Video-assisted mediastinoscopic resection compared with video-assisted thoracoscopic surgery in patients with esophageal cancer

Objective

The purpose of this study was to explore the indications of radical vedio-assisted mediastinoscopic resection for esophageal cancer.

Methods

The data of 109 patients with T1 esophageal cancer who underwent video-assisted mediastinoscopic resection (VAMS group) in Third Affiliated Hospital of Soochow University Hospital from December 2005 to December 2011 were collected in the study for comparison with the 58 patients with T1 esophageal cancer who underwent video-assisted thoracoscopic surgery (VATS group) in Zhongshan Hospital, Fudan University. The perioperative safety and survival were compared between the two groups.

Results

All operations were successful in both groups. One perioperative death was noted in the VATS group. The incidences of post-operative complications were not significantly different between these two groups, whereas the VAMS group was favorable in terms of operative time (P<0.001) and blood loss (P<0.001), and a significantly larger number of chest lymph nodes were dissected in the VATS group compared with the VAMS group (P<0.001). Long-term follow-up showed that the overall survival was not significantly different between these two groups (P=0.876).

Conclusions

T1N0M0 esophageal cancer can be as the indication of VAMS radical resection. VAMS radical resection can be considered as the preferred option for patients with poor pulmonary and cardiac function or a history of pleural disease.     

Diagnostic delay of pulmonary nontuberculous mycobacterial infection in China

Background

Nontuberculous mycobacteria (NTM) infection is an emerging, but neglected public health concern in China.

Findings

To investigate diagnostic delay of NTM diseases in China, we analyzed 91 patients with pulmonary NTM infection in ShandongProvince. The median diagnostic delay time of the analyzed patients was 84 days, which was significantly associated with rural inhabitance (135 days vs. 73 days of urban inhabitance, p?<?0.01) and lower level of first visiting hospitals/clinics (70 and 82 days of tertiary and secondary hospitals/clinics respectively vs. 120 days of primary hospitals/clinics, p?<?0.05). M. farcinogenes was isolated from a 79-year-old male patient, which is the first report of pulmonary infection in humans.

Conclusions

Our results indicate a significant diagnostic delay of NTM diseases in China, especially for rural patients with limited access to higher-level healthcare services.

     

Infrequent ERBB2 mutations in Chinese patients with non-small cell lung cancer

ERBB2 mutations have been reported to occur in a subset of patients with lung adenocarcinomas or lung squamous cell carcinomas for some ethnicities, but it is unclear for Chinese patients with lung squamous cell carcinomas up to now. We retrospectively evaluated the status of ERBB2 mutations in a large cross-sectional cohort of 212 Chinese patients with non-small cell lung cancer (NSCLC) diagnosed in several hospitals from southern China during a time period of 1.5 years by polymerase chain reaction (PCR)-based direct sequencing and PCR-single strand conformation polymorphism (PCR-SSCP) analysis. ERBB2 mutation was found in 1 of 49 lung adenocarcinomas (2.0%) and none in lung squamous cell carcinomas and lung adenosquamous carcinomas. It implies the occurrence of ERBB2 mutations is infrequent in Chinese patients with NSCLC, especially in lung squamous cell carcinomas.     

茜草炮制前后红外图谱分析

[目的]分析茜草及茜草炭的红外原谱及二阶导数谱,提取红外谱图特征。[方法]利用现代红外光谱技术,对茜草及茜草炭进行分析。[结果]茜草炒炭前后红外原谱、二阶导数谱有明显的变化,表明红外技术用于中药材及其炮制品的鉴别是可行的。[结论]红外光谱法样品的制备较简单,仪器设备普及性较强,在中药材饮片的快速鉴别中占据一定的优势。     

Identification and characterization of alphavirus M1 as a selective oncolytic virus targeting ZAP-defective human cancers

Oncolytic virotherapy is a growing treatment modality that uses replicating viruses as selective antineoplastic agents. Safety and efficacy considerations dictate that an ideal oncolytic agent would discriminate between normal and cancer cells on the basis of common genetic abnormalities in human cancers. Here, we identify a naturally occurring alphavirus (M1) as a novel selective killer targeting zinc-finger antiviral protein (ZAP)-deficient cancer cells. In vitro, in vivo, and ex vivo studies showed potent oncolytic efficacy and high tumor tropism of M1. We showed that the selectivity depends on ZAP deficiency by systematic identification. A large-scale multicenter pathology study using tissue microarrays reveals that ZAP is commonly deficient in human cancers, suggesting extensive application prospects for M1. Additionally, M1 killed cancer cells by inducing endoplasmic reticulum stress-mediated apoptosis. Our report provides novel insights into potentially personalized cancer therapy using oncolytic viruses.Despite advances in cancer therapy over the past few decades, cancer is still a major health problem all over the world (1). One innovative class of targeted anticancer strategies is the use of replicating oncolytic viruses with selective tropism for cancerous cells and tissues (2, 3). The tumor selectivity of oncolytic virus is primarily based on the genetic abnormalities of malignant cells, including innate immune defects, aberrant oncogenic signaling, and tumor-specific receptors (4–6). The thriving viruses in tumor cells may lead to direct cell lysis, anticancer immune response, or modulation of tumor vasculature (3, 7). Moreover, some of the cancer-targeted multimechanistic oncolytic viruses have been proven to be well-tolerated in clinical trials, with patients exhibiting only mild flu-like symptoms, offering great potential for increasing efficacy while eliminating the side effects (8). To date, several oncolytic viruses have been tested in preclinical and clinical trials, of which the milestone is a pivotal phase III trial using talimogene laherparepvec for unresected melanoma (2, 3, 9). Although a few therapeutic viruses are performing well in clinical trials, not all patients showed good response. Novel oncolytic viruses that grow better in some cancer cells in a predictable manner remain to be discovered for potentially personalized cancer therapy.M1 is a strain of Getah-like alphavirus that was isolated from culicine mosquitoes collected on Hainan Island of China (10, 11). Getah virus is transmitted mainly among horses and pigs, and it has not been linked to human illness (12–14). Also, M1 does not cause apparent disease symptoms in mice or rats, even on administration of doses up to 3 × 10⁷ pfu per mouse or 3 × 10⁸ pfu per rat. Earlier, we reported that M1 induces apoptosis in glioma cells (10). Thus, we hypothesized that an apathogenic cancer cell-killing virus could be a candidate for systemic oncolytic therapy.In this study, we sought to investigate the anticancer effectiveness and tumor tropism of M1 and uncover the mechanisms, aiming to identify a candidate for personalized oncolytic virotherapy.     

