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KEY MESSAGE: VviWOX13C plays a key regulatory role in the expansin during fruit set. Expansins as a type of non-enzymatic cell wall proteins, are responsible for the loosening and extension in cell walls leading to the enlargement of the plant cells. However, the current studies are still lacking in expansin genes associated with promoting fruit set. Here, 29 members of the expansin gene family were identified in the whole genome of grapes (Vitis vinifera L.), and the functional prediction of expansins was based on the gene annotated information. Results showed that the 29 members of grape expansin gene family could be mainly divided into four subfamilies (EXPA, EXPB, LIKE A, and LIKE B), distributed on 16 chromosomes. Replication analysis showed that there were four segmental duplications and two tandem duplications. Each expansins sequence contained two conserved domain features of grape EXPs (DPBB_1 and Expansin_C) through protein sequence analysis. The transcriptome sequencing results revealed that VviEXPA37, VviEXPA38, and VviEXPA39 were induced and upregulated by CPPU. Furthermore, transcriptional regulatory prediction network indicated that VviWOX13C targeted regulates VviEXPA37, VviEXPA38, and VviEXPA39 simultaneously. EMSA and dual luciferase assays demonstrated that VviWOX13C directly activated the expression of VviEXPA37, VviEXPA38, and VviEXPA39 by directly binding to its promoter. These results provide a basis for further studies on the function and regulatory mechanisms of expansin genes in fruit set.
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Fatores de Transcrição , Vitis , Vitis/genética , Frutas/genética , Regulação da Expressão Gênica , Redes Reguladoras de GenesRESUMO
BACKGROUND: Carotid body tumors (CBT) surgery is a challenging procedure, and the role of embolization (EMB) in CBT surgery has remained unclear. This study is performed to analyze the management of CBTs, particularly the use of preoperative EMB and image features in minimizing surgical complications. METHODS: A total of 200 CBTs were identified among 184 medical records involving CBT surgery. Regression analysis was used to explore the prognostic predictors of cranial nerve deficit (CND), including image features. In addition, blood loss, operation times, and complication rates were compared between patients who had surgery only versus patients who had surgery along with preoperative EMB. RESULTS: Overall, 96 males and 88 females were identified for inclusion in the study, with a median age of 37.0 years. Computed tomography angiography (CTA) showed the presence of a tiny gap adjacent to the encasement of carotid vessels, which could help minimize carotid arterial injury. High-lying tumors that encased the cranial nerve were usually managed with synchronous cranial nerve resection. Regression analysis revealed that the incidence of CND was positively associated with Shamblin â ¢, high-lying, and a maximal CBT diameter of ≥ 5 cm. Among 146 EMB cases, 2 cases of intracranial arterial EMB occurred. No statistical difference was found between the EBM and non-EBM groups in terms of bleeding volume, operation time, blood loss, blood transfusion requirement, stroke, and permanent CND. Subgroup analysis revealed that EMB decreased CND in Shamblin III and low-lying tumors. CONCLUSIONS: CBT surgery should be performed with preoperative CTA to identify favorable factors for minimizing surgical complications. Shamblin â ¢ or high-lying tumors, as well as CBT diameter, are predictors of permanent CND. EBM does not reduce blood loss or shorten operation time.
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Tumor do Corpo Carotídeo , Embolização Terapêutica , Masculino , Feminino , Humanos , Adulto , Tumor do Corpo Carotídeo/diagnóstico por imagem , Tumor do Corpo Carotídeo/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Embolização Terapêutica/efeitos adversos , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Cuidados Pré-OperatóriosRESUMO
BACKGROUND: This study summarizes our experience in the surgical management of arterial lesions secondary to Behçet disease (BD) and assesses the value of endografts. METHODS: Data from BD patients with arterial lesions managed surgically in our center from January 1998 to December 2015 were studied retrospectively. Surgical procedures, graft selection, graft-related complications, and retreatments were analyzed. RESULTS: We recruited 33 patients (29 men and 4 women; male-to-female ratio, 7.25:1) with an average age of 36.7 years (range, 25-51 years). The arterial lesions included 27 aneurysms in 24 patients and nine stenotic or occlusive lesions in nine patients. Immunosuppressive therapy was administered routinely preoperatively and postoperatively as recommended. Altogether, 15 great saphenous veins (GSVs), 8 synthetic grafts, and 13 endografts were used in 36 primary procedures. The mean follow-up duration was 3.8 ± 2.9 years. Graft-related pseudoaneurysm was seen in three GSVs (20%) and in three synthetic grafts (38%) at the anastomosis, but not in endograft implantations (log-rank, P = .171). Graft occlusions were observed in 1 GSV (7%), 2 synthetic (25%), and 2 endografts (15%; log-rank, P = .881). Graft infection occurred in one synthetic graft (13%) and in one endograft (8%) but not in the GSVs (log-rank, P = .689). Graft-related artery rupture occurred in only one endograft (8%). Two patients died, giving a mortality rate of 6.1%. CONCLUSIONS: In the surgical management of arterial lesions secondary to BD, endografts were superior to GSV and synthetic grafts in decreasing anastomotic pseudoaneurysm. However, improvements are needed to enhance the long-term patency and reduce infections.
