Diagnostic value of ultrasound elastography for differentiation of benign and malignant axillary lymph nodes: a meta-analysis.

AIM: To investigate the diagnostic value of ultrasound elastography (UE) for benign and malignant axillary lymph nodes. MATERIALS AND METHODS: A literature search was conducted from PubMed, Cochrane EMBASE, and Medline. Fourteen studies including 1,186 patients with 1,411 lymph nodes were enrolled. Overall, diagnostic descriptive statistics included pooled sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) with corresponding 95% confidence intervals (95% CIs) were generated by random effect model. Subgroup analyses were performed in (real-time elastography [RTE] versus shear wave elastography [SWE]) and (conventional ultrasound versus combination of traditional ultrasound and elastography). Meta-regression was used to explore potential sources of heterogeneity. RESULTS: The overall pooled sensitivity, specificity, and AUC of UE was 0.79 (95% CI: 0.71-0.86), 0.90 (95% CI: 0.83-0.95), and 0.91 (95% CI: 0.88-0.93), respectively. In the subgroup analysis of the two UE techniques, the pooled sensitivity, specificity, and AUC of SWE was higher than that of RTE (sensitivity: 0.82>0.77; specificity: 0.91>0.89; AUC: 0.94>0.89). The pooled diagnostic value of ultrasound combined with UE were significantly improving compared with traditional ultrasound (sensitivity: 0.87>0.82, specificity: 0.83>0.78, and AUC: 0.91>0.87). No independent heterogeneous factor was found in meta-regression. CONCLUSION: The results indicate that UE was an effective technique for identifying malignant axillary lymph nodes due to its high diagnostic efficiency, which can provide useful information for surgical procedure selection.

[Construction of latent membrane protein 2A chimeric antigen receptor-T cells and their lethal effects on nasopharyngeal carcinoma cells].

Objective: To produce latent membrane protein 2A (LMP2A) chimeric antigen receptor (CAR)-T cells and detect the lethal effect of LMP2A CAR-T cells on nasopharyngeal carcinoma (NPC) cells. Methods: The study was conducted from September 2016 to December 2017.Genetic engineering technology was used to construct anti-LMP2A CAR lentiviral expression vector and sequencing was identified. The expression of anti-LMP2A CAR in the 293T cells was confirmed by western blot. CCK8 assay was used to evaluate the cytotoxicity of LMP2A CAR-T cells to NPC cells. ELISA assay was performed to test IL-2 and IFN-γ releasing of activated LMP2A CAR-T cells. The inhibition effect of LMP2A CAR-T cells on NPC xenograft tumor was observed in vivo. Statistical analysis was performed by statistical software SPSS 21.0. Results: The results of PCR and sequencing showed that anti-LMP2A CAR lentiviral expression vector was constructed successfully. The result of western blot indicated the expression of anti-LMP2A CAR in the 293T cells effectively. The results of CCK-8 assay showed that the killing activities of LMP2A CAR-T cells to LV-LMP2A-CNE1 cells were (72.11±9.75)%, (54.65 ±5.42)% and (36.68±3.80)% at 20∶1, 10∶1 and 5∶1 ratio of effective cells to target cells, and had a statistical difference compared to CD19 CAR-T cells and T cells (P<0.05). There was no significant difference in the killing activities of LMP2A CAR-T cells to CNE1 cells compared with CD19 CAR-T cells and T cells. The results of ELISA showed that the content of IL-2 and IFN-γ in the co-culture supernatant of LMP2A CAR-T cells and LV-LMP2A-CNE1 cells was significantly higher than that of LMP2A CAR-T cells and CNE1 cells which had statistical difference (P<0.05); In vivo experiment, the volume of LMP2A CAR-T cell group was (80.3±10.0) mm(3) which was significantly lower than that of the control groups, and the difference was statistically significant (P<0.05). Conclusion: LMP2A CAR-T cells are successfully prepared and have an obvious targeting cytotoxicity on LMP2A-positive NPC cells.

Determinants of suicidal ideation in gynecological cancer patients.

OBJECTIVE: Gynecological cancer survivors are at increased risk of psychological problems including suicide risk. Suicidal ideation, which was thought to be precursor to suicide attempts, has not been well studied. This study aimed to investigate the prevalence, and determinants of suicidal ideation for women with gynecological cancer, and then to assess the effect of coping style and social support on suicidal ideation. METHODS: Patients with cervical, ovarian and endometrial cancers seen at Hunan Provincial Tumor Hospital from September 2012 to June 2013 were consecutively recruited and were asked to complete the Zung Self-Rating Depression Scale, Suicidal Ideation of Self-rating Scale, Medical Coping Modes Questionnaire and Social Support Rating Scale. Path analysis was used to examine the relationship among coping style, social support, depression symptoms and suicidal ideation. RESULTS: A total of 579 (579/623, 93.0%) gynecological cancer patients were enrolled in this study and completed all investigations between September 2012 and June 2013. Among them, 105 (18.1%) patients reported suicidal ideation, with the highest rate in patients with ovarian cancer (30.16%). Suicidal ideation was associated with depression symptoms, care providers, chemotherapy history and acceptance-resignation. Path analysis showed that the acceptance-resignation affected suicidal ideation directly as well as mediated by social support and depression symptoms, while confrontation and avoidance affected suicidal ideation entirely through social support and depression symptoms. CONCLUSIONS: Suicidal ideation is high among patients with gynecological cancer, especially among ovarian cancer patients. Coping strategies such as confrontation and avoidance, and social support may be helpful for preventing suicidal ideation among them.

