ABSTRACT
Objective:To explore the sex-based heterogeneity in demographic and pathological trends of lung cancer during the past 30 years.Methods:Patients with primary lung cancer who received surgical treatment in the Department of thoracic surgery, Shanghai Pulmonary Hospital Tongji University from 1989 to 2018 were retrospectively analyzed. The differences between male and female patients in age, smoking history, pathological stage and type were compared. Mann- Kendall trend test was performed for trend analysis. Results:A total of 58 433 patients were included in this study, encompassing 30 729(52.6%) men and 27 , 704(47.4%) women. Compared with male patients, female patients were younger(56.0 years old vs. 59.7 years old), and had a higher proportion of non-smokers(98.3% vs. 52.3%), stage Ⅰ lung cancers(60.6% vs. 49.3%), and adenocarcinoma(93.7% vs. 56.1%, all P-values <0.001). Trend analyses revealed that the proportion of female patients increased year by year, and surpassed males in 2015, with the current ratio of male to female being 1∶1.5. After 2013, the age of onset in females was getting younger, and the average age decreased from 58.7 years old to 54.7 years old( P=0.02). The decrease in the proportion of smoking patients was mainly reflected by male patients(from 68.5% to 31.1%, P<0.01). Stage Ⅰ lung cancers in male and females outnumbered advanced stage in 2012 and 2010, respectively, with a much higher proportion in female patients. Among male patients, adenocarcinoma has replaced squamous cell carcinoma as the most common pathological type since 2012, while in female patients adenocarcinoma remained the most common pathological type of lung cancer, and its proportion continued to increase reaching over 98%. Conclusion:A dramatic change in gender distribution was noticed during the past 30 years. Female patients became the primary population in surgically-treated lung cancers, with a trend of getting younger. The proportion of smokers and squamous cell carcinoma decreased significantly in male patients, and adenocarcinoma has become the most common pathological type of lung cancer. The proportion of stage Ⅰ lung cancers was on a dramatic rise, with the popularization of CT screening for lung cancer.
ABSTRACT
Objective:To evaluate the effect of prolonged graft cold ischemia time(CIT)on outcomes of lung transplantation(LTx).Methods:Clinical data are retrospectively reviewed for 111 patients undergoing LTx at Affiliated Shanghai Pulmonary Hospital of Tongji University between January 2019 and January 2022. They are divided into two groups of prolonged CIT(8~12 h, 41 cases)and control(<8 h, 70 cases)according to CIT. Kaplan-Meier method is employed for estimating 1-year cumulative survival rate and multivariable Cox proportional hazard regression model for identifying independent risk factors of 1-year mortality.Results:No significant inter-group difference existed in the incidence of primary graft dysfunction grade Ⅲ within the first 72 h post-LTx(21.2% vs. 16.3%). The 30-day(90.2% vs. 94.3%)and 90-day(82.9% vs. 82.9%)survival rates are comparable between two groups. Similarly 1-year cumulative survival is also comparable between two groups (74.6% vs. 60.4%, Log-rank P=0.279). Multivariate Cox regression analysis indicated that prolonged CIT was not associated with an elevated risk of 1-year mortality( HR 0.691; 95% CI: 0.317~1.506). However, an absence of ECMO support during surgery( HR 3.562; 95% CI: 1.061~11.959)and postoperative mechanical ventilation for >3 days(HR 2.892; 95% CI: 1.387~6.031)elevate 1-year risk of mortality. Conclusions:Prolongation of CIT to 8~12 h has no adverse effect on the prognosis of recipients. Given a great scarcity of donor lungs and a growing number of LTx candidates, it is reasonable to accept prolonged CIT donor lungs for clinical LTx.
ABSTRACT
Objective:To explore the efficacy and safety of neoadjuvant chemoimmunotherapy combined with surgery for stage ⅢA NSCLC patients.Methods:Six patients with NSCLC who were diagnosed as ⅢA and received two cycles of neoadjuvant chemoimmunotherapy and surgery between September 2019 and January 2020 were described in this study.Results:Five of them experienced AEs during neoadjuvant therapy. All of them received surgery and achieved an MPR of 50%. No viable tumor cells were found in the tissues of one patient. One patient with a small bronchopleural fistula after lobectomy.Conclusion:Neoadjuvant chemoimmunotherapy combined with surgery for stage ⅢA NSCLC patients is safe and efficient. Long-term outcomes of neoadjuvant chemoimmunotherapy combined with surgery should be further validated.