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Aneurisma/cirurgia , Arteriopatias Oclusivas/cirurgia , Síndrome de Behçet/complicações , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Procedimentos Endovasculares/instrumentação , Veia Safena/transplante , Adulto , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Aneurisma/mortalidade , Falso Aneurisma/etiologia , Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/etiologia , Arteriopatias Oclusivas/mortalidade , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Síndrome de Behçet/mortalidade , Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/mortalidade , China , Intervalo Livre de Doença , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/mortalidade , Feminino , Oclusão de Enxerto Vascular/etiologia , Oclusão de Enxerto Vascular/fisiopatologia , Humanos , Imunossupressores/uso terapêutico , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Infecções Relacionadas à Prótese/microbiologia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Grau de Desobstrução VascularRESUMO
OBJECTIVE: To summarize the experience of treating aortic arch disease with ascending aorta to carotid artery revascularization and subsequent endovascular repair. METHODS: From January 2002 to June 2013, 10 high risk patients with aortic arch disease were treated with ascending aorta to carotid artery revascularization with subsequent endovascular repair in the First Affiliated Hospital, Sun Yat-sen University. There were 9 male and 1 female patients with a mean age of (54 ± 14) years (ranging from 34 to 71 years). Of the 10 patients, 8 were aortic dissection and 2 were thoracic aortic aneurysm. All aortic arch debranching was performed with mid-sternotomy, including 7 ascending aorta to innominate artery and left common carotid artery bypass, and 3 ascending aorta to left common carotid artery and left subclavian artery bypass.Subsequently, simultaneous (n = 5) and staged (n = 5, mean interval (7 ± 4) days) endovascular repair were performed via femoral artery. RESULTS: Technical success rate was 10/10. The 30 day-mortality was 3/10, including 1 brain stem infarction, 1 circulatory failure and 1 aorto-tracheal fistula. Complication included 1 type II endoleak. The median time of follow-up was 24 (14) months. CT scanning was performed at 1, 3 months and annually thereafter. There was no death and no occlusion of bypass during follow-up.No complication occurred except 1 existing type II endoleak. CONCLUSION: Ascending aorta to carotid artery revascularization with subsequent endovascular repair is suitable for high risk aortic arch pathology patients in poor general condition with little tolerance to aortic arch replacement.
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Doenças da Aorta/cirurgia , Implante de Prótese Vascular , Adulto , Idoso , Dissecção Aórtica , Aorta , Aneurisma Aórtico , Aneurisma da Aorta Torácica , Tronco Braquiocefálico , Artéria Carótida Primitiva , Endoleak , Procedimentos Endovasculares , Feminino , Artéria Femoral , Humanos , Masculino , Pessoa de Meia-Idade , Esternotomia , Artéria Subclávia , Tomografia Computadorizada por Raios X , Procedimentos Cirúrgicos Vasculares , CicatrizaçãoRESUMO
OBJECTIVE: We investigated the molecular mechanism underlying the role of monocyte chemoattractant protein-1 (MCP-1) in the formation and development of human abdominal aortic aneurysm (AAA). METHODS: We examined protein expression profiles using a protein array and found that MCP-1 was the most highly expressed protein in AAA tissues compared with normal aortas. To investigate the potential mechanism of MCP-1 involvement in the pathogenesis of AAA, we treated human aortic smooth muscle cells (HASMCs) with human recombinant MCP-1. RESULTS: MCP-1 was the most highly expressed protein in AAA tissues compared with normal aorta; matrix metalloproteinase-9 (MMP-9) expression was also significantly increased. Treatment with MCP-1 significantly increased the expression and activation of MMP-9 and activated the three major mitogen activated protein kinases (MAPKs) extracellular signal regulated kinase (ERK), c-Jun amino terminal kinase (JNK1/2) and p38 MAPK. Furthermore, MCP-1-induced secretion of MMP-9 was inhibited by U0126 (inhibitor of the ERK 1/2 pathway) and SB203580 (inhibitor of the p38 MAPK pathway), but not SP600125 (inhibitor of the JNK1/2 pathway). CONCLUSION: These data demonstrate that MCP-1 stimulates secretion of MMP-9 directly through the ERK1/2 and p38 MAPK mediated pathways in HASMCs. Thus, inhibition of this molecular mechanism might be a potential therapeutic target in the non-surgical treatment of AAA.
