ABSTRACT
Objective: To report the clinical efficacy of adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures in patients with initially unresectable hepatocellular carcinoma. Methods: This is a retrospective case series study. Data from 100 patients who underwent adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures with long-term survival were collected from December 2018 to December 2022 at the Faculty of Hepato-Pancreato-Biliary Surgery, First Medical Center, Chinese People's Liberation Army General Hospital. According to inclusion and exclusion criteria, 47 cases were included, among which patients who met the discontinuation criteria and maintained a drug-free tumor-free status. Thirty-nine male and eight female patients were included, with an age of (54.2±18.8)years(range:38 to 73 years) at initial diagnosis. At the time of initial diagnosis, 43 cases (91.5%) were classified as Barcelona Clinic Liver Cancer stage C. Survival curves were made using Kaplan Meier method. Results: Forty-seven patients underwent R0 resection, all achieved a drug-free tumor-free state through postoperative adjuvant therapy based on pathological examination results. Thirty-six patients(76.6%) maintained a drug-free tumor-free survival status for more than 6 months,28 patients(59.6%) for more than 12 months,and 8 patients(17.0%) for more than 24 months. The longest drug-free tumor-free survival in this cohort reached 48 months. The median follow-up time in this study was 32 months. After diagnosis, the overall survival rates at 1- and 3- years were 97.7%(95%CI:93.4% to 100%) and 90.7%(95%CI:82.5% to 99.8%). The postoperative recurrence-free survival rates at 1- and 3- years were 91.0%(95%CI:83.0% to 99.8%) and 71.3%(95%CI:58.7% to 86.5%). Conclusions: The adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical approach provides long-term survival benefits for patients with initially unresectable hepatocellular carcinoma. Standardized adjuvant therapy maybe sustain long-term tumor-free status,and achieve drug-free tumor-free survival.
Subject(s)
Carcinoma, Hepatocellular , Immunotherapy , Liver Neoplasms , Humans , Male , Female , Retrospective Studies , Carcinoma, Hepatocellular/therapy , Carcinoma, Hepatocellular/surgery , Middle Aged , Liver Neoplasms/therapy , Liver Neoplasms/surgery , Adult , Aged , Combined Modality Therapy , Chemotherapy, Adjuvant , Survival Rate , HepatectomyABSTRACT
Rhegmatogenous retinal detachment (RRD) is a retinal vitreous disease, with increasing incidence in recent years. Pars plana vitrectomy is one of the most common treatments for RRD. To prevent re-detachment after the primary surgery and guarantee the visual outcome of the patients, we highlight the techniques for RRD during the PPV, including the surgical skills to manipulate the breaks, peripheral retina and vitreous base, meanwhile, empathized on the posterior vitreous detachment and posterior vitreous cortex. The aim is to increase the rate of anatomical re-attachment and to improve visual function.
Subject(s)
Retinal Detachment , Humans , Retinal Detachment/surgeryABSTRACT
The patient was a 48-year-old male with a previous history of diabetes mellitus and hypertension. The patient had persistent bleeding after vitrectomy of the left eye, and the patient was examined for abnormal coagulation factor â § combined with â «. This case suggests that we need effective control of blood glucose and blood pressure in patients undergoing vitrectomy in clinical work, and adequate examination of coagulation function. Patients with coagulation factor deficiency should be treated with plasma transfusion to supplement coagulation factors before performing the necessary surgical treatment to prevent severe bleeding.
Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Male , Humans , Middle Aged , Diabetic Retinopathy/therapy , Factor VIII/therapeutic use , Blood Component Transfusion , Plasma , Vitrectomy , Laser Coagulation , Diabetes Mellitus/surgeryABSTRACT
A 5-year-old girl came to the Tianjin Medical University Eye Hospital in May 2021 because of her poor eyesight after birth. The physical examination showed that she had high myopia, esotropia, horizontal tremor, and high myopia retinopathy of both eyes. After inquiring about her medical history, we found that the baby's occipital cystic mass swelled after birth, and CT examination showed that the occipital skull plate defect with meningocele, but without treatment, at present, the occipital mass had subsided by itself. Considering the eye manifestations and skull changes of the child, it may be conformed to Knobloch syndrome, after the detection of V4 by full exon gene, it was found that the child had the compound heterozygous variation of pathogenic gene COL18A1, and Knobloch syndrome was definite, Knobloch syndrome is a rare autosomal recessive hereditary disease with typical features of high myopia, retinal detachment and occipital encephalocele. At present, there is no clear treatment plan, and gene therapy may be an effective treatment for Knobloch syndrome in the future.
