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Objective:To compare the clinicopathological features between patients with gallbladder adenosquamous carcinoma and gallbladder adenocarcinoma, and analyze the prognostic factors for overall survival.Methods:The clinical data of 135 patients with gallbladder cancer, confirmed by postoperative pathology, treated in Department of Hepatobiliary and Pancreatic Surgery of Ningbo Medical Center Lihuili Hospital within 5 years (from January 2018 to December 2022) were retrospectively analyzed. A total of 122 patients were enrolled in this study, including 55 males and 67 females, aged (68.0±9.8) years. Patients were divided into the adenosquamous carcinoma group ( n=14) and adenocarcinoma group ( n=108). The clinicopathological features (tumor size, differentiation of tumor, tumor TNM stage) and survivals of patients were compared. The survival rates were analyzed using the Kaplan-Meier method and log-rank test. Multivariate Cox regression analysis was performed to identify prognostic factors for overall survival. Results:Compared with the adenocarcinoma group, patients with adenosquamous carcinoma had a larger tumor size, higher incidence of liver invasion, higher proportion of poor differentiation of tumor, higher proportion of TNM stage Ⅲ-Ⅳ (all P<0.05). There was also a statistically significant difference in the extent of liver resection between the two groups ( χ2=9.22, P=0.016). The 1- and 2-year cumulative survival rates after surgery in adenosquamous carcinoma group were 28.6% and 9.5%, respectively, lower than those in adenocarcinoma group (78.7% and 60.5%, respectively; χ2=27.88, P<0.001). For patients with gallbladder adenosquamous carcinoma, the cumulative survival rate of patients who received postoperative adjuvant chemotherapy ( n=11) was significantly better than that of patients without postoperative adjuvant chemotherapy ( n=3) ( χ2=5.82, P=0.016). For patients with gallbladder adenocarcinoma, multivariate Cox regression analysis identified that the N stage (N 1/N 0HR=4.521, 95% CI: 1.399-14.612, P=0.012; N 2/N 0HR=8.644, 95% CI: 2.407-31.039, P=0.001) and M stage (M 1/M 0HR=4.699, 95% CI: 1.540-14.340, P=0.007) were associated with a poor survival. Conclusions:Compared to gallbladder adenocarcinoma, adenosquamous carcinoma had more aggressive features and a worse prognosis. For patients with gallbladder adenosquamous carcinoma, postoperative adjuvant chemotherapy was associated with an improved overall survival. For patients with gallbladder adenocarcinoma, N stage and M stage were independent risk factors for overall survival.
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Objective@#To investigate the value of four-dimensional echocardiography combined with speckle tracking technique on the assessment of right heart function and prognosis in patients with pulmonary arterial hypertension (PAH).@*Methods@#In this prospective study, 51 patients with PAH diagnosed by right heart catheterization in east hospital and south hospital of Renji hospital affiliated to school of medicine of Shanghai Jiaotong University from September 2015 to July 2017 were enrolled as PAH group from July to November 2017. Meanwhile, 26 healthy volunteers with age and sex matched with pulmonary hypertension patients were recruited as control group. The patients were aged (45.8±15.5) years old in PAH group, and there were 6 males and 45 females. The healthy volunteers were aged (45.4±14.6) years old in control group, and there were 4 males and 22 females. Two-dimensional and four-dimensional echocardiographic images were obtained to measure the structure and function of the right heart. The myocardial strain of each ventricle and atrium was measured by sparkle tracking. The patients in PAH group were followed up from July 2017 to August 2018 to observe the endpoint events including all-cause death, re-hospitalization, and clinical deterioration.@*Results@#There were significant differences in two-dimensional echocardiographic parameters(including tricuspid annular plane systolic excursion (TAPSE), right ventricular area change fraction (FAC), and right ventricular systolic pressure (RVSP)), speckle tracking parameters (including global longitudinal systolic peak strain of left ventricle (LVGLS), global longitudinal systolic peak strain of right ventricle (RVGLS),left atrial reservoir function(LASr), left atrial conduit function (LASc), left atrial pump function (LASp), right atrial reservoir function (RASr), right atrial conduit function (RASc), and right atrial pump function (RASp)), and four-dimensional echocardiographic parameters(including right ventricular end diastolic volume (RVEDV) , right ventricular end systolic volume(RVESV), right ventricular stroke volume(RVSV), right ventricular freewall longitudinal strain(RVLSf), interventricular septum longitudinal strain(IVSLS), right ventricular