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Objective@#To compare survival outcomes between cervical adenocarcinoma (ADC) and squamous cell carcinoma (SCC) using a propensity score matching (PSM) analysis based on the Surveillance, Epidemiology, and End Results (SEER) Program. @*Methods@#Patients diagnosed with cervical cancer between 1998 and 2016 were identified from the SEER database. The Kaplan-Meier method and Cox regression analysis were used to analyze survival. A subgroup analysis of overall survival (OS) between patients with ADC and SCC was performed after the 1:1 PSM analysis. @*Results@#Of the 33,148 patients, 24,591 (79.19%) had SCC and 8,557 (25.81%) had ADC. In the unmatched cohort, after adjustment in multivariate analysis, patients with ADC had a worse prognosis than patients with SCC (hazard ratio [HR]=1.12; 95% confidence interval [CI]=1.07– 1.18; p<0.001). In the propensity matched cohort, Kaplan-Meier analysis and subgroup analysis showed that ADC was associated with a worse prognosis than SCC (p=0.001). An analysis stratified by SEER stage revealed a worse prognosis for patients with ADC patients presenting with a regional disease than patients with SCC (HR=1.24; 95% CI=1.14–1.36 p<0.001), but no statistically significant differences were observed between the localized disease (HR=0.97; 95% CI=0.86–1.10; p=0.664) and distant disease (HR=1.09; 95% CI=0.97–1.22; p=0.162) subgroups. @*Conclusion@#The significant differences in survival outcomes between patients with cervical ADC and SCC were only observed in the regional disease subgroup, but not in the localized disease and distant disease subgroups.
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Objective@#To compare survival outcomes between cervical adenocarcinoma (ADC) and squamous cell carcinoma (SCC) using a propensity score matching (PSM) analysis based on the Surveillance, Epidemiology, and End Results (SEER) Program. @*Methods@#Patients diagnosed with cervical cancer between 1998 and 2016 were identified from the SEER database. The Kaplan-Meier method and Cox regression analysis were used to analyze survival. A subgroup analysis of overall survival (OS) between patients with ADC and SCC was performed after the 1:1 PSM analysis. @*Results@#Of the 33,148 patients, 24,591 (79.19%) had SCC and 8,557 (25.81%) had ADC. In the unmatched cohort, after adjustment in multivariate analysis, patients with ADC had a worse prognosis than patients with SCC (hazard ratio [HR]=1.12; 95% confidence interval [CI]=1.07– 1.18; p<0.001). In the propensity matched cohort, Kaplan-Meier analysis and subgroup analysis showed that ADC was associated with a worse prognosis than SCC (p=0.001). An analysis stratified by SEER stage revealed a worse prognosis for patients with ADC patients presenting with a regional disease than patients with SCC (HR=1.24; 95% CI=1.14–1.36 p<0.001), but no statistically significant differences were observed between the localized disease (HR=0.97; 95% CI=0.86–1.10; p=0.664) and distant disease (HR=1.09; 95% CI=0.97–1.22; p=0.162) subgroups. @*Conclusion@#The significant differences in survival outcomes between patients with cervical ADC and SCC were only observed in the regional disease subgroup, but not in the localized disease and distant disease subgroups.
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Prosthetic joint infection (PJI) is a catastrophic complication after joint replacement.It has become the primary cause of revision surgery after knee arthroplasty and the third cause of revision after hip replacement surgery.The risk factors involve the patient (intrinsic factor) and the environment (extrinsic factor),which can be further divided into uncontrollable factors such as the history of surgical infection and other factors related to age and sex of tumor,as well as the risk factors caused by patients' own characteristics and associated diseases,such as body mass index,smoking,diabetes,rheumatoid arthritis and medicine use.The authors summarize the patients' own characteristics,associated diseases and medication to comprehensively evaluate and understand how to reduce the risk of PJI in the perioperative period,so as to provide some reference for clinical treatment.
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Objective: To summarize the current research progress of anterior cruciate ligament (ACL) anatomy, and discuss its effect on the reconstruction technique.
