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Objective To analyze the clinical features and surgical treatment strategies of T4a thyroid cancer.Methods We retrospectively analyzed patients with thyroid cancer treated in the Department of Head and Neck Surgery of Sichuan Cancer Hospital from January 2004 to May 2021.A total of 303 cases were included and statistically analyzed for pathological type,invaded organs,surgical approach,survival time,and overall survival rate.The postoperative survival curves of the patients were analyzed using the Kaplan Meier method.Results Of the 303 patients enrolled,53 patients were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 98.4%(246/250),97.0%(224/231)and 90.2%(92/102),respectively.Of the 94 patients with recurrent laryngeal nerve invasion only,13 were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 100%(81/81),98.7%(77/78)and 97.4%(38/39),respectively.There were 151 patients with invasion of recurrent laryngeal nerve and tracheal/laryngeal/esophageal nerve,31 of them were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 96.7%(116/120),95.3%(101/106)and 82.2%(37/45),respectively.According to the survival curve analysis,the group with recurrent laryngeal nerve invasion only had an advantage in overall survival time over the group with recurrent laryngeal nerve and tracheal/laryngeal/esophageal invasion.Conclusion Surgical resection is supposed to be preferred for T4a thyroid cancer if there is a chance of surgery.A reasonable surgical strategy,radical surgery while preserving the vital tissues and organs,and one-stage repair and reconstruction can bring patients a better quality of life and prognosis.
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Objective:To observe the effect of a new modified double-eyelid operation.Methods:From February 2018 to January 2021, modified tarsal plate-orbicularis oculi muscle-orbital septum (TMS) suture was performed in 193 double-eyelid operation in the plastic surgery department of Peking Union Medical College Hospital, including 14 males and 179 females. The patients aged from 18 to 45 years with an average of (22.3±4.2) years. The patients were followed up for 6-24 months to observe the morphology of the double eyelid fold and complications.Results:The 193 patients were included. The double eyelid lines of 173 patients were smooth, natural, durable and the scar was shallow; both doctors and patients were satisfied. There were no obvious complications after the operation. The double eyelid line became shallow or disappeared in 11 patients, and the double eyelid asymmetry occurred in 7 patients after the operation. However, the folds were symmetrical and natural after secondary operation, and both doctors and patients were satisfied.Conclusions:TMS suture not only establishes a firm adhesion, but also effectively transmits the force of the levator aponeurosis with significant advantages. After the operation, the double eyelid line is smooth, natural and stable. Both doctors and patients are highly satisfied. It is an improved double eyelid procedure worthy of clinical promotion.
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Hypoxia, a salient feature of most solid tumors, confers invasiveness and resistance to the tumor cells. Oxygen-consumption photodynamic therapy (PDT) suffers from the undesirable impediment of local hypoxia in tumors. Moreover, PDT could further worsen hypoxia. Therefore, developing effective strategies for manipulating hypoxia and improving the effectiveness of PDT has been a focus on antitumor treatment. In this review, the mechanism and relationship of tumor hypoxia and PDT are discussed. Moreover, we highlight recent trends in the field of nanomedicines to modulate hypoxia for enhancing PDT, such as oxygen supply systems, down-regulation of oxygen consumption and hypoxia utilization. Finally, the opportunities and challenges are put forward to facilitate the development and clinical transformation of PDT.
