Metastatic incidence of (PET)CT positive lung hilar and retroperitoneal lymph nodes in esophageal cancer patients

BackgroundExtra-regional lymph node metastases strongly determine treatment options in patients with esophageal cancer. Staging modalities such as (FDG-PET) CT scanning frequently show activity in retroperitoneal and lung hilar lymph nodes. This study evaluated the incidence of histologically confirmed metastases, treatment approach and recurrence patterns in patients with (FDG-PET) CT positivity in these regions.MethodsAll patients with (FDG-PET-) CT positive hilar and/or retroperitoneal lymph nodes at primary staging or restaging discussed at a multidisciplinary tumor board meeting for staging of esophageal cancer between January 2012–December 2017 were included. Biopsies and follow-up were evaluated to determine the presence of metastases and progression rates.ResultsFrom 2012 to 2017, 65 of 857 patients (7.6%) were selected with positive retroperitoneal and/or hilar lymph nodes. A total of 47/65 (72.3%) patients had positive retroperitoneal lymph nodes, which contained metastases in 19 (29.2%). When no biopsy was performed and curative treatment was given (n = 14), 9 patients had progression or locoregional and distant recurrence. Positive hilar lymph nodes were identified in 21 (32.3%) patients; 4 were biopsied and none contained metastases. In these patients no recurrence of disease was seen during follow-up.ConclusionsThe majority of biopsied (PET)CT-positive retroperitoneal lymph nodes at staging contained metastases, while biopsied (PET)CT-positive hilar nodes did not. Histological evaluation of (PET)CT -positive retroperitoneal lymph nodes at staging imaging is recommended, while based on this small series, (PET)CT-positive hilar lymph nodes most likely represent reactive lymphadenopathy.     

4种常见清热燥湿类中药对肠道菌群及粪便胆汁酸和短链脂肪酸代谢的影响

  目的  探究在长期临床等效剂量下4种清热燥湿类中药对正常小鼠肠道菌群、胆汁酸及短链脂肪酸的影响。  方法  30只Balb/c雄性小鼠被随机分为对照组、苦参组、黄连组、黄柏组和黄芩组, 每组各6只。除对照组外, 苦参组、黄柏组、黄连组和黄芩组给药剂量分别为2.34、3.12、1.3 g·kg-1和2.6 g·kg-1, 连续灌胃2周, 采用液相色谱-串联质谱法检测粪便中短链脂肪酸和胆汁酸含量, 利用16S rRNA高通量基因测序技术分析肠道内容物中菌群结构变化。  结果  清热燥湿类中药对正常小鼠粪便中6种短链脂肪酸无明显影响。在常见的23种胆汁酸中, 与正常组相比, 黄芩组、苦参组、黄连组和黄柏组分别有4、3、2、1种胆汁酸显著变化。从肠道菌群丰度变化上看, 与对照组相比, 除苦参组外, 黄连组、黄芩组和黄柏组小鼠厚壁菌门均呈现下降趋势, 拟杆菌门均呈现上升趋势, 其中黄连组变化更显著。  结论  苦参、黄柏、黄连和黄芩对正常小鼠长期药效剂量下短链脂肪酸影响较小, 但可以通过改变肠道菌群结构影响胆汁酸含量的变化。      

A homozygous MITF mutation leads to familial Waardenburg syndrome type 4

Waardenburg syndrome (WS) is a genetic disorder characterized by hearing loss and pigmentary abnormalities with variable penetrance. Though heterozygous mutations in MITF are a major cause for Waardenburg syndrome type 2 (WS2), homozygous mutations in this gene and the associated phenotype have been rarely characterized. In this study, we identified a novel p.R223H mutation in MITF in a Chinese Han family with variable WS features. Both parents carried a heterozygous p.R223H mutation. They had normal hearing, and premature greying of the hair is their only pigmentary abnormality. In contrast, their two children both carried a homozygous p.R223H mutation and had classic WS features including profound hearing loss, heterochromia irides and marked pigmentary abnormalities in hair and skin. Interestingly, the two affected children also have persistent chronic constipation since the neonatal period, symptoms suggestive of Waardenburg syndrome type 4 (WS4). Our study revealed a likely association between homozygous mutations in MITF and WS4, which implies a dosage effect for the underlying pathogenesis mechanism.     

人工组织神经移植物对大鼠陈旧性坐骨神经缺损(60天)的修复作用

目的 观察人工组织神经移植物对陈旧性大鼠坐骨神经缺损的修复作用.方法 切除成年SD大鼠部分左侧坐骨神经,饲养60d形成陈旧性坐骨神经缺损后,以人工组织神经移植物修复缺损,同时设自体神经修复和不修复两对照组.修复术后3个月做神经-肌复合电位、腓肠肌湿重及再生神经形态学检测.结果 人工组织神经移植物修复组实验侧的运动神经传导速度、腓肠肌湿重、移植物远侧再生神经有髓神经纤维髓鞘厚度等结果与自体神经修复组相似.不修复对照组则未记录到神经-肌复合电位,未观察到再生神经纤维结构,腓肠肌湿重明显小于人工组织神经移植组和自体神经移植组.结论 人工组织神经移植物在一定程度上能修复缺损60d的大鼠坐骨神经.     

大鼠坐骨神经缺损半个月后人工组织神经移植物修复的实验研究

为了观察人工组织神经移植物对大鼠坐骨神经非新鲜损伤的修复作用。我们在成年SD大鼠左侧股中部切除部分坐骨神经制造神经缺损模型。15d后,实验组(9只)用人工组织神经移植物修复神经缺损,自体神经修复作为阳性对照(6只),保持神经缺损为阴性对照(6只)。第二次手术后3个月,电生理学、形态学结果显示实验组的再生神经虽略差于自体对照组,但明显优于缺损对照组,腓肠肌的萎缩形态学指标变化则较接近自体对照组。实验结果表明人工组织神经移植物对已缺损15d的大鼠周围神经具有较好修复作用。