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Objective To evaluate the value of miniprobe endoscopic ultrasound(EUS)in guiding endoscopic treatment of small-diameter(maximum diameter less than 1 cm)and low-grade(G1 grade)rectum neuroendocrine neoplasm(R-NEN),and to provide evidence and clues for its clinical application and further research.Methods The clinical data of 85 cases of low-grade(G1 grade)R-NEN with a maximum diameter of less than 1 cm who underwent endoscopic treatment in our center from January 2014 to December 2020 were retrospectively analyzed.The patients were divided into the EUS group(37 cases)and control group(48 cases)according to whether EUS was performed before endoscopic treatment.The positive rate of incision margin,the incidence of complications,the recurrence rate,the hospital stay,the cost of hospitalization and endoscopic therapy were compared between the two groups.Results The positive rate of incision margin in the EUS group was significantly lower than that in control group(P<0.05).There was no significant difference in the incidence of complications,tumor recurrence rate,hospital stay or hospital costs between the two groups(P>0.05).There was statistically significant difference in the endoscopic therapy between the two groups(P<0.05).Conclusion Evaluating the lesion depth of small-diameter and low-grade(G1 grade)R-NEN before surgery by miniprobe EUS and selecting endoscopic surgery according to its results of can significantly reduce the residual risk of resection margin tumors.
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Atrial fibrillation (AF) is the most frequently diagnosed cardiac arrhythmia worldwide. Patients with permanent atrialfibrillation are at an increased risk of developing valvular heart disease. Atrial fibrosis occurs in this pathophysiologicalsetting. LIM kinase 1 (LIMK1) is a serine/threonine kinase that regulates microtubule stability and actin polymerization infibroblasts. LIMK1 has been implicated in the pathogenesis of atrial fibrillation. Clinical data and biopsies of the right atrialappendage were collected from 50 patients with valvular heart disease who underwent heart valve replacement surgery.Data from patients with permanent atrial fibrillation (AF) and patients with sinus rhythm (SR) were compared. We foundthat AF patients had upregulated expression of LIMK1 as well as higher fibrosis. Transforming growth factor-b (TGF-b)stimulation induced the differentiation of cardiac fibroblasts into myofibroblasts as well as upregulated expression ofLIMK1. Downregulation of LIMK1 by siRNA inhibited TGF-b induced fibroblast-myofibroblast transition, as evidencedby the downregulation of the expression of several differentiation markers, namely alpha-smooth muscle actin and type Iand III collagen. Our findings revealed that increased LIMK1 protein levels may contribute to atrial fibrosis, and suggestedthat LIMK1 might be involved in AF development by promoting fibrogenesis associated with TGF-b.
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OBJECTIVE: We aimed to assess the chemotactic response of endothelial progenitor cells to angiotensin-converting enzyme inhibitors in T2DM patients after acute myocardial infarction, as well as the associated prognosis. METHODS: Sixty-eight T2DM patients with acute myocardial infarction were randomized to either receive or not receive daily oral perindopril 4 mg, and 36 non-diabetic patients with acute myocardial infarction were enrolled as controls. The numbers of circulating CD45−/low+CD34+CD133+KDR+ endothelial progenitor cells, as well as the stromal cell-derived factor-α and high-sensitivity C reactive protein levels, were measured before acute percutaneous coronary intervention and on days 1, 3, 5, 7, 14, and 28 after percutaneous coronary intervention. Patients were followed up for 6 months. Chinese Clinical Trial Registry: ChiCTR-TRC-12002599. RESULTS: T2DM patients had lower circulating endothelial progenitor cell counts, decreased plasma vascular endothelial growth factor and α levels, and higher plasma high-sensitivity C reactive protein levels compared with non-diabetic controls. After receiving perindopril, the number of circulating endothelial progenitor cells increased from day 3 to 7, as did the plasma levels of vascular endothelial growth factor and stromal cell-derived factor-α, compared with the levels in T2DM controls. Plasma high-sensitivity C reactive protein levels in the treated group decreased to the same levels as those in non-diabetic controls. Furthermore, compared with T2DM controls, the perindopril-treated T2DM patients had lower cardiovascular mortality and occurrence of heart failure symptoms (p<0.05) and better left ventricle function (p<0.01). CONCLUSIONS: The use of angiotensin-converting enzyme inhibitors represents a novel approach for improving cardiovascular repair after acute myocardial infarction in T2DM patients. .