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Aorta/metabolismo , Quimiocina CCL2/fisiologia , Sistema de Sinalização das MAP Quinases , Metaloproteinase 9 da Matriz/metabolismo , Músculo Liso Vascular/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Aorta/citologia , Aorta/enzimologia , Sequência de Bases , Células Cultivadas , Primers do DNA , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Liso Vascular/citologia , Músculo Liso Vascular/enzimologia , Reação em Cadeia da Polimerase em Tempo Real , Transdução de SinaisRESUMO
Ammonia borane (AB) has emerged as a promising chemical hydrogen storage material. The development of efficient, stable, and cost-effective catalysts for AB hydrolysis is the key to achieving hydrogen energy economy. Here, cobalt phosphide (CoP) is used to anchor single-atom Pt species, acting as robust catalysts for hydrogen generation from AB hydrolysis. Thanks to the high Pt utilization and the synergy between CoP and Pt species, the optimized Pt/CoP-100 catalyst exhibits an unprecedented hydrogen generation rate, giving a record turnover frequency (TOF) value of 39911 mo l H 2 mo l Pt - 1 mi n - 1 ${\mathrm{mo}}{{{\mathrm{l}}}_{{{{\mathrm{H}}}_{\mathrm{2}}}}}{\mathrm{\ mo}}{{{\mathrm{l}}}_{{\mathrm{Pt}}}}^{{\mathrm{ - 1}}}{\mathrm{\ mi}}{{{\mathrm{n}}}^{{\mathrm{ - 1}}}}$ and turnover number of 2926829 mo l H 2 mo l Pt - 1 ${\mathrm{mo}}{{{\mathrm{l}}}_{{{{\mathrm{H}}}_{\mathrm{2}}}}}{\mathrm{\ mo}}{{{\mathrm{l}}}_{{\mathrm{Pt}}}}^{{\mathrm{ - 1}}}$ at room temperature. These metrics surpass those of all existing state-of-the-art supported metal catalysts by an order of magnitude. Density functional theory calculations reveal that the integration of single-atom Pt onto the CoP substrate significantly enhances adsorption and dissociation processes for both water and AB molecules, thereby facilitating hydrogen production from AB hydrolysis. Interestingly, the TOF value is further elevated to 54878 mo l H 2 mo l Pt - 1 mi n - 1 ${\mathrm{mo}}{{{\mathrm{l}}}_{{{{\mathrm{H}}}_{\mathrm{2}}}}}{\mathrm{\ mo}}{{{\mathrm{l}}}_{{\mathrm{Pt}}}}^{{\mathrm{ - 1}}}{\mathrm{\ mi}}{{{\mathrm{n}}}^{{\mathrm{ - 1}}}}$ under UV-vis light irradiation, which can be attributed to the efficient separation and mobility of photogenerated carriers at the Pt-CoP interface. The findings underscore the effectiveness of CoP as a support for single-atom metals in hydrogen production, offering insights for designing high-performance catalysts for chemical hydrogen storage.
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Accurate diagnosis and prognosis prediction are conducive to early intervention and improvement of medical care for natural killer/T cell lymphoma (NKTCL). Artificial intelligence (AI)-based systems are developed based on nasopharynx magnetic resonance imaging. The diagnostic systems achieve areas under the curve of 0.905-0.960 in detecting malignant nasopharyngeal lesions and distinguishing NKTCL from nasopharyngeal carcinoma in independent validation datasets. In comparison to human radiologists, the diagnostic systems show higher accuracies than resident radiologists and comparable ones to senior radiologists. The prognostic system shows promising performance in predicting survival outcomes of NKTCL and outperforms several clinical models. For patients with early-stage NKTCL, only the high-risk group benefits from early radiotherapy (hazard ratio = 0.414 vs. late radiotherapy; 95% confidence interval, 0.190-0.900, p = 0.022), while progression-free survival does not differ in the low-risk group. In conclusion, AI-based systems show potential in assisting accurate diagnosis and prognosis prediction and may contribute to therapeutic optimization for NKTCL.
