Childhood adversity, perceived social support, and depressive symptoms among pre-abortion Chinese women.

BACKGROUND: Unintended (unwanted) pregnancy is a sexual and reproductive health issue with psychosocial consequences for the individual, their family, and society. However, the relationship between social support and related mental health issues, like depression and the effects of childhood adversity, is poorly studied. This study aims to explore the connections between childhood adversity, perceived social support, and depressive symptoms in pre-abortion women (women who have decided to have an abortion) in a clinical setting, based on the common risk factor approach and social support theory. METHODS: A total of 299 pre-abortion Chinese women 18-45 years were recruited in a hospital in Shantou, China. Hierarchical linear regression analyses were employed to examine the relative effects of childhood adversity and sources of social support on depressive symptoms, controlling for sociodemographic influences. RESULTS: The results show that 37.2 percent of participants reported at least one adverse experience in childhood. More than half of the respondents were at risk for depression. Results of regression analysis showed that childhood adversities were negatively associated with depressive symptoms before sources of social support were entered into the model. However, when the sources of perceived social support were added, the effect of childhood adversity was not significant. Perceived social support explained the additional 15 percent variance in depressive symptoms. Additionally, being married (ß = -.12, p < .05) and number of siblings (ß = .13, p < .05) were significantly related to depressive symptoms. DISCUSSION: Pre-abortion women are at risk of mental health problems. Peer and familial social supports can alleviate the influence of childhood adversity on depression among pre-abortion Chinese women. Strengthening the role of various sources of social support can help to improve the mental health conditions of pre-abortion women.

ABAT targeted by miR-183-5p regulates cell functions in liver cancer.

BACKGROUND: Liver cancer triggers a considerable number of global deaths. This work focused on mechanisms as well as impacts of ABAT in liver cancer. METHODS: Differentially expressed mRNAs in liver cancer were analyzed with The Cancer Genome Atlas (TCGA) database to determine and evaluate the prognostic significance of the target gene ABAT. ABAT was overexpressed to explore its effect on liver cancer. Furthermore, the targeted regulation between miR-183-5p and ABAT was verified through dual-luciferase method. The effects of their expression on liver cancer functions were detected by cell functional experiments like Cell Counting Kit-8 (CCK8), Transwell and flow cytometry. Lastly, the inhibitory effect of ABAT on the tumor was proved in nude mice in vivo. RESULTS: At tissue and cell levels, ABAT was inactivated in liver cancer, and liver cancer patients with lowly expressed ABAT had poor prognosis. Overexpressing ABAT could inhibit cancer cell behaviors, and suppress tumorigenesis in nude mice. Meanwhile, overexpressed ABAT could upregulate E-cadherin in liver cancer cells, while downregulate MMP-9, Vimentin, MMP-2, N-cadherin, Ki67. Of note, miR-183-5p was highly expressed in liver cancer tissue and cells, which could target and downregulate ABAT expression. It was indicated by rescue assay that lowly expressed miR-183-5p could repress functions of liver cancer cells, while such inhibitory effect could be recovered by ABAT silencing. CONCLUSION: Downstream of miR-183-5p, ABAT was targeted to mediate progression of liver cancer.

Impact of Subjective and Objective Sleep Quality on Peptic Ulcer Rebleeding in Older Adults.

OBJECTIVE: This study aimed to examine the association of subjective and objective sleep quality with subsequent peptic ulcer rebleeding among older patients. METHODS: Of 1196 older patients with peptic ulcer bleeding (PUB) recruited from 12 grade A hospitals in the People's Republic of China, 1106 achieved full recovery from PUB, and they were followed up for up to 30 days. Using multiple measures at 1-week intervals, patients who presented PUB symptoms were invited to have an esophagogastroduodenoscopy examination. Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index. Objective sleep quality domains were measured using an accelerometer, including sleep onset latency, sleep efficiency, total sleep time, and the number of awakenings. RESULTS: This study documented a 30-day cumulative ulcer rebleeding rate of 15.3%. Multivariate analyses showed that longer sleep onset latency (hazard ratio [HR] = 2.136 [1.336-2.558]) and more nighttime awakenings (HR = 1.698 [1.169-2.666]) increased the risk of ulcer rebleeding. However, a longer total sleep time (HR = 0.768 [0.698-0.887]) and better sleep efficiency (HR = 0.795 [0.682-0.975]) protected against ulcer rebleeding. Older patients who perceived poorer sleep quality were also more likely to experience ulcer rebleeding (HR = 2.295 [1.352-3.925]). CONCLUSIONS: The present results highlight the importance of proper treatment and prevention of sleep problems in older adults after successful PUB treatment. Our results, if replicable in future studies with more rigorous design and representative samples, might shed light on the etiology of ulcer rebleeding and suggest new pathways for preventing this disease.

