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OBJECTIVE@#To compare the surgical outcome and the clinical value between endoscopic axillary lymph node dissection and conventional open excision in the treatment of breast cancer. @*METHODS@#A computer-based online search of Medline, PubMed, Embase, Ovid, Cochrane Library, Vip, Wanfang, CNKI and Chinese Biological Medicine Database was performed, and conference literatures were manually searched. Using the Cochrane Collaboration guidelines, all randomized controlled trials comparing endoscopic axillary lymph node dissection and conventional open excision were systematically reviewed. The Cochrane Collaboration's RevMan 5.0 software was used for data analysis. @*RESULTS@#A total of 25 studies involving 3 028 patients were included. The results of Meta-analyses showed that there were no significant difference in the number of lymph nodes harvested and recurrence between endoscopic axillary lymph node dissection and conventional open excision (P>0.05). The operative time of endoscopic axillary lymph node dissection was longer than that of conventional open excision. However, it was superior to open excision in the rate of complication and intra-operative blood loss (P<0.05). @*CONCLUSION@#As a minimally invasive surgery technique to treat breast cancer, endoscopic axillary lymph node dissection might be a promising replacement for conventional axillary lymph node dissection.
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Female , Humans , Axilla , Breast Neoplasms , General Surgery , Endoscopy , Lymph Node Excision , Lymph Nodes , Minimally Invasive Surgical Procedures , Neoplasm Recurrence, LocalABSTRACT
We analyzed the characters of Sagliker syndrome by reporting a case of Sagliker syndrome and reviewed literature. We found that Sagliker syndrome had low incidence rate, young onset age, and was more common in women. There were high levels of alkaline phosphatase and parathyroid hormone in the blood of the patients. Patients with Sagliker syndrome with primary onset of non-diabetic nephropathy usually had chronic glomerulonephritis. We thought that secondary hyperparathyroidism in patients with Sagliker syndrome was induced by parathyroid hyperplasia, but high levels of alkaline phosphatase and parathyroid hormone in the blood of the patients with the secondary hyperparathyroidism were the main cause of Sagliker syndrome. Parathyroidectomy could stop the progress of Sagliker syndrome, but it could not reverse the occurrence of skeletal malformation.
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Female , Humans , Alkaline Phosphatase , Chronic Disease , Diabetic Nephropathies , Hyperparathyroidism, Secondary , Parathyroidectomy , SyndromeABSTRACT
Objective To investigate the predictive values of P-selectin (P-sel),thrombus precursor protein (TpP) and D-dimer (D-D) in the early diagnosis of portal vein thrombosis (PVT) in patients submitted to splenectomy (or to devascularization).Methods The clinical data of 48 patients with portal hypertension (the PVT group,n=26; and the non-PVT group,n=22) who received operation in our hospital from 2009 to 2011 were retrospectively analyzed.Detecting the P-sel,TpP and D-D levels in the two groups of patients were done on preoperative day 1 and postoperative day 1,3,5,7,14.The SPSS software was used for statistic analysis.Results There were no significant differences on the preoperative day 1 levels of P-sel,TpP and D-D in the two groups (P＞0.05).The postoperative day1 levels of the three indicators in the PVT group were significantly higher than the non-PVT group (P＜0.05).Receiver operating characteristic (ROC) curves showed the area under curve (AUC) of P-sel was largest (0.893),followed by D-D,and TpP.The combined detection of the 3 indicators was highest,with the AUC up to 0.977.Conclusions Combined detection of P-sel,D-D and TpP levels were useful in the early diagnosis of PVT after splenectomy in patients with portal hypertension.
