Expressions of key molecules affiliated cytoskeleton in laryngeal squamous cell carcinoma and their implications for prognosis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the expressions of key assemblies of cytoskeleton, Fascin-1, Ezrin and Paxillin, in laryngeal squamous cell carcinoma (LSCC) and their correlation with clinicopathologic characteristics, cancer recurrence and survival of patients with LSCC.</p><p><b>METHODS</b>The expressions of Fascin-1, Ezrin and Paxillin proteins were detected by immunohistochemistry in 199 cases of LSCC. Unconditional Logistic regression model or Cox proportional hazards model was used for the analyses of recurrent risks and prognostic factors.</p><p><b>RESULTS</b>Significantly increased expression of Fascin-1, Ezrin or Paxillin expression was showed in the LSCC with poorly differentiated, positively cervical lymph nodal metastasis, and clinical stage III + IV respectively (P < 0.05). The expressions of three kinds of proteins in the recurrent cases were higher than those in non-recurrent cases respectively (χ(2) were 42.479, 43.673 and 22.261, P < 0.05). The highest recurrence rate (69.1%) was observed in group of cases with the highly co-expression of the three kinds of proteins (P < 0.05). The expression of Fascin-1 (OR = 7.89, 95%CI 2.26 - 27.53, P = 0.001), or Ezrin (OR = 2.51, 95%CI 1.18 - 5.32, P < 0.001) was independent risk for recurrence. Five-year disease-free survival rates of patients with high expression of Fascin-1, Ezrin or Paxillin were lower than those of patients with negative or low expressions for the proteins (P < 0.05). Patients with highly co-expression of three kinds of proteins showed the poorest survival prognosis, with a 5-year disease free survival (DFS) of only 26.4% (P < 0.05), and expressions of three proteins were independent prognostic factors for 5-year DFS (P < 0.05).</p><p><b>CONCLUSION</b>Fascin-1, Ezrin, and Paxillin were correlative with LSCC progression and might be potential predictors for cancer recurrence and survival of patients with LSCC, as well as therapeutic targets for LSCC.</p>

Selection of surgical modalities for T3 glottic carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To determine the optimal surgical modality for T3 glottic carcinoma.</p><p><b>METHODS</b>Clinical data of 57 cases of T3 glottic carcinoma were retrospectively reviewed. Their clinical characteristics, surgical procedures and prognosis were analyzed. At different ages and by surgical procedures performed, the 3-year disease-free survival rate of the patients were analyzed.</p><p><b>RESULTS</b>All cases underwent surgical procedures including total laryngectomy, near total laryngectomy and partial laryngectomy, and the 3-year disease-free survival rate was 63.2% (36/57). The 3-year disease-free survival rate of patients who received total laryngectomy was 66.7% (16/24), near total laryngectomy 50.0% (4/8), and partial laryngectomy 64.0% (16/25, P = 0.694). The 3-year survival rate of the cases ≥ 70.0 years old was 70.0% (7/10), and that of < 70 years old was 61.7% (29/47, P = 0.621). Thirty-six cases had neck dissection, including 2 cases with radical neck dissection, 6 cases with modified neck dissection, and 28 cases with selective neck dissection. The lymph node metastasis rate of all cases was 17.5%. Ten cases were diagnosed as postoperative local recurrence, including 1 cases treated with total laryngectomy, 2 cases treated with near total laryngectomy and 7 cases treated with partial laryngectomy.</p><p><b>CONCLUSIONS</b>Both total laryngectomy and partial laryngectomy are important surgical procedures for treating patients with T3 glottic carcinoma. The optimal individual surgical procedure for the patient with T3 glottic carcinoma should be determined on the basis of the local lesions and physical status. Total laryngectomy is prior to partial laryngectomy for the patients with T3 glottic carcinoma ≥ 70 years old.</p>

