Diagnostic potential of ultrasonography and computed tomography in differentiating cervical lymph node metastasis of thyroid cancer: a systematic review and meta-analysis.

Introduction: Ultrasonography (US) and computed tomography (CT) are the most common diagnostic modalities of cervical lymph node metastasis of thyroid cancer, but few studies have been conducted to compare their diagnostic accuracy, with inconclusive results. Material and methods: Multiple databases including PubMed, Springer, EMBASE, Ovid, and the Cochrane Library were searched with the keywords "thyroid cancer OR thyroid carcinomas", "cervical lymph nodes", "metastatic OR metastasis", and "ultrasonography OR ultrasound OR CT OR computed tomography" in June 2018. Full-text articles comparing diagnostic accuracy of US and CT were reviewed. Meta-analyses were conducted to estimate sensitivity and specificity. The forest plots of sensitivity and specificity and summary receiver operating characteristic curves (SROC) are also presented in this article. Results: Finally, 8 of 1785 studies which eventually met the inclusion criteria were selected in this study. The mean sensitivities and specificities of CT in whole and central cervical areas were 0.65, 0.56 and 0.89, 0.83, respectively, while for US, the sensitivities and specificities were 0.58, 0.39 and 0.89, 0.91, respectively. The area under the curve (AUCs) observed of CT and US in whole, central and lateral cervical areas were 0.79 vs. 0.79, and 0.76 vs. 0.67. Because only a few articles were included in this study, publication bias was not assessed. Conclusions: The diagnostic accuracy of US and CT was comparable. The specificity of these two methods was much higher than the sensitivity.

Long-term exposure to arsenic in drinking water leads to myocardial damage by oxidative stress and reduction in NO.

Chronic arsenic exposure causes myocardial damage. The aim of this study is to investigate if oxidative stress and reduction in NO is involved in the myocardial damage induced by arsenic in drinking water. Rats were divided into a control group and different doses of sodium arsenite. With increasing sodium arsenite concentrations in drinking water, localised inflammatory foci and necrotic myocardial tissues were gradually observed. Compared to the control group, the activities and gene expression of antioxidant enzymes in arsenic-exposed rats decreased. NO content and the NOS activity as well as the expression of NOS mRNA in the myocardial tissue of exposed rats, decreased, and the extracellular NO content of cardiomyocytes treated with sodium arsenite also decreased. The rate of cell apoptosis induced by sodium arsenite decreased after treatment with sodium nitroprusside (an NO donor). In conclusion, arsenic exposure in drinking water can lead to myocardial injury and cardiomyocyte apoptosis through oxidative stress and a reduction in NO content.

CCNI2 plays a promoting role in the progression of colorectal cancer.

Colorectal cancer (CRC) is one of the most common malignancies and most of the patients diagnosed with advanced CRC have unsatisfactory treatment effect and poor prognosis. The purpose of this study was to investigate the effect of CCNI2 on the development of CRC. In this sutdy, immunohistochemical staining was used to detect CCNI2 expression levels in clinical samples, meanwhile, the Kaplan-Meier survival analysis was conducted. Celigo cell counting assay was used for screening shCCNI2s. QPCR and WB were performed to verify knockdown efficiency of CCNI2. Cell proliferation, colony formation, cell cycle, apoptosis, and mechanism investigation of CCNI2 knockdown were investigated by MTT assay, colony formation assay, fluorescence-activated cell sorting, and human apoptosis antibody array, respectively. Otherwise, the mouse model of CCNI2 knockdown was also constructed. The results of immunohistochemical staining and qPCR indicated that CCNI2 had a high expression level in the CRC tissues and cell lines. Kaplan-Meier survival analysis manifested that the high expression of CCNI2 suggested poor prognosis. The expression of CCNI2 was significantly reduced by CCNI2-siRNAs, and the downregulated expression level of CCNI2 inhibited CRC cell proliferation and colony formation, arrested cell cycle in G2 phase, as well as promoted cell apoptosis. The various indexes of solid tumor in mice models indicated that CCNI2 knockdown could suppress the growth of CRC tumor. Based on the comprehensive analysis of the above results, CCNI2 was contributed to the progression of CRC and could serve as a prognostic marker for CRC.

Stabilization/solidification and recycling of sediment from Taihu Lake in China: Engineering behavior and environmental impact.

