Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis.

OBJECTIVE: The scope of surgical resection for paratracheal (level VI) lymph nodes in patients with Papillary Thyroid Carcinoma (PTC) remains debatable. The aim of our study was to evaluate the effectiveness and safety of prophylactic ipsilateral Central Neck lymph node Dissection (CND) versus bilateral CND at the time of total thyroidectomy for Clinically Node-negative (cN0) unilateral PTC. METHODS: A systematic retrieval of electronic databases, including Pubmed, Web of Science, and the China Journal Net, was conducted from January 1990 to September 2021. Outcome data of interest included transient hypoparathyroidism, permanent hypoparathyroidism, transient Recurrent Laryngeal Nerve (RLN) injury, permanent RLN injury and local recurrence. We constructed the summary Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for every study with either fixed or random effect models. RESULTS: A full total of 1792 patients from 6 studies were enrolled. Our meta-analysis showed that transient hypoparathyroidism was significantly more frequent in bilateral CND group (OR=0.58; 95% CI 0.44-0.76). The prevalence of permanent hypoparathyroidism was significantly higher in bilateral CND group patients compared to those in ipsilateral CND group (OR=0.26; 95% CI 0.15-0.45). On the other hand, our meta-analysis indicated that there were no significant differences in the incidence of transient RLN injury, permanent RLN injury and local recurrence. CONCLUSIONS: Compared with bilateral CND, the rate of temporary and permanent hypoparathyroidism in ipsilateral CND is lower, but the local recurrence is similar. It may be presumptuous to suggest that ipsilateral CND is an adequate treatment for cN0 unilateral PTC.

Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis

Abstract Objective: The scope of surgical resection for paratracheal (level VI) lymph nodes in patients with Papillary Thyroid Carcinoma (PTC) remains debatable. The aim of our study was to evaluate the effectiveness and safety of prophylactic ipsilateral Central Neck lymph node Dissection (CND) versus bilateral CND at the time of total thyroidectomy for Clinically Node-negative (cN0) unilateral PTC. Methods: A systematic retrieval of electronic databases, including Pubmed, Web of Science, and the China Journal Net, was conducted from January 1990 to September 2021. Outcome data of interest included transient hypoparathyroidism, permanent hypoparathyroidism, transient Recurrent Laryngeal Nerve (RLN) injury, permanent RLN injury and local recurrence. We constructed the summary Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for every study with either fixed or random effect models. Results: A full total of 1792 patients from 6 studies were enrolled. Our meta-analysis showed that transient hypoparathyroidism was significantly more frequent in bilateral CND group (OR = 0.58; 95% CI 0.44-0.76). The prevalence of permanent hypoparathyroidism was significantly higher in bilateral CND group patients compared to those in ipsilateral CND group (OR = 0.26; 95% CI 0.15-0.45). On the other hand, our meta-analysis indicated that there were no significant differences in the incidence of transient RLN injury, permanent RLN injury and local recurrence. Conclusions: Compared with bilateral CND, the rate of temporary and permanent hypoparathyroidism in ipsilateral CND is lower, but the local recurrence is similar. It may be presumptuous to suggest that ipsilateral CND is an adequate treatment for cN0 unilateral PTC.

Clinicopathological and genomic features of breast mucinous carcinoma.

INTRODUCTION: Mucinous carcinoma (MC) of the breast is a special histological type of breast cancer. Clinicopathological characteristics and genomic features of MC is not fully understood. MATERIALS AND METHODS: 186,497 primary breast cancer patients from SEER database diagnosed with invasive ductal carcinoma (IDC) or MC were included. 801 primary IDC or MC patients from TCGA cohort were included for transcriptomic and genomic analysis. RESULTS: MC patients were older, had lower tumor grade and T and N stage, higher hormone receptor positive proportions and lower HER2 positive proportions than IDC patients. Kaplan-Meier plots showed that the breast cancer-specific survival (BCSS) of MC patients was significantly better than IDC patients (P < 0.001). However, after adjusting for clinicopathological factors, survival advantage of MC disappeared. In terms of genomic features of MC, representative upregulated genes of MC in transcriptomic level were MUC2, TFF1 and CARTPT. Upregulated pathways of MC included neurotransmitter-related pathways. Moreover, MC was featured by the amplification of 6p25.2, 6q12 and 11q12.3. CONCLUSION: MC is a distinct histological subtype compared with IDC in terms of clinicopathological characteristics and genomic features. Further investigation need to be conducted to explore the formation of this specific histological subtype.

Asiatic acid ameliorates acute hepatic injury by reducing endoplasmic reticulum stress and triggering hepatocyte autophagy.

