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1.
Plant Cell Rep ; 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32025802

RESUMO

KEY MESSAGE: BIG regulates the shoot stem cell population. The shoot apical meristem (SAM) contains a population of self-renewing cells, and provides daughter cells for initiation and development of aerial parts of plants. However, the underlying mechanisms of SAM size regulation remain largely unclear. Here, we identified a mutant that displayed a large SAM, designated big-shoot meristem (big-m), in Arabidopsis thaliana. The phenotype of big-m is caused by a new T-DNA insertion allele of BIG, causing a loss of function. The big-m mutant had more stem cells in the SAM than in the wild type. Expression of WUSCHEL (WUS) and SHOOTMERISTEMLESS (STM) was promoted in big-m compared with the wild type, showing that BIG functions upstream of WUS and STM. Therefore, BIG is an important regulator of the stem cell population in the SAM. Furthermore, genetic analysis indicated that BIG acts synergistically with PIN-FORMED1 (PIN1) in controlling SAM size. Our results suggest that BIG plays an important role in controlling Arabidopsis thaliana SAM growth via PIN1-mediated auxin homeostasis.

2.
Menopause ; 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32049928

RESUMO

OBJECTIVE: To investigate the relationship between serum vitamin D concentration and lumbar disc degeneration (LDD) in postmenopausal women and the epidemiologic factors affecting low back pain (LBP). METHODS: Between July 2017 and December 2018, 232 participants were retrospectively enrolled. Serum concentrations of bone turnover markers were measured using electrochemiluminescence assays. Disc degeneration was evaluated using the Pfirrmann grading system. Other variables were assessed using relevant questionnaires. RESULTS: The mean age of the women was 65.6 ±â€Š10.1 and their serum 25(OH)D concentrations were 19.38 ±â€Š9.21 ng/mL. The prevalences of severe vitamin D deficiency (<10 ng/mL) and normal status (>30 ng/mL) were 12.9% and 12.5%, respectively. The severely deficient group had higher visual analog scale (VAS) scores for LBP (P = 0.002) and lower bone mineral density T scores (P = 0.004) than the other groups. Lower 25(OH)D concentration (<10 ng/mL) was significantly associated with more severe LDD in the lumbosacral region (L4-S1, L1-S1, P < 0.05), but less so in the upper lumbar region. There was an inverse relationship between vitamin D concentration and the severity of disc degeneration (L2-L3, L4-S1, L1-S1, P < 0.05). After adjustment for confounding factors, smoking, vitamin D deficiency, lack of vitamin D supplementation, high body mass index, and low bone mineral density T score were associated with higher incidence of moderate-to-severe pain in postmenopausal women (P < 0.05). CONCLUSIONS: Vitamin D deficiency is associated with LDD and LBP in postmenopausal women. Specifically, a serum vitamin D concentration < 10 ng/mL is a marker of severe LDD and LBP. Smoking, severe vitamin D deficiency, lack of vitamin D supplementation, high body mass index, and osteoporosis are associated with a higher prevalence of moderate-to-severe pain.

3.
World Neurosurg ; 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32035201

RESUMO

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed Primary non-Hodgkin lymphoma of the spine and it can induce spinal compression. Reports of lymphoma arising in bone adjacent to metallic prostheses are increasing. However, to our knowledge, DLBCL arising from a scar after lumbar fusion surgery has not been reported previously. CASE PRESENTATION: A 63-year-old man complained of a 2-month history of severe pain in the back and both legs, radiating down to the ankle, similar to sciatica with a past-history of L2-S1 decompression and fusion seven years ago. Imaging revealed an irregular mass in the epidural space and around the internal fixation surgical site, which was initially diagnosed as an epidural infectious abscess. Most of the lesion was completely excised and a detailed immuno-histopathological analysis was performed revealing the diagnosis of a DLBCL. After surgery and chemotherapy, he was discharged without complications. Unfortunately, he was died 2 years later due to brain metastasis. CONCLUSIONS: This case highlights the need to consider malignancy in the differential diagnosis, and carefully examine surgical specimens in revision surgery. Further understanding of the role of metal implants in the development of lymphoma is required.

4.
Chem Commun (Camb) ; 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32022003

RESUMO

We describe a colorimetric and fluorescent probe 3a to detect cellular peroxynitrite with high selectivity and sensitivity. 3a was successfully applied in the bioimaging of exogenous and endogenous peroxynitrite in living cells. The up-regulation of peroxynitrite in cancer cells and normal cells during 5-fluorouracil treatment was finally monitored.

