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Objective:To investigate the feasibility of dynamic contrast-enhanced (DCE)-MRI in assessing the depth of invasion (DOI) of early tongue squamous cell carcinoma.Methods:From January 2016 to December 2020, a total of 100 patients with early tongue squamous cell carcinoma confirmed by postoperative pathology were retrospectively analyzed in the Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine. The study included 48 cases of T1 stage and 52 cases of T2 stage. All patients underwent routine MRI, DCE-MRI and contrast-enhanced T 1WI (CE-T 1WI) before surgery. The DOI was measured on images at different phases of axial DCE-MRI (30, 60 and 120 s after contrast injection) and CE-T 1WI (MRI-DOI) by 2 doctors independently. The intraclass correlation coefficient (ICC) was applied to evaluate the consistency of the measurements. MRI-DOI measured on DCE-MRI 30, 60, 120 s, CE-T 1WI and pathological DOI measured on biopsies were statistically analyzed with analysis of variance for repeated measurement and least significant difference t test. Pearson correlation coefficient was used to compare the correlation between MRI-DOI and pathological DOI. Receiver operation characteristic (ROC) curve analysis was used to explore the performance of MRI-DOI for clinical T1 and T2 staging. Results:There was a good consistency in MRI-DOI measured on DCE-MRI 30, 60, 120 s, and CE-T 1WI images with ICC of 0.752, 0.875, 0.883, and 0.841, respectively. The values of MRI-DOI were (8.35±3.52), (6.88±2.41), (7.52±2.65) and (8.60±3.39) mm, respectively, and pathological DOI was (5.75±2.01) mm. There was statistically significant difference in the overall comparison among different phases of MRI-DOI and pathological DOI ( F=69.25, P<0.001). MRI-DOI were significantly higher than pathological DOI ( P<0.05). All MRI-DOI measured on DCE-MRI 30, 60, 120 s and CE-T 1WI correlated positively with pathological DOI ( r=0.574, 0.851, 0.731, 0.663, all P<0.001). MRI-DOI derived from DCE-MRI 60 s showed the highest diagnostic efficiency for T1 and T2 staging (area under the ROC curve was 0.931, 95%CI 0.881-0.982). When the optimal cutoff value was 6.0 mm, the accuracy, sensitivity and specificity were 88.0%, 96.2% and 79.2%, respectively. Conclusions:DCE-MRI can be applied to assess DOI in early tongue squamous cell carcinoma. MRI-DOI based on DCE-MRI 60 s has the best correlation with pathological DOI and has a potential to predict clinical T staging in early tongue squamous cell carcinoma.
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Objective To evaluate the molecular mechanism of 11 beta-hydroxysteroid dehydrogenase type 1 (11 β-HSD1)in tumor necrosis factor-α (TNF-α) induced insulin resistance.Methods The optimal concentration and incubation time of TNF-α for treating HepG2 cells were selected.Real-time polymerase chain reaction(PCR)and Western blot analysis were used to explore the effect of TNFα on the mRNA and protein expression levels of 11β-HSD1,glucocorticoid receptor (GR),phosphoenolpyruvate carboxylase(PEPCK)and glucose 6-phosphatase(G6Pase).Glucose(GO) Assay Kit was used to determine the level of gluconeogenesis.Liver/Muscle glycogen assay kit,PAS/Glycogen Stain kit were used to detect glycogen synthesis.The expression of AKT/GSK pathway was analyzed by Western blot analysis.In addition,HepG2 cells were pre-treated with BVT2733,a specific inhibitor of 11β-HSD1,before exposure to TNFα The expression of AKT/GSK pathway,the level of gluconeogenesis and glycogen synthesis were analyzed.Results The expression of 11β-HSD1 was increased along with the increasing concentration of TNF-α,showing a dose-dependent effect.When HepG2 cells treated with the optimal dose of TNF-α 10 μg/L for 24 hours,the levels of GR,gluconeogenesis and gluconeogenesis-related genes PEPCK and G6Pase were increased,while conversely,the levels of phosphorylation of AKT and GSK,and glycogen synthesis were decreased.However,all the above effects induced by TNF-α in HepG2 cells were greatly reversed by BVT2733 pre treatment.Conclusions 11 β-HSD1 participates in TNF-α-induced insulin resistance in HepG2 cells,and BVT2733 could significantly improve insulin sensitivity.
