Low red blood cell predicts high risk of temporary postoperative complications after carotid body tumor surgical resection.

Background: Carotid body tumor (CBT) is a rare paraganglioma located at the carotid bifurcation. The red blood cell count, hemoglobin, and hematocrit are indexes to be evaluated in blood routine tests. The purpose of this study was to clarify their predictive value for temporary postoperative complications in patients that had undergone CBT surgery. Methods: This retrospective trial included data from 169 patients received surgical treatment for CBT from October 2008 to September 2018 in this retrospective study. Postoperative follow-up was conducted under the guidance of both vascular surgeon and neurologist. The symptoms existed less than 2 years postoperatively were regarded as temporary injuries. The red blood cell count, hemoglobin, and hematocrit were obtained from the complete blood count results of the participants. Analyses of multilevel multivariable regression and descriptive statistics were conducted. Results: The baseline data showed no significant difference. Patients were predominantly women (53.8%), with a mean age of 42.6 years. The total incidence of temporary postoperative complications was 22 (13.0%), including transient ischemic attack (8, 4.7%), tongue bias (7, 4.1%), dysphagia (2, 1.2%), hoarseness (4, 1.8%), and eyelid ptosis (1, 2.4%). The univariate and multivariate regression analysis results revealed that the occurrence of temporary postoperative complications was increased with age [odd ratio (OR, 0.09; 95% CI (CI), 0.9-1.0; P = 0.014], length of operation time (OR, 1.0; 95% CI, 1.0-1.0; P = 0.005), Shamblin type II vs. I (OR, 0.1; 95% CI, 0.0-0.5; P = 0.008), red blood cell count postoperative (OR, 0.2; 95% CI, 0.1-0.8; P = 0.026), hemoglobin (OR, 0.9; 95% CI, 0.9-1.0; P = 0.011), and hematocrit (OR, 0.8; 95% CI, 0.7-1.0; P = 0.025). The smooth curve fitting showed that the trend of complications occurrence rate was reduced with the increase of patients' postoperative red blood cell count, hemoglobin, and hematocrit. Gender, weight, length of operation, Shamblin type, postoperative red blood cell count, hemoglobin, and hematocrit were included in the risk model with AUC = 0.86. Conclusion: These patients with CBT who received surgical resection with low postoperative red blood cell, hemoglobin, or hematocrit had a high risk of temporary postoperative complications. The risk prediction model established for predicting temporary postoperative complications showed satisfactory prediction effects.

WNT7A Promotes EGF-Induced Migration of Oral Squamous Cell Carcinoma Cells by Activating ß-Catenin/MMP9-Mediated Signaling.

AIMS AND HYPOTHESIS: Epidermal growth factor (EGF) has been shown to induce the migration of various cancer cells. However, the underlying signaling mechanisms for EGF-induced migration of oral squamous cell carcinoma (OSCC) remain to be elucidated. WNT7A, a member of the family of 19 Wnt secreted glycoproteins, is commonly associated with tumor development. It is mostly unknown whether and, if so, how EGF modulates WNT7A in OSCC cells. The role of WNT7A in OSCC was thus investigated to explore the underlying signaling mechanisms for EGF-induced migration of OSCC. METHODS: Cell migration was measured by Wound healing assay and Transwell assay. Western blotting was carried out to detect the expression of WNT7A, MMP9, ß-catenin, p-AKT, and p-ERK. The cells were transfected with plasmids or siRNA to upregulate or downregulate the expression of WNT7A. The location of ß-catenin was displayed by immunofluorescence microscopy. Immunohistochemistry was carried out to confirm the relation between WNT7A expression and OSCC progression. RESULTS: The present study showed that the levels of WNT7A mRNA and protein were increased by EGF stimulation in OSCC cells. Besides, it was proved that p-AKT, but not p-ERK, mediated the expression of WNT7A protein induced by EGF. Furthermore, the inhibition of AKT activation prevented the EGF-induced increase of WNT7A and matrix metallopeptidase 9 (MMP9) expression and translocation of ß-catenin from the cytoplasm to the nucleus. Moreover, histological analysis of OSCC specimens revealed an association between WNT7A expression and poor clinical prognosis of the disease. CONCLUSIONS: The data in this paper indicated that WNT7A could be a potential oncogene in OSCC and identified a novel PI3K/AKT/WNT7A/ß-catenin/MMP9 signaling for EGF-induced migration of OSCC cells.

