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Objective:To investigate the incidence and treatment of gastric cancer in 16 medical centers in Tianjin from 2020 to 2021.Methods:The retrospective and descriptive study was conducted. The clinical data of 3 122 gastric cancer patients who underwent surgery in 16 medical centers, including Tianjin Medical University Cancer Institute & Hospital, et al, in Tianjin from 2020 to 2021 were collected. There were 2 112 males and 1 010 females, aged (64±11)years. Observation indicators: (1) general data of patients; (2) treatment situations; (3) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were descri-bed as absolute numbers or percentages, and comparison between groups was conducted by the chi-square test. Results:(1) General data of patients. From 2020 to 2021, a total of 3 122 gastric cancer patients received surgeries in 16 medical centers in Tianjin, including 2 112 males and 1 010 females. There were 1 443 cases in 2020, including 976 males and 467 females, aged (63±11) years. There were 1 679 cases in 2021, including 1 136 males and 543 females, aged (65±11) years. Of the 3 122 pati-ents, cases in stage Ⅰ, Ⅱ, Ⅲ, Ⅳ were 696, 667, 1 466, 293, accounting for 22.293%(696/3 122), 21.365%(667/3 122), 46.957%(1 466/3 122), 9.385%(293/3 122), respectively. Cases with early gastric cancer, locally advanced gastric cancer, advanced gastric cancer account for 17.265%(539/3 122), 73.350%(2 290/3 122), 9.385%(293/3 122). There were 2 829 patients without distant metastasis and 293 patients with distant metastasis. For the 2 829 patients without distant metas-tasis, cases in stage T1, T2, T3, T4a, T4b accounted for 19.053%(539/2 829), 12.089%(342/2 829), 20.148%(570/2 829), 41.499%(1 174/2 829), 7.211%(204/2 829)respectively, cases in stage N0, N1, N2, N3 account for 37.328%(1 056/2 829), 16.331%(462/2 829), 15.836%(448/2 829), 30.505%(863/2 829). For the 293 advanced gastric cancer patients with distant metastasis, 190 cases had peri-toneal metastasis, 47 cases had lymph node metastasis, 27 cases had ovarian metastasis, 37 cases had liver metastasis, 14 cases had other metastasis (some patients had ≥2 distant metastases). (2) Treatment situations. ① For the 539 with early gastric cancer, cases undergoing endoscopic submu-cosal dissection, laparoscopic surgery, open surgery were 22, 150, 86 in 2020, versus 19, 212, 50 in 2021, showing a significant difference between them ( χ2=19.42, P<0.05). For the 498 patients with early gastric cancer who underwent laparoscopic or open surgery, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 25, 81, 30, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrec-tomy were 18, 309, 35, respectively, showing a significant difference between them ( χ2=40.62, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery and laparoscopic surgery were 446 and 617 in 2020, versus 410 and 817 in 2021, showing a significant difference between them ( χ2=17.75, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proxi-mal gastrectomy were 336, 377, 143, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 377, 920, 137, respectively, showing a significant difference between them ( χ2=89.64, P<0.05). Of the 293 patients with advanced gastric cancer, 175 cases underwent surgeries due to hemorrhage, stenosis, perforation, 76 cases under-went surgery after chemotherapy, 42 cases underwent surgery directly. ② For 756 cases of 3 122 pati-ents undergoing total gastrectomy, 357 and 4 cases received open digestive tract reconstruction including Roux-en-Y and other anastomosis, versus 380 and 15 cases with laparoscopic digestive tract reconstruction including Roux-en-Y and other anastomosis, showing a significant difference between them ( χ2=5.57, P<0.05). For 1 687 cases undergoing distal gastrectomy, 84, 160, 158, 55 cases received open digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, versus 154, 489, 417, 170 cases with laparoscopic digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, showing a significant difference between them ( χ2=10.90, P<0.05) . Of the 539 patients with early gastric cancer, 65 cases had lymph node metastasis, in which 18 of 306 stage T1a cases had lymph node metastasis and 47 of 233 stage T1b cases had lymph node metastasis. The number of detected lymph nodes for the 2 290 patients with advanced gastric cancer was 31±15, including ≥16 for 2 059 cases and ≥30 for 1 276 cases. Of the 3 122 patients, cases with neoadjuvant therapy, complete response and incomplete response was 128, 13 and 115 in 2020, versus 250, 49 and 201 in 2021, showing a significant difference between them ( χ2=5.51, P<0.05). (3) Postoperative complications. Of the 3 122 patients, 746 cases had postoperative complications, with an incidence of 23.895%(746/3 122). There were 62 patients with grade 3 or more complications. Reoperation was conducted in 34 patients. There were 14 cases of postoperative death. The duration of postoperative hospital stay and hospital expense were (11±5)days and (98 114±46 598)yuan for the 3 122 patients, (26±14)days and (122 066±68 317)yuan for cases with complications, (40±21)days and (196 926±12 747)yuan for cases with grade 3 or more complications. Conclusion:Compared with 2020, cases undergoing laparoscopic surgery and distal gastrectomy for gastric cancer in Tianjin increases in 2021, and the digestive tract reconstruction also differs. The number of patients with neoadjuvant chemotherapy and complete response rate for advanced gastric cancer increases.