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Objective To analyze the effects of acute depletion of liver-specific insulin signaling on secretion of apolipoprotein B (apoB) and triglyceride (TG).Methods Based on Cre-LoxP principle,a promoter of hepatic tissue specific albumin gene was inserted into upstream of the cre recombinase gene.Albumin-Cre adenovirus (Ad-CRE) and GFP adenovirus (Ad-GFP) were amplified in 293A cells and purified before intravenous administration to mice.After adenovirus infection for 2 days,4 days and 6 days,blood samples from mice were collected and hepatic tissues were frozen.The secretion rates of hepatic newly synthesized apoB and very low density lipoprotein (VLDL)-TG were determined by injection of Triton WR-1339.The levels of plasma cholesterol (TC) and TG were measured.The expressions of insulin receptor and other lipoprotein metabolism related proteins in hepatic tissues were analyzed by Western blot.Results After 2 d,4 d and 6 d of the Ad-CRE injection into mice,insulin receptor expression was reduced by 30.50％ (P＜0.05),60.12％ (P＜ 0.01) and 99.54％ (P＜0.001),and VLDL-TG secretion rate was decreased by 20.43％ (P＜0.05),33.63％ (P＜0.05) and 44.21％ (P＜0.01),respectively.Expressions of sterol regulatory binding proteins 1,fatty acid synthase,and the related proteins of VLDL-formation were decreased,but there were no changes in hepatic secretion of apoB100 and hepatic lipids.The hepatic secretion of apoB48 was increased by 35.07％ (P＜0.05) 6 d after Ad-CRE injection.Conclusions Acute depletion of hepatic insulin receptor might reduce VLDL-TG secretion in manner of time-dependent,and increase the assembly and secretion of smaller apoB-containing lipoproteins in mice liver,which is probably associated with decreased lipogenesis.
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Objective To study the efficacy of gestrinone and Sanjie zhentong capsule for the adjunctive treatment of endometriesis cyst of ovary after laparoscopic operation.Methods 116 patients with ovarian endometriosis cyst after laparoscopic operation were randomly divided into three groups:A group(gestfinone and Sanjie Zhentong capsule,n=42),after operation were given gestrinone(2.5mg each time,two times per-week for 3～months)and Sanjie zhentong capsule(4 pills each time,three times everyday for 3 months);B group(gestrinone,n=38),after operation were only given gestrinone(2.5mg each time,two times per-week for 3-6 months);C group(Sanjie zhentong capsules,n=36),after operation were only given Sanjie zhentong capsules(4 pills each time,three times everyday for 3 months).All patients were followed up for 6～12 months.Results The follow-up visit rate was 96.5%(112/116).A group,B group and C group,their excellence rate was respectively 97.5%,67.6%and 65.7%,their recurrence rate was respectively 2.5%,24.3%and 22.9%.There was significant difference between A group and B group.C group(P＜0.05).Incidence rate of three groups'side effects was respectively 35.0%,29.7%and 14.3%,there was no significant difference among three groups(P＞0.05).Conclusion The efficacy of gestfinone and Sanjie zhentong capsule for the adjunctive treatment of endometriosis cyst of ovary after laparoscopic operation was better than that of the only medicine treatment.
