The Prevalence and Risk Factors for Postoperative Thirst: A Systematic Review and Meta-analysis.

PURPOSE: Thirst is a symptom of dehydration and one of the main complications affecting postoperative outcomes and comfort. Persistent water scarcity can have a detrimental effect on the cognitive function and psychology of patients. However, the current evidence about the prevalence and risk factors for postoperative thirst is not fully understood. Therefore, this study aims to investigate the prevalence and risk factors of postoperative thirst and provide guidance for clinical practice. DESIGN: Systematic review and meta-analysis. METHODS: We searched PubMed, Cochrane Library, Web of Science, Embase, Clinicaltrials.gov, China National Knowledge Infrastructure, and Wanfang Database. Eligible studies were evaluated using the Agency for Healthcare Research and Quality. The collected data were pooled and analyzed using Stata15.0. FINDINGS: A total of 11 cross-sectional studies were included involving 20,612 patients. Eight studies reported prevalence and the pooled prevalence of postoperative thirst was 76.8% (95% confidence interval [CI]: 0.664 to 0.858). Five studies contributed to meta-syntheses of risk factors for postoperative thirst. The results indicated that sex (odds ratio [OR] = 1.44, 95% CI = 1.13 to 1.84, I2 = 80.2%, P = .006), anesthesia drug (OR = 1.48, 95% CI = 1.06 to 2.06, I2 = 94.8%, P < .001), surgical type (OR = 0.66, 95% CI = 0.49 to 0.9, I2 = 77.9%, P = .004) were statistically associated with postoperative thirst. CONCLUSIONS: Our study shows a high prevalence of postoperative thirst. Sex, anesthesia drug, and surgical type are risk factors that influence postoperative thirst. Nurses and other health care professionals should routinely assess the postoperative thirst of patients and perform targeted interventions to alleviate their distressing symptoms and improve the quality of care.

Effect of Individualized Cardiac Rehabilitation on Cardiac Function, Time Consumption, and Quality of Life in Patients After CABG.

BACKGROUND: To investigate the effect of individualized cardiac rehabilitation (CR) on cardiac function, time consumption, and quality of life (QoL) in post-CABG patients. METHODS: Two different CR strategy: basic rehabilitation and individualized rehabilitation was designed. The patients were screened and randomized into the two groups: the basic rehabilitation group (BRG) and individualized rehabilitation group (IRG). Data, such as clinical characteristics, LVEF, 6MWD (6-min walk distance), BNP, LVEDD (left ventricular end diastolic dimension), SF-36 score, and time consumption were collected and recorded. RESULTS: There was no difference between the IRG and BRG patients in the clinical characteristics. The 6MWD and LVEF on post-op significantly were higher, while BNP and LVEDD significantly was lower in the IRG than in BRG. The time to first out-of-bed activity, ICU stay time, and post-op hospital stay time of the IRG in post-op was significantly shorter than BRG. The IRG patients scored significantly higher on the SF-36. CONCLUSION: Individualized CR is safe and can reduce the time consumption and improve the cardiac function and QoL of patients undergoing CABG.

Investigation of stretchable strain sensor based on CNT/AgNW applied in smart wearable devices.

Stretchable strain sensor, an important paradigm of wearable sensor which can be attached onto clothing or even human skin, is widely used in healthcare, human motion monitoring and human-machine interaction. Pattern-available and facile manufacturing process for strain sensor is pursued all the time. A carbon nanotube (CNT)/silver nanowire (AgNW)-based stretchable strain sensor fabricated by a facile process is reported here. The strain sensor exhibits a considerable Gauge factor of 6.7, long-term durability (>1000 stretching cycles), fast response and recovery (420 ms and 600 ms, respectively), hence the sensor can fulfill the measurement of finger movement. Accordingly, a smart glove comprising a sensor array and a flexible printed circuit board is assembled to detect the bending movement of five fingers simultaneously. Moreover, the glove is wireless and basically fully flexible, it can detect the finger bending of wearer and display the responses distinctly on an APP of a smart phone or a host computer. Our strain senor and smart glove will broaden the materials and applications of wearable sensors.

Accessory Climbing Routes Associated With More Rescue Operations Than the Main Climbing Route: A Retrospective 12-Year Report of Yushan National Park.