Investigations of stabilized/solidified sediment (S/S sediment) by simulated field-construction processes (crushing and filling) are fundamental to evaluating the potential reuse as fill materials. A series of tests were conducted on the samples prepared from S/S sediment grains (SG), which was obtained by crushing the cement treated sediment. By sampling the SG with different field-curing durations (t1: 28, 35, 56 and 98 days) and measuring them by unconfined compressive strength (UCS) tests, the effect of t1 on the UCS was investigated. By continually curing the samples prepared from the SG with 28 field-curing days in laboratory for an additional 7, 28, 35 and 70 days (t2) and subjecting them to UCS and tank leaching tests with different ambient (leachate) pH values (1, 4, 7, 10 and 14), the effect of t2 and ambient pH was evaluated. Increasing t1 and t2 was found to significantly influence the strength of SG, which highlights the importance of an appropriate curing period. The releases of the metals (As, Cr, Cu, Zn, Pb, Ni, and Hg) in the SG exhibited a strongly pH-dependence but less correlation with t2. Neutral conditions (pH = 7) offered the best immobilization capacity for Cu; As, Cr, Ni and Zn exhibited the lowest release at pH = 10; the release of Pb decreased moderately with increasing pH. The S/S sediment complied with the acceptance criteria in terms of metal release and can be regarded as an environmentally friendly fill material. The results highlight the technical feasibility of stabilized sediment recycling in aquatic environment projects.

The up-regulation of NDRG1 by HIF counteracts the cancer-promoting effect of HIF in VHL-deficient clear cell renal cell carcinoma.

BACKGROUND: Hypoxia-inducible factors (HIFs) are thought to play important roles in the carcinogenesis and progression of VHL-deficient clear cell renal cell carcinoma (ccRCC). METHODS: The roles of HIF-1/2α in VHL-deficient clear cell renal cell carcinoma were evaluated by bioinformatics analysis, immunohistochemistry staining and Kaplan-Meier survival analysis. The downstream genes that counteract the cancer-promoting effect of HIF were analysed by unbiased proteomics and verified by in vitro and in vivo assays. RESULTS: There was no correlation between the high protein level of HIF-1/2α and the poor prognosis of ccRCC patients in our large set of clinical data. Furthermore, NDRG1 was found to be up-regulated by both HIF-1α and -2α at the cellular level and in ccRCC tissues. Intriguingly, the high NDRG1 expression was correlated with lower Furman grade, TNM stage and longer survival for ccRCC patients compared with the low NDRG1 expression. In addition, NDRG1 suppressed the expression of series oncogenes as well as the proliferation, metastasis and invasion of VHL-deficient ccRCC cells in vitro and vivo. CONCLUSIONS: Our study demonstrated that HIF downstream gene of NDRG1 may counteract the cancer-promoting effect of HIF. These results provided evidence that NDRG1 may be a potential prognostic biomarker as well as a therapeutic target in ccRCC.

Dredged marine sediments stabilized/solidified with cement and GGBS: Factors affecting mechanical behaviour and leachability.

Management strategies for the safe disposal of contaminated dredged marine sediment constitute a global-scale environmental issue. The stabilization/solidification method was investigated as a sustainable approach to the recycling of the sediment as a construction material. A systematic study of the factors affecting the mechanical performance and contaminant release was performed. The physico-chemical variables selected to assess the potential re-use of the sediment treated with Ordinary Portland cement (OPC) and Ground Granulated Blast Furnace Slag (GGBS) in an aquatic environment were: curing duration (7, 28, 56 and 98 days), curing temperature (5, 20 and 40 °C) and ambient (leachate) pH (1, 4, 7 and 10). Unconfined compressive strength (UCS) tests were conducted and extended-duration tank leaching tests were used to characterize the long-term leaching of Al, Cr, Mn, Fe, Ni, Cu, Zn, As, Cd, Ba, Pb. The results showed that S/S methods provide excellent immobilization of metals in marine sediment at a pH range of 4 to 10. Immobilization efficiencies of >99.9% for Mn, Fe, Zn, As, Ba, Pb and >97.8% for Al, Cu and Zn are reported over 100 days. GGBS replacement is an effective way to further improve sediment properties by enhancing strength, mitigating sediment alkalization and offering a better immobilization capacity for Fe, Ni and Zn. The release of metals (Al, Mn, Cu, As, Ba and Pb) was strongly associated with a coupling effect of the physico-chemical factors, with metal-specific responses to curing temperature, curing duration and pH. Mn mobility showed a dramatic sensitivity to ambient pH while Ba was less pH-dependent. Al release is related to strength and leached out by dissolution in all situations considered. Considering that dredged marine sediments may contain multiple metal contaminants which exhibit individual responses to remediation, treatment with GGBS may be considered a potentially suitable management option.