Sleep duration, depression, and peptic ulcer recurrence in older patients with mild cognitive impairment.

OBJECTIVES: To examine the longitudinal association between objective measure of sleep duration and subsequent recurrence of peptic ulcer disease (PUD) in older patients with mild cognitive impairment (MCI) and the potential influence of change in the severity of depression on this association. METHOD: Older Chinese patients with MCI and Helicobacter pylori (H. pylori)-infected PUD (N = 2,208) were recruited from hospitals in the People's Republic of China between 2010 and 2014. H. pylori was eradicated and PUD cleared in 2,015 patients by the end of 2014; 1,866 of these were followed for up to 48 months. Sleep duration was measured using an accelerometer. The Kaplan-Meier method was used to assess how PUD recurrence in older patients, as confirmed with esophagogastroduodenoscopy, varied with the levels of sleep duration and change in depression. Multivariate Cox-proportional hazards models were calculated to examine the associations between sleep duration, depression, and PUD recurrence. RESULT: The present results are based on no change, a decrease, or an increase in caregiver-assessed depressive symptoms. Multivariate analyses showed that short sleep duration was associated with PUD recurrence during the 48-month follow-up period (hazard ration [HR] = 2.685; 95% confidence interval [CI: 1.622, 4.538]). Sleep duration did not affect recurrence in patients without depression (HR = 1.325; 95% CI [.878, 1.998]) or with reduced depression (HR = 1.048; 95% CI [.695, 1.581]). However in patients with unchanged or increased depression, a higher risk of PUD recurrence was found in short sleepers (HR = 1.598; 95% CI [1.042, 2.451]; HR:HR = 2.668; 95% CI [1.720, 4.083], respectively) than in medium and long sleepers. DISCUSSION: Short sleep duration is associated with a greater risk of PUD recurrence, but decrease in depression or absence of depression may alter this relationship. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Impact of Social Isolation on Subsequent Peptic Ulcer Recurrence in Older Adults With Mild Cognitive Impairment: The Role of Change in Severity of Depression.

OBJECTIVE: This study aimed to examine the association between social isolation, change in severity of depression, and subsequent recurrence of peptic ulcer disease (PUD) in older adults with mild cognitive impairment. METHODS: Older adults (≥55 years) with mild cognitive impairment and Helicobacter pylori-infected PUD (N = 2208) were recruited between 2010 and 2014 from 12 hospitals in the People's Republic of China. H. pylori was eradicated and PUD was cleared in 2015 participants by the end of 2014; 1900 of these were followed up for up to 36 months. The Kaplan-Meier method was used to assess how PUD recurrence varied with social engagement levels and changes in depression severity. Multivariate Cox proportional hazard models were used to examine associations between social isolation, changes in depression severity, and PUD recurrence. RESULTS: PUD recurrence was more prevalent in socially isolated (10.8%) than in socially engaged participants (5.5%). However, the rates of PUD were lower in socially isolated individuals without (absence of) depression (7.2%) and those with decreased depression (8.2%), whereas socially isolated individuals with unchanged and increased depression had substantially higher rates of PUD (16.3% and 17.8%, respectively; the social isolation by depression group for PUD recurrence was significant (p < .001). Specifically, although social isolation was associated with PUD recurrence during the 36-month follow-up period (hazard ratio [HR] = 2.665 [1.602-4.518]), it did not increase PUD recurrence risk in participants without depression or with reduced depression. However, in participants with unchanged or increased depression, PUD recurrence was more likely to occur in socially isolated (HR = 1.587 [1.125-2.588]; HR = 1.886 [1.012, 3.522] respectively) than in socially engaged participants. CONCLUSIONS: Social isolation is associated with a greater risk of PUD recurrence; however, the absence of or decreased severity of depression may alter this relationship.

