Advances on the mechanisms regulating the formation of the biofilm of Listeria monocytogenes / 生物工程学报

Listeria monocytogenes is an important food-borne pathogen. The distribution and survival of L. monocytogenes are related to its ability to form biofilms. Biofilms are resistant to adverse environments, and bacteria separated from the biofilms may lead to persistent food contaminations. The formation, maturation and structure of biofilms depend on a variety of external and internal factors, among which a variety of regulatory mechanisms play important roles. This review summarizes the regulatory mechanisms (including intracellular, intercellular and interspecific interactions) involved in the biofilm formation of L. monocytogenes in order to control the biofilm formation in food processing environments, thus providing new intervention strategy for food safety.

Progress of prognosis-related immune factors in esophageal neoplasms / 肿瘤研究与临床

Immunotherapy has recently become a new therapeutic method. Related cells and cytokines mediating tumor immunity play different roles in the process of tumor immunity, and they are correlated with tumor prognosis, which has a reference significance in the evaluation of tumor prognosis. In China, esophageal carcinoma is one of the common tumors of digestive system, and its 5-year overall survival rate is low. With the wide use of immunotherapy and introduction of precision medicine, the study on the relationship between tumor immune-related cells, cytokines and the prognosis of esophageal carcinoma can provide the guidance for the diagnosis and treatment of esophageal carcinoma.

Prognostic factors of small non-functional pancreatic neuroendocrine tumors / 中华消化杂志

Objective To investigate the clinical features and prognostic factors of small (maximum diameter≤ 2.0 cm) non-functional pancreatic neuroendocrine tumors (NF-PNET).Methods From January 2002 to April 2017,the clinical data of 18 patients with small NF-PNET were retrospectively analyzed.The prognosis and clinical pathological features were investigated.According to the prognosis,the patients were divided into death group (four cases) and disease-free survival group (14 cases).Fisher's exact test and Mann-Whitney rank inspection were performed for statistical analysis.Results All 18 patients (nine males,nine females) aged 23 to 80 years old,median age 52.5 years old received radical resection.The median follow-up time was 54 months.Four patients died during the follow-up.There was no statistically significant difference in median age (61.0 years,32.0 to 80.0 years vs 49.0 years,23.0 to 72.0 years) and median tumor maximum diameters (1.9 cm,0.8 to 2.0 cm vs 1.5 cm,0.8 to 2.0 cm) between the death group and disease-free survival group (Z=-1.223 and-0.752,P=0.233 and 0.505).Compared with that of disease-free survival group,tumor differentiation degree of the death group was lower (poor/high differentiation,2/2 vs 0/14),and the difference was statistically significant (Fisher's exact test,P=0.039).However,there was no significant difference in histological grades (G1/G2/G3,1/1/2 vs 9/5/0;Fisher's exact test,P=0.057).The distribution of tumor in death group and disease-free survival group was similar.The proportion of patients with tumor at pancreatic head was 2/4 and 6/14 of the death group and disease free survival group,respectively.The surgical methods of the death group included pancreaticoduodenectomy (two cases),distal pancreatectomy (one case),and total pancreatectomy (one case),and there was no statistically significant difference in rates of surgical methods between the two groups (Fisher's exact test,P=0.260).Conclusion Age,tumor maximum diameter,degree of differentiation,histological grade and surgical methods may be correlated with poor prognosis of small NF PNET.

The diagnostic role of N-terminal brain natriuretic peptide in identifying acute pulmonary thromboembolism versus congestive heart failure in dyspnea patients / 中华老年医学杂志

Objective To explore the role of NT-proBNP in the differentiation of acute pulmonary embolism (APE) from congestive heart failure (CHF) in patients with acute dyspnea.Methods Consecutive 260 patients aged ≥ 60 years complaining of acute dyspnea were collected between June 2010 and October 2015.The patients were divided into two groups of APE and CHF according to their diagnosis standards.The levels of NT-proBNP between the two groups were compared using t test,and receiver operating characteristic curve (ROC curve) was made to show the value of NT-proBNP in differentiation of APE from CHF.Results Patients in APE group had significantly lower median levels of NT-proBNP as compared with patients in CHF group [(2 478.8±1 473.9)ng/L vs.(5 955.4±3 180.1)ng/L,t =-12.020,P ＜ 0.01].The ROC curve of APE existence against serum levels of NT-proBNP showed an optimal cut-point of NT-proBNP of 1 518 ng/L,with specificity up to 98.8％,and the area under the ROC curve for NT-proBNP was 0.877.Conclusions NT-proBNP as a simple and bedside approach to identify APE versus CHF patients with acute dyspnea can help clinicians identify APE early and reduce the rates of misdiagnosis and missed diagnosis of APE.But the confirmative diagnosis of APE is still based on spiral CT angiography.