Exploration of the association between FOXE1 gene polymorphism and differentiated thyroid cancer: a meta-analysis.

BACKGROUND: Several association analyses and linkage researches indicated that inherited genetic variations effectively influence differentiated thyroid carcinogenesis. METHODS: The results from 15 published studies on differentiated thyroid carcinoma (DTC) were combined. The genetic model included rs965513, rs944289 and rs1867277. Meta-analyses were performed and cochran's χ2 based Q-statistic and I2 test were performed to assess heterogeneity using STATA software. RESULTS: Significant results were noticed for rs965513(Odds Ratio(OR) = 1.162(1.117, 1.208)), rs944289(OR = 1.082(1.035, 1.131)) and rs1867277(OR = 1.415(1.324, 1.512)). In the subgroup analysis by ethnicity, rs965513 polymorphism conferred that risk of Caucasians (OR = 1.168(1.122, 1.215)) was more than that of East Asians of 1.35 (OR = 0.897(0.680, 1.193)). CONCLUSION: This meta-analysis revealed that common variations of FOXE1 (rs965513, rs944289 and rs1867277) were risk factors associated with increased DTC susceptibility.

GFOD1 and peejar are promising markers for clear-cell renal cell carcinoma disease progression.

Clear cell renal cell carcinoma (ccRCC) is a common genitourinary malignancy. The molecular pathogenesis of ccRCC remains unclear and biomarkers for daily practice were still limited. We performed an integrative analysis of two public ccRCC microarray datasets, E-GEOD-22541 and E-MTAB-1050, The candidate differential expression genes (DEG) were then confirmed in the E-GEOD-53757 dataset. In addition, an independent cohort of 50 ccRCC and 36 non-tumor kidney tissues were analyzed to examine the selected DGEs by qRT-PCR. We identified and validated two DEGs, namely GFOD1 and peejar, which were significantly up-regulated in ccRCC compared with normal renal tissues (p < 0.001). Moreover, the expression of these two genes are related to histological grade and stage and decrease of their expression correlated with disease progression (p < 0.05). Furthermore, we found the expression of peejar was positively correlated with the expression of GFOD1 in ccRCC tissue, with Pearson correlation coefficiency reaching 0.939 (p < 0.001). GFOD1 and peejar were novel genes correlated with ccRCC disease progression and patients' poor prognosis.

Renal AML with inferior vena cava thrombus treated by workbench surgery and autotransplantation.

Renal angiomyolipoma may sometimes require surgical intervention. In this paper, we present a case of renal angiomyolipoma which infiltrated the sinus and extended into the inferior vena cava. He was successfully treated with a combined approach of laparoscopic radical nephrectomy, extracorporeal workbench tumor resection, and autotransplantation. Three months postoperatively, no evidence of tumor recurrence or presence of thrombus in the inferior vena cava was noted. Our experience represents the successful application of a combined nephron-sparing approach in the management of angiomyolipoma with extension into a major blood vessel.

Treatment of renal cell carcinoma with a level III or level IV inferior vena cava thrombus using cardiopulmonary bypass and deep hypothermic circulatory arrest.

BACKGROUND: The aim of this study was to investigate the minimally invasive cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) approach in the management of renal cell carcinoma (RCC) with level III or IV inferior vena cava (IVC) thrombus and evaluate the survival outcomes. METHODS: We performed a retrospective analysis on 32 RCC patients with IVC thrombus that underwent nephrectomy and thrombectomy via the minimally invasive CPB/DHCA approach between January 2007 and December 2013. Perioperative variables (for example, operative time, CPB duration, and circulatory arrest duration), estimated blood loss, hospital stay, perioperative complications, and survival data were recorded and analyzed. RESULTS: Thirty-two patients (median age: 56 years) were treated surgically using the CPB and DHCA approach for RCC with a level III (n=25) or level IV (n=7) tumor thrombus. The median operation time was 360 min (interquartile range (IQR): 300 to 435 min) with median CPB and DHCA durations of 149 min and 23 min, respectively. The median estimated blood loss was 2,500 ml. Four complications were observed but no deaths occurred perioperatively. The median follow-up was 25 months (range: 4 to 64 months). The mean overall survival (OS) was 28.2±4.6 months while the disease-free survival (DFS) was 19.5±11.6 months. In patients with M0 disease, ten patients developed metastases and were treated with sorafenib as an adjuvant therapy. The mean OS and DFS of this subgroup were 25.4±12.8 months and 16.0±14.2 months, respectively. CONCLUSIONS: Radical nephrectomy and thrombectomy using CPB and DHCA to treat RCC is a relatively safe approach associated with low morbidity and mortality. This minimally invasive procedure may help minimize surgical trauma and improve perioperative outcomes.