ABSTRACT
Objective:The Corona Virus Disease 2019 (COVID-19), caused by a novel virus (2019-nCoV), is a current epidemic throughout the world. Widespread discussion has been going on about the suitability of lung transplantation for critically-ill patients as an emergent treatment. So far lung transplantation has been performed sporadically in China; however, the relevant treatment and prognosis after transplantation are inconclusive. This article mainly reviews the literature in terms of transplantation and viral infection, indications of lung transplantation, postoperative complications, ethics, and health economics, to elaborate this argument and to further explore the future of lung transplantation for COVID-19.
ABSTRACT
Lung transplantation is an effective treatment for many end-stage lung diseases. Lung cancer was considered to be a contraindication of lung transplantation for a long time. However, multifocal diffuse adenocarcinoma has been indicated for lung transplantation nowadays. In the preoperative course of lung transplantation for chronic end-stage lung diseases, patients should be examined thoroughly to exclude malignant tumors. If malignant tumors were incidentally found in recipient' s explanted lung, a careful evaluation of tumor stage and the prognosis of recipient is needed. Lung transplantations for metastatic lung tumors have only been reported in a few case reports, limiting the application of transplantation in current clinical practice.
ABSTRACT
Objective:To explore the incidence and treatment of lung cancer after lung transplantation.Methods:Between January 2003 and July 2016, 80 patients were retrospectively reviewed after lung transplantation. And the incidence, treatment and prognosis of lung cancer were analyzed after lung transplantation.Results:Twelve cases (15%) of malignancies occurred after lung transplantation, including lung cancer ( n=10, 12.5%), renal carcinoma ( n=1, 1.25%) and larynx cancer ( n=1, 1.25%). One lung cancer patient became lost to follow-ups. Among 9 other cases, 5 patients of stage I lung cancer had a median survival of >24 months while another 4 patients with stage II/III lung cancer had a median survival of 2.5(2-5) months. All tumors occurred at the preserved side. Pathological types included squamous cell carcinoma, adenocarcinoma, adenosquamous cell carcinoma and small cell lung cancer. Age(61.8±6.6 vs. 54.0±11.0 years, P=0.03) and smoking (20.4% vs. 2.7%, P=0.02)were two important risk factors for lung cancer. The differences were statistically significant. Conclusions:Lung cancer is a major late complication after lung transplantation. Age and smoking are two important risk factors for lung cancer. The pathological types of lung cancer are diverse and the overall prognosis is poor.
ABSTRACT
@#The quality control of lung transplantation involves many aspects, such as team building, selection of recipients, preoperative diagnosis and evaluation of recipients, maintenance of brain-dead donors, evaluation and acquisition of donors, surgical operation, postoperative management and postoperative follow-up. Precision management is the core concept of operation quality control. Only by normalizing the operation quality control of lung transplantation to provide basic guarantee for multi-team cooperation and development of lung transplantation management in the future, building a complete lung transplantation database to excavate data resources and improve the quality of transplanta-tion, and comprehensively building a Chinese lung transplantation quality control system with multi-team participation and cooperation, can we improve the overall level of surgical diagnosis and treatment of lung transplantation in China.
ABSTRACT
Objective To investigate the level and influencing factors of quality of life in patients with osteoradionecrosis of the jaws (ORNJ) in order to provide theory basis for nursing intervention. Methods Ninety-five patients hospitalized from January 2015 to Febury 2017 and participated in the investigation by a convenient sampling method. The functional assessment of cancer therapy-head and neck (FACT-H&N), social support rating scale (SSRS) and general information questionnaire were used to assess the quality of life, social support and basic information in ORNJ patients in our hospital respectively. Results The score of quality of life was (79.99 ±15.72). The index value of common module of quality of life was higher than that of additional concern. The average scores of each dimension of common module from low to high were as follows: functional well-being, social/family well-being, physical well-being and emotional well-being. The multiple linear regression analysis showed that the influencing factors of quality of life were social support, severe mouth opening difficulty (grade Ⅲ and Ⅳ), the course of primary disease (3 ～5 years, 5 ～10 years), which explained 35.6％variation in the quality of life. Conclusions The quality of life of ORNJ patients is generally lower than that of other head and neck cancer patients. The social support, severe mouth opening difficulty and course of primary disease can affect the patients' quality of life.The smaller the mouth opening (≤1 cm), the longer the course of primary disease (3～5 years) and the worse the quality of life is. Thus, nursing staff should pay attention to the quality of life of ORNJ patients and give prospective nursing intervention to improve the quality of life according to the characteristics of the development of the disease.
