[Risk factors of recurrence or metastasis in patients with medullary thyroid carcinoma].

Objective: To analyze the risk factors of recurrence or metastasis of medullary thyroid carcinoma (MTC) and the influencing factors of disease-free survival (DFS). Methods: The clinicopathological data of MTC patients who visited Tianjin Medical University Cancer Institute and Hospital and underwent surgery from August 2014 to August 2019 were retrospectively analyzed. The patients were divided into recurrence or metastasis group and no recurrence or metastasis group. Multivariate logistic regression analysis was used to analyze the risk factors for recurrence or metastasis. Kaplan-Meier survival analysis and Cox regression analysis were used to determine the risk factors of DFS. Results: A total of 158 MTC patients were enrolled in final analysis, including 83 females and 75 males, with a median age of 52 (19-74) years. There were 146 cases of sporadic MTC (92.4%) and 12 cases of familial MTC (7.6%), respectively. Bilateral thyroid lesions presented in 33 cases (20.9%) and multiple lesions presented in 57 cases (36.1%), respectively. The median follow-up time was 59.7 (10.0-93.0) months and the median DFS was 55.5 (0-92.9) months. Presence of multifocality, the largest tumor size>2 cm, T3/4, N1b, clinical stage Ⅲ/Ⅳ, lymph node metastasis ratio (LNR)>0.3, preoperative calcitonin>2 000 ng/L, postoperative calcitonin>40 ng/L and no biochemical cure were significantly correlated with the recurrence or metastasis and DFS of MTC (all P<0.05). Clinical stage Ⅲ/Ⅳ (OR=36.57, 95%CI: 1.33-1 006.98, P=0.033), the largest tumor size>2 cm (OR=5.81, 95%CI: 1.01-33.33, P=0.049), multifocality (OR=3.64, 95%CI: 1.03-12.88, P=0.045) and postoperative calcitonin>40 ng/L (OR=15.03, 95%CI: 1.39-162.61, P=0.026) were independent risk factors of recurrence or metastasis. Clinical stage Ⅲ/Ⅳ (HR=19.39, 95%CI:1.40-268.19, P=0.027), the largest tumor size>2 cm (HR=3.64, 95%CI: 1.02-13.02, P=0.047) and postoperative calcitonin>40 ng/L (HR=10.68, 95%CI: 1.34-84.95, P=0.025) were influencing factors for DFS (all P<0.05). Conclusion: The larger tumor size, advanced clinical stage and higher postoperative calcitonin at the initial treatment of MTC are risk factors for recurrence or metastasis and influencing factors for DFS.

Propofol induces apoptosis of epithelial ovarian cancer cells by upregulation of microRNA let-7i expression.

OBJECTIVE: Propofol is one of the extensively and commonly used intravenous anaesthetic agents. The aims of the current study were to evaluate effects of propofol on the behavior of human epithelial ovarian cancer (EOC) cells and role of miR-let-7i in these effects. MATERIALS AND METHODS: The effects of propofol on cell proliferation and apoptosis were detected by MTT assays and flow cytometry. Real-time polymerase chain reaction (PCR) was used to assess miR-let-7i expression in human EOC cells OVCAR-3 with or without propofol treatment. Finally, the authors evaluated the effect ofmiR-let-7i on propofol-induced anti-tumor activity using anti-miR-let-7i. RESULTS: Propofol inhibited the proliferation of OVCAR-3 cells in a dose- and time-dependent manner. After exposure to propofol for 24 hours, OVCAR-3 cells showed increased apoptosis and increased expression of miR-let-7i. Finally, anti-miR-let-7i reversed the effect of propofol on cell proliferation and apoptosis. CONCLUSIONS: Propofol can effectively inhibit proliferation and induce apoptosis of EOC cells and modulation of miR-let-7i possibly contributes to the anti-tumor action of propofol.

[Clinical analysis of femoral neck fracture in 188 adult cases].

There were 188 cases of femoral neck fracture of adult below the age of fifty-five years old admitted to our hospital from 1974 to 1989, including 152 cases of fresh fracture, 36 old fracture. The rate of femoral head necrosis after fracture was 11.8 percent in the group of patients under fifty years of age, and 9.8 percent in patients between fifty-one and fifty five years old. The operation adopted in our series was mainly the percutaneous screw-thread pinning for internal fixation. Bone graft transplantation with the pedicle of quadratus femoris muscle was simultaneously performed in some cases, 26.7 percent in patients between the age of fifteen and twenty, along with the increase of age the patient number for transplantation decreased, only 7.8 percent in patients between the age of fifty-one and fifty-five. The author suggests that in treatment of femoral neck fracture of adult generally should not consider the use of artificial prosthesis replacement. We should decide according to the patients general and local status as the basis for the choice of a reasonable internal fixation, and consider whether an operation should be performed to further improve blood circulation of the femoral head.

Treatment of intra-articular fractures with shape memory compression staples.

The management of intra-articular fractures remains difficult. Shape memory compression staples fulfil nearly all the special treatment requirements of intra-articular fractures. Early bone union and 93.5 per cent satisfactory function were achieved in a series of 121 cases. Stable fixation, 'early' movement and continuous compressive force produced by the staple are the main factors contributing to good results.

[Early arthroscopy in diagnosis and treatment of acute injury of the knee].

Twelve patients with swelling and functional embarrassment of the knee joint caused by a traffic accident were radiographically found to have tibial plateau fractures (7 patients), posterior dislocation (1), fracture of anterior tibial spine (1), single fracture of the posterior tibial spine (1), anterior dislocation (1), and negative findings (1). Arthroscopy was performed 2 to 10 days after trauma, revealed associated injuries not shown on X-ray films in every knee including rupture of cruciate ligaments (ACL 8, PCL 1), tear of menisci (lateral one 8; medial one 2), and disruption of collateral ligaments (medial one 3; lateral 1). These injuries were promptly treated accordingly either through the scope or by open operation. Beside, inadequately reduced bone fragments, viewed through the scope, were further corrected incidentally and conveniently. We believe that early arthroscopy for acute knee injury is a real necessity in perfecting diagnosis and improving treatment.

[Posterior lumbar interbody fusion].

This paper reports the posterior lumbar interbody fusion (PLIF) that has been performed on fourteen patients. It includes 6 cases of spondylolytic spondylolisthesis, 3 cases of degenerative spondylolisthesis, 2 cases of postoperative recurrence of lumbar disc protrusion, 2 cases of unstable prolapse of intervertebral disc, 1 cases of consequent spinal canal stenosis after lumbar lamina fusion. As a result 92 per cent of the operations are successful. The method of operation and it's modification are reported in detail. The indication of operation and the evaluative criteria of interbody bone union discussed. The intact of lumbar posterior structures, the condition of bone grating bed, the quality and disperse of bone graft are main factors that influencing bone union. Bleeding from venous plexus of spinal canal and from vertebral cancellous bone, injury of lumbosacral nerve root and cauda equina are the main surgical complications that should be stressed.