Effects of repeated +Gz exposures on lipid peroxidation of various organs in rats.

OBJECTIVE: To investigate the change of lipid peroxidation in various organs of rats after repeated +10 Gz stress. METHOD: Twenty male Wistar rats were randomly divided into control (+1 Gz) group and +10 Gz group (n = 10 for each group ). The two groups were exposed to +1 Gz or +10 Gz on an animal centrifuge respectively. The onset rate of +Gz was 0.5 G/s; the sustained time at peak +Gz was 30 s each time, with 5 times/d, 1 min intervals, 3 d/wk, 3 wk in total. The rats were decapitated in ice bath on the next day after the last +Gz exposure. The lung, heart, liver and kidney of rats were collected for the following determinations. These organs were made into homogenates and the mitochondria of heart and kidney were isolated from their homogenates. Then malondialdehyde (MDA) content , superoxide dismutase (SOD) activity and glutathion (GSH) concentration in these homogenates and mitochondria were determined individually. RESULT: Compared with the control, MDA concentration in myocardial mitochondria increased significantly (P < 0.01) after repeated +10 Gz exposures, and the SOD activity in liver homogenate and renal mitochondria decreased remarkably (P < 0. 01). But there was no significant difference between GSH concentrations of the two groups. CONCLUSION: Repeated +10 Gz stress induced lipid peroxidation injury of myocardial mitochondria and had some influences on the oxygen radical metabolism of liver and kidney in rats.

Effects of tea polyphenols on cardiac function and myocardial ultrastructure in rats after repeated +Gz stress.

Objective. To observe the effects of tea polyphenols (TP) on cardiac function and myocardial ultrastructure in rats after repeated +10 Gz stress. Method. Twenty four male Wistar rats were randomly divided into three groups (n=8 each): group A (control), group B (+10 Gz), group C (+Gz with TP). Group B and C were repeatedly exposed to +10 Gz (each for 30 s, onset rate about 0.5 G/s, 3 times/d with +1 Gz 1 min intervals, 3 d/wk, 4 weeks in total), but group A was only submitted to +1 Gz. TP (200 mg kg-1) was given orally to group C about 1 h prior to the +Gz experiment, and distilled water was given to group A and B. Function of isolated rat working hearts and myocardial ultrastructure were observed. Result. A significant decrease of left ventricular systolic pressure (LVSP) and injury of myocardial structure in rats were demonstrated after repeated +10 Gz stress. But TP could remarkably elevate the LVSP and improve myocardial ultrastructural injury in +10 Gz stressed rats. Conclusion. These results indicated that repeated high G exposure may produce cardiac structural and functional injuries in rats which might be partly related to free radical metabolism; and antioxidant TP had significant protective effects on the hearts of +Gz stressed rats.

Effects of tea polyphenols on cerebral lipid peroxidation, liver and renal functions in rats after repeated +Gz stress.

OBJECTIVE: To observe the effects of repeated +10 Gz stress on cerebral lipid peroxidation, liver and renal function in rats and the prophylactic effects of antioxidant tea polyphenols (TP). METHOD: Twenty-four male Wistar rats were randomly divided into three groups (n = 8, each): group A (control), group B (+10 Gz), and group C (TP). Group B and C were exposed to repeated +10 Gz stress (each for 30s, onset rate about 0.5 G/s, 3 times/d with +1 Gz 1 min intervals, 3 d/wk, 4 weeks in total), but group A was only submitted to +1 Gz. TP (200 mg/kg) was given orally in group C about 1 h prior to the +Gz experiment, while distilled water was given in group A and B. Lipid peroxidation in the brain, liver and renal functions and serum lipids were determined. RESULTS: As compared with the control, lipid peroxidation in rat cerebral homogenate, mitochondria and cytoplasm was significantly increased (P < 0. 05), and serum creatinine concentration was markedly elevated after repeated +10 Gz stress (P < 0. 01). But, TP had significant inhibitory effect on +10 Gz stress induced peroxidative injury in rat brain and reduced the serum creatinine level. There were no differences of serum triglyceride and total cholesterol concentrations and glutamic-pyruvic transaminase activity among the three groups. CONCLUSION: These results indicated that repeated high +Gz stress could bring about peroxidative injury in brain and harmful effect on renal function, and natural antioxidant TP had significant protective effects.

Gastroesophageal anastomotic leakage following resection of carcinoma of the esophagus and gastric cardia: analysis of ten cases.

Postoperative anastomotic leakage is one of the most dangerous and, unfortunately, most frequent complications. Many methods have been tried to prevent such leakage. The incidence of leakage has decreased to 3.84% in our hospital in recent years. Ten cases of gastroesophageal anastomotic leakage following resection of carcinoma of the esophagus and gastric cardia are analyzed and a new tool, the three-leaf clamp, which reduced the anastomotic leakage, is introduced.