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ABSTRACT Purpose: This study aims to evaluate the safety and efficacy of ultrasound-guided balloon dilation compared to non-balloon dilation for percutaneous nephrolithotomy (PCNL). Materials and methods: A systematic review and meta-analysis were conducted by searching PubMed, EMBASE, and the Cochrane Library. Results were filtered using predefined inclusion and exclusion criteria as described and meta-analysis was performed using Review Manager 5.4 software. Results: A total of six studies involving 1189 patients who underwent PCNL were included. The meta-analysis results demonstrated that compared to non-balloon dilation, balloon dilation was associated with reduced haemoglobin drop [mean difference (MD) = -0.26, 95% CI = -0.40 ~ -0.12, P = 0.0002], decreased transfusion rate [odds ratio (OR) = 0.47, 95% CI = 0.24 ~ 0.92, P = 0.03], shorter tract establishment time (MD = -1.30, 95% CI = -1.87 ~ -0.72, P < 0.0001) and shorter operation time (MD = -5.23, 95% CI = -10.19 ~ -0.27, P = 0.04). Conclusions: Overall, ultrasound-guided balloon dilatation offered several advantages in PCNL procedures. It facilitated faster access establishment, as evidenced by shorter access creation time. Additionally, it reduced the risk of kidney injury by minimizing postoperative haemoglobin drop and decreasing the need for transfusions. Moreover, it enhanced the efficiency of surgery by reducing the operation time. However, it is important to note that the quality of some included studies was subpar, as they did not adequately control for confounding factors that may affect the outcomes. Therefore, further research is necessary to validate and strengthen these findings.
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Objective@#To discuss the possible etiology, pathogenesis, clinical features, diagnosis and treatment of epidermoid cysts of the jaw and to provide a reference for clinical diagnosis and treatment.@*Methods@#A case of an epidermoid cyst in the right mandible with retained deciduous teeth and succedaneous impacted teeth was reviewed and analyzed in combination with the relevant literature.@*Results@#A patient presented with a mass in the right mandible that had persisted for 1 month after being found at imaging examination. Tooth 83 was retained, and tooth 43 was unerupted. Swelling was characterized by no obvious tenderness, fluctuation, or table tennis sensation and was observed in the lingual alveoli of teeth 83, 44, and 45. Imaging revealed a low-density shadow in the apex of teeth 83, 44, 45, and 46, approximately 1.9 cm × 2.6 cm × 1.6 cm in size, which wrapped around the dental crown of tooth 43. Preliminary diagnoses were as follows: right mandibular mass thought to be a dentigerous cyst; impacted tooth 43; and retained primary tooth 83. The mass in the right mandible was removed, and teeth 43 and 83 were extracted under intravenous and inhalation anesthesia. During the operation, the mass was observed to have a thin cyst wall and contained bean-like residue. Histopathological examination indicated an epidermoid cyst in the right mandible. At the 1-week follow-up examination, the patient reported no discomfort, and the surgical area showed good recovery. According to the literature, epidermoid cysts are benign cysts originating from ectopic ectodermal tissue that can occur throughout the body but rarely in the oral cavity and are even extremely rarer in the jaw. Epidermoid cysts of the jaw, which have no specific clinical manifestations, can be confused with odontogenic cysts such as dentigerous cysts and odontogenic tumors. Dental pulp tests and other techniques can serve as a reference for clinicians. The diagnosis is confirmed via histopathology. Surgical removal is a common treatment, with a good prognosis and a low recurrence rate.@*Conclusion@#The principle of treatment for an epidermoid cyst of the jaw is similar to that for a jaw cyst. The prognosis is good when the cyst is removed completely.