INTRODUCTION: This study compared the casualties and types of rescues conducted on the main climbing route (MCR) and accessory climbing routes (ACRs) in Yushan National Park (YSNP) between 2008 and 2019. METHODS: We collected the following information for all documented mountain rescue operations conducted on the MCRs and ACRs in YSNP between 2008 and 2019: accident location, casualty type, victim number, and type of rescue. The victims were categorized as to injury, illness, mortality, or no medical problem (NMP) groups according to their condition at the time of rescue. RESULTS: Two-hundred forty-four rescue operations involving 329 victims were conducted during the 12-y study period. Among them, 105 (32%) did not require medical treatment, 102 (31%) were injured, 82 (25%) were ill, and 40 (12%) were deceased. Of the 82 individuals with illness, 69 (84%) had acute altitude sickness. The accident and mortality rates on the ACRs were significantly higher than those on the MCR (P<0.001; χ2). The ACR incidents involved significantly higher percentages of helicopter-based rescues and victims in the NMP group (P<0.001). CONCLUSIONS: Acute altitude sickness accounted for most of the rescues. ACRs had higher injury and mortality rates and required more helicopter-based rescues for patients who did not have medical problems. This study may serve as a reference to reduce casualties and overuse of helicopters by educating tourists on the appropriate use of maps and the evaluation of trails in relation to weather conditions.

A positive COX-2/IL-1ß loop promotes decidualization by upregulating CD82.

A successful pregnancy requires sufficient decidualization of endometrial stromal cells (ESCs). CD82, a metastasis suppressor, is a critical regulator for trophoblast invasion but the effect in decidualization was largely unknown. Here we reported that there was a high level of CD82 in DSC by the immunohistochemistry staining and flow cytometer analysis. Stimulation with prostaglandin E2 (PGE2) elevated the expression of CD82 in ESCs. In contrast, celecoxib, a selective COX-2 inhibitor, significantly downregulated the expression of CD82 in decidual stromal cells (DSCs). Bioinformatics analysis and further research showed that recombinant human interleukin (IL)-1ß protein (rhIL-1ß) upregulated CD82 in ESCs. Of note, blocking IL-1ß signaling with anti-human IL-1ß neutralizing antibody could reverse the stimulatory effect of PGE2 on CD82 in ESCs. Silencing CD82 resulted in the decease of the decidualization markers PRL and IGFBP1 mRNA levels in DSCs. More importantly, we observed rhIL-1ß also upregulated the expression of COX-2, and the upregulation of PRL and IGFBP1 induced by rhIL-1ß could be abolished by celecoxib in ESCs or CD82 deficiency in DSCs. This study suggests that CD82 should be a novel promotor for decidualization under a positive regulation of the COX-2/PGE2/IL-1ß positive feedback loop.

Propagation of a hospital-associated cluster of COVID-19 in Malaysia.

BACKGROUND: Hospitals are vulnerable to COVID-19 outbreaks. Intrahospital transmission of the disease is a threat to the healthcare systems as it increases morbidity and mortality among patients. It is imperative to deepen our understanding of transmission events in hospital-associated cases of COVID-19 for timely implementation of infection prevention and control measures in the hospital in avoiding future outbreaks. We examined the use of epidemiological case investigation combined with whole genome sequencing of cases to investigate and manage a hospital-associated cluster of COVID-19 cases. METHODS: An epidemiological investigation was conducted in a University Hospital in Malaysia from 23 March to 22 April 2020. Contact tracing, risk assessment, testing, symptom surveillance, and outbreak management were conducted following the diagnosis of a healthcare worker with SARS-CoV-2 by real-time PCR. These findings were complemented by whole genome sequencing analysis of a subset of positive cases. RESULTS: The index case was symptomatic but did not fulfill the initial epidemiological criteria for routine screening. Contact tracing suggested epidemiological linkages of 38 cases with COVID-19. Phylogenetic analysis excluded four of these cases. This cluster included 34 cases comprising ten healthcare worker-cases, nine patient-cases, and 15 community-cases. The epidemic curve demonstrated initial intrahospital transmission that propagated into the community. The estimated median incubation period was 4.7 days (95% CI: 3.5-6.4), and the serial interval was 5.3 days (95% CI: 4.3-6.5). CONCLUSION: The study demonstrated the contribution of integrating epidemiological investigation and whole genome sequencing in understanding disease transmission in the hospital setting. Contact tracing, risk assessment, testing, and symptom surveillance remain imperative in resource-limited settings to identify and isolate cases, thereby controlling COVID-19 outbreaks. The use of whole genome sequencing complements field investigation findings in clarifying transmission networks. The safety of a hospital population during this COVID-19 pandemic may be secured with a multidisciplinary approach, good infection control measures, effective preparedness and response plan, and individual-level compliance among the hospital population.