ABSTRACT
Objective To compare the clinical value of different endoscopic methods for infiltration depth of early esophageal cancer. Methods Patients with suspected esophageal cancer, examined in Sichuan Provincial People′s Hospital from August 2013 to February 2016 were enrolled to this study. The patients underwent narrow band imaging( NBI) with magnifying endoscopy( including IPCL?type and B?type methods) and endoscopic ultrasonography(EUS) to estimate infiltration depth and then underwent iodine staining and biopsy. All lesions, which included the identified moderate?severe hyperplasia, high?grade intraepithelial neoplasia and early esophageal cancer and those which were diagnosed as possible cancer by white light and NBI with the negative pathological results, were given endoscopic or surgical procedure depending on patients′ choices. A total of 54 cases were diagnosed as early esophageal cancer, with pathological results as the gold standard. The diagnostic accuracy of invasion depth of these patients was compared by the statistic kappa values. Results Type B of NBI was highly consistent with the final pathological results(Kappa=0?802). White light endoscopy and IPCL type had poorer results(Kappa=0?596, Kappa = 0?601 ) compared with the final pathological results. However, EUS had the lowest consistency with the final pathological results( Kappa=0?132) . For the mucosal layer( M1?M2) infiltration of the esophageal cancer, type B showed the highest accuracy ( 86?7%, 26/30 ) , followed by white light endoscopy(76?7%, 23/30) and IPCL type(73?3%, 22/30). And EUS showed the lowest diagnostic accuracy(30?0%, 9/30) and the highest over?diagnostic rate(70?0%,21/30). For the cancer infiltration depth( M3?SM1 ) , type B also showed slightly higher accuracy rate ( 89?5%, 17/19 ) than IPCL type (78?9%, 15/19) and white light endoscopy (73?7%, 14/19). And EUS still showed the lowest accuracy rate( 42?1%, 8/19 ) and the highest over?diagnostic rate ( 52?6%, 10/19 ) . Conclusion White light endoscopy is still valuable for the invation depth of early esophageal cancer. But B type and IPCL?type of NBI are superior to white light endoscopy. B type presents higher accuracy rate than others, and it seems much easier to operate than IPCL?type for beginners. Accuracy rate of EUS is unsatisfactory, and the over?diagnostic rate is much higher than others. Diagnosis with EUS alone is not recommended.
ABSTRACT
Objective To assess the incidence and prognosis of the bronchial anastomosis complications following lung transplantation.Methods Between January 2003 and July 2016,all 81 cases after lung transplantation at Department of Thoracic Surgery of Shanghai Pulmonary Hospital,Tongji University were retrospectively analyzed.We analyzed the incidence and prognosis of postoperative complications of bronchial anastomosis in lung transplant recipients.Results The overall incidence of bronchial anastomotic complications was 30.9％,including anastomotic infection (18.5 ％),anastomotic fistula (4.9 ％),stenosis (6.2 ％),and bronchomalacia (1.2 ％).One case died of infection,and 3 cases died of anastomotic fistula.Conclusion The main bronchial anastomosis complications occurred early,and the prognosis was acceptable.