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Aged , Female , Humans , Male , Middle Aged , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , /complications , Endothelial Cells/drug effects , Hematopoietic Stem Cell Mobilization , Myocardial Infarction/drug therapy , Perindopril/therapeutic use , Stem Cells/drug effects , C-Reactive Protein/analysis , /blood , /blood , Endothelial Cells/cytology , Follow-Up Studies , Myocardial Infarction/blood , Myocardial Infarction/complications , Prognosis , Prospective Studies , Stem Cells/cytology , Vascular Endothelial Growth Factor A/bloodABSTRACT
<p><b>OBJECTIVE</b>To investigate the principle of management of colorectal high-grade intraepithelial neoplasia(HGIN) based on colonoscopic biopsy.</p><p><b>METHODS</b>Patients diagnosed as colorectal HGIN based on colonoscopic biopsy in the Changhai Hospital from January 2002 to December 2009 were enrolled in the study. The clinical data of all the patients were collected and analyzed. According to the subsequent operation, cases were divided into local complete resection group and radical operation group. The discrepancy between the biopsy diagnosis and postoperative diagnosis was investigated.</p><p><b>RESULTS</b>Of the 203 biopsy-based colorectal HGIN lesions, 156 underwent radical resection, while 47 received local complete resection. Univariate analyses indicated that tumors located in colon(P=0.02), tumors with sessile growth (P=0.00) and large tumors (P=0.00) were more likely to be treated with radical resection. Postoperative diagnosis revealed that 163 cases(80.3%) were invasive cancers, while the other 40 cases(19.7%) were HGIN lesions. Of the 156 cases resected radically, 140 cases were invasive cancers, 16 cases were diagnosed as HGIN. Of the 47 cases who underwent local complete resection, 24 cases were confirmed as HGIN but the other 23 cases were invasive cancers, in which 15 cases received subsequent radical operation.</p><p><b>CONCLUSIONS</b>A large proportion of biopsy-proven colorectal HGIN lesions are invasive cancers. Therefore, local resection should be performed to confirm diagnosis. For highly suspected malignant tumors which can not be removed completely by local resection, if anus can be reserved, a radical transabdominal surgery is recommended even without biopsy-proven malignancy in order to avoid treatment delay.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Biopsy , Carcinoma in Situ , Diagnosis , Pathology , General Surgery , Colorectal Neoplasms , Diagnosis , Pathology , General Surgery , Endoscopy, GastrointestinalABSTRACT
<p><b>OBJECTIVE</b>To explore the surgical strategy for ectopic kidney and evaluate the clinical outcomes.</p><p><b>METHODS</b>From January 2000 to October 2009, 35 cases of ectopic kidney were treated surgically in our hospital. Definite diagnoses were established in all the cases by ultrasound, intravenous urography (IVU), cystoscope, CT, magnetic resonance urography (MRU) and radionuclide imaging before the surgery. In these patients, 26 had ipsilateral ectopic ureteral orifice (including 5 with bilateral duplicated kidneys and ureter), 9 had moderate or severe hydronephrosis (including 3 with ectopic kidney calculi), and 24 had dysplastic kidney (24/35). All the patients underwent operations, including 26 with ectopic nephrectomy, 7 with ectopic ureterovesical reimplantation, and 3 with ectopic renal pelvis incision.</p><p><b>RESULTS</b>The clinical effect was satisfactory in all the cases during the follow up of 7 to 29 months.