Knowledge, Behaviors, and Attitudes Regarding Venous Thromboembolism Prophylaxis: A Survey of Clinicians at a Tertiary Hospital of China.

BACKGROUND: In this study, we sought to assess knowledge, attitudes, and behaviors regarding venous thromboembolism (VTE) prophylaxis among clinicians at a tertiary hospital of China. METHODS: An electronic questionnaire was sent to clinicians to gather information regarding demographic data (5 items), knowledge about VTE prophylaxis (21 items), behaviors regarding VTE prophylaxis (8 items), and attitudes regarding VTE prophylaxis (7 items). Answers of "strongly agree" and "agree" on the behaviors and attitude items were defined as affirmative responses. Clinicians were also asked to provide suggestions regarding VTE prophylaxis. RESULTS: A total of 867 clinicians were included in this study. The overall correct response rate for knowledge items was 60.9%. The median affirmative response rate for behavior items was 48.6% (range 29.5-80.3%), and the median affirmative response rate for attitude items was 98.7% (range 96.9-99.3%). Clinicians were most concerned about the adverse effects triggered by chemical VTE prophylaxis (79.5%) and possibility of a financial penalty when a patient could not be treated with VTE prophylaxis (72.3%). Low patient compliance and low level of clinician knowledge and participation were identified most commonly as difficulties involved in VTE prophylaxis. A total of 78 suggestions were collected; these suggestions generally focused on improving the quality and frequency of staff training (n = 24) and enhancing learning opportunities (n = 22). CONCLUSIONS: Although the clinicians' overall attitude toward VTE prophylaxis was positive, the knowledge level was relatively poor, and the rate of affirmative responses regarding behaviors was low. Medical institutions should improve clinician training regarding VTE prophylaxis.

Nurses' knowledge, attitudes, and behaviors toward venous thromboembolism prophylaxis: How to do better.

OBJECTIVES: To investigate the cognition of nurses on the control and treatment of venous thromboembolism in China, thereby providing suitable countermeasures for clinical venous thromboembolism prophylaxis and treatment. METHODS: In December 2019, a total of 1121 registered nurses from a university-affiliated hospital were selected to answer the self-designed and electronic questionnaire (Wenquanxing: www.wjx.cn/), which was designed to evaluate the nurses' knowledge (21 items), attitudes (6 items), and behaviors (9 items) toward venous thromboembolism prophylaxis. Descriptive, correlation, and regression analyses were conducted for data analysis. RESULTS: Of the included 1121 nurses, only 55.43% nurses selected 100% correct answer. The influencing factors of knowledge included the department, education, professional ranks, and venous thromboembolism nursing experience. The nurses from ICU department gained the highest score, but the nurses from pediatrics department obtained the lowest score. The nurses with higher education level and professional ranks, and nursing experiences achieved higher scores. The total positive response rate for the attitude-related items was 68.54%. Nurses were primarily concerned about the financial penalty due to the inability to complete the work (49.0%). An increasing workload is the second primary concern of nurses (40.8%). The increasing medical cost, extension of hospital stay, and exacerbation of doctor-patient conflicts were the most serious difficulties involved in venous thromboembolism prophylaxis. The total correct score rate for the behaviors was 56.19%. Nearly half of the nurses could not offer advice for venous thromboembolism patients. The nursing experience, department, and years of work were related to the scores of knowledge-related items (all P < 0.05). CONCLUSIONS: The overall knowledge level of the nurses was not optimistic. Although their general attitude toward venous thromboembolism prophylaxis was positive, their behaviors were influenced by many factors. Administrators should, therefore, make countermeasures to deal with these problems.

Risk Factors of Endotracheal Intubation-Related Pressure Injury among Patients Admitted to the ICU.