ABSTRACT
OBJECTIVE:To explore the clinical efficacy and safety of nalmefene combined with monosialotetrahexosylganglio-side sodium in the treatment of patients in brain tumor operation. METHODS:64 patients in brain tumor operation were randomly divided into observation group and control group,32 cases in each group. Control group received brain cell protection,reducing in-tracranial pressure,anti-infective,vasodilator and other conventional treatment;observation group additionally received 0.7μg/(kg· h) nalmefene combined with 100 mg/d monosialotetrahexosylganglioside sodium from the first day of operation,for continuous 7 d. The plasma cortisol,adrenocorticotropic hormone (ACTH) before and 3,7 d after treatment,changes of serum IL-6,TNF-αand Barthel index (BI) in 2 groups were observed,improvement of neurological function and ADR were observed;Karnofsky (KPS)score was determined after 90 d follow-up used to assess the patient’s ability to take care of themselves. RESULTS:After treatment,plasma cortisol and ACTH content,serum TNF-αand IL-6 levels in 2 groups significantly decreased than before,the dif-ference was statistically significant(P<0.05);cortisol,ACTH and TNF-α levels 3,7 d after treatment,IL-6 level 7 d after treat-ment in observation group decreased more significantly than control group,the differences were statistically significant(P<0.05). After treatment,BI score in 2 groups significantly increased,and observation group increased more significantly than control group,the differences were statistically significant (P<0.05). 7 d after treatment,improvement rate of neurological function was 50.00%,which was significantly higher than that of the control group(18.75%),the difference was statistically significant(P<0.05). There was no significant ADR occurred of 2 groups in the study. Following-up for 90 d,the KPS score in observation group with not less than 70 points accounted for 71.88%,which was significantly higher than the control group(46.87%),the difference was statistically significant (P<0.05). CONCLUSIONS:Nalmefene combined with monosialotetrahexosylganglioside sodium can promote the recovery of patients in brain tumor operation,reduce cortisol,ACTH,IL-6 and TNF-α levels and improve prognosis of patients.
ABSTRACT
Objective To preliminarily explore the effects of human microRNA-181a on migration of gastric cancer cells and its mechanism.Methods The expression of miRNA-181a-5p in gastric cancer cell line GC9811 and peritoneal high metastasis gastric cancer cell line GC9811-P were tested by quantitative real-time polymerase chain reaction (qRT-PCR ). GC9811 cell line was transfected byendogenous synthetic analog mimic and its homologous negative control of miRNA-181a-5p,which were considered as up-regulated group and its control group respectively;GC9811-P were transfected by miRNA inhibitor and its homologous negative control of miRNA-181a-5p,which were considered as down-regulated group and its control group respectively.After miRNA-181a-5p was up or down-regulated,cell proliferation,migration and apoptosis capabilities of gastric cells were detected by matrix thiazolyl tetrazollium (MTT)assay,cloning-forming assay,Transwell migration test,wound healing assays and apoptosis test.After miRNA-181a-5p was up or down regulated,the changes of matrix metalloproteinase (MMP)14 expression were determined by Western blot.Independent sample t test was performed for mean comparison between samples and chi square test was used for rate comparison.Results The results of qRT-PCR showed the relative expression quantity of miRNA-181a-5p in GC9811 was 1 .000 00 ± 0.021 26 and in GC9811-P was 3.175 61 ±0.106 76,and the difference was statistically significant (t =34.620,P <0.01 ).The results of MTT assay indicated that the cell proliferation rate of up-regulated group was higher than that of up-regulated control group,and that of down-regulated group was lower than down-regulated control group.The cloning-forming assay demonstrated that the number of clone forming and clone forming rate of up-regulated group,up-regulated control group,down-regulated group and down-regulated control group were 234.00±10.12 and 46.8%,93.00±9.61 and 18.6%,51 .00 ±7.96 and 10.2%,99.00±8.05 and 19.8%,respectively.The differences between up-regulated group,down-regulated group and their control group were statistically significant (t = 17.500,7.344,χ2 = 12.27, 9.51 ,all P <0.01).The results of Transwell migration experiment showed the number of cells migrated through membrane hole of up-regulated group was 164.00±19.31 ,and which was higher than that of up-regulated control group (87.00±23.04,t=4.436,P <0.05);that of down-regulated group was 157.00± 11 .50,and which was lower than that of down-regulated control group (234.00 ±12.12,t =7.982,P <0.05).The result of wound healing assays indicated that the rate of migration distance of up-regulated group,up-regulated control group,down-regulated group and down-regulated control group were 2.09 ± 0.18,1 .27 ±0.23,1 .15 ±0.15 and 1 .67 ±0.12,respectively.The differences between up-regulated group,down-regulated group and their control group were statistically significant (t =4.863 and 4.689, both P <0.05).The results of apoptosis experiments demonstrated that the apoptosis rate of up-regulated group,up-regulated control group,down-regulated group and down-regulated control group were (6.10± 1 .02 )%,(9.10 ± 2.13 )%,(12.70 ± 1 .23 )%,(8.70 ± 2.54 )%,respectively,and there was no statistically significant difference between up-regulated group,down-regulated group and their control group (both P *0.05).The results of Western blot showed that the grey value of up-regulated group was 561 .881 ±35 .740,which was higher than that of up-regulated control group (275 .784±23.520);that of down-regulated group was 579.565 ±37.950,which was lower than that of down-regulated control group (1 312.760±51 .270),and the differnces were statistically significant (t =11 .580 and 19.910,both P <0.01).Conclusion miRNA-181a-5p highly expresses in peritoneal high metastasis gastric cancer cell line GC9811-P and promoted the proliferation and migration of gastric cancer cell line GC9811 and GC9811-P with a tendency to suppress apoptosis.
