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Objective:To explore the effect of Quercus Salicina Extract Capsulese on preventing the formation of adherent stones on ureteral stent tube after percutaneous nephrolithotomy (PCNL).Methods:The clinical data of 186 patients who underwent PCNL due to unilateral renal stone in the Affiliated Hospital of Xuzhou Medical University from October 2018 to April 2020 were retrospectively analyzed. All of the patients were indwelling 6 F ureteral stent tube during operation. After postoperative reexamination of kidneys, ureters and bladder, it was confirmed that the postoperative residual stones were clinically meaningless stones (maximum diameter ≤ 4 mm). According to postoperative medication, they were divided into drug group ( n=62) and control group ( n=124). Patients in the drug group were given oral Quercus Salicina Extract Capsules, while patients in the control group did not take the drug. Both groups received the same health education and dietary guidance after operation. The formation of adherent stones on ureteral stent tube was observed when the ureteral stent tube was removed 6 weeks after PCNL. Meanwhile, the adverse reaction, complication and treatment satisfaction of the patients were recorded during the period of taking the drug. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups; the Chi-square test was used to compare the count data between groups. Results:When the ureteral stent tube was removed 6 weeks after PCNL, the weight of adherent stones on ureteral stent tube in the drug group was (334.20±26.65) mg for male, and (336.00±25.64) mg for female. In the control group, the weight of adherent stones on ureteral stent tube was (374.11±42.28) mg for male, (374.42±42.44) mg for female. The weight of adherent stones on ureteral stent tube in the drug group was significantly lighter than that in the control group, and the difference was statistically significant ( P<0.01). The drug group had no obvious serious adverse reaction during the period of taking the drug. At the same time, the complications of the drug group during the intubation period were significantly less than the control group, and the difference was statistically significant ( P=0.040). The satisfaction of patients in the drug group was 93.5%, and that in the control group was 82.3%. The difference was statistically significant between the two groups ( P=0.036). Conclusion:Quercus Salicina Extract Capsules can effectively prevent the occurrence of adherent stones on ureteral stent tube after PCNL, and there are no serious adverse reaction, which is worthy of clinical promotion.
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Liver-resident natural killer (LrNK) cells, as a type of newly discovered tissue-resident natural killer cells, have a strong immune killing function. During the development and progression of hepatocellular carcinoma (HCC), the function of LrNK cells is impaired and such cells may promote the progression of HCC by upregulating the expression of related immune checkpoints. Based on the latest research, this article reviews the immune function of LrNK cells and their role in the development and progression of HCC, in order to explore the application prospect of these cells in HCC immunotherapy.
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Objective:To explore the effect of the interval of radical prostatectomy after prostate puncture on the perioperative period and prognosis of patients.Methods:Patient’s data from September 2016 to September 2018 whom performed laparoscopic radical prostatectomy at the Affiliated Hospital of Xuzhou Medical University were collected and retrospectively analyzed. All prostate biopsy confirmed prostate cancer and 66 patients underwent laparoscopic radical prostatectomy. The average age was (70.11 ± 5.01) years, ranged from 60 to 79 years. The patients were divided into two groups according to the interval time from prostate biopsy to laparoscopic radical prostatectomy: <7 d group ( n=32) and 6-8 weeks group ( n= 34). The operation time, intraoperative blood loss, postoperative hospital stays, positive rate of incisional margin, postoperative urinary incontinence rate and the rate of urinary incontinence 6 months after operation, rate of postoperative erectile dysfunction and bone metastasis were compared and analyzed between the two groups. When the data conformed to the normal distribution, the data were expressed in Mean±standard deviation ( Mean± SD), and the independent sample t-test was used to evaluate the statistical significance between groups. When the data did not conform to the normal distribution, the measurement data was expressed as Median (interquartile range) [ M( P25, P75)], and the Mann-Whitney U test was used for the comparison between groups. Count data comparison between groups using Chi-square test or Fisher exact probability method. Unconditional multivariate Logistic regression was used to analyze the relationship between outcome and exposure. Results:All the 66 patients successfully underwent surgery, the surgery success rate was 100%. The average operation time of <7 d group and group 6-8 weeks group was [185.00(174.50, 193.50)] min and [183.00(175.00, 187.50) min], respectively, the difference was not statistically significant ( P=0.685 8, U=512.0). The average intraoperative blood loss of group <7 d group and 6-8 weeks group was [185.50(177.75, 205.25)]ml, [189.00(180.75, 206.00)] ml, respectively, the difference was not statistically significant ( P=0.685 9, U=512.0). The average postoperative hospital stays of <7 d group and 6-8 weeks group was [14.00(11.75, 16.00)] d, [13.50(12.00, 15.00)] d, respectively, the difference was not statistically significant ( P=0.785 7, U=522.5). The positive rate of incisal margin of<7 d group and 6-8 weeks group was 18.75%, 14.71%, respectively, the difference was not statistically significant ( P=0.659 5, χ2=0.194). The postoperative urinary incontinence rate of <7 d group and 6-8 weeks group was 6.25% and 8.82%, respectively, the difference was not statistically significant ( P=1.000 0). The urinary control after follow-up for six months of <7 d group and 6-8 weeks group was 6.25% and 2.94%, respectively, the difference was not statistically significant ( P=0.607 7). The postoperative erectile dysfunction rate of<7 d group and group 6-8 weeks group was 9.38% and 8.82%, respectively, the difference was not statistically significant ( P=1.000 0). The postoperative bone metastasis rate of group<7 d and 6-8 weeks group was 6.25% and 5.88%, respectively, the difference was not statistically significant ( P=1.000 0). Conclusions:Performing laparoscopic radical prostatectomy within 7 days following prostate biopsy did not adversely affect the postoperative outcomes and prognosis, also not increased postoperative complications, can shorten the patient′s treatment cycle.
