RESUMO
Objective: To investigate the clinicopathological features and molecular phenotypes of gastric cancer with enteroblastic dif-ferentiation (GCED). Methods: A retrospective analysis of 337 patients with gastric adenocarcinoma diagnosed by the pathology de-partment of the First Affiliated Hospital of Zhejiang University in March 2013-2017 was conducted. Of them, 8 patients were diag-nosed with gastric carcinoma with intestinal blastocyte differentiation. All the patients were elderly, including 6 men and 2 women. The onset age was 68-83 years (mean 76.6 years). Two cases had serum AFP≥200 μg/L before treatment. According to the histopatho-logical morphology, the immunophenotype was analyzed by immunohistochemistry, the SALL4 gene was detected using reverse tran-scription-polymerase chain reaction (RT-PCR), and the relevant literature was reviewed. Results: Microscopically, all cases had primi-tive enteroid structures, consisting of cubic or columnar cells with clear cytoplasm, and immunohistochemical staining showed positivi-ty for either AFP and GPC3 or SALL4. The expression of SALL4 mRNA was significantly increased by RT-PCR. Follow-up from 1 to 5 years showed that 5 patients had liver and other organ metastases, 2 patients died, and 1 patient survived without a tumor. Conclusions:GCED is a rare invasive gastric adenocarcinoma with a worse prognosis than that of normal intestinal adenocarcinoma. The treatment of general intestinal adenocarcinoma has little effect. There are some characteristic changes in histology. It would be helpful for diag-nosis and differential diagnosis if clinicians are familiar with the tumor spectrum and genetic characteristics. Target therapy for an origi-nal marker, such as SALL4, has a bright future.
RESUMO
Objective To investigate the iodine nutritional status,thyroid function and the prevalence of thyroid nodules of residents using non-iodized salt in Ningbo City,Zhejiang Province.Methods In 2011,using typical sampling method,6 villages/communities consumption of non-iodized salt were selected as study fields and residents aged 6-70 were selected as study subjects in Ningbo.Urinary iodine detection,thyroid ultrasound examination and tests of thyroid function [free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb)] were performed in all participants.Urinary iodine concentration (UIC) was determined by arsenic cerium catalytic spectrophotometry,and thyroid function was monitored by chemiluminescence method.Results A total of 1 177 residents agreed to participate in the study,482 were male,and 695 were female (including 2 pregnant women).The participants' mean age was (48.54 ± 13.98) years.The median UIC in all participants was 90.36 μg/L,and the proportions with a UIC ＜ 100μg/L was 56.07％ (660/1 177).Furthermore,the median UIC in male was 97.05 μg/L and in female was 83.84 μg/L,there was a significant difference in UICs between male and female (Z =-2.99,P ＜ 0.05).Similarly,significant difference in UICs was observed among age groups (x2 =99.34,P ＜ 0.01).Among the participants,19.88％ had thyroid nodules,with standardized prevalence rate of 13.95％.Furthermore,in male,11.83％ had thyroid nodules,with standardized prevalence rate of 8.11％,and in female was 25.47％,with standardized prevalence rate of 19.83％,there was a significant difference in the detection rate of thyroid nodules between male and female (x2 =33.25,P ＜ 0.01).Likewise,significant difference in the detection rate of thyroid nodules was observed among age groups (x2=49.65,P＜ 0.01),and there was a positive and significant correlation between the detection rate of thyroid nodules and increasing age (x2trend =44.22,P ＜ 0.01).Conclusions The residents who using non-iodized salt in Ningbo City are in the status of iodine deficiency.The detection rate of thyroid nodules is higher in female than in male and it has increased with age.
RESUMO
Objective To investigate the prevalence of thyroid nodules among residents of Ningbo City and to explore the risk factors for thyroid nodules.Methods Totally 3 596 residents aged 6-70 were selected by multistage stratified cluster random sampling in Ningbo City,2011.Thyroid ultrasound examination was performed in all participants,while salt iodine and urinary iodine were measured.Possible risk factors for thyroid nodules were analyzed by single factor and multi-factor logistic regression.Results The prevalence rate of thyroid nodules in residents of Ningbo City was 22.66％ (815/3 596),with standardized prevalence rate of 17.69％.Female [(odds ratio (OR) =2.06,95％ confidence interval (CI) =1.74-2.43],groups of aged 18-(OR =3.42,95％ CI =1.22-9.61),aged 40-(OR =13.06,95％ CI =4.80-35.51),aged 65-(OR =16.67,95％ CI =5.97-46.54) and occasional consumption of seafood habits (less than twice per week,OR =1.23,95％ CI =1.02-1.49) were significant associated with thyroid nodules.Conclusions There is no link Letween iodine nutrition and thyroid nodules.It is demonstrated that female and aged ≥ 18 groups have higher risk of thyroid nodules; frequent consumption of seafood seems to be a protective factor.
RESUMO
Objective To introduce a method using hydroxyapatite methylmethacylate cement implanted in the femoral head for the treatment of patients suffering from avascular necrosis of the femoral head due to different causes and to review the medium term follow up results. Methods From January 1990 to December 1995, eight hips in seven patients(male 4, female 3) with femoral head necrosis at Ficat stage Ⅲ were treated with the hydroxyapatite methylmethacylate cement implantation in the involved femoral head. Four osteonecrosis were secondary to femoral neck fracture, two were due to corticosteroid intake and one had alcohol abuse history. All patients complained pain and limited joint activity. The operation consisted of the removal of necrotic bone under weight loading cartilage with curet and the implantation of the hydroxyapatite methylmethacylate cement. The function of hip joint were well evaluated and X ray films were taken pre and postoperatively. The average postoperative follow up was 7.9 years, ranging from 5.1 to 11 years. Results Merle d Aubign? method was used to assess and compare the pre and post operative function of hip joint. The average score for unilateral cases increased from 8.66 to 15.5 at final examination. On radiography, the improvement of the contours of the femoral head was seen in all patients and most of them could preserve their initial postoperative contours during the follow up. No sign of expansion of the bone necrosis appeared in most of the patients, although certain patients presented various joint degeneration such as narrowing of joint space,sclerosis and osteophyte. Subjective evaluation was satisfactory except two suffering from painless limited activity of hip joint. Conclusion This method is relatively simple with less invasion and rapid postoperative recovery. It may be a choice of surgery for the treatment of certain femoral head necrosis at Ficat stage Ⅲ, especially for young patients.