ABSTRACT
Objective To compare the clinical effect of platelet rich plasma and sodium hyaluronate in the treatment of knee osteoarthritis .Methods According to the different treatment methods ,100 patients with knee osteo-arthritis were divided into the control group ( for treatment of platelet rich plasma ) and study group ( for treatment of sodium hyaluronate),each group 50 cases.The treatment effect would be compared between two groups ,and the patients were scored knee joint active function using Lysholms score standard ,using visual analogue score method on patients with knee joint pain .Results The excellent and good rate had no significant difference between the study group(98.0%) and control group(94.0%)(P>0.05);The knee joint activity of study group (76.81 ±9.24) was significantly better than that of the control group (60.46 ±7.41),the difference was statistically significant (t =-9.76,P<0.05);the knee joint pain degree of the study group (1.91 ±0.88) was lower than that of the control group (3.58 ±0.85),the difference was statistically significant (t=9.65,P<0.05).Conclusion Platelet rich plasma and the knee joint injection of sodium hyaluronate in the treatment of osteoarthritis were able to effectively alle -viate knee joint pain ,activity limitation and other clinical symptoms ,improve the curative rate ,but the treatment effect of sodium hyaluronate is more remarkable ,which is worthy of promotion .
ABSTRACT
Objective To develop a radiology algorithm and test its the accuracy in distinguish pacing in the septum from the other parts. Methods One hundred patients were implanted with double-chamber pacemakers. Sites of the leads were verified by two-dimensional echocardiography, and the patients were divided into 4 groups according to the echocar?diography:septal right ventricular outflow tract group(RVOT), RVOT anterior free wall group, mid septum group, and anteri?or septum group (near to the anterior free wall ). An algorithm was developed according to radiological characteristics in the 45° left anterior oblique (LAO45° ) view and the 30° right anterior oblique (RAO30° ) view. Then its sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were tested . Results The algorithm has high sensitivi?ty and specificity, which were 90%and 97%respectively. The positive predictive value and negative predictive value were 90% and 97% respectively. Conclusion The radiology algorithm we developed have a high sensitivity and specificity in identifying the site of the leads.
ABSTRACT
Objective To explore the value of procalcitonin (PCT)and interleukin -6 (IL -6)in the early diagnosis and prognostic evaluation of the patients with lumbar intervertebral disc herniation,and their correlation with the course and lumbar function.Methods 100 patients with lumbar disc herniation (study group)and 35 patients with lumbar non -borne diseases (control group)were collected,their preoperative clinical symptoms were scored on the basis of the lumbar scoring system of Japanese Orthopaedic Association (JOA),the enzyme -linked immunosor-bent assay was applied to determining the content changes of PCT and IL -6 of the two groups,and the linear correla-tion analysis was used to explore the relevance of PCT and IL -6 to the course.Results The contents of the PCT and IL -6 in the study group's serum were respectively (25.13 ±0.86)ng/L and (10.26 ±0.36)ng/L,while those in the control group's serum were respectively (223.85 ±0.61)ng/L and (50.11 ±1.23)ng/L,both with statistical sig-nificance (t =2.542,2.206,P <0.01).The IL -6 was positively correlated with the disease duration of the patients with lumbar disc herniation (r =0.32,P =0.000),and negatively correlated with their JOA score (r =-0.45,P =0.003),and the PCT was positively correlated with the patients'disease duration (r =0.35,P =0.001),and nega-tively correlated with their JOA score (r =-0.53,P =0.005).Conclusion The PCT and IL -6 have a certain role in the early diagnosis of lumbar disc herniation,and have some relevance to the course of disease and the lumbar func-tion changes.