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OBJECTIVE: To study release behavior in vitro of Risperidone sustained-release tablets and its pharmacokinetics in rabbits. METHODS: Risperidone sustained-release tablets were prepared by using mesoporous silica as matrix. Release rates in vitro within 12 h (Q12 h) of commercially available Risperidone tablets, Risperidone sustained-release tablets and its physical mixture in 0.1 mol/L HCl fluid were investigated with basket method. The release model of Risperidone sustained-release tablets were fitted. Using clozapine as an internal standard, HPLC method was used to determine blood concentration of risperidone and 9-hydroxyrisperidone in rabbits 48 h (n=6) after intragastric administration of commercially available Risperidone tablets and Risperidone sustained-release tablets 2 mg. Pharmacokinetic parameters were calculated by using non-compartmental model of Kinetica 4.4 software. RESULTS: Compared with commercially available Risperidone tablets (Q12 h=97%) and physical mixtures (Q12 h=95%), release rate of Risperidone sustained-release tablets (Q12 h=83.7%) slowed down significantly, and the release of Risperidone sustained-release tablets in 0.1 mol/L HCl fluid was closed to first-order release (R2=0.998 9), with diffusion as the main factor and dissolution as the supplement. By risperidone, the pharmacokinetic parameters of commercially available Risperidone tablets and Risperidone sustained-release tablets included that t1/2 were (4.64±0.93),(6.65±0.92) h; cmax were (34.46±7.75) and (8.57±6.91) ng/mL; MRT were (11.48±1.23), (17.46±2.10) h; AUC0-48 h were (314.39±10.33),(192.98±49.14) ng·h/mL, respectively. By 9-hydroxyrisperidone, the pharmacokinetic parameters of them included that t1/2 were(7.08±0.93),(10.45±0.78) h; cmax were (98.08±5.43),(54.55±4.88) ng/mL; MRT were (11.48±1.23), (17.46±2.10) h; AUC0-48 h were (894.71±131.15), (1 227.99±112.12) ng·h/mL (n=6), respectively. Compared with commercially available Risperidone tablets, t1/2 and MRT of Risperidone sustained-release tablets prolonged significantly, while cmax decreased significantly (P<0.05). CONCLUSIONS: Risperidone loaded in mesoporous silica has sustained release effect and prolong the time of drug efficacy.
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Perioperative venous thromboembolism (VTE) of patients after thoracic cancer surgery has proved to be a serious or even fatal postoperative complication, which calls for great attention. China National Research Collaborative Group released the first edition of Chinese experts consensus on the perioperative VTE prophylaxis in 2018. This article is to interpret it on the aspect of epidemiological characteristics of perioperative venous thromboembolism and the current status of prophylaxis in China and other countries, in order to provide a better understanding of Chinese experts consensus for readers.
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Objective@#To investigate the mechanism of apoptosis of CD8+T lymphocyte in peripheral blood of patients with hepatocellular carcinoma (HCC).@*Methods@#The proportion and apoptosis of peripheral blood CD8+T lymphocytes in 30 healthy controls, 30 patients with cirrhosis and 60 HCC patients were detected by Flow cytometry, and the expression of Fas on the surface of CD8+T lymphocytes was reported. The differences between groups were compared using independent sample t-test, and data of variance were tested with Mann-Whitney U non-parametric test, P < 0.05 was considered statistically significant.@*Results@#The proportion of CD8+T lymphocytes in peripheral blood of patients with HCC was 26.4% ± 9.2%, higher than that of 24.5% ± 7.1% in cirrhosis (t = 0.783, P = 0.489), and and healthy control 19.7% ± 4.7% (t = 2.920, P = 0.004). The proportion of apoptotic CD8+T lymphocytes in peripheral blood of HCC patients was 25.3% ± 6.5%, of the total CD8+T lymphocytes, which was significantly higher than that of healthy controls 12.1%±6.5% (t = 7.555, P < 0.001) and cirrhotic 13.6% ± 5.8% (t = 5.213, P < 0.001), the differences were statistically significant. The proportion of Fas+CD8+T lymphocytes in the HCC group was 62.2% ± 18.5%, higher than that in the healthy control group 42.6%±16.5% (t = 4.127, P < 0.001) and 46.1% ± 14.5% (t = 2.561, P < 0.01)of the cirrhosis group, the differences were statistically significant. Fas expression was positively correlated with the apoptosis of CD8+T lymphocytes (r 2 = 0.113, P < 0.05).@*Conclusion@#The proportion of CD8+T lymphocytes in peripheral blood of patients with HCC is higher than that of healthy controls, but the proportion of CD8+T lymphocyte apoptosis based on Fas/FasL pathway increased, which may be an important mechanism for tumor cell immune escape.