Subject(s)
Myopia , Retinal Degeneration , Retinal Detachment , Child , Child, Preschool , Encephalocele/diagnosis , Encephalocele/genetics , Encephalocele/pathology , Female , Humans , Myopia/genetics , Retinal Detachment/congenital , Retinal Detachment/diagnosisABSTRACT
Objective: To analyze the characteristics of modifiable risk factors, coronary artery lesions, reperfusion and drug treatment in young women hospitalized for first acute coronary syndrome (ACS). Methods: Clinical data of young adults of 18 to 44 years hospitalized for first ACS in Beijing Anzhen Hospital between January 2007 and December 2017 were analyzed. A total of 7 106 young adults with ACS were enrolled, 6 593(92.8%) were male and 513(7.2%) were female. There were 2 254(31.7%) patients with ST-segment elevation myocardial infarction (STEMI), 704(9.9%) patients with non-ST-segment elevation myocardial infarction (NSTEMI) and 4 148(58.4%) patients with unstable angina (UA). Clinical characteristics, laboratory examinations, coronary angiography and medical treatment were recorded. The gender differences in the characteristics of modifiable risk factors and coronary artery stenosis in young patients with ACS were also analyzed. Results: Dyslipidemia (87.5%) followed by overweight/obese(83.8%) and smoking (68.5%) were most prevalent modifiable risk factors in men. Dyslipidemia (63.4%), overweight/obese (63.4%) and hypertension (45.5%) were most prevalent modifiable risk factors in women. The prevalence rates of at least 1 risk factor in men and women patients were 99.1% and 87.9%, respectively. Between 2007 and 2017, the rates of hypertension and overweight/obese in men increased, and the rates of dyslipidemia and smoking decreased (trend P<0.01). The changes of incidence of modifiable risk factors through the years in women were not statistically significant. The rate of men receiving coronary angiography was higher than that in women (96.6% vs 93.4%, P<0.01). Women were more likely to suffer left main coronary artery disease than men (7.3% vs 4.1%, P<0.01). Multi-vessel coronary artery disease occurred more in men (43.4%), and single vessel coronary artery disease occurred more in women (47.0%). Women presented with STEMI had a lower probability of receiving clopidogrel/ticagrelor (76.8% vs 86.1%, P<0.01) and angiotensin â -converting enzyme inhibitor/angiotonin receptor blocker (ACEI/ARB) (46.5% vs 60.2%, P<0.01) than that in men. Women presented with UA had a lower probability of receiving aspirin (86.3% vs 89.9%), clopidogrel/ticagrelor (69.7% vs 75.6%), statin (78.8% vs 85.0%) and ACEI/ARB (32.7% vs 38.6%) than men (all P<0.01). Women had a higher probability of presenting Killip II-IV than men (38.6% vs 25.6%, P<0.05). Conclusion: The majority of young patients with ACS were men. The prevalence rates of modifiable risk factors are very high in both man and woman. Compared with man, women with AMI are more likely to develop acute heart failure with lower probability of reperfusion and drug treatment.
Subject(s)
Acute Coronary Syndrome , Acute Coronary Syndrome/epidemiology , Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Female , Humans , Male , Risk Factors , Sex Characteristics , Treatment OutcomeABSTRACT
Diabetic retinopathy is one of the three major microvascular complications of diabetes. Proliferative diabetic retinopathy (PDR) is an important ocular complication that affects the vision and quality of life of patients. Vitrectomy is the most effective treatment option. The characteristic of fibrovascular membranes in PDR varies at different stages of the disease, which requires specific treatment strategy and techniques. In order to improve the clinical diagnosis and treatment of PDR, this article proposes that different treatment methods should be correctly adopted for different types of proliferative membranes on the basis of fully understanding the tissue morphology of these membranes, and more attention should be paid to the treatment of the vitreous body to achieve more effective therapeutic effects. (Chin J Ophthalmol, 2021, 57: 881-885).
Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Humans , Quality of Life , Vitrectomy , Vitreous BodyABSTRACT
Objective: To report the efficacy and safety of minimally invasive vitrectomy for the treatment of severe proliferative diabetic retinopathy (PDR) and the effect of preoperative retinal photocoagulation on prognosis. Methods: Case-series study and cohort study. This study included 48 severe PDR patients (53 eyes). There are 28 males and 20 females. The average age was 53.5 (range, 40.0 to 59.0) years old. Patients were divided into two groups according to whether preoperative retinal photocoagulation was performed. Under the guidance of the concept of minimally invasive vitrectomy, all patients received intravitreal injection of conbercept 3 days before standard pars plana vitrectomy with a 27G+ vitrectomy system. To relieve traction, the proliferative fibrovascular membrane was divided into islands as small as possible. It was not necessary to pursue a complete removal of the proliferative membrane. The 27G+ vitrector was flexibly applied as a multifunctional tool for membrane removal by reducing frequencies at which the device entered and left the eye. Intraocular retinal photocoagulation was performed in the main area. The primary outcome measures were best corrected visual acuity (BCVA) and retinal reattachment rate, and the secondary outcome measures were intraoperative and postoperative complications. Statistical analysis was performed using t test, rank sum test and χ² test. Results: All patients tolerated intravitreal conbercept, with no serious intraoperative or postoperative adverse events. Postoperative BCVA values were improved significantly compared with preoperative values (χ²=125.11, P<0.01). The mean logMAR BCVA improved from 1.90 (1.30, 2.30) preoperatively to 1.00 (0.70, 1.90) at 1 week postoperatively, 0.8 (0.5, 1.3) at 1 month postoperatively, 0.7 (0.40, 1.20) at 3 months postoperatively, and 0.70 (0.40, 1.20) at 6 months postoperatively. The visual function increased progressively with time. Postoperatively, the primary and final reattachment rates were 92.5% (50/53) and 96.2% (51/53), respectively. Abnormal intraocular pressure lasted for more than one week occurred in 2 eyes; Vitreous hemorrhage recurred in 5 eyes; Retinal detachment occurred in 4 eyes (7.5%); No postoperative endophthalmitis, choroidal detachment or incision related retinal hole occurred. The intraoperative and postoperative parameters in the preoperative retinal photocoagulation group were better than the preoperative non-photocoagulation group, but the difference was not significant (P>0.05). Conclusions: Minimally invasive vitrectomy is fully qualified for the management of severe PDR, with maximized benefits. (Chin J Ophthalmol, 2021, 57:440-446).
Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Retinal Detachment , Adult , Cohort Studies , Diabetic Retinopathy/surgery , Female , Humans , Male , Middle Aged , Postoperative Complications , Retinal Detachment/surgery , Treatment Outcome , Visual Acuity , Vitrectomy , Vitreous Hemorrhage/surgeryABSTRACT
Objective: To evaluate the clinical safety and efficacy of A1-UV aspheric intraocular lens (IOL) implantation over the postoperative 5 years. Methods: Prospective cohort study. The subjects came from a finished multicenter, randomized and controlled clinical trial with a follow-up period of 1 year from April to November 2012. The clinical research centers were Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Peking University Third Hospital, Tianjin Medical University Eye Hospital, and Daping Hospital of Army Medical University. Cataract patients in the experimental group were implanted with A1-UV type IOL, while cataract patients in the control group were implanted with SN60WF type IOL, and monocular patients were enrolled. From April to May 2018, patients enrolled in the previous study were recalled for follow-up and continued observation. The visual acuity, spherical equivalent, postoperative complications, non-contact intraocular pressure and subjective evaluation results were statistically analyzed preoperatively, at 1 to 2 days, 1 week, 1 month, 3 months, 6 months, 1 year and 5 years after operation. The main statistical methods included Mann Whitney U test, Wilcoxon signed rank test, independent sample t test, chi square test and Fisher exact test. Results: A total of 42 subjects (22 in the experimental group and 20 in the control group) completed 5-year continuous observation. Among the 42 subjects, 28 were female and 14 were male. The age was (70±9) years, and the time from surgery to recall was (5.77±0.19) years. The age, gender distribution, left/right eye distribution, axial length, IOL power and nucleus hardness classification data of the experimental group and the control group were balanced and comparable (all P>0.05). At different visiting time points, there was no significant difference in the best corrected distance visual acuity (BCDVA), best corrected near visual acuity (BCNVA), uncorrected distance visual acuity (UCDVA) and uncorrected near visual acuity (UCNVA) between the groups (all P>0.05). At 5 years after operation, the UCDVA, BCDVA and BCNVA of the two groups were significantly improved compared with the baseline [all P<0.01; UCDVA was improved from 0.75 (0.30 to 1.30) to 0.10 (-0.10 to 0.70) in the experimental group and from 0.75 (0.30 to 1.60) to 0.20 (-0.10 to 0.80) in the control group; BCDVA was from 0.60 (0.10 to 1.00) to 0.00 (-0.10 to 0.54) in the experimental group and from 0.60 (0.10 to 1.60) to 0.10 (-0.10 to 0.50) in the control group; BCNVA was from 0.55 (0.00 to 1.10) to 0.10 (-0.10 to 0.60) in the experimental group and from 0.55 (0.10 to 1.60) to 0.10 (-0.20 to 0.60) in the control group], but there was no significant change in the UCNVA (both P>0.05). There were no significant differences in the spherical equivalent, intraocular pressure, subjective evaluation of visual adverse symptoms, distance vision spectacle independence and comprehensive evaluation of satisfaction between the groups (all P>0.05). In the experimental group, one eye (4.5%) had an abnormal pupil, one eye (4.5%) had an abnormal IOL with a few particles on the surface of the IOL but no glistening, and 3 eyes (13.6%) had posterior capsular opacification (PCO); in the control group, one eye (5.0%) had an abnormal cornea, five eyes (25.0%) had abnormal IOLs [one eye (5.0%) had IOL calcification, and four eyes (20.0%) had IOL glistening], and one eye (5.0%) had PCO with posterior capsular folds and IOL tilt. There was no significant difference in PCO and IOL abnormality between the two groups (both P>0.05), but there was significant difference in the occurrence of IOL glistening (P=0.04). Conclusion: The long-term effect of A1-UV aspheric IOL on improving the UCDVA is stable and good, with high subjective satisfaction of patients, a low incidence of PCO, no glistening and good biocompatibility, over the postoperative 5 years. (Chin J Ophthalmol, 2021, 57: 41-47).