ejection fraction(RVEF)) between control group and PAH group (all P<0.01 or 0.05).Spearman correlation analysis showed that RVEF was correlated with 6-minute walking distance (r=0.540, P<0.001), B-type natriuretic peptide (r=-0.545,P<0.001), New York Heart Association (NYHA) cardiac function classification(r=-0.583, P<0.001), TAPSE(r=0.595, P<0.001), LVGLS (r=-0.461, P=0.001) ,LASc (r=0.453, P=0.002) ,RASc (r=0.532, P<0.001) ,RVESV (r=-0.418, P=0.004) , RVSV (r=0.351, P=0.017) , and IVSLS (r=-0.450, P=0.002) . Pearson correlation analysis also showed that RVEF was correlated with FAC(r=0.579, P<0.001),RVSP (r=-0.442, P=0.002) ,RVGLS (r=-0.521, P<0.001) , LASr (r=0.483, P=0.001) , RASr (r=0.617, P<0.001) , RASp (r=0.513, P<0.001) , and RVLSf (r=-0.592, P<0.001) .After a follow-up of (10.4±2.7) months, there were 4 all-cause deaths, 5 re-hospitalizations and 5 clinical deterioration. Multivariate Cox regression analysis showed that increased RVEF was independent protective factor for end-point events in PAH patients (HR=0.702, P=0.043), and increased RVSP was independent risk factor for end-point events in PAH patients (HR=1.083, P=0.017). The receiver operating characteristic (ROC) curve showed that RVEF and RVSP could be used to predict the end-point events in PAH patients. The area under the curve (AUC) was 0.835(P=0.001) and 0.820(P=0.001), respectively.@*Conclusions@#RVEF measured by four-dimensional echocardiography is correlated with right ventricular function parameters measured by two-dimensional echocardiography and can be used to estimate the prognosis of PAH patients. The right atrial and left atrial function assessed by speckle tracking can also reflect the right ventricular function to a certain extent.
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Autologous submandibular gland (SMG) transplantation has been proved to ameliorate the discomforts in patients with severe keratoconjunctivitis sicca. The transplanted glands underwent a hypofunctional period and then restored secretion spontaneously. This study aims to investigate whether autonomic nerves reinnervate the grafts and contribute to the functional recovery, and further determine the origin of these nerves. Parts of the transplanted SMGs were collected from the epiphora patients, and a rabbit SMG transplantation model was established to fulfill the serial observation on the transplanted glands with time. The results showed that autonomic nerves distributed in the transplanted SMGs and parasympathetic ganglionic cells were observed in the stroma of the glands. Low-dense and unevenly distributed cholinergic axons, severe acinar atrophy and fibrosis were visible in the patients' glands 4-6 months post-transplantation, whereas the cholinergic axon density and acinar area were increased with time. The acinar area or the secretory flow rate of the transplanted glands was statistically correlated with the cholinergic axon density in the rabbit model, respectively. Meanwhile, large cholinergic nerve trunks were found to locate in the temporal fascia lower to the gland, and sympathetic plexus concomitant with the arteries was observed both in the adjacent fascia and in the stroma of the glands. In summary, the transplanted SMGs are reinnervated by autonomic nerves and the cholinergic nerves play a role in the morphological and functional restoration of the glands. Moreover, these autonomic nerves might originate from the auriculotemporal nerve and the sympathetic plexus around the supplying arteries.
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Animais , Feminino , Humanos , Masculino , Coelhos , Vias Autônomas , Fáscia , Ceratoconjuntivite Seca , Cirurgia Geral , Modelos Animais , Recuperação de Função Fisiológica , Taxa Secretória , Glândula Submandibular , Transplante , Transplante AutólogoRESUMO
Objective To investigate the expression and the clinical significance of meningioma-association protein（MAC30）mRNA and protein in colorectal carcinomas.Methods MAC30 was immunohistochemically examined in 130 primary tumours,73 distant normal mucosa specimens and 34 lymph node metastases from rectal cancer patients＇paraffin embedded blocks.MAC30 mRNA expression was detected by RT-PCR in primary tumors,adjacent and distal normal mucosa of 50 rectal cancer patients underwent colectomy.Results MAC30 cytoplasmic expression level in colorectal primary tumors and lymph node metastases was significantly higher than that in distant normal mucosa.MAC30 mRNA expression was upregulated in primary tumor,and the expression level was related to the histologic type of the tumor.Three-year survival rate of the colorectal carcinomas patients with strong expression of MAC30 was significantly lower than that of the patients with weak MAC30 expression（P 0.05）.Conclusion MAC30 overexpression might be involved in the development of colorectal carcinomas and seemed to be a prognostic factor.