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Objective: To evaluate the diagnostic accuracy of line probe assays for drug- resistant tuberculosis (TB) in China. Methods: Chinese databases (CNKI, Wanfang, SinoMed, VIP Information) and English databases (PubMed, Embase, Cochrane Library) were used to retrieve the literatures regarding the accuracy of line probe assays in the diagnosis of drug-resistant tuberculosis in China between January 1, 2000 and September 1, 2017. Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the included studies. Sensitivity and specificity in different studies (using drug sensitivity test or gene sequencing as gold standard) were combined by Meta-analysis using bivariate or univariate model. In addition, subgroup analysis (GenoType MTBDRplus, GenoType MTBDRsl and Reverse dot blot hybridization) and sensitivity analysis were also carried out. Results: A total of 24 literatures involving 82 studies were included in the final analysis. The sensitivity and specificity of line probe assays for rifampicin resistant TB were 0.91(0.88-0.94) and 0.98 (0.97-0.99), respectively. The sensitivity and specificity of line probe assays for isoniazid resistant TB were 0.80 (0.77-0.83) and 0.98 (0.96-0.99), respectively. The sensitivity and specificity of line probe assays for multidrug-resistant TB were 0.81 (0.76-0.85) and 0.99 (0.99-1.00), respectively. The sensitivity and specificity of line probe assays for quinolone resistant TB were 0.92(0.88-0.95) and 0.94 (0.91-0.97), respectively. The sensitivity and specificity of line probe assays for second-line injectable drug resistant TB (including kanamycin, Capreomycin, amikacin) were 0.79(0.58-0.91) and 0.98 (0.90-1.00), respectively. The sensitivity and specificity of line probe assays for extensively drug-resistant TB were 0.46 (0.19-0.75) and 1.00 (0.98-1.00), respectively. Subgroup analysis showed that the overall diagnostic accuracy of GenoType MTBDRplus and GenoType MTBDRsl was higher than that of Reverse dot blot hybridization. According to the results of sensitivity analysis, the results of this study were robust. Conclusion: The diagnostic accuracy of line probe assays for drug-resistant TB is high.
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Humains , Antituberculeux/usage thérapeutique , Dosage biologique/méthodes , Chine , Isoniazide/pharmacologie , Tests de sensibilité microbienne/méthodes , Mycobacterium tuberculosis/isolement et purification , Rifampicine/pharmacologie , Sensibilité et spécificité , Tuberculose multirésistante/traitement médicamenteuxRésumé
Objective: Chronic obstructive pulmonary disease, asthma, interstitial lung disease and pulmonary thromboembolism are the most common and severe respiratory diseases, which seriously jeopardizing the health of the Chinese citizens. Large-scale prospective cohort studies are needed to explore the relationships between potential risk factors and respiratory disease outcomes and to observe disease prognoses through long-term follow-ups. We aimed to develop a common data model (CDM) for cohort studies on respiratory diseases, in order to harmonize and facilitate the exchange, pooling, sharing, and storing of data from multiple sources to serve the purpose of reusing or uniforming those follow-up data appeared in the cohorts. Methods: The process of developing this CDM of respiratory diseases would follow the steps as: ①Reviewing the international standards, including the Clinical Data Interchange Standards Consortium (CDISC), Clinical Data Acquisition Standards Harmonization (CDASH) and the Observational Medical Outcomes Partnership (OMOP) CDM; ②Summarizing four cohort studies of respiratory diseases recruited in this research and assessing the data availability; ③Developing a CDM related to respiratory diseases. Results: Data on recruited cohorts shared a few similar domains but with various schema. The cohorts also shared homogeneous data collection purposes for future follow-up studies, making the harmonization of current and future data feasible. The derived CDM would include two parts: ①thirteen common domains for all the four cohorts and derived variables from disparate questions with a common schema, ②additional domains designed upon disease-specific research needs, as well as additional variables that were disease-specific but not initially included in the common domains. Conclusion: Data harmonization appeared essential for sharing, comparing and pooled analyses, both retrospectively and prospectively. CDM was needed to convert heterogeneous data from multiple studies into one harmonized dataset. The use of a CDM in multicenter respiratory cohort studies would make the constant collection of uniformed data possible, so to guarantee the data exchange and sharing in the future.