Subject(s)
Capsule Opacification , Lens Implantation, Intraocular , Lenses, Intraocular , Phacoemulsification , Female , Humans , Male , Postoperative Complications , Prospective Studies , Prosthesis Design , Visual AcuityABSTRACT
Objective: To analyze the risk factors and clinical characteristics as well as long-term prognosis of young patients (aged 18-35 years) with acute ST-segment elevation myocardial infarction (STEMI). Methods: In this retrospective study, from January 2007 to December 2017, STEMI patients who were hospitalized in Beijing Anzhen Hospital, Capital Medical University and younger than 45 years old were collected. Patients were divided to the 18-35 years old group and 36-44 years old group. The basic information of patients, clinical laboratory results, surgical information and discharge diagnosis of enrolled patients were extracted from the electronic medical record system. Subgroup analysis on STEMI patients aged 18 to 35 years was performed to compare the clinical features and outcome of patients with normal coronary angiography or stenotic coronary angiography. Results: 496 patients (20.3%) were between 18 and 35 years old, 480 cases (96.8%) were men, and 371 cases (74.8%) were smokers. The proportion of hypertension and diabetes was lower, but percent of obese (122 cases (43.3%)), level of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), uric acid and homocysteine ââ(Hcy) were significantly higher in patients aged 18 to 35 years compared with STEMI patients aged 36 to 44 years (all P<0.05). In the 18-35 years old group, there were 53 patients (10.7%) with normal coronary angiography and 443 patients (89.3%) with stenosis. The age, proportion of hypertension and diabetes, TC, LDL-C, and triglyceride (TG) levels were lower in the normal coronary angiography group than those in the coronary artery stenosis group (all P<0.05). The main coronary artery lesions were single vessel lesions (263 cases (59.4%)), and the main culprit vessels were left anterior descending artery lesions (238 cases (53.7%)). The follow-up time was 7.0 (4.0, 10.0) years, cardiovascular events were reported in 62 patients (18.9%), of which 14 patients (3.2%) died. The survival rate of patients without cardiovascular events in normal coronary angiography group was higher than that in stenosis group (P=0.029). Multivariate Cox regression analysis showed that diabetes (HR=2.713, 95%CI 1.479-4.976, P=0.001) and dyslipidemia (HR=2.819, 95%CI 1.564-5.079, P=0.001) were independent risk factors for recurrence of cardiovascular events in adult STEMI patients aged 18 to 35 years. Conclusions: STEMI patients aged 18 to 35 years were featured by male sex, obese and smokers. The proportion of hypertension and diabetes was low, while the levels of LDL-C, uric acid and Hcy were high in these patients. Coronary artery stenosis was common, and the stenosis was more likely to occur in the left anterior descending branch. Patients with normal coronary angiography had a better prognosis than those with stenosis. Diabetes and hyperlipidemia increased the risk of recurrent cardiovascular events.
Subject(s)
Anterior Wall Myocardial Infarction , Percutaneous Coronary Intervention , ST Elevation Myocardial Infarction , Adolescent , Adult , Coronary Angiography , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , ST Elevation Myocardial Infarction/diagnostic imaging , Young AdultABSTRACT
ABSTRACT: Objective To observe the metabolomics changes of serum after skin incision of rats and to determine the wound age of skin incision. Methods A rat skin incision model was established, 21 SD rats were divided into 1 h, 2 h, 4 h, 8 h, 16 h, 24 h after skin incision groups and the control group, then blood was taken from rats in the experimental groups at the corresponding time points after injury, and taken from the control group directly. Gas chromatography-mass spectrometry ï¼GC-MSï¼ technology was used to detect serum metabolites and screen marker metabolites, then orthogonal partial least square-discriminant analysis ï¼OPLS-DAï¼ model was used to establish a regression model for the relationship between marker metabolite content and wound age to determine wound age of skin. Results GC-MS was used to detect the serum collected, and 21 marker metabolites were obtained through initial screening, and 4 marker metabolites were further analyzed and screened using multivariate statistical analysis methods. There was no correspondence between the change rule of the serum content and wound age, therefore it cannot be used directly to determine wound age. OPLS model could be used to obtain regression models of the content and wound age of 21 marker metabolites and 4 marker metabolites, both of which can determine wound age, but the prediction accuracy of the regression model of 21 marker metabolites was significantly higher. Conclusion Using metabolomics to establish a regression model of the metabolite content and wound age has the potential to be applied to skin incision wound age determination.