The relationship between comorbidities in dementia patients and burden on adult-child primary caregivers: Does having a secondary caregiver matter?

Primary family caregivers of patients with dementia often experience high caregiver burden and significant decline in a range of health outcomes. The current study examined the relationship between medical comorbidities of inpatients with dementia and caregiver burden in adult-child primary caregivers, and the buffering effect of having a secondary caregiver on the relationship between patients' comorbidities and caregiver burden. The study is a secondary analysis of data from a cross-sectional observational study design. The sample comprised 477 dyads of inpatients with dementia and adult-child primary caregivers attending the neurological department of two grade A hospitals. All the inpatients were assessed with the Charlson Comorbidity Index (CCI) and the Mini-Mental State Examination (MMSE). All the adult-child primary caregivers were assessed with the Zarit Burden Interview (ZBI) and completed the questionnaires on socio-demographic data, caring hours, presence of secondary caregiver, and the level of impairment of the patient. Higher burden was associated with higher scores on the CCI and having a spouse of the patient as the secondary caregiver. A significant interaction occurred between the CCI and caregiver burden when having a spouse as the secondary caregiver, indicating the negative effect of the CCI on caregiver burden was greater when the spouse of the patient served as the secondary caregiver. In summary, the negative impact of patients' comorbidities on caregiver burden in adult-child primary caregivers was heightened when the secondary caregiver role was undertaken by the spouse of the patient with dementia. These results may inform programmes targeted to improve care arrangements for people with dementia and their caregivers.

Association between depression and subsequent peptic ulcer occurrence among older people living alone: A prospective study investigating the role of change in social engagement.

OBJECTIVE: To examine whether baseline depression predicts subsequent peptic ulcer disease (PUD) in older people living alone and whether social engagement plays a role in such an association. METHODS: Between May 2010 and May 2015, 2, 850 older people living alone were recruited from eight Grade-A hospitals in the People's Republic of China and followed for up to 36 months. The Kaplan-Meier method was used to investigate how the incidence of PUD varied with depression and social engagement status. Multivariate Cox proportional hazards models were estimated to examine the association between depression and incidence of PUD and assess the role of social engagement in this relationship. RESULTS: Kaplan-Meier curves indicated that the 36-month cumulative incidence of PUD was higher in depressed (10.1%) than non-depressed participants (5.3%). However, among the depressed participants, increased or continued social engagement reduced the incidence to 6.2% and 7.9%, respectively. Multivariate analyses showed that baseline depression was associated with subsequent PUD development (hazard ratio [HR] = 2.520, 95% confidence interval [CI]: 1.525-3.356). The incidence of PUD was similar in non-depressed and depressed participants who reported increased (HR = 1.956, 95% CI: 0.913-3.374) or continued social engagement (HR = 1.827, 95% CI: 0.918-3.690) during the follow-up period. However, depressed participants who reported decreased (HR = 2.485, 95% CI: 1.459-3.295) or no social engagement (HR = 2.896, 95% CI: 1.817-4.228) were more likely to develop PUD than those without depression. CONCLUSIONS: Baseline depression was associated with subsequent incidence of PUD, but this association appears to be reduced by increased or continued social engagement.

Effect of Subjective and Objective Sleep Quality on Subsequent Peptic Ulcer Recurrence in Older Adults.