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Inteligência Artificial , Imageamento por Ressonância Magnética , Humanos , Prognóstico , Imageamento por Ressonância Magnética/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Linfoma Extranodal de Células T-NK/diagnóstico por imagem , Linfoma Extranodal de Células T-NK/patologia , Linfoma Extranodal de Células T-NK/mortalidade , Linfoma Extranodal de Células T-NK/diagnóstico , IdosoRESUMO
Photothermal catalysis, as one of the emerging technologies with synergistic effects of photochemistry and thermochemistry, is highly attractive in the fields of environment and energy. Two-dimensional (2D) nanomaterials have received extensive attention toward photothermal catalysis because of their ultrathin layer structures, superior physical and optical properties, and high surface areas. These merits are beneficial for shortening the transfer distance of charge carriers, improving the efficiency of solar to thermal, and providing a great opportunity for the development of photothermal chemistry. In this review, we have summarized the state-of-art advances in various 2D nanomaterials with emphasis on the driving force and relevant mechanism of photothermal catalysis, including the involved three types, namely, localized surface plasmonic resonance (LSPR), nonradiative relaxation, and thermal vibrations of molecules. Moreover, the synthesis strategies of 2D materials and their photothermal applications in carbon dioxide (CO2) conversion, hydrogen (H2) production, volatile organic compounds (VOCs) degradation, and water (H2O) purification have been discussed in detail. Ultimately, the existing challenges and prospects of future development in the field are proposed. It is believed that this review will afford a great reference for the exploration of the high-efficiency 2D nanomaterials and their structure-activity relationship.
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This work presents a highly secure anticounterfeiting strategy based on upconversion/afterglow hybrids with tricolor emissions tuned by a single 975 nm laser. The hybrids are composed of NaYF4:Yb/Tm and NaYF4:Yb/Er microrods and CaS:Eu2+ afterglow phosphors. Under 975 nm excitation, the hybrids exhibit multicolor emissions from green to white by adjusting laser power and then emit red afterglow light when the 975 nm laser is off. Under synergistic excitation of the blue-green light emitted by Tm/Er microrods, the red afterglow emission not only has a strong initial intensity but also lasts for 3 s. Obvious trichromatic changes from green to white to red can be observed by the naked eye. A pattern printed by the hybrid ink exhibits tricolor emissions by laser adjustment and switch. This proves that upconversion/afterglow hybrids are an excellent candidate for anticounterfeiting applications with high-level security but a simple recognition method.
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OBJECTIVE: As a common disease, the molecular etiology of noninherited vascular anomalies is still poorly understood. Recently, somatic mutations in exon 17 of the endothelial cell tyrosine kinase receptor Tie-2 (encoded by TEK) were identified in 49.1% of patients with common sporadic venous malformation, a subtype of vascular anomalies. We assessed whether such a mutational region also had a role in the Chinese population or in other subtypes of noninherited vascular anomalies (vascular tumors and vascular malformations). METHODS: Direct sequencing of polymerase chain reaction (PCR)-amplified DNA, extracted from 139 lesions in 129 individuals with noninherited vascular anomalies (vascular tumors or vascular malformations) and 60 control samples, was used for detecting the mutations in exon 17 of the TEK gene. Mutations were confirmed by allele-specific PCR. Clone sequences were then used for the mutations identified for the first time. We also explored the associations between these mutations and clinical characteristics (gender, onset age, number of lesions, severity, category, and recurrence of the disease) in both vascular tumors and vascular malformations. RESULTS: Two somatic TEK mutations (Y897C, R915C) were identified in vascular tumors, and seven somatic TEK mutations (Y897H, Y897C, L914F, R915C, S917I, R918C, R918H) were identified in vascular malformations. Among these mutations, R918C (2,752 C > T) and R918H (2,753 G > A) were first identified in noninherited vascular anomalies. Somatic TEK mutations were detected in lesions from 4 of 23 (17.4%) vascular tumors and 35 of 106 (33.0%) vascular malformations, where most mutations were single substitutions in vascular tumors (100%) and vascular malformations (88.6%), while the remainders were double substitutions. In addition to the reported venous malformation, such mutations were identified in some other subtypes of vascular anomalies, including vascular tumors (infantile hemangioma, pyogenic granuloma, and epithelioid hemangioma) and vascular malformations (capillary malformation, arteriovenous malformation, capillary lymphatic malformation, and capillary arteriovenous malformation). By contrast, these mutations were absent from the control tissues or blood. However, mutations showed no association (P > .05) with clinical characteristics in vascular anomalies or either of its two types (vascular tumors or vascular malformations). CONCLUSIONS: Our study revealed that somatic mutations in exon 17 of the TEK gene were more common in noninherited vascular anomalies than previously reported. Furthermore, such substitutions may shed new light on the molecular etiology, diagnosis, and potential therapeutic targets of vascular anomalies.