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Objective:To explore the efficacy and safety of transvaginal anterior pelvic floor reconstruction with mesh in treatment of patients with cystocele and lower urinary tract symptoms.Methods:A retrospective analysis of 32 patients who underwent transvaginal anterior pelvic reconstruction with mesh from June 2015 to February 2019 was performed. The age of the patients was 57-86 years old, with an average of (67.8±7.6) years; body mass index(BMI) (22.6±3.0) kg/m 2; mean duration of disease (2.9±2.3) years; delivery 1-7 times, mean(3.0±1.5) times. All patients underwent transvaginal anterior pelvic reconstruction. The anterior wall of the vagina was incised, and the space between the pelvic floor and the bladder was bluntly separated. The mesh was placed under the guidance of the puncture needle after locating marks of body surface. Patients underwent the American Urological Association Symptom Scoring (AUASS) with (14.2±3.5) points, the residual urine (71.3±53.0) ml and the maximum urine flow rate (16.9 ± 3.8) ml/s were measured preoperative. The Pelvic Organ Prolapse Distress Inventory(POPDI-6), Urogenital Distress Inventory(UDI-6) and Pelvic Floor Impact Questionnaire(PFIQ-7) were recorded as the value of (48.0±7.3) points, (41.7 ± 8.2) points and (62.5 ± 16.4) points, respectively. Thirty-two patients were divided into 2 groups as the group of urinary storage symptom (22 patients) and the group of voiding symptom (10 patients) according to the preoperative lower urinary tract symptoms. The operative time, intraoperative bleeding volume and average hospital stay were recorded. The patients were followed up with AUASS, maximum urine flow rate, residual urine, POPDI-6, UDI-6, PFIQ-7 and complications during and after operations. Results:All the operations of 32 cases were successfull. The average operation time was (61.1±18.6) min, the average intraoperative blood loss was (41.5±12.3)ml, and the average hospital day was (9.1±1.8)d. There were no major organ injuries such as bladder, ureter, iliac vessels and rectum. 27 patients were followed up for 3 to 36 months, with an average of (24.7±10.8) months. There significant improvement of LUTS. At the last follow-up, the AUASS storage phase score (3.4±1.9) points in the urinary storage symptom group(19 patients) and the AUASS urinating phase score (3.9±1.7) points in the voiding symptom group(8 patients) were compared with the preoperative AUASS scores (11.6±1.9) points and (13.9±1.2) points which were significantly reduced. By the last follow up of all the 27 patients, residual urine (23.4±11.0)ml, POPDI-6(3.1±5.4) points, UDI-6 (3.2±5.1) points and PFIQ-7 (12.4±1.7) points were significantly lower than preoperative data. The maximum urinary flow rate(22.4±4.1)ml/s, was significantly higher than that before the operation. All the differences were statistically significant ( P<0.05). All patients had no recurrence of cystocele. One patient had anterior vaginal wall mesh exposure 3 months after surgery. After removing excess mesh in the outpatient clinic, she was cured by smearing with estrogen ointment. One patient experienced frequent urination and urgency who was cured by oral tolterodine tartrate. One patient with de novo mild SUI during the 1-year follow-up. The symptoms were improved in the outpatient clinic after pelvic floor muscle exercise. At 2-year follow-up, one patient was observed de novo mild posterior wall prolapse with no clinical manifestations and no treatment was carried out. Conclusions:Transvaginal anterior pelvic reconstruction with mesh could be effective in treating cystocele with lower urinary tract symptoms with less surgical trauma, fewer complications and lower recurrence rate. It could effectively improve lower urinary tract symptoms such as frequent urination, urgency and difficulty urinating.However, safety issues such as the incidence of long-term de novo SUI and mesh exposure still require further long-term follow-up.