OBJECTIVE: To examine the effect of subjective and objective sleep quality on subsequent recurrence of peptic ulcer disease (PUD) among older patients after Helicobacter pylori eradication. SETTING: Eight grade A hospitals in China. PARTICIPANTS: Of 1689 older Chinese with H. pylori-infected PUD recruited between January 2011 and October 2014, H. pylori were eradicated and PUD was cleared in 1538 patients by the end of 2014; 1420 of these patients were followed up for up to 36 months. MEASUREMENTS: Using multiple measures at 6-month intervals, PUD recurrence was determined with esophagogastroduodenoscopy. Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index. Objective sleep quality domains were measured using an accelerometer, including sleep onset latency, sleep efficiency, total sleep time, and number of awakenings. RESULTS: This study documented a 36-month cumulative PUD recurrence of 8.3% (annual rate = 2.8%). Multivariate analyses showed that participants who reported poorer sleep quality were more likely to experience PUD recurrence during the 36-month follow-up period (hazard ratio [HR] = 1.895; 95% confidence interval [CI] = 1.008-3.327). Regarding objective sleep quality domains, longer sleep onset latency (HR = 1.558; 95% CI = 1.156-2.278) and more nighttime awakenings (HR = 1.697; 95% CI = 1.168-2.665) increased the risk of PUD recurrence. However, a longer total sleeping time protected against PUD recurrence (HR = 0.768; 95% CI = 0.699-0.885). CONCLUSIONS: Poor sleep quality predicts a greater risk of PUD recurrence. Accurate diagnosis and effective treatments should, therefore, be provided for older adults afflicted with poor sleep, particularly for those who previously had PUD. It is equally important to include sleep assessment as an integral part while dealing with these patients.

Association between Poor Sleep Quality and Subsequent Peptic Ulcer Recurrence in Older Patients with Mild Cognitive Impairment: Examining the Role of Social Engagement.

This study aims to examine whether perceived poor sleep quality predicts subsequent recurrence of peptic ulcer disease (PUD) in older patients with mild cognitive impairment following Helicobacter pylori eradication and to investigate whether social engagement status alters this association. Of 1,689 older patients with H. pylori-infected PUD recruited from eight Grade-A hospitals in the People's Republic of China between 2011 and 2014, H. pylori was eradicated and PUD cleared in 1,538 patients by the end of 2014; 1,420 of these were followed for up to 36 months. The Kaplan-Meier method was used to compare the proportion of PUD recurrence, as confirmed with esophagogastroduodenoscopy, among older patients with different levels of sleep quality and social engagement statuses. Multivariate Cox-proportional hazards models were performed to examine the association between sleep quality and PUD recurrence, and the role of social engagement in altering this relationship. The results showed that PUD recurrence was more prevalent in poor (10.8%) compared with good sleepers (5.5%). However, increased and continued social engagement reduced the proportion to 7.2% and 8.2% among poor sleepers, respectively. Poor sleep quality was associated with subsequent PUD recurrence (hazard ratio [HR] 1.965 (1.002, 3.518)). However, no significant difference was observed between good and poor sleepers who reported increased (HR 1.428 (0.736, 2.380)) and continued (HR 1.273 (0.915, 2.492)) social engagement, suggesting that increased and continued social engagement prevented the effect of poor sleep quality on PUD recurrence. To conclude, poor sleep quality is associated with subsequent PUD recurrence. However, increased and continued social engagement may moderate this association.

Transforming growth factor-ß1 and lysophosphatidic acid activate integrin ß6 gene promoter in Hep-3B cells.

Although it is difficult to detect αvß6 integrin (αvß6) in normal epithelia cells, its expression is upregulated during wound healing and carcinogenesis. Overexpression of αvß6 has been demonstrated in epithelial cell carcinomas, such as adenocarcinoma of the colon and ovary. However, the expression of αvß6 has not been reported in hepatocellular carcinoma (HCC). We previously indicated that LPA may induce αvß6-mediated TGF-ß1 signaling mechanisms during the pathogenesis of lung injury and fibrosis. In addition, transforming growth factor-ß1 (TGF-ß1) and lysophosphatidic acid (LPA) have been demonstrated to participate in the progression of HCC. In the present study, we hypothesized that TGF-ß1 and LPA would serve a key role in the subunit integrin ß6 (Itgß6) transcriptional regulatory mechanism in HCC. It was identified that human HCC tissues and Hep-3B cells expressed Itgß6. Treatment of Hep-3B with TGF-ß1 or LPA increased the expression of Itgß6. Furthermore, truncation experiments indicated a positive regulatory region at -326 to -157 bp of the Itgß6 promoter. TGF-ß1 and LPA increased transcriptional activation at this regulatory region. To the best of our knowledge, the present study was the first to demonstrate Itgß6 expression in HCC, and the data indicate that TGF-ß1 and LPA regulate Itgß6 expression through the Itgß6 gene promoter, which is an important factor in the development of HCC.