5.
Nat Biomed Eng ; 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32015409

RESUMO

The low magnetic saturation of iron oxide nanoparticles, which are developed primarily as contrast agents for magnetic resonance imaging, limits the sensitivity of their detection using magnetic particle imaging (MPI). Here, we show that FeCo nanoparticles that have a core diameter of 10 nm and bear a graphitic carbon shell decorated with poly(ethylene glycol) provide an MPI signal intensity that is sixfold and fifteenfold higher than the signals from the superparamagnetic iron oxide tracers VivoTrax and Feraheme, respectively, at the same molar concentration of iron. We also show that the nanoparticles have photothermal and magnetothermal properties and can therefore be used for tumour ablation in mice, and that they have high optical absorbance in a broad near-infrared region spectral range (wavelength, 700-1,200 nm), making them suitable as tracers for photoacoustic imaging. As sensitive multifunctional and multimodal imaging tracers, carbon-coated FeCo nanoparticles may confer advantages in cancer imaging and hyperthermia therapy.

6.
Gene ; 735: 144407, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32007582

RESUMO

Krüppel-like factor13 (klf13), a member of the Krüppel-like factor family, plays a vital role in cell proliferation and differentiation. When sea cucumber Apostichopus japonicus is attacted by predators, it can spit viscera in order to escape attack, and then complete the intestine regeneration process within 15 days. However, the potential role of klf13 from A. japonicus (Aj-klf13) in the intestine regeneration of sea cucumber A. japonicus still remains unknown. In present paper, the full-length cDNA of klf13 gene from A. japonicus was cloned by RACE techniques, and it was composed of 2496 bp, including a 245 bp 5' UTR, a 1396 bp 3' UTR and a 855 bp open reading frame, which encoded a polypeptide of 284 amino acids and C2H2 zinc finger domains. The expression level of Aj-klf13 showed an increasing trend in intestine regeneration process of sea cucumber, and it reached the highest at 6 days, returning to the normal at 15 days. By western blot, the expression level of Aj-KLF13 protein was basically consistent with that of Aj-klf13 gene. The expression locations of protein by immunofluorescence indicated that Aj-KLF13 was widely expressed in the normal physiological state and intestine regeneration process of sea cucumbers, which was in the nucleus. There was tissue specificity of the protein, which was mainly distributed in luminal epithelium and coelomic epithelium. These results indicate that Aj-klf13 plays a crucial role in the intestine regeneration process of sea cucumber A. japonicus.

7.
Dermatol Ther ; : e13241, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32017310

RESUMO

Hand-foot syndrome (HFS) is a specific cutaneous toxicity caused by a variety of antitumor drugs. The most common drugs include capecitabine, pegylated liposomal doxorubicin and fluorouracil (PLD), tyrosine kinase inhibitor. It is a dose-limiting cutaneous toxicity of these drugs. We reported an advanced lung adenocarcinoma female patient, who developed a Grade 3 HFS after a third-line treatment with apatinib of 250 mg for 10 days, the patient developed intolerable pain with pruritus. Large erythema on the skin of the hand, with local ulceratio, exudation, and desquamation of cutaneous lesions. After treatment with 100 mg of thalidomide every night for 1 week, the patient's HFS was significantly relieved, and the duration of the remission was about 2 months, which not only significantly improved the patient's quality of life, but also maintained the antitumor strength.

8.
J Enzyme Inhib Med Chem ; 35(1): 468-477, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31902266

RESUMO

C-Met plays a crucial role in the development and progression of neoplastic disease. Type II c-Met inhibitors recognise the inactive DFG-out conformation of the kinase, result in better anti-tumour effects due to synergistic effect against the other kinases. According to our previous works, an (E)-N'-benzylidene group was selected as the initial fragment. Two series of (E)-N'-benzylidene hydrazides were designed by fragment growth method. The inhibitory activities were in vitro investigated against c-Met and VEGFR-2. Compound 10b exhibited the most potent inhibitory activity against the c-Met inhibitor (IC50 = 0.37 nM). Compound 11b exhibited multi-target c-Met kinase inhibitory activity as a potential type II c-Met inhibitor (IC50 = 3.41 nM against c-Met; 25.34 nM against VEGFR-2). The two compounds also demonstrate the feasibility of fragment-based virtual screening method for drug discovery.