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Povo Asiático/genética , Éxons/genética , Mutação/genética , Receptor TIE-2/genética , Malformações Vasculares/genética , Neoplasias Vasculares/genética , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Malformações Vasculares/patologia , Neoplasias Vasculares/patologia , Adulto JovemRESUMO
OBJECTIVE: To evaluate the efficacy and safety of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), and to compare the prognosis between patients of different ages. METHODS: The hospitalization and follow-up data of 81 AAA patients treated by EVAR from May 2005 to May 2011 were retrospectively analyzed. All the patients were divided into advanced age group (age ≥ 75 years, 24 cases) and relatively young group (age < 75 years, 57 cases). General conditions, comorbidity, procedure, in-hospital complications, and follow-up were compared between these two groups. RESULTS: All covered stents were successfully deployed, a technical success rate of 91.4% (74/81) was achieved. There was no intraoperative death. In-hospital mortality was 1.2% (1/81). The follow-up rate was 91.4% (74/81), with a mean follow-up of 47.5 months. Twelve deaths were recorded during follow-up, 1, 2, 3, 4, and 5-year survival rates were 98.6%, 92.2%, 80.8%, 58.7%, and 44.1%, respectively. When compared with relatively young group, the advanced age group had a lower rate of abdominal pain as the major symptom, but a higher rates of renal diseases and coronary artery diseases. Furthermore, the advanced age group had a longer stay in intensive care unit and higher morbidity of endoleaks, and also tended to have increased rates of pulmonary infection and access site hematoma, while the other parameters were similar between the two groups. CONCLUSIONS: EVAR of AAA is less invasive, safe, and effective during short to mid-tern follow-up. The patients of advanced age suffer from higher rates of some complications, thus careful perioperative preparation and intensive monitor are mandatory for preventing or treating potential complications and improving prognosis for these patients.
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Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/efeitos adversos , Endoleak/etiologia , Idoso , Idoso de 80 Anos ou mais , Implante de Prótese Vascular/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
Low-salinity water flooding, known as an environmentally friendly and efficient oil recovery technology, has attracted the attention of several researchers all over the world. However, its field application is suffering restrictions because of the ambiguous mechanisms of the oil recovery by controlling the salinity. In this study, a water flooding microfluidic experiment was conducted to investigate the pore-scale mechanism of enhanced sweep efficiency by low-salinity water flooding. This experiment used a reservoir-on-a-chip that preserved the real rock properties and morphological features. Crude oil-water-rock contact angle experiments by altering water salinity were conducted to investigate the mechanism of the improvement of sweep efficiency by low-salinity water flooding. The experiment results show that unlike high-salinity water flooding, low-salinity water flooding improves its sweep efficiency from wettability alteration. Specifically, in the microfluidic model, it clearly shows that the pore-scale sweep efficiency is improved by reducing the salinity of injected water. Low-salinity water can invade the pores that cannot be reached by high-salinity water and displace the remaining oil after high-salinity water flooding. In the altering water salinity contact angle experiments, the contact angles decrease from 91.05° (neutral-wet) to 64.41° (water-wet) as the water salinity decreases from 46.58 to 2.31 g/L. The wettability of the rock surface changes from oil or neutral-wet to water-wet and induces the imbibition process, during which the hydrophilic pores absorb the low-salinity water into the smaller pores where the high-salinity water cannot invade. This investigation provides a further in situ and pore-scale evidence of improved sweep efficiency and wettability alteration by low-salinity water flooding and a possible reference to solve the difficulty in upscaling fluid flow behavior from microfluidics to reservoir rocks.
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Pentatricopeptide repeat (PPR) proteins play important roles in plant growth and development. However, little is known about their functions in the leaf morphogenesis of Jingxiu grape (Vitis vinifera L.). Here, we explored the function of VvPPR1, which encodes a DYW-type PPR protein in grape. We showed that VvPPR1 is involved in the regulation of leaf rolling, anthocyanin accumulation, and trichome formation in Arabidopsis thaliana. Analysis of structural characteristics showed that VvPPR1 is a DYW-type PPR gene in the PLS subfamily consisting of 15 PPR motifs. The N-terminal had a targeted chloroplast site, and the C-terminal had a DYW domain. Quantitative PCR analysis revealed that the expression level of VvPPR1 was highest in grape leaves. Subcellular localization revealed that VvPPR1 is localized in the cytoplasm and chloroplast. VvPPR1-overexpressing plants had rolled leaves, high degrees of anthocyanin accumulation, and longer trichomes. The expression levels of genes related to these phenotypes were either significantly up-regulated or down-regulated. These results demonstrate that VvPPR1 is involved in leaf rolling, anthocyanin accumulation, and trichome formation in Arabidopsis; more generally, our findings indicate that VvPPR1 could be a target for improving the cultivation of horticultural crops.