Effect of compound astragalus recipe on lymphocyte subset, immunoglobulin and complements in patients with myasthenia gravia / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect and mechanisms of Compound Astragalus Recipe (CAR) for regulating cellular immune in patients with myasthenia gravis (MG).</p><p><b>METHODS</b>Sixty MG patients were equally assigned to two groups randomly, the test group administered with CAR and the control group with prednisone for 3 months. Changes of patients' symptoms and adverse reactions were observed. The peripheral lymphocyte subsets distribution was examined by flow cytometry, and the levels of immunoglobulins and complements in the peripheral blood were measured by immuno-turbidimetry before and after treatment.</p><p><b>RESULTS</b>The total effective rate in the test group after 12-week treatment reached 80% (24/30), while that of the control group reached 83.3% (25/30), difference between them showed no statistical significance (P > 0.05). CD4+ and CD4+/CD8+ ratio were lowered significantly in both groups, but the decrement of CD4+/CD8+ ratio in the test group was more significant than that in the control group, showing significance between groups (P < 0.05). While CD8+ in the test group after treatment was significantly increased as compared with that before treatment (P < 0.05), but with no significant difference in comparing with that in the control group (P > 0.05). Serum levels of IgM and IgA in MG patients were significantly higher than normal range (P < 0.01). Levels of C3 and C4 were significantly increased in both groups after treatment (P < 0.05). Moderate high level of ALT and AST revealed transiently at the 2nd week in 5 patients of the control group, while no adverse reaction was found in the test group.</p><p><b>CONCLUSION</b>One of the mechanisms for CAR in playing its immuno-modulate effect may be its regulation on lymphocyte subsets distribution and humoral immune function.</p>

Significance of sentinel lymph node detection for cN0 laryngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The purpose of this study was to investigate the clinical value of radiolabeled tracer method, methylene blue method and combination of these two methods in detection of sentinel lymph node (SLN), and to evaluate the accuracy of SLN in predicting the cervical lymph nodes status in laryngeal carcinoma patients with clinically negative neck lymph nodes (cN0 ).</p><p><b>METHODS</b>Forty-one patients with cN0 laryngeal neoplasms underwent SLN detection using both of radiolabeled tracer and methylene blue. SLN imaging was performed with laryngoscope-guided injection of radioactive isotope 99Tc(m)-sulfur colloid (SC) into the laryngeal carcinoma before surgery, then all these patients underwent intraoperative lymphatic mapping with a handheld gamma-detecting probe. After mapping of SLN, methylene blue was subsequently injected at the same spots around the tumor in order to identify SLN during surgery. The results of SLN detection by isotope tracer, dye and combination of both methods were compared.</p><p><b>RESULTS</b>The SLN detection rates by radiolabeled tracer, methylene blue and combined method were 87.8%, 70.7% and 92.7%, respectively (P < 0.01). The number of detected SLN was significantly different between radiolabeled tracer method and combined method (P < 0.05), and also between blue dye method and combined method (P < 0.01). However, no statistically significant difference was found between methylene blue method and radiolabeled tracer method (P > 0.05). Nine patients were found to have lymph node metastasis by final pathological examination. The sensitivity, accuracy and negative predictive values of SLN detection by the combined method using radiolabeled tracer and methylene blue were 88.9%, 97.4% and 96.7%, respectively.</p><p><b>CONCLUSION</b>The combined method using radiolabeled tracer and methylene blue can improve the accuracy of sentinel lymph node detection. Furthermore, sentinel lymph node detection can accurately predict the cervical lymph node status in cN0 laryngeal carcinoma.</p>

Optimization of Expression by Response Surface Methodology and Purification of Recombinant Human Cardiac Troponin-I(cTnI) in Escherichia coli / 中国生物工程杂志

To optimize the growth condition for the established gene engineer bacteria express cardiac troponin-I(cTnI) and to obtain purified cTnI as an antigen to produce clinical assay kits used in acute myocardial injury(AMI) diagnosis.Plackett Burman Design(PBD) was applied to select the factors which effect the expression of cTnI in Escherichial coli(E.coli) mostly.Induction time,pH and KCl were proved influenced expression of cTnI notably.Afterward,Response Surface Methodology(RSM) as second step to optimize the selected three factors,an equation was deduced to predict the percent of cTnI.In the most optimized condition,the percent of cTnI can reach to 26% of total cell protein.The procedures of purification included ammonium sulfate deposition and DEAE Cellulose ion exchange chromatography.SDS-PAGE shows that purified cTnI contain one band.cTnI could be used to immune animals as an antigen to produce monoclonal antibodies with high affinity and specificity.It maybe as calibrators to harmony the difference assays of cTnI measurement in clinical.