OBJECTIVE: To investigate the characteristics and risk factors of endotracheal intubation-related pressure injury (EIRPI) in patients admitted to the ICU and provide a basis for EIRPI prevention and treatment. METHODS: A total of 156 patients with endotracheal intubation who were admitted to ICU at a first-class hospital from January to December 2018 were enrolled in this study. Investigators collected and analyzed data and outcomes such as patient characteristics (demographic and clinical), endotracheal catheter-related factors, and the assessment and features of pressure injuries. RESULTS: The incidence of EIRPI was 23.7%. The most commonly affected site was the lip (76.7%). The incidence was affected by endotracheal intubation types, endotracheal catheter indwelling time, subglottic suction, catheter fixation, and fixator types (P < .05). In addition, the moisture, mobility, and friction/shear Braden subscale scores were also correlated with the incidence of pressure injury (P < .05). Long endotracheal catheter indwelling time, the use of catheters with subglottic suction, high Braden moisture subscale score, low Braden mobility subscale score, and low Braden friction and shear subscale scores were predictive factors for EIRPI (P < .05). CONCLUSIONS: Patients in the ICU are at higher risk of developing EIRPI. Early identification of risk factors and timely intervention are the keys to preventing EIRPI.

Salvianolic acid B combined with mesenchymal stem cells contributes to nucleus pulposus regeneration.

PURPOSE: To investigate whether salvianolic acid B is able to enhance repair of degenerated intervertebral discs by mesenchymal stem cells (MSCs) through the promotion of MSC differentiation into nucleus pulposus cells in a nucleus-pulposus-like environment and by enhancing the trophic effect of MSCs on residual nucleus pulposus cells (mediated by transforming growth factor-ß1). MATERIALS AND METHODS: Successful intervertebral disc degeneration models, established by aspiration of the nucleus pulposus in New Zealand white rabbits, were randomly divided into eight groups: Group A was treated with MSC transplantation. Group B was treated with MSC transplantation and salvianolic acid B, with the subgroups B1, B2, B3, and B4 receiving 0.01 mg/L, 0.1 mg/L, 1 mg/L, and 10 mg/L salvianolic acid B, respectively. Groups C and D were treated with phosphate buffer saline and sham graft, respectively. Group E was the normal control group. At the end of week 8, the type II collagen, proteoglycan, transforming growth factor-ß1, and water contents in each group were examined by semi-quantitative immunohistochemistry, spectrophotometry, enzyme-linked immunosorbent assay, and magnetic resonance, respectively. RESULTS: The content of type II collagen, proteoglycan, transforming growth factor-ß1, and water in groups B3 and B4 were significantly higher than those in group A (p < 0.01). CONCLUSIONS: Salvianolic acid B (1 mg/L to 10 mg/L) plus MSC transplantation was more effective in repairing degenerated intervertebral discs than was stem cell transplantation alone.

Evaluation of the Perinodular Stiffness Potentially Predicts the Malignancy of Thyroid Nodules.

OBJECTIVES: To evaluate the surrounding tissue stiffness measured by sound touch elastography for differential diagnosis of thyroid nodules (TNs). METHODS: Thirty-nine benign and 90 malignant TNs were included in this study. The conventional ultrasound features, the maximum Young modulus value of the stiffness of the TNs (recorded as E), and the stiffness of the 0.5-, 1.0-, 1.5-, and 2.0-mm perinodular regions of the TNs (recorded as Eshell0.5 , Eshell1.0 , Eshell1.5 , and Eshell2.0 , respectively) were prospectively analyzed and compared to histopathologic results. The abundance of collagen fibers at various widths in the perinodular regions of the TNs was evaluated by Masson staining and ImageJ software (National Institutes of Health, Bethesda, MD). The fibrous structures in the perinodular regions of the TNs were classified. RESULTS: The various Eshell values of malignant TNs were significantly higher than those of benign TNs (P < .001 for all). Eshell0.5 correlated highly with E in the malignant TNs and in all samples (r = 0.722 and 0.772; P < .001 for both). Eshell2 yielded the highest area under the receiving operating characteristic curve value (0.96) for the differential diagnosis of TNs. The abundance of collagen fibers in the 2-mm perinodular region of the TNs was closely correlated with Eshell2 in the malignant TNs and in all samples (r =0.729 and 0.867; P < .001). The Eshell2 values for different levels of disorder of the tissue surrounding TNs were significantly different (P < .01 for all). CONCLUSIONS: Perinodular stiffness measured by sound touch elastography improved the diagnostic accuracy in TNs.

