ABSTRACT
Objective:To observe the correlation between serum immunoglobulins levels with the disease severity and nutritional indexes in elderly patients with heart failure.Methods:The clinical data of 53 elderly patients with heart failure (observation group) from October 2020 to January 2022 in the Affiliated Hospital of Ningbo University Medical College were retrospectively analyzed, and 53 cases of health examination at the same time were selected as the control group. The disease severity was assessed by a 6-minute walk test (6MWT), and nutritional status was assessed by nutritional index. The serum levels of IgA, IgM and IgG were measured by PUZS-300 fully automated biochemical analyzer; the serum nutrient indexes were measured by enzyme linked immunosorbent assay, including total protein, albumin and proalbumin. Pearson method was used for correlation test; the value of IgA, IgM and IgG in predicting disease severity in elderly patients with heart failure was analyzed by the receiver operating characteristic (ROC) curve.Results:The IgA, IgM and IgG in observed group were significantly higher than those in control group: (4.31 ± 1.50) g/L vs. (1.63 ± 0.71) g/L, (18.50 ± 3.93) g/L vs. (11.33 ± 1.12) g/L and (4.58 ± 1.26) g/L vs. (1.96 ± 0.36) g/L, and there were statistical differences ( P<0.01). The 6MWT result showed that 23 cases were with mild status, 18 cases moderate, and 12 cases severe. The IgA, IgM and IgG in moderate and severe patients were significantly higher than those in mild patients: (4.34 ± 0.78) and (6.38 ± 0.91) g/L vs. (3.23 ± 0.94) g/L, (18.90 ± 2.09) and (23.81 ± 2.78) g/L vs. (15.44 ± 2.03) g/L, (4.77 ± 0.56) and (6.47 ± 0.34) g/L vs. (3.45 ± 0.44) g/L, the indexes in severe patients were significantly higher than those in moderate patients, and there were statistical differences ( P<0.05). Pearson correlation analysis result showed that IgA, IgM and IgG were positively correlated with disease severity in elderly patients with heart failure ( r = 0.801, 0.830 and 0.925; P<0.01). The nutritional index result showed that malnutrition was in 25 cases, and normal nutrition in 28 cases. The IgA, IgM and IgG in patients with malnutrition were significantly higher than those in patients with normal nutrition: (4.89 ± 0.80) g/L vs. (1.98 ± 0.69) g/L, (19.45 ± 2.01) g/L vs. (12.01 ± 1.28) g/L and (4.88 ± 0.59) g/L vs. (2.01 ± 0.47) g/L, the nutritional index, total protein, albumin and proalbumin were significantly lower than those in patients with normal nutrition: (49.44 ± 6.98) scores vs. (58.34 ± 8.12) scores, (62.87 ± 5.20) g/L vs. (66.74 ± 4.54) g/L, (33.21 ± 2.64) g/L vs. (39.12 ± 3.11) g/L and (185.55 ± 16.72) mg/L vs. (196.33 ± 18.90) mg/L, and there were statistical differences ( P<0.01 or <0.05). Pearson correlation analysis result showed that the IgA and IgM were negatively correlated with nutritional index, total protein, albumin and proalbumin in elderly patients with heart failure (IgA: r = - 0.456, - 0.353, -0.620 and -0.281; IgM: r = -0.445, -0.327, -0.611 and -0.321; P<0.01 or <0.05); IgG was negatively correlated with nutritional index, total protein and albumin ( r = - 0.425, - 0.359 and - 0.646; P<0.01), and it had no correlation with proalbumin ( P>0.05). ROC curve analysis result showed that the areas under the curve of IgA, IgM and IgG in predicting disease severity in elderly patients with heart failure were 0.891, 0.943 and 0.838, sensitivity of 76.70%, 90.00% and 73.33%, and specificity of 87.00%, 87.00% and 100.00%. Conclusions:The serum levels of IgA, IgM and IgG increased significantly in elderly patients with heart failure, who were also with abnormal immune function and decreased nutritional status. The serum levels of IgA, IgM and IgG correlate with disease severity and nutritional indexes.
