ABSTRACT
The effectiveness of platelet-rich plasma (PRP) for the treatment of Achilles tendon disorders still needs to be evaluated through a series of prospective studies, but genomic analysis can reveal the existence of complementary PRP treatment options. Based on the 96 platelet activation-related genes in the Kyoto Encyclopedia of Genes and Genomes (KEGG) database, we performed Gene Ontology functional enrichment analysis and KEGG enrichment analysis, pathway correlation analysis, and enrichment mapping to determine the enrichment results of the gene set enrichment analysis and found that the cAMP signalling pathway may be the key to enhancing the effectiveness of PRP treatment. The cAMP signalling pathway interacts with the Rap1 signalling pathway and cGMP-PKG signalling pathway to mediate the entire pathophysiological process of Achilles tendon disease. Moreover, ADCY1-9 may be the key to the activation of the cAMP signalling network. Further based on the data in the Gene Expression Omnibus database, it was found that ADCY4 and ADCY7 may be the players that play a major role, associated with the STAT4-ADCY4-LAMA5 axis and the GRbeta-ADCY7-SEMA3C axis, which is expected to be a complementary target for enhancing the efficacy of PRP in the treatment of Achilles tendon disease.
ABSTRACT
BACKGROUND: Multiple gastrointestinal stromal tumors (MGISTs) are specific and rare. Little is known about the impact of MGISTs on the survival of patients with gastrointestinal stromal tumors (GIST). The diagnosis, treatment and follow-up strategies of MGISTs is not specifically described in guidelines. AIM: To compare the clinicopathological characteristics and prognosis of MGISTs and solitary GISTs (SGISTs). METHODS: Patients diagnosed with primary GISTs from March 2010 to January 2020 were included. Due to the inhomogeneous distribution of several baseline characteristics and uneven MGIST and SGIST group sizes, propensity score matching was performed according to comorbidities, body mass index, tumor location, mitotic index, sex, age and American Society of Anesthesiologists score. Differences in clinicopathological characteristics and prognosis between patients with MGISTs and patients with SGISTs were compared. RESULTS: Among the entire cohort of 983 patients, the incidence of MGISTs was 4.17%. Before matching, patients with MGISTs and those with SGISTs had disparities in body mass index, surgical approach, tumor size and mitotic index. After 1:4 ratio matching, the clinical baseline data were comparable. The 5-year progression-free survival rate was 52.17% in the MGIST group and 75.00% in the SGIST group (P = 0.031). On multivariate analysis, tumor location, tumor size, mitotic index, imatinib treatment and MGISTs (hazard ratio = 2.431, 95% confidence interval = 1.097-5.386, P = 0.029) were identified as independent prognostic factors of progression-free survival. However, overall survival was similar between the SGIST and MGIST groups. CONCLUSION: Patients with MGISTs had poorer progression-free survival than patients with SGISTs. Risk criteria and diagnostic and treatment strategies should be developed to achieve personalized precision therapy and maximize the survival benefit.
Subject(s)
Gastrointestinal Stromal Tumors , Neoplasms, Multiple Primary , Gastrointestinal Stromal Tumors/therapy , Humans , Mitotic Index , Prognosis , Propensity ScoreABSTRACT
OBJECTIVE: To study the time-dependent effects of pentabrominated diphenyl ethers on thyroid hormones and the histological structure of thyroids in rats. METHODS: One hundred healthy 4-week-old SD rats were randomly divided into 10 groups. The rats in the experimental groups were orally administered with pentabrominated diphenyl ethers (BDE-99) at a dose of 60 mg/kg for 10, 15, 20, 30 and 40 days respectively, while the rats in the control groups received equal volumes of corn oil for the same periods of time. Serum FT4, FT3 and TSH were measured by radioimmunoassay. Sections of thyroids were dyed with hematoxylin-eosin (HE) to detect pathological alterations in thyroid tissues. RESULTS: Decreased serum FT4 and FT3 and increased TSR were detected in the BDE-99 treated rats at DiS and D20. No significant differences of serum hormones were found between the experimental and control groups at D10, D30 and D40. The thyroid follicle epithelium of the BDE-99 treated rats proliferated into multiple-layer structure at DiS. At D20, proliferative plaque formed in local areas. Solid buds and follicles secondary to the solid buds were detected at D30 and D40. CONCLUSION: BDE-99 leads to structural changes of thyroids, reduces serum FT4 and FT3 and increases TSR. The time-dependent effects are evident in a damage and compensate pattern.
