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Objective To investigate the predictive value of depth of invasion (DOI) of tongue squamous cell carcinoma (TSCC) for cervical lymph node metastasis and prognosis. Methods We retrospectively analyzed the clinical and pathological data of 73 patients with T1/2 TSCC. ROC curve was used to determine the optimal cut-off value of DOI for predicting cervical lymph node metastasis, and logistic regression analysis was performed to analyze the related factors affecting cervical lymph node metastasis of TSCC. Kaplan-Meier method and Cox regression analysis were used for survival analysis. Results Among 73 patients, 18 patients were with lymph node metastasis and 55 patients were without lymph node metastasis. The median DOI with and without lymph node metastasis were 8.00 and 5.00 mm, respectively (P=0.003). The optimal cut-off value for DOI was 6.15 mm, with AUC 0.75 (95%CI: 64.1%~87.1%, P=0.001), sensitivity 77.8% and specificity 63.6%. DOI and pathological differentiation were independent prognostic factors for cervical lymph node metastasis in multivariate analysis. DOI, nerve invasion and pathological differentiation were independent prognostic factors of survival in Cox regression analysis. Conclusion DOI of TSCC patients has important predictive value for both cervical lymph node metastasis and prognosis. Neck lymph node dissection is recommended for patients with DOI > 6.15 mm to improve survival rate and reduce recurrence rate.
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Antiplatelet therapy is commonly used for the secondary prevention of embolic stroke of undetermined source (ESUS). However, the embolic source of ESUS is extremely heterogeneous, and the effect of antithrombotic therapy is different. This article describes the etiology and secondary prevention research progress of ESUS, in order to provide reference for clinical diagnosis and treatment.
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Objective To compare the effects of ticagrelor and clopidogrel on platelet aggregation rate, myocardial perfusion and prognosis in patients with acute myocardial infarction. Methods One hundred and sixty-nine patients with acute ST segment elevation myocardial infarction (STEMI) and emergency percutaneous coronary intervention (PCI) were recruited and randomly divided into ticagrelor group (85 cases) and clopidogrel group (84 cases). The TIMI blood flow before and after PCI was recorded, and the ST segment fall rate of 1 h ECG after PCI was calculated. The platelet aggregation rate was measured. After 12 months' follow-up, the incidence of major adverse cardiac events (MACE) was recorded. The Logistic regression analysis was used to discover the factors of MACE. Results One hundred and sixty-nine patients with acute STEMI were recruited including 85 cases treated with ticagrelor and 84 cases in clopidogrel group. The ECG ST segment fall rate after PCI in ticagrelor group was significantly higher than that in clopidogrel group: (61.3 ± 30.7)％ vs. (47.8 ± 26.6)％, P<0.05. The platelet aggregation rate 2 h, 24 h and 7 d after PCI in ticagrelor group was significantly lower than that in clopidogrel group (P<0.05). MACE occurred in 19 cases (22.4％) in ticagrelor group and in 21 cases (25.0％) in clopidogrel group, and there was no significant difference (P > 0.05). Multiple Logistic regression analysis revealed that age and ECG ST segment fall rate were independent risk factors for MACE (P<0.05). Conclusions Compared with clopidogrel, ticagrelor can effectively reduce platelet aggregation rate and accelerate ST segment fall in STEMI patients, but their long-term prognosis is similar.
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Objective@#To understand the relationship between perceived social support, psychological capital and job satisfaction, and analyze the mediating effect of psychological capital between perceived social support and job satisfaction.@*Methods@#In 2017, June to July, we use cluster random sampling method to evaluate 888 medical staff from 5 hospitals in Jinan and Yantai in Shandong provience by Perceived Social Support Scale、PsyCap Questionnaire and MinnesotaSatisfaction Questionnaire.@*Results@#Correlation analysis showed that perceived social support was significantly positively correlated with self-efficacy, hope, resilience, optimism and job satisfaction (r=0.42, 0.42, 0.56, 0.47, P<0.05) . There was a significant positive correlation between job satisfaction and self-efficacy, hope, resilience and optimism (r=0.45, 0.50, 0.43, 0.46, P< 0.05) . The structural equation model shows that hope and optimism play a significant partly mediating effect between perceived social support and job satisfaction.@*Conclusion@#Perceived social support is a positively predictive factor of job satisfaction in medical staff. The Increase of perceived social support and psychological capital are conducive to improving job satisfaction of medical staff's.
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PURPOSE: The characteristic expression of DNA damage response proteins in familial breast cancers with BRCA1, BRCA2, or non-BRCA1/2 mutations has not been analyzed in Chinese patients. Our study aimed to assess the differential expression of microcephalin 1 (BRIT1), ATM serine/threonine kinase (ATM), checkpoint kinase 2 (CHEK2), BRCA1, RAD51 recombinase (RAD51), and poly (ADP-ribose) polymerase 1 (PARP-1) and establish the profile of Chinese familial breast cancers with different mutation status. METHODS: We constructed five tissue microarrays from 183 familial breast cancer patients (31 with BRCA1 mutations; 14 with BRCA2 mutations, and 138 with non-BRCA1/2 mutations). The DNA response and repair markers used for immunohistochemistry analysis included BRIT1, ATM, CHEK2, BRCA1, RAD51, and PARP-1. The expressions of these proteins were analyzed in BRCA1/2 mutated tumors. The association between pathologic characteristics with BRCA1/2 mutation status was also analyzed. RESULTS: In familial breast cancer patients, BRCA1 mutated tumors were more frequent with high nuclear grade, estrogen receptor/progesterone receptor/human epidermal growth factor receptor 2 negative, low Ki-67, and positive CK5/6. BRCA1 mutated tumors had lower CHEK2 and higher cytoplasmic BRIT1 expression than BRCA2 and non-BRCA1/2 mutation tumors. BRCA2-associated tumors showed higher CHEK2 and cytoplasmic RAD51 expression than those in other groups. Nuclear PARP-1 expression in BRCA1/2-associated tumors was significantly higher than in non-BRCA1/2 mutation tumors. Moreover, we found quite a few of negative PARP-1 expression cases in BRCA1/2 mutated groups. CONCLUSION: The clinicopathologic findings of BRCA1-associated Chinese familial breast cancers were similar to the results of other studies. Chinese familial breast cancer patients with BRCA1/2 mutations might have distinctive expression of different DNA damage response proteins. The reduced expression of PARP-1 in Chinese BRCA1/2 mutated breast cancer patients could influence the therapeutic outcome of PARP-1 inhibitors.