人源类器官的研究进展及在口腔医学的展望

类器官是指在体外三维培养构建的,依赖于人造细胞外基质的多细胞团,具有自我更新、自我组织能力,并维持了其来源组织的生理结构和功能。类器官作为一种新兴的研究模型,兼具细胞系和动物模型两者的优点。其构建材料简单、培养效率高、耗时短,在疾病研究模型构建、临床药敏试验和再生医学中有良好的应用前景。类器官模型主要分为三种细胞来源类型：胚胎干细胞/诱导多能干细胞、成体干细胞、肿瘤细胞。本文将重点介绍三种细胞来源类器官最新的研究进展,并展望其在口腔医学中的应用。     

牙周牙髓联合病变的综合治疗效果观察

目的研究牙周牙髓综合治疗对下前牙牙周牙髓联合病变的疗效,以期为临床治疗提供依据。 方法收集2017年1月至2018年2月至广州市海珠区口腔医院就诊的31例下颌重度牙周炎伴牙髓病变前牙,给予牙周治疗（龈上洁治、龈下刮治及根面平整术）,根管治疗和松牙固定的综合治疗。记录患者基线、治疗后3个月、6个月、12个月的牙石指数（CI）、龈沟出血指数（SBI）、探诊深度（PD）、附着水平（AL）值,采用单因素重复测量资料方差分析统计数据（检验水准α = 0.05）,比较患牙治疗前、后差异,评价临床疗效。 结果31例患牙中,牙周牙髓联合治疗有效率为96.8%。患牙在术后3、6、12个月较基线相比,其CI、SBI、PD、AL值均显著下降,差异均有统计学意义（P<0.001）。术后6个月与3个月相比,PD、AL值继续下降,差异有统计学意义（F_PD = 112.51,P_PD<0.001;F_AL = 117.64,P_AL<0.001）;术后12个月较6个月仍持续降低,但差异无统计学意义（F_PD = 0.04,P_PD = 0.815;F_AL = 0.09,P_AL = 0.786）。 结论对于下前牙牙周牙髓联合病变,综合治疗效果显著。     

Antecedent hypoglycaemia does not diminish the glycaemia-increasing effect and glucoregulatory responses of a 10 s sprint in people with type 1 diabetes

Aims/hypothesis

A 10 s sprint has been reported to provide a means to prevent acute post-exercise hypoglycaemia in young adults with type 1 diabetes because of its glycaemia-raising effect, but it is unclear whether this effect is impaired by antecedent hypoglycaemia. The purpose of this study was to investigate whether antecedent hypoglycaemia impairs the glycaemia-raising effect of a 10 s sprint in individuals with type 1 diabetes.

Methods

Eight individuals underwent a hyperinsulinaemic–hypoglycaemic or hyperinsulinaemic–euglycaemic clamp on two separate mornings. Thereafter, the participants underwent a basal insulin–euglycaemic clamp before performing a 10 s sprint on a cycle ergometer. The levels of blood glucose and glucoregulatory hormones and rates of glucose appearance (Ra) and disappearance (Rd) were compared between conditions.

Results

During the morning clamps, blood glucose levels were significantly different between conditions of hypoglycaemia (2.8?±?0.1 mmol/l) and euglycaemia (5.4?±?0.2 mmol/l; p?<?0.001). Mean glycaemia prior to sprinting was similar (5.6?±?0.4 and 5.5?±?0.3 mmol/l for hypoglycaemic and euglycaemic conditions, respectively; p?=?0.83). In response to the afternoon sprint, the pattern of increase in blood glucose levels did not differ between conditions, reaching similar maximal levels 45 min after exercise (6.5?±?0.4 and 6.6?±?0.3 mmol/l, respectively; p?=?0.43). The early post-exercise patterns in glucose Ra and Rd and increases in plasma adrenaline (epinephrine), growth hormone and cortisol levels did not differ between conditions.

Conclusions/interpretation

Hypoglycaemia in the morning does not diminish the glycaemia-raising effect of an afternoon 10 s sprint in young adults with type 1 diabetes, suggesting that sprinting is a useful strategy for opposing hypoglycaemia, regardless of prior hypoglycaemia.