Surgical treatment for unilateral papillary thyroid microcarcinoma / 中华普通外科杂志

Objective To investigate the appropriate surgical procedure for unilateral papillary thyroid microcarcinoma (PTMC).Methods Clinical data of 323 patients with unilateral PTMC in Cancer Hospital of Chinese Academy of Medical Sciences from 1999-2007 were retrospectively studied.Survival outcomes and prognostic factors were analyzed.Results After a median follow-up of 102 (range,12-188) months,the 10-year overall and disease-specific survival was 95.3％ and 98.9％.The 10-year recurrence-free survival was 85.5％.The 10-year cumulative recurrence rate of residue glands was 6.5％.Capsular invasion,pT stage and clinical stage were significant predictive factors for recurrence of residue glands (all P ＜ 0.05).Cox regression multivariate analysis showed that pT stage (HR 2.153,95％ CI 1.231-3.767,P =0.007) was independent predictive factor.Of the 311 patients treated with non-total thyroidectomy,the 10-year cumulative recurrence rate of residue glands was 6.8％ Conclusions Unilateral PTMC has a good prognosis and hemithyroidectomy (lobectomy and isthmusectomy) is an appropriate surgical pattern.Extrathyroidal extension is a significant predictor for recurrence.

Clinical Study on Montelukast in the Treatment of Pediatric Cough Variant Asthma / 中国药房

OBJECTIVE:To investigate the effects of leukotriene receptor antagonist montelukast on inflammatory factor,air-way anatomy and lung function of children with cough variant asthma. METHODS:A total of 86 children with cough variant asth-ma selected from our hospital during Apr. 2010 to Aug. 2015 were divided into control group and observation group according to random number table,with 43 cases in each group. Control group was given Budesonide aerosol 0.4 mg,bid;observation group was given Montelukast sodium chewable tablets with different dose according to age(4 mg for 2-6 year-old,tid;5 mg for 7-12 year-old,tid).A treatment course of 2 groups lasted for 4 weeks,and both groups received 2 courses of treatment. The levels of inflammatory factor,airway anatomy and lung function indexes were detected in 2 groups before and after treatment,and the oc-currence of ADR was also observed. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). Compared to before treatment,the levels of IL-4,IL-6,IL-8,TNF-α and hs-CRP in 2 groups were de-creased significantly after treatment;airway wall thickness,basement membrane thickness,airway wall thickness/outside diameter ratio,total area of airway wall,total area of airway wall/total area of airway were decreased significantly,while FVC,FEV1, FEV1/FVC,PEF were increased significantly;the indexes in observation group were significantly better than control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:For pediatric cough variant asthma,montelukast can significantly improve inflammatory reaction,airway status and lung function with good safety.

Clinical Study on Montelukast in the Treatment of Pediatric Cough Variant Asthma / 中国药房

OBJECTIVE:To investigate the effects of leukotriene receptor antagonist montelukast on inflammatory factor,air-way anatomy and lung function of children with cough variant asthma. METHODS:A total of 86 children with cough variant asth-ma selected from our hospital during Apr. 2010 to Aug. 2015 were divided into control group and observation group according to random number table,with 43 cases in each group. Control group was given Budesonide aerosol 0.4 mg,bid;observation group was given Montelukast sodium chewable tablets with different dose according to age(4 mg for 2-6 year-old,tid;5 mg for 7-12 year-old,tid).A treatment course of 2 groups lasted for 4 weeks,and both groups received 2 courses of treatment. The levels of inflammatory factor,airway anatomy and lung function indexes were detected in 2 groups before and after treatment,and the oc-currence of ADR was also observed. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). Compared to before treatment,the levels of IL-4,IL-6,IL-8,TNF-α and hs-CRP in 2 groups were de-creased significantly after treatment;airway wall thickness,basement membrane thickness,airway wall thickness/outside diameter ratio,total area of airway wall,total area of airway wall/total area of airway were decreased significantly,while FVC,FEV1, FEV1/FVC,PEF were increased significantly;the indexes in observation group were significantly better than control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:For pediatric cough variant asthma,montelukast can significantly improve inflammatory reaction,airway status and lung function with good safety.