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Humains , Collecte de données/normes , Bases de données factuelles/normes , Prestations des soins de santé/organisation et administration , Diffusion de l'information , Broncho-pneumopathie chronique obstructiveRésumé
Objective Chronic obstructive pulmonary disease,asthma,interstitial lung disease and pulmonary thromboembolism are the most common and severe respiratory diseases,which seriously jeopardizing the health of the Chinese citizens.Large-scale prospective cohort studies are needed to explore the relationships between potential risk factors and respiratory disease outcomes and to observe disease prognoses through long-term follow-ups.We aimed to develop a common data model (CDM) for cohort studies on respiratory diseases,in order to harmonize and facilitate the exchange,pooling,sharing,and storing of data from multiple sources to serve the purpose of reusing or uniforming those follow-up data appeared in the cohorts.Methods The process of developing this CDM of respiratory diseases would follow the steps as:①Reviewing the international standards,including the Clinical Data Interchange Standards Consortium (CDISC),Clinical Data Acquisition Standards Harmonization (CDASH) and the Observational Medical Outcomes Partnership (OMOP) CDM;②Summarizing four cohort studies of respiratory diseases recruited in this research and assessing the data availability;③Developing a CDM related to respiratory diseases.Results Data on recruited cohorts shared a few similar domains but with various schema.The cohorts also shared homogeneous data collection purposes for future follow-up studies,making the harmonization of current and future data feasible.The derived CDM would include two parts:①thirteen common domains for all the four cohorts and derived variables from disparate questions with a common schema,②additional domains designed upon disease-specific research needs,as well as additional variables that were disease-specific but not initially included in the common domains.Conclusion Data harmonization appeared essential for sharing,comparing and pooled analyses,both retrospectively and prospectively.CDM was needed to convert heterogeneous data from multiple studies into one harmonized dataset.The use of a CDM in multicenter respiratory cohort studies would make the constant collection of uniformed data possible,so to guarantee the data exchange and sharing in the future.
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Objective To evaluate the diagnostic accuracy of line probe assays for drugresistant tuberculosis (TB) in China.Methods Chinese databases (CNKI,Wanfang,SinoMed,VIP Information) and English databases (PubMed,Embase,Cochrane Library) were used to retrieve the literatures regarding the accuracy of line probe assays in the diagnosis of drug-resistant tuberculosis in China between January 1,2000 and September 1,2017.Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the included studies.Sensitivity and specificity in different studies (using drug sensitivity test or gene sequencing as gold standard) were combined by Meta-analysis using bivariate or univariate model.In addition,subgroup analysis (GenoType MTBDRplus,GenoType MTBDRsl and Reverse dot blot hybridization) and sensitivity analysis were also carried out.Results A total of 24 literatures involving 82 studies were included in the final analysis.The sensitivity and specificity of line probe assays for rifampicin resistant TB were 0.91 (0.88-0.94) and 0.98 (0.97-0.99),respectively.The sensitivity and specificity of line probe assays for isoniazid resistant TB were 0.80 (0.77-0.83) and 0.98 (0.96-0.99),respectively.The sensitivity and specificity of line probe assays for multidrug-resistant TB were 0.81 (0.76-0.85) and 0.99 (0.99-1.00),respectively.The sensitivity and specificity of line probe assays for quinolone resistant TB were 0.92 (0.88-0.95) and 0.94 (0.91-0.97),respectively.The sensitivity and specificity of line probe assays for second-line injectable drug resistant TB (including kanamycin,Capreomycin,amikacin) were 0.79 (0.58-0.91) and 0.98 (0.90-1.00),respectively.The sensitivity and specificity of line probe assays for extensively drug-resistant TB were 0.46 (0.19-0.75) and 1.00 (0.98-1.00),respectively.Subgroup analysis showed that the overall diagnostic accuracy of GenoType MTBDRplus and GenoType MTBDRsl was higher than that of Reverse dot blot hybridization.According to the results of sensitivity analysis,the results of this study were robust.Conclusion The diagnostic accuracy of line probe assays for drug-resistant TB is high.
