[Clinical analysis of 12 cases of laryngeal neuroendocrine carcinoma].

Objective: To investigate the clinical and pathological features, treatments and prognosis of laryngeal neuroendocrine carcinoma (LNEC). Methods: We conducted the retrospective analysis of the clinical data of 12 patients with LNEC admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Second Hospital of Shanxi Medical University from May 2014 to December 2021, including 9 males and 3 females, aged 50-77 years. There were 4 cases of typical carcinoid tumour (highly differentiated), 5 cases of atypical carcinoid tumour (moderately differentiated) and 3 cases of neuroendocrine small cell carcinoma (hypofractionated). The clinical features, diagnosis, treatment and prognosis of LNEC were analysed. Results: The clinical manifestations of LNEC varied according to the tumour type but did not correlate with the pathological types. The supraglottic type was characterized by sore throat, foreign body sensation in the pharynx, coughing, obstructive sensation when eating and choking on water. The treatments were determined according to the pathological types, lesion location and invasion scope. Of 12 patients 4 underwent horizontal partial laryngectomy plus elective lymphatic dissection plus postoperative radiotherapy/chemotherapy, 4 underwent vertical partial laryngectomy (3 of them with cervical lymphatic dissection), 3 underwent supported laryngoscopic plasma laryngectomy for laryngeal cancer, and 1 abandoned for treatment. With the follow-up of 8 -78 months, 5 patients were alive, 1 died from chemotherapy reactions, 3 died from other diseases, 1 died from lung metastasis, 1 died from lung infection and 1 was lost to follow-up. Conclusion: LNEC is clinically rare, the clinical manifestations are less specificity, diagnosis relies on pathological and immunohistochemical examinations, and treatment modalities and prognoses are closely related to the pathological subtypes of LNEC.

[Randomized controlled trial on application of negative pressure materials of polyvinyl alcohol and polyurethane in full-thickness burn wounds after escharotomy].

Objective: To compare the effects and characteristic difference of negative pressure materials of polyvinyl alcohol and polyurethane in the treatment of full-thickness burn wounds after escharotomy. Methods: From January 2018 to December 2019, 60 patients with full-thickness burns who met the inclusion criteria and hospitalized in Xuzhou Renci Hospital were recruited in this prospective randomized controlled trial. According to the random number table, 60 cases were divided into polyvinyl alcohol group (n =30, 13 males and 17 females) and polyurethane group (n =30, 14 males and 16 females), aged (34±7) and (35±6) years respectively, with burn area of 4.20% (2.23%, 4.90%) total body surface area (TBSA) and 3.89% (2.18%, 4.76%)TBSA and escharectomy area of 2.70% (1.97%, 3.42%) TBSA and 2.87% (2.12%, 3.34%)TBSA, respectively. After patient's admission, debridement was immediately performed on the full-thickness burn wound, and the dressing was changed with iodophor once a day. Escharectomy was performed on post injury day 3. After thorough hemostasis and washing the wounds with normal saline, patients of the two groups chose corresponding foam materials and supporting facilities for continuous negative-pressure treatment for 1 week, with the negative pressure value setting at -19.9 kPa. Installation time of negative-pressure material was recorded. After a week of negative-pressure treatment, the maximum pulling force of removing foam material was recorded to evaluate the adhesional degree between foam materials and wounds. The amount of bleeding in the process of removing foam materials was recorded, hyperplasiaof granulation tissue was observed with hematoxylin eosin (HE) staining, and the expression of CD31 was detected by immunohistochemical staining and Western blotting to denote vascularization. The ratio of R1 to R0 of coefficient of restitution of foam material before and one week after negative-pressure treatment and drainage volume of wound exudate within a week of negative-pressure treatment were recorded to denote the drainage ability of foam material to wound exudate. One week after negative-pressure treatment, the bacterial colonization, residual foreign body, and eczema rate of skin edge were recorded. Data were statistically analyzed with chi-square test, independent-sample t test, and Mann-Whitney U test. Results: (1) Installation time of negative-pressure material of patients in polyurethane group was (14±3) min, which was significantly shorter than (18±3) min in polyvinyl alcohol group (t=2.788, P<0.01). (2) One week after negative-pressure treatment, the maximum pulling force of removing foam material of patients in polyvinyl alcohol group was (6.4±0.4) N, which was significantly lower than (16.7±0.8) N in polyurethane group (t=12.010, P<0.01). (3) One week after negative-pressure treatment, the volume of wound bleeding of patients in polyvinyl alcohol group was (20±3) mL in the process of removing foam material, which was significantly less than (59±3) mL in polyurethane group (t=50.200, P<0.01). (4) One week after negative-pressure treatment, HE staining showed that hyperplastic thickness of wound granulation tissue of patients in polyurethane group was (2.3±0.6) mm which was significantly higher than (1.6±0.4) mm in polyvinyl alcohol group ( t=6.667, P<0.01); immunohistochemical staining showed that the number of microvascular lumen in wound granulation tissue of patients in polyurethane group was significantly more than that in polyvinyl alcohol group; Western blotting showed that protein expression of CD31 in wound granulation tissue of patients in polyurethane group (1.00±0.05) was significantly higher than 0.42±0.03 of polyvinyl alcohol group (t=10.490, P<0.01). (5)The ratio of R1 to R0 of coefficient of restitution of foam material of patients in polyvinyl alcohol group was 0.39±0.19, which was significantly lower than 0.52±0.16 in polyurethane group (t=2.975, P<0.01). In patients of polyvinyl alcohol group, the drainage volume of wound exudate of foam material during one week after negative-pressure treatment was (1 258±444) mL, significantly less than (1 658±580) mL of polyurethane group (t=3.003, P<0.01). (6) One week after negative-pressure treatment, the number of residual foreign body in wounds of patients of polyurethane group was (14.14±0.37) particles, which was significantly more than (3.36±0.15) particles in polyvinyl alcohol group (t=26.200, P<0.01). The level of bacterial colonization of wounds and eczema rate of skin edge of patients between the two groups were close. Conclusions: Polyurethane foam material is easy to install and operate, relatively difficult to dry and shrink, and has strong ability to discharge wound exudation. Polyurethane foam material is better than polyvinyl alcohol foam material in promoting wound angiogenesis and tissue proliferation. Polyurethane foam material can be chosen firstly for the wounds with need of protecting deep tissues and important organs, as well as the wounds with obvious inflammatory edema and serious contamination. Polyvinyl alcohol foam material is less adherent to wounds, which is better than polyurethane foam material in the aspects of reducing wound bleeding and residual foreign body. Polyvinyl alcohol foam material can be firstly selected to fix and promote skin graft survival after skin grafting, wound bed preparation before skin grafting of burn with large area and deep wound cavity or sinus, etc. Both types of foam materials need to be improved in the aspects of bacterial colonization and prevention and treatment of skin eczema.

