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Objective: To explore the value of nanoparticles (CN) in lateral cervical lymph node mapping in papillary thyroid carcinoma using carbon. Methods: Thyroid cancer patients with suspicious lymph node metastasis but without typical signs of metastatic disease from March 2016 to November 2017 in Fudan University Shanghai Cancer Center were prospectively included in the cohort. Neck dissection was performed in all patients (compartmentsⅡ-Ⅴ). Suspicious lateral lymph node metastasis was identified using pre-operative ultrasound or computed tomography. CN were used for lymph node mapping during surgery. Results: A total of 70 surgeries were performed in 67 patients, among which 57 were found to have lateral lymph node metastasis (81.4%). The median number of CN-dyed lateral lymph nodes was 6. Compartment IV had the highest number of CN-dyed positive lymph nodes as well as the highest rate of metastasis, followed by compartmentⅢ. In compartmentsⅢandⅣ, the incidence of lymph node metastasis was significantly higher in the CN-dyed group than in the CN-undyed group (P<0.001). When the final pathology of neck dissection was set as the gold standard, lateral CN-dyed lymph node biopsy was found to have a sensitivity of 86.0%; its negative predictive value was 61.9% and its overall accuracy was 88.6%. Conclusions:Injection of CN during surgery was a potential method of mapping lateral lymph nodes in papillary thyroid carcinoma. CompartmentⅢ-ⅣCN-dyed lymph node biopsy had a satisfactory sensitivity and thus, served as a reasonable range for lymph node biopsy.
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Objective To evaluate the reliability of the inhibitor enhanced carbapenem inactivation method (ieCIM) in the detection and preliminary classification of carbapenemase in gram-negative rods.Methods The carbapenem inactivation method (CIM) was modified by adding tazobactam or ethylene diamine tetraacetic acid disodium salt as carbapenemase inhibitors into the reaction system.A total of 198 isolates of Enterobacteriaceae and 35 strains of nonfermenters were collected,and their preliminary classification of carbapenemase was performed by the ieCIM.Meanwhile,their carbapenemase genes were detected by polymerase chain reaction (PCR),and the results were compared with that of the ieCIM.Results Among 198 strains of Enterobacteriaceae,101 were positive for carbapenemase genes,while 99 were detected by the CIM.Among the other 97 strains with negative carbapenemase gene,the results of the ieCIM were also negative.Among 35 strains of nonfermenters,25 were positive for carbapenemase genes,while 24 were detected by the CIM.Among the other 10 strains with negative carbapenemase gene,the results of the CIM were also negative.Using the ieCIM,97.7％ (85/87) of strains producing class A carbapenemase and 88.0％ (22/25) of strains producing class B carbapenemase were detected.Twelve strains producing class D carbapenemase and 2 strains producing both class A and class B carbapenemase were detected by the ieCIM.The total detection sensitivity and specificity of the ieCIM were 96％ and 100％,respectively.Conclusion The ieCIM has the consistent results with the detection method of carbapenemase genes,which may be used to detect and classify carbapenemase in clinical microbiology laboratories.
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Objective@#To investigate the rationality of management of active surveillance for papillary thyroid microcarcinoma (PTMC) and the main indications for active surveillance for PTMC.@*Methods@#In this study, two criteria were used to evaluate patients with PTMC: low-risk PTMC conditions defined by Kuma hospital and Chinese Association of Thyroid Oncology (CATO) consensus on PTMC management of active surveillance. The patients had received surgical treatment. Clinicopathological characteristics and prognosis of the patients in different groups were compared.@*Results@#A total of 778 patients were enrolled in the study, 565 (72.6%) of them met Kuma screening criteria and only 112 (14.4%) met CATO screening criteria. Kuma low-risk subgroup had lower incidence of cervical lymph node metastasis than Kuma high-risk PTMC subgroup(30.6% vs 47.9%, P<0.05). There were significant differences in multifocal lesions(6.3% vs 16.4%), extrathyroidal extension (1.8% vs 7.5%) and cervical lymph node metastasis(19.6% vs 38.0%) between low-risk and high-risk CATO PTMC subgroups. Patients in the CATO low-risk PTMC subgroup had lower recurrence and longer disease-free survival (DFS) than those in the CATO high-risk PTMC subgroup. But there was no significant difference in recurrence or DFS between Kuma low-risk and high-risk Kuma PTMC subgroups.The Chi-square test of Fisher′s exact probabilities test was used to compare clinicopathological characteristics of patients between different groups.Rates of disease-free survival were calculated using the Kaplan-Meier method.@*Conclusion@#CATO screening criteria is relatively strict and may be more suitable for Chinese patients with active surveillance for PTMC.