Low enhancement on multiphase contrast-enhanced CT images: an independent predictor of the presence of high tumor grade of clear cell renal cell carcinoma.

OBJECTIVE: The purpose of this study was to assess the relation between tumor enhancement on multiphase contrast-enhanced CT images and Fuhrman grade of clear cell renal cell carcinoma. MATERIALS AND METHODS: A single-institution retrospective review was conducted on the records of 255 patients who underwent radical or partial nephrectomy and received a histologic diagnosis of clear cell renal cell carcinoma. Two radiologists recorded the radiographic features of each patient, including the attenuation value of the lesion, lesion size, calcification within the lesion, cystic versus solid appearance, and margin regularity. Parameters representing the extent of tumor enhancement were defined and calculated. The association between tumor enhancement and Fuhrman grade was analyzed, and multivariate analysis was performed to find independent predictors of high tumor grade. RESULTS: Significant differences existed in tumor enhancement among different Fuhrman grades (p < 0.001). High-grade tumors had significantly lower enhancement (p < 0.001). The enhancement parameter had a sensitivity of 0.84 and specificity of 0.93 in prediction of high tumor grade. In the multivariate analysis, more advanced age, irregular margin, and low tumor enhancement were the three independent predictors of high tumor grade. CONCLUSION: Tumor enhancement of clear cell renal cell carcinoma on multiphase contrast-enhanced CT images is associated with Fuhrman grade. Low tumor enhancement in the corticomedullary phase is an independent predictor of high tumor grade. This system may be helpful in clinical decision making about the care of patients treated by nonsurgical approaches.

Renal mucinous tubular and spindle cell carcinoma: a report of 8 cases and review of the literature.

BACKGROUND: Mucinous tubular and spindle cell carcinoma of kidney (MTSCC-K) is a rare variant of renal tumor. The current data show most of MTSCCs are of low malignant potential and rare cases metastatic to lymph nodes have been reported; however, the recorded computed tomography (CT) and follow up data are limited. MATERIAL AND METHOD: In the present study, we retrospectively analyzed CT and clinicopathological data of eight patients with renal MTSCC-K. RESULTS: A total of eight cases, including six females and two males, were included in this analysis with a mean age of 48.4 (range 25 to 81) years. Mean tumor size was 4.2 (range 2.5 to 10.0) cm. Preoperative CT demonstrated that all tumors were slightly enhanced on both corticomedullary and nephrographic phase, which was different from many other renal cell carcinomas. Three of them were treated with open radical nephrectomy, three with laparoscopic radical nephrectomy and the other two with laparoscopic partial nephrectomy. No postoperative therapy was applied. Patients were followed up for 15 to 64 months and there was no evidence of recurrence and metastasis. CONCLUSIONS: The MTSCC-K has special clinicopathological characteristics, low degree of malignancy and relative good prognosis. The diagnosis mainly depends on the histopathological examination and CT may help to differentiate with papillary renal cell carcinoma. Surgical treatment is recommended and additional therapies are not necessary. VIRTUAL SLIDES: The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8435581771088249.

Increased expression of forkhead box M1 protein is associated with poor prognosis in clear cell renal cell carcinoma.

Forkhead box protein M1 (FoxM1) is crucial in the regulation of various biological processes, including cell proliferation, organogenesis, and angiogenesis. Overexpression of FoxM1 is associated with carcinogenesis. In this study, immunohistochemistry was carried out to examine FoxM1 expression in clear cell renal cell carcinoma (ccRCC), and these data were examined for correlation with clinicopathological parameters and prognosis. FoxM1 protein had high expression in 37 of 87 cases of ccRCC (42.5 %), which was significantly higher than in normal tissues, and FoxM1 overexpression was significantly associated with tumor stage (P = 0.005) and recurrence (P = 0.027). The Kaplan-Meier survival analysis demonstrated that FoxM1 expression was significantly associated with shorter recurrence-free survival and overall survival (P = 0.007 and P = 0.008, respectively). Multivariate analysis further demonstrated that FoxM1 was an independent prognostic factor for patients with ccRCC. So FoxM1 might be a potential molecular marker to predict the prognosis of patients with ccRCC.