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Abstract Background Osteoarthritis (OA) is one of the most frequent chronic diseases with high morbidity worldwide, marked by degradation of the cartilage and bone, joint instability, stiffness, joint space stenosis and subchondral sclerosis. Due to the elusive mechanism of osteoarthritis (OA), we aimed to identify potential markers for OA and explore the molecular mechanisms underlying OA. Methods Expression profiles data of OA were collected from the Gene Expression Omnibus database to identify differentially expressed mRNAs (DEmRNAs) and differentially expressed lncRNAs (DElncRNAs) in OA. Functional annotation and protein-protein interaction (PPI) networks were performed. Then, nearby DEmRNAs of DElncRNAs was obtained. Moreover, GO and KEGG pathway enrichment analysis of nearby DEmRNAs of DElncRNAs was performed. Finally, expression validation of selected mRNAs and lncRNAs was performed by quantitative reverse transcriptase-polymerase chain reaction. Results In total, 2080 DEmRNAs and 664 DElncRNAs were determined in OA. PI3K-Akt signaling pathway, Endocytosis and Rap1 signaling pathway were significantly enriched KEGG pathways in OA. YWHAB, HSPA8, NEDD4L and SH3KBP1 were four hub proteins in PPI network. The AC093484.4/TRPV2 interact pair may be involved in the occurrence and development of OA. Conclusion Our study identified several DEmRNAs and DElncRNAs associated with OA. The molecular characters could provide more information for further study on OA.
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ABSTRACT Introduction: Youngsters are an important source of reserve strength among short-speed skaters, so it is necessary to perform special strength training for young lower limb muscles while improving athletes' endurance and physical function. Objective: Study the systematic development of physical training of speed skating athletes. Methods: The author uses the method of experimentation and mathematical statistics, the first level male athletes were selected as experimental objects, and the double-blind test method was used to conduct a comparative study through experiments. Results: Statistically, the T-test considerations of the control and experimental groups in the unipodal take-off stand and bilateral sliding jump tests showed statistical differences (P>0.05). The comparison of the experimental group pre and post-intervention indicates that the experimental group's performance in this test item increased significantly after training(P<0.05). Conclusion: The adaptation of the entry-level trainers to the scientific training concept played an auxiliary role in the results by increasing the emphasis on small muscle group training. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: Os jovens são uma importante fonte de força de reserva entre os patinadores de velocidade curta, portanto é necessário realizar um treinamento de força especial para os jovens músculos dos membros inferiores, melhorando ao mesmo tempo a resistência e a função física dos atletas. Objetivo: Estudar o desenvolvimento sistemático do treinamento físico dos atletas de patinação de velocidade. Métodos: O autor utiliza o método de experimentação e estatística matemática, foram selecionados como objetos experimentais os atletas do primeiro nível masculino, e o método de teste duplo-cego foi utilizado para conduzir um estudo comparativo através de experimentos. Resultados: Estatisticamente, as considerações do teste T do grupo de controle e do grupo experimental no suporte de decolagem unipodal e teste bilateral de salto deslizante apresentaram diferença estatística (P>0,05). A comparação do grupo experimental pré e pós intervenção indica que o desempenho do grupo experimental neste item de teste aumentou significativamente após o treinamento(P<0,05). Conclusão: A adaptação dos treinadores de nível básico para o conceito de treinamento científico desempenhou um papel auxiliar nos resultados, aumentando a ênfase no treinamento dos pequenos grupos musculares. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: Los jóvenes son una importante fuente de reserva de fuerza entre los patinadores de velocidad corta, por lo que es necesario realizar un entrenamiento de fuerza especial para los músculos de las extremidades inferiores de los jóvenes, mejorando al mismo tiempo la resistencia y la función física de los atletas. Objetivo: Estudiar el desarrollo sistemático de la preparación física de los atletas de patinaje de velocidad. Métodos: El autor utiliza el método de la experimentación y la estadística matemática, se seleccionaron atletas masculinos de primer nivel como objetos experimentales, y se utilizó el método de prueba de doble ciego para realizar un estudio comparativo a través de experimentos. Resultados: Estadísticamente, las consideraciones de la prueba T del grupo de control y del grupo experimental en la prueba de despegue unipodal y de salto deslizante bilateral mostraron diferencias estadísticas (P>0,05). La comparación del grupo experimental antes y después de la intervención indica que el rendimiento del grupo experimental en este ítem de la prueba aumentó significativamente después del entrenamiento (P<0,05). Conclusión: La adaptación de los entrenadores de nivel inicial al concepto de entrenamiento científico desempeñó un papel auxiliar en los resultados al aumentar el énfasis en el entrenamiento de los grupos musculares pequeños. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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Objective@#To analyze the current situation and research update on campus air quality in China, and to provide reference for effective campus environment improvement.@*Methods@#The documents of China national knowledge internet (CNKI) from 1980 to 2020 were extracted and the key words related to campus air quality were analyzed by CiteSpace software. Microorganisms, formaldehyde and benzene were selected, data of 200 literatures were classified and sorted out in different functional areas.@*Results@#Studies on campus air quality in China has been increasing gradually since 2004, especially focusing on indoor air, PM 2.5 and benzene series. The primary microorganism in the air environment of Chinese campuses was bacteria with the concentration of 2 309.31 cfu/m 3 . The ranking of the overall load of bacteria in air of different functional areas was consistent with that of microorganisms: living service area > landscape leisure area > public transport area > scientific research and teaching area > administrative office area > sports activity area. The average value of microbial indicators in indoor air of computer room, office area and campus living areas were more likely exceed the standard. The formaldehyde concentration in the computer room and reading room was high. The health of students exposed to formaldehyde and benzene on campus evaluated by using the evaluation model of the U.S. Environmental Protection Agency proved out to be in the safe range.@*Conclusion@#The concentrations of microorganisms, formaldehyde and benzene in campus environment mostly meet the requirements. Further measures need to be taken to reduce microbial concentration and strengthen formaldehyde monitoring and pollution source management in computer room and reading room.
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Objective: This study evaluated the effect of leucocyte and platelet-rich fibrin (L-PRF) techniques used in alveolar ridge preservation on dimensional hard tissue changes of the alveolar ridge assessed using cone-beam computed tomography (CBCT) scans. Material and Methods: Elective alveolar ridge preservation surgeries were performed on seven systemically healthy patients who underwent single posterior tooth extraction. Patients were randomly treated with PRF mixed with a commercial bone xenograft (n = 3) or PRF plug (n = 4). CBCT scans were taken immediately after tooth extraction and then four months later, just before implant surgery. Dimensional alterations in socket height (SH), socket area (SA) and socket volume (SV) were evaluated on CBCT scans by percentage differences before and after treatments. Results: Sockets treated with PRF plus bone xenograft had a tendency to maintain alveolar bone dimensions over time (SH= 11.22% to 82.74%, SA= 1.84% to 48.91% and SV= 9.11% to 203.62%), while sockets treated only with PRF plug technique presented only a modest increase in height (SH= 1.47% to 11.11%) but greater alveolar ridge resorption confirmed by a decrease in socket area and volume dimensions (SA= 0.21% to -24.09% SV= 8.53% to -54.12%). Conclusion: Within the limitations of this study, the maintenance of alveolar socket dimensions was observed when PRF was associated with a xenograft. However, the loss of alveolar ridge dimensions was not entirely prevented by PRF treatment alone.(AU)
Objetivo: Este estudo avaliou o efeito das técnicas de fibrina rica em leucócitos e plaquetas (L-PRF) usadas na preservação da crista alveolar em alterações dimensionais de tecido duro da crista alveolar avaliadas por tomografia computadorizada de feixe cônico (CBCT). Material e Métodos: Foram realizadas cirurgias eletivas de preservação da crista alveolar em sete pacientes sistemicamente saudáveis que foram submetidos a uma única extração dentária posterior. Os doentes foram tratados aleatoriamente com PRF misturado com um xenoenxerto ósseo comercial (n = 3) ou com PRF plug (n = 4). CBCT foi realizada imediatamente após a extração dentária e quatro meses depois, imediatamente antes da cirurgia de implante. Alterações dimensionais na altura do alvéolo (SH), área do alvéolo (SA) e volume do alvéolo (SV) foram avaliadas em exames CBCT por diferenças percentuais antes e depois