Endoplasmic reticulum stress (ERS), mutual crosstalk between autophagy and apoptosis-related signaling pathway, plays an important role in the process of acute liver injury (ALI). The present study was to investigate the effects and underlying mechanisms of Asiatic acid from Potentilla chinensis (AAPC) on ALI. The model of ALI in mice was induced by administration with Lipopolysaccharide/D-Galactosamine (LPS/D-GalN). The effects of AAPC on hepatic pathology and hepatocyte apoptosis were observed by hematoxylin-eosin (H&E) staining and TUNEL staining. Serum transaminases activities were measured using an automated biochemical analyzer. Moreover, ERS and autophagy were induced in LO2 cells, respectively. Cell cycle and apoptosis were analyzed using flow cytometry. In addition, ERS and autophagy-related pathways were detected in vivo and in vitro. The results showed that AAPC significantly ameliorated LPS/D-GalN-induced ALI in mice, as evidenced by the improvement of liver pathology and the decrease in serum alanine aminotransferase (ALT) and aspartate transaminase (AST) activities. Moreover, AAPC pre-treatment markedly inhibited thapsigargin-induced cell apoptosis, accompanied by cell cycle arrest at S/G1 phase in LO2 cells. AAPC notably inhibited the activation of the PERK/ATF6 and IRE1 pathway, alleviating the extent of ERS. Additionally, AAPC significantly promoted autophagy, as evidenced by the increase in the formation of autophagic vacuoles and the number of autophagosomes as well as the increased expressions of LC3II/I, Beclin-1, Atg5 and Atg7. In summary, our results indicate that AAPC significantly ameliorates ALI by inhibiting the ERS pathway and promoting hepatocyte autophagy.

Asiatic acid from Potentilla chinensis alleviates non-alcoholic fatty liver by regulating endoplasmic reticulum stress and lipid metabolism.

Endoplasmic reticulum stress (ERS) is induced by accumulation of misfolded proteins, playing a pivotal role during the processes of non-alcoholic fatty liver disease (NAFLD). The present study was to investigate the effect of Asiatic acid from Potentilla chinensis (AAPC) on liver cell lipid metabolism, exploring the underlying mechanism of AAPC against NAFLD. In vivo, the animal NAFLD model was induced by feeding rats with high fat diet (HFD) for 18 weeks, and meanwhile the rats were treated with AAPC from weeks 8 to 18; In vitro experiment, the effect of AAPC on dyslipidemia induced by oleic acid (OA) in hepatic cells (HepG2) was evaluated. The results showed that AAPC significantly decreased lipidosis in rats and in HepG2 cells; it notably alleviated hepatocyte damage and lipid disturbance in rats. Moreover, the cell experiments showed that AAPC strongly inhibited HepG2 cell proliferation. It markedly decreased hepatocyte lipogenesis by regulating the key lipid metabolism-related factors, such as sterol regulatory element-binding protein 1c (SREBP-1c), encoding carboxylase, liver X Receptor Rα (LXRα), fatty acid synthase (FAS), and AMP-activated protein kinase (AMPK). The further study elucidated that AAPC treatment significantly alleviated inflammatory response by inhibiting the nuclear factor-kappa B (NF-kB) pathway. Moreover, AAPC significantly alleviated hepatocyte apoptosis and lipid metabolism disorder through reducing the extent of ERS. In conclusion, our study demonstrates that AAPC significantly ameliorates NAFLD by inhibiting the ERS pathway and lipid deposition, which may be a potential natural medicine for the treatment of NAFLD.

[Study of Rhizoma Darynaria on regulation of cellular immune function in immunosuppressive mice].

OBJECTIVE: To study the effect of Rhizoma Drynaria ethanol extract on regulation of cellular immune functions in cyclophosphamide-induced immunosuppressive mice. METHODS: A total of 60 kunming mice were randomly divided into six groups:normal control group, model group, positive control group( levamisole, 0. 05 g / kg) and low-, medium- and high-dose Rhizoma Drynaria ethanol extract-treated groups( 2. 5, 5, 10 g / kg). The mice in the four administration group were administered with 10 mL / kg of the drug for 20 days. Except normal control group, the mice in the other 5 groups were intraperitoneally injected( ip) with cyclophosphamide to establish immunosuppression model. After the end of the experiment, the indices of lymphocyte proliferation capacity and delayed type hypersensitivity were detected, speen histological structure and Tlymphocyte subsets CD_4~+, CD_8~+T cells in peripheral blood were measured. The relativemRNA expression of Interleukin 4( IL-4) and Interferon-γ( IFN-γ) in the spleen tissues were detected. RESULTS: Rhizoma Drynaria ethanol extract( 5, 10 g / kg) enhanced Con Ainduced T-lymphocytes proliferative capacity and delayed type hypersensitivity, increased CD_4~+T cells, CD_4~+/ CD_8~+ratio in peripheral blood, IFN-γ mRNA expression and IFN-γ /IL-4 ratio, decreased CD_8~+T cells and IL-4 mRNA expression. However, there was no obvious difference in LPS-induced B-lymphocyte proliferation capacity. CONCLUSION: Rhizoma Drynaria ethanol extract could regulate the cellular immune functions in cyclophosphamide-induced immunosuppressive mice.