Non-canonical role of Hippo tumor suppressor serine/threonine kinase 3 STK3 in prostate cancer

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Comparing bone resorption after anatomical shoulder arthroplasty between various surgical procedures using a single-stem model

BackgroundIn shoulder arthroplasty, bone resorption around the stem can lead to stem loosening and makes surgery difficult at the time of revision. Proximal bone resorption after reverse shoulder arthroplasty can cause instability because of a decrease of deltoid wrapping effect. As factors of the stem itself, such as stem coating, shape, length, and use of bone cement, may also affect bone resorption, a single-stem model should be used to compare bone resorptions between different pathologies and surgical procedures. However, to date, a few reports have compared these differences in detail using a single-stem model. Therefore, we investigated the prevalence and location of humeral bone resorption in a single-stem model.MethodsThe study included 100 shoulders that underwent anatomical total shoulder arthroplasty (TSA) or humeral head replacement (HHR) with a single uncemented humeral stem from 2008 to 2018. The patients were 31 men and 69 women. The mean age at surgery was 72.9 years (range, 41-86 years). The patients were divided into three groups: especially, 25, 61, and 14 shoulders received TSA for primary osteoarthritis without rotator cuff tears (TSA group), HHR using an anatomical head with rotator cuff repair for cuff tear arthropathy (CTA) (HHR group), and HHR using a CTA head without rotator cuff repair (CTA group), respectively. Patients were monitored for a mean of 56 months (range, 12-98 months). The location of bone resorption was divided into seven zones as follows: zone 1, greater tuberosity; zone 2, lateral diaphysis; zone 3, lateral diaphysis beyond the deltoid tuberosity; zone 4, tip of the stem; zone 5, medial diaphysis beyond the deltoid tuberosity; zone 6, medial diaphysis; and zone 7, calcar region. The degree of bone resorption was classified from grade 0 to 4.ResultsBone resorption of grade 3 or higher was significantly more frequent at the greater tuberosity in the HHR and CTA groups (P < .001 and P < .001, respectively) than that in the TSA group. Grade 4 bone resorption was significantly more frequent in the CTA than that in the TSA and HHR groups in zone 1 (P = .016 and P = .041, respectively).ConclusionThe state of attachment of the rotator cuff to the greater tuberosity might affect bone resorption at the greater tuberosity, such as the greater tuberosity after shoulder arthroplasty. In cases of shoulder arthroplasty for arthropathy with rotator cuff tear, performing rotator cuff repair might prevent bone resorption.Level of evidenceLevel IV; Prognosis Study     

外泌体在肿瘤细胞与TAMs之间相互作用中“桥梁”和调控作用的研究进展北大核心

外泌体是一类直径为30~100 nm的圆盘囊泡,其内包含许多组分,诸如复杂RNA和蛋白质等,主要参与细胞间的信号转导。肿瘤相关巨噬细胞(tumor-associated macrophages,TAMs)是肿瘤微环境中普遍存在的巨噬细胞,通过对肿瘤生长、免疫逃逸、侵袭和转移、耐药性等多方面的作用影响肿瘤进程。外泌体在肿瘤相关巨噬细胞的招募、极化及抗肿瘤免疫调控等方面发挥着重要的调节功能。同时,TAMs以外泌体为媒介作用于肿瘤细胞,从而构成了外泌体、TAMs与肿瘤细胞之间相互作用的调控通路。综上所述,本文旨在阐明肿瘤细胞与TAMs之间,以外泌体为“桥梁”相互影响的潜在机制,以及靶向肿瘤细胞和TAMs来源的外泌体在恶性肿瘤治疗中的展望。     