Subject(s)
Metabolomics , Skin , Animals , Biomarkers , Gas Chromatography-Mass Spectrometry , Rats , Rats, Sprague-DawleyABSTRACT
ABSTRACT: Objective To identify species of common sarcosaprophagous flies based on digital image analysis of veins, in order to provide new idea for fast and accurate species identification of sarcosaprophagous flies in forensic entomology. Methods Random trapping of 226 male and female sarcosaprophagous flies that comprised of 7 common species, including Sarcophaga peregrina, Parasarcophaga ruficornis, Sarcophaga dux, Seniorwhitea reciproca, Bercaea cruentata, Aldrichina grahami, and Synthesiomysia nudiseta with carrion in the field was conducted. The 17 landmarks on the right wing of each fly were digitally processed and the images were analyzed. The effects of allometry were evaluated using a permutation test. Wing shape variations among 7 sarcosaprophagous fly species and female species was analyzed using canonical variate analysis ï¼CVAï¼. Additionally, cross-validation test was used to evaluate the reliability of classification. Results Among 7 sarcosaprophagous fly species and female species, the effect of allometry had statistical significance ï¼P<0.05ï¼. The CVA results showed that among 7 sarcosaprophagous fly species and female species, differences in the wing shape were significant, and the first two canonical variates accounted for 82.9% and 84.1% of the total variation of vein shape. Vein digital image analysis can be used to separate the 7 common sarcosaprophagous flies, with an overall species identification accuracy of 81.2%-100.0%, and with a species identification accuracy of 75.0%-100.0% to distinguish the female flies of the 7 sarcosaprophagous flies species. Conclusion Vein digital image analysis is a relatively convenient and reliable method for identification of insect species, which can be used for species identification of common sarcosaprophagous flies.
Subject(s)
Diptera , Animals , Calliphoridae , Female , Male , Reproducibility of ResultsABSTRACT
For patients with clinically early-stage localized prostate cancer, radiotherapy is another treatment that can achieve radical treatment in addition to radical prostatectomy. Despite this, there are still a large number of patients with prostate cancer who have a biochemical recurrence after undergoing radiotherapy, or even clinical recurrence, leading to treatment failure. Although the expression of the fructose-1,6-bisphosphatase 1 (FBP1) gene has been found to be absent in various tumors and is associated with a poor prognosis in tumor patients. However, the expression and role of FBP1 in prostate cancer are not clear. The purpose of this study was to investigate the role and mechanism of FBP1 in the radiotherapy resistance of prostate cancer. By analyzing the microarray data of prostate cancer radiotherapy resistant cells and parental cells (GSE53902), we found that FBP1 expression in DU145 radiotherapy resistant cells was significantly higher than in the DU145 parental cells. In addition, we searched for the expression of FBP1 in 492 prostate cancer samples from TCGA and found that its expression in prostate cancer was significantly higher than that in normal tissues. Knockdown of FBP1 expression significantly inhibited the proliferation of prostate cancer cells, promoted DNA damage-mediated apoptosis, and enhanced the sensitivity of prostate cancer cells to radiotherapy. Further mechanism analysis revealed that FBP1 knockdown could activate autophagy mediated by the AMPK-mTOR signaling pathway, while inhibition of the AMPK-mTOR signaling pathway could reverse FBP1 knockdown-mediated autophagy and apoptosis, as well as radiosensitization. In conclusion, this study clarified that FBP1 is an oncogene in prostate cancer, and the main mechanism for knockdown of FBP1 to increase radiosensitivity is to enhance autophagy mediated by the AMPK-mTOR signaling pathway. Therefore, FBP1 may be a potential target for enhancing prostate cancer radiotherapy.
Subject(s)
Autophagy , Prostatic Neoplasms/genetics , Radiation Tolerance , Cell Line, Tumor , Fructose-Bisphosphatase/genetics , Gene Knockdown Techniques , Humans , Male , Neoplasm Recurrence, Local , Prostatic Neoplasms/radiotherapyABSTRACT
In 2018, the myopia detection rate of children and adolescents aged 5-18 years old in Shaanxi Province was 54.9% (11 060/20 144). The myopia detection rate of girls ï¼»58.6%(5 830/9 949)ï¼½ was higher than that of boys ï¼»58.6% (3 416/5 830)ï¼½ (P<0.001). In children and adolescents, the myopia detection rate increased with the age before their 16 years old, and saw a stable or downward trend after the age of 16. After adjusting the confounding factors, the myopia detection rate of children and adolescents from regions with per capita GDP>100 000 yuan was higherthan that of children and adolescents from regions with per capita GDP<50 000 yuanï¼»OR (95%CI):1.58(1.34-1.87)ï¼½.