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Proteínas de Arabidopsis , Arabidopsis , Vitis , Arabidopsis/genética , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Regulação da Expressão Gênica de Plantas , Fenótipo , Folhas de Planta/genética , Folhas de Planta/metabolismo , Edição de RNA , Vitis/genética , Vitis/metabolismoRESUMO
BACKGROUND: We developed a new nomogram combining serum biomarkers with clinicopathological features to improve the accuracy of prediction of nonsentinel lymph node (SLN) metastases in Chinese breast cancer patients. METHODS: We enrolled 209 patients with breast cancer who underwent SLN biopsy and axillary lymph node dissection. We evaluated the relationships between non-SLN metastases and clinicopathologic features, as well as preoperative routine tests of blood indexes, tumor markers, and serum lipids, including lipoprotein a (Lp(a)). Risk factors for non-SLN metastases were identified by logistic regression analysis. The nomogram was created using the R program to predict the risk of non-SLN metastases in the training set. Receiver operating characteristic (ROC) analysis was applied to assess the predictive value of the nomogram model in the validation set. RESULTS: Lp(a) was significantly associated with non-SLN metastasis status. Compared with the MSKCC model, the predictive ability of our new nomogram that combined Lp(a) level and clinical variables (pathologic tumor size, lymphovascular invasion, multifocality, and positive/negative SLN numbers) was significantly greater (AUC: 0.732, 95% CI: 0.643-0.821) (C-index: 0.703, 95% CI: 0.656-0.791) in the training cohorts and also performed well in the validation cohorts (C-index: 0.773, 95% CI: 0.681-0.865). Moreover, the new nomogram with Lp(a) improved the accuracy (12.10%) of identification of patients with non-SLN metastases (NRI: 0.121; 95% CI: 0.081-0.202; P = 0.011). CONCLUSIONS: This novel nomogram based on preoperative serum indexes combined with clinicopathologic features facilitates accurate prediction of risk of non-SLN metastases in Chinese patients with breast cancer.
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Biomarcadores Tumorais/sangue , Neoplasias da Mama/patologia , Lipoproteína(a)/sangue , Linfonodos/patologia , Metástase Linfática/patologia , Nomogramas , Linfonodo Sentinela/patologia , Neoplasias da Mama/sangue , Neoplasias da Mama/cirurgia , China , Feminino , Seguimentos , Humanos , Excisão de Linfonodo , Linfonodos/metabolismo , Linfonodos/cirurgia , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Estudos Retrospectivos , Linfonodo Sentinela/metabolismo , Linfonodo Sentinela/cirurgiaRESUMO
BACKGROUND: We analyzed the hemodynamic changes induced by femoral artery ligation with concomitant thrombectomy in intravenous drug abusers with infected femoral artery pseudoaneurysm (IFAP) and their clinical significance. METHODS: Between January 2000 and November 2007, a total of 55 patients presented to our clinic with IFAP. Among these patients, 54 were treated by femoral artery ligation with concomitant thrombectomy. Open collateral circulations were assessed by intraoperative angiography, including detection of mean artery pressure (MAP) of back-flow from the profunda femoris artery and the superficial femoral artery after operation. Patients were followed up for 3-72 months (mean 35). The data were then subjected to statistical analysis. RESULTS: Preoperative death occurred in one patient due to acute onset of drug addiction in the ward. Preoperatively, massive necrosis developed in the left limb of the only patient with bilateral IFAPs. All 54 patients underwent femoral artery ligation with concomitant thrombectomy, including nine cases of ligation of the external iliac artery and one case of above-knee limb amputation. All wounds were completely healed within 3 months. Six late deaths (11.1%), resulting solely from refractory drug addiction, were observed during the follow-up period, of which two occurred 2 years, one 4 years, and three 5 years postoperatively. No toe amputations were noted during the follow-up period. Fourteen patients (25.9%) developed intermittent claudication. One postoperative limb was lost. Of all 54 patients, 38 were subjected to collateral circulation assessment by intraoperative angiography. Collateral circulations were found well open in a baseline path with four stations down to the distal lower limbs of all assessed patients. Four preferred types of iliac-femoral collaterals were defined. Postoperatively, compared to the external iliac artery, the MAP levels of back-flow from the profunda femoris artery and the superficial femoral artery significantly dropped to 43.89+/-2.75 and 18.08+/-2.76 mm Hg, respectively. CONCLUSION: As a result of femoral artery ligation without reconstruction, well open collateral circulations and acceptable distal arterial runoff blood are seen, which suggests that this procedure is a reliable alternative to the emergent treatment of IFAPs in drug addicts. However, arterial reconstruction may be used as a backup approach if necessary during observation.
