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Abstract@#Over the past 40 years, there has been a long term trend of early pubertal onset in children in China. Early pubertal timing is closely associated with mental health and behavioral problems in children, and can even lead to cardiovascular and metabolic diseases, cancers of the endocrine system and abnormalities of the bone and joint system in adulthood. Prompt detection of early pubertal timing in children is important. There are many methods for evaluating pubertal timing, the appropriateness of which is worth exploring. This paper reviews previous literature publications, examines current research progress in evaluation methods of pubertal timing, evaluates their applicability in the study of children and adolescents, and provides a reference for the selection of an evaluation method to assess pubertal timing in children in China.
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Pathological specimen sampling is not only the prerequisite of a good pathological diagnosis, but also the primary clinical skill that must be mastered by the standardized residency training trainees (resident trainees) in clinical pathology department. In view of the problems and difficulties encountered in the teaching of specimen sampling, through five years of exploration and attempt, this paper has gradually established a new model with five basic elements, including theory teaching, practice teaching, promoting teaching effect by examination, learning from senior students, and review teaching. The results of evaluation analysis and questionnaire survey show that the teaching mode can make the trainees master the methods of specimen sampling quickly and efficiently, learn and improve clinical skills in practice, and lay a solid foundation for the subsequent standardized training of histopathological diagnosis.
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BACKGROUND@#SMARCA2 (SWI/SNF Related, Matrix Associated, Actin Dependent Regulator of Chromatin, Subfamily A, Member 2) is an important ATPase catalytic subunit in the switch-sucrose nonfermenting (SWI/SNF) complex. However, its relationship with the pathological features of NSCLC and its prognosis remain unclear.@*METHODS@#We retrospectively reviewed 2390 patients with surgically resected NSCLC, constructed tissue microarrays (TMAs) and performed immunohistochemical assays. We analyzed the correlation of SAMRCA2 with clinicopathological features and evaluated its prognostic value.@*RESULTS@#Among 2390 NSCLC cases, the negative expression ratios of SAMRCA2, SMARCA4, ARID1A, ARID1B and INI1 were 9.3%, 1.8%, 1.2%, 0.4% and 0%, respectively. In NSCLC, male sex, T3 and T4 stage, moderate and poor differentiation, tumor ≥ 2 cm, Ki67 ≥ 15%, SOX-2 negative expression, middle lobe lesion and adenocarcinoma were relative risk factors affecting SMARCA2-negative expression. In lung adenocarcinomas, high-grade nuclei, histological morphology of acinar and papillary, solid and micropapillary and TTF-1-negative expression were relative risk factors affecting SMARCA2-negative expression. Kaplan-Meier survival analysis showed that the OS was shorter in the SMARCA2-negative group. Multivariate survival analysis revealed that SMARCA2-negative expression was an independent factor correlated with a poor prognosis in NSCLC.@*CONCLUSION@#In conclusion, SMARCA2-negative expression is an independent predictor of a poor outcome of NSCLC and is a potential target for NSCLC treatment.
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Humans , Male , Adenosine Triphosphatases/metabolism , Carcinoma, Non-Small-Cell Lung/genetics , Retrospective Studies , Transcription Factors/geneticsABSTRACT
Objective:To investigate the effect of dexmedetomidine combined with flurbiprofen axetil on pain and cognitive function of patients after thyroidectomy.Methods:A total of 80 patients with thyroid gland surgery in the People's Hosptial of Shouguang from January 2016 to December 2017 were selected and randomly divided into four groups according to the digital table: saline control group(C), dexmedetomidine group(D), flurbiprofen axetil group(F), dexmedetomidine combined with flurbiprofen axetil group(DF), with 20 casess in each group.The extubation time and wake-up time of the four groups were observed.The VAS scores were used to assess the analgesic effect after surgery, and the Riker sedation scale was used to assess postoperative anxiety.Results:The extubation time of the C, D, F and FD group were (16.66±3.37)min, (24.63±2.80)min, (14.55±3.74)min, (26.22±3.45)min, respectively, which of group D and group DF was significantly longer than that in group C and group F( F= 4.59, P<0.01). The recovery time of group D[(17.98±2.54)min] and group DF[(17.84±3.63)min] was significantly longer than that of group F[(10.92±2.21) min] and group C[(9.95±2.16)min] ( F=5.01, P<0.01). The VAS scores of group DF at 30 min, 3 h, 6 h and 24 h after recovery were significantly lower than those of group F and group D ( F=4.53, 4.59, 4.61, 4.35, all P<0.01). The Rick sedation scores of C, D, F and FD groups were (5.28±1.81)points, (4.20±1.56)points, (4.24±2.01)points and (3.76±1.43)points, respetively, which of group DF was significantly lower than those of the other three groups( F=3.01, P<0.01). The MMSE scores of cognitive function in group DF at 3 h, 1 d and 3 d after surgery were significantly higher than those in group C ( F=5.89, 4.95, 4.56, all P<0.01). Conclusion:The combined use of dexmedetomidine and flurbiprofen axetil significantly reduces pain and relieves postoperative cognitive impairment after thyroid surgery.