dos tratamentos. Resultados: Os alvéolos tratados com PRF mais xenoenxerto ósseo apresentaram tendência a manter as dimensões ósseas alveolares ao longo do tempo (SH= 11.22% a 82.74%, SA= 1.84% a 48.91% e SV= 9.11% a 203.62%), enquanto alvéolos tratados apenas com a técnica de PRF plug apresentaram apenas um aumento modesto na altura (SH= 1.47% a 11.11%), mas uma maior reabsorção alveolar confirmada pela redução das dimensões de área e volume do alvéolo (SA= 0.21% a -24.09% SV= 8.53% a -54.12%). Conclusão: Dentro das limitações deste estudo, a manutenção das dimensões alveolares foi observada quando o PRF foi associado ao xenoenxerto. No entanto, a perda das dimensões alveolares não foi totalmente evitada pelo tratamento apenas com PRF. (AU)
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Humains , Résorption alvéolaire , Substituts osseux , Alvéole dentaire , Tomodensitométrie à faisceau conique , Fibrine riche en plaquettesRésumé
Objective: The aim of this study is to develop a predictive model for identifying true negatives among nonspecific benign results on computed tomography-guided lung biopsy. Materials and Methods: This was a single-center retrospective study. Between December 2013 and May 2016, a total of 126 patients with nonspecific benign biopsy results were used as the training group to create a predictive model of true-negative findings. Between June 2016 and June 2017, additional 56 patients were used as the validation group to test the constructed model. Results: In the training group, a total of 126 lesions from 126 patients were biopsied. Biopsies from 106 patients were true negatives and 20 were false-negatives. Univariate and multivariate logistic regression analyses were identified a biopsy result of “chronic inflammation with fibroplasia” as a predictor of true-negative results (P = 0.013). Abnormal neuron-specific enolase (NSE) level (P = 0.012) and pneumothorax during the lung biopsy (P = 0.021) were identified as predictors of false-negative results. A predictive model was developed as follows: Risk score = −0.437 + 2.637 × NSE level + 1.687 × pneumothorax - 1.82 × biopsy result of “chronic inflammation with fibroplasia.” The area under the receiver operator characteristic (ROC) curve was 0.78 (P < 0.001). To maximize sensitivity and specificity, we selected a cutoff risk score of −0.029. When the model was used on the validation group, the area under the ROC curve was 0.766 (P = 0.005). Conclusions: Our predictive model showed good predictive ability for identifying true negatives among nonspecific benign lung biopsy results
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Objective:To report our experience in the admission and perioperative management of 88 patients with lower extremity fracture in a mildly affected area in the epidemic of COVID-19.Methods:A retrospective analysis was conducted of the 88 patients with 97 lower extremity fractures who had been admitted to Department of Orthopedic Trauma, Honghui Hospital Affiliated to Xi'an Jiaotong University College of Medicine from 23rd January, 2020 to 22nd February, 2020. They were 43 males and 45 females, aged from 15 to 95 years (average, 65.5 years). The patients underwent screening for COVID-19 infection before admission. Their fractures were located at the femoral neck in 33 cases and at the femoral trochanter in 26. Open reduction and internal fixation was performed for 29 cases, internal fixation with proximal femoral nail anti-rotation (PFNA) for 25 and hip replacement for 28. The time from injury to admission, time from admission to surgery, operation time, fracture reduction, hospital stay, and perioperative deep venous thrombosis (DVT) of lower limbs were recorded. COVID-19 infection was observed in the medical staff and patients as well.Results:All the 88 patients were COVID-19 negative in the screening before admission. The time from injury to admission averaged 4.5 days, the time from admission to surgery 3.7 days and hospital stay 6.6 days. The prostheses were all well located in the 28 patients undergoing hip replacement. The rate of functional and anatomic reduction was 94.2%(65/69) in the 69 patients undergoing internal fixation. Peri-operatively, DVT occurred in 25 cases (28.4%). High temperature was observed in 7 patients within 3 days after operation, which was diagnosed as absorption fever. No medical staff or patients were infected by COVID-19.Conclusion:In the epidemic of COVID-19, orthopedic surgeons in a medical institute in a mildly affected area can still provide effective and safe medical services for fracture patients and reduce nosocomial infection, as long as they comprehend the diagnosis and treatment guidelines for the epidemic, strictly screen the patients accordingly, stick to operative indications, protect against possible infection cautiously, and carry out the procedures in a standard manner.
