[Radical vulvectomy and inguinal lymphadenectomy using a single incision for the treatment of vulvar malignancy].

Objective: To describe a novel procedure of radical vulvectomy and inguinal lymphadenectomy using a single incision (RVIL-SI) for the treatment of vulvar malignancy. Methods: In March, 2019, two cases affected with vulvar cancer (the first one is stage ⅢA squamous cell carcinoma and the second one is stage ⅠB with malignant melanoma) underwent this novel procedure, which was characterized by the combination of radical vulvectomy and bilateral inguinal lymphadenectomy without making additional incisions in groin areas. The boundaries of femoral triangle could be exposed perfectly using the initial incision of radical vulvectomy and the combined superficial and deep groin lymph node dissection were done subcutaneously from medial to lateral. Preoperative data and short term follow-up outcomes were collected. Results: The RVIL-SI was successfully conducted in two patients without any incisions of groin. The great saphenous veins were all spared. The operative time, average blood loss and median total regional lymph nodes of two cases were close. No major intraoperative complications occurred. Micrometastasis in one right superficial inguinal node was found in the first case with ipsilateral huge cancer lesion. No drain tube was left in inguinal areas intraoperatively. On postoperative day 3, the second case suffered mild lymphocele of right groin, which was resolved via repeated percutaneous needle puncture followed by elastic compression. Postoperative hospital stay of two cases were 10 and 11 days, respectively. With no skin complication at the time of writing this report. Conclusion: Our preliminary experience with the RVIL-SI has confirmed the reproducibility and minimal invasive therapeutic potential in the treatment for patients with vulvar cancer. But this novel procedure is in its infancy stage. Although short-term results are encouraging, a larger series with longer follow-up are required to fully evaluate the therapeutic efficacy.

Fondaparinux vs. enoxaparin in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) treated with percutaneous coronary intervention and tirofiban: an exploratory study in China.

WHAT IS KNOWN AND OBJECTIVE: Fondaparinux and enoxaparin are used in patients with acute coronary syndrome (ACS), but their effect in particular populations of patients is not well known. The objective was to explore the difference between fondaparinux and enoxaparin in patients with non-ST elevation ACS (NSTE-ACS) treated with percutaneous coronary intervention (PCI) and tirofiban. METHODS: We prospectively enrolled 461 patients with NSTE-ACS treated with PCI, tirofiban, and either fondaparinux (n = 229) or enoxaparin (n = 232). Death, myocardial infarction, recurrent ischaemia and its composite outcome were assessed. The incidences of major or minor bleeding not related to coronary artery bypass grafting were also evaluated. RESULTS AND DISCUSSION: The rates of death, MI or refractory angina did not differ between the fondaparinux and enoxaparin groups at day 7 (4·40% vs. 4·70%), 30 (7·90% vs. 8·60%) or 180 (9·60% vs. 10·80%). Similarly, there were not statistically significant differences in the rates of major bleeding at day 7 (0·87% vs. 2·16%), 30 (1·31% vs. 2·59%) or 180 (2·18% vs. 3·88%), or in the rates of minor bleeding at day 7 (3·49% vs. 6·47%), 30 (5·68% vs. 9·48%) or 180 (8·30% vs. 13·36%). WHAT IS NEW AND CONCLUSION: In this relatively small study of Chinese patients with NSTE-ACS treated with tirofiban, there was no statistically significant difference in ischaemic or bleeding outcomes with the use of either fondaparinux or enoxaparin.

The PPI network and clusters analysis in glioblastoma.

OBJECTIVE: Glioblastoma is the most aggressive tumor of the brain. To further understand its molecular mechanism, we carried out a systemic bioinformatics study of gene chips downloaded from Gene Expression Omnibus database. MATERIALS AND METHODS: LIMMA package in R language was used to identify the differentially expressed genes (DEGs) between glioblastoma samples and normal controls. RESULTS: Further, we constructed protein-protein interaction networks by mapping the DEGs into PPI data and identified network clusters in these networks. The results revealed that expression of 516 genes, which are mainly involved in phosphate metabolic process and signal transduction, were altered in glioblastoma samples. LYN, CD22 and LCP2 form a densely protein complex in the PPI network. CONCLUSIONS: Our results suggest that LYN, CD22 and LCP2 play important roles in the occurrence and progression of glioblastoma.

Inactivation of putative PKS genes can double geldanamycin yield in Streptomyces hygroscopicus 17997.

The putative polyketide biosynthesis (PKS) genes cos10 and pg10 were inactivated by insertion of a kanamycin-resistance gene into the genome of the geldanamycin-producing strain, Streptomyces hygroscopicus 17997. The resultant inactivation were confirmed by PCR analysis. The abilities of the PKS gene inactivation strains to produce geldanamycin were compared with the natural geldanamycin- producing strain, S. hygroscopicus 17997. The cos10-inactivated strain exhibited an unchanged ability to produce geldanamycin, but the pg10- inactivated strain can produce twice the yield of the natural strain when grown under the same conditions. We propose that there is a sub-PKS pathway in the geldanamycin-producing strain, S. hygroscopicus 17997.