ABSTRACT
A 22-year-old female patient complained of neck discomfort for one week. Examination revealed bilateral neck masses. Color doppler ultrasound showed bilateral thyroid masses,which resulted in two thyroid lobes asymmetry. Bilateral cervical enlarged lymph nodes were not found. Thyroid function was normal. Complete left lobe and subtotal right lobe of thyroid gland were resected. The pathological results showed poorly differentiated carcinoma of left thyroid and papillary carcinoma of right thyroid with bilateral Hashimoto's thyroiditis. The patient received resection of residual thyroid and lymph nodes in another hospital, with no tumor or metastasis found. The patient without radiotherapy or chemotherapy was followed up for 34 months, and no progressive lesions were found.
Subject(s)
Female , Humans , Young Adult , Carcinoma, Papillary , Pathology , Hashimoto Disease , Pathology , Lymph Nodes , General Surgery , Neck , Thyroid Neoplasms , Pathology , ThyroidectomyABSTRACT
Objective To study the safety and efficacy of damage control using percutaneous transhepatic biliary drainage (PTBD) in acute cholangitis of severe type (ACST) secondary to intrahepatic choledocholithiasis.Methods The clinical data of 8 patients who received PTBD after hospital admission followed by conventional surgery for ACST when their general condition improved were retrospectively studied.Results All patients received PTBD successfully and the amount of bile drained was 100-400 ml in the first day.The general condition of these 8 patients became better after 24 h and the total bilirubin decreased for about 25-100 mmol/L after 48 h.Three patients with a platelet count of less than 20 × 109/L showed an improved count to more than 50 × 109/L 72 h after PTBD.All patients were operated at different times after the PTBD:2 received T-tube drainage,3 T-tube drainage combined with left hepatectomy,and 3 choledochojejunostomy.Seven patients recovered uneventfully,but 1 developed hepatic failure with the total billurubin rose to more than 200 μmol/L.He was discharged home with the PTBD tube.During the waiting time of 7 days to 3 months before surgery,the tubes were kept patent and no mortality or morbidity such as bleeding,bile leakage,and peritonitis occurred.Conclusions PTBD was a safe and efficacious procedure for patients who were in a serious condition with ACST secondary to intrahepatic choledocholithiasis.It was more likely to be successful as it is minimally invasive and therefore well-tolerented.It reduced the biliary pressure,relieved the ongoing sepsis,and was a good preparatory procedure before any conventional surgery.
ABSTRACT
BACKGROUND:Previous studies have demonstrated that transplantation of control ed release glial cellline-derived neurotrophic factor and bone marrow mesenchymal stem cells-derived neuron-like cells can effectively promote the motor function and sensory function recovery of rhesus monkeys with spinal cord injury. OBJECTIVE:To validate whether co-transplantation of control ed release glial cellline-derived neurotrophic factor and bone marrow mesenchymal stem cells-derived neuron-like cells exhibits better protective effects on spinal cord glial scar of rhesus monkeys with spinal cord injury than celltransplantation alone. METHODS:Twelve rhesus monkeys were col ected to prepare animal models of acute severe spinal cord injury using modified Al en’s method, and then randomly divided into three groups:experimental group, co-transplantation of control ed release glial cellline-derived neurotrophic factor and bone marrow mesenchymal stem cells-derived neuron-like cells;control group, simple transplantation of bone marrow mesenchymal stem cells-derived neuron-like cells;blank control group, PBS. After 5 months, paraffin specimens of the spinal cord were made for detection of morphological and compositional characteristics of glial scar, regeneration of nerve fibers in the scar, glial scar area, and average absorbance of glial fibril ary acidic protein. RESULTS AND CONCLUSION:Glial scar in the injured spinal cord was composed of astrocytes and histocytes. Less spinal cord glial scar area and lower absorbance value could be observed in the experimental and control groups as compared with the blank control group (P<0.05). In addition, in the blank control group, neurofilament negative fibers could be observed in the glial scar, and astrocytes proliferated obviously. The experimental and control groups showed less fibers passed through the scar area. The glial scar area and average absorbance in the experimental group was lower than that in the control group (P<0.05). These findings suggest that compared with simple transplantation of bone marrow mesenchymal stem cells-derived neuron-like cells, co-transplantation of control ed release glial cellline-derived neurotrophic factor and bone marrow mesenchymal stem cells-derived neuron-like cells shows better protective effects spinal tissue structure after spinal cord injury, which may be one of mechanisms by which the number of glial scars is reduced to a greater extent.