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Falso Aneurisma/cirurgia , Aneurisma Infectado/cirurgia , Usuários de Drogas , Artéria Femoral/cirurgia , Hemodinâmica , Abuso de Substâncias por Via Intravenosa/complicações , Procedimentos Cirúrgicos Vasculares , Adulto , Amputação Cirúrgica , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/microbiologia , Falso Aneurisma/fisiopatologia , Aneurisma Infectado/diagnóstico por imagem , Aneurisma Infectado/microbiologia , Aneurisma Infectado/fisiopatologia , Angiografia Digital , Pressão Sanguínea , Circulação Colateral , Feminino , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/microbiologia , Artéria Femoral/fisiopatologia , Humanos , Ligadura , Salvamento de Membro , Masculino , Estudos Prospectivos , Fluxo Sanguíneo Regional , Abuso de Substâncias por Via Intravenosa/mortalidade , Trombectomia , Fatores de Tempo , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversos , CicatrizaçãoRESUMO
OBJECTIVE: To evaluate the effect of preoperative embolization of the feeding vessels of carotid body tumor in the treatment thereof. METHODS: 33 patients with carotid body tumors not less than 3 cm in diameter were examined by color Doppler ultrasound. Polyvinyl alcohol particle 250-1000 microm in diameter were suspended in meglumine diatrizoate or Ultravist and then injected via microcatheter into the feeding vessels until detainment or reflux was seen. Operation was performed 1 day later on 23 patients and 4 days later on 10 patients. External carotid artery to internal carotid artery bypass was performed on 1 case, anastomosis of common carotid to internal carotid artery with auto-saphenous vein interposition on 3 cases, and repair of internal carotid artery on 1 case. RESULTS: One-stage resection was completed on all tumors. One case suffered contralateral hemiplegia two times in the operative day, on the next day the contralateral lower limb could move, but the patient could not speak clearly and his tongue was not in right position, after 3 months he was completely recovered and MRI illustrated cranial infarction. CONCLUSION: An important adjunct in treating large carotid body tumor, preoperative embolization makes the surgical exploration proceed much smoother, blood loss become less, and morbidity lower.
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Tumor do Corpo Carotídeo/cirurgia , Procedimentos Cirúrgicos Vasculares , Adulto , Tumor do Corpo Carotídeo/irrigação sanguínea , Tumor do Corpo Carotídeo/terapia , Embolização Terapêutica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
PURPOSE: The role of surgery in patients with initially metastatic breast cancer (IMBC) is unclear. The purpose of this study was to determine if surgery improves the prognosis of patients with IMBC. METHODS: Data of patients with IMBC at the First Affiliated Hospital of Sun Yat-Sen University from 2000 to 2014 were retrospectively analyzed. The last follow-up was October 2015. Clinical characteristics and overall survival (OS) were compared and evaluated by univariate and multivariate analysis. RESULTS: Eighty-one patients were included in this study; 59 were operated and 22 were not. The median survival time was 28 months, 3-year survival rate was 32.5%, and 5-year survival rate was 8.4%. The OS of operated patients was significantly longer than those without surgery (34 vs. 23 months, p=0.002). Surgery (estimated hazard ratio [HR] =0.12, 95% confidence interval [CI]: 0.04-0.42) and endocrine therapy (HR=0.17, 95% CI: 0.06-0.54), were significantly associated with a better prognosis in the multivariate model. However, patients with surgery were younger, had fewer metastases, and a higher ratio of patients with Ki-67≤14%. Patients who were operated more than 3 months after diagnosis had better OS that those who had surgery less than 1 month (p=0.009). Stratified analyses of the surgery group found that younger age (HR 0.28, p=0.016), bone-only metastases (HR 0.24, p=0.006) and chemotherapy administration (HR 0.38, p=0.004) or endocrine therapy (HR 0.06, p=0.006) were favorable predictors of survival. Conclusion Surgery may prolong the OS of patients with IMBC, especially in certain of them, and in those who undergo surgery at a certain time.