Subject(s)
Myopia/epidemiology , Adolescent , Child , Child, Preschool , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , PrevalenceABSTRACT
Currently, the epidemic of 2019 coronavirus disease (COVID-19) is still ongoing. Its characteristics include high contagiousness, herd susceptibility and clinical phenotype diversity, which have a severe influence on people's daily life and rountine therapy for other diseases. Breast dieases are clinical common diseases. In the central epidemic area of COVID-19, the clinical specialists of breast diseases should consider all of the following factors comprehensively: the prevention of COVID-19, the diagnosis and treatment of breast diseases and the accessibility of medical resources. Besides, we should select the appropriate therapy and optimize treatment process so as to prevent the propagation and cross infection of COVID-19 as well as manage the breast diseases without delay. Therefore, we carried out some management proposals of the patients with breast diseases in the central epidemic area during the epidemic of COVID-19 on the basis of conventional treatment guidelines and clinical experiences. The suggestions and corrections from colleagues will be welcomed.
Subject(s)
Breast Diseases , Coronavirus Infections , Infection Control , Infectious Disease Transmission, Patient-to-Professional , Pandemics , Pneumonia, Viral , Betacoronavirus , Breast Diseases/complications , Breast Diseases/therapy , COVID-19 , China , Coronavirus , Coronavirus Infections/complications , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cross Infection/prevention & control , Humans , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/complications , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , SARS-CoV-2ABSTRACT
Objective: To summarize the status of immediate breast reconstruction (IBR) after mastectomy in Beijing City, Tianjin City and Hebei Province. Methods: A retrospective analysis was made on the data of 382 cases with breast cancer who were treated and followed up successfully with immediate breast reconstruction after mastectomy from January 2012 to December 2016 in Beijing City, Tianjin City and Hebei Province. Clinic data of the followed-up 382 cases (all female, age (38.5±4.2) years (range: 24 to 70 years)), including general information, tumor information, sugery methods, and treatments after surgery were collected. The survival status, metastasis,complications and prognosis were followed up. Cosmetic effcet was evalated by Harris method, and life quality by Functional Assessment of Cancer Therapy-Breast scale (FACT-B). χ(2) test was used to compare the difference between year 2012 and year 2013 to 2016. Bonferroni method was used to correct the inspection level, which was 0.05/10=0.005. The trend of IBR rate (ratio of IBR to modified radical mastectomy) from 2013 to 2016 was analyzed by trend χ(2) test. Results: There was 46 cases in stage 0, 152 cases in stage â , 165 cases in stage â ¡, 19 cases in stage â ¢. Twenty-five cases was treated by neoadjuvant chemotherapy, 231 by chemotherapy and 35 by radiotherapy. The proportion of implant reconstruction was 48.7% (186/382), more than expanded of 21.5% (82/382), with latissimus dorsi of 12.0% (46/382), TRAM of 8.9% (34/382), DIEP of 2.1% (8/382), and latissimus plus implant of 6.8% (26/382). According to the Harris standard, the excellent and good rate of the cosmetic effect of the reconstructed breast was 93.7%. The score of FACT-B was 108.20±16.9 (range: 67 to 144) 1 year postoperatively. Compared with 2012, the IBR rate was significant increased, till 2015, the IBR rate was 153/10 000 cases (χ(2)=47.028, P=0.000). Conclusions: There is a significant increase on IBR rate in Beijing City, Tianjin City and Hebei province by year. Most of cases received IBR is stage â to â ¡. Implant reconstruction is the main reconstructive method. Postoperative cosmetic effects and quality of life are both meet patients' demon.
Subject(s)
Breast Neoplasms , Mammaplasty , Mastectomy , Adult , Beijing , Breast Neoplasms/surgery , Female , Humans , Quality of Life , Retrospective StudiesABSTRACT
Objective: To study the expression levels of secretogranin â ¢ (SCG3) in the peripheral blood and vitreous of patients with diabetic retinopathy (DR). Methods: Cross-sectional research. A total of 77 patients (41 men and 36 women, 77 eyes) received vitrectomy in Tianjin Medical University Eye Hospital from May to December 2018, with an average age of (60.75±11.34) years. According to the blood glucose level, diabetes history and fundus status, all the patients were divided into the DR group and the non-diabetic group. According to the patients' blood lipids and body mass index (BMI), patients were further divided into subgroups of high blood lipids, normal blood lipids, high BMI and normal BMI. All patients were tested with eye examinations, height and weight to calculate the BMI, and blood lipid levels in the peripheral blood. The vitreous was collected during the vitrectomy surgery, and the levels of SCG3 in the vitreous and peripheral blood were analyzed by ELISA. All the data were analyzed statistically with Wilcoxon rank sum test. Results: There were 43 patients in the DR group, among whom 25 had hyperlipidemia, 18 had normal blood lipids, 22 had a high BMI, and 21 had a normal BMI. There were 34 patients in the non-diabetic group, among whom 13 had hyperlipidemia, 21 had normal blood lipids, 17 had a high BMI, and 17 had a normal BMI. The level of SCG3 in the DR group [6.02 (4.34, 11.76) ng/ml] was higher than that in the non-diabetic group [4.30 (3.20, 10.78) ng/ml] (Z=-2.339, P =0.019). The level of SCG3 in the hyperlipidemia subgroup of the DR patients [7.94 (5.33, 13.51) ng/ml] was higher than that in the normal blood lipid subgroup of the non-diabetic patients [4.04 (3.12, 7.77) ng/ml] (Z=-3.473, P=0.001), and higher than that in the DR patients without hyperlipidemia [4.45 (3.71, 9.14) ng/ml] (Z=-2.511, P=0.012). The level of SCG3 in the DR patients with a high BMI [7.12 (4.56, 13.12) ng/ml] was higher than that in the non-diabetic patients with a normal BMI [3.53 (3.16, 4.38) ng/ml] (Z=-3.767, P =0.000). The level of SCG3 in the DR patients with a normal BMI [5.72 (4.10, 11.60) ng/ml] was higher than that in the non-diabetic patients with a normal BMI (Z=-2.862, P = 0.004). SCG3 in the plasma was rare or can not be detected. Conclusions: The concentration of SCG3 in the vitreous increase in DR patients. However, SCG3 can not be detected in the healthy vascular system. (Chin J Ophthalmol, 2020, 56: 933-937).
Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Aged , Chromogranins , Cross-Sectional Studies , Diabetic Retinopathy/surgery , Female , Humans , Male , Middle Aged , VitrectomyABSTRACT
Objective: To identify differentially expressed proteins between the patients with proliferative diabetic retinopathy (PDR) and vitreous floaters, and explore treatment target for PDR based on isobaric tags for relative and absolute quantification (iTRAQ) LC-MS/MS Proteomics. Method: Vitreous samples were collected from 28 eyes of patients with PDR and 4 eyes with vitreous floaters, which served as controls. For quantitative proteomics, vitreous samples were combined and proteins extracted and labeled with iTRAQ peptide-tagging reagents. Samples were fractionated by liquid chromatography (LC), analyzed by tandem mass spectrometry (MS/MS) and Gene Ontology (GO) analyses performed on differentially expressed proteins identified in the PDR samples. Results: In the PDR vitreous, 26 proteins were identified that were differentially expressed when compared to the controls. Of these, 7 showed a significant increase (P<0.05) and 19 a significant decrease (P<0.05)in expression in PDR patients. These included some high abundance proteins including Retinoic acid receptor reactive protein 2 (PDR 1=85.0, PDR 2=83.0, Control 1=119.6, Control 2=120.2, FC=0.710, P=0.001), Semaphorin-4B(PDR 1=64.4, PDR 2=68.8, Control 1=135.4, Control 2=146.0, FC=0.473, P=0.023), Apolipoprotein B (PDR 1=104.4, PDR 2=106.6, Control 1=89.0, Control 2=85.3, FC=1.211, P=0.024), and Heat shock protein 70 (PDR 1=69.3, PDR 2=75.0, Control 1=137.7, Control 2=138.3, FC=0.523, P=0.026), which are closely related to the pathological mechanism of PDR. GO analysis clustered the differentially expressed genes into three major functional domains: Biological Processes, Molecular Function and Cellular Component. Differential gene expression was found in the categories of cellular metabolism, organonitrogen compound and carbohydrate derivative metabolic processes, transferase activity and transmembrane signaling receptor activity. KEGG Pathway analysis indicate that Chemerin signaling through Akt, Sema4B signaling via PI3K, and HIF-1α signal pathways were all altered in the PDR samples. Conclusions: In this study we identified variations in expression of genes extensively involved in key biological processes in the retina including neovascularization, cellular metabolism and transmembrane signaling, which provide new insights into the pathophysiology of PDR. Extracellular matrix was degraded and endothelial cell migration was induced by Chemerin, in addition, the destruction of blood-retinal barrier and neuronal apoptosis were induced by ApoB. Chemerin and ApoB accelerated the development of PDR. Sema 4B participated in vascular protection, HSP70 conducted anti-apoptosis. These two cytokines protected the retinal neurovascular in PDR patients. Therefore, Chemerin, Sema 4B, ApoB and HSP70 may be the treatment target for PDR. (Chin J Ophthalmol, 2019, 55:769-776).