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<p><b>OBJECTIVE</b>To establish an immunological method for detecting antibodies of Penicillium marneffei.</p><p><b>METHODS</b>The recombinant Mp1p protein of Penicillium marneffei was expressed in Pichia pastoris and labeled with HRP (Mp1p-HRP) with a modified sodium periodate method. A double-antigen sandwich enzyme-linked immunosorbant assay (ELISA) was established by determining the optimal coating concentration of Mp1p protein and the concentration of the detecting protein Mp1p-HRP. The sensitivity and specificity of the assay was evaluated by detecting Mp1p antibodies in 100 serum samples from healthy donors, 15 samples from culture-confirmed penicilliosis patients, and 21 samples from patients with culture-confirmed other fungal infections.</p><p><b>RESULTS</b>A double-antigen sandwich ELISA was successfully established for detecting Mp1p-specific antibody. The specificity of the assay was 100% (121/121) for detecting Mp1p-specific antibody in the sera from healthy donors and patients with other fungal infection. The detection results of the 15 serum samples from patients with culture-confirmed penicilliosis showed positivity for Mp1p antibody in 2 samples and Mp1p antigen positivity in 12 samples; combining the detection results of Mp1p antigen and antibody obviously increased the diagnostic sensitivity to 93.3% (14/15).</p><p><b>CONCLUSION</b>The double-antigen sandwich ELISA shows a high specificity in detecting Mp1p-specific antibody, and simultaneous detection of Mp1p antigen and antibody can increase the diagnostic sensitivity for penicilliosis.</p>
Subject(s)
Humans , Antibodies, Fungal , Blood , Allergy and Immunology , Antigens, Fungal , Blood , Allergy and Immunology , Enzyme-Linked Immunosorbent Assay , Methods , Mycoses , Blood , Diagnosis , Microbiology , Penicillium , Allergy and Immunology , Pichia , Allergy and Immunology , Sensitivity and SpecificityABSTRACT
ObjectiveTo discuss the prevention and treatment of the perioperative complications in endovascular treatment for arteriosclerosis obliterans (ASO) of lower extremities.MethodsEndovascular treatment was performed for 210 patients (248 limbs) with ASO of lower extremities,including 28 iliac lesions,76 femoral-popliteal lesions,56 inferior genicular lesions and 88 multiple segment lesions.The clinical data and complications were reviewed and analyzed.Results The technical success was achieved in 92.74％ (230/248).Perioperative complications occurred in 21 patients (21/210,10.00 ％),including hematoma (n= 6),pseudoaneurysm (n= 1),heart failure (n= 2),constrast-induced nephropathy (n = 1),artery perforation (n= 3),artery section (n = 3) and restenosis (n= 5).All the complications were relieved after corresponding treatment.ConclusionEndovascular treatment is a safe and effective method for ASO of lower extremities because of its high success rate and few complications.Effective control of systemic diseases,careful operation and regular treatment after operation are all the effective measures to prevent and reduce the occurrenceof complications.
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OBJECTIVE@#To investigate the expression of inflammatory cytokines in patients with recurrent nasal polyps by antibody chips.@*METHODS@#Proteins from the patients'nasal membrane in a nasal polyps group, a recurrent nasal polyps group, and a control group were labeled with biotin. The biotin-labeled proteins reacted with antibody chips on which the antibodies of 40 major inflammatory cytokines were prepared. The target proteins were conjugated with streptomycin antibody labeled with horseradish peroxidase (HRP),and signals were imaged by laser scanner.@*RESULTS@#Compared with the control group, the levels of inflammatory cytokines of nasal polyp group were notably increased, including pro-and anti-inflammatory cytokines, chemokines and certain cytokine receptors; while in recurrent nasal polyps, expression of chemokines were increased and most anti-inflammatory cytokines were decreased.@*CONCLUSION@#Antibody chips demonstrate a significant change in cytokine profiles in patients with recurrent nasal polypsis, as compared with those with nasal polyps. The abnormally higher expression of chemotatic factors in the nasal mucosa may play an important role in the recurrence of human nasal polyps.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antibodies , Chemokine CCL11 , Metabolism , Chemokines , Metabolism , Cytokines , Metabolism , Interleukin-1beta , Metabolism , Interleukin-6 , Metabolism , Nasal Polyps , Metabolism , Protein Array Analysis , Methods , RecurrenceABSTRACT
The actin depolymerizing factor/cofilin (ADF/cofilins) are a family of actin-binding proteins expressed in all eukaryotic cells. The ADF/cofilins appear to have multiple functions, and this is reflected in their very complex association with both monomeric and filamentous actin. Phosphorylation by some kinases and other factors such as LIM kinases 1 and 2, TESK 1 and TESK 2 kinase, Insulin, etc, prevents ADF/cofllins from binding actin. The serial researchs of ADF/cofilins are increasingly becoming study hot spots, especially on the relationship between homo-sapiens disease and mechanism of action of ADF/cofilins.Now in this domain wilderness details are still far from clear, such as the mechanism by which actin filaments are depolymerized by ADF/cofilins has been controversial.