ABSTRACT
Objective::To analysis the chemical constituents in Sancao Baogan decoction by ultra-high performance liquid chromatography coupled with hybrid quadrupole-orbitrap mass spectrometry (UPLC-ESI-HRMSn). Method::The separation was performed on an ACQUITY UPLC BEH C18 column (2.1 mm×100 mm, 1.7 μm) by a gradient elution of methanol (A)-0.1% formic acid solution (B) (0-2 min, 5%A; 2-20 min, 5%-12%A; 20-35 min, 12%-40%A; 35-38 min, 40%A; 38-48 min, 40%-80%A; 48-50 min, 80%A). The flow rate was 0.3 mL·min-1 and the column temperature was set at 30 ℃, the injection volume was 10 μL. Electrospray ionization was applied and the data were collected via positive and negative ion modes. By using Xcalibur 3.0 software, the chemical constituents were analyzed based on the relative retention time, excimer ion peak and fragment ion peak of the compounds, as well as comparison with human metabolome database (HMDB), reference substances and literature data. Result::A total of 40 chemical components were identified from Sancao Baogan decoction, including 16 phenolic acids, 19 flavonoids, 2 anthraquinones, 1 triterpenoid, 1 sterol, and 1 monoterpenoid. Six compounds (dansensu, α-pinene, epigallocatechin, 2, 5-dihydroxybenzoic acid, naringenin and emodin) were reported for the first time from Sancao Baogan decoction. Conclusion::The established UPLC-ESI-HRMSn can quickly, accurately and comprehensively analyze the chemical constituents of Sancao Baogan decoction, which lays a foundation for the basic research of pharmacodynamic substances and quality control of this formula.
ABSTRACT
By means of non-targeted quantitative determination of various low-molecular-weight metabolites in biological samples, metabonomics enables a better understanding of the metabolic variation in organisms subject to internal and external stimuli. As a result, it is particularly suitable for characterizing the metabonomic alternation associated with diseases and exploring the disease-related early metabolic biomarker clusters, which may provide a novel approach to the early diagnosis of diseases and individual medication. Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease in which autoantibodies can cause tissue damage and potentially life-threatening mul-tiple organ failure. The complicated pathogenesis and varied clinical symptoms of SLE pose great challenges for the diagnosis and monitoring of this disease. Development of new biomarkers that can be used to reliably confirm SLE or monitor its progression is still one of the main goals and challenges in SLE research. Metabolomics are alternative biomarker discovery approaches. In order to explore the application of metabolomics in SLE, we summarize the current progress in the field of metabtomics in the studies of SLE.
ABSTRACT
By means of non-targeted quantitative determination of various low-molecular-weight metabolites in biological samples,metabonomics enables a better understanding of the metabolic variation in organisms subject to internal and external stimuli.As a result,it is particularly suitable for characterizing the metabonomic alternation associated with diseases and exploring the disease-related early metabolic biomarker clusters,which may provide a novel approach to the early diagnosis of diseases and individual medication.Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease in which autoantibodies can cause tissue damage and potentially life-threatening mul-tiple organ failure.The complicated pathogenesis and varied clinical symptoms of SLE pose great challenges for the diagnosis and monitoring of this disease.Development of new biomarkers that can be used to reliably confirm SLE or monitor its progression is still one of the main goals and challenges in SLE research.Metabolomics are alternative biomarker discovery approaches.In order to explore the application of metabolomics in SLE,we summarize the current progress in the field of metabtomics in the studies of SLE.
