospitals was 67. 7%. The study found low compliance rates in both severity assessment and timely examinations/diagnosis within two days after admission ( 5. 8% and 35. 3%, respectively) . Conclusions Public hospitals in China should strengthen their supervision over the medical care process for inpatients of cholecystectomy with acute cholecystitis, and the clinical pathways in question should be updated and improved in time.
ABSTRACT
Objective To study the compliance of medical care at public hospitals in China with corresponding clinical pathway for inpatients of community acquired pneumonia ( CAP) . Methods Thirty medical records of inpatients with CAP admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding clinical pathways. Results The average compliance rate of inpatient care of CAP at public hospitals was 65. 1%. The study the lowest compliance rates in both timely examinations/diagnosis and severity assessment within three days after admission (0. 7% and 26. 6%, respectively). The compliance rate of reasonable initial antibiotic use was 48. 5%. Conclusions The compliance rate of inpatient care of CAP is low in China. Thus admission examinations, patient severity assessment and antibiotic utilization should be enhanced accordingly for their compliance.
ABSTRACT
Objective To discuss the clinical characteristics for central compartment lymph node metastasis in stage cNO papillary thyroid microcarcinoma and significance and feasibility of preventive dissection,aimed to provide reference for clinical treatment.Methods Reviewed the clinical data of 277 patients with stage cNO papillary thyroid microcarcinoma from Jul.2011 to Dec.2015 underwent surgery in the Department of General Surgery of Lianyungang East Hospital.Evaluated the necessity of prophylactic central lymph node dissection.Adopted chi square test and Logistic regression to analyze its relationship with patients' gender,age,tumor number,tumor size,enveloped infiltration,single and bilateral tumor.All 277 patients underwent primary radical resection with ipsilateral central lymph node dissection.The specimen of resection was analyzed by routine pathology.Results The positive rate of thyroid papillary microcarcinoma lymph node metastasis was 36.8 ％ (102/277).The elements of male patients (P =0.023),age ＜ 45 years (P ＜ 0.001) and tumor diameter ＞ 0.5 cm (P =0.019)had high positive rate.The multivariable analysis showed that male patients (OR =2.63,P ＜ 0.001),age ＜ 45 years (OR =2.25,P =0.016),tumor diameter ＞ 0.5 c m (OR =2.13,P =O.009) were independent risk factors for CLN metastasis.Forty-three (15.5％) cases had transient parathyroid function.No Permanent recurrent nerve paralysis and hyperparathyroidism occurred in this group.Conclusions Prophylactic central lymph node dissection is helpful for accurate staging of tumor classification and risk assessment,has important significance,on the follow-up of patients after treatment of choice.For male patients,age ＜ 45,tumor diameter ＞ 0.5 cm,enveloped infiltration,the central compartment lymph node dissection may be necessary.
ABSTRACT
Objective To analyze the implementation of clinical pathways ( CP) at public hospitals at different levels and in different regions in China. Methods The status of CPs′ implementation at 54 public hospitals in Shanghai, Hubei province and Gansu province was surveyed by questionnaires from March to May of 2015. Results 51 (94. 4%) of the surveyed public hospitals put in place clinical pathway(s), where the average CPs implemented were 45 and the average percentage of the cases using CPs was 52. 7%. There were great variations among these hospitals. In addition, the common diseases with definite diagnostic and treatment options were found with the highest implementation rates of CPs at such hospitals. Conclusions CPs are implemented widely at public hospitals of China, yet enhanced implementation strategies are expected to further CPs′adoption.
ABSTRACT
Objective To analyze the management of clinical pathways ( CP) in China. Methods Cross-sectional questionnaire surveys of 51 public hospitals with CPs in place in Shanghai, Hubei province and Gansu province were conducted from March to May of 2015. Results Among the 51 public hospitals with CPs, 48 ( 94. 1%) of them organized training on CPs, 48 ( 94. 1%) of them monitored CPs′implementation, and 40 (78. 4%) applied incentives for CPs′ implementation. But there were some issues and difficulties encountered in CPs′ implementation. Conclusions Comprehensive measures are necessary to improve the management of CPs at public hospitals of China.
ABSTRACT
Objective To study the compliance of medical care with corresponding national clinical pathways for inpatients of cholecystectomy for cholecystolithiasis with acute cholecystitis at public hospitals of China. Methods Thirty medical records of the inpatients with cholecystectomy admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding national clinical pathways. Results The average compliance rate of inpatient care of cholecystectomy at public hospitals was 67. 7%. The study found low compliance rates in both severity assessment and timely examinations/diagnosis within two days after admission ( 5. 8% and 35. 3%, respectively) . Conclusions Public hospitals in China should strengthen their supervision over the medical care process for inpatients of cholecystectomy with acute cholecystitis, and the clinical pathways in question should be updated and improved in time.
ABSTRACT
Objective To study the compliance of medical care at public hospitals in China with corresponding clinical pathway for inpatients of community acquired pneumonia ( CAP) . Methods Thirty medical records of inpatients with CAP admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding clinical pathways. Results The average compliance rate of inpatient care of CAP at public hospitals was 65. 1%. The study the lowest compliance rates in both timely examinations/diagnosis and severity assessment within three days after admission (0. 7% and 26. 6%, respectively). The compliance rate of reasonable initial antibiotic use was 48. 5%. Conclusions The compliance rate of inpatient care of CAP is low in China. Thus admission examinations, patient severity assessment and antibiotic utilization should be enhanced accordingly for their compliance.
