Analysis of risk factors for lymph node metastasis and prognosis in T1-stage esophageal squamous cell carcinoma / 中国胸心血管外科临床杂志

@#Objective    To investigate the risk factors for lymph node metastasis (LNM) and prognosis of T1-stage esophageal squamous carcinoma (ESC). Methods    Clinical data of 387 patients with T1-stage ESC who underwent surgical treatment in our hospital from March 2013 to March 2018 were collected. There were 281 males and 106 females aged 60 (41-80) years. The patients were divided into a lymph node metastasis group (n=77) and a non-metastasis group (n=310). The risk factors for LNM and prognosis were analyzed. Results    Among 387 patients with T1-stage ESC, 77 (19.9%) patients had LNM. The incidence of LNM was 8.4% (8/95) in T1a-stage patients and 23.6% (69/292) in T1b-stage patients. Univariate analysis showed that tumor size, differentiation degree, depth of invasion and vascular tumor thrombus were associated with LNM (P<0.05). Multivariate logistic regression analysis showed that invasion depth of tumor [OR=2.456, 95%CI (1.104, 5.463), P<0.05] and vascular tumor thrombus [OR=15.766, 95%CI (4.880, 50.938), P<0.05] were independent risk factors for LNM. The follow-up time was 41 (12, 66) months. The 1-year, 3-year and 5-year survival rates were 98.71%, 89.67% and 86.82%, respectively. Univariate analysis showed statistically significant differences in tumor invasion depth, vascular tumor thrombus and LNM between the survival group and the death group. Cox analysis showed that LNM [OR=3.794, 95%CI (2.109, 6.824), P<0.05] was an independent risk factor for prognosis. Conclusion    T1-stage ESC patients with deeper invasion or vascular tumor thrombus have a higher risk of LNM. The prognosis of T1-stage ESC with LNM is relatively poor.

Research progress of benign anastomotic stricture after esophagectomy / 国际肿瘤学杂志

Benign anastomotic stricture is one of the most common complications after esophagectomy,which can result in the dysphagia and weight loss of patients.It can severely impair the patient's quality of life with the progress of the stricture.What is more,refractory benign stricture is a major challenge for physicians and needs repeated treatments,which aggravates the patient's pain and increases extra costs.Benign anastomotic stricture is associated closely with various risk factors,which can be prevented by adopting some measures.Dilation remains the first-line treatment to manage benign anastomotic stricture and it may be effective to combine with drug therapy.Endoscopic incisional therapy is a promising method as a new treatment therapy.The use of various stents fails to improve overall long-term dysphagia-free rate.In addition,stent has a possible risk of migration and hyperplastic tissue growth,which should be used by weighing the pros and cons.

Effect of silencing of Yes-associated protein 1 gene on proliferation and invasion of human non-small cell lung cancer cells / 第二军医大学学报

Objective To explore the role of Yes-associated protein 1 (YAP1) in the proliferation,cell cycle,migration and invasion of human non-small cell lung cancer (NSCLC) cells.Methods A lenti-siRNA targeting YAP1 (si-YAP1) was used to inhibit the expression of YAP1 gene of human NSCLC cell line A549 cells.CCK-8 assay and flow cytometry were used to determine the effects of silencing of YAP1 expression on A549 cells proliferation and cell cycle,respectively;Transwell assay was used to observe the effect of silencing of YAP1 expression on A549 cell migration and invasion.Results After infection with si-YAP1,the expressions of YAP1 mRNA and protein in A549 cells were significantly down-regulated (P＜0.01).YAP1 silencing significantly inhibited A549 cell proliferation,increased the percentage of cells in G0/G1 phase (P＜0.01),and significantly decreased the migration and invasion of A549 cells (P＜0.01).Conclusion YAP1 silencing can inhibit malignant biological characteristics of NSCLC,which suggests that YAP 1 gene may serve as an important target in the gene therapy of lung cancer.

Emergency treatment for aorto-esophageal fistula by endovascular aortic repair / 中华胸心血管外科杂志

Objective To investigate the clinical features,essentials of diagnosis,selection of endovascular treatment and prognosis of aorto-esophageal fistula(AEF).To improve the understanding of the disease.Methods 3 patients with AEF from October 2010 to July 2016 in Changhai Hospital,including clinical symptoms and signs,endovascular treatment process and follow-up results,and review the relevant literature.Results Two of the 3 patients are men,and another is a woman.Aged 64-70 years.The causes of AEF are chest trauma,thoracic aorta pseudoaneurysms and foreign body ingestion,respectively.All the 3 patients had chest pain,hematemesis,and fever.Two of them showed sentinel hemorrhage and another showed a sudden massive hematemesis.Upper gastrointestinal endoscopy or computed tomographic angiography (CTA) confirmed the diagnosis in all patients.They all underwent thoracic endovascular aortic repair(TEVAR).The effect was good in acute phase.It didn't have any significant short-term complications.Re-bleeding time was 35 days to 85 days.Two patients died of recurrent severe hemorrhage post operation,and one of them had received TEVAR again but not it was ineffective.Another died of multiple organ failure after open surgery.Conclusion Since it showed the short-term effect but not the long-term effect,TEVAR can only be applied as a temporary remedy to the patients in poor conditions and be substituted by the open surgery when the patients were in better conditions.