9.
Arch Toxicol ; 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31897520

RESUMO

The evaluation of developmental and reproductive toxicity of food contact materials (FCMs) is an important task for food safety. Since traditional experiments are both time-consuming and labor-intensive, only a small number of FCMs have sufficient toxicological data for evaluating their effects on human health. While computational methods such as structural alerts and quantitative structure-activity relationships can serve as first-line tools for the identification of chemicals of high toxicity concern, models with binary outputs and unsatisfied accuracy and coverage prevent the use of computational methods for prioritizing chemicals of high concern. This study proposed a genetic algorithm-based method to develop a weight-of-evidence (WoE) model leveraging complementary methods of structural alerts, quantitative structure-activity relationships and in silico toxicogenomics models for chemical prioritization. The WoE model was applied to evaluate 623 food contact chemicals and identify 26 chemicals of high toxicity concern, where 13 chemicals have been reported to be developmental or reproductive toxic and further experiments are suggested for the remaining 13 chemicals without toxicity data related to developmental and reproductive effects. The proposed WoE model is potentially useful for prioritizing chemicals of high toxicity concern and the methodology may be applied to toxicities other than developmental and reproductive toxicity.

10.
J Hazard Mater ; 387: 121983, 2020 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-31911383

RESUMO

The use of indium in semiconductor products has increased markedly in recent years. The release of indium into the ecosystem is inevitable. Under such circumstances, effective and accurate assessment of indium risk is important. An indispensable aspect of indium risk assessment is to understand the interactions of indium with plants, which are fundamental components of all ecosystems. Physiological responses of Arabidopsis thaliana exposed to indium were investigated by monitoring toxic effects, accumulation and speciation of indium in the plant. Indium can be taken up by plants and is accumulated mainly in roots. Limited indium root-to-shoot translocation occurs because of immobilization of indium in the root intercellular space and blockage of indium by the Casparian band in the endodermis. Indium caused stunted growth, oxidative stress, anthocyanization and unbalanced phosphorus nutrition. Indium jeopardizes phosphate uptake and translocation by inhibiting the accumulation of phosphate transporters PHOSPHATE TRANSPORTER1 (PHT1;1/4), responsible for phosphate uptake, and PHOSPHATE1 (PHO1), responsible for phosphate xylem loading. Organic acid secretion is stimulated by indium exposure. Secreted citrate could function as a potential detoxifier to lower indium uptake. Our findings provide insights into the potential fate and effects of indium in plants and will aid the evaluation of risks with indium contamination.

11.
J Hazard Mater ; 389: 122117, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31978821

RESUMO

Coconut-fiber biochar (CFB) was applied at 3% (w/w) to two soils spiked with 250, 2500, 5000 mg kg-1 of lead (Pb), respectively, aiming to explore the effects of CFB and the significance of iron (Fe) plaque on rice roots on the accumulation and translocation of Pb in rice plants using micro-X-ray fluorescence and X-ray absorption spectroscopies. The CFB amendment resulted in a significant decrease in the EDTA-extractable Pb availability in the soils, which might be attributed to the increased amounts of Pb-loaded humic acid and Pb3(PO4)2 formed in the soils. Consequently, the addition of CFB caused a significant decrease in Pb concentrations of the brown rice harvested from the CFB-amended soils under all Pb levels by 14 %-47 %, as compared to those from the unamended soils. Therefore, CFB could be used as an immobilizing agent for Pb in contaminated soils. However, CFB application significantly inhibited the formation of Fe/Mn plaques on rice roots and reduced its interception effect on Pb uptake, which consequently increased the Pb translocation rate from root to shoot. Therefore, the increased translocation rate of Pb in rice plants by CFB should not be ignored when CFB is applied to remediate Pb-contaminated paddy soils.