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Objective@#To investigate the effect of dexmedetomidine combined with flurbiprofen axetil on pain and cognitive function of patients after thyroidectomy.@*Methods@#A total of 80 patients with thyroid gland surgery in the People's Hosptial of Shouguang from January 2016 to December 2017 were selected and randomly divided into four groups according to the digital table: saline control group(C), dexmedetomidine group(D), flurbiprofen axetil group(F), dexmedetomidine combined with flurbiprofen axetil group(DF), with 20 casess in each group.The extubation time and wake-up time of the four groups were observed.The VAS scores were used to assess the analgesic effect after surgery, and the Riker sedation scale was used to assess postoperative anxiety.@*Results@#The extubation time of the C, D, F and FD group were (16.66±3.37)min, (24.63±2.80)min, (14.55±3.74)min, (26.22±3.45)min, respectively, which of group D and group DF was significantly longer than that in group C and group F(F= 4.59, P<0.01). The recovery time of group D[(17.98±2.54)min] and group DF[(17.84±3.63)min] was significantly longer than that of group F[(10.92±2.21) min] and group C[(9.95±2.16)min] (F=5.01, P<0.01). The VAS scores of group DF at 30 min, 3 h, 6 h and 24 h after recovery were significantly lower than those of group F and group D (F=4.53, 4.59, 4.61, 4.35, all P<0.01). The Rick sedation scores of C, D, F and FD groups were (5.28±1.81)points, (4.20±1.56)points, (4.24±2.01)points and (3.76±1.43)points, respetively, which of group DF was significantly lower than those of the other three groups(F=3.01, P<0.01). The MMSE scores of cognitive function in group DF at 3 h, 1 d and 3 d after surgery were significantly higher than those in group C (F=5.89, 4.95, 4.56, all P<0.01).@*Conclusion@#The combined use of dexmedetomidine and flurbiprofen axetil significantly reduces pain and relieves postoperative cognitive impairment after thyroid surgery.
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Objective@#To investigate the intention of breast reconstruction in breast cancer patients and explore the potentially-related impact factors.@*Methods@#Breast reconstruction related questionnaires were distributed among 525 women breast cancer patients in multiple centers. Proportion constitution, univariate analysis and Logistic regression analysis were applied to the returned data.@*Results@#84 valid questionnaires were collected. There were 35.1%(170/484) patients who had the intention of breast reconstruction, and the patients with no intention of reconstruction accounted for 40.7%(197/484), while 24.2%(117/484) of the patients showed an unclear attitude to breast reconstruction. The average cognitive and attitude scores of reconstructive patients were significantly higher than those without reconstructive wishes (t=8.194, P<0.05; t=13.795, P<0.05). The higher rate of breast reconstruction willingness in breast cancer patients was associated with a lower age (χ2=13.466, P<0.05) and a better educational background (χ2=14.955, P<0.05). The rate in in-service personnel was higher than that in unemployed personnel (χ2=12.744, P<0.05). The rate of breast reconstruction willingness in the patients with various family income and medical insurance categories was significantly different (χ2=10.551, P<0.05; χ2=4.255, P<0.05). The marital status and the place of residence had no relation to the rate of reconstruction willingness (P>0.05). A further Logistic regression analysis showed that there was a significant correlation between the intention of breast reconstruction and the following factors: the age of patients, family income, medical expense category, the attitude of breast reconstruction (P<0.05).@*Conclusions@#Breast cancer patients have severe lack of knowledge of breast reconstruction. However, the young patients, with good economic condition and a positive attitude to reconstruction had a strong desire for breast reconstruction. Therefore, it is necessary to strengthen the communication with breast cancer patients in clinical environment and improve the cognitive level of patients and their families to increase the rate of breast reconstruction.