Subject(s)
Humans , Asian People , Breast Neoplasms , Breast , Checkpoint Kinase 2 , Cytoplasm , DNA Damage , DNA Repair , DNA , Estrogens , Genes, BRCA1 , Genes, BRCA2 , Immunohistochemistry , Phosphotransferases , Rad51 Recombinase , ErbB ReceptorsABSTRACT
Subjective memory complaints (SMC) is increasingly recognized as the earliest prodromal stage of Alzheimer's disease.Individuals with SMC whose memory without measurable cognitive deficits,however,demonstrated some neurodegenerative brain changes.It would be more appropriate to prevent or postpone the AD process by interventing in this earlier stage of SMC,while relatively little is known about the brain plasticity in elderly with SMC.Therefore,further research is necessary in understanding the brain plasticity in SMC on the basis of further elucidating the pathophysiological mechanisms in this group of individuals.
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BACKGROUND: Because of the special structure of enamel fluorosis, the traditional bonding adhesives often lower the bonding strength and increase bracket loss rate, which affected the therapeutic effects seriously.OBJECTIVE: To observe the clinical bracket loss rate differences among the 3 different bonding adhesives in treating moderate and severe dental fluorosis.METHODS: A total of 15 cases (total 288 teeth) with dental fluorosis were selected, including 6 males and 9 females, aged 13-26 years. All cases were randomly divided into 3 groups, and treated by using Beijing-Tianjin enamel adhesive bonding brackets,photo-curing-flowable Resin + Single Bond 2 adhesive bonding brackets and a small amount of dental fluorosis of enamel surfaces were ground and bonding bracket, the loss rate of brackets were observed.RESULT AND CONCLUSION: The total loss rates of the Beijing-Tianjin-enamel adhesive bonding bracket group, photo-curing flowable resin + Single Bond 2 adhesive bonding bracket group, and a small amount of dental fluoresis of enamel surfaces were ground and bonding bracket group were 65.6%, 20.5%, and 2.5%, respectively. There was significant difference in bracket loss rate among bonding adhesives (P< 0.01). It suggested that a small amount of surface enamel were ground and bonding bracket got the best effect, followed by photo-curing fiowable resin + Single Bond 2 adhesive bracket bonding group, both of them were significantly better than the Beijing-Tianjin-enamel adhesive bracket bonding group. Because veneering directly requires to grind part of the tooth structure which is difficult to accept for some patients, therefore, under the premise of not destroying the tooth structure, using photo-curing fiowable resin + Single Bond 2 adhesive bonding of brackets instead of the traditional Beijing-Tianjin enamel adhesive bonding of brackets can effectively reduce the loss rate of brackets for moderate and severe dental fluorosis.
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BACKGROUND: Recently, with the increasing popularity of dental implant and orthognathic surgery, more and more people pay attention to the structure of mandibular canal and adjacent tissues. However, there are few reports addressing specimen measurements at home and abroad. OBJECTIVE: To measure the anatomical data of mandibular canal and adjacent tissue of mandible specimen to provide reliable reference data and anatomical evidence for alveolus surgery, tooth implantation, and orthognathic surgery. DESIGN, TIME AND SETTING: A controlled observation was performed at the Laboratory of Anatomy, Jilin Medical College between March 2007 and September 2007. MATERIALS: Twenty complete mandible specimens. METHODS: Sixteen adult, ex vivo mandibles with complete dentition and 4 edentulous mandibles were measured in every dental position of sagittal profile and posterior mental foramen in terms of molar, alveolar crest, and mandibular canal. Data were statistically analyzed. MAIN OUTCOME MEASURES: Mental foramen location, horizontal distance from anterior border of mental foramen to anterior border of mental canal, mandibular foramen location, distances from mandibular canal to molar root tip, lingual bone plate of mandible, inferior border of mandible, mandibular buccal bone plate, and alveolar ridge crest. RESULTS: Mandibular canal, located in the inferior region of the mandible body, ran towards the lingual side and was close to the inferior border of mandible and most close to the mandibular molar root tip. It turned towards posterolateral and buccal side in front of mental foramen and then passed through mental foramen. The distance of mandibular canal between edentulous mandible and alveolar ridge crest was obviously shortened. CONCLUSION: Multi-section observation and measurement of ex vivo mandible specimens provide precise, reliable evidence for preoperative design of orthognathic surgery, facilitate surgeons to better formulate surgical proposals, and prevent some complications, including intraoperative massive hemorrhage, interior alveolar nerve injury, mandibular angle fracture, and mental bone lateral wall perforation.