Current status and future perspectives of robotic surgery for esophageal carcinoma / 国际外科学杂志

The esophageal cancer is a commmon maligant tumor.The main treatment for esophageal cancer is surgery.Robotic surgery,a new rising surgery,offers an option for esophageal cancer,besides the traditional open surgery and minimally invasive esophagectomy.The robotic surgical system with the advantages like magnifying 3-dimensional view,accuracy and stability,has been increasingly applied in the field of esophageal cancer recent years.Robotic surgery for esophageal cancer has a wide range of indication,and its trauma is small.Long-term and short-term outcone is good.So robotic surgery for esophageal concer is a safe and feasible surgical approach.

Synthesis of strontium-containing porous hydroxyaptite ceramics and study of its biological properties / 生物医学工程学杂志

Strontium added into porous hydroxyaptite ceramics has the functions of improving its osseointegration, decreasing its dissolution rate and improving the bone density. Strontium-containing hydroxyaptite (Sr-HA) ceramics has been used as bone replacement and scaffold to treat the osteoporosis and bone default in clinic, but the mechanism of interfacial tissue response caused by the trace element Sr in Sr-HA ceramics still remains to be further studied. Four types of Sr-HA ceramic samples with different contents of Sr were prepared by microwave plasma sintering for testing the response of the soft tissue implanted in dog muscles in our laboratory. The contents of Sr element in the samples are 0 mol%, 1 mol%, 5 mol%, and 7 mol%, respectively. The samples were implanted in the muscle of the dogs for 4 weeks, 8 weeks and 12 weeks, respectively. The histological observations at the end of each period showed that the irritant ranking increased with the content of Sr in Sr-HA ceramics at the end of 12 weeks, and there were rich bone tissue in Sr-HA ceramic samples with 5 mol% Sr element. The overdose of element Sr is harmful to soft tissues. When the content of Sr in Sr-HA ceramic was below 5 mol%, the soft tissue response was very slight and the new bones were induced to grow well.

Splenic sarcoidosis: a case report and review of literature / 中华内科杂志

Objective To describe the clinical features and imaging characteristics of nodular splenic sarcoidosis. Methods We describe a patient with splenic sarcoidosis and review the related medical literature, the etiology, symptomatology, pathology, diagnosis, differential diagnosis, management and prognosis of splenic sarcoidosis. Results The etiology of this rare disease remains unknown. Symptoms are scanty and usually mild; computed tomography usually reveals splenomegaly or the presence of multiple nodules, confusing with metastatic tumor in spleen. On histopathologic examination, sarcoid produces noncaseating granulomas. Sarcoid is typically treated only when symptomatic. Oral corticosteroids is the most important method of treatment in patients with progressive loss of organ functions. Prognosis has closed relationship with early clinical manifestation. Conclusion Splenic sarcoidosis is rare and often misdiagnosis as other diseases.

Three-dimensional finite element analysis and biomechanical study on reconstruction of the large defect of proximal femur with allograft prosthesis composite in clinical bone-healing phase / 生物医学工程学杂志

Three-dimensional finite element models of the large defect of proximal femur were reconstructed with allograft prosthesis composite in clinical bone-healing phase; current model was under the given conditions of 138mm-intramedullary stem-length of host bone and 135mm defect-length of proximal femur. The femur was constructed with efilm software from CT data, then three-dimensional concrete models were created by using Proe-Wildfire software; the three-dimensional finite element models of allograft prosthesis composite were made in ANSYS11 software. Loads were simulated using the peaking values during stance walking. The stress on femur-cement-callus-prostheses and the influence of stress on the clinical bone-healing phase were analysed. The highest stress value of femur is on the medial side of the tip of the prostheses. The highest stress value of cement mantle is on the medical side of the cement mantle at the tip of the stem. The highest stress value of the prostheses is on the medial side near the upper 4cm of the stem tip. The highest stress value on the callus is at the medial side of the callus layer. The highest stress value on every part is under the corresponding fatigue strength. Clinical bone-healing phase model is well enough for stance walking.