12.
Mater Sci Eng C Mater Biol Appl ; 108: 110506, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31923929

RESUMO

Sponges, which are parasitic on plants widely found in lakes and oceans, represent a vast resource that has yet to be effectively utilised. Sponge spicules (SS), which contain high amounts of silica dioxide, form after long-term biomineralisation. In this study, SS attached to plant bodies were subjected to acid and heat treatments, followed by grinding, to obtain 10-40-nm siliceous sponge spicules (SSS). SSS and polylactic acid (PLA) were then combined to create 50-450-nm PLA/SSS composite nanofibers. The morphology and bioactivity of the electrospun PLA/SSS nanofibers were examined; the tensile, thermal, and water-resistant properties of the fibers were also evaluated. Our results showed a dramatic enhancement in the thermal and tensile properties of PLA with increasing SSS content; specifically, a 3 wt% increase in SSS content resulted in a 47 °C increase in the initial decomposition temperature and a 73.3-MPa increase in Young's modulus. The water resistance of PLA/SSS increased with SSS content, as indicated by the increase in the water contact angle compared with PLA nanofibers. PLA/SSS nanofibers also exhibited slightly enhanced human foreskin fibroblast cell proliferation, good cytocompatibility, and an antibacterial effect. The enhanced antibacterial and biodegradable properties of PLA/SSS are expected to be useful in biomedical material applications.

13.
J Affect Disord ; 263: 667-675, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31780131

RESUMO

BACKGROUND: The present study aimed to determine whether there were gender differences in the effects of prenatal maternal depression on motor development in newborn infants, and further to explore the role of plasma homocysteine in the delayed motor development in male newborn infants following prenatal maternal depression. METHODS: The term pregnant women within 37-42 weeks of gestation were assessed depressive symptoms by Hamilton Rating Scale for Depression. According to the gender of the newborn infants, all the subjects were divided into four groups: female control group (n = 45), male control group (n = 47), female depression group (n = 50), male depression group (n = 60). Motor development in newborn infants were assessed by Neonatal Behavioral Assessment Scale. Plasma homocysteine concentrations both in mothers and newborn infants were measured by enzymatic cycling assay. RESULTS: There were the worse scores of the items of motor development and significantly higher plasma homocysteine concentrations  in the male newborn infants of depression group than those of the female depression group and female control group, male control group, respectively. Plasma homocysteine concentrations significantly correlated with the items of motor development in all newborn infants, including the depression group and control group. LIMITATIONS: We should further explore homocysteine-mediated gender-dependent effects of prenatal maternal depression on motor development in newborn infants in the long-term follow-up. CONCLUSIONS: Prenatal maternal depression could result in delayed motor development in male newborn infants, but not female newborn infants. Plasma homocysteine may mediate gender-dependent effects of prenatal maternal depression on motor development in newborn infants.

14.
Appl Microbiol Biotechnol ; 104(2): 861-871, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31822981

RESUMO

INTRODUCTION: Naphthalene catabolic strain Pseudomonas putida ND6 harbors two megaplasmids pND6-1 and pND6-2; naphthalene-degrading associated genes are located on pND6-1, while plasmid pND6-2 possesses potential coding genes for conjugative transfer. METHODS: In this study, the recombinant ND6 in which pND6-1 and pND6-2 were labeled with gentamicin and kanamycin-encoding genes, respectively, was constructed to investigate the conjugative transfer behavior of the two plasmids in distinct aqueous matrices. RESULTS: The results indicated that both pND6-1 and pND6-2 plasmids could transfer from donor strain ND6 to a recipient strain P. putida KT2440, while the transfer frequency of pND6-2 (1.90 × 10- 2) was significantly higher than that of pND6-1 (3.12 × 10- 9). Furthermore, the concomitant transfer of pND6-1 and pND6-2 was confirmed at a lower frequency of 10- 9 colonies per recipient similar with that of pND6-1. The conjugative transfer efficiency was obviously affected by the initial inoculum and the stability of microbes. Moreover, more than 90% of the transconjugants lost the plasmids after 20 generations cultivation without resistance pressure, suggesting the importance of selective pressure to maintain the plasmid stability. Finally, the naphthalene degradation analysis by mixed ND6 and KT2440 revealed that conjugative transfer of catabolic plasmids contributed to the rapid dispersion of the degradation genes on plasmids and enhanced the naphthalene removal.

15.
Food Chem ; 310: 125867, 2020 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31767486

RESUMO

Phosphorylation could improve functional characteristics of proteins/peptides, and might be used in the functional improvement of herring egg peptides owing to their enriched phosphorylation sites. The present study aimed to study the effect of phosphorylation on calcium-binding ability of herring egg peptides, and investigate the conformational structure and intermolecular forces of herring egg phosphopeptides (HEPPs)-calcium complex. The HEPPs were found to be superior in calcium-binding activities, as compared to the non-phosphorylated variant. This finding might be attributed to the interaction between calcium ions and the introduced phosphate groups of HEPPs. Calcium favored the formation of ß-sheet structure on the HEPPs and induced structural folding, thus assembling into spherical nanoparticles. The conformation of HEPPs-Ca nanoparticles was formed and stabilized mainly by hydrophobic interaction, hydrogen bonds and electrostatic interaction.