Comparison for Blood Levels of NT-proBNP and Uric Acid in Patients With Pulmonary Thromboembolism and Chronic Heart Failure / 中国循环杂志

Objective: To compare blood levels of NT-proBNP and uric acid (UA) in patients with pulmonary thromboembolism (PTE) and chronic heart failure (CHF). Methods: A prospective research was conducted in 288 acute dyspnea patients treated in our hospital from 2010-06 to 2015-05. The patients were divided into 2 groups based on clinical diagnosis: PTE group,n=107 and CHF group, n=181. Blood levels of NT-proBNP and UA were examined in all patients, statistical analysis was performed by SPSS 17.0 software, independent samplet test or variance analysis were used to make comparison between 2 groups. Results: There were more male patients as 64/107 (59.8%) in PTE group and 103/181 (56.9%) in CHF group. Compared with CHF group, PTE group had the lower blood levels of NT-proBNP (2421.7±1678.1) pg/ml vs (6964.3±3873.1) pg/ml and UA (340.6±121.3) μmol/L vs (492.1±166.2) μmol/L, allP<0.01. Conclusion: In our research, blood levels of NT-proBNP and UA were lower in PTE patients than CHF patients; with general background, such phenomenon might be helpful to distinguish PTE and CHF in acute dyspnea patients in clinical practice.

Short-term complications in reconstruction of the postoperative defects with free jejunum graft in patients with pharyngeal, laryngeal or cervical esophageal cancers / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical effects and short-term complications of using free jejunum graft (FJG) to reconstruct the defects by resections of pharyngeal, laryngeal or cervical esophageal cancers.@*METHOD@#Fifty-eight cases of pharyngeal, laryngeal or cervical esophageal cancers were reconstructed with FJG. All cases were analyzed retrospectively.@*RESULT@#The success rate of FJG transplantations was 91.4% (53/58). The incidence of post-operative short-term complication was 43.1% (25/58), which was not related to age or BMI. The most common complication was anastomotic leakage (18.9%), which was not related to per-operative radiation therapy. However, BMI > 25 cases had significantly higher incidence of anastomotic leakage than BMI ≤ 25 cases (P = 0.009). The second and third most common complications were respiratory system complications (10. 3%) and FJG necrosis (8. 6%). Para-operative death rate was 3.4% (2/58). Two-year overall survival rates of hypopharyngeal cancer and cervical esophageal cancer were 49% and 67% respectively. The group with no short-term complications had a slightly better survival rate than the group with short-term complications from the Kaplan-Meier curve, but there was no significant difference (P = 0.103).@*CONCLUSION@#FJG is ideal to reconstruct cervical digestive tract circumferential defects with a high success rate and a low mortality. However, the post-operative complication rate is high. Intensive observation, early detection and timely treatment of complications are crucial.

Analysis of the effectiveness of radiotherapy in postoperative residual tumors in patients with thyroid papillary carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to assess the impact of radiotherapy on patients with postoperative residual or recurrent papillary thyroid cancer (PTC).</p><p><b>METHODS</b>We retrospectively reviewed the medical records of 34 patients with PTC, who underwent surgery and radiotherapy in other hospitals, and treated at the Department of Head and Neck Surgery at Cancer Institute & Hospital CAMS from January 2011 to January 2014. Among the 34 cases, 22 were in stage I, 5 in stage II and 7 in stage IVa. The 34 patients received 1.5 times of surgery before radiotherapy in average. All the cases received radiotherapy (mean, 56 Gy; range, 50-70 Gy). The patients were re-operated in our hospital, and the specimens were examined by pathology. The pre- and post-radiotherapy images (CT and B-ultrasound) were compared, and the changes of tumor volume were examined. The objective effect of treatment on the tumor residual focus was evaluated using RECIST, and analyzed by t-test (SPSS 17.0).</p><p><b>RESULTS</b>All the re-resected lesions after radiotherapy were proved by pathology to be papillary thyroid cancer (PTC) or metastatic PTC in cervical lymph nodes. Among the 34 patients, 22 cases showed mild or moderate cell degeneration and the other 12 cases showed no obvious degeneration. The largest tumor diameter was 27.18 mm before radiotherapy and 27.76 mm after radiotherapy, with a non-significant difference between them (t=-1.618, P>0.05). Among the 34 patients, only 3 patients received reoperation, all other 31 cases had complete resection, and no severe complications were observed except recurrent laryngeal nerve injury in one case.</p><p><b>CONCLUSIONS</b>Radiotherapy has few therapeutic benefit to PTC patients after surgery with residual tumor or local recurrence. It should be used in the PTC patients, in which the tumor invasion involves important organ tissues and is difficult for a single operation to achieve safe resection margin, or in patients who can't bear a surgery because of severe coronary heart disease or others.</p>