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Objective To evaluate the repair of the immense abdominal wall defect after resection of malignant tumours occurred primarily in the abdominal wall or that invaded the abdominal wall secondarily. Methods Among the 20 eases, 12 eases were of malignant tumours within abdominal wall (9 eases of rhabdomyosareoma, 3 eases of malignant fibrous histocytoma), 8 eases with the invasion of abdominal wall from malignant turnouts were of retroperitoneal or intraabdominal malignant tumors (3 eases with retroperitoneal malignant tumours, 1 ease of transverse eolon carcinoma, 3 eases with local reeurrenee in abdominal wall of ascending colon carcinoma undergoing fight hemieoleetomy 2～3 years ago, 1 ease with abdominal wall implantation metastasis of renal carcinoma after resection 5 years ago ). Abdominal wall defects left over by resection were repaired with polypropylene and expanded polytetrafluoroethylene (PPePTFE) mesh. The postoperative eomplieation and healing rate were observed. Results Wounds healed by primary intension, with no subeutaneous hydrops, no incision infeetion, dehiscence and hernia, no intestinal adhesion in all eases. The rate of successful repairing for the abdominal defect was 100%. All patients were followed up, the meshes with no rejection, inflammation and incision hernia, no reeurrenee of tumour in the repaired abdominal wall. Conclusion The PP-ePTFE mesh is a favourable repairing material for the abdominal defect after tumour resection, with the advantages of strong tensility, good bioeompatibility.
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ObjectiveTo determine the effects of combination of parenteral nutrition(PN) with enteral nutrition (EN) on patients with gastric cancer in perioperative period of total gastrectomy . MethodsIn 52 patients with advanced gastric cancer, 41 had PN support preoperatively and all 52 patients received combination of PN with EN after the total gastrectomy. Results48 of the 52 patients whose intestinal function was recovered within 3 days postoperatively. When using EN, 5 cases felt borborygmus,abdominal pain or mild diarrhea, but these symptoms decreased by slowing down of the infusion speed. The concentration of plasma albumin showed a marked increase on the 10th postoperative day(P
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Objective To study the indications of carotid endarterectomy(CEA) and perioperative managements . Methods The clinical data of 11 patients with transient ischemia attack (TIA) and carotid artery stenosis who underwent CEA were reviewed retrospectively. Results After CEA, the TIA symptoms disappeared in all patients, and the chronic symptoms of cerebral ischemia had obvious improvement in 4 cases . There were no serious postoperative complications, such as cerebral hemorrhage, hemiplegia, etc. Conclusions CEA may be considered when one or both sides of carotid stenosis more than 50% is discovered by Duplex scanning, digital subtraction angiography or MRA in patients with TIA. Stage operation for bilateral carotid occlusive lesion is safer. Paying attention to perioperative managements is important for reducing operative complications.
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Objective To evaluate the diagnosis and differential diagnosis methods for chronic lymphocytic thyroiditis(CLT).Methods One hundred and eight patients with CLT were treated in our department during recent 20 years,the clinical data were analyzed retrospectively.The diagnostic methods included thyroid function measurement,anti-thyroid antibody measurement,image detection,fine needle aspiration,diagnostic drug therapy and biopsy exam during operation.The preoperative examinations and diagnoses of 94 patients,who had received operation,were compared with postoperative pathological results.Results Forteen of the 108 cases did not receive any operation,of whom,9 had a definite diagnosis of CLT by fine needle biopsy under color ultrasound and 5 by drug(prednisone) diagnostic treatment.Before operation,57 patients were diagnosed as nodular goiter,16 as thyroid cancer and 13 as nodular goiter associated with hyperthyroidism.Only 8 patents were diagnosed as CLT with nodular goiter.Postoperative pathological reports were simple CLT in 59 cases(62.7%),CLT with nodular goiter in 19(20.2%),CLT with hyperthyriodism in 10(10.6%)and CLT with thyroid cancer in 6(6.3%).The preoperative misdiagnosis rate reached 91.5%(86cases).Conclusions It is easy for CLT to be misdiagnosed because of the complex clinical manifestations.Careful analysis of examination results,especially thyroid function measurement,anti-thyroid antibody measurement and image detection is significant for confirming the diagnosis.The fine needle biopsy and diagnostic drug treatment are better methods for CLT diagnosis.Unwarranted operation should be avoided in patients with CLT.