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OBJECTIVE@#To study the association of fatty acid composition in human milk with breast milk jaundice (BMJ) in neonates.@*METHODS@#A total of 30 full-term neonates who were admitted to the neonatal intensive care unit from October 2016 to October 2017 and were diagnosed with late-onset BMJ were enrolled as the BMJ group. Thirty healthy neonates without jaundice or pathological jaundice who were admitted to the confinement center during the same period of time were enrolled as the control group. Related clinical data were collected, including sex, mode of birth, feeding pattern, gestational age, birth weight, gravida, parity, and peak level of total serum bilirubin. Breast milk was collected from the mothers, and the MIRIS human milk analyzer was used to measure macronutrients (fat, protein, and carbohydrate) and calorie. Gas chromatography was used to analyze the content of different fatty acids in breast milk.@*RESULTS@#The control group had higher levels of macronutrients in human milk than the BMJ group, with significant differences in fat, dry matter, and calorie (@*CONCLUSIONS@#Some macronutrients and fatty acid composition in human milk may be associated with the pathogenesis of BMJ in neonates.
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Femelle , Humains , Nouveau-né , Grossesse , Études cas-témoins , Acides gras/analyse , Ictère néonatal/étiologie , Lait humain/composition chimique , Nutriments/analyseRésumé
Background: Radiofrequency ablation (RFA) is a safe, highly effective, and novel method used to treat benign thyroid nodules. This study aimed to evaluate the efficacy and safety of a combination of RFA and hydrodissection for treating benign thyroid nodules larger than 2 cm. Materials and Methods: The data of 137 patients with at least one thyroid nodule ≥2 cm who underwent RFA combined with hydrodissection at our medical center from November 2014 to October 2016 were analyzed. Ultrasound-guided RFA was applied to 532 nodules, including 139 nodules ≥2 cm and 393 nodes <2 cm. Results: The volumes of thyroid nodules, complications, and changes in thyroid function were analyzed. Ablation treatments were successfully performed without intraoperative skin burns, serious bleeding, or serious thyroid storm. A positive correlation was observed between ablation time and nodule size (R2 = 0.674). Only one patient (0.7%) experienced laryngeal nerve injury after operation. Moreover, the results of thyroid function tests (free triiodothyronine, free thyroxine, and thyroid-stimulating hormone) remained within normal ranges both before and after ablation. The complete ablation rate was 99.06%. The volumes of both nodules ≥2 cm and <2 cm significantly decreased after ablation. Six months after ablation, the average volume of nodules ≥2 cm had decreased to 1.02 ± 2.42 mL, and the volume reduction ratio was 83.11%. Conclusion: The combination of ultrasound-guided RFA with hydrodissection very effectively treats benign thyroid nodules while reducing damage to the surrounding tissues. This method is safe and effective for treating benign thyroid nodules
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Objective @#To explore the clinical application of an extended clavicular epithelial flap with a transverse cervical arterial blood supply in the repair of postoperative soft tissue defects in elderly patients with oral cancer.@*Methods@#From January 2015 to June 2018, 24 elderly patients with oral cancer were admitted to the Department of Oral and Maxillofacial Surgery, Hainan Provincial People′s Hospital, including 15 males and 9 females, aged 65-82 years, with an average age of 71.8 years. The supraclavicular epithelial flap was used to repair the soft tissue defect after radical resection of the oral cancer. The flap was at least 4 cm × 6 cm, and the maximum size was 7 cm × 9 cm. All patients completed a University of Washington Quality of Life (UW-QOL) survey 6 months after surgery, and a subjective satisfaction survey was conducted.@*Results @#The prolonged clavicular epithelial flap survival rate was 91.6% (22/24). The patients had good speech and swallowing function, hidden scars and no obvious sequelae. The average UW-QOL score 6 months after the operation was 76.5 ± 6.4. The follow-up satisfaction rate was 87.5% (21/24).@*Conclusion@#An extended clavicular epithelial flap with a transverse cervical arterial supply is reliable, of moderate thickness, is simple to implement, causes little trauma at the donor site, and yields a relatively concealed donor site. It is suitable for the simultaneous repair of soft tissue defects in elderly patients with oral cancer.
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@#Esophageal cancer is one of the most common malignant tumors in China. The comprehensive treatment of esophageal cancer based on operation is important. In recent ten years, with the development of surgical techniques and medical instruments, tubular stomach has been widely used. Although the advantages of tubular stomach are becoming more and more obvious, there are still many details and problems for the function and application of tubular stomach worthy of further discussion and study. In this paper, the technical progress, advantages, functions and applications of tubular stomach are reviewed and discussed, and the future prospect is predicted.
