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1.
Zhongguo Gu Shang ; 36(11): 1030-5, 2023 Nov 25.
Article in Chinese | MEDLINE | ID: mdl-38012870

ABSTRACT

OBJECTIVE: To compare the short-term clinical efficacy of SuperCap approach and direct anterior approach in total hip arthroplasty. METHODS: Clinical data of 70 patients who underwent minimally invasive SuperCap approach and DAA THA in January 2016 to June 2017 were retrospective analyzed. These patients were divided into two groups:SuperCap approach group(SuperCap group) and direct anterior approach group(DAA group). There were 15 males and 15 females in SuperCap group, aged from 45 to 71 years old, and the follow-up time ranged from 24 to 30 months. There were 24 males and 16 females in Group B, aged from 51 to 76 years and the follow-up time ranged from 24 to 36 months. Hemoglobin level of the 3rd day after operation, transfusion rate, acetabular abduction angle, anteversion angle and creatine kinase level of the 3rd day after operation, Harris score of 3 months and the last time, VAS score of 1 week and the last time were recorded and compared. Complications were recorded at the final follow-up. RESULTS: All patients were followed up, the follow-up time of SuperCap group ranged from 24 to 30 months, that of DAA group ranged from 24 to 36 months. No significant differences were found in hemoglobin level on the 3rd day after operation, transfusion rate, Harris score or VAS score between two group (P>0.05). There was no significant difference in Harris score between 3 months after operation and the final follow-up in both groups (P>0.05). There were no significant difference in VAS scores of 6 weeks after operation and on the final follow-up neither(P>0.05). The level of creatine kinase in SuperCap group was significant lower than that in DAA group(P<0.05). Until the final follow-up, there was no significant difference in the incidence of complications between the two groups(P>0.05). CONCLUSION: The clinical effect of minimally invasive SuperCap approach after total hip arthroplasty is comparable to that of DAA approach with less soft tissue injury. Patients can recover rapidly after operation and it is a safe and effective surgical approach for surgeons with short learning curve.


Subject(s)
Arthroplasty, Replacement, Hip , Male , Female , Humans , Middle Aged , Aged , Retrospective Studies , Antiviral Agents , Treatment Outcome , Creatine Kinase , Hemoglobins
2.
Oral Dis ; 29(7): 2895-2906, 2023 Oct.
Article in English | MEDLINE | ID: mdl-36577658

ABSTRACT

OBJECTIVES: Mastication is associated with brain activation at the primary somatosensory cortex (S1) and the primary motor cortex (M1). Masticatory functions differ between patients with cognitive impairment (CI) and cognitively healthy older adults (non-CI). The association between cognitive health, brain network of functional connectivity, and mastication has remained unknown. The study investigated the association between masticatory performance (MP) and the topological feature of the functional network at the M1 and S1 in the CI and non-CI groups. SUBJECTS AND METHODS: Forty-nine non-CI and 15 CI subjects received resting-state (rs) fMRI and assessment of MP. The topological feature of the M1 and S1 was quantified by eigenvector centrality (EC), an index that reflects a brain region as a functional "hub" of brain network. RESULTS: In the non-CI group, MP was significantly correlated with EC of the left M1 and the right M1. The correlation was not statistically significant in the CI group. Cognitive status (CI or non-CI) and EC of the left M1 and the right M1, respectively, were statistically significant predictors to individual MP. CONCLUSION: Cognitive status and the topological feature of the M1 in the intrinsic functional network may contribute to the individual difference in masticatory function.


Subject(s)
Cognitive Dysfunction , Motor Cortex , Humans , Aged , Brain Mapping , Motor Cortex/diagnostic imaging , Motor Cortex/physiology , Brain/diagnostic imaging , Brain/physiology , Cognitive Dysfunction/diagnostic imaging , Magnetic Resonance Imaging , Cognition/physiology
3.
Int J Colorectal Dis ; 31(3): 561-70, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26700099