LncRNA DSCAM-AS1 promoted cell proliferation and invasion in osteosarcoma by sponging miR-101.

OBJECTIVE: Long noncoding RNAs (lncRNAs) play critical roles in osteosarcoma (OS) progression. LncRNA DSCAM-AS1 has been reported to function as a tumor promoter in various cancers. However, the potential mechanism of DSCAM-AS1 in OS remains rarely know. PATIENTS AND METHODS: The expression levels of DSCAM-AS1 and miR-101 were detected by RT-qPCR. The correlation between DSCAM-AS1 and miR-101 expression was analyzed by Pearson's correlation. Kaplan-Meier analysis was used to assess the overall survival rate. Cell viability and invasion were assessed by MTT assay and transwell assays, respectively. A Luciferase reporter assay was used to identify the relationship between DSCAM-AS1 and miR-101. RESULTS: In the present study, it was demonstrated that DSCAM-AS1 expression was significantly upregulated in OS tissues and cells and high expression of DSCAM-AS1 predicted poor prognosis in OS patients. In addition, the silencing of DSCAM-AS1 suppressed the viability and invasion of OS cells, while DSCAM-AS1 overexpression promoted cell viability and invasion. Furthermore, we found that DSCAM-AS1 inhibited miR-101 expression by direct interaction and DSCAM-AS1 promoted OS progression by sponging miR-101. In addition, miR-101 expression was negatively correlated with DSCAM-AS1 expression. Patients with low miR-101 expression had a shorter overall survival time compared with those with high miR-101 expression. CONCLUSIONS: The present study demonstrated that DSCAM-AS1 accelerated OS cell progression by sponging miR-101, which might provide a new sight in the treatment of OS.

SPARCL1 suppresses osteosarcoma metastasis and recruits macrophages by activation of canonical WNT/ß-catenin signaling through stabilization of the WNT-receptor complex.

Metastasis significantly reduces the survival rate of osteosarcoma (OS) patients. Therefore, identification of novel targets remains extremely important to prevent metastasis and treat OS. In this report, we show that SPARCL1 is downregulated in OS by epigenetic methylation of promoter DNA. In vitro and in vivo experiments revealed that SPARCL1 inhibits OS metastasis. We further demonstrated that SPARCL1-activated WNT/ß-catenin signaling by physical interaction with various frizzled receptors and lipoprotein receptor-related protein 5/6, leading to WNT-receptor complex stabilization. Activation of WNT/ß-catenin signaling contributes to the SPARCL1-mediated inhibitory effects on OS metastasis. Furthermore, we uncovered a paracrine effect of SPARCL1 on macrophage recruitment through activated WNT/ß-catenin signaling-mediated secretion of chemokine ligand5 from OS cells. These findings suggest that the targeting of SPARCL1 as a new anti-metastatic strategy for OS patients.