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Objective To study the effect of moxibustion acupuncture and Chinese medicine external treatment for the severe knee osteoarthritis. Methods A total of 86 severe knee osteoarthritis patients were enrolled between December 2014 and December 2016, in Department of Integrated TCM & Western Medicine, Shijiazhuang first hospital. According to the enrolled sequency, patients were divided into observation group and control group, 43 in each group. The control group was treated with intra-articular injection of sodium hyaluronate of 2ml, and the observation group was treated with the combined acupuncture moxibustion and traditional Chinese medicine external treatment on the basis of the control group. Two groups were performed for 3 months of follow-up. The clinical effect, WOMAC values, VAS score and Lysholm scale, and the serum high sensitivity C reactive protein (hs-CRP), interleukin 1 (IL-1) and tumor necrosis factor a (TNF-a) changes before and after the treatment were observed and compared. Results The total effective rate of observation group was 93.0％ (40/43), while control group total effective rate was 76.7％ (33/43), and the differences between two groups was statistically significant (χ2=4.441, P=0.035). After treatment, the WOMAC joint stiffness scores (3.2 ± 1.2 vs. 4.8 ± 2.1, t=4.338), joint pain (4.2 ± 1.3 vs. 5.9 ± 1.7, t=4.903), daily activities (14.5 ± 2.8 vs. 18.7 ± 2.9, t=6.832) in observation group were significantly lower than those in the control group. The VAS score (2.5 ± 0.8 vs. 4.1 ± 1.2, t=7.275) in observation group was significantly lower than the control group, while the Lysholm score (74.2 ± 3.7 vs. 67.4 ± 3.9, t=8.295) was significantly higher than the control group (P<0.05). The serum hs-CRP (8.34 ± 2.24 mg/L vs. 13.67 ± 2.54 mg/L, t=10.321), IL-1 (0.85 ± 0.11 ng/L vs. 1.32 ± 0.42 ng/L, t=7.099), TNF-a (98.67 ± 15.74 ng/L vs. 178.44 ± 26.53 ng/L, t=16.955) in the observation group patients were significantly lower than those in the control group (P<0.05). Conclusions The acupuncture combined moxibustion and traditional Chinese medicine external treatment could treat severe knee osteoarthritis, improve the function of knee joint.
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OBJECTIVE:To prepare nanostructured lipid carrier of adefovir dipivoxil(ADV-NLC),and optimize the formula-tion. METHODS:Using stearic acid and glycerin monostearate as solid lipid,oleic acid as liquid lipid,Gemini surfactant and poly-sorbate 80 as emulsifier,sodium dodecyl sulfate (SDS) as stabilizer,solvent dispersion ultrasonic method was used to prepare ADV-NLC. And using particle size,polydispersity index,Zeta potential,encapsulation efficiency as indexes,single factor test was conducted to screen Gemini surfactant-polysorbate 80 ratio,emulsifier dosage(ratio of emulsifier to water phase),drug-lipid ratio, solid-liquid lipid ratio. RESULTS:The formula was as follow as 3% emulsifier (Gemini surfactant-polysorbate 80 ratio of 1:2), 4.5% drug-lipid ratio,solid-liquid lipid ratio of 6:5. The average particle size of the prepared ADV-NLC was(48.83±2.65)nm, polydispersity index<0.3,Zeta potential was(-28.7±1.8)mV,encapsulation efficiency was(77.65±0.03)%(n=3). CONCLU-SIONS:ADV-NLC is successfully prepared,and the formulation is reasonable and feasible.