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OBJECTIVE@#To evaluate the efficacy and safety of the third-generation aromatase inhibitor letrozole in the treatment of McCune-Albright syndrome (MAS) girls with peripheral precocious puberty.@*METHODS@#Twenty-one MAS girls with peripheral precocious puberty treated in Pediatrics Department of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from March 2012 to June 2017 were enrolled in the study. Patients presented with repeated vaginal bleeding, premature breast enlargement, café-au-lait spots or dysplasia of bone fibers, and low levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH); and the congenital adrenal hyperplasia, estrogen-producing tumors, and exogenous estrogen intake were excluded. Letrozole were administrated at a dose of 0.5-2 mg·m ·d for 6 to 12 months. The patients were observed for changes in breast staging, vaginal bleeding, sex hormone levels, liver function and bone age changes, and changes in uterine and ovarian volume.@*RESULTS@#After treatment, bone age/chronological age (BA/CA)was decreased from 1.23±0.30 to 1.11±0.18 ( < 0.01); the predicted adult height (PAH) increased from (156.2±5.9)cm to (158.4±2.1)cm after treatment ( < 0.05); the vaginal bleeding was reduced and the estradiol level decreased, while the teststosterone level and the uterus showed no significant increase, and no adverse reactions such as ovarian torsion and abnormal liver function were observed.@*CONCLUSIONS@#Precocious puberty is one of the most common endocrine manifestations in MAS. Our findings suggest that letrozole may be an effective and safe therapy to precocious puberty in girls with McCune-Albright Syndrome.
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Child , Female , Humans , Aromatase Inhibitors , China , Fibrous Dysplasia, Polyostotic , Letrozole , Puberty, PrecociousABSTRACT
Five patients with primary malignancies in the pterygopalatine fossa (PPF) and infra temporal fossa (ITF) were enrolled in this retrospective study between January 2012 and January 2018. After malignancies proven by biopsy and evaluation with CT and MRI scan, all patients received modified maxillary swing (MMS) approach for extirpation of malignant tumors in the PPF and ITF under general anesthesia. En bloc resection with wide surgical margins was successfully performed in all cases. Negative margins were observed in 4 cases and positive margins were found in one patient with adenoid cystic carcinoma who received postoperative radiotherapy. The most common complication was facial numbness. During the follow-up period (range 12 to 57 months), one patient suffered from recurrence while others did not. The advantages of MMS include wide surgical field, full exposure and easy manipulation. The MMS approach is expected to become an standard method for monobloc resection of malignancies in the PPF and ITF.
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Objective@#To analyze the clinical characteristics of chronic pancreatitis (CP) and evaluate its impact on growth of children.@*Methods@#A retrospective study was conducted in 94 children (male 49 cases, female 45 cases) who were diagnosed with CP in the Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from August 2008 to July 2015. Clinical characteristics, such as features of abdominal pain, etiologies, image data, levels of serum amylase and lipase, and physical development data were extracted from electronic medical records. The comparison between groups based on etiology or with normal control was performed with student′s t test.@*Results@#The age of first episode was (8.2±3.7) years. There were 61 (65%) children diagnosed with idiopathic CP, and 25 (27%) with anatomic abnormalities. The age of onset in the group with anatomic abnormalities was lower than that in the idiopathic CP group ((6.3±3.5) vs. (8.9±3.4) years, t=3.211, P=0.002). There were 51 (54%) patients with serum amylase elevation, 41(44%) patients with lipase elevation, and 35 (37%) with elevation in both. The questionnaire showed that 28 out of 30 children had moderate to severe abdominal pain. The patients′ weight standard score (SDS) was significantly lower than the overall average in normal control (-0.4±1.1 vs. 0, t=-3.308, P=0.001). Meanwhile, the mean level of insulin like growth factor-1 (IGF-1) SDS of 35 children was significantly decreased (-1.8±1.8 vs. 0, t=-6.136, P<0.01). There were 69% (37/54) patients diagnosed by magnetic resonance cholangiopancreatography (MRCP) combined with magnetic resonance imaging (MRI), higher than that diagnosed by abdominal ultrasound (29%, 27/94).@*Conclusions@#Idiopathic CP and anatomic abnormalities were the two main etiologies. Normal level of serum amylase and lipase or negative finding of ultrasound cannot exclude CP, while MRCP and MRI should be considered to improve CP diagnostic rate. It is noteworthy that growth delay would happen in children with CP history.