16.
Am J Pathol ; 190(1): 176-189, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31676329

RESUMO

Nephronophthisis (NPHP), the leading genetic cause of end-stage renal failure in children and young adults, is a group of autosomal recessive diseases characterized by kidney-cyst degeneration and fibrosis for which no therapy is currently available. To date, mutations in >25 genes have been identified as causes of this disease that, in several cases, result in chronic DNA damage in kidney tubular cells. Among such mutations, those in the transcription factor-encoding GLIS2 cause NPHP type 7. Loss of function of mouse Glis2 causes senescence of kidney tubular cells. Senescent cells secrete proinflammatory molecules that induce progressive organ damage through several pathways, among which NF-κB signaling is prevalent. Herein, we show that the NF-κB signaling is active in Glis2 knockout kidney epithelial cells and that genetic inactivation of the toll-like receptor (TLR)/IL-1 receptor or pharmacologic elimination of senescent cells (senolytic therapy) reduces tubule damage, fibrosis, and apoptosis in the Glis2 mouse model of NPHP. Notably, in Glis2, Tlr2 double knockouts, senescence was also reduced and proliferation was increased, suggesting that loss of TLR2 activity improves the regenerative potential of tubular cells in Glis2 knockout kidneys. Our results further suggest that a combination of TLR/IL-1 receptor inhibition and senolytic therapy may delay the progression of kidney disease in NPHP type 7 and other forms of this disease.

17.
Nucleic Acids Res ; 48(2): 709-718, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31713613

RESUMO

DNA interstrand crosslinks (ICLs) induced by the highly genotoxic agent azinomycin B (AZB) can cause severe perturbation of DNA structure and even cell death. However, Streptomyces sahachiroi, the strain that produces AZB, seems almost impervious to this danger because of its diverse and distinctive self-protection machineries. Here, we report the identification of a novel endonuclease-like gene aziN that contributes to drug self-protection in S. sahachiroi. AziN expression conferred AZB resistance on native and heterologous host strains. The specific binding reaction between AziN and AZB was also verified in accordance with its homology to drug binding proteins, but no drug sequestering and deactivating effects could be detected. Intriguingly, due to the high affinity with the drug, AziN was discovered to exhibit specific recognition and binding capacity with AZB-mediated ICL structures, further inducing DNA strand breakage. Subsequent in vitro assays demonstrated the structure-specific endonuclease activity of AziN, which cuts both damaged strands at specific sites around AZB-ICLs. Unravelling the nuclease activity of AziN provides a good entrance point to illuminate the complex mechanisms of AZB-ICL repair.

18.
Chemosphere ; 241: 124956, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31605996

RESUMO

High contents of arsenic were detected in soils in Guandu plain, northwest Taiwan. To determine the sources and speciation of As in the soils, the depth profiles of soil properties, elemental composition and As speciation were investigated. The As concentrations in the soil profile ranged from 152 to 1222 mg kg-1, with the highest concentration at the depth of 70-80 cm. The As distribution was found to be positively correlated to Fe, Pb, and Ba. The As(V)-adsorbed ferrihydrite and scorodite were the predominant phases in the top layers (<50 cm), while beudantite was the predominant phase below 50 cm along with As(III)- and As(V)-adsorbed ferrihydrite as the minor components. The results of sequential extraction showed that As-associated with noncrystalline and crystalline Fe/Al hydrous oxides and residual phases were predominant at the depths of 0-60, 60-100 and 100-140 cm, respectively, indicating an increasing As recalcitrance with soil depth. Based on the soil properties, and elemental and mineral compositions at different soil depths, the origin of beudantite in the soils was likely allogenic rather than authigenic or anthropogenic. The formation of scorodite in the surface soils was suggested to be transformed from beudantite. As-associated Fe hydrous oxides may be contributed by the progressive dissolution of beudantite and scorodite, and the continuous influxes of As and Fe. While Fe hydrous oxides were able to immobilize As during the dissolution of As-bearing minerals, the increase of As mobility in soils may imply an increase in the environmental risk of As over time.