Helical Self-Assembly-Induced Singlet-Triplet Emissive Switching in a Mechanically Sensitive System.

In nanoscience, chirality has shown a significant ability to tune materials' electronic properties, whereas imposing macrochirality into the regulation of singlet-triplet features of organic optoelectronics remains a challenging research topic. Since the tuning for singlet and triplet excited-state properties in a single π-functional molecule connects to its multicolor luminescent application and potential improvement of internal quantum efficiency, we here report that supramolecular chirality can be employed to toggle the singlet and triplet emissions in a well-designed asterisk-shaped molecule. Employing a hexathiobenzene-based single luminophore as a prototype and functionalizing it with chiral α-lipoiate side groups, we find that helical nanoarchitectures can accordingly form in mixed DMF/H2O solution. On this basis, switching between fluorescence and phosphorescence of the material can be realized upon helical self-assembly and dissociation. Such a behavior can be attributed to a helical-conformation-dependent manipulation of the intersystem crossing. Furthermore, reversible mechanoluminescence of the corresponding solid sample was also observed to rely on an analogous molecular self-assembly alternation. These results can probably provide new visions for the development of next-generation supramolecular chiral functional materials.

Multi-path photon-phonon converter in optomechanical system at single-quantum level.

Based on photon-phonon nonlinear interaction, a scheme of controllable photon-phonon converters is proposed at single-quantum level in a composed quadratically coupled optomechanical system. With the assistance of the mechanical oscillator, the Kerr nonlinear effect between photon and phonon is enhanced so that the single-photon state can be converted into the phonon state with high fidelity even under the current experimental condition that the single-photon coupling rate is much smaller than mechanical frequency (g ≪ ωm). The state transfer protocols and their transfer fidelity are discussed analytically and numerically. A multi-path photon-phonon converter is designed by combining the optomechanical system with low frequency resonators, which can be controlled by experimentally adjustable parameters. This work provides us a potential platform for quantum state transfer and quantum information.

From Discrete Molecular Cages to a Network of Cages Exhibiting Enhanced CO2 Adsorption Capacity.

We have adopted the concept of "cage to frameworks" to successfully produce a Na-N connected coordination networked cage Na-NC1 by using a [3+6] porous imine-linked organic cage NC1 (Nanjing Cage 1) as the precursor. It is found that Na-NC1 exhibits hierarchical porosity (inherent permanent voids and interconnected channel) and gas sorption measurements reveal a significantly enhanced CO2 uptake (1093 cm3 g-1 at 23 bar and 273 K) than that of NC1 (162 cm3 g-1 under the same conditions). In addition, Na-NC1 exhibits very low CO2 adsorption enthalpy making it a good candidate for porous materials with both high CO2 storage and low adsorption enthalpy.

High-level expression of periostin is significantly correlated with tumour angiogenesis and poor prognosis in osteosarcoma.

Periostin (PN), originally named as osteoblast-specific factor-2 (OSF-2), has been involved in regulating adhesion and differentiation of osteoblasts. Recently many studies have shown that high-level expression of PN is correlated significantly with tumour angiogenesis and prognosis in many kinds of human cancer. However, whether and how periostin expression influences prognosis in osteosarcoma remains unknown. This study aimed to examine the expression of PN in patients with osteosarcoma and explore the relationship of PN expression with clinicopathologic factors, tumour angiogenesis and prognosis. Immunohistochemistry was performed to determine the expression of PN in osteosarcoma and osteochondroma respectively. Vascular endothelial growth factor (VEGF) and CD34 were also examined in tissues from the osteosarcoma patients mentioned above. The results showed that PN expression was significantly (P < 0.05) higher in osteosarcoma (80.9%) than in osteochondroma (14.7%). Increased PN protein expression was associated with histological subtype (P = 0.000), Enneking stage (P = 0.027) and tumour size (P = 0.009). The result also showed that high expression of PN correlated with VEGF expression (r = 0.285; P = 0.019) and that tumours with PN-positive expression significantly had higher microvessal density (44.6 ± 13.7 vs. 20.6 ± 6.5; P = 0.000) compared to those in normal bone tissues. Additionally, the expression of PN was found to be an independent prognostic factor in osteosarcoma patients. In conclusion, our findings suggest that PN may have an important role in tumour progression and may be used as a prognostic biomarker for patients with osteosarcoma.