ABSTRACT
Ginsenoside Rg1 is one of the main active components of ginseng with various pharmacological activities including anti-inflammatory, anti-oxidation, anti-aging, anti-tumor and anti-apoptosis. Ginsenoside Rg1 plays a protective role in multiple tissues and organs, which shows the multiple targeting properties of the pharmacological effects. Recently, a number of studies have demonstrated that ginsenoside Rg1 has a protective role in the liver due to its multiple pharmacological effects. In chemical liver injury models, or in other liver injury models, ginsenoside Rg1 can alleviate liver necrosis induced by oxidative stress and inflam-mation. This article provides a review of the recent studies on the efficacy of ginsenoside Rg1 in the treatment of various liver damage and the molecular mechanism.
ABSTRACT
Objective:To research the best processing method for Strychni Semen with children's urine by orthogonal test. Methods:L9(34) orthogonal test was used with the types of children's urine, dosage of children's urine, soaking time and drying temperature as the influencing factors,HPLC was applied to determine the contents of brucine and strychnine as the indices to obtain the comprehensive weighted score. ANOVA was used to optimize the processing technology of Strychni Semen with children's urine. Results:The soaking time showed significant effect on the content of brucine and strychnine, while the other three factors had no significant effect. The best processing technology was A1B1C3D3. Conclusion:The optimum processing of Strychni Semen with children's urine is as follows:3-year-old children's urine with 3-fold amount is used to soak for 10 d,and the drying temperature is 90 ℃. The method is stable and reliable, which can be used for the new processing technology of Strychni Semen.
ABSTRACT
Objective:To investigate the effects of two drugs on the asphyxia oxygen concentration and the oxygen consumption rate of zebrafish,and explore the possibility of zebrafish as a drug model and the feasibility of oxygen microelectrode used for drug screening. Methods:The zebrafish were treated with the drugs for 5 days,and transferred into the asphyxia chambers. The solute oxy-gen concentration was assessed continuously until the asphyxia condition. The asphyxia oxygen concentration,asphyxia time and mass specific oxygen consumption rate were determined. Results:The results showed that the asphyxia time,asphyxia concentration and ox-ygen consumption rate of the zebrafish were not significantly changed by deproteinized calfblood extractives injection(P>0.05),sug-gesting no reduction in hypoxia tolerance ability. The asphyxia time and oxygen consumption rate of the zebrafish were not significantly changed,either (P>0.05),however,the asphyxia concentration was increased significantly by cervus and cucumis polypeptide injec-tion (P<0.05),suggesting the reduction in hypoxia tolerance ability. Conclusion:It is suggested that the hypoxia tolerance ability of zebrafish can be significantly decreased by the solution of cervus and cucumis polypeptide. The results also suggest that zebrafish can be used as an experimental animal in medicine studies,and the oxygen microelectrode method can be used in drug screening.
ABSTRACT
Objective To observe the effect of low temperature compound propofol on the changes of apoptosis protein Caspase-3,autophagy-related proteins Beclin-1 and LC3-Ⅱ and thier changes of hippocampal neurons.Methods The rats were randomly divided into blank control group (Group A),propofol group at low temperature (Group B) and chloral hydrate group at low temperature (Group C),Group B and C were treated with low temperature for 30 min.Then,each group was subjected to cardiac perfusion and decapitated brain to prepare rat hippocampal neuronal tissue samples.The expression of Caspase-3 was detected by immunohistochemistry,Beclin-1 and LC3-Ⅱ protein was detected by immunoblotting.The ultrastructural changes of neurons were observed by transmission electron microscopy.Results The expression of Caspase-3,Beclin-1 and LC3-Ⅱ protein in each group were statistically significant differences(P＜0.05).The results of transmission electron microscopy showed that the neurons in group B and C were changed in different degrees,especially in group C neuronal apoptosis is obvious.Conclusion Autophagy and apoptosis in existence still exist in low temperature condition,while propofol can reduce this damage and have better protective effect on neurons.