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Objective To explore the correlation of pulmonary heart disease (PHD) with erythrocyte immunity function and serum erythropoietin(EPO)level. Methods Forty-eight patients with PHD were selected as PHD group, while forty people were chosen as control group. The erythrocyte C3b receptor (E-C3bRR), erythrocyte immunity complex (RBC-ICR) and serum EPO content were detected by yeast rosette method and enzyme-linked immunosorbent assay (ELISA),and blood gas indexes were examined by blood gas analyser.Results The E-C3bRR and serum EPO content were lower, while the RBC-ICR was higher in PHD group than in control group(both P< 0. 01). Compared with control group, PCOz and HCO3-levels were higher, but blood oxygen saturation(SaO2) level was lower in the PHD group than in control group(both P<0. 01). There were no differences in pH value and PO2between two groups(both P>0. 05). The E-C3bRR was positively related to serum EPO content (r=0. 623, P<0.01), and HCO3-was positively related to pH value and PCO2(r=0. 219 ,P<0. 05;r=0. 585,P<0. 01) ,whereas PCO2was negatively related to pH value(r=-0. 529,P<0.01),and PO2was positively related to SaO2(r=0. 682,P<0.01)in PHD group. Conclusions There is a correlation between E-C3bRR and serum EPO content in PHD patients.
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Objective To investigate the risk factors of hyperthermia in early period of an acute cerebral infarction.Methods 299 patients admitted to hospital from January 2003 to December 2004 with a diagnosis of cerebral infartion by CT or MRI,were retrospectively studied.The risks of hyperthermia in the early period for stroke,such as admission conscious level,bulbar palsy,emphysema,atrial fibrillation,multi-cerebral infarction,diabetes mellitus and chronic heart failure were analyzed,Logistic regression analysis was used to determine the factors that were associated with hyperthermia in the early period of stroke.Results 71 patients had fever in early period of an acute cerebral infarction(23.7%).The most common infection was pneumonia(18.4%).The analysis showed that the admission conscious level and atrial fibrillation were the risks of early hyperthermia of an acute cerebral infarction.Conclusion Admission conscious level(subconscious or unconscious/coma) and atrial fibrillation and chronic heart failure are independent risk factors for development of early hyperthermia for acute stroke.
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The apparent digestibilities of two preparations of corn as staples in men were estimated during March and April in 1979. Seven healthy adult men, who lived in this region for many years, were accustomed to eat corn as their staple diets. Each of the two preparations from the same batch of corn was used in the experiment. One preparation was "cooked corn meal" and the other was Jian-bing, the latter was considered the better way of cooking. Other ingredients of food in these two test diets were the same. During the test periods, the volunteers ate the test diets and drank boiled water ad lib, but the quantities were recorded. No other foodstuffs and drinks were allowed. The nutritive values of test diets were sufficient to meet the subjects' physiological needs. The 12 days period was divided into adaptative and testing periods of three days each for the two kinds of test diets. During the test periods, the total foodstuffs and the volunteers' faeces were analysed for the contents of water, anhydrates, total ni- trogen, crude fat, ash and fiber in the samples. From the data obtained, the apparent digestibilities of anhydrates, total nitrogen and crude fat ware calculated. Urine nitrogen was analysed and the nitrogen balance was calculated. The body weight at the beginning and the end of test periods were measured.The apparent digestibility (%) of anhydrates was 93.31?0.393 and 94.79 ? 0.578, total nitrogrn 84.60 ? 0.843 and 87.77 ? 1.080 and crude fat 86.32 ? 1.296 and 94.68 ? 0.838 in cooked corn meal diet and the corn flour Jian-bing diet respectively. The apparent digestibility in corn Jian-bing diet was higher statistically than that of cooked corn diet. Body weights fluctuated within the normal range. The nitrogen balances of all subjects were positive and the difference of nitrogen balance studies between the two test diets was not statistically significant.The results of the experiment suggest that, the differences of apparent digestibility between two diets was mainly due to the methods of preparation, Jian-bing being better than cooked corn diet in human nutrition.