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Objective To investigate the value of 99Tcm-diethylene triamine pentoacetic acid (DTPA) renal dynamic imaging for detecting renal function before liver transplantation and predicting early acute kidney injury (AKI) postoperation.Methods A total of 40 patients (29 males,11 females,average age (45± 8) years) with end-stage liver diseases who underwent orthotopic liver transplantation from June 2015 to June 2016 were selected in this retrospective study.All patients underwent 99Tcm-DTPA renal dynamic imaging within one week before liver transplantation,the general glomerular filtration rate (GFR) and normalized GFR (NGFR) were calculated.The serum creatinine (SCr) and blood urea were detected during the perioperative period.Patients were divided into AKI group (n =15) and non-AKI group (n =25) according to whether the patients suffered from AKI 3 d after liver transplantation.The general GFR,NGFR,SCr and blood urea between two groups were compared using two-sample t test.The sensitivities and specificities of general GFR and NGFR for predicting AKI were evaluated by receiver operating characteristic (ROC) curve.Correlations between general GFR,NGFR and SCr,blood area before liver transplantation were investigated by Pearson correlation analysis.Results The general GFR,NGFR before operation in AKI group were significantly lower than those in non-AKI group:(58.6±7.7) ml/min vs (77.3±12.3) ml/min,(57.7±7.5) ml· min-1· 1.73 m-2 vs (76.8±12.6) ml · min-1 · 1.73 m-2(t values:-5.924,-5.981,both P＜0.05).The SCr,blood urea before operation in the 2 group were not significantly different:(93.5±13.0) μmol/L vs (85.8±15.7) μmol/L,(8.9±4.0) mmol/L vs (7.0±3.0) mmoL/L (t values:1.604,1.733,both P＞0.05).The area under curve (AUC) of general GFR and NGFR was 0.947 and 0.944,respectively.The early AKI was predicted by general GFR and NGFR under the cut-off＜60 ml/min and ＜60 ml · min-1 · 1.73 m-2 with sensitivities of 9/15,10/15 and specificities both of 96.0％ (24/25).There were negative correlations between the general GFR and SCr,general GFR and blood urea,NGFR and SCr,NGFR and blood urea (r values:-0.555,-0.391,-0.562,-0.390,all P＜0.05).Conclusions 99Tcm-DTPA renal dynamic imaging is helpful for the early detection of potential injury of the renal function.Both general GFR and NGFR could be the accurate indicators for predicting early AKI following orthotopic liver transplantation.
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Objective To compare the clinical effect of two-person operations of disposable circumcision stitching instrument and one-man operations of disposable circumcision stitching instrument.Methods Clinical data of 340 patients with redundant prepuce or phimosis from March 2015 to August 2017 were randomly divided into control group which patients with two-person operation of disposable circumcision stitching instrument and study group which patients with one-man operation of disposable circumcision stitching instrument were reviewed prospectively.There were 188 patients in the study group,including 22 patients with phimosis and 166 patients with redundant prepuce;Among the 152 patients in the control group,there were 17 cases with phimosis and 135 cases with redundant prepuce.Two groups with operation time,intraoperative blood loss,postoperative skin staple missing,2 hours postoperative pain,postoperative edema,the swelling subsided time,postoperative complications,postoperative patient satisfaction,and so on.Measurement data were represented as (x) ± s,and comparison between groups was analyzed using t test;count data were represented as percentage and comparison between groups was analyzed chi-square.Results All operations were finished successfully for the patients by two-person or one-man of operations of disposable circumcision stitching instrument.In terms of operation,the operation time of the observation group and the control group was (7.76 ±0.45) minutes and (7.86 ±0.91) minutes respectively,and the difference was not statistically significant(P ＞ 0.05).Intraoperative hemorrhage of observation group and control group were (1.77 ± 0.22) ml and (1.72 ± 0.26) ml,and the difference was not statistically significant (P ＞ 0.05).There was no statistically significant difference between the observation group and the control group (P ＞ 0.05) in the postoperative 2 hours pain score and skin staple missing.In the postoperative complications,the deviation rate of the prepuce was 1.11％,significantly lower than the control group 5.92％,and the difference was statistically significant (P ＜ 0.05).There was no statistically significant difference between the observation group and the control group in terms of edema on the third postoperative day,short postoperative anastomosis,patient satisfaction,and postoperative infection.Conclusion The way of one-man operation of disposable circumcision stitching instrumente not only saves labor costs,but also has a good postoperative clinical effect,meanwhile,it has high efficiency and strong operability,and is worthy of promotion for clinical first-line urologists.