[Analysis of clinicopathological features and prognosis in 68 patients with chromophobe renal cell carcinoma].

OBJECTIVE: To investigate the clinicopathological features and prognosis of chromophobe renal cell carcinoma (ChRCC). METHODS: The clinical data of 68 ChRCC cases treated in our department between January 2003 and September 2010 were collected and retrospectively analyzed. The prognostic factors were evaluated by Log-rank test. Kaplan-Meier survival curve was used to estimate the survival rate. RESULTS: Fifty cases were treated with radical nephrectomy and 18 with partial nephrectomy. The mean tumor size was 5.7 cm (1.5 - 16.0 cm). The TNM stages were as follows: pT1aN0M0 in 25, pT1bN0M0 in 22, pT2aN0M0 in 9, pT2bN0M0 in 5, and pT3aN0M0 in 7. According to the Fuhrman grading system, 8 patients were classified as grade I, 42 cases were grade II, 14 cases were grade III, and 4 cases were grade IV. The 3-year and 5-year survival rates were 93.0% and 90.0%, respectively. The log-rank test showed that tumor size (> 7 cm vs. ≤ 7 cm) (P = 0.004), TNM stage (T1-2 vs. T3-4) (P = 0.008) and urinary collecting system invasion (P = 0.024) were associated with survival time. The multivariable Cox regression model revealed that tumor size (> 7 cm vs. ≤ 7 cm) was an independent predictor of aggressive ChRCC (P = 0.038). CONCLUSIONS: ChRCC is a distinct type of renal cell carcinoma exhibiting a low degree of malignancy. Most tumors are larger, but predominantly with a favorable prognosis. Fuhrman nuclear grading is not suitable for ChRCC. Tumor size (> 7 cm vs. ≤ 7 cm) is an independent predictor of prognosis of ChRCC.

[Comparative analysis of three different surgical approaches to varicocelectomy].

OBJECTIVE: To compare three different surgical approaches to varicocelectomy. METHODS: Eighty-eight cases of varicocelectomy performed in our hospital between January 2006 and January 2008 were divided into an retroperitoneal high ligation group (n = 44), a laparoscopy group (n = 12) and a microsurgery group (n = 32), and retrospectively analyzed for postoperative semen quality, recurrence, early complications, hospital stay, and medical cost. RESULTS: The rates of semen quality improvement were 56.52% (13/23), 66.67% (4/6) and 78.26% (18/23) , the rates of recurrence were 25% (8/32), 22.22% (2/9) and 7.41% (2/27), and the medical costs were RMB yen (1984 +/- 126), (8576 +/- 547) and (2159 +/- 298), respectively, in the retroperitoneal high ligation, laparoscopy and microsurgery groups (P < 0.05). None experienced serious early complications. CONCLUSION: Microsurgery is obviously superior to retroperitoneal high ligation and laparoscopic approaches in improving semen quality and preventing postoperative recurrence, and, with its advantages of minor invasiveness and quick recovery, is preferred by most patients. Laparoscopy, however, ranks highest in medical cost.

[Mutagenesis on biofilm formation of Listeria monocytogenes by Tn917 transposon insertion].

Surface-attached populations of bacteria comprising either single or multiple species were referred to as biofilm. The bacteria in the biofilm had more resistant ability against antibiotics and disinfectors, which could cause the constituent clinical affection or food contamination. In order to isolate and characterize the genes involved in biofilm formation of Listeria monocytogenes, the plasmid pTV1-OK containing the transposon Tn917 was transformed into the protoplasm of Listeria monocytogenes. After cultivating for 4 days, twenty positive transformants per microgram DNA were generated. Some transformants were selected for inducing transposition in water bath overnight at 42 degrees C, and the transposition efficiency of Tn917 was 10(-7). The LM-49 strain with higher ability on biofilm formation than the wild strain was obtained by microtiter plate assaying, and the purple ring formed by the LM-49 was thicker than that by the wild after a 4-day incubation. The PCR result using specific primers of Tn917 proved that Tn917 was inserted into the genome of L. monocytogenes. So the LM-49 strain can be regarded as the mutant of biofilm formation, and the higher ability of biofilm formation is caused by the insertion of Tn917.