ABSTRACT
Objective The aim of this study was to investi-gate the changes of brain function in patients with drug-naive idiopath-ic epilepsy ( DNIE ) using resting-state functional MRI ( rs-fMRI ) amplitude of low-frequency fluctuation ( ALFF) , analyze the correlation of abnormal brain regions with the clinical variable ( disease course) , and gain a deeper insight into the pathophysiological mechanisms of idiopathic epilepsy. Methods This study included 25 cases of DNIE (15 males and 10 females) and 34 cases of drug idiopathic epilepsy (DIE, 22 males and 12 females).Another 25 healthy volunteers matched with the DNIE patients in sex, age, education and handedness were recruited as normal controls.The rs-fMRI data obtained from all the subjects were processed, subjected to ALFF analysis, and compared among the DNIE, DIE, and nor-mal control groups.The correlation was evaluated between the ALFF statistical brain mapping and the course of disease. Results Obvious differences were found in ALFF among the DNIE, DIE and control subjects.Compared with the normal controls, the DNIE pa-tients showed increased ALFF in the right inferior temporal gyrus, right lingual gyrus and right cuneus, but decreased ALFF in the right insula, left hippocampus, right midbrain, right middle frontal gyrus, left anterior cingulated gyrus, left middle cingulate gyrus and right inferior parietal lobule.In comparison with the DIE patients, those of the DNIE group exhibited increased ALFF in the left inferior occipital gyrus, right middle occipital gyrus and left middle occipital gyrus, but decreased ALFF in the right inferior frontal gyrus, left insula, right superior temporal gyrus and right middle frontal gyrus.In the DNIE patients, the disease course was found to be correlated positively with ALFF in the right cerebellum posterior lobe, left cerebellar tonsil, right lingual gyrus, left orbital gyrus, left middle oc-cipital gyrus, left corpus callosum, left caudate nuclear, left superior frontal gyrus, left medial frontal gyrus, right precuneus and left middle frontal gyrus, but negatively with ALFF in the right parahippocampal, right superior temporal gyrus, left superior temporal gyrus and right post-central gyrus. Conclusion The ALFF of resting-state cerebral function is abnormal in DNIE patients.The correlation between ALFF and the clinical variable ( disease course) provides a new insight into the pathophysiological mechanisms of epilepsy.
ABSTRACT
Objective To investigate the role of early enteral nutrition on TLR 4 signaling pathway in rats with acute necrotizing pancreatitis (ANP).Methods Sixty SD rats were randomly divided into three groups:sham operation group ( SO group ) , total parenteral nutrition group ( TPN ) , early enteral nutrition group ( EEN ) .One day after ANP model induction , the serum level of amylase was measured .Nutrient solution was given for five days , then the rats were sacrificed , and the blood , pancreas and colon tissue were collected.The serum levels of IL-6, TNF-αwere detected by ELISA .Pathologic changes of pancreas were observed by HE staining.The intestinal TLR4, NF-κB expression was measured by Western blot .Results Mortality rates of SO group, TPN group, EEN group were 0, 50%, 25%, respectively; the serum levels of amylase were (744 ±41), (3 278 ±219), (2 227 ±169) U/L, respectively;the serum levels of TNF-αwere (81.57 ±18.25), (465.72 ±42.47), (223.21 ±29.94)ng/L, respectively; the serum levels of IL-6 were (362.83 ±41.32), (932.46 ±57.21), (628.62 ±142.24) ng/L, respectively; the pancreatic pathologic scores were (0.91 ±0.15), (11.1 ±0.61), (6.9 ±0.62);the intestinal TLR4 expressions were 0.7506 ± 0.003, 1.3404 ±0.004, 0.9544 ±0.004;the intestinal NF-κB expressions were 1.33 ±0.50, 6.92 ±1.06,2.93 ±0.89.The values of TPN and EEN group were significantly higher than those of SO group (P<0.05). The values of EEN group were significantly lower than those of TPN group (P<0.05).Conclusions EEN can inhibit TLR4 and NF-κB signal pathway in gut , then reduce IL-6 and TNF-αexpression and relieve inflammatory reaction of ANP , finally decrease the mortality of ANP .