Research on the correlation of diabetes mellitus complicated with osteoporosis with lipid metabolism, adipokines and inflammatory factors and its regression analysis.

OBJECTIVE: To investigate the correlation of type 2 diabetes mellitus (DM) complicated with osteoporosis with lipid metabolism, adipokines and inflammatory factors, and to define the risk factors via the multivariate regression analysis. PATIENTS AND METHODS: A total of 80 patients with DM admitted into our hospital from November 2015 to November 2016 were enrolled, including 40 patients complicated with osteoporosis and 40 patients not complicated with osteoporosis. The levels of blood lipid, adipokines and inflammatory factors were compared; the correlations between bone mineral density (BMD) and total cholesterol (TC), adiponectin and tumor necrosis factor-α (TNF-α) were analyzed; and multivariate Logistic regression analysis was performed for osteoporosis, hyperlipidemia, abnormal adipokine levels and body's inflammatory response. RESULTS: The levels of serum lipid indexes, total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C), in patients without complicating osteoporosis were significantly lower than those in patients complicated with osteoporosis. The level of high-density lipoprotein cholesterol (HDL-C) was significantly higher than that in patients complicated with osteoporosis. The levels of adipokines, adiponectin and visfatin, in patients without complicating osteoporosis were significantly lower than those in patients complicated with osteoporosis. The levels of inflammatory factors, TNF-α, interleukin-6 (IL-6) and C-reactive protein (CRP), in patients without complicating osteoporosis were significantly lower than those in patients complicated with osteoporosis. There were negative correlations between BMD and TC, adiponectin and TNF-α. Abnormal blood lipid, abnormal adipokine levels and elevated inflammatory factor levels were independent risk factors for osteoporosis. CONCLUSIONS: Enhanced inflammatory response, abnormal blood lipid metabolism and abnormal changes in adipokines may increase the risk of osteoporosis in patients with diabetes mellitus.

Comparison of lumbar pedicular dynamic stabilisation systems versus fusion for the treatment of lumbar degenerative disc disease: A meta-analysis.

This study aimed to systematically compare the safety, effectiveness and radiological changes after lumbar pedicular dynamic stabilisation systems and fusion to treat lumbar degenerative disc disease . All studies that were performed to compare various lumbar pedicular dynamic stabilisation systems with any lumbar fusion to treat lumbar degenerative disc disease and were published until April 30, 2015 were acquired through a comprehensive search in various databases. A meta-analysis was performed after the methodological qualities of trials were assessed and after data were extracted. Sixteen trials with 881 patients with a short-term follow-up (within 2 years) and a middle-term follow-up (2 to 4 years) were identified. Patients treated with lumbar pedicular dynamic stabilisation systems experienced more significant advantages in terms of operation time, intra-operative blood loss, complications and adjacent segment degeneration/disease development than those treated with lumbar fusion. The two groups did not significantly differ in terms of improvement in Oswestry Disability Index, visual analogue scale scores, satisfaction rate of operation and range of motion of adjacent segments. Lumbar pedicular dynamic stabilisation systems is superior to lumbar fusion to some extent, although some of its advantages have yet to be verified and compared with those of lumbar fusion. However, the two interventions were not significantly different in terms of relief in symptoms, functional recovery and motion preservation. Thus, lumbar pedicular dynamic stabilisation systems is recommended for its safety. A prudent attitude is necessary to choose between these interventions on the basis of effectiveness and changes in adjacent segments before a large-scale and long-term follow-up study can be performed.

An updated meta-analysis of the Fc receptor-like 3 -169T/C polymorphism and rheumatoid arthritis risk.

OBJECTIVES: Published studies have shown conflicting results concerning the association between the -169T/C promoter polymorphism in the Fc receptor-like 3 (FCRL3) gene and rheumatoid arthritis (RA). In this study we conducted an up-to-date meta-analysis to examine the relationship. METHOD: We searched the PubMed database for all papers published up to 20 April 2012. Overall, 18 case-control studies with 12 620 cases and 12 613 controls were retrieved based on the search criteria for RA susceptibility related to the FCRL3 -169T/C polymorphism. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the strength of this association. Publication bias was assessed using the Egger test. RESULTS: We found that the FCRL3 -169T/C polymorphism increased the risk for RA overall in genetic models (allelic contrast: OR 1.09, 95% CI 1.03-1.14, p = 0.001; homozygote comparison: OR 1.20, 95% CI 1.08-1.34, p = 0.001; dominant genetic model: OR 1.03, 95% CI 1.01-1.05, p = 0.001). Stratified analysis by race also showed a significant positive association with Asians and Caucasians. Subgroup analysis of rheumatoid factor (RF) revealed a slightly positive relationship between the FCRL3 -169T/C polymorphism and RF-positive RA risk. No obvious evidence of publication bias was detected in the overall analysis. CONCLUSION: Our study indicates that the FCRL3 -169T/C polymorphism is significantly associated with increased RA risk.