ABSTRACT
Objective To investigate the preventive effect of N-acetylcysteine (NAC) on contrast-induced nephropa-thy (CIN) in patients undergoing elective percutaneous coronary intervention (PCI). Methods A total of 521 patients under-went PCI in Tianjin were randomly divided into conventional treatment group (n=261) and NAC treatment group (n=260). NAC treatment group was given oral NAC (600 mg twice daily) for 48 h and 72 h before PCI plug hydration therapy, and the conventional treatment group was given only hydration therapy. The serum levels of creatinine(Scr), urea nitrogen(BUN), creatinine clearance rate (Ccr), C-reactive protein (CRP),β2-microglobulin(β2-MG), tumor necrosis factor-α(TNF-α), inter-leukin-6 (IL-6), superoxide dismutase (SOD), glutathione peroxidase (GPX) and incidence of CIN were detected at admission and 72 h after the procedure. Results (1) There was no significant difference in the incidence of CIN between NAC treat-ment group (6.2%) and conventional treatment group (3.8%,χ2=1.48, P>0.05). (2) There were no significant differences in se-rum levels of Scr, BUN, Ccr, CRP,β2-MG, TNF-α, IL-6, SOD and GPX before PCI ( P>0.05). (3) The serum levels of CRP, SOD and GPX were significantly higher 72 h after the procedure in two groups ( P＜0.05). There were significantly lower se-rum levels in CRP, SOD and GPX in NAC treatment group than those of conventional treatment group ( P＜0.05). There were no significant differences in serum levels of Scr, BUN,β2-MG and Ccr between NAC treatment group and conventional treat-ment group ( P >0.05). Conclusion N-acetylcysteine may have no beneficial effect on the prevention of CIN after PCI.
ABSTRACT
Objective To evaluate the safety and efficacy of multi-band mucosectomy (MBM) for early esophageal cancer and precancerous lesions.Methods Data of 28 patients with early esophageal cancer or precancerous lesions undergoing MBM were reviewed in regarding of procedure complications and follow-up results.Results A total of 32 lesions were resected successfully by MBM in one session,with mean procedure time of 28.3 minutes.The mean diameter of specimens was 12mm.No residual neoplasm was found at the base of any resected specimens.The post-MBM pathological findings consisted of 2 cases of intramucosal cancer,1 case of submucosal cancer,and 25 cases of moderate-severe dysplasia.No perforation,delayed hemorrhage or subcutaneous emphysema occurred.Intraoperative bleeding occurred in 23 cases,including 3 cases of pulsatile bleeding,which were controlled with metal clip,and 20 cases of minor bleeding which were managed with APC or halted automatically at the end of procedure.Chest pain after the procedure occurred in 5 cases and were relieved soon.The patient with submucosal cancer underwent subsequent surgical resection,with no residual cancer in surgical specimen or lymph node metastasis.Twenty seven other cases were followed up endoscopically for 2-12 months.Esophageal stricture occurred in 2 cases,and were successfully relieved by dilatation with stent or bougienage.No recurrent lesion or metastasis were revealed.Conclusion MBM is a relatively safe and effective endoscopic technique for treatment of early esophageal intramucosal cancer and precancerous lesions,but further studies are needed to evaluate the long-term results.