ABSTRACT
Objective To investigate the expression changes and significance of Pdlim2 in the glomerular podocyte of hyperlipidemic rats.Methods Forty-five individuals of SD rats were divided randomly into 3 groups (n =15 in each group).The control group was fed with normal diet.The high fat group was fed with high fat diet.The simvastatin group was fed with high fat diet plus with simvastatin gavage (10 mg· kg-1 · d-1).Five rats were sampled randomly from each group at week 4,6,and 10 and the urinary protein excretion,the concentration of serum cholesterol,and the concentration of low density lipoprotein cholestorol were determined,the glomerular podocyte damage in rats was detected by electron microscope,the expression of Pdlim2 protein was determined by immunohistochemistry and by Western blotting.Results The levels of serum cholesterol and low density lipoprotein cholestorol increased significantly in high fat group and simvastatin group at week 4 compared to that in control group(P ＜ 0.05),and the level in simvastatin group was significantly decreased compared with that in high fat group(P ＜ 0.05).The urinary protein levels of high fat group and simvastatin group were significantly higher than that in control group at week 10,and the level in simvastatin group was significantly decreased in high fat group,there was significant difference in each group of comparison(P ＜ 0.05).Podocyte injury was detected by electronic microscopy in high fat group at week 4,and the injury became more serious as the treatment time increased.Podocyte injury in the simvastatin group was significantly less than that in the high fat group and the control group at week 10.The positive staining of Pdlim2 was mainly in the glomeruli and the expression of Pdlim2 of the high fat group was lower than the simvastatin group,and both were lower than the control group at week 10.The expression of Pdlim2 protein of high fat group was lower than that in the control group since week 4(P ＜0.05).The expression of Pdlim2 protein of high fat group was lower than that in the simvastatin group (P＜0.05),and both were lower than the control group at week 10(P＜0.05).Conclusions Hypedipidemia induces podocyte injury before urinary protein,which is suggested to be associated with the decrease of Pdlim2 protein.Simvastatin reduces podocyte toot processes of high fat induced fusion,which may be through protecting the expression of glomerular Pdlim2.
ABSTRACT
Objective To analyze the coincidence situation of the results of neonatal ABO blood group reciprocal stereotypy with crossmatching test of allotype blood and to investigating the limitations of cross-matching test in infant blood transfusion and effec-tive measures for ensuring the neonatal safe blood transfusion.Methods The micro-column gel test was adopted to identify the ABO blood group and conduct the crosshatching test of allotype blood in 1 095 cases of neonatal blood samples.Results Among the 1 095 samples,the detected rates of weak A and weak B antigen were 3.99% and 17.93% respectively,and the weak B antigen was predominant.The negative rates of anti-A and anti-B antibody were 53.72% and 60.70% respectively;in the cross-matching test with allotype blood,the main side without appearing agglutination accounted for 52.87% and weak agglutination accounted for 33.27%,and the secondary side appearing weak agglutination accounted for 9.49%.Conclusion The maturity of antibody and an-tigen and the coincidence rates of group typing and reciprocal stereotypy in the newborns are less than those in the adults;so blood transfusion according to the cross-matching test results has certain limitation;high attention should be paid to the accuracy of neo-natal ABO blood type,the individual blood transfusion strategy in the newborn should be determined in order to avoid hemolytic blood transfusion reaction caused by ABO allotype blood transfusion and ensure the blood transfusion safety in newborns.
ABSTRACT
Objective To investigate the electrophysiological changes of peripheral nerves in both patients with hereditary neuropathy with liability to pressure palsies(HNPP).Methods The nerve conduction velocities of a family consisting of a proband and 4 members were tested,and the proband was detected by biopsy.Results The proband's median nerve,ulnar nerve,sural sensory nerve conduction velocity (SCV) were decreased.The median nerve,ulnar nerve,common peroneal nerve motor nerve conduction velocity(MCV) of proband were decreased.The sensory fibers of the most frequently involved nerve sural nerve,sural nerve damage to the results:the motor nerve conduction motor nerve evoked potential latency and 18 abnormal rate was 75.0％,the nerve distal to the abnormal rate of MCV was 87.5％.Conclusion Prolongation of distal nerve conduction latencies occurs in essentially all individuals whether symptomatic or asymptomatic.Nerves may be more easily damaged at the site of compression.