MiR-145 functions as a tumor suppressor via regulating angiopoietin-2 in pancreatic cancer cells.

BACKGROUND: Pancreatic cancer is currently one of the leading causes of cancer deaths without any effective therapies. Mir-145 has been found to be tumor-suppressive in various types of cancers. The aim of this study is to investigate the role of miR-145 in pancreatic cancer cells and explore its underlying mechanism. METHODS: Quantitative real time PCR was used to determine the expression level of miR-145 and angiopoietin-2 (Ang-2) mNRA, and the expression level of Ang-2 protein was measured by western blotting. The anti-cancer activities of miR-145 were tested both in in vitro by using cell invasion and colony formation assay and in vivo by using xenograft assay. The direct action of miR-145 on Ang-2 was predicted by TargetScan and confirmed by luciferase report assay. The vascularization of xenografts were performed by immunohistochemical analysis. RESULTS: The expression level of miR-145 was significantly lower and the expression levels of Ang-2 mRNA and protein was significantly higher in the more aggressive pancreatic cancer cells (MiaPaCa-2 and Panc-1) when compared to that in BxPC3 cells. Overexpression of miR-145 in the BxPC3, MiaPaCa-2 and Panc-1 cells suppressed the cell invasion and colony formation ability, and the expression level of Ang-2 protein in MiaPaCa-2 and Panc-1 cells was also suppressed after pre-miR-145 transfection. Intratumoral delivery of miR-145 inhibited the growth of pancreatic cancer xenografts and angiogenesis in vivo, and also suppressed the expression level of angiopoietin-2 protein. Luciferase report assay showed that Ang-2 is a direct target of miR-145, and down-regulation of angiopoietin-2 by treatment with Ang-2 siRNA in the BxPC3, MiaPaCa-2 and Panc-1 cells suppressed cell invasion and colony formation ability. The reverse transcription PCR results also showed that Tie1 and Tie2 were expressed in BxPC3, MiaPaCa-2 and Panc-1 cells. CONCLUSION: MiR-145 functions as a tumor suppressor in pancreatic cancer cells by targeting Ang-2 for translation repression and thus suppresses pancreatic cancer cell invasion and growth, which suggests that restoring of miR-145 may be a potential therapeutic target for pancreatic cancer.

The Utilization of Amide Groups To Expand and Functionalize Metal-Organic Frameworks Simultaneously.

A new stepwise ligand-elongation strategy by amide spacers is utilized to prepare isoreticularly high-porous metal-organic frameworks (MOFs), namely, quasi-mesoporous [Cu2 (PDBAD)(H2 O)]n (H4 PDBAD=5,5'-((4,4'-((pyridine-3,5-dicarbonyl)bis(azanediyl))bis(benzoyl))bis(azanediyl))diisophthalic acid; NJU-Bai22: NJU-Bai for Nanjing University Bai's group), and mesoporous [Cu2 (PABAD)(H2 O)]n (H4 PABAD=5,5'-((4,4'-((4,4'-((pyridine-3,5-dicarbonyl)bis(azanediyl))bis(benzoyl))bis (azanediyl))bis(benzoyl))bis(azanediyl))diisophthalic acid; NJU-Bai23). Compared with the prototypical MOF of [Cu2 (PDAD)(H2 O)]n (H4 PDAD=5,5'-(pyridine-3,5-dicarbonyl)bis(azanediyl)diisophthalic acid; NJU-Bai21, also termed as PCN-124), both MOFs exhibit almost the same CO2 adsorption enthalpy and CO2 selectivity values, and better capacity for CO2 storage under high pressure; these results make them promising candidate materials for CO2 capture and sequestration. Interestingly, this new method, in comparison with traditional strategies of using phenyl or triple-bond spacers, is easier and cheaper, resulting in a better ability to retain high CO2 affinity and selectivity in MOFs with large pores and high CO2 storage capacity. Additionally, it may lead to the high thermal stability of the MOFs and also their tolerance to water, which is related to the balance between the density of functional groups and pore sizes. Therefore, this strategy could provide new opportunities to explore more functionalized mesoporous MOFs with high performance.