Outcome of Surgical Treatment for Carotid Body Tumors in Different Shambling Type Without Preoperative Embolization: A Single-Center Retrospective Study.

BACKGROUND: Carotid body tumor (CBT) is the most common head and neck paragangliomas. Surgical resection is the golden standard management for CBT. While preoperative embolization is still controversial, long-term outcomes and perioperative results are still deficient. We, here, presented the outcomes of surgical treatment for CBT without preoperative embolization at our institution. METHODS: In this retrospective study, we collected data from 101 patients who received surgical treatment for CBTs without preoperative embolization from 2011 to 2016. In addition, we attempted to conduct 2 years of follow-up under the guidance of both neurologist and vascular surgeon. Patients' demographics, clinical characteristics, complications, and follow-up results were all analyzed with descriptive statistics. RESULTS: Complete resection of the CBT was achieved in 101 cases (100%). Postoperative adverse events (AEs) mostly observed during hospitalization were as follows: tongue bias (I: 4, 36.4%; II: 8, 19.5%; III: 13, 26.5%), hoarseness (I: 1, 9.1%; II: 4, 9.8%; III: 7, 14.3%), dysphagia (I: 0; II: 2, 4.9%; III: 7, 14.3%), and hematoma (I: 0; II: 0; III: 1, 2.0%). No other serious AEs were observed. The total incidence of AEs in type I patients was 5 (45.5%), 14 (34.1%) in type II, and 28 (57.1%) in type III, and the type III group has significantly higher than the other two groups. At the end of 2 years of follow-up, there were no AEs in type I patients. The number of patients with AEs in type III was greater than that in type II, although there was no significant difference. Based on our findings, 3 most commonly injured cranial nerves (CNs) after surgical resection of CBT were CN XII (hypoglossal nerve, 21.9%), CN X (vagus nerve, 20.3%), and recurrent laryngeal nerve (18.8%). CONCLUSIONS: Surgical management without preoperative embolization for CBT patients is a safe and effective therapeutic approach.

Upregulation of miR-330-5p is associated with carotid plaque's stability by targeting Talin-1 in symptomatic carotid stenosis patients.

BACKGROUND: The aim of this study was to investigate the relationship between Talin-1 and stability of carotid atherosclerosis plaque and also find out the role of miRNA, as an upstream regulator, in regulating the expression level of Talin-1. METHODS: Human carotid plaques were obtained from 20 symptomatic carotid stenosis patients who underwent carotid endarterectomy (CEA) in our hospital between October 2014 and August 2017. Western blot analysis and immunohistochemistry was carried out to detect the distribution and expression level of Talin-1 in each plaque sample. The content of miRNAs in carotid plaque was decected by quantitative reverse transcription polymerase chain reaction (RT-qPCR), and the relative expression levels were calculated by 2-△△Ct method after the (cycle threshold) Ct value (power amplification knee point) was obtained. Dual-luciferase reporter assays were applied to verify the successful transfections. Finally, we compared all the groups with independent-samples t-test and one-way analysis of variance (ANOVA). RESULTS: Talin-1 was significantly downregulated in human unstable carotid plaque samples compared with stable carotid plaques (P < 0.05), and the distribution of Talin-1 was mainly found in the fibrous cap of carotid plaque. The overexpression of miRNA-330-5p was found in unstable carotid plaque, which significantly induced the inhibition of expression level of Talin-1. CONCLUSION: Upregulated miR-330-5p may lead to unstable carotid plaques by targeting Talin-1 in symptomatic carotid stenosis patients. This might be a new target for the treatment of atherosclerotic diseases through future studies.

[Bone regeneration effect of injectable-platelet rich fibrin (I-PRF) in lateral sinus lift: a pilot study].