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ABSTRACT Objective: To report our experience of retroperitoneoscopic technique in semi-lateral decubitus position for the retroperitoneal nonadrenal ganglioneuromas in 18 patients, and to evaluate its clinical outcomes. Materials and Methods: From January 2012 to May 2016, 18 patients with retroperitoneal nonadrenal ganglioneuromas underwent retroperitoneoscopic resection. With the patients in semi-lateral decubitus position, a 4-port retroperitoneal approach was used. Data were collected on the tumor size, tumor location, perioperative outcomes, pathology, and last-known disease status. We reviewed the operative videos to identify surgical tips and tricks. Results: All procedures were carried out successfully without converting to open surgery. The tumors had an average size of 5.2cm. The mean operative time was 86.5 min, with a mean estimated blood loss of 85.4mL. There were three patients suffering from intraoperative complications. Postoperatively, all patients achieved an uneventful recovery; the mean postoperative hospital stay was 5.5 days. The postoperative pathology revealed to be retroperitoneal ganglioneuromas. With a mean follow-up of 39.5 months, all patients were recurrence free. The review of the operative videos revealed several tips and tricks, including keeping peritoneum and posterior Gerota fascia intact to provide a favorable operative exposure of tumors, and placing the harmonic scalpel through different ports during tumor dissection. Conclusions: With the patient in semi-lateral decubitus position and a 4-port retroperitoneal approach, retroperitoneoscopic resection of retroperitoneal nonadrenal ganglioneuroma is a feasible, effective, and safe procedure. This approach has distinct advantages including direct access to the tumor, optimal exposure of tumor and less intraperitoneal interference.
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Humains , Mâle , Femelle , Tumeurs du rétropéritoine/chirurgie , Laparoscopie/méthodes , Ganglioneurome/chirurgie , Études de suivi , Résultat thérapeutique , Durée opératoire , Adulte d'âge moyenRésumé
Background: Tamarix ramosissima is a desert forest tree species that is widely distributed in the drought-stricken areas to sustain the fragile ecosystem. Owing to its wide usage in the desert restoration of Asia, it can be used as an ecophysiological model plant. To obtain reliable and accurate results, a set of reference genes should be screened before gene expression. However, up to date, systematical evaluation of reference genes has not been conducted in T. ramosissima. Results: In this study, we used eigenvalues derived from principal component analysis to identify stable expressed genes from 72,035 unigenes from diurnal transcriptomes under natural field conditions. With combined criteria of read counts above 900 and CV of FPKM below 0.3, a total of 7385 unigenes could be qualified as candidate reference genes in T. ramosissima. By using three statistical algorithm packages, geNorm, NormFinder, and BestKeeper, the stabilities of these novel reference genes were further compared with a panel of traditional reference genes. The expression patterns of three aquaporins (AQPs) suggested that at least UBQ (high expression), EIF4A2 (low expression), and GAPDH (moderate expression) could be qualified as ideal reference genes in both RT-PCR and RNA-seq analysis of T. ramosissima. Conclusions: This work will not only facilitate future studies on gene expression and functional analysis of genetic resources of desert plants but also improve our understanding of the molecular regulation of water transport in this plant, which could provide a new clue to further investigate the drought adaptation mechanism of desert plant species under harsh environments.
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Tamaricaceae/génétique , Transcriptome , Normes de référence , Adaptation biologique , Expression des gènes , Écosystème , Feuilles de plante/génétique , Désert , Assainissement et restauration de l'environnement , Sécheresses , Réaction de polymérisation en chaine en temps réel , RNA-SeqRésumé
@#Objective To explore the feasibility and safety of non-gastrointestinal decompression after esophagectomy and the necessity of gastric tube or the time to remove gastric tube. Methods Thirty patients with esophageal cancer who underwent surgical treatment in the Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, were included in the trial from June to October 2017. The patients were randomly and equally assigned to a trial group (non-gastrointestinal decompression) or a control group (gastrointestinal decompression). There was no significant difference in age (P=1.000), sex (P=1.000), tumor location (P=0.732), pathological type (P=1.000), pathological stage (P=0.507), and operation time (P=0.674) between the two groups. The clinical effect between the two groups were compared. Results There was no statistical difference in incidences of anastomotic leakage (P=1.000), anastomotic bleeding (P=1.000), gastroesophageal reflux (P=1.000) between the two groups. And there was no statistical difference in time of the first flatus (P=0.629) and the first bowel movement (P=0.599) after operation between the two groups. Conclusion Without gastrointestinal decompression after Ivor Lewis esophagectomy does not increase the incidences of anastomotic leakage, anastomotic bleeding and gastroesophageal reflux, and has no significant effect on the recovery of gastrointestinal function. Without gastrointestinal decompression after Ivor Lewis esophagectomy is safe and feasible. Removing gastric tube on the second day after operation is reasonable and feasible.