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Objective To investigate the application value of nasopharyngeal airway combined with polysom-nography in positing relieve airway obstruction before surgery for patients with obstructive sleep apnea-hypopnea syn-drom(OSAHS).Methods 69 patients with OSAHS were underwent consecutive 3 nights of sleep monitoring.At first night,the polysomnography figures were detected by using 36 polysomnography.At second night,patients were wearing nasopharyngeal airway all night and undergoing polysomnography figure monitoring.At third night,the airway pressures were measured by using ApneaGraph sleep monitoring and obstructive positioning system.The indicators of AHI, LSaO2 ,SaO2 and SaO2 <90% T before and after wearing nasopharyngeal airway were compared.The patients were divided into the treatment success group(S group)and treatment failure group(F group),according to AHI change before and after wearing nasopharyngeal airway.The indicators of the two groups were compared.The AHI in the lower part and proportion of lower portions blocking in the total congestion events under the ApneaGraph monitoring system were analyzed.Results 69 patients were successfully implanted nasopharyngeal airway,without nasal trauma,nasal bleeding,etc.63 cases of patients(91.3%)were well tolerated.The AHI and SaO2 <90% T at second night were lower than the first night,while LSaO2 and SaO2 were higher than the first night,the differences were statistically significant(t =13.811,13.307,10.852,4.277,all P <0.05).45 cases(71.4%)were in S group and 18 cases (28.6%)were in F group.LSaO2 in S group was higher than F group,while the lower AHI and lower portions blocking ratio were lower than F group,the differences were statistically significant(t =2.534,14.925,9.541,all P <0.05).Pearson correlation analysis showed the AHI at second night were positive correlated with the lower AHI and lower portions blocking ratio at third night(r =0.638,0.510,all P <0.05).Conclusion Nasopharyngeal airway combined with polysomnography could locate the overnight airway obstruction sites of OSAHS patients,and could be used as a simple base for locating before surgery for relieving upper airway obstruction.
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ObjectiveThe aim of this study was to evaluate and compare the surgical outcomes of endoscop ic and conventional open thyroidectomies in patients with thyroid disease.Methods116 patients with tyroid tumor were enrolled.56 patients underwent endoscopic thyroidectomy ( endoscopic group ),and 60 patients underwent conventional open thyroidectomy( conventional group).We analyzed the patients' clinic characteristics,surgical outcomes and complications between the two groups.ResultsThe blood loss was less in the endoscopic group than the open group[( 16.8 ± 9.6) ml vs ( 24.9 ± 14.2 ) ml,t =- 2.427,P ＜ 0.05].The degree of satisfaction for cosmetic outcome in endoscopy group( 96.4％ ) was higher than that in conventional group ( 16.7％ ) ( x2 =74.508,P ＜ 0.01 ).There was no significant difference in the operating time,volume of drainage and postoperative hospital stay between two groups,and there was no significant difference in the skin ecchymosis,redness and swelling and postoperative pain between two groups( all P ＞ 0.05).No severe postoperative complication was encountered,such as injuries of the re current or superior laryngeal nerve,parathyroid gland injury or massive hemorrhage.ConclusionEndoscopic thyroidectomy has less blood loss,mini-open and excellent cosmetic benefits compared with conventional open thyroidectomy.
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Objective To investigate the expressions of Smad3 and Smad7 in patients with ulcerative colitis(UC)and their relation with clinicopathology.Methods The expressions of Smad3 and Smad7 were measured by immunohistochemistry with SABC method in 60 UC specimens and 16 normal colonic tissues.The association of expressions of Smad3 and Smad7 proteins with clinical staging,lesion extent and pathologic grading were retrospectively analyzed.Results The expression of Smad3 was significantly lower in UC patients than in normal controls(P＜0.05),however,there was no relation between Smad3 expression and lesion extent(P＞0.05).There was a negative correlation between the expression of Smad3 and histological grade(r=-0.283,P＜0.05).The expression of Smad7 was significantly higher in UC patients than in normal controls,and its expression in active disease was higher than that in clinical remission(Z=2.097,P=0.036).There was a positive correlation between the expression of Smad7 and histological grade(r_s=0.453,P=0.000),and no relation between Smad7 expression and lesion extent(r_s=0.066,P=0.614).The statistical analysis showed a negative correlation between Smad3 expression and Smad7 expression(r=-0.420,P＜0.05).Conclusion The abnormal expressions of Smad3 and Smad7 are correlated with pathogenesis of UC.Furthermore.Smad7 may serve as marker for disease activity of UC.
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AIM:To investigate the construction of oligonucleotide microarray specialized for pancreatic adenocarcinoma-associated genes and its preliminary application of detecting differential expressed genes in pancreatic cancer.METHODS:Pancreatic cancer related genes were purposely selected,and oligonucleotide microarray was prepared by spotting oligonucleotide probes on glass slides coated with APS-PDC.Labeled cDNA targets for hybridizations were synthesized by reverse transcription from total RNA in the presence of Cy5-dCTP and Cy3-dCTP,respectively.Hybridized microarray was scanned by Agilent laser scanner,and the aquired image was analyzed by Imagene3.0 software.The intensity ratios of Cy3 and Cy5 were calculated.To confirm the expression profiles of these genes,quantitative reverse transcription-PCR (QRT-PCR) was carried out for CDC25B and TUSC3 genes,and β-actin gene was taken as internal control.The product of PCR was quantitated by comparative Ct method.RESULTS:The signal of microarray hybridization was clear,and the images had a lower background and higher signal-noise ratio.In comparison with normal pancreas,twenty -four differentially expressed genes were identified which included seventeen up-regulated and seven down-regulated genes.The results of QRT-PCR demonstrated that the expressions of CDC25B and TUSC3 in pancreatic cancer were up-regulated and down-regulated respectively,which is consistent with microarray results.CONCLUSION:The oligonucleotide microarray specialized for pancreatic cancer is desirable for its specialty and sensitivity,which can simultaneously and parallelly detect multiple pancreatic cancer-associated genes.