RESUMO
Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.
RESUMO
Objective:To explore the relationships among perceived social constraints, social participation, as well as anxiety and depression in first stroke patients, and to further analyze the mediating effect of social participation on these variables.Methods:A total of 216 first stroke patients in the Department of Neurology of Affiliated Hospital of Qingdao University from April to December 2020 were recruited by convenience sampling and investigated by general information questionnaire, Social Constraints Scale (SCS), Chinese version of Impact on Participation and Autonomy Questionaire (IPA-C) and Hospital Anxiety and Depression Scale (HADS).Results:The total score of SCS, IPA-C, depression and anxiety were 33.49 ± 6.81, 43.42 ± 9.62, 8.05 ± 4.15 and 8.61 ± 2.59. Social constraints were positively correlated with social participation as well as anxiety ( r=0.644, 0.383, both P<0.05). Social constraints were positively correlated with social participation as well as depression ( r=0.482, 0.371, both P<0.05). The quality of social participation partially mediated the relationship between social constraints and anxiety (intermediary effect was 0.119), and also partially mediated the relationship between social constraints and depression (intermediary effect was 0.270). Conclusions:First stroke patients experience high level of social constraints, low quality of social participation and severe anxiety and depression. Social constraints can affect anxiety and depression through social participation. Medical staff should build a good environment to meet the needs of stroke patients of social participation, help patients to establish a correct psychological coping style, reduce patients' avoidance of social participation due to perceived constraints and exclusion, and thus promote the mental health of patients.
RESUMO
Objective:To analyze the clinicopathological characterization of primary esophageal benign tumor (EBT). Methods:A total of 1,058 EBTs were enrolled from 500,000 cases in an esophageal and cardiac tumor biological sample and clinical information data-base of Henan Key Laboratory for Esophageal Cancer Research (1973-2015) in the First Affiliated Hospital of Zhengzhou University. SPSS 21.0 software was applied for data analysis. Results:In this database, 1,058 cases with primary EBTs among the 249,246 esopha-geal tumor patients with detailed clinical and pathological information were identified with an incidence of 0.42%(1,058/249,246). A total of 544 patients were male with an average age of 50±11 years old, whereas 514 patients were female, with an average age of 52± 11 years old. Among the 10 types of EBTs, leiomyoma was the most common type (84.50%, 894/1,058), followed by papilloma (6.90%, 73/1058). Adenoma (0.38%, 4/1,058) was the rarest type. Leiomyoma, gastrointestinal stromal tumor, and neurofibroma mainly oc-curred in male patients. By contrast, lipoma, granulosa cell tumor, schwannoma, and hemangioma mainly occurred in female patients.All five cases of hamartoma occurred only in female patients. Given the incidence of≥50%as the common standard, the common EBT in sequence in young male patients was leiomyoma and gastrointestinal stromal tumor, whereas that in young female patients was granulosa cell tumor and lipoma. The common EBT in sequence in older male patients was papilloma, gastrointestinal stromal tumor, and leiomyoma, whereas that in older female patients was schwannoma, papilloma, leiomyoma, gastrointestinal stromal tumor, and hamartoma. Additionally, lipoma, hemangioma, neurofibroma, and adenoma in male patients and neurofibroma in female patients oc-curred in older patients. The different ages of patients with EBTs (P=0.034) and leiomyoma (P=0.004) had a statistical significance. In these EBTs, leiomyoma, papilloma, gastrointestinal stromal tumor, and schwannoma mainly occurred in the middle esophagus, where-as lipoma mainly occurred in the lower esophagus. The major treatment for EBT in the present study was surgery (57.54%, 492/855), which was followed by endoscopic resection (38.01%, 325/855) and others (4.45%, 38/855). Conclusion:The incidence of EBT is low, with a couple of different histological types. Gender, age, and predilection sites are different depending on the histological types of EBTs. Surgery and endoscopic resection are the major treatment methods.
RESUMO
Objective To investigate the effect of dexmedetomidine on the expression of purinergic P2X4 receptor (P2X4R) mRNA and p38 mitogen-activated protein kinase (p38 MAPK) mRNA in spinal cord in a rat model of neuropathic pain (NP).Methods Seventy-two male SD rats weighing 180-220 g were randomly assigned into 3 groups ( n =24 each):sham operation group (group S),group NP and dexmedetomidine group ( group DEX).The animals were anesthetized with intraperitoneal 10％ choral hydrate 350 mg/kg.NP was induced by chronic constrictive injury (CCI).The right sciatic nerve was exposed and 4 ligatures were placed on sciatic nerve at 1 mm intervals with 4-0 silk thread in groups NP and DEX.In group S,the right sciatic nerve was only exposed but not ligated.Dexmedetomidine 50μg/kg was injected intraperitoneally daily staring from the end of operation,while the equal volume of normal saline was injected in groups S and NT.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured on day 1 before operation and on day 1,3,7 and 14 after operation.Six animals were sacrificed after MWT and TWL measurement on day 1,3,7 and 14 after operation in each group,the L4～6 segment of spinal cords was removed for determination of P2X4 R mRNA and p38 MAPK mRNA expression by RT-PCR.Results Compared with group S,MWT and TWL were significantly decreased and the expression of P2X4 R mRNA and p38 MAPK mRNA was significantly up-regulated after operation in groups NP and DEX ( P ＜0.05).Compared with group NP,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and p38 MAPK mRNA was significantly down-regulated after operation in group DEX ( P ＜ 0.05 ).TWL and MWT were significantly higher and the expression of P2X4 R mRNA and p38 MAPK mRNA was significantly lower on day 1,3 and 14 after operation than on day 7 after operation in groups NiP and DEX ( P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine attenuates NP is related to inhibition of the expression of P2X4 R mRNA and p38 MAPK in rats.
RESUMO
Objective To investigate the effects of dexmedetomidine (Dex) on the neuronal apoptosis in spinal dorsal horn in a rat model of chronic neuropathic pain.Methods Seventy-two adult male SD rats weighing 180-220 g were randomly divided into 3 groups ( n =24 each):sham operation group (group S) ; chronic constrictive injury (CCI) group; Dex + CCI group (group D).Two ligatures were placed on right sciatic nerve at 1 mm intervals with 4-0 silk thread in groups CCI and D.In group D Dex 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (PWT) and paw withdrawal latency to thermal stimulation (PWL) were measured at one day before (T0,baseline) and on the 3rd,7th and 14th day after operation (T1,2,3).Six animals were sacrificed at each time points (T1,2,3) after the measurement of PWT and PWL.Their lumbar segments (L4,5)were removed for examination with transmission electron microscope and detection of Bcl-2 and caspase-3 expression (by immune-histochemistry).Results CCI significantly decreased PWT and PWL,increased Bcl-2 and caspase-3 expression at T1,2,3 and induced apoptosis in spinal dorsal horn neurons in group CCI as compared with group S.Intraperitoneal Dex significantly attenuated CCI-induced mechanical and thermal hyperalgesia and neuronal apoptosis in group D as compared with group CCI.Dex injected intraperitoneally further increased Bcl-2 expression but decreased caspase-3 expression in group D as compared with group CCI.Conclusion Reduction in neuronal apoptosis in spinal dorsal horn is involved in the attenuation of neuropathic pain by Dex.