Curative efficacy and influencing factors of 131I treatment for pulmonary metastases from differentiated thyroid carcinoma / 上海交通大学学报（医学版）

Objective · To investigate the curative efficacy and influential factors of 131I treatment for pulmonary metastases from differentiated thyroid carcinoma (DTC). Methods · A total of 95 DTC patients (33 males and 62 females) with pulmonary metastasis who underwent 131I treatment in Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, from April 2012 to May 2016 were retrospectively analyzed. The efficacy of 131I treatment was assessed using determination of serum thyroglobulin level and 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (～ (18) F-FDG PET/CT). The possible factors affecting efficacy included gender, age, pathological classification, wheteer pulmonary metastasis diagnosed before treatment, the iodine and 18F-FDG uptake of pulmonary lesions, the size and number of lung lesions, extrapulmonary distant metastasis.Univariate analysis was performed using Rank test and χ2 test, the critical value was obtained through receiver operating characteristic (ROC) curve and Logistic regression was also performed. Results · The rates of efficacy and inefficacy of 131I treatment were 53.68％ and 46.32％, respectively. Univariate analyses showed that maximum standardized uptake value (SUVmax) evaluated by 18F-FDG PET/CT (P=0.004), the size of lung metastases (P=0.000), age＜45 years (P=0.004), 131I uptake (P=0.022), whether pulmonary metastasis diagnosed before treatment (P=0.000), extrapulmonary distant metastasis (P=0.014) were the factors influencing outcome of 131I treatment. The critical value of 18F-FDG uptake for patients obtained by ROC curve was 1.45 (sensitivity of 56.8％ and specificity of 76.5％) and the critical value of lung lesion diameter was 9.63 mm (sensitivity of 43.2％ and specificity of 88.2％). Multivariate Logistic regression analysis showed that the influential factors included the age of patients, the size and 18F-FDG SUVmax of lung metastases and whether pulmonary metastasis diagnosed before treatment. Conclusion · 131I treatment is an effective method for pulmonary metastases from DTC. The patients aged less than 45 years, with the lung lesion size less than 9.63 cm, low 18F-FDG SUVmax and diagnosed before treatment may have good response to 131I treatment.

Cutaneous metastasis: a rare phenomenon of colorectal cancer

Cutaneous metastases from colorectal cancer are extremely rare and generally appear several years after diagnosis or resection of the primary tumor. Although this phenomenon is uncommon, it is very important and often indicates a poor prognosis. We present a case of a 76-year-old female patient with multiple cutaneous metastatic nodules on the back, just 1 month after resection of rectal cancer. Unfortunately, the patient gave up the follow-up treatment due to her age and poor physical condition; she died 3 months later. In view of its rarity of occurrence and lack of experience in treatment, we reviewed the literature and report as follows.

Clinical observation of methylprednisolone combined with peri - orbital injection of triamcinolone acetonide for diffuse - type orbital inflammatory pseudotumor / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the effect of intravenous methylprednisolone combined with peri - orbital injection of triamcinolone acetonide for diffuse - type orbital inflammatory pseudotumor. METHODS: Diffuse - type orbital inflammatory pseudotumor in 15 cases ( 19 eyes ) were treated. Intravenous implosive methylprednisolone therapy (0. 5g/ d) was used in the first 3d, and 0. 5g once a week in the following 3wk, ended by 0. 25g once a week in the last 6wk, which meant the total dose was 4. 5g and the whole course lasted for 10wk. At the same time, peri - orbital injection of triamcinolone acetonide ( 40mg ) was performed once in every 3wk, totally 2-4 times. RESULTS: Eight eyes from 7 cases were completely cured, 11 eyes from 8 cases were partly cured. No recurrence and severe complications were observed in the treatment duration. CONCLUSION: Intravenous methylprednisolone combined with peri - orbital injection of triamcinolone acetonide is effective, safe and feasible in treatment of diffuse type orbital pseudotumor with less complications.

ERG11 mutations associated with azole resistance in Candida albicans isolates from vulvovaginal candidosis patients

Objective: To investigate the azole susceptibility of Candida albicans ( C. albicans) from vulvovaginal candidosis patients and to analyze the relationship between ERG11 gene mutations in these isolates and azole resistance. Methods: Three hundred and two clinical isolates of Candida species were collected. Azole susceptibility was tested in vitro in microdilution studies. The ERG11 genes of 17 isolates of C. albicans (2 susceptibles, 5 dose-dependent resistants and 10 resistants) were amplified and sequenced. Results: Of the 302 isolates collected, 70.2% were C. albicans, of which 8.5%, 3.8% and 4.2% were resistant to fluconazole, itraconazole and voriconazole, respectively. In total, 27 missense mutations were detected in ERG11 genes from resistant/susceptible dose-dependent isolates. Among them, Y132H, A114S, and Y257H substitutions were most prevalent and were known to cause fluconazole resistance. G464S and F72S also have been proved to cause fluconazole resistance. Two novel substitutions (T285A, S457P) in hotspot regions were identified. Conclusions: Twenty seven mutations in the ERG11 gene were identified in azole-resistant C. albicans isolates, which indicated a possible relation with the increase in resistance to azole drugs and the recurrence of vulvovaginal candidosis. The relationship of two novel substitutions (T285A, S457P) with fluconazole resistance needs to be further verified by site-directed mutagenesis.

