Relationship of different surgical margins with recurrence-free survival in patients with hepatocellular carcinoma

To investigate the impact of different surgical margin and recurrence-free survival in patients with hepatocellular carcinoma (HCC). The data of 601 patients who underwent curative hepatectomy for HCC between January 1997 and December 2009 were analyzed. Milan group and exceeding Milan group were divided according to the Milan Criteria. Each of them was divided into 3 groups: group A (surgical margin ≤ 1 mm), group B (1 mm < surgical margin ≤ 9 mm) and group C (surgical margin ≥ 10 mm). The relationship between surgical margin and recurrence-free survival in different groups was analyzed. In Milan group recurrence-free survival of group C was more than group B and group B more than group A (P < 0.05). And in the exceeding Milan group recurrence-free surgical of group B was more than group A. There were no statistic differences within groups of B and C. Enlarging surgical margin may increase recurrence-free survival in HCC under Milan criteria.1mm in cases of exceeding Milan criteria may be regarded as the suitable surgical margin for operation of HCC.     

Expression of cancer stem cell markers and their correlation with pathogenesis in vascular tumors

Objective: Vascular tumor, which belongs to a kind of complicated lesion in soft tissue tumor, is derived from mesenchymal tissue. Although many studies have been focused on the pathogenesis of vascular tumors in human, the specific mechanism of the vascular tumors was currently unclear. Previous studies have reported an association of cancer stem cells with the development of tumor in many solid tumors. Thus the purpose of this study was to explore whether different expression level of cancer stem cell markers including CD29, CD44, CD133, nestin and ALDH1 in vascular tumor may help to elucidate the possible pathogenesis of vascular tumor. In present study, tissues of 9 cases of hemangioma, 22 cases of hemangiosarcoma, 3 cases of Kaposi’s sarcoma, and 5 cases of hemangioendothelioma were immunostained for CD29, CD44, CD133, nestin and ALDH1. Of the 39 vascular tumor cases included in the current study, CD29, CD133 and nestin were positive in most vascular tumor cases. Although CD44 and ALDH1 were observed in vascular tumor cases, the percentage of cells staining for the two markers was less than 2% in all cases of vascular tumor. Capillary hemangiomas exhibited significantly higher expression rate of CD29 and nestin compared with malignant vascular tumors and hemangioendotheliomas (P<0.05, Fisher’s exact test), while CD44, CD133 and ALDH1 exhibited no statistically significant difference between these two groups. Pearson correlation analysis exhibited that CD29 expression and nestin expression in vascular tumor were no statistically significant relationship (C=0.288, P=0.063>0.05). Our findings confirmed that the five cancer stem cells markers, including CD29, CD44, CD133, nestin and ALDH1, exhibited different expression levels in vascular tumors and demonstrated that immonhistochemical analysis for cancer stem cells markers may provide useful information for studying the pathogenesis of vascular tumors.     

单用依托咪酯或丙泊酚诱导插管在急诊危重患者中的临床观察

目的:探讨单用依托咪酯或丙泊酚诱导气管插管在急诊危重患者中的可行性和安全性。方法:回顾性分析单用依托咪酯或丙泊酚诱导气管插管的首次成功率、反流误吸发生率、诱导后低血压和心律失常发生率、气管插管后药物的使用情况。结果:所有患者在诱导插管过程中都无反流误吸发生。与丙泊酚诱导比较,依托咪酯诱导低血压与心律失常发生率更低,插管后升压药物使用率更低(P<0.05)。首次成功率和降压药使用率差异无统计学意义。结论:急诊危重病患者单用依托咪酯或丙泊酚诱导气管插管都具有良好可行性,但用依托咪酯诱导插管更安全。     