ABSTRACT
The combination of preoperative chemoradi-otherapy and surgery has become the standard treatment for locally advanced rectal cancer. Up to 30% of patients received pathologic complete response(pCR) after neoadjuvant therapy, for whom low rates of local recurrence and improved outcome after surgery were achieved. Given that, some authors have recommended local resection for clinical extensive response or non operative "wait and see" policy for clinical complete response(cCR) respectively, in which radical surgery-associated complication and dysfunction can be avoided. Current imaging can provide excellent accuracy in primary staging of rectal cancer, however, when used for restaging, the ability is less satisfactory, especially for pCR prediction, as a result of modification on tumor and surrounding tissue induced by neoadjuvant therapy. The question on how to identify patients with pCR before surgery has received more attention recently. On the basis of pathological findings after surgery, in this article, we review the reliability and predictive ability of current imaging for restaging and pCR after preoperative chemoradiotherapy in rectal cancer.
Subject(s)
Humans , Chemoradiotherapy , Neoadjuvant Therapy , Rectal Neoplasms , Pathology , Therapeutics , Treatment OutcomeABSTRACT
Objective To evaluate reformative encircling constriction combined with the retrograde venograms in operation for treating primary deep venous insufficiency. Methods The clinical data of 25 cases (29lower extremities) undergoing primary deep venous insufficiency from March 1998 to December 2006 were analyzed retrospectively. 25 eases(29 lower extremities) were treated with reformative encircling constriction combined with the retrograde venograms in operations. Results 25 eases were treated with reformative encircling constriction combined with the retrograde venograms in operations,the leg swelling improved and no deep vein thrombus occurred; all the varicose veins are welt controlled. Conclusion Reformative encircling constriction operations are eutherapeutic for severe femoral venous valve dysfunction, when combined with the retrograde venogram, it can be a guidance in encircling constriction of superficial femoral vein and number of femoral venous valves.
ABSTRACT
Objective To observe the therapeutic effect of Laparescopic Cholecystectomy(LC) on acute calculous cholecystitis.Methods The data from 35 patients receiving laparoscopic cholecystectomy for acute calculous cholecystitis were analyzed.Results Successful rate of operation was 100% in all cases with no complications such as biliarducy injury,intestines damage and hemorrhage taken place,and mortality was 0%.Conclusion LC is safe for treatment of acute calculous cholecystitis.
ABSTRACT
Objective: To investigate the role of Bcl-XL siRNA in sensitizing ovary cancer cells for TRAIL-induced apoptosis and the underlying mechanisms.Methods: Western blotting analysis was performed to confirm whether Bcl-XL siRNA could effectively down-regulate Bcl-XL protein after SKOV3 cells were transfected with Bcl-XL siRNA and then the cells were treated with TRAIL.Flow cytometry analysis and cell counting were used for assessment of apoptotic rate and survival rate,respectively.Western blotting analysis was performed to determine the changes of apoptosis-related protein in SKOV3 cells.Results: Compared with control group,Bcl-XL siRNA transfection effectively down-regulated the expression of Bcl-XL protein and suppressed the growth of SKOV3 cells;the suppression peaked at 96 h after transfection,being 43.9% that of the control group(P
ABSTRACT
AIM: To explore the mechanisms of resistance to 5-fluorouracil(5-FU) in human colon cancer cells.METHODS: 5-FU-resistant cell lines were established and their IC50 were calculated by detection of cell survival rate.Western blotting was performed to analyze the expression of several proteins,by which the possible mechanisms of acquired resistance to 5-FU were determined in human colon cancer cells.RESULTS: The resistant cells were resistant to 5-FU-induced S phase arrest as well as the expression of DNA damage marker-phosphor-histone H2A.X.Furthermore,data demonstrated that over-expression of Bik,Bcl-Xs,and Bcl-XL proteins were observed in 5-FU-resistant cell lines.However,the DLD1/Bcl-XL cells were only partially resistant to 5-FU-induced apoptosis,but not 5-FU-induced S phase arrest and phosphor-histone H2A.X.CONCLUSION: Over-expression of Bcl-XL protein certainly contributes to acquired 5-FU resistance in human colon caners,but has no effect on 5-FU-induced DNA damage and cell cycle disorder,suggesting that other mechanisms are involved in acquired resistance to 5-FU in human colon cancer.
ABSTRACT
AIM:To evaluate effects of different chemotherapeutic agents on reversing the acquired resistance to TRAIL gene and clarify the involved mechanisms in DLD1-TRAIL/R colon cancer cells.METHODS: Human colon cancer cell line DLD1-TRAIL/R cells that were resistant to TRAIL-expressing adenovector(Ad/gTRAIL) were treated with Ad/gTRAIL combined with different chemotherapeutic agents.Then,the cell viability was measured by MTT method,and apoptotic signaling conditions,including activation of caspase-3 and caspase-8,expression of Bax and Bcl-XL,were measured by Western blotting analysis.RESULTS: In vitro data showed that several chemotherapeutic agents,including 5-fluorouracil(5-FU) and mitomycin c(MMC),overcome the acquired resistance to TRAIL gene in DLD1-TRAIL/R colon cancer cells.The combination of Ad/gTRAIL and 5-FU effectively suppressed tumor growth in vivo in subcutaneous tumors established from DLD1-TRAIL/R cells.Further data showed that treatment with the combination of Ad/gTRAIL and 5-FU or MMC led to enhance the activation of caspase-3.Moreover,MMC but not 5-FU induced overexpression of Bax gene that was sufficient to overcome the resistance to TRAIL gene in DLD1-TRAIL/R cells.CONCLUSION: Chemotherapeutic agents,such as 5-FU and MMC,overcome the acquired resistance to TRAIL gene in DLD1-TRAIL/R cells.The candidate mechanisms for MMC but not 5-FU to overcome this resistance might involve the induction of over-expressed Bax protein in DLD1-TRAIL/R cells.