High expression of periostin is dramatically associated with metastatic potential and poor prognosis of patients with osteosarcoma.

BACKGROUND: Recent studies have found that periostin (PN), as a kind of secreted glycoprotein, is closely related to the metastatic potential and prognosis of many kinds of tumors. This study aimed to examine the expression of PN in patients with osteosarcoma and explore the relationship of PN expression with clinicopathologic factors and prognosis. METHODS: PN was detected by histopathological and immunohistochemical methods in 62 cases of osteosarcoma and 62 of osteochondroma. Detailed pathological and clinical data were collected by reviewing medical records. RESULTS: The results showed that increased PN protein expression was prevalent in osteosarcoma and was significantly associated with pathologic subtype (P =0.000), tumor size (P =0.016) and Enneking stage (P =0.047). Additionally, expression of PN was found to be an independent prognostic factor in osteosarcoma patients. High expression of PN protein is closely correlated to the tumor progression and poor survival of osteosarcoma. CONCLUSIONS: Our data suggest that PN is a promising biomarker for identifying individuals with poor prognostic potential and suggests its possible use as a prognostic marker in patients with osteosarcoma.

Analysis of diagnosis and treatment for pancreatic neuroendocrine neoplasms: results of 47 cases in a single institution.

BACKGROUND/AIMS: There are few large sample, single-center series that focus on the methods of diagnosis, treatment and long-term survival of patients with Pancreatic neuroendocrine neoplasms (pNENs). METHODOLOGY: Forty-seven patients with pNENs treated at Anhui province hospital affliated of Anhui Medical University during January 2002 to December 2013 were analyzed retrospectively. Clinical data were collected and statistically analyzed. RESULTS: The sensitivity of abdominal ultrasound, CT and MRI was 71.2% (28/39), 92.3% (38/41), and 75% (6/8), respectively. All patients received operation. 46 underwent radical surgery, pancreatic fistula in 9 patients, seroperitoneum in 4 patients, incisional infection in 4 patients. The cases of grade G1, G2, and G3 were 22, 19, and 6, respectively. The cases of stage I, II, III and IV were 32, 11, 4, and 0, respectively. The overall 1-, 3, and 5-year survival rates were 94.9%, 88.4%, and 84.4%. Univariate analysis showed that TNM, WHO classification, lymph nodes metastasis, vascular and neural invasion were risk factors of pNENs. CONCLUSION: Sprial CT was an optimal diagnostic method, while surgery was the first choice for treatment. Surgical resection in pNENs results in long-term survival. TNM, WHO classification, lymphatic metastasis, vascular and neural invasion were closely related to the prognosis of pNENs.

Prognostic value of matrix metalloproteinase-9 in gastric cancer: a meta-analysis.

BACKGROUND/AIMS: The purpose of this study was to evaluate the effect of matrix metalloproteinase-9 overexpression on clinical outcome of gastric cancer using a meta-analysis. METHODOLOGY: Relevant studies concerning the association between Matrix metalloproteinase-9 expression and survival of patients with gastric cancer were collected from electronic databases. Hazard ratios (HRs) with 95% confidence intervals (Cls) were calculated to estimate the association. Subgroup analysis was calculated to evaluate potential sources of heterogeneity. Besides, we also assessed the relationship between Matrix metalloproteinase-9 level and relevant clinicopathological parameters by estimating the Odds ratios (ORs) with 95% Cls. RESULTS: Ten studies with 1,478 patients were included to perform a meta-analysis of the survival results. Pooled HRs indicated that MMP-9 overexpression had a negative impact on the over survival (OS) of patients with gastric cancer (HR = 1.69, 95% Cl: 1.29-2.23, P = 0.00), without significant heterogeneity (chi2 = 14.17, I2 = 36.5%, P = 0.117). Similarly, high level of MMP-9 tended to be correlated with lymph node metastasis (OR = 1.91, 95% Cl: 1.40-2.59, P < 0.05) and presence of vascular invasion (OR = 2.64, 95% CI: 1.52-4.59, P <0.05). CONCLUSIONS: This meta-analysis shows that Matrix metalloproteinase-9 overexpression is a poor prognostic factor in patients with gastric cancer. However, larger scale and randomized studies are needed to confirm its potential clinical value.