基于苗药五藤膏外敷对CIA大鼠炎性骨破坏的影响探讨苗医外治就近驱邪的作用＊

目的 通过研究明确苗药五藤膏外敷缓解胶原诱导性关节炎（CIA）大鼠关节局部炎症和骨破坏的机制，证实苗医外治就近驱邪的作用。方法 将70只Wistar大鼠随机分为空白组、模型组、苗药五藤膏高、中、低剂量组、扶他林组及IL-17阻断组，每组10只。除空白组外，其余6组均构建CIA模型，并给予相应的外敷治疗。观察大鼠一般情况，HE染色进行病理学分析，TRAP染色检测OC生成，ELISA检测各炎症因子的含量，RT-PCR和WB分别检测RANKL的基因及蛋白表达。结果 苗药五藤膏能改善CIA大鼠破骨细胞浸润及关节病理性结构，并降低RANKL蛋白、基因表达以及TNF-α、IL-1、IL-6、IL-17含量。结论 苗药五藤膏外敷剂对CIA大鼠的治疗机制可能与降低致炎因子的分泌，抑制RANKL及OC的表达相关。     

乙肝相关性肝癌临床病理学特征与高敏C反应蛋白和溶血磷脂酸表达的相关性

目的探讨乙肝相关性肝癌临床病理学特征与溶血磷脂酸(LPA)和高敏C反应蛋白(hs-CRP)表达的相关性。方法选取2019年1月至2020年1月间河南省驻马店市中心医院收治的198例乙肝相关性肝癌患者作为乙肝组,198例酒精相关性肝癌患者作为酒精组。两组患者都进行血清hs-CRP和LPA表达检测,调查患者的病理学特征并进行相关性分析。结果乙肝组患者血清hs-CRP和LPA含量均高于酒精组,差异均有统计学意义(均P <0.05)。两组患者血清ALP、AFP、ALT、AST和GGT含量比较,差异均无统计学意义(P> 0.05)。乙肝组不同临床分期和组织学分化患者的血清hs-CRP和LPA含量比较,差异均有统计学意义(均P <0.05)。乙肝组患者的临床分期和组织学分化与血清hs-CRP和LPA表达均存在相关性,差异均有统计学意义(均P <0.05)。患者的临床分期和组织学分化均为影响hs-CRP和LPA表达的重要因素,差异均有统计学意义(均P <0.05)。结论相对于酒精相关性肝癌,乙肝相关性肝癌的血清hs-CRP和LPA呈现高表达,与患者的临床病理学特征存在相关性。     

Robotic-assisted central pancreatectomy: A minimally invasive approach for benign and low-grade lesions

BackgroundCentrally located pancreatic lesions are often treated with extended pancreaticoduodenectomy or distal pancreatectomy resulting in loss of healthy parenchyma and a high risk of diabetes and exocrine insufficiency. Robotic central pancreatectomy (RCP) is a parenchyma sparring alternative that has been shown safe and feasible [[1], [2]].MethodsIn this article, we describe our operative technique and the perioperative outcomes of a series of RCP for low-grade or benign pancreatic tumors.ResultsSix patients (5 female and 1 man) with a median age of 51.5 (44–68) years underwent a RCP for 2 serous cystadenomas, 2 mucinous cystic tumors, 1 neuroendocrine tumor, and 1 autoimmune pancreatitis. There were no conversions, intraoperative complications, or perioperative transfusions. Median operative time and was 240 (230–291) minutes and median blood loss was 100 (100–400) ml. The median hospital stay was 8 (5–27) days. There were no mortalities, reoperations, or readmissions. One patient developed a grade B pancreatic fistula which was successfully managed conservatively. All resections had free margins and the median tumor size was 2.5 (1.5–3.5) cm. After a mean follow-up of 46 months, no patients presented new-onset diabetes or exocrine insufficiency.ConclusionsRCP represents the least invasive option for both the patient and the pancreatic parenchyma. With a standardized technique, RCP results in low postoperative morbidity and excellent long-term pancreatic function. Although our results are excellent, POPF still represents the main complication of central pancreatectomy with an incidence ranging from 0 to 80% depending on multiple factors such as the surgeon, technique, and pancreatic texture.