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Mycoplasma capricolum subsp. capripneumoniae (Mccp) is the cause of contagious caprine pleuropneumonia (CCPP) in goats. Inactivated vaccines and capsular polysaccharide (CPS) indirect hemagglutination reagents are available for prevention and serological detection, but high culture costs and complex antigen quantification have been plagued by production staff. In order to solve these problems in production practice, a sugar fermentation medium with an initial pH value of 7.8, which could improve the production of two antigens simultaneously, was screened out by changing the initial pH value based on previous Mccp metabolomics analysis. Since phenol red can be identified by UV absorption spectrum and cetyltrimethylammonium bromide (CTAB) can bind to anionic capsular polysaccharide, a UV spectrum measurement method for analyzing the culture stage reached by Mccp and a CTAB precipitation test for relative quantification of capsular polysaccharide antigen content in the fermentation broth were established. The UV spectrum observation method can guide the production of Mccp according to the growth curve of Mccp, which greatly reduces the monitoring time of the traditional CCU method and improves the accuracy of the original eye-observation method. The established CTAB precipitation test can complete the monitoring of CPS content within 5 hours, which greatly reduces the time required compared with the traditional differential technique, and its accuracy was verified by the phenol-sulfuric acid method. The optimized culture medium and the two correlation comparison methods established in this study can effectively reduce the production cost of Mccp and improve the production efficiency. The two assays have been used in the research at our laboratory, which provides experimental data for further improvement of the production process of CCPP inactivated vaccine and capsular polysaccharide as well as rapid quantification.
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Humanos , Animales , Cabras , Cetrimonio , Mycoplasma , PolisacáridosRESUMEN
Objective:To explore the soft tissue composition underlying upper eyelid puffiness and the experience in treating it with tailor-made procedure during upper blepharoplasty.Methods:In a retrospective study from January 2017 to December 2018, 165 patients with upper eyelid puffiness underwent full-incision upper blepharoplasty. During the procedure, the anterior wall of orbital septum was exposed, and the volume of the retro-orbicularis oculus fat (ROOF) and preaponeurotic fat was observed. The orbital septum would be opened if lacrimal gland prolapse was suspected. The puffy upper eyelid would be targeted with tailor-made procedure such as partial ROOF resection, removal or transposition of the preaponeurotic fat, as well as lacrimal gland refixation.Results:All 165 cases were healed by first intention. No relapse was found after a 6 to 24 months follow-up. Persistent mild pain and local skin tightness epiphora chemosis were presented in isolated cases with self-resolution within a short time. There were no severe adverse reaction or complications occurred during the operation and follow-up.Conclusions:The tailor-made procedure during upper blepharoplasty targets the soft tissue anatomy underlying upper eyelid puffiness. It is safe and effective in maintaining a natural look of upper eyelids while retaining the appropriate amount of adipose tissue in the upper eyelid.