Impact of an Information Leaflet on Knowledge of Hepatocellular Carcinoma and Hepatitis B among Chinese Youth.

BACKGROUND: To assess the effect of an information leaflet on the level of Chinese youth's knowledge about hepatitis B and hepatocellular carcinoma (HCC), the most common type of primary liver cancer (PLC). MATERIALS AND METHODS: A total of 500 students, from two universities in the Chaoshan area of China, were randomly divided into an intervention group of 280 participants and a control group of 220. Baseline knowledge of HCC and hepatitis B was evaluated by questionnaire interview. Subsequently, only the intervention group was given an information leaflet of HCC and hepatitis B. Three months later, the two groups were contacted for a second interview. Changes in knowledge from baseline of HCC and hepatitis B were compared between the two groups. RESULTS: There was no statistically significant difference in mean PRE-questionnaire scores between the intervention and control groups. However, the mean POST-questionnaire score was significantly higher in the intervention group after the intervention. The leaflet had the greatest effect on the participants' questionnaire score, and raised their level of knowledge about HCC and hepatitis B. CONCLUSIONS: The information leaflet intervention is significantly effective in improving the knowledge of HCC and hepatitis B among the youth.

The composition of surgical teams in the operating room and its impact on surgical team performance in China.

BACKGROUND: Previous studies on surgical team composition have shown that surgical team size had an independent impact on surgical performance in US and Canadian hospitals. We aimed to investigate the impact of team composition on surgical performance in two Chinese hospitals. METHODS: General surgery procedures performed from April 2011 to June 2012 were retrospectively reviewed to record the number of attendees in the operating room (OR) and the procedure time (PT). RESULTS: A total of 1,900 valid procedures, mostly laparoscopic, were performed during the study period. The mean PT was 90.5 min. On average, there were a total of 6 (range = 3-8) team members per procedure: 3 (range = 1-5) surgeons, 2 nurses, and 1 anesthesiologist. Unlike the data reported for the US and Canada, the number of nurses and anesthesiologists remained stable in most cases, whereas the number of surgeons differed by procedure. Multiple-regression analysis revealed that both the complexity of the operation and the team size significantly affected PT. When procedure complexity and patient condition were kept constant, adding one team member in our data analysis predicted an increase of 34.7 min in the PT. CONCLUSION: The surgical team size has a measurable effect on PT. Aside from surgical complexity, the team composition and member stability affected PT in the OR. Optimizing surgical teams and developing a strategy to maintain team stability are of great importance for improving OR efficiency.

Prognostic and predictive value of a microRNA signature in stage II colon cancer: a microRNA expression analysis.