ABSTRACT
On the basis of ‘ cooperation between schools and hospitals’,teaching of specialized course of clinical medicine in the second academic year was arranged in affiliated hospitals and teaching hospitals.According to the teaching content and features of specialized courses,flexible teaching methods were adopted,including theoretical instruction,bedside teaching,case studies,situational teaching,integration of teaching,practicing and studying and clinical internships etc.Through selecting and training qualified teachers,establishing practical training base and strengthening teaching management and quality control,the quality of teaching was effectively guaranteed and satisfactory teaching effect was received.
ABSTRACT
ObjectiveTo investigate the brain function in the patients with transient ischemic attack (TIA) using index of regional homogeneity ( ReHo ).MethodsSixteen TIA patients ( TIA group ) and 16 age-matched normal controls(control group) underwent standard resting state functional MRI (fMRI)scan.The changes of the brain ReHo were studied by DPARSF analysis.ResultsCompared with that of control group,TIA group showed significantly decreased ReHo in the left cingulate gyrus (z =-3.72),left frontal gyrus (z =-3.02),right frontal gyrus (z =-3.23),right superior frontal gyrus (z =-3.75),right precuneus (z =-3.80),right inferior parietal lobule (z =-3.98 ),left inferior parietal lobule (z =-3.82),precentral gyrus ( z =- 3.85 ),right midfrontal gyrus ( z =-4.15 ),right midtemporal gyrus (z =- 3.43 ),and increased ReHo in the right hippocampus (z =3.37) and right cerebellum (z =3.55).Conclusion The rest-state brain function is abnormal in TIA interictal phase,and the increased ReHo in the hippocampus and cerebellum may reflect stress-induced brain protection of TIA and partial comoensatory response.
ABSTRACT
ObjectiveTo detect the fiber structure and volume differences in frontal lobe between patients with amnestic mild cognitive impairment (aMCI) and normal control.MethodsT1 -weighted magnetic resonance imaging and diffusion tensor imaging were obtained in 28 aMCI patients and 25 normal controls.Volumes,fiber fractional anisotropy (FA),fiber apparent diffusion coefficient (ADC),fiber number,and average fiber length of frontal lobe in the two groups were measured.ResultsVolumes of left frontal lobe ( ( 337.35 ± 20.45 ) cm3 ) in aMCI group were smaller than control ( (358.54 ± 27.26) cm3 ) ( t =- 3.223,P =0.002 ).Numbers of short range fiber in left frontal lobe ( 16985 ± 892) were significantly increased relative to control ( 16387 ±752) ; while numbers of long range fiber (3214 ± 185 ) were reduced compared with control (3425 ± 277 ),and ADC values increased ( t =2.621,P =0.012; t =-3.714,P =0.001 ; t =17.595,P=0.000).In aM CI group,numbers of long range fiber in right frontal lobe were reduced (2895 ± 343 vs.3451 -± 230,t =- 7.011,P =0.000),and ADC values were increased ( t =4.443,P =0.000).In aMCI group,numbers of long range fiber in left frontal lobe were positively correlated with scores of mini-mental state examination ( MMSE ) ( r =0.457,P =0.015 ),while ADC values of long range fiber in left frontal lobe were negatively correlated with scores of MMSE ( r=-0.415,P=0.028).ConclusionThe structure and fiber connectivity are affected in aMCI patients and the lesion of connectivity in left frontal lobe are related to the severity of symptom.