</p><p><b>CONCLUSION</b>Appropriate surgical approaches according to the concurrent deformities and complications can achieve good clinical results in patients with ectopic kidneys.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Young Adult , Abnormalities, Multiple , Diagnosis , General Surgery , Kidney , Congenital Abnormalities , General Surgery , Nephrectomy , Methods , Ureter , Congenital Abnormalities , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the role of Thl7 cells and the cytokine interleukin-17 (IL-17) in acute allograft rejection in mice.</p><p><b>METHODS</b>Mouse models of kidney transplantation were randomly divided into rejection group and isograft group. On the post-operative day (POD) 3 and 7, we tested the serum IL-17 level using enzyme-linked immunosorbent assay and measured the number of Th17 cells in the renal grafts by flow cytometry. The grafts were harvested and fixed in 10% formalin to prepare paraffin sections for routine pathological inspection.</p><p><b>RESULTS</b>Compared to isograft group, the allograft group showed a significantly higher level of serum IL-17 on POD3 and POD7 (P<0.05), and the level of IL-17 is significantly higher on POD7 than on POD3 (P<0.05). The allograft group showed more infiltrating Th17 cells in the grafts on POD3 and POD7 (P<0.05), and the cell number was significantly greater on POD7 (P<0.05). Pathological examination also showed an increased severity of graft rejection with the post-transplantation time.</p><p><b>CONCLUSION</b>Thl7 cells may play an important role in the development of renal graft rejection. IL-17 may serve as a potential specific indicator for predicting allograft rejection.</p>
Subject(s)
Animals , Male , Mice , Graft Rejection , Blood , Allergy and Immunology , Interleukin-17 , Blood , Kidney Transplantation , Allergy and Immunology , Mice, Inbred BALB C , Mice, Inbred C57BL , Th17 Cells , Allergy and Immunology , Transplantation, HomologousABSTRACT
Objective: To investigate the expression of ER, PR, HER-2, PCNA and P53 in breast cancer patients in Shanghai and the relevant clinical significance. Methods: Expressions of ER, PR, HER-2, PCNA and P53 in the breast cancer tissues of 544 patients in Shanghai were detected by immunohistochemistry methods. Statistical analysis was applied to analyze the relationship of these immunohistochemical indices with the clinicopathological features of breast cancer. Results: The positive rates of ER, PR, HER-2, PCNA and P53 in the breast cancer tissues of 544 patients were 62.2%, 57.2%, 15.1%, 82.6% and 58.5%, respectively. The expressions of ER, PCNA and P53 were correlated with the tumor size (P<0.05, P<0.01). The expressions of HER-2 and PCNA were correlated with axillary lymphatic metastasis (P<0.05, P<0.01). ER expression was positively correlated with PR expression(r=0.452, P=0.000) and PR expression was positively correlated with P53 expression (r=0.520, P=0.03). The 123 (22.6%) patients with triple-negative breast cancer (TNBC) had a higher axillary lymphatic positive rate than patients with non-TNBC (P<0.01). Co-expression of HER-2 with PCNA and co-expression of HER-2 with P53 were positively correlated with lymphatic metastasis (P<0.05). Conclusion: Population aging has a influence on the immunohistochemical characteristics of breast cancer patients patients in Shanghai. Combined examination of ER, PR, HER-2, PCNA and P53 is of clinical significance in the diagnosis, treatment, and prognosis prediction of breast cancer patients.