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In October 2017, a female patient, 3 years and 5 months of age, with Crouzon syndrome, associated with multiple craniosynostoses was admitted to Plastic Surgery Hospital. Combined intracranial and extracranial approaches of fronto-orbital advancement and cranial suture release were performed to treat plagiocephaly and scaphocephaly. The patient′s families were investigated. Corresponding mutations were detected by DNA sequencing. Therapeutic effect was satisfactory. The mutation was inherited for 5 generations. Genomic sequencing results showed that the exons of fibroblast growth factor receptor 2 gene in the child was mutated, which excessively activated downstream signals and caused craniosynostosis.
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Objective@#To evaluate the clinical outcomes of a series of patients who have undergone reconstruction of craniofacial defects after resection of intracranial tumors or craniofacial trauma with free composite anterolateral thigh flaps.@*Methods@#Retrospective analyses the clinical cases from September 2007 to September 2016. Data included flap survival rate, complication, satisfaction survey was reviewed to evaluate the efficacy and safety of this surgical strategy.@*Results@#Totally 10 free anterolateral thigh flaps including 3 cases of fasciocutaneous flaps, 2 case of adipofascial flaps, 4 cases of myocutaneous flaps, 1 case of chimeric flap, were adopted to reconstruct craniofacial defects. Follow-up ranged from 3 to 17 months (average, 12 months). All flaps were transferred successfully. There were no cranial spinal fluid(CSF) leaks, intracranial infections or donor site complications. All patients were satisfied.@*Conclusions@#Because of its abundance of tissue, matched vessels to recipient site, versatility of muscular flaps to fill irregularly intracranial defects, reliable blood supply, feasibility of simultaneous fascia lata harvesting, free composite anterolateral thigh flap is the reconstructive method of choice for craniofacial defects reconstruction after resection of intracranial tumors or craniofacial trauma. The use of ALT flap was reliable in the decrease of CSF leak and infection rate and dependable according to long time follow-up.
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Objective To study the correlation between status of methylation of DKK3 gene promoter and expression of its mRNA in gastric cancer.Methods Methylation of DKK3 gene promotor and its mRNA expression in 76 gastric cancer specimens and paired adjacent non-cancerous tissues were detected by methylation-specific PCR(MSP) and RT-PCR respectively.Results The expression of DKK3 mRNA in gastric cancer tissues was lower than that of adjacent non-cancerous tissues (43％ vs.60％,x2 =5.663,P =0.017).29 cases had methylation of DKK3 gene promoter for adjacent non-cancerous tissues.In gastric cancer tissues,however,44 cases had methylation of DKK3 gene promoter (38％ vs.58％,x2 =19.405,P =0.000).There were significant difference in depth of invasion (P =0.014),TNM stage (P =0.032),pathological grading (P =0.016) and lymphatic metastasis (P =0.007).There was distinct negative correlation between methylation of DKK3 gene promoter and expression of its mRNA (x2 =64.286,P =0.000).Conclusions Abnormal methylation of DKK3 gene promoter is an important mechanism of its inactivation,and might play an important role in carcinogenesis and progression of gastric cancer.
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Objective To discuss a surgical treatment to correct prominent mandibular angle with long chin.Methods From July 2015 to October 2017,21 patients with malocclusion who suffered from prominent mandibular angle with long chin underwent en-bloc mandibular U-shaped osteotomy through oralincision in order to shorten mandibular angle,the body of mandible and the chin and to improve the facial contour.We assessed the surgical effect through comparison of radiologic images,satisfaction of patients and surgical complications between pre-operation and post-operation.Results In this group,all oral incisions had healing by first intention,without hematoma,infection and osteonecrosis.Low lip numbness occurred in 16 patients.After following up for 6-12 months,the lower lip numbness was recovered in 14 patients and relieved in 2 patients.All patients satisfied with the appearance after the operation.Conclusions En-bloc mandibular U-shaped osteotomy is an improvement for mandible surgery treatment.Its osteotomy line involves the whole mandible,which makes the length and width of mandible smaller apparently.This procedure can effectively correct prominent mandibular angle with long chin.