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@#To conduct the characterization of its pharmacokinetics in rats of nifedipine sustained-release pellets and to study the relationship between the pellets and CYP3A4 activity. A gradient HPLC method was developed to simultaneously determine 6β-hydroxycortisol and hydrocortisone. CYP3A4 activity of rats was quantified by urinary ratio of 6β-hydroxycortisol/hydrocortisone after intravenous injection of hydrocortisone as a biomarker. HPLC method was also developed to quantify the drug concentration in plasma of rats, and the studies of pharmacokinetics were performed after oral administration of single dose of two formulations: Nifedipine matrix sustained-release pellets and nifedipine tablet(using as control). The results showed that the ratio of ten rats was 0. 271±0. 129. cmax of nifedipine sustained-release pellets decreases by nearly 70%, tmax significantly increased by 400% and t1/2 and MRT significantly increased by 230% compared to control. Nifedipine sustained-release pellets had a significant sustained-release property compared to the control and CYP3A4 activity affected its pharmacokinetics behavior.
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Background and purpose:Thermal ablation (radiofrequency ablation, RFA/microwave ablation, MWA) is the most commonly used minimally invasive technique for the treatment of liver cancer. Real-time shear wave elastography (SWE) is a new type of ultrasonic imaging technology, which was used in our study to monitor thermal ablation of liver cancer. This study aimed to investigate the stiffness change of liver cancer and that of surrounding liver parenchyma before and after thermal ablation, and to evaluate the application of SWE for monitoring thermal ablation for liver cancer.Methods:From Oct. 2014 to Apr. 2015, a total number of 36 patients, with 39 lesions, were treated with RFA or MWA and got complete response. SWE examination was performed before and after ablation. The SWE-mean, SWE-min, SWE-max, SWE-SD of lesions and the surrounding liver parenchyma were measured. Statistical analysis was made to compare the stiffness changes of liver cancer with those of the surrounding liver parenchyma before and after thermal ablation, and to determine whether there were differences between two different ablation modes.Results:Before and after ablation, the SWE-mean of lesions was (30.09±11.67) kPavs (52.11±17.56) kPa,SWE-min was (10.46±8.22) kPavs (20.57±11.42) kPa, SWE-max was (51.50±20.84) kPavs (88.54±27.75) kPa, SWE-SD was (10.63±4.30) kPavs (16.89±7.72) kPa; There were statistically signiifcant differences (P0.05). After ablation, the SWE-mean of RFA and MWA was (45.55±10.91) kPavs (60.59±20.99) kPa, SWE-min was (18.95±8.86) kPavs (25.93±10.93) kPa, SWE-max was (76.58±15.51) kPavs (104.01±32.59) kPa, SWE-SD was (13.82±3.52) kPavs (20.85±9.77) kPa; There were statistically signiifcant differences (P<0.05).Conclusion:SWE can quantitively analyze the stiffness of lesions. The ablation zone became stiffer after RFA or MWA, and the ablation zone of MWA was stiffer than that of RFA. Two kinds of ablation methods did not signiifcantly affect the stiffness of liver parenchyma around the lesion. SWE could potentially be used to monitor thermal ablation of liver cancer.