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Objective To compare the difference of T-stage between Chinese 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma,and to investigate the optimization of T-stage and provide suggestions for further revision.Methods The MRI data of 183 patients with histology-proven newly diagnosed nasopharyngeal carcinoma in our hospital were enrolled from September 2009 to May 2017.All the anatomic sites mentioned in the two staging systems were marked,and all patients were staged according to the 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma.Comparisons of T-stage were made between the two staging systems.Results Involvement of oropharynx,nasopharynx,prevertebral muscles,cervical vertebra,hypopharynx and orbit were 100％ accompanied with other same or more advanced T-stage classifications.The invasion rates of the cervical vertebra,orbit and hypopharynx were very low (all ＜ 5.00％).The incidence of involvement of pterygoid structure was 15.30％,most of which incorporated with erosion of skull base,only 1 case was invaded alone.All cases of involvement of paranasal sinuses were incorporated with erosion of skull base.Compared with the 2008 staging system,the consti-tuent ratio of T1 + T2 in the 2017 staging system increased from 36.61％ to 61.75％,and that of T3 + T4decreased from 63.39％ to 38.25％,the constituent ratio of T-stage between the 2017 staging system and the 2008 staging system was significantly different (x2 =26.94,P ＜ 0.001).There was moderate consistency of T-stage between these two staging systems (Kappa =0.514,P ＜ 0.001).Conclusion The T-stage of 2017 staging system still has a larger simplification and optimization space.Therefore,according to the principle of concise,the T-stage parameters including oropharynx,nasopharynx,prevertebral muscles,paranasal sinuses,cervical vertebra,orbit and hypopharynx are recommend to delete,and it does not have an impact on the composition of T-stage.We suggest that the pterygoid structure shall combine with the skull base to be one anatomical structure.
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Aim To investigate the effects of dalbinol on proliferation and apoptosis of human colon cancer HCT1 16 cells and its mechanisms.Methods Anti-proliferative effect of dalbinol was evaluated by MTT assay.The morphological changes of apoptosis were observed by Hoechst33342 staining.Apoptotic rate and ROS generation were analyzed by flow cytometry.The related proteins of Wnt/β-catenin pathway and the ap-optosis-associated proteins expression were measured by Western blot.Results The growth of HCT1 16 treated with dalbinol was inhibited in a dose and time dependent manner with IC50 (4.8 ±0.53 ),(2.5 ± 0.43)and (0.6 ±0.22)μmol·L-1 at 24,48 and 72 h,respectively.Typical morphological changes of ap-optosis such as cell shrinkage,karyopyknosis and nu-clear condensation were observed by Hoechst33342 staining.Meanwhile,the apoptotic rate and intracellu-lar ROS generation of dalbinol were both increased dose-dependently. Western blot results showed that dalbinol could activate the expression of cleaved Caspase-3 and cleaved PARP by decreasing anti-apop-totic protein levels such as Bcl-2 and Mcl-1 and in-creasing pro-apoptotic protein levels such as Bax and Bim,which induced further apoptosis.Moreover,dal-binol can reduce the protein expression of the total and nuclear β-catenin,but not cytoplasmic β-catenin by suppressing the protein expression of Dvl-2 and GSK-3β(pS9 ),as well as its target proteins c-Myc and Sur-vivin.Conclusion dalbinol can induce apoptosis in colon cancer HCT1 16 cells by upregulating the intra-cellular ROS generation and suppressing Dvl/GSK-3β/β-catenin pathway.
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Objective To evaluate the reliability and validity of hepatocellular carcinoma (HCC)using the liver imaging reporting and data system (LI-RADS).Methods By using the LI-RADS v2013.1,two radiologists evaluated 1 62 patients with cirrhosis or with a risk of HCC according to an inclusion criteria.The Kappa value was used to evaluate the consistency between two different diagnoses and was compared with pathological and follow-up results.The accuracy of the LI-RADS was assessed including sensitivi-ty,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and accuracy rating.Results In all 1 62 patients,there were HCCs in 97 patients including 7 patients belonging to the LR3,benign diseases in 50,and other kinds of malignancy in 1 5.The Kappa value was 0.882 (P =0.000)between two observers on LI-RADS grading. The sensitivity,specificity and accuracy rating of LI-RADS grading in diagnosing HCC was 100.00%,91.30%,and 97.06%,re-spectively.Conclusion The LI-RADS has high consistency and stability in evaluation and diagnosis of HCC by enhanced CT.LR3 di-agnosis should be cautious because of a susceptible development to HCC,which can be improved through the combination of clinic and laboratory examination.
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BACKGROUND:Cartilage injury is stil one of the clinical problems difficult to be treated completely so far. Recently, the discovery of synovial mesenchymal stem cells (SMSCs) has brought about the new hope to cartilage repair. OBJECTIVE:To explore the process concerning SMSCs-based therapy for cartilage repair in the past few years, such as the characteristics of SMSCs, culture conditions, preclinical and clinical studies, and then to summarize the literatures published in recent years. METHODS:A computed-based online search of PubMed and SpringerLink databases was performed using the key words of“synovial mesenchymal stem cells, cartilage repair”for literatures published from January 1993 to May 2013. RESULTS AND CONCLUSION:Final y, 37 articles were included. SMSCs have a greater proliferative capability, colony-forming potential and chondrogenic potential than other mesenchymal stem cells. The diseases such as osteoarthritis and rheumatoid arthritis can influence the characteristics of SMSCs. Numerous articles have aimed at the studies of cellculture in vitro and celltransplantation in vivo. However, the process of SMSCs therapy is mostly at its preliminary stage. Reports on its unique characteristics, optimal culture conditions and the high-quality clinical studies are stil largely lacking. In a word, though further studies are needed, SMSCs appear to be a promising cellsource for cartilage repair in the future.