ABSTRACT
Objective To investigate any changes in motor functional connectivity in the brains of acute ischemic stroke patients after low frequency electrical stimulation.Methods Twenty-five ischemic stroke patients were given low frequency electrical stimulation in addition to their conventional rehabilitation treatment.Another 20 patients received only conventional treatment as a control group.Resting-state functional magnetic resonance imaging (rs-fMRl)was employed to assess motor function connectivity in the brains of all 45 subjects before and after treatment.Any differences in functional impairment,extremity motor function or ability in the activities of daily living were also recorded before and after treatment.Results In both groups,average scores on the Canadian neurological scale (CNS)and the National Institutes of Health stroke scale (NIHSS) had been reduced significantly after treatment and FuglMeyer assessment (FMA) and modified Barthel index (MBI) scores had significantly increased.The average improvements in terms of FMA and MBI scores were significantly greater in the observation group.Compared with before treatment,the coefficient of functional connectivity of the bilateral motor cortex had decreased significantly after treatment in both groups.In the observation group the changes were significantly correlated with the improvements in FMA scores.Conclusion Neural functional impairment after ischemic stroke can be reduced significantly and extremity motor function and ability in the activities of daily living can be significantly improved by low frequency electrical stimulation.
ABSTRACT
<p><b>OBJECTIVE</b>To study the related factors of central lymph node (CLN) metastasis in papillary thyroid carcinoma (PTC),the indications and the extent of central neck dissection (CND).</p><p><b>METHODS</b>A total of 153 cases treated between Jan. 2009 and Dec. 2010 was analysed retrospectively. Of the cases 28 males and 125 cases females, with a mean age of (44 ± 14) years. T1, T2, and T3 diseases accounted for 51, 10 and 81 cases, respectively; I, II, III and IV diseases for 88, 3, 26 and 36 cases, respectively. Multifocal tumors were found in 63 cases. The related clinicopathologic factors were analyzed, including sex, age, tumor size, extrathyroidal extension, and multifocal tumor.</p><p><b>RESULTS</b>All the cases had total/near total thyroidectomy and CND, of them 64 cases had unilateral neck dissection and 18 cases had bilateral neck dissection. CLN metastases existed in 68.6% (105/153) cases, 37.2% (57/153) for unilateral and 31.4% (48/153) for bilateral respectively. The rates of CLN metastasis were 86.6% (71/82) in cN1 cases and 47.9% (34/71) cN0 cases, respectively,and the rates of bilateral CLN metastases were 45.1% (37/82) in cN1 cases and 15.5% (11/71) in cN0 cases. Multivariate analysis showed that extrathyroidal extension (P = 0.002, OR = 3.502) was an independent risk factor for CLN metastasis and that lateral neck lymph node metastasis (P = 0.028, OR = 3.080), surrounding tissue invasion (P = 0.014, OR = 3.113), and maximum tumor diameter greater than 1 cm (P = 0.012, OR = 3.732) were independent risk factors for bilateral CLN metastases.</p><p><b>CONCLUSIONS</b>It is indicated that ipsilateral CND should be obligatory for PTC. Intraoperative frozen section examination should be routine. Bilateral CND should be conducted when ipsilateral CLN metastases accompanied by one of following issues such as more invasive tumor (surrounding tissue invasion, T3 or T4 disease), maximum tumor diameter greater than 1 cm, and lateral neck lymph node metastasis.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Carcinoma , Pathology , Carcinoma, Papillary , Lymphatic Metastasis , Neck Dissection , Retrospective Studies , Thyroid Neoplasms , PathologyABSTRACT