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Objective Pulmonary dysfunction is common in the obese patients after laparoscopic surgery. To reduce or avoid this complication caused by improper combination of mechanical ventilatory parameters,we conducted the following trial of 3 factors with 3 levels of mechanical ventilation in order to explore the optimal combination with low airway pressure. Methods Patients were randomly allocated into 9 groups (k=3,n=27) according to the "30≤BMI<40" obesity index (ASAⅠ-Ⅱ). Anesthesia machine parameters were set as follows: respiratory frequency (f), tidal volume (VT), respiratory ratio (I:E) as the three factors of A, B, C, with 3 levels of f=15, 12, 9 (bpm), VT=8, 10, 12 (mL/kg), I:E=1:2.5, 1:2.0, 1:1.5. By using L9(3~4)K=3 repeat orthogonal experimental design and analysis table, the variable factors that affect the respiratory index such as the end tidal carbon dioxide pressure (P_(ET)CO_2), peak airway pressure (PIP), mean airway pressure (P_(mean)), and the end of endogenous airway pressure (PEEPi) were analyzed. Results In this study, 27 cases undergoing laparoscopic surgery under general anesthesia were allocated into 9 experimental groups. The hemodynamics of these patients was stable, SPO_2 was kept at 100 percent during the operation. The results of different combinations were described as follows: ①P_(ET)CO_2: f and VT with different level had great impact on P_(ET)CO_2 (P<0.01), I:E had no significant difference in three levels (P>0.05);② PIP: f had great effect on PIP (P<0.05);VT and I:E in three levels also had significant effect on PIP(P<0.01);③ P_(mean): all the ventilation parameters with different combination had significant effect on P_(mean)(P<0.01). Conclusions The best combination of respiratory parameters is A3B1C2, i.e., f=9 bpm, VT=8 mL/kg, and I:E=1:2.0, which indicates that neither small tidal volume and faster frequency, nor slow frequency large tidal volume is a good choice. In order to let obese patients under general anesthesia obtain the best lung protective effect by low airway pressure with good ventilation, it is worth noting that: ①I:E has a great effect on airway pressure (PIP, P_(mean)), which is important for lung protection;②I:E has the opposite effect on PIP and P_(mean).
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Objective To compare the postoperative recovery of vaginal and abdominal hysterectomies of non-prolapsed uterus ,in order to offer the advantages, surgical indications and contraindieations ,surgical characteristic and diflieuhy of transvaginal hysterectomies of non-prolapsed uterus. Methods To retrospectively analyze 480 cases transvaginal hysterectomies (TVH) and 440 cases transabdominal hysterectomies (TAH) with similar indications in the corresponding period, and compare the operation duration ,blood lost during the procedure, postoperative analgesic, morbidity, recovery time of the function of intestine, activity time of getting up and hospitalization between those surgi-ca] techniques. Results There were no intraoperation and postoperative complications in group TVH. In group TAH: more blood was lost(P <0.01) ,the function of intestine recovered more slowly(P <0.01) ,more analgesic needed, more morbidity noted (P < 0.01), activity time of getting up is much longer(P < 0.01). The hospital stay after opera-tion was much shorter in group TVH(P <0.01). No statistical difference was found between the two groups in terms of the duration(P 0.05). Conclusion TVH is minimal invasive surgery that include small trauma,reduced pain, no abdomen scar and quick recovery. So the patients are happy to accept it.
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AIM: To study the effect of wild-type p53 gene on the differentiation, apoptosis and expression of scavenger receptor CD36 in U937 cells. METHODS: Recombinant adenovirus vector with wild-type p53 gene was constructed and used to transfect U937 cells. With the expression of wild-type p53 gene following adenoviral infection, transfected U937 cells were largely promoted to differentiate into macrophages. RESUITS: Trypanblue-staining test demonstrated that the percentage of positive cells increased from (14.2±5.5)% to (64.6±9.2)% and nitroblue tetrazolium (NBT) reduction test reached similar results (6.3±1.8)% vs (49.7±12.6)%. Furthermore, CD36 mRNA was up-regulated as confirmed by RT-PCR. The increased expression level of CD 36 was also detected by flow cytometry analysis. CONCLUSION: These results suggest that wild-type p53 gene can affect U937 cells differentiation and apoptosis, up-regulate expression of scavenger receptor CD36. It may have a potential significance on atherogenesis.