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Phosphaturic mesenchymal tumors (PMTs) are very rare tumors which are frequently associated with Tumor Induced Osteomalacia (TIO), a paraneoplastic syndrome that manifests as renal phosphate wasting. The tumor cells produce a peptide hormone-like substance known as fibroblast growth factor 23 (FGF23), a physiologic regulator of phosphate levels. FGF23 decreases proximal tubule reabsorption of phosphates and inhibits 1-α-hydroxylase, which reduces levels of 1-α, 25-dihydroxyvitamine D3. Thus, overexpression of FGF23 by the tumor cells leads to increased excretion of phosphate in the urine, mobilization of calcium and phosphate from bones, and the reduction of osteoblastic activity, ultimately resulting in widespread osteomalacia. Patients typically present with gradual muscular weakness and diffuse bone pain from pathologic fractures. The diagnosis is often delayed due to the non-specific nature of the symptoms and lack of clinical suspicion. While serum phosphorus and FGF23 testing can assist in making a clinical diagnosis of PMT, the responsible tumor is often difficult to locate. The pathologic diagnosis is often missed due to the rarity of PMTs and histologic overlap with other mesenchymal neoplasms. While patients can experience severe disabilities without treatment, excision is typically curative and results in a dramatic reversal of symptoms. Histologically, PMT has a variable appearance and can resemble other low grade mesenchymal tumors. Even though very few cases of PMT have been reported in the world literature, it is very important to consider this diagnosis in all patients with hypophosphatemic osteomalacia. Here we present a patient who suffered for almost 5 years without a diagnosis. Ultimately, the PMT was located on a 68Ga-DOTA TATE PET/CT scan and subsequently confirmed by histologic and immunohistologic study. Interestingly, strong positivity for FGFR1 by IHC might be related to the recently described FN1-FGFR1 fusion. Upon surgical removal, the patient's phosphate and FGF23 levels returned to normal and the patient's symptoms resolved.
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Humains , Mâle , Adulte d'âge moyen , Tumeurs osseuses/diagnostic , Tumeurs du tissu conjonctif/diagnostic , Maladies osseuses métaboliques/diagnostic , Retard de diagnostic/prévention et contrôle , Diagnostic différentiel , Facteurs de croissance fibroblastique , Hypophosphatémie , Faiblesse musculaire/diagnostic , Ostéomalacie/diagnosticRésumé
The theory of branch atheromatous disease (BAD) has been commonly underused in clinical practice and research since it was proposed in 1989.In this study,we sought to explore clinical characteristics of its substypes and biomarkers for prognosis of BAD.A total of 176 consecutive patients with BAD were classified into two groups:paramedianpontine artery group (PPA group,n=70) and lenticulostriate artery group (LSA group,n=106).Bivariate analyses were used to explore the relationship between white matter hyperintensities (WMHs),National Institutes of Health Stroke Scale (NIHSS) scores and prognosis evaluated by the modified Rank Scale (mRS) at 6th month after stroke.The differences in prevalence of diabetes mellitus and a history of ischemic heart disease were statistically significant between PPA group and LSA group (x2=8.255,P=0.004;x2=13.402,P<0.001).The bivariate analyses demonstrated a positive correlation between NIHSS and poor prognosis in patents with BAD and in the two subtype groups,and a positive correlation between WMHs and poor prognosis in the PPA group.It is concluded that a significantly higher prevalence of diabetes mellitus and a history of ischemic heart disease exist in the PPA group than in the LSA group.In addition,high grades of NIHSS scores imply poor prognosis in patients with BAD and in the two subtype groups.Moreover,WMHs are a positive predictor for poor prognosis in patients in the PPA group.