Assuntos
Neoplasias Ósseas/cirurgia , Neoplasias da Mama/cirurgia , Prognóstico , Receptor ErbB-2/genética , Adulto , Idoso , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/patologia , Neoplasias Ósseas/secundário , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica , Intervalo Livre de Progressão , Modelos de Riscos Proporcionais , Estudos RetrospectivosRESUMO
Overexpression of PDE5 is observed in certain human cancers, but PDE5 expression in well-differentiated thyroid carcinoma (WDTC) is unknown. We therefore examined PDE5 expression and its relationship with the clinicopathological features of WDTC. Real-time qPCR and Western blotting were performed to analyze the expression of PDE5 mRNA and protein in paired WDTC tumor and adjacent nontumor tissues. Immunohistochemistry was used to analyze the expression of PDE5 in paraffin-embedded tissues obtained from 103 cases of WDTC. Statistical analyses were performed to examine the correlation between PDE5 expression and clinicopathological features. The expression of PDE5 mRNA and protein was upregulated in WDTC lesions compared to their paired noncancerous tissues. The expression of PDE5 was significantly correlated with age (P = 0.032), regional lymph node status (P = 0.004), and the presence of distant metastasis (P = 0.020). High PDE5 expression was more closely associated with lymph node involvement in patients over 45 years (OR = 15.60, P ≤ 0.05). Thus, PDE5 may be a potential biomarker in WDTC, particularly in patients with regional lymph node metastasis, which is associated with disease recurrence, treatment failure, and morbidity. PDE5 expression may also help predict the prognosis and recurrence of WDTC after surgery.
RESUMO
TFIIB-related factor 1 (Brf1) modulates the transcription of RNA Pol III genes (polymerase-dependent genes). Upregulation of Pol III genes enhances tRNA and 5S RNA production and increases the translational capacity of cells to promote cell transformation and tumor development. However, the significance of Brf1 overexpression in human breast cancer (HBC) remains to be investigated. Here, we investigate whether Brf1 expression is increased in the samples of HBC, and we explore its molecular mechanism and the significance of Brf1 expression in HBC. Two hundred and eighteen samples of HBC were collected to determine Brf1 expression by cytological and molecular biological approaches. We utilized colocalization, coimmunoprecipitation, and chromatin immunoprecipitation methods to explore the interaction of Brf1 with estrogen receptor alpha (ERα). We determined how Brf1 and ERα modulate Pol III genes. The results indicated that Brf1 is overexpressed in most cases of HBC, which is associated with an ER-positive status. The survival period of the cases with high Brf1 expression is significantly longer than those with low levels of Brf1 after hormone treatment. ERα mediates Brf1 expression. Brf1 and ERα are colocalized in the nucleus. These results indicate an interaction between Brf1 and ERα, which synergistically regulates the transcription of Pol III genes. Inhibition of ERα by its siRNA or tamoxifen reduces cellular levels of Brf1 and Pol III gene expression and decreases the rate of colony formation of breast cancer cells. Together, these studies demonstrate that Brf1 is a good biomarker for the diagnosis and prognosis of HBC. This interaction of Brf1 with ERα and Brf1 itself are potential therapeutic targets for this disease.
Assuntos
Adenocarcinoma/metabolismo , Neoplasias da Mama/metabolismo , Receptor alfa de Estrogênio/metabolismo , Regulação Neoplásica da Expressão Gênica , Mapas de Interação de Proteínas , Fatores Associados à Proteína de Ligação a TATA/metabolismo , Adenocarcinoma/diagnóstico , Adenocarcinoma/genética , Adenocarcinoma/patologia , Adulto , Idoso , Mama/metabolismo , Mama/patologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Feminino , Humanos , Células MCF-7 , Pessoa de Meia-Idade , Prognóstico , Fatores Associados à Proteína de Ligação a TATA/genética , Regulação para Cima , Adulto JovemRESUMO
OBJECTIVE: To verify the role and effect of external vavuloplasty in the treatment of chronic venous insufficiency (CVI) of lower extremity. METHODS: Thirty patients with CVI of bilateral lower extremities were enrolled to accept surgical management of vein systems. Both limbs of each patient were randomized into two groups respectively according to the operating style. One limb was given external vavuloplasty of the superficial femoral vein and surgery of superficial venous system (group A), the another limb was only given the surgery of superficial venous system (group B). The effect comparison between both limbs of each patient and two groups by color duplex scanning, color doppler velocity profile (CDVP), air plethysmography and CEAP score system one month and 3 years after operation. RESULTS: All 60 limbs of 30 cases were CEAP C(2)-C(4) with degree III reflux (Kistner's method) in the deep veins confirmed by color duplex scanning and venography. In 1 month and 3 years after surgery, all the indexes of the limb in the group A were dramatically improved compared with those of the limbs in the group B. The average value of venous reflux degree, reflux volume, and venous filling index (VFI) had significant difference between the two groups (P < 0.001). In 3 years after surgery, there was significant difference between the two groups on ejective fraction (EF)and residual volume fraction (RVF) (P < 0.05) and CEAP clinical score (P < 0.001). CONCLUSION: External vavuloplasty of deep vein may reduce the reflux volume of the affected deep vein and improve the valve function, and can result in better outcomes when combined with surgery of the superficial venous system.