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Objective To determine whether Auto-Planning-based volumetric modulated radiotherapy(Auto-VMAT)planning can improve planning efficiency without compromising plan quality compared with current manual trial-and-error-based volumetric modulated arc therapy(Manual-VMAT) planning for patients with rectal cancer. Methods Ten patients with stage Ⅱ-Ⅲ rectal cancer who underwent Dixon surgery were enrolled as subjects. The Pinnacle 9.10 planning system was used to design Manual-VMAT and Auto-VMAT plans. Dose distribution,homogeneity index(HI),conformity index(CI), D meanvalues of different organs at risk or dose-volume histogram of regions of interest,total planning time, and manual planning time were compared between the two plans. The differences were analyzed by paired t test. Results Dosimetric prescriptions were achieved in both plans. There were no significant differences in HI or CI between the Auto-VMAT plans and the Manual-VMAT plans(0.058 vs. 0.058, P=0.972;0.921 vs. 0.940,P=0.115). Compared with the Manual-VMAT plans,the V 40,D mean,and D 50%of the bladder were significantly reduced by 25.6%, 11.5%, and 8.9%, respectively, in the Auto-VMAT plans(P=0.004,0.016,0.001);the V 40,D mean,and D 50%of the small intestine were also significantly reduced by 12.1%,5.4%,and 6.8%,respectively,in the Auto-VMAT plans(P=0.023,0.001,0.001);the V 30, D mean,and D 50%of the left and right femoral heads were slightly reduced in the Auto-VMAT plans. The Auto-VMAT plans had significantly longer total planning time but significantly shorter manual planning time than the Manual-VMAT plans(50.38 vs. 36.81 min, P= 0.000;4.47 vs. 16.94 min, P= 0.000). Conclusions Compared with the Manual-VMAT plans, the Auto-VMAT plans have substantially shorter manual planning time and improved planning efficiency.
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Objective · To observe effect of 17β estrodial (17β E2) with different concentrations on C type natriuretic peptide (CNP), insulin like growth factor 1 (IGF1), and natriuretic peptide receptor B (NPR-B) expression and proliferation of growth plate chondrocytes of rats in vitro. Methods · Eight Wistar rats were sacrificed and their epiphyseal cartilages of the upper tibias were separated to obtain chondrocytes on the 14th day after birth. Then chondrocytes were cultured with 17β E2 in different concentrations (10-4、10-6、10-8、10-10 and 10-12 mol/L) for 48 h, while control group was cultured without 17β E2. CCK8 method, ELISA and qRT-PCR were used to analyze the proliferation of chondrocytes, the levels of CNP and IGF1 in culture medium and mRNA levels of CNP, NPR-B and IGF1, respectively. Results · 17β E2 in different concentrations affected the proliferation of growth plate chondrocytes significantly. When the concentration of 17β E2 was 10-8 mol/L, it had the strongest effect on the cell proliferation. When the concentration increased to 10-4 mol/L, the proliferation of chondrocytes was inhibited. With the increasement of 17β E2 concentration, the levels of CNP in the culture medium and the mRNA levels of CNP in the chondrocytes were significantly different. The highest levels of CNP protein and mRNA both appeared in 10-8 mol/L group, while the lowest levels both appeared in 10-4 mol/L group. IGF1 and its mRNA also reached the highest levels in 10-8 mol/L group,but the lowest concentration and mRNA level were in 10-10 mol/L group and 10-12 mol/L, respectively. Both CNP mRNA and protein levels were positive correlated with the proliferation of chondrocytes (P=0.000). Nevertheless, there was no significant correlation between the proliferation of chondrocytes and IGF1 mRNA or protein levels (P>0.05). Conclusion · 17β E2 modulates proliferation of rat growth plate chondrocytes in a dose-effect manner. It enhances proliferation at relatively low concentrations (10-10-10-8 mol/L) and inhibits proliferation at high concentration. This effect is positively related to CNP expression in chondrocytes.
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Objective@#To investigate the expression of LIM and SH3 protein 1 (LASP1) in renal cell carcinoma and its significance in the invasion and migration of renal clear cell carcinoma 786-O cell line.@*Methods@#The expression level of LASP1 in 41 cases of renal cell carcinoma tissues and normal renal tissues was analyzed by immunohistochemistry. The relationship between the expression level of LASP1 and clinical characteristics was further analyzed. Expression of LASP1 in 10 cases of tumor tissues with or without lymph node metastasis was analyzed by Western blot. Furthermore, small interfering RNA (siRNA) targeting LASP1 was constructed and transfected into 786-O cells to downregulate LASP1 expression. The interference effect of LASP1 siRNA on LASP1 protein and the expression of related proteins in epithelial mesenchymal transition (EMT) pathway were detected by Western blot. The effects of LASP1 knockdown on cell proliferation, migration and invasion and gene expression were then assessed using CCK8 assay, transwell cell migration system and western blot analysis, respectively.@*Results@#The positive rate of LASP1 expression in renal clear cell carcinoma tissues was 90.2% (37/41), which was significantly higher than that in the adjacent tissues (29.3%, P=0.002). The expression of LASP1 in renal cell carcinoma was positively correlated with lymph node metastasis and TNM stage of renal cell carcinoma (P<0.05). The results of Western blot showed that LASP1 (0.696±0.053) was highly expressed in renal cell carcinoma (1.459±0.628), especially in cases with lymph node metastasis (2.692±0.186, P<0.05). The LASP1 siRNA remarkably down-regulated the expression of LASP1 protein in 786-O cells. The abilities of proliferation, invasion and migration of 786-O cells were decreased significantly in the LASP1 siRNA groups.The relative expression of E-cadherin protein in the siRNA group (0.848±0.020) was significantly higher than those in the siRNA-NC group (0.671±0.018) and control group (0.691±0.037, P<0.05). The relative expression of N-cadherin protein in the siRNA group (0.449±0.047) was significantly lower than those in the siRNA-NC group (0.613±0.018) and control group (0.633±0.045, P<0.05). The relative expression of vimentin protein in the siRNA group (0.477±0.029) was significantly lower than those in the siRNA-NC group (0.598±0.069) and control group (0.633±0.045, P<0.05 for both).@*Conclusions@#LASP1 is highly expressed in renal clear cell carcinoma, which is closely related to the development of the cancer. The effects of LASP1 on the invasion and migration of 786-O cells and lymph node metastasis may be related to the EMT.