The role of hand-assisted laparoscopic surgery in total colectomy for colonic inertia: a retrospective study / 대한외과학회지

PURPOSE: To compare and assess the efficacy, safety and utility of hand-assisted laparoscopic surgery (HALS) with open surgery (OS) in total colectomy with ileorectal for colonic inertia. METHODS: From January 2001 to February 2012, 56 patients diagnosed with colonic inertia who failed to respond to medical treatments underwent hand-assisted laparoscopic total colectomy with ileorectal anastomosis. Another 68 patients underwent laparotomy. Main parameters such as clinical manifestations, conversion to open procedure, operative time, incision length, pain score, intraoperative blood loss, time to first flatus and hospitalization, early postoperative complications and hospitalization cost were retrospectively analyzed. Postoperative defecating frequencies were followed up in both groups. RESULTS: All patients received successful operation, no surgical mortality happened and none of the patients required conversion to an exploratory laparotomy in HALS group. The clinical features, the estimated blood loss, incision length, pain score, first passing flatus time, and postoperative hospitalization time were superior in HALS group (P < 0.05). The early postoperative complications and frequency of defecation were similar. However, the mean operative time was longer and hospitalization cost was higher in HALS group than those in OS group (P < 0.05). CONCLUSION: HALS total colectomy can be a safe and efficient technique in the treatment of colonic inertia. HALS can result in a better cosmetic result and a quicker postoperative recovery, but requires higher direct cost.

Relation between fat mass, fat free mass and ventilatory function in children and adolescents / 生理学报

The aim of the present study was to evaluate the relation between fat mass (FM), fat free mass (FFM) and ventilatory function in children and adolescents. 1 174 healthy children and adolescents (583 males and 591 females) aged 10-18 years were selected from Heilongjiang Province through random sampling by means of questionnaire and physical examination, and measured for height, weight, waist to hip ratio (WHR), FM, FFM and ventilatory function. The data were analyzed by means of independent-samples t test, Pearson correlation analysis and multi-factors regression analysis. Regardless of sex, an independent positive correlation was found (P<0.001) between age and FFM index (FFMI). FM index (FMI) correlated negatively with age in males (P<0.001), but positively with age in females (P<0.001). Regardless of sex, FFMI correlated positively with forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow at 25% of forced vital capacity (FEF25%), FEF50%, and maximal mid-expiratory flow (MMEF) (P<0.05), while negatively with FEV1/FVC (P<0.01). FFMI was correlated positively with FEF75% in males (P<0.05), but not correlated in females. In males, FMI correlated negatively with FEV1, FEV1/FVC, PEF, FEF25%, FEF50%, FEF75% and MMEF (P<0.05), but not correlated with FVC. No correlation was found between the ventilatory function indices and FMI in females. Except FEV1/FVC and FEF75% in males, the effect of FFMI in predicting ventilatory function was higher than FMI regardless of sex. Moreover, the predicting effect of FFMI was higher in males than that in females. Growth spurt of lung function occurred in the ages of 12-15 years in males, while in the ages of 12, 13 and 18 years in females. During the period of growth spurt of lung function, regardless of sex, the effect of FFMI in predicting the lung function was higher than that of age. In conclusion, regardless of sex, FFMI correlates positively with ventilatory function, as a reflection of muscle mass. The effect of FFM in predicting ventilatory function is higher in males than that in females. FM correlates negatively with ventilatory function in males, but not in females. The rapid growth of height and FFM are possibly the main reasons for growth spurt of lung function.

The relationship between body fat percentage, waist-hip ratio and pulmonary ventilatory function among the adult females in Heilongjiang, in 2008 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To examine the effect of body fat mass and fat distribution on pulmonary ventilatory function among the adult females.</p><p><b>METHODS</b>Based on the multistage cluster sampling principal, we selected 935 healthy adult females with ages of 19-81 years old in Heilongjiang province to conduct the study. Every 10-years old as a age group. Firstly obtain the basic situation through the questionnaire survey, and then measure the height, body weight, waistline, hip circumference, body composition and lung function. FVC, FEV1, PEF, FEF25%, FEF 50%, FEF 75% and MMEF were determined. This study also examined the relationships between percentage body fat (PBF), waist-hip ratio (WHR) and FVC, FEV1, PEF, FEF25%, FEF 50%, FEF 75%, MMEF.</p><p><b>RESULTS</b>PBF of subjects with ages of 19 - 29 years old and over 60 years old were (16.89 ± 5.34)% and (24.39 ± 6.83)%, WHR were 0.77 ± 0.05 and 0.88 ± 0.06, respectively. PBF and WHR tended to increase with age (F = 50.11, P value < 0.01). PBF obesity rates of subjects with ages of 19 - 29 years old and over 60 years old were 3.23% (7/217) and 43.75% (28/64), WHR obesity rates were 19.35% (42/217) and 85.94% (55/64) respectively. PBF obesity rate and WHR obesity rate tended to increase with age (χ(2) = 161.66, P value < 0.01; χ(2) = 159.61, P value < 0.01). PBF obesity groups compared with the normal groups, the former pulmonary ventilation function reduced significantly, of which FEF 50%, FEF 75% and MMEF decreased 2.61%, 19.44%, 10.28%, respectively. WHR obesity groups compared with the normal groups, the former pulmonary ventilation function reduced significantly, of which FEF 50%, FEF 75% and MMEF decreased 7.61%, 23.15%, 12.04%. After adjustment of age, height and body mass index (BMI), PBF was negatively correlated with FVC, FEV1, PEF and FEF25% (r values were -0.14, -0.14, -0.07, -0.07, respectively, all P value s < 0.05); WHR was negatively correlated with FEV1 (r value was -0.07, P value < 0.05) after adjustment of age, height and BMI.</p><p><b>CONCLUSION</b>PBF augmentation and abdominal obesity among adult females may be the risk factors of pulmonary function impairment.</p>