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Objective To study the expression of DKK3 protein and mRNA levels in gastric cancer and its correlation with the clinical prognosis of gastric cancer.Methods The expression of DKK3 protein in 158 gastric cancer specimens and paired adjacent non-cancerous tissues were detected by immunohistochemistry.The relationship between the protein expression and clinicopathological features was analyzed.Immunoblotting and real time quantitative PCR were used to examine the expression of DKK3 protein and mRNA levels in 76 paired fresh gastric cancer and adjacent non-cancerous tissues.Results The expression of DKK3 in gastric cancer tissues was lower than that in adjacent non-cancerous tissues (40.5％ vs.55.1％,x2 =41.442,P =0.000).DKK3 protein and mRNA levels in 76 cases were lower than that in adjacent non-cancerous tissues (1.096 ± 1.110 vs.3.476 ± 1.119,t =3.332,P =0.017;1.136 ± 1.013 vs.3.314 ± 1.105,t =2.673,P =0.022).There were close correlations between DKK3 expression and depth of tumor invasion (P =0.006),TNM stage (P =0.005) and lymphatic metastasis (P =0.009).The expression of DKK3 in gastric cancer was positively related with overall survival rate (47.4％ vs.28.0％,P =0.011),as an independent prognosis predictor (P =0.016).Conclusions DKK3 is an independent prognostic factor of gastric cancer,its decreased expression is significantly related with shortened survival time of gastric cancer patients.
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Objective To evaluate the significance of serum 8-hydroxy-deoxyguanosine acid ( 8-OHdG) in the diagnosis of nonalcoholic steatohepatitis ( NASH).Methods Patients or healthy subjects were enrolled at the Second Hospital of Tianjin Medical University and the Second People ′s Hospital of Tianjin from May 2013 to December 2015.A total of 41 patients with nonalcoholic fatty liver disease were enrolled in the study , including 20 nonalcoholic simple fatty liver ( NAFL) patients and 21 NASH patients whose diagnosis were proven by liver biopsy.The other 32 healthy subjects were studied as controls.Serum 8-OHdG, ALT, AST and GGT were tested.Nonalcoholic fatty liver disease activity score ( NAS ) and expression of 8-OHdG in liver was investigated between NAFL patients and NASH patients.The correlations between serum 8-OHdG and serum ALT , AST, GGT, and 8-OHdG in liver tissue in NASH group were investigated.In addition , the receiver operating characteristic ( ROC) curve analyses for ALT and 8-OHdG levels were performed in NAFL patients and NASH patients , and the cut-off value was determined.Results Serum 8-OHdG values in healthy controls , NAFL and NASH patients were (0.19 ±0.16) μg/L, (0.22 ±0.16) μg/L, (0.42 ±0.21) μg/L respectively.The serum 8-OHdG and serum ALT, GGT and 8-OHdG in liver tissue were all positively correlated in NASH group with respective correlation coefficient r values as 0.454 7, 0.382 9, and 0.497 6.AUC of 8-OHdG was 0.901 with cut-off value 0.39 μg/L.Its sensitivity was 88.3%and specificity was 81.5%, which were higher than those of ALT.Conclusion The value of serum 8-OHdG would be used as a marker for the diagnosis of NASH.
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Objective To investigate clinical characteristics and treatment of upper eyelid lipogranuloma cases that developed after facial autologous fat injection.Methods This retrospective study involved 8 patients who presented with upper eyelids symptoms (final diagnosis of lipogranulo ma) and had history of facial autologous fat injection.The collected data included information on patient sex,age,clinical presentation,laboratory findings,treatment and outcome.Results All 8 cases were managed by exploration and surgical removal through double eyelid surgery.All patients showed complete resolution over 1-12 months follow up period.Conclusions Lipogranuloma can develop in the upper eyelid after autologous fat injection into the face.and surgical removal can yield satisfactory outcomes in cases of repeated failure of conservative therapies.