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<p><b>OBJECTIVE</b>To study the risk factors of hepatitis B virus (HBV) intrauterine infection.</p><p><b>METHODS</b>Risk factors of HBV intrauterine infection were analyzed by nested case control study.</p><p><b>RESULTS</b>Data from univariate analysis revealed that risk factors of HBV intrauterine infection were positive results on HLA-DR3 (OR = 4.71, 1.62-13.66), HBV DNA (OR = 6.59, 2.72-15.97) and HBeAg (OR = 4.53, 1.93-10.64) in pregnant women, HLA-DR3 (OR = 3.91, 1.18-12.94) in newborn, HLA-I) R3 (OR = 5.96, 1.14-31.15) both in pregnant women and her newborns and HBV infection in placentas (OR = 2.51,1.12-5.60). Results from Multivariate unconditional logistics regression analysis showed that the risk factors of HBV intrauterine infection were positive in both HLA-DR3 (OR = 4.65, 1.44-15.05) and HBV DNA (OR = 6.56, 2.65-16.23) in pregnant women. However, there was no interaction between the two factors. The exposure rate of other factors did not reveal the difference in the two groups. With the increase of HBV DNA in pregnant women, the risk of HBV intrauterine infection was rising (chi2 = 16.74, P < 0.05).</p><p><b>CONCLUSION</b>Risk factors of HBV intrauterine infection were HLA-DR3 positive and HBV DNA positive in pregnant women but there was no interaction between the two factors. The risk of HBV intrauterine infection was increased along with the increase of HBV DNA in pregnant women.</p>
Subject(s)
Adult , Female , Humans , Infant, Newborn , Pregnancy , DNA, Viral , Genetics , HLA-DR3 Antigen , Metabolism , Hepatitis B , Virology , Hepatitis B virus , Genetics , Physiology , Infectious Disease Transmission, Vertical , Logistic Models , Pregnancy Complications, Infectious , Virology , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To explore the role of the gene polymorphism of cytokine and cytokine receptors in the pathogenesis of type III prostatitis.</p><p><b>METHODS</b>We genotyped 24 outpatients diagnosed with type III prostatitis and 51 healthy volunteer controls for the single nucleotide polymorphisms of 13 cytokines and cytokine receptors at 22 sites by Sequence Specific Primer -PCR (SSP-PCR).</p><p><b>RESULTS</b>The patients exhibited significantly higher frequencies of the genotypes of IL-10-819 T/T (62.5%) and IL-10-592 A/A (62.5%), the haplotype of IL-10 (-1082/-819/-592) ATA (75.0%) and the diploid genotype of IL-10 (-1082/-819/-592) ATA/ATA (62.5%), than with the healthy controls (31.3% , 31.3%, 25.0% and 31.2%) (P < 0. 05).</p><p><b>CONCLUSION</b>Our data suggested that anti-inflammation cytokine IL-10 gene polymorphisms were associated with the pathogenesis of type III prostatitis.</p>
Subject(s)
Adult , Humans , Male , Case-Control Studies , Gene Frequency , Genotype , Interleukin-10 , Genetics , Polymerase Chain Reaction , Polymorphism, Genetic , Prostatitis , Genetics , Receptors, Interleukin-10 , GeneticsABSTRACT
OBJECTIVE@#To investigate the feasibility and safety of substituting tacrolimus(FK506) for cyclosporin A(CsA) on delaying the pace of renal dysfunction in patients with biopsy-proven chronic allograft nephropathy(CAN).@*METHODS@#Seventy-three renal transplantation patients with CAN proved by allograft biopsy were collected in this study. Patients were randomly divided into 2 groups. Patients were either converted to FK506(FK506 group, n=43) or remained on their initial CsA-based immunosuppression(CsA group, n=30). The clinical data at study entry and after 12 months including blood urea nitrogen(BUN), serum creatinine(SCr), glomerular filtration rate(GFR), 24-hour urine protein excretion, serum total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL) and the side effects of calcineurin inhibitors were monitored during a follow-up of over 12 months.@*RESULTS@#Twelve months later, the level of SCr was statistically reduced and GFR levels were obviously elevated in the FK506 group as compared with CsA group [(194.8+/-42.5)micromol/L vs. (245.4+/-52.8)micromol/L and (50.14+/-3.92)mL/(min.1.73 m(2)) vs. (40.58+/-2.49)mL/(min.1.73 m2), P<0.01]. Quantity of 24-hour urine protein excretion in the FK506 group was (2.0+/-0.5)g which is significantly lower than (3.9+/-0.7)g in the CsA group(P<0.01). TC, TG, and LDL levels remained unchanged in the CsA group, while those were statistically reduced in the FK506 group respectively [(5.19+/-0.73)mmol/L vs. (6.94+/-1.37)mmol/L, (1.86+/-0.84)mmol/L vs. (3.14+/-1.38)mmol/L, (3.03+/-0.71)mmol/L vs. (3.82+/-0.89)mmol/L, P<0.01]. Tremor obviously increased (P<0.01) and hypertension obviously decreased (P<0.05) in the FK506 group compared with the CsA group.@*CONCLUSION@#FK506 treatment can greatly improve the proteinuria and hyperlipidemia. Conversion from CsA to FK506 is an effective and safe alternative therapy for delaying the progression of renal dysfunction induced by CAN.