BACKGROUND: Current staging methods do not accurately predict the risk of disease recurrence and benefit of adjuvant chemotherapy for patients who have had surgery for stage II colon cancer. We postulated that expression patterns of multiple microRNAs (miRNAs) could, if combined into a single model, improve postoperative risk stratification and prediction of chemotherapy benefit for these patients. METHOD: Using miRNA microarrays, we analysed 40 paired stage II colon cancer tumours and adjacent normal mucosa tissues, and identified 35 miRNAs that were differentially expressed between tumours and normal tissue. Using paraffin-embedded specimens from a further 138 patients with stage II colon cancer, we confirmed differential expression of these miRNAs using qRT-PCR. We then built a six-miRNA-based classifier using the LASSO Cox regression model, based on the association between the expression of every miRNA and the duration of individual patients' disease-free survival. We validated the prognostic and predictive accuracy of this classifier in both the internal testing group of 138 patients, and an external independent group of 460 patients. FINDINGS: Using the LASSO model, we built a classifier based on the six miRNAs: miR-21-5p, miR-20a-5p, miR-103a-3p, miR-106b-5p, miR-143-5p, and miR-215. Using this tool, we were able to classify patients between those at high risk of disease progression (high-risk group), and those at low risk of disease progression (low-risk group). Disease-free survival was significantly different between these groups in every set of patients. In the initial training group of patients, 5-year disease-free survival was 89% (95% CI 77·3-94·4) for the low-risk group, and 60% (46·3-71·0) for the high-risk group (hazard ratio [HR] 4·24, 95% CI 2·13-8·47; p<0·0001). In the internal testing set of patients, 5-year disease-free survival was 85% (95% CI 74·3-91·8) for the low-risk group, and 57% (42·8-68·5) for the high-risk group (HR 3·63, 1·86-7·01; p<0·0001), and in the independent validation set of patients, was 85% (79·6-89·0) for the low-risk group and 54% (46·4-61·1) for the high-risk group (HR 3·70, 2·56-5·35; p<0·0001). The six-miRNA-based classifier was an independent prognostic factor for, and had better prognostic value than, clinicopathological risk factors and mismatch repair status. In an ad-hoc analysis, the patients in the high-risk group were found to have a favourable response to adjuvant chemotherapy (HR 1·69, 1·17-2·45; p=0·0054). We developed two nomograms for clinical use that integrated the six-miRNA-based classifier and four clinicopathological risk factors to predict which patients might benefit from adjuvant chemotherapy after surgery for stage II colon cancer. CONCLUSION: Our six-miRNA-based classifier is a reliable prognostic and predictive tool for disease recurrence in patients with stage II colon cancer, and might be able to predict which patients benefit from adjuvant chemotherapy. It might facilitate patient counselling and individualise management of patients with this disease. FUNDING: Natural Science Foundation of China.

Inpatients' knowledge about primary liver cancer and hepatitis.

OBJECTIVE: To assess the level of an inpatient population's awareness about hepatitis and primary liver cancer (PLC), the most common type of which is hepatocellular carcinoma (HCC), and then to initiate education of this group. METHODS: A survey was conducted with 1300 participants within the inpatient unit in representative tertiary hospitals in the Chaoshan area of China. Structured questionnaires contained demographic data and statements about different aspects of liver cancer and hepatitis. The questionnaires were completed by trained medical practitioners after they had conducted the interviews. RESULTS: One way ANOVA showed that the sample population lacked adequate knowledge about HCC and hepatitis. Stepwise multiple regression analysis demonstrated that the participant's level of education had the greatest impact on their total knowledge score when other variables remained constant. CONCLUSIONS: The study demonstrated: a general lack of awareness amongst the participants about the preventative strategies, and the management options available for people with primary liver cancer and hepatitis; education level was an important factor affecting knowledge levels. The demonstrated deficiencies in people's knowledge about hepatitis and HCC, and their lack of subsequent protective behaviours are likely to play an important role in HCC and hepatitis transmission or prevention.

[Protein kinase C mediates thrombin-induced monocyte chemoattractant protein-1 release from human lung fibroblasts].

OBJECTIVE: To investigate the role of protein kinase C (PKC) in thrombin-induced monocyte chemoattractant protein-1(MCP-1) release by human lung fibroblasts (HLF-1). METHODS: Cultured human lung fibroblasts HLF-1 were incubated with different concentrations of PKC inhibitors before by thrombin stimulation. MCP-l protein levels in the supernatants were assessed using ELISA, and MCP-1 mRNA levels in the cell lysate were measured by quantitative real-time PCR. RESULTS: The broad spectrum PKC inhibitors bisindolylmaleimide I and RO-31-8220 obviously inhibited thrombin-induced MCP-l mRNA and protein expressions in HLF-1 cells, whereas Ca(2+)-dependent PKC inhibitor Go 6976 had no such effects. CONCLUSION: Ca(2+)-independent PKC mediates thrombin-induced MCP-1 release in cultured HLF-1 cells.

Systematic comparison of cervical and extra-cervical surgical approaches for endoscopic thyroidectomy.