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Objective To investigate the influence of long non-coding RNA HOTAIR in proliferation and apoptosis of human tongue squamous cell carcinoma in vitro and in vivo. Methods siHOTAIR was used to inhibit the HOTAIR expression in Tb3.1 human tongue squamous cell carcinoma cell line. The experiments were divided into siHOTAIR group, nonsense sequence group and blank control group. Real-time PCR was used to detect the HOTAIR expression. MTT assay was employed to determine the cell survival. The expression levels of Bcl2, BAX, caspase-3, cleaved caspase-3 were examined by Western blot assay. Tb3.1 xenograft tumor model was established in BALB/c nude mice, and the tumor model was divided into control group, negative group, and siHOTAIR treated group. The tumor tissues were measured by immunohistochemistry stain (IHC) and TUNEL assay. Results The detection of real-time PCR showed that HOTAIR expression was reduced after treated with siHOTAIR. Western blots assay showed that Bcl-2 protein was suppressed while cleaved caspase-3 and BAX protein were up-regulated after treated with siHOTAIR. MTT assay indicated that the cell survival rate was significantly reduced in siHOTAIR treated group. Flow cytometry detected that apoptosis levels were increased in siHOTAIR group. The level of cell senescence was higher in the siHOTAIR group than that of control group. Results of IHC indicated that Ki-67 and Bcl-2 protein of tumor tissue were inhibited, while BAX and cleaved caspase-3protein expressions were elevated simultaneously in the siHOTAIR group. TUNEL assay suggested that more apoptosis was observed in siHOTAIR group. Conclusion HOTAIR can affect proliferation and apoptosis of tongue squamous cancer cells. HOTAIR may be one of the new candidate targets for human tongue cancer therapy.
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The lymphatic metastasis affects prognosis and survival of colorectal cancer seriously,and lymphangiogenesis plays an important role in the lymphatic metastasis. Many factors such as COX-2 and MMP-7 which are found in many researches recently can promote the expression of VEGF-C which can promote the lym-phangiogenesis by connecting with its receptor and activating the relevant signal pathway. At present,as these related factors of lymphangiogenesis are found in colorectal cancer,the process of lymphangiogenesis in colorec-tal cancer becomes more clear,but the exact mechanism of these factors needs to be researched in future.
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Objective To explore the expressions of Cyclin-dependent kinase 5 (CDK5) and Epithelial-Mesenchymal Transition (EMT) related proteins including N-cadherin, Vimentin and E-cadherin in head and neck squamous cell carcino? ma (HNSCC), and to determine the relationship between the expression of CDK5 and prognosis. Methods The expression levels of CDK5 and EMT related proteins were evaluated by immunohistochemistry in 55 patients who were diagnosed as HN?SCC. They were also analyzed in different clinical pathological factors. The correlation of CDK5 and EMT related proteins as well as the relationship between the expression of CDK5 and prognosis were also analyzed. Results The expression level of CDK5 was significantly higher in patients with lymph node metastasis than that in patients with non-lymph node metastasis (91.67%vs 30.23%, P<0.05). It’s also higher in T3-T4 stages than that in T1-T2 stages (85%vs 20%, P<0.05). The ex?pression levels of N-cadherin and Vimentin were significantly higher in patients with lymph node metastasis than those in patients with non-lymph node metastasis (75.00%vs 6.98%;91.67%vs 27.91%, all P<0.05). However, the expression level of E-cadherin was significantly lower in patients with lymph node metastasis (8.33%vs 86.05%, P<0.05) compared to that in patients without. CDK5 was positively correlated with N-cadherin and Vimentin, but negatively correlated with E-cad?herin (rs=0.512, 0.443,-0.363, all P<0.01). The 3-year survival rates were significantly lower in patients with high expres?sion of CDK5 (37.5%) than that in patients with low expression of CDK5 (87%, Log-rankχ2=12.678, P<0.01). Conclusion CDK5 and EMT related proteins were activated abnormally in HNSCC with lymph node metastasis. CDK5 may be a new bio?logical marker for prognosis of HNSCC.
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Objective:To investigate the risk factors of central lymph node metastasis (CLNM) and lateral neck lymph node me-tastasis in papillary thyroid microcarcinoma (PTMC) patients, and to analyze the importance of high resolution ultrasonography in the diagnosis of lateral neck lymph node metastasis in PTMC patients. Methods:A retrospective protocol was applied, and a total of 1 037 PTMC patients were reviewed. These patients underwent central lymph node dissection or thyroidectomy with lateral neck lymph node dissection between January and November in 2013 in the Tianjin Medical University Cancer Institute and Hospital. Clinicopathological factors, namely, age, sex, primary tumor size, multifocality, bilateralism, thyroid capsular invasion, and local invasion, were analyzed. Results: CLNMs were found in 332 of 1037 patients (32.0%), and 71 out of 1037 patients had lateral neck lymph node metastasis (6.85%). In the univariate analysis, patients with the following risk factors were at high risk of CLNM (P5 mm, multifocality, bilateralism, thyroid capsular invasion, and local invasion. Male patients with cen-tral lymph node metastasis positively showed high lateral neck lymph node metastasis rate (P5 mm, multifocality, bilateralism, thyroid capsular invasion, and lo-cal invasion). The importance of high-resolution ultrasonography in diagnosing lateral neck lymph node metastasis was revealed by the results. Thus, this method should be widely popularized. Radical neck dissection should be performed in male patients who received a positive diagnosis via ultrasonography or those with PTMC who had more than three positive nodes in the central lymph node metasta-sis. However, given the high occurrence rate of PTMC, a prospective study needs to be conducted in the future.