19.
Spine (Phila Pa 1976) ; 45(1): E18-E24, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31415460

RESUMO

STUDY DESIGN: Retrospective comparative cohort study. OBJECTIVE: Assess the incidence, risk factors, and outcomes of recurrent proximal junctional kyphosis (r-PJK) in PJK revision patients. SUMMARY OF BACKGROUND DATA: Several studies have identified the incidence and risk factors for PJK after primary surgery. However, few studies have reported on PJK recurrence after revision for PJK. METHODS: A multicenter database of patients who underwent PJK revision surgery with minimum 2-year follow-up was analyzed. Demographic, operative, and radiographic outcomes were compared in patients with r-PJK and patients without recurrence no-Proximal Junctional Kyphosis (n-PJK). Postoperative Scoliosis Research Society-22r, Short Form-36, and Oswestry Disability Index were compared. Preoperative and most recent spinopelvic, cervical, and cervicothoracic radiographic parameters were compared. Univariate and multivariate analyses were used to determine r-PJK risk factors. A predictive model was formulated based on our logistic regression analysis. RESULTS: A total of 70 patients met the inclusion criteria with an average follow-up of 21.8 months. The mean age was 66.3 ±â€Š9.4 and 80% of patients were women. Before revision, patients had a proximal junctional angle angle of -31.7°â€Š±â€Š15.9°. The rate of recurrent PJK was 44.3%. Logistic regression showed that pre-revision thoracic pelvic angle (odds ratio [OR]: 1.060 95% confidence interval [CI] 1.002; 1.121; P = 0.042) and prerevision C2-T3 sagittal vertical axis (SVA; OR: 1.040 95% CI [1.007; 1.073] P = 0.016) were independent predictors of r-PJK. Classification with these parameters yielded an accuracy of 72.7%, precision of 80.6%, and recall of 73.5%. When examining correction, or change in alignment with revision surgery, we found that change in SVA (OR: 0.981 95% CI [0.968; 0.994] P = 0.005) was the only predictor of r-PJK with accuracy of 66.7%, precision of 74.2%, and recall of 69.7%. CONCLUSION: Patients after PJK revision surgery had a recurrence rate of 44%. Logistic regression based on the prerevision variables showed that prerevision thoracic pelvic angle and prerevision C2-T3 SVA were independent predictors of r-PJK. LEVEL OF EVIDENCE: 4.

20.
Eur J Surg Oncol ; 46(1): 115-122, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31471089

RESUMO

BACKGROUND: The surgical and oncological outcome of extra-levator abdominoperineal excision (ELAPE) procedure remains unclear in low rectal cancer. METHODS: A total of 194 cases of rectal cancer patients underwent ELAPE or conventional abdominoperineal excision (APE) procedure were analyzed in four hospitals' databases from January 2010 to December 2015. Clinicopathological data, overall survival (OS), disease free survival (DFS) and local recurrence free survival (LRFS) of patients were compared between two groups. RESULTS: The operation time spent in perineal phase was significantly shorter in the ELAPE group than that in conventional APE procedure (P < 0.001). There were more specimens with excellent or good quality in ELAPE group compared to conventional APE group (P = 0.033). Patients whom underwent ELAPE procedures showed significantly better OS, DFS and LRFS than those underwent conventional APE procedures. Patients with preoperative stage cT3∼T4 (P = 0.033, P = 0.008, P = 0,033), cN+ (P = 0.002, P < 0.001, P = 0.006) and pathological stage III-IV (P = 0.023, P = 0.008, P = 0.016) were associated with significant benefits from ELAPE procedure in terms of OS, DFS and LRFS. DFS differed significantly between two groups of patients whom got preoperative chemoradiation therapy (P = 0.009) or postoperative chemotherapy (P = 0.029). For patients of pathological stage IIII-IV without preoperative chemoradiation, ELAPE procedures resulted in statistically better OS (P = 0.018) and DFS (P = 0.030). ELAPE procedure was an independent risk factor of OS, DFS and LRFS in multivariate analysis. CONCLUSION: Low rectal cancer patients might benefit from ELAPE procedure on both surgical and oncological outcomes, especially in patients with relatively advanced tumors, inspite of the effects of pre-operative radio- and chemotherapy.

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