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Objective:Abnormal angiogenesis is an important hallmark of HCC. Ectopic miR-375 overexpression led to repression of proliferation, migration, invasion, and colony formation, and it induced apoptosis in hepatoma cells as well. In this study, we explored the effect of miR-375 on HCC angiogenesis. Methods:We evaluated the antiangiogenic effects of miR-375 using human umbilical vein endothelial cells, tube formation assays, rat aortic ring sprouting assays, and chicken chorioallantoic membrane assays. Bioinformatics software was used to predict the downstream target gene of miR-375. MiR-375 regulation to target genes was explored by overexpres-sion and knockdown of miR-375 in hepatoma cells. Luciferase assay was performed to confirm its molecular mechanism. Rescue assay of target gene was further used to prove that miR-375 inhibited HCC angiogenesis by directly regulating its target gene. Results:MiR-375 inhibited HCC angiogenesis. Platelet-derived growth factor-C (PDGFC) was a potential target gene of miR-375. MiR-375 inhibited PDGFC expression in hepatoma cells by targeting its 3′-UTR. MiR-375 exerted its antiangiogenic effect partially by PDGFC inhibition. Conclusion:MiR-375 repressed tumor angiogenesis by targeting PDGFC in HCC.
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PURPOSE: To investigate the effect of remote ischemic post-conditioning (RIPoC) against ischemia-reperfusion (I/R) injury on flaps of rats. METHODS: Sprague-Dawley rats were randomized into the Sham, Control, RIPoC1 and RIPoC2 groups. All the animals were submitted to a 5×4 cm superficial inferior epigastric artery flap. Eight hours of flap ischemia was induced and two protocols of limb RIPoC were applied. Tissue MDA level and SOD activity in 24-h reperfusion were assessed. Flap survival was assessed 7 days postoperatively. RESULTS: Compared to the Control group, the RIPoC1 group showed statistically decreased MDA level at 6-, 12-, and 24-h reperfusion (P = 0.01, P < 0.01 and P < 0.01, respectively), and statistically increased SOD activity at 12- and 24-h reperfusion (P < 0.05 and P < 0.01, respectively). Flap survival rate on the 7th day was significantly higher in the RIPoC1 group than the control group (47.9 ± 6.4 vs . 29.4 ± 7.1 %, P < 0.01). CONCLUSION: Three cycles of 5-min Limb remote ischemic post-conditioning rather than a single cycle of 15-min limb RIPoC has protective effect on flaps against ischemia-reperfusion injury by attenuating oxidative stress.
Sujets)
Animaux , Mâle , Procédures chirurgicales dermatologiques , Postconditionnement ischémique/méthodes , Stress oxydatif , Lésion d'ischémie-reperfusion/thérapie , Lambeaux chirurgicaux/vascularisation , Procédures chirurgicales dermatologiques/méthodes , Artères épigastriques/chirurgie , Membres/traumatismes , Malonaldéhyde/analyse , Nécrose , Répartition aléatoire , Rat Sprague-Dawley , Lésion d'ischémie-reperfusion/métabolisme , Superoxide dismutase/analyse , Lambeaux chirurgicaux/anatomopathologie , Facteurs tempsRésumé
Porcine circovirus type 2 (PCV2) is the primary infectious agent of PCV-associated disease (PCVAD) in swine. ORF4 protein is a newly identified viral protein of PCV2 and is involved in virus-induced apoptosis. However, the molecular mechanisms of ORF4 protein regulation of apoptosis remain unclear, especially given there is no information regarding any cellular partners of the ORF4 protein. Here, we have utilized the yeast two-hybrid assay and identified four host proteins (FHC, SNRPN, COX8A and Lamin C) interacting with the ORF4 protein. Specially, FHC was chosen for further characterization due to its important role in apoptosis. GST pull-down, subcellular co-location and co-immunoprecipitation assays confirmed that the PCV2 ORF4 protein indeed interacted with the heavy-chain ferritin, which is an interesting clue that will allow us to determine the role of the ORF4 protein in apoptosis.