<p><b>OBJECTIVE</b>To study the pattern of lymph node spread in papillary thyroid carcinoma (PTC) with clinically negative node (cN0).</p><p><b>METHODS</b>A total of 106 patients with cN0 PTC who underwent total or subtotal thyroidectomy plus unilateral or bilateral lateral neck dissection (LND, level II-V or level I-V) at West China Hospital of Sichuan University between April 2004 and August 2010 were analyzed retrospectively.</p><p><b>RESULTS</b>The lateral neck lymph node metastasis in cN0 PTC was significantly associated with sex (male, P = 0.007), tumor stage (T3/T4, P = 0.006), tumor size (> 1 cm, P = 0.014) and the number of positive central lymph nodes (≥ 2, P < 0.001), but not with age and multifocal tumor. Level III (47/116, 40.5%) was the most prevalent metastatic site, followed by level IV (41/116, 35.3%), level II (18/116, 15.5%) and level V (2/29, 6.9%). Of the cases with lymph node metastases in level III and IV, 89.8% (79/88) of primary thyroid tumors existed in the lower and middle sites of the thyroid lobes, while in the cases with lymph node metastases in level II, 77.8% (14/18) of primary thyroid tumors in the upper sites of the thyroid lobes, and 83.3% of cases with level II metastases were accompanied with level III metastases. Two cases with level V metastases were accompanied with metastases in levels II, III and IV.</p><p><b>CONCLUSIONS</b>LND should be considered for cN0 PTC in male, with T3/T4 lesions and positive central lymph nodes ≥ 2, and the range of dissection should include level III and IV. Dissection of level II should be considered in cN0 PTC with primary tumor localized in the upper site of the thyroid lobe or with level III metastasis. Dissection of level V should be considered at present of metastases in level II, III, and IV. For cN0 PTC with tumor size < 1 cm, confined to the thyroid and without lymph node metastasis in the central compartment, LND is not recommended.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Carcinoma , Pathology , Carcinoma, Papillary , Lymph Nodes , Pathology , Lymphatic Metastasis , Pathology , Neck Dissection , Neoplasm Staging , Retrospective Studies , Thyroid Neoplasms , PathologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of autophagy gene Beclin 1 on growth of cervical cancer HeLa cells in vitro and vivo.</p><p><b>METHODS</b>The eukaryotic expression vector of Beclin1 was constructed and transfected via lipofectamine into HeLa cells. The experimental cells were classified into 3 groups: pcDNA3.1(+)-Beclin1 group,pcDNA3.1(+) group and HeLa group. Real time-ploymerase chain reaction and Western blot were used for detecting expression of Beclin1 mRNA and protein in the transfected cells. Flow cytometry (FCM) was employed to observe the effect of transfection on the apoptosis of HeLa cells, and proliferation was analyzed by MTT assay. The formation of autophagic vacuoles was measured by MDC staining. HeLa cells transfected with plasmid pcDNA3.1(+)-Beclin1 and pcDNA3.1(+) were inoculated subcutaneously in nude mice. The carcinogenic and growth activities of cancer cells in vivo were observed.</p><p><b>RESULTS</b>Eukaryotic expression vector pcDNA3.1(+)-Beclin1 was constructed successfully. It significantly improved the expression of Beclin1 mRNA and protein in HeLa cells. The proliferation of HeLa cells was inhibited, and the inhibition rate was 58.7%. FCM investigation showed that the apoptotic rate was (28.22 ± 2.34)% of pcDNA3.1(+)-Beclin1 group, significantly higher than the (14.6 ± 4.6)% in the pcDNA3.1(+) group and (11.2 ± 3.0)% in the HeLa group (P < 0.05). The monodansylcadaverin (MDC) staining showed significantly more autophagic vacuoles in the pcDNA3.1(+)-Beclin1 group (10.9%) than that in the pcDNA3.1(+) group (3.1%) and HeLa group (2.5%) (P < 0.05). After transfected with vector pcDNA3.1(+)-Beclin1, the carcinogenic activity of HeLa cells was decreased in nude mice, and the inhibition rate of tumor growth was 52.2%.</p><p><b>CONCLUSIONS</b>Autophagy gene Beclin 1 overexpression can inhibit the proliferation and growth of HeLa cells in vitro and vivo,while promote autophagy and apoptosis of HeLa cells. So it might be one of new gene therapy strategies for cervical carcinoma.</p>