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Objective Retrospectively evaluate low dose computed tomography (CT) as part of a combined 18F-NaF positron emission tomography (18F-NaFPET/CT) examination in lung cancer patients suspected of bone metastases. Methods 118 of 122 lesions with increased uptake of 18F-NaF were assessed. Characteristics of bone metastases on CT images were reviewed by radiologists. Results 27 of 47 metastases presented as sites of increased uptake with corresponding lytic or sclerotic changes on low dose CT. Other 20 show normal or non-specific appearing bone on CT. Most benign lesions (67 of 71,94%)have a benign appearance on low-dose CT. Conclusions Low dose CT images were useful in precisely diagnosing bone metastasis. Negative low dose CT appearance to the abnormal foci on PET may be a reliable sign of metastases.
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Objective To investigate the clinical characteristics and molecular pathological mechanism of McCune-Albright syndrome ( MAS) in order to provide a guidance for the precision medicine of MAS. Method The clinical data and genetic findings of 41 patients with MAS were analyzed retrospectively. Results (1) MAS girls had the phenotype of peripheral precocious puberty with premature sexual development and high estradiol, low LH and FSH, and the increased volume of uterus and ovary. ( 2 ) In 41 MAS cases, there were 17 cases with GNAS1 gene mutation, and the total positive rate was 41. 5%, of which the classic triad was 66. 7%, two signs 56. 3%, and 12. 5% in only one classic sign. GNAS1 gene mutation was found in 78. 6% of patients with polyostotic fibrous dysplasia of bone, while only 55. 0% in patients with cafe au lait skin spots. Children with precocious puberty and fibrous dysplasia of bone is an important basis for clinical diagnosis of MAS, but cafe au lait skin spots does not seem to be the specifical manifestation of MAS. Conclusion Clinically MAS was lack of typical clinical manifestations, and the most important clinical weight factor for the diagnosis of MAS was peripheral precocious puberty with fibrous dysplasia of bone. GNAS1 gene screening may be helpful to improve the clinical accurate diagnosis of MAS.
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Objective To investigate the effects of β adrenergic receptor blocker carvedilol and cholinergic receptor blocker scopolamine on the biological behaviors of prostate cancer in C57BL/6 mice.Methods From June 2014 to November 2014, sixty male C57BL/6 mice, 10 weeks old, were injected with RM-1 cells (0.5 × 106) into bilateral dorsal prostate capsules of each mice by microsyringe and were randomly divided into three groups, including carvedilol group (K), scopolamine group (D) and saline group (N) after modeling.In K group, the carvedilol (10 mg/kg) was given to mice through gastric tube.The normal saline was given to them by subcutaneous injection.In D group, the normal saline was given to mice through gastric tube.Meanwhile, the scopolamine (1 mg/kg) was injected subcutaneously.In N group, daily normal saline was given by through gastric tube and subcutaneous injection.At the seventh day of postoperation, five mouse were sacrificed in each group every three days to observe the local growth,invasion and metastasis of prostate cancer to pelvic nodes and liver.Immunohistochemical determination of prostate tumor was made by TH staining and VAChT staining in each group.Results The volume of the prostate cancer was gradually increased in three groups.There was no statistical difference of prostate volume among three groups on the day 7 and 10 post-operatively (all P ＞ 0.05).The prostate volume of K group, D group and N group on the day 13 were 0.05 ± 0.04, 0.18 ± 0.08, 0.14 ± 0.05 cm3, respectively (P ＜0.05).However, the statistical significance existed between K and N group (P ＜ 0.05).There was no statistical difference of AOD between TH and VAChT among three groups on the day 7 (all P ＞ 0.05).The AOD of TH and VAChT in prostate cancer of K group, D group and N group on the day 10 were [(0.0114±0.016), (0.114±0.002), (0.059±0.008)] and [(0.025 ±0.011), (0.0226±0.003), (0.009±0.003)], respectively (P ＜0.05).Those values on the day 13 were [(0.147 ±0.036),(0.129 ±0.025), (0.071 ±0.022)] and [(0.020 ±0.005), (0.020 ±0.002), (0.010 ±0.002)],respectively (P ＜0.05).TH and VAChT expression of K and D in 10th and 13th is higher than in N (all P ＜ 0.05).At the 7th day, no metastasis of pelvic nodes was detected in all groups.At 10th day, 2 cases of K, no case of D and 3 cases of N were detected the lymph node metastasis.At the 13th day, 3 cases of K, 1 case of D and 4 cases of N were recorded the lymph node metastasis.At the 7th day, no metastasis of liver was detected.At 10th day, 1 case of K, no case of D and 2 cases of N were found the liver metastasis.At the 13th day, 3 cases of K, 1 case of D and 4 cases of N were recorded the liver metastasis.The lifesapn of tumor-bearing mice in K group, D group and N group was 16.8 ±0.8, 17.6 ±0.5, 15.8 ±0.1, respectively (P ＞ 0.05).Conclusions β adrenergic receptor blocker carvedilol can suppress the growth of prostate cancer and cholinergic receptor blocker scopolamine may can inhibit metastasis of prostate cancer.