Subject(s)
Diabetes Mellitus, Type 2/complications , Diabetic Retinopathy/metabolism , Intercellular Signaling Peptides and Proteins/metabolism , Proteome/metabolism , Proteomics/methods , Vitreous Body/metabolism , Biomarkers/metabolism , Case-Control Studies , Chemokines/metabolism , Chromatography, Liquid/methods , Diabetes Mellitus, Type 2/metabolism , Enzyme-Linked Immunosorbent Assay , Humans , Proteome/analysis , Tandem Mass Spectrometry/methods , Vitreous Body/chemistryABSTRACT
Objective: To analyze the difference among expression of aqueous humor proteins in acute primary angle-closure glaucoma (APACG). Methods: Case-control study. The patients with APACG combined cataract (APACG with cataract group) and patients with cataract (cataract group), who had undertaken surgical treatment at the Tianjin Medical University Eye Hospital from October 2016 to June2017 were collected. Upon receipt of patient's consent, 50 µl of aqueous humor were collected with 1 ml syringe and No.1 needle through the surgical access during the surgery, and then injected into a sterile collection tube to be stored at -80 â. Those proteins extracted from aqueous humor were analyzed by quantitative proteomic mass spectrometry. The differential significance test was performed by Maxquant significances A approach. The differential proteins of the two groups were screened and determined with the conditions of P<0.05 and difference multiple>2. The functions and signal pathway of differential proteins in aqueous humor were annotated in biological big data, on the basis gene ontology (GO) and the Kyoto gene and genomic encyclopedia (KEGG) analyses. Results: There were 3 males and 7 females with an average age of (68±6) years in the APACG group. The cataract group included 2 males and 8 females with an average age of (71±8) years. There were no statistical differences in gender ratio and age between the two groups (both P>0.05). A total of 91 differential proteins were detected in this experiment, including 50 up-regulated proteins (annexinA1, vimentin, S100 calcium binding protein A8, interleukin 6, C reactive protein, laminin ß2, etc.) and 41 down-regulated (keratin 85, γ-crystallin D, syntaxin-binding protein 5, semaphoring 4B, matrilin 2, cathepsin O, cadherin 4, semaphoring 3B, platelet-derived growth factor D, transforming growth factor ß, etc.). On one hand, the functions of differential proteins involved in many aspects. AnnexinA1, CD163, S100 calcium-binding protein A8, C reactive protein, interleukin 6 are involved in the inflammatory reaction, cadherin 4 and laminin ß2 regulate cell adhesion, matrilin 2, vimentin and laminin ß2 participate in tissue fibrosis; on the other hand, KEGG analysis showed that the differential proteins participate diverse signaling pathways such as phosphatidylinositol-3-kinase-protein kinase B signaling pathway, transformation growth factor ß signaling pathway, mitogen activated protein kinase signaling pathway, Toll-like receptor signaling pathway, the nuclear factor κ-light chain enhancer of the activated B cells signaling pathway, focal adhension and extracellular matrix receptor interaction pathway and so on. Conclusions: The expression of annexin A1 is significantly up-regulated in the aqueous humor in APACG, while some other factors such as transformation growth factor ß, cadherin-4, and matrilin 2 are down-regulated. The change of proteins in aqueous humor is related with the outbreak of APACG. (Chin J Ophthalmol, 2019, 55: 687-694).
Subject(s)
Aqueous Humor/chemistry , Glaucoma, Angle-Closure , Glaucoma, Open-Angle , Proteomics , Aged , Case-Control Studies , Female , Humans , Male , Middle AgedABSTRACT
Facing rising global antibiotics resistance, physical membrane-damaging antimicrobial peptides (AMPs) represent promising antimicrobial agents. Various strategies to design effective hybrid peptides offer many advantages in overcoming the adverse effects of natural AMPs.
ABSTRACT
Facing rising global antibiotics resistance, physical membrane-damaging antimicrobial peptides (AMPs) represent promising antimicrobial agents. Various strategies to design effective hybrid peptides offer many advantages in overcoming the adverse effects of natural AMPs. In this study, hybrid peptides from different species were investigated, and three hybrid antimicrobial peptides, LI, LN, and LC, were designed by combining the typical fragment of human cathelicidin-derived LL37 with either indolicidin, pig nematode cecropin P1 (CP-1) or rat neutrophil peptide-1 (NP-1). In an aqueous solution, all hybrid peptides had an unordered conformation. In simulated membrane conditions, the hybrid peptide LI displayed more ß-turn and ß-hairpin structures, whereas LN and LC folded into α-helix structures. The three interspecific hybrid peptides LI, LN, and LC exhibited different levels of antimicrobial activity against Gram-positive and Gram-negative bacteria. LI demonstrated the highest antimicrobial activity and cell selectivity. The results of the swimming motility indicated that LI repressed bacterial motility in a concentration-dependent method. Endotoxin binding assay demonstrated that hybrid peptide LI conserved the binding ability to LPS (polyanionic lipopolysaccharides) of its parental peptides. Fluorescence assays, flow cytometry, and SEM further revealed that hybrid peptide LI acted through different bacteriostatic mechanisms than LL37 and indolicidin and that LI killed bacterial cells via membrane damage. In summary, this study demonstrated that hybrid peptide LI produced by interspecific hybrid synthesis possessed strong cell selectivity and is a promising therapeutic candidate for drug-resistant bacteria infection.