OBJECTIVE: To evaluate the clinical application of different surgical approaches for endoscopic thyroidectomy and provide more rational treatment criteria. METHODS: Collect all randomized controlled trials, multi-center studies, clinical controlled trials, clinical trials and other comparative studies of endoscopic thyroidectomy with a large sample size in different databases through an established search strategy, make a systematic analysis of all the included literature. RESULTS: This study selected 12 publications for analysis from more than 800 articles: these included six publications describing cervical thyroidectomy (A) and six publications describing extra-cervical thyroidectomy (B). Conversion to open surgery occurred in 29 patients in group A and only 4 in group B (p < 0.001). The patients in group A experienced shorter hospital stays than patients in group B (1.90 ± 0.80 vs. 4.03 ± 0.99 days, p < 0.001), and there was shorter operating time in group A (p < 0.001). Hemorrhage occurred in 3 cases in group A and 8 cases in group B (p = 0.04), Seroma occurred in 25 cases in group B but in no cases in group A (p < 0.001). Postoperative cosmetic results evaluated by verbal response scales (VRS) registered showed: group A (3.35 ± 0.60) and group B (3.74 ± 0.50; p < 0.001). Other complications such as recurrent laryngeal nerve injury and hypocalcemia showed no significant differences. CONCLUSIONS: Evaluation of the different surgical approaches for endoscopic thyroidectomy shows that the incidence of hemorrhage and seroma are higher in the extra-cervical group, but the rate of conversion to conventional open surgery is significantly higher in the cervical group. Furthermore, patients who undergo extra-cervical endoscopic thyroidectomy are associated with longer operating time and hospital stays; however, these studies suggest that the extra-cervical surgical approach for endoscopic thyroidectomy is preferable for dealing with more kinds of thyroid tumor and leaving no scars on neck.

[Construction of recombinant adenovirus containing TK gene and its effect against human liver cancer cells].

OBJECTIVE: To construct a replication-defective adenovirus containing TK gene and investigate the killing effects of TK gene against human liver cancer cells SMMC-7721. METHODS: The recombinant adenovirus ADV-TK was constructed using homologous recombination in the cells. SMMC-7721 cells transfected with recombined adenovirus were exposed to GCV, and the cell viability was measured by MTT assays. RESULTS: The recombinant adenovirus containing TK gene was successfully constructed. Transfection by the recombinant adenovirus ADV-TK and GCV exposure significantly suppressed the growth of SMMC-7721 cells. CONCLUSION: A replication-defective adenovirus containing TK gene has been successfully constructed, and in combination with GCV, the recombinant adenovirus produces significant killing effect against SMMC-7721 cells in vitro.

Production of a human single-chain variable fragment antibody against esophageal carcinoma.

AIM: To construct a phage display library of human single-chain variable fragment (scFv) antibodies associated with esophageal cancer and to preliminarily screen a scFv antibody against esophageal cancer. METHODS: Total RNA extracted from metastatic lymph nodes of esophageal cancer patients was used to construct a scFv gene library. Rescued by M13K07 helper phage, the scFv phage display library was constructed. esophageal cancer cell line Eca 109 and normal human esophageal epithelial cell line (NHEEC) were used for panning and subtractive panning of the scFv phage display library to obtain positive phage clones. Soluble scFv was expressed in E.coli HB2151 which was transfected with the positive phage clone, then purified by affinity chromatography. Relative molecular mass of soluble scFv was estimated by Western blotting, its bioactivity was detected by cell ELISA assay. Sequence of scFv was determined using the method of dideoxynucleotide sequencing. RESULTS: The size of scFv gene library was approximately 9X10(6) clones. After four rounds of panning with Eca109 and three rounds of subtractive panning with NHEEC cells, 25 positive phage clones were obtained. Soluble scFv was found to have a molecular mass of 31 ku and was able to bind to Eca109 cells, but not to HeLa and NHEEC cells. Variable heavy (VH) gene from one of the positive clones was shown to be derived from the gamma chain subgroup IV of immunoglobulin, and variable light (VL) gene from the kappa chain subgroup I of immunoglobulin. CONCLUSION: A human scFv phage display library can be constructed from the metastatic lymph nodes of esophageal cancer patients. A whole human scFv against esophageal cancer shows some bioactivity.