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Objective To evaluate the impact of preoperative prognostic nutritional index (PNI) on surgical outcomes and long-term survival of elderly patients with gastric cancer.Methods From Jan 2007 to Dec 2012,the clinicopathological data of 165 elderly patients (age ＞ 65 years old) with gastric cancer undergoing radical gastrectomy in the Second Hospital of Tianjin Medical University were analyzed retrospectively.PNI value was calculated by serum albumin (g/L) + 5 × lymphocyte count (× 109/L).The receiver operating characteristic (ROC) curve and Youden index was used to determine the cut-off value of PNI.Patients were then divided into low PNI group and high PNI group based on the cut-off value.The two groups were compared according to clinicopathological characteristics,postoperative complication and longterm survival.Results The mean PNI value was 46.1-± 5.3,When the PN1 was 46.4,the Youden index was maximal,with a sensitivity of 78％ and specificity of 59％.There were 79 patients in the low PNI group and 86 patients in high PNI group.No significant correlations between PNI and gender,age,BMI,pathological type,tumor diameter,extranodal metastasis and postoperative morbidity were observed.There were significant difference in the depth of invasion (x2 =6.732,P =0.009),N stage(x2 =13.191,P =0.004),TNM stage(x2 =12.137,P =0.000) and postoperative hospital stay (t =4.595,P =0.000).By Kaplan-Meier method,PNI (P =0.000),depth of invasion (P =0.002),N stage (P =0.000),TNM stage(P =0.000) and extranodal metastasis (P =0.031) had significant impacts on overall survival.PNI (P =0.016)and N stage (P =0.018) were independent factors for predicting overall survival rate.Conclusions PNI helps in evaluating preoperative nutritional status and postoperative prognosis for elderly patients with gastric cancer.
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Objective To evaluate the surgical outcomes in octogenarians and older of gastric cancer and to identify the reasonable therapy for these patients.Methods From Jan 2000 to Dec 2010,the clinicopathological data of 533 patients with gastric cancer undergoing gastrectomy were analyzed retrospectively.We conducted comparative analysis for the differences in clinicopathological characteristics and prognosis between 80 years and older (≥80 y,n =75) and younger (＜ 80 y,n =458).Results There were significant differences in comorbidities,anemia and histological type between the two groups.There was no significant difference in operative morbidity and mortality between the two groups.The 5-year survival rate for octogenarians was lower (21.1％) than nonoctogenarians (32.8％),but with no significant difference.TNM stage was the only independent prognostic factor for gastric cancer in octogenarians.Conclusions Older gastric cancer patients have comparative postoporative complication rate and survival with younger patients.
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Objective To detect the level of serum fragmented cytokeratin 18 (CK-18 M30) in patients with nonalcoholic steatohepatitis (NASH), to explore the relationship between the expression of CK-18 M30 and NASH. Methods 33 healthy people as control group, 24 nonalcoholic simple fatty liver (NAFL) patients, and 21 NASH patients were included in this study. CK-18 M30, ALT, AST and GGT were detected in all patients’ vein blood. NAFLD activity points (NAS) was examined in biopsy specimens of NAFL patients and NASH patients. Pearson correlation was applied to analyze the correlations between serum CK-18 M30, ALT, AST, GGT and the NAS of liver tissue in NASH group. Results Serum CK-18 M30 level of healthy control, NAFL and NASH group were (96.557 2 ± 41.226 8)U/L, (104.321 7 ± 45.167 3)U/L, (263.125 5 ± 61.578 1)U/L respectively. Serum CK-18 M30 level in NASH patients positively correlated with both NAS of liver tissue and serum ALT, which correlation coefficient r values were 0.601 5 and 0.420 6. Conclusion The concentration of serum CK-18 M30 could be used as a marker in the diagnosis of NASH.