ABSTRACT

BACKGROUD: The efficacy and safety of self-expandable metallic stents (SEMSs) as a bridge for patients with acute malignant colorectal obstructions (AMCOs) are still controversial. We conducted this study to evaluate the outcomes of patients with AMCOs treated by different strategies. METHODS: From January 2010 to March 2014, a total of 171 patients with AMCOs from Zhongshan Hospital were retrospectively enrolled in this study. One hundred twenty patients successfully received stent placement followed by one-stage laparoscopic or open resection in the stent group, and 51 patients received emergency operations in the emergency group. RESULTS: The operation duration and postoperative hospital stay were significantly shorter in the stent group (114.51 ± 28.65 vs. 160.39 ± 58.94 min, P < 0.001; 8.00 ± 3.97 vs. 12.59 ± 9.07 days, P = 0.001). The stent group also had significantly reduced intraoperative blood loss and the incidence of postoperative complications compared with the emergency group (61.00 ± 43.70 vs. 121.18 ± 85.90 ml, P < 0.001; 16.7 vs. 37.3%, P = 0.003). Kaplan-Meier survival curves showed that the median survival time in the stent group was significantly longer than that in the emergency group (53 vs. 41 months, P = 0.034). In subgroup analysis of stent group, the stent laparoscopy group had significantly decreased postoperative complications (P = 0.025), and similar long-term survival (P = 0.81). CONCLUSIONS: Stent placement as a bridge to surgery is a safe and feasible procedure and provides significant advantages in terms of short-term outcomes and favorable prognoses for patients with AMCOs. Laparoscopic surgery could be considered as an optimal treatment after stent placement.


Subject(s)
Colorectal Neoplasms/complications , Colorectal Neoplasms/surgery , Elective Surgical Procedures , Emergencies , Intestinal Obstruction/complications , Intestinal Obstruction/surgery , Self Expandable Metallic Stents , Adult , Aged , Elective Surgical Procedures/adverse effects , Female , Humans , Kaplan-Meier Estimate , Laparoscopy/adverse effects , Male , Middle Aged , Postoperative Complications/etiology , Self Expandable Metallic Stents/adverse effects , Treatment Outcome , Young Adult
4.
Tumour Biol ; 36(11): 8747-54, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26050227

ABSTRACT

Long noncoding RNA (lncRNA) plays a crucial role in the regulation of various cellular processes and human diseases. However, little is known about the role of lncRNAs in colorectal liver metastasis (CLM). In the present study, we aimed to determine whether lncRNAs are differentially expressed in CLM tissue and to further assess their clinical value. lncRNA arrays were employed to screen for differentially expressed lncRNAs in colorectal cancer (CRC) tissues with synchronous, metachronous, or nonliver metastasis. Based on bioinformatics data, a quantitative reverse-transcription polymerase chain reaction (qRT-PCR) assay was performed to identify target lncRNAs in an expanded set of CRC samples with various subtypes of liver metastasis. The relationships between the target lncRNAs and the clinical characteristics and patient prognosis were further analyzed. After determining the expression profile of lncRNAs (n = 1332) in CLM tissue, 40 differentially expressed lncRNAs that were potentially related to CLM were selected for further examination in an expanded set of clinical samples, and three novel target lncRNAs, termed lncRNA-CLMAT1-3, were verified. High lncRNA-CLMAT3 expression strongly correlated with liver metastasis (P = 0.03) and lymph node metastasis (P = 0.009). Moreover, patients displaying high lncRNA-CLMAT3 expression exhibited a shorter median overall survival duration than those displaying low lncRNA-CLMAT3 expression (30.7 vs. 35.2 months, P = 0.007). Multivariate analysis demonstrated that the lncRNA-CLMAT3 expression level is an independent prognostic factor (hazard ratio 2.05, P = 0.02) after adjusting for other known prognostic factors. lncRNA-CLMAT3 over-expression was significantly associated with CLM and was an independent predictor of poor survival for patients with CRC.


Subject(s)
Colorectal Neoplasms/genetics , Liver Neoplasms/genetics , Prognosis , RNA, Long Noncoding/biosynthesis , Adolescent , Adult , Aged , Colorectal Neoplasms/pathology , Female , Gene Expression Regulation, Neoplastic , Humans , Kaplan-Meier Estimate , Liver Neoplasms/pathology , Liver Neoplasms/secondary , Lymphatic Metastasis , Male , Middle Aged , RNA, Long Noncoding/genetics
5.
World J Gastroenterol ; 21(14): 4184-94, 2015 Apr 14.
Article in English | MEDLINE | ID: mdl-25892868