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OBJECTIVE@#This study aimd to evaluate the application and clinical effect of improved submental island flap in hypopharyngeal cancer reserved laryngeal function surgery.@*METHOD@#A retrospective review of clinical data was performed on 38 patients of hypopharyngeal cancer reserved laryngeal function using sumental island flaps, by the way of improving in design of vascular pedicle, reconstructive mode of laryngeal and hypopharyngeal function and closing of wound of neck following hypopharyngeal cancer resection. Meanwhile, the effect and prognosis was comprehensively assessed on patients with hypopharyngeal cancer reserved laryngeal function using improved submental island flaps.@*RESULT@#The submental flaps kept alive in all 38 cases. During the follow-up period, 18 cases were dead, and of them, 7 cases died of the second primary carcinoma, included 4 cases of esophagus cancer, 1 case of cancer of soft palate, 2 cases of nasopharyngeal carcinoma; and 5 cases died of cervical or parapharyngeal lymph nodes recurrence; 2 cases died of hepatic metastasis; and 4 cases died of pulmonary metastasis. The overall 5-years survival rate was 52.6%.@*CONCLUSION@#Improved submental island flap repairing postoperative defect of hypopharyngeal cancer reserved laryngeal function has many advantages including higher success rate, more security, easy and simple to operate as well as good clinical effects, and is worth to widespread using.
Subject(s)
Humans , Hypopharyngeal Neoplasms , General Surgery , Hypopharynx , General Surgery , Larynx , Neck , General Surgery , Neoplasm Recurrence, Local , Prognosis , Plastic Surgery Procedures , Retrospective Studies , Surgical Flaps , Survival RateABSTRACT
Objective To detect the relationship between the molecular defects and their phenotypes in children with growth hormone insensitivity syndrome (GHIS).Methods 21 patients defined as GHIS were enrolled in the study.4 candidate genes (GHR,IGFALS,JAK2,and STAT5B) were analyzed by genomic DNA sequence screening and clinical relevance analysis.Results The statistical descriptions of the patients were showed as an average height standard deviation (SDS)-4.33 ± 1.91 (-9.17 to-2.21),average serum peak values of GH (22.67 ±20.98) tg/L (11.33 to 104.21 μg/L),basal serum insulin-like growth factor-Ⅰ SDS-2.65 ± 0.53 (-3.57 to -1.79),insulin-like growth factor-binding protein 3 SDS-1.77 ± 1.64 (-4.13 to 0.96).Bone age of backward difference (chronological age-bone age) (43.10 ± 19.54) months (6 to 82 months).One of two children with severe growth failure and mid-face hypoplasia was found to a homozygote for G to A gene mutation in the intron 6 splice donor consensus sequences (IVS6 ds+ 1 G-A) in the GHR gene,causing its functional defect.3 cases with mild dwarf were found gene variations as novel finding:c.1097T＞C c.1098C＞T p.V366A pathogenic variant,c.1229C＞T p.S410L and nt1843707 A→G of 5' UTR region in the IGFALS gene.JAK2 and STAT5b genes mutations were not found.Conclusion Molecular pathology of GHIS is considered as involving the defects of GHR and its signal pathway.The mutation of intron 6 splice donor sequences in GHR gene has been reported which affect the function of GHR.The 3 novel type base variants in IGFALS gene,causing non severe dwarfism,might be suspected with pathogenic roles of GHIS.