PURPOSE: The aim of the present research was to evaluate the regeneration effect of injectable-platelet rich fibrin (I-PRF) in lateral sinus lift. METHODS: A total of 46 cases, who lost their single posterior tooth with residual bone height of 3-5 mm, who needed lateral sinus lift, were treated in our hospital for implantation from June 2014 to Jun 2015. They were randomly divided into 2 groups. In group A, Bio-oss was used as a sole grafting material to fill the sinus; in group B, Bio-oss was used in combination with I-PRF to fill the sinus. Cone-beam CT (CBCT) was taken preoperatively, the residual bone height (RBH) was measured. The new formed bone height (NFBH) was measured immediately, 6 months and 12 months after surgery. ISQ values of implants were taken 4 months, 6 months postoperatively. SPSS 20.0 software was used for statistical analysis. RESULTS: All cases achieved primary healing, no infection or dehiscence was found. No significant difference of the RBH and NFBH was found between pre-operation or 12 months postoperatively, while significant difference was found immediately and 6 months postoperatively. The value of ISQ in group A was significantly higher than that in group B at 4 months(P＜0.05), and there was no significant difference between 2 groups 6 months after operation(P＞0.05). CONCLUSIONS: I-PRF is a safe and reliable material in sinus lift, which can effectively shorten the healing time and enhance the effect of osteogenesis.

[Cone-beam CT study of bone septa during maxillary sinus lift among Changzhou population].

PURPOSE: To observe the incidence, location, morphological characteristics of sinus septa among Changzhou population, and to investigate the relationship between maxillary posterior teeth loss and bony septum, and the guiding significance for sinus lift. METHODS: One hundred and twenty-four subjects were selected, the preoperative cone-beam CT (CBCT) data was analyzed by NNT software, which provided a three-dimensional measurement of the maxillary sinus septa. SPSS 13.0 software package was used for statistical analysis. RESULTS: 33.87%（42/124）subjects had sinus septa, 27.42%（68/248）sinus had septa. 66.18% (45/68) of the septa were located in the middle region, 22.06% （15/68）in the posterior region, 11.76%（8/68） in the anterior region. The occurrence of sinus septa had no relation with gender, age and loss of teeth. CONCLUSIONS: The sinus septa can be observed by CBCT for the position, pattern, to predict the difficulty of the surgery, and enhance the success rate.

Ex vivo activated immune cells promote survival and stimulate multilineage hematopoietic recovery in myelosuppressed mice.

Recovery of multilineage hematopoiesis from severe myelosuppression due to chemotherapy and radiotherapy remains a clinical problem. The authors have developed a simple immunotherapy to treat this disease in a mouse model. Syngeneic spleen cells or xenogeneic human peripheral mononuclear cells were cultured ex vivo with a combination of IL-2 at 500 IU/mL, GM-CSF at 200 U/mL, and calcium ionophore A23187 at 100 ng/mL for 2 days and injected intravenously into mice that had previously received a lethal dose of carboplatin and radiation. The therapy was highly effective: a single injection of activated cells enhanced survival and simulated multilineage recovery of hematopoiesis. Ex vivo activated immune cells produced multiple cytokines, including several hematopoietic growth factors. Adherent cells were found to be more potent than nonadherent cells in promoting survival, and the therapy alone was capable of mobilizing peripheral blood stem cells in normal mice.

[Cost-benefit analysis on the replacement program of ordinary syringes by auto-disposal syringes in China].

OBJECTIVE: To explore the feasibility of replacement of ordinary syringes by auto-disposal syringes (AD) in China. METHODS: Sampling survey was conducted in Hebei province to collect data on the direct medical spending of hepatitis B and their Disability Adjusted Life Year (DALY) losses. The financial burden on hepatitis B was calculated based on the result of field survey as well as through data-base of the Second National Health Services Survey of MOH in 1998. The cost-benefit analysis was employed, in which the saving of the financial burden on hepatitis B patients attributing to unsafe injections was taken as the benefit of intervention and the increased expenditures of AD syringes as the costs. RESULTS: The total financial disease burden of Hepatitis B in China in 2001 was between RMB 16.19 and 20.17 billion Yuan and the financial disease burden per patient was between RMB 1755.38 and 1409.64 Yuan. Study on the cost-benefit analysis in the replacement intervention program showed high financial feasibility. The Benefit-Cost Ratio (BCR) of the measure was between 32.46 and 97.39, which was bigger in rural areas than that in cities. The direct BCR was less than one when the price gap between ordinary syringe and AD exceeded RMB 0.24 Yuan. CONCLUSION: The intervention of safe injection practice through universal usage of AD to replace ordinary syringe seemed to be applicable due to its high potential economic benefits.