ABSTRACT

AIM: To test whether hepatic stellate cells (HSCs) at different activation stages play different roles in acetaminophen (APAP)-induced acute liver injury (ALI). METHODS: HSCs were isolated from mouse liver and cultured in vitro. Morphological changes of initiation HSCs [HSCs (5d)] and perpetuation HSCs [HSCs (p3)] were observed by immunofluorescence and transmission electron microscopy. The protective effects of HSC-derived molecules, cell lysates and HSC-conditioned medium (HSC-CM) were tested in vivo by survival and histopathological analyses. Liver injury was determined by measuring aminotransferase levels in the serum and by histologic examination of tissue sections under a light microscope. Additionally, to determine the molecular mediators of the observed protective effects of initiation HSCs, we examined HSC-CM using a high-density protein array. RESULTS: HSCs (5d) and HSCs (p3) had different morphological and phenotypic traits. HSCs (5d) presented a star-shaped appearance with expressing α-SMA at non-uniform levels between cells. However, HSCs (p3) evolved into myofibroblast-like cells without lipid droplets and expressed a uniform and higher level of α-SMA. HSC-CM (5d), but not HSC-CM (p3), provided a significant survival benefit and showed a dramatic reduction of hepatocellular necrosis and panlobular leukocyte infiltrates in mice exposed to APAP. However, this protective effect was abrogated at higher cell masses, indicating a therapeutic window of effectiveness. Furthermore, the protein array screen revealed that HSC-CM (5d) was composed of many chemokines and growth factors that correlated with inflammatory inhibition and therapeutic activity. When compared with HSC-CM (p3), higher levels of monocyte chemoattractant protein-1, macrophage inflammatory protein-1γ, hepatocyte growth factor, interleukin-10, and matrix metalloproteinase-2, but lower levels of stem cell factor and Fas-Ligand were observed in HSC-CM (5d). CONCLUSION: These data indicated that initiation HSCs and perpetuation HSCs were different in morphology and protein expression, and provided the first experimental evidence of the potential medical value of initiation HSC-derived molecules in the treatment of ALI.


Subject(s)
Chemical and Drug Induced Liver Injury/metabolism , Chemokines/metabolism , Hepatic Stellate Cells/metabolism , Intercellular Signaling Peptides and Proteins/metabolism , Liver/metabolism , Paracrine Communication , Acetaminophen , Animals , Anti-Inflammatory Agents/administration & dosage , Cell Shape , Cells, Cultured , Chemical and Drug Induced Liver Injury/drug therapy , Chemical and Drug Induced Liver Injury/etiology , Chemical and Drug Induced Liver Injury/pathology , Chemokines/administration & dosage , Culture Media, Conditioned/metabolism , Disease Models, Animal , Hepatic Stellate Cells/drug effects , Hepatic Stellate Cells/ultrastructure , Intercellular Signaling Peptides and Proteins/administration & dosage , Liver/drug effects , Liver/ultrastructure , Male , Mice, Inbred C57BL , Necrosis , Phenotype , Signal Transduction , Time Factors
6.
World J Gastroenterol ; 21(9): 2848-53, 2015 Mar 07.
Article in English | MEDLINE | ID: mdl-25759560

ABSTRACT

The Da Vinci Surgical System may help to overcome some of the difficulties of laparoscopy for complicated abdominal surgery. The authors of this article present a case of robot-assisted, one-stage radical resection of three tumors, including robotic anterior resection for rectal cancer, segmental hepatectomy for liver metastasis, and wedge-shaped excision for lung metastasis. A 59-year-old man with primary rectal cancer and liver and lung metastases was operated upon with a one-stage radical resection approach using the Da Vinci Surgical System. Resection and anastomosis of rectal cancer were performed extracorporeally after undocking the robot. The procedure was successfully completed in 500 min. No surgical complications occurred during the intervention and postoperative period, and no conversion to laparotomy or additional trocars were required. To the best of our knowledge, this is the first case of simultaneous resection for rectal cancer with liver and lung metastases using the Da Vinci Surgery System to be reported. The procedure is feasible and safe and its main advantages for patient are avoiding repeated operation, reducing surgical trauma, shortening recovery time, and early implementation of postoperative adjuvant therapy.