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Objective To evaluate the prognostic value of three different staging system based on positive lymph nodes,lymph node ratio and log odds of positive lymph nodes in breast carcinoma.Methods In 472 breast carcinoma patients,survival analysis was performed with Kaplan-Merier and COX regression model,the hazard ratio (HR) of the three staging system were compared.Results When more than 10 lymph nodes were dissected in the operation,there was statistical differences in survival among the staging systems based on lymph node ratio and log odds of positive lymph nodes (P ＜ 0.05),while the prognosis was highly homologous between the staging systems based on positive lymph nodes in stage N0 and N1.Univariate analysis showed age,tumor size,Her2 status,estrogen receptor status and the total lymph nodes dissected were related to overall survival (all P ＜ 0.05).COX multivariate analysis showed that the staging system based on lymph node ratio (5.495) and log odds of positive lymph nodes (4.662) had the higher HR than the N staging system (2.722).Conclusions Compared with the number of involved lymph nodes,the staging system based on lymph node ratio and log odds of positive lymph nodes were superior to the staging system based on positive lymph nodes for prognostic assessment of breast carcinoma.
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Bone-modifying agents (BMA) is a series drugs to alleviate the pain,pathological fractures,spinal cord compression,hypercalcemia,bone-related events which induced by bone metastases.Bisphosphonate drugs and denosumab are two dominant kinds of BMA at present.It has been proved that BMA is used in bone metastases patients with bone destruction,as adjuvant therapy for chemotherapy and radiotherapy,which can significantly improve the efficacy and prolong the survival of patients.In addition,some traditional Chinese medcine can effectively relieve a series of related symptoms caused by bone metastases and improve prognosis.Choosing right medication in clinical work can maximize the reduction of pain caused by bonerelated events and improve the quality of life of patients.
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Biochemical markers of bone metabolism are some of the final product which are released into the blood during the process of bone resorption or bone formation.Accumulative evidence shows that biochemical markers of bone metabolism through enzyme-linked immunoassay (ELISA) are more sensitive and specific than imaging examination.Moreover,biochemical markers of bone metabolism also display their superiorities on the early diagonosis,monitoring efficacy and prognosis evaluation in patients with bone metastases.Applications of biochemical markers of bone metabolism combined with imaging examination are more value for the early diagonosis,monitoring efficacy and prognosis evaluation in patients with bone metastases.
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FGFR2 plays an important role in cell proliferation and differentiation and FGFR2 gene has its own genetic polymorphism. It has recently been demonstrated that this genetic polymorphism is associated with risk of development of breast cancer and clinically pathological factors
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OBJECTIVE@#To observe normal and abnormal findings of foramina within internal auditory canal (IAC) fundus with Virtual Endoscopy of multisection helical Computed Tomography.@*METHOD@#CT scanning of temporal bone was undergone in 25 volunteers (50 ears) in the normal group, in 8 cases (13 ears) with foramina hypoplasia within IAC fundus which were shown on CT and MRI images. CT virtual endoscopy (CTVE) findings were observed in the normal and abnormal groups. The lower threshold value was 900-1200 HU, the upper value was 3,071 HU in CTVE definitions.@*RESULT@#The shape and position of foramina within IAC fundus were shown on the CTVE image, 50 foramina within IAC fundus were shown in all normal cases. In abnormal group, 9 ears were shown as IAC fundus disorder and foramina absent, only 1 foramina was shown in 1 ear, 2 foramen in 4 ears, 3 foramen in 2 ears, 4 foramen in 2 ears; Abnormal shape of cochlear nerve foramina was seen in 4 ears. Other malformations were also shown, including IAC malformations in 3 ears and inner ear malformations in 8 ears.@*CONCLUSION@#CTVE is useful to show the shape and position of normal foramina and pathological changes in the patients with foramina hypoplasia within IAC fundus.