Management of vascular crisis of free flaps after reconstruction of head and neck defects caused by tumor resection / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To discuss the management of vascular crisis of free flaps after reconstruction of head and neck defects caused by tumor resection.</p><p><b>METHODS</b>A total of 259 cases of free flap reconstruction performed in the Cancer Hospital of Chinese Academy of Medical Sciences from 2010 to 2013 were retrospectively analyzed, including 89 cases of anterolateral thigh flaps, 48 cases of radial forearm flaps, 46 free fibula flaps, 5 cases of inferior epigastric artery perforator flaps, 5 cases of free latissimus dorsi flaps, one case of lateral arm flap, and one case of medial femoral flap. The surveillance frequency of free flaps was q1h on post-operative day (POD) 1, q2h on POD 2 and 3, and q4h after POD 3. Vascular crises were reviewed for analysis.</p><p><b>RESULTS</b>The incidence rate of vascular crisis was 8.1% (21/259), with 15 males and 6 females. The average age was 54.8 years old (17-68), and the average time of vascular crisis was 100.8 h post-operation (3-432). There were 7 cases of free jejunum flaps and 14 dermal free flaps. Seven of these 21 cases with vascular crisis were rescued by surgery. The success rate of salvage surgery within 72 hours from the primary operation was 54.5% (6/11), significantly higher than that of salvage surgery performed later than 72 hours from primary operation (10.0%, 1/10, P=0.043). There were 14 cases of flap necrosis, two of which died of local infection.</p><p><b>CONCLUSION</b>Early detection of vascular crisis can effectively improve the success rate of salvage, so as to avoid the serious consequences caused by free flap necrosis.</p>

Treatment and prognosis of the carcinoma arising from nasal and sinonasal inverted papilloma: report of 62 cases and systematic review / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the factors affecting prognosis of the carcinoma arising from nasal and sinonasal inverted papilloma.</p><p><b>METHODS</b>The clinicopathological data of sixty-two patients treated in our hospital from January 1974 to February 2012 were retrospectively analyzed. Of the 62 cases, 10 were at stage I or II, 24 at stage III, and 28 at stage IV. Twenty-six patients were treated with surgery alone, and 36 with surgery combined with radiation therapy. Kaplan-Meier method and log-rank test were used for the survival analysis.</p><p><b>RESULTS</b>The overall 5-years survival rate was 39.6%. The 5-years survival rate was 67.5% in the stage I or II patients,51.3% in the stage III patients, and 18.3% in the stage IV patients (P<0.05). The 5-years survival rate was 65.7% in patients who had no surgical history, and 29.9% in patients who had surgery (P<0.05). The 5-year survival rate was 17.6% in the group who relapsed after the treatment, and 49.6% in the non-relapsed patients (P<0.05). The 5-year survival rate was 23.4% in the patients who had involvement of cranial base and (or) orbit, and 47.6% in the patients whose cranial base and (or) orbit were clean (P<0.05). Of the patients at the same stage (III-IV), the 5-year survival rate of patients treated with surgery alone was 32.4%, and those treated with combination therapy was 36.2%(P=0.89). The univariate analysis showed that clinical stage, surgical history before malignization, involvement of the cranial base and (or) orbit organs, and post-operative relapse are significantly correlated to prognosis of the patients (P<0.05 for all). Multivariate analysis showed that age, clinical stage, and previous history of surgery were independent factors affecting the prognosis of the patients. Distant metastasis was the major cause of death, mostly lung metastases.</p><p><b>CONCLUSIONS</b>Age, clinical stage and surgical history are the main factors affecting the prognosis of the patients. The history of recurrence and involvement of cranial base or orbit also play an important role for the prognosis. Distant metastasis is the main cause of death in the patients with carcinoma arising from nasal and sinonasal inverted papilloma.</p>

Reconstruction of defect after resection of hypopharyngeal and cervical esophageal cancer by multiple tissue flaps / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore a new method for the reconstruction of defect after resection of hypopharyngeal and cervical esophageal cancer using pulled-up stomach combined with free jejunal flap or lanryngotracheal flap if pulled-up stomach can not reach the level of oral pharynx for ananstamosis.</p><p><b>METHODS</b>From June 2010 to June 2014, 56 cases of hypopharyngeal or cervical esophageal cancer were treated with pharyngogastric anastamosis, in 5 cases of them, because the length of pulled-up stomach was limited and could not reach oral pharynx, free jejunal flap was used in 2 cases with laryngeal invasion and laryngotracheal flap was used in 3 cases without laryngeal invasion to reconstruct the defect between oral pharynx and stomach.</p><p><b>RESULTS</b>Pharyngeal fistula occurred in 1 case with laryngotracheal flap reconstruction, but healed after 2 weeks of wound dressing. Other 4 cases had oral liquid diet two weeks after surgery and did not occur any complications such as infection or pharyngeal fistula. Follow-up showed 1 case died from mediastinal and lung metastases after 3 years, 1 case had cervical lymph recurrence after 2 years and still survived, and other 3 cases were tumor free survival for 28, 37, and 56 months respectively.</p><p><b>CONCLUSIONS</b>The defect after resection of hypopharyngeal and esophageal cancer can be reconstructed with pulled-up stomach combined with free jejunal flap or lanryngotracheal flap if pulled-up stomach can not reach the level of oral pharynx for ananstamosis.</p>