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Objective:To investigate Intraflagellar Transport 80 (IFT80) protein expression in bone, lung, pancreatic, stomach, in-testinal, prostate, breast, and ovarian cancers to explore its mechanism in cancer cell proliferation and to diagnose and identify new tar-gets in cancer treatment. Methods:Immunohistochemistry was used to investigate the expression of IFT80 in gastric cancer tissue of different stages and in eight other kinds of human cancer tissues. We studied the relationship between cancer cell proliferation and inhi-bition of IFT80. Immunofluorescence method and cell culture were used to study the cilia and IFT80. Results:Results showed the fol-lowing:a) the expression of IFT80 was high in gastric and lung carcinoma tissues, moderate in breast and colorectal cancers, low in bone and ovarian cancers, and nearly absent in prostate and pancreatic cancers;b) inhibition of IFT80 in the A549 cancer cell line accel-erated cell proliferation and resulted in shorter, lower quality cilia;and c) IFT80 was abundantly expressed in cancer tissues of well-dif-ferentiated stage-IIA gastric cancer and normal gastric tissues, but was hardly expressed in late-stage, poorly differentiated gastric can-cer. IFT80 could have various degrees of expression in gastric carcinoma of other stages and differentiation. Conclusions:Different can-cer organs showed variation in IFT80 expression. IFT80 can be distributed in the organs with mechanical motion function, such as lungs and stomach. IFT80 is distributed on the cell cilia and can adjust the number and length of the cilia by reducing IFT80 protein ex-pression. Through a variety of ways, IFT80 directly or indirectly participates in the proliferation of cancer cells. Thus, the lowest or nearly zero expression of IFT80 can be seen in cancer tissues of high-grade malignancy, such as advanced cancers with poor differentia-tion.
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BACKGROUND:In order to avoid heterotopic ossification after total hip arthroplasty, nonsteroidal anti-inflammatory drugs are commonly used for prevention. OBJECTIVE:To compare the effect of meloxicam and indomethacin in the prevention of heterotopic ossification after total hip arthroplasty. METHODS:Fifty-one patients who treated in the Department of Orthopedics, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from 2010 to 2011 were col ected. Among the 51 patients, nine patients were treated with bilateral total hip arthroplasty, and al the patients had total hip arthroplasty with the posterior-lateral approach. The patients were divided into the control group and the experimental group according to the drugs used after replacement, and the patients in the two groups were administered with indomethacin sustained-release tablet 25 mg+omeprazole capsule 20 mg or meloxicam tablet 15 mg after replacement. RESULTS AND CONCLUSION:There were no significant differences in the incidence of heterotopic ossification, pain, modified D’Aubigne and Postel scores after replacement between two groups (P>0.05). But, the gastrointestinal adverse reactions of the experimental group were less than those of the control group. The application of meloxicam only can effectively avoid the heterotopic ossification and release pain. Consequently, we recommend meloxicam as postoperative drug for the prevention of heterotopic ossification and pain remission fol owing total hip arthroplasty.
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BACKGROUND: Periprosthetic infection after total hip replacement usually results in surgery failure and needs a second operation.OBJECTIVE: To explore the pathogenesis, diagnosis and treatment of periprosthetic infection after total hip replacement by-reviewing and summarizing articles published in recent years.METHODS: A computed-based online search of Pubmed database was performed by using the key words of total hip arthroplasty, infection for manuscripts published from January 1990 to December 2010 and of those in SpringerLink database between January 1,1970 and December 31, 2010. A total of 2 109 manuscripts were retrieved. Moreover, related book or manuscripts that published by high-impact journals were included. Totally, 29 manuscripts were included. RESULTS AND CONCLUSION: The formation of biofilms on the surface of prosthesis is the main cause for hardly eradicated. Resistant bacteria and polymicrobial infection seems to be an increasing tendency. A correct diagnosis as soon as possible is very important to prognosis. However, without a gold-standard way, each mean has advantages and shortages, and comprehensive considerations are necessary. lnterleukin-6 seems a good choice for its inexpensive, non-invasive and a high sensitivity and specificity, which has aroused increasing attention. The antibiotics only, debridement with retention, one-stage replacement, two-stage replacement, joint arthrodesis, even amputation, are used to treat infection after total hip replacement. Prophylactic antibiotics are important to prevent infection. Antibiotic-loaded acrylic cement seems to be reliable and accept for more and more patients. However, each option must be selected according to the presence of infection individually.