Subject(s)
Hepatectomy/methods , Liver Neoplasms/secondary , Liver Neoplasms/surgery , Lung Neoplasms/secondary , Lung Neoplasms/surgery , Metastasectomy/methods , Pneumonectomy/methods , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Robotic Surgical Procedures/methods , Humans , Male , Middle Aged , Multimodal Imaging , Positron-Emission Tomography , Time Factors , Tomography, X-Ray Computed , Treatment Outcome
7.
World J Gastroenterol ; 20(15): 4263-75, 2014 Apr 21.
Article in English | MEDLINE | ID: mdl-24764664

ABSTRACT

Colorectal liver metastasis (CLM) is common worldwide. Targeted therapies with monoclonal antibodies have been proven effective in numerous clinical trials, and are now becoming standards for patients with CLM. The development and application of anti-epidermal growth factor receptor (anti-EGFR) and anti-vascular endothelial growth factor (anti-VEGF) antibodies represents significant advances in the treatment of this disease. However, new findings continue to emerge casting doubt on the efficacy of this approach. The Kirsten rat sarcoma viral oncogene (KRAS) has been proven to be a crucial predictor of the success of anti-EGFR treatment in CLM. Whereas a recent study summarized several randomized controlled trials, and showed that patients with the KRAS G13D mutation significantly benefited from the addition of cetuximab in terms of progress-free survival (PFS, 4.0 mo vs 1.9 mo, HR = 0.51, P = 0.004) and overall survival (OS, 7.6 mo vs 5.7 mo, HR = 0.50, P = 0.005). Some other studies also reported that the KRAS G13D mutation might not be absolutely predictive of non-responsiveness to anti-EGFR therapy. At the same time, "new" RAS mutations, including mutations in neuroblastoma RAS viral (v-ras) oncogene homolog (NRAS) and exons 3 and 4 of KRAS, have been suggested to be predictors of a poor treatment response. This finding was first reported by the update of the PRIME trial. The update showed that for patients with non-mutated KRAS exon 2 but other RAS mutations, panitumumab-fluorouracil, leucovorin, and oxaliplatin (FOLFOX)4 treatment led to inferior PFS (HR = 1.28, 95%CI: 0.79-2.07) and OS (HR = 1.29, 95%CI: 0.79-2.10), which was consistent with the findings in patients with KRAS mutations in exon 2. Then, the update of the PEAK trial and the FIRE-III trial also supported this finding, which would reduce candidates for anti-EGFR therapy but enhance the efficacy. In first-line targeted combination therapy, the regimens of cetuximab plus FOLFOX was called into question because of the inferior prognosis in the COIN trial and the NORDIC-VII trial. Also, bevacizumab plus oxaliplatin-based chemotherapy was questioned because of the NO16966 trial. By the update and further analysis of the COIN trial and the NORDIC-VII trial, cetuximab plus FOLFOX was reported to be reliable again. But bevacizumab plus oxaliplatin-based chemotherapy was still controversial. In addition, some trials have reported that bevacizumab is not suitable for conversion therapy. The results of the FIRE-III trial showed that cetuximab led to a significant advantage over bevacizumab in response rate (72% vs 63%, P = 0.017) for evaluable population. With the balanced allocation of second-line treatment, the FIRE-III trial was expected to provide evidence for selecting following regimens after first-line progression. There is still no strong evidence for the efficacy of targeted therapy as a preoperative treatment for resectable CLM or postoperative treatment for resected CLM, although the combined regimen is often administered based on experience. Combination therapy with more than one targeted agent has been proven to provide no benefit, and even was reported to be harmful as first-line treatment by four large clinical trials. However, recent studies reported positive results of erlotinib plus bevacizumab for maintenance treatment. The mechanism of antagonism between different targeted agents deserves further study, and may also provide greater understanding of the development of resistance to targeted agents.


Subject(s)
Colorectal Neoplasms/therapy , ErbB Receptors/antagonists & inhibitors , Liver Neoplasms/secondary , Liver Neoplasms/therapy , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Clinical Trials as Topic , Colorectal Neoplasms/pathology , Disease-Free Survival , Exons , Fluorouracil/therapeutic use , Humans , Leucovorin/therapeutic use , Mutation , Organoplatinum Compounds/therapeutic use , Practice Guidelines as Topic , Proto-Oncogene Proteins/metabolism , Proto-Oncogene Proteins p21(ras) , Randomized Controlled Trials as Topic , Treatment Outcome , ras Proteins/metabolism
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