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Background and purpose: Currently, intraoperative radiation therapy (IORT) has become the adjuvant therapy of cancer. The study was to establish the daily quality assurance (QA) program and analyze dosimetric characteristics’ long-term stability for mobile IORT accelerator. Methods:The QA program of this study included two parts:safety and functionality and energy and output. The two years’ QA datasets were acquired and analyzed to investigate the stability of energy and output. Results:All safety and functionality tests passed on a daily basis. The energy index was (0.666±0.015)mm, (0.839±0.009)mm, (0.781±0.010)mm, (0.724±0.009)mm and the output dose error was (0.511 ± 0.671)%, (0.278 ± 0.516)%, (0.368 ± 0.532)%, (0.382 ± 0.912)%for all energy, respectively. There was no signiifcant time trend in the dosimetric characteristics. Conclusion:The daily QA program is suitable for mobile IORT accelerator. The long-term stability is acceptable for IORT in clinical use.
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OBJECTIVE@#To observe Effect of nasal epithelial lining prognosis and turnover changed by vesicles molecular immuno-pathology after nasal endoscopic surgery.@*METHOD@#Forty patients (80 sides) with chronic nasal polyps in accordance with the EPOS standard after endoscopic sinus surgery were randomly divided into treatment group and control group according to weather scraping the vesicles. Compared the speed of epithelialization of nasal cavity mucosa in the two groups. Observed the pathological features of vesicles through HE staining and transmission electron microscopy. Divided the treatment group into 1-3 weeks group, 6-8 weeks group and 11-14 weeks group. And make the inferior turbinate mucosa and nasal polyps during surgery the control group. Compared the level of vascular endothelial growth factor(VEGF) and transforming growth factor beta1 (TGF beta1) between the groups.@*RESULT@#Vesicles were divided into mild groups and moderate to severe groups according to the sizes and amonts. Vesicles in moderate to severe groups were faster epithelialization than the mild groups, 1.5 weeks shortened on average (P < 0.05). There wes no significant difference between the two groups in mild group. The level of TGF beta1 in the nasal polyps, 1-3 weeks group and 6-8 weeks group were significantly higher than the inferior turbinate mucosa and 11-14 weeks group (P < 0.05). The level of VEGF in the nasal polyps, 6-8 weeks group were significantly higher than the inferior turbinate mucosa, 1-3 weeks group and 11-14 weeks group (P < 0.05). Vesicles were displayed discontinuous basal membranes, interstitial edama, infiltration of inflammatory cells, increased pathological glands, abnormal microtubule structure, reduction of mitochondrials.@*CONCLUSION@#Vesicles is a dynamic process, which may predict the increased levels of inflammatory factors (VEGF and TGF beta1) and contribute to some of the patheologic changes observed in nasal polyps. The level of VEGF and TGF beta1 in vesicles after endoscopic sinus surgery can be used as indicators of prognosis. Treating the moderate to severe vesicles after surgery is benefit to the epithelium of the nasal mucosa.
Subject(s)
Aged , Humans , Male , Endoscopy , Nasal Mucosa , Metabolism , Pathology , General Surgery , Nasal Polyps , Metabolism , Pathology , General Surgery , Nasal Surgical Procedures , Methods , Paranasal Sinuses , Prognosis , Transforming Growth Factor beta1 , Metabolism , Vascular Endothelial Growth Factor A , MetabolismABSTRACT
Objective To explore the clinical value of dual-source CT(DSCT) in the diagnosis of coronary artery disease by comparing the result of DSCT and coronary angiography(CAG).Methods From July 2009 to August 2010,36 patients with suspected coronary hear disease underwent both DSCT coronary angiography(DSCTCA) and selective GAG examination.The results of DSCT coronary angiography were compared with CAG which was the gold standard of diagnosing coronary disease.The sensitivity,specificity,positive and negative predictive value,and accuracy of DSCT were evaluated.Results 144 coronary arteries were well evaluated of 36 cases.The sensitivity,specificity,positive and negative predictive value,and accuracy of DSCT in the diagnosis of coronary hear disease were 100.00％,66.67％,93.75％,100.00％ and 97.20％ respectively by the number of patients;The McNemar test showed no significant difference between two methods( x2 =0.500,P ＞0.05 ) with a higher diagnosis concordance (Kapp =0.768,P ＜0.01).By detecting moderate to severe coronary artery stenosis,the sensitivity,specificity,positive and negative predictive value,accuracy were 95.24％,96.08％,90.91％,98.00％,95.83％,respectively.The McNemar test showed no significant difference between two methods(x2 =0.167,P ＞0.05) with a higher diagnosis concordance ( Kapp =0.899,P ＜ 0.01 ).Conclusion DSCT has a diagnostic accuracy of coronary heart disease close to that CAG,especially in evaluating patients with moderate to severe coronary artery stenosis,it has high compliance and consistency with CAG.DSCT is a noninvasive,safe and reliable radiographic method.