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BACKGROUND:Previous studies of our research group have confirmed that the texture of porcine reticular dermis at lateral ventral part is softer and has more extensibility than other parts. Therefore, it may serve as the raw material of xenogenic aceluar dermal matrix. However, its comparison with human and rat reticular dermis has not been reported systematicaly in aspects of histomorphology and material characterization. OBJECTIVE:To compare the reticular dermis from the lateral region of porcine abdomen and rat dorsal part with the reticular dermis from human in histology, biomechanics, molecular structure, thermal stability and other properties. METHODS:The reticular dermis samples were taken from adult human, the lateral region of porcine abdomen, the back of rats, for gross observation. Paraffin sections were observed by hematoxylin and eosin staining and sirius red staining under a light microscopy. The relevant data of micrograph were measured by imagine analysis software. These samples were also vacuum-freezing dried and rehydrated, and then their mechanical properties were tested with a electronic tensile machine to calculate the Young’s modulus. Some vacuum-freezing dried samples were powdered and detected by Fourier transform infrared spectrometer and simultaneous thermal analyzer. RESULTS AND CONCLUSION:There were no differences in colagen fiber bundle diameter of the reticular dermis from adult human and the lateral region of porcine abdomen, but the reticular dermis from the back of rats was thinner than that from adult human (P 0.05). There was no significant difference in the Young’s modulus of the three kinds of reticular dermises. Hydrogen bonds involved in the reticular dermal colagen molecules ranged as folows: rats > swine > human. Rat reticular dermis has better thermal stability than that of swine and adult human.
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Objective To investigate the expression and significance of MMP-9 and Ki67 for predicting the progres-sion and prognosis of pancreatic cancer. Methods S-P immunohistochemical method was used to detect the expressions of MMP-9 and Ki67 in 100 pancreatic cancer tissue specimens. The relationship between the expressions of MMP-9 and Ki67 and patient age, tumor size, lymph node metastasis, tumor differentiation, clinical stages and prognosis were analyzed. Re-sults There were higher expressions of MMP-9 protein 46%(46/100) and Ki67 protein 53%(53/100) in 100 samples of pancreatic adenocarcinoma. And the expressions of MMP-9 and Ki67 were inversely associated with tumor differentiation, clinical stages, and lymph node metastasis of pancreatic cancer (P＜0.05). There were no significant differences in the ex-pressions of MMP-9 and Ki67 between patient age and tumor size. The expressions of MMP-9 and Ki67 were positive corre-lated (rs=0.405,P＜0.05). Moreover, the overall survival rates were correlated with patient age, lymph node metastasis, tumor differentiation and the expression of MMP-9, but no correlation with tumor size, clinical stages, and the expression of Ki67. Conclusion The expressions of MMP-9 and Ki67 were associated with pancreatic cancer progression. And the detection of expression of MMP-9 may have practical value in prognosis in patients with pancreatic cancer.
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<p><b>OBJECTIVE</b>To explore the influence of recombinant human growth hormone (rhGH) on the apoptosis and intestinal mucosal structure in severely scalded rats.</p><p><b>METHODS</b>Thirty male Wistar rats were randomly divided into three groups, i.e. control, scalding and rhGH groups. The rats in scalding and rhGH groups were inflicted with 25% TBSA III degree scalding on the back and immediately followed by intraperitoneal injection of dexamethasone (80 mg/kg). The scalded rats were administered with normal saline and rhGH (1.33 IU.kg(-1).d(-1)) since 2 postburn hours (PBHs), respectively in the last two groups. The changes of the apoptosis rate, the intestinal mucosal proliferative index (PI) and epithelial ultrastructure and the intestinal mucosal pathomorphology of the distal end of ileal mucosal tissue were observed on 30 and 96 PBHs.</p><p><b>RESULTS</b>The intestinal mucosa morphology and epithelia in scalding group were severely injured but were significantly ameliorated by rhGH to near those in control group. The PI in rhGH and scalding groups at 30 PBHs was evidently higher that that in control group (P < 0.05 - 0.01). But the PI exhibited no obvious difference between scalding and rhGH groups. While the PI in rhGH group at 96 PBHs was obviously higher than that in both scalding and control groups (P < 0.01). The intestinal mucosal epithelial apoptotic rate in scalding group was significantly higher than that in control group (P < 0.01), while that in rhGH group was evidently lower than that in scalding and control groups (P < 0.05 - 0.01).</p><p><b>CONCLUSION</b>rhGH could promote postburn intestinal mucosa epithelial proliferation in slow - action manner and inhibit intestinal mucosal epithelial apoptosis with rapid and obvious effects. As a result, the intestinal mucosal epithelial injury could be ameliorated by rhGH by means of its inhibiting roles and the normal morphological structure of intestinal mucosa was maintained ad hoc.</p>