红激光与等离子经尿道前列腺剜除术治疗大体积良性前列腺增生的疗效及安全性比较

目的比较经尿道前列腺红激光剜除术(diode laser enucleation of the prostate,Di LEP)和经尿道前列腺等离子剜除术(bipolar plasmakinetic enucleation of the prostate,PKEP)治疗大体积良性前列腺增生(benign prostatic hyperplasia,BPH)的疗效及安全性。方法回顾性分析2012年6月到2014年1月收治的70例大体积BPH患者,分别采用等离子或红激光行经尿道前列腺剜除术。比较两组手术时间、血红蛋白值下降值、手术前后国际前列腺症状评分(IPSS)、残尿量(PVR)、最大尿流率(Qmax)。结果两组手术均获成功;术后随访12个月,两组IPSS、Qmax、生活质量评分(Qo L)无差异。Di LEP组术后血红蛋白下降值、膀胱灌注时间、留置尿管时间及住院时间均显著低于PKEP组。两组手术时间[(123.5±27.2)min vs.(102.7±20.4)min]、切除组织重量[(64.7±16.8)g vs.(61.2±20.5)g]、术后血红蛋白下降值[(0.92±0.43)g/dl vs.(1.24±0.55)g/dl]、膀胱灌注时间[(28.9±14)h vs.(38.5±16.6)h]、导尿管留置时间[(2.6±1.8)d vs.(3.8±2.3)d]和住院时间[(4.84±1.8)d vs.(6.2±2.3)d]比较差异均有统计学意义(P<0.05);刺激症状、逆行射精亦有差异(P<0.05);但尿潴留、输血、压力性尿失禁发生率无差别;且术后均未发生经尿道电切综合征。PKEP组1例因术后出血给予输血治疗。结论与PKEP相比,Di LEP治疗大体积BPH出血风险更小,膀胱灌注、留置尿管及住院时间更短,具有良好的疗效及安全性。     

维生素D和自噬与疾病的关系

自噬是真核细胞的Ⅱ型程序性细胞死亡过程,自噬失调会导致多种疾病的发生。该领域已经成为目前生物医学研究的热点,而通过调控自噬活性来防治疾病是重要的研发方向。研究表明,维生素D除具有维持机体钙磷代谢、介导免疫反应等功能外,还能介导自噬活性,参与多系统疾病的发生。深入了解维生素D的自噬调节功能及其与疾病的关系不仅有助于阐明疾病病理机制,还具有重要的实际应用意义。     

老年急性下壁心肌梗死溶栓后冠状动脉介入治疗安全性研究

目的 探讨老年急性下壁心肌梗死急诊溶栓后经皮冠状动脉介入治疗的有效性和安全性。方法 对由外院首诊后转运接受溶栓治疗的50例老年急性下壁心肌梗死患者按简单随机化分为两组,每组25例。对照组患者使用常规药物（阿司匹林300mg,氯吡格雷300mg）后直接行经皮冠状动脉介入治疗,研究组患者使用尿激酶150万U,再行急诊经皮冠状动脉介入治疗。观察患者胸痛缓解情况及动脉开通率,术后并发症发生率。结果所有接受治疗的老年急性下壁心肌梗死的患者均成功行血运重建,研究组患者来院后胸痛缓解率为80.0%,对照组为40.0%;研究组患者梗死相关动脉总开通率达88.0%,对照组为32.0%;研究组术后并发症主要有心律失常,严重出血,一过性窦性心动过缓、房室传导阻滞及低血压,经药物治疗后可恢复。结论需要急诊转运的老年急性下壁心肌梗死患者,在溶栓后转运再行急诊血运重建治疗的临床疗效及安全性较好,可考虑作为基层医院转运急性心肌梗死患者的首选处理方法。     

MiR-21通过PTEN/PI3K/AKT信号通路抑制胰腺癌细胞系生长侵袭能力的体外研究

目的 探讨MiR-21对胰腺癌细胞生长和侵袭的影响.方法 采用脂质体Lipofectamine 2 000将MiR-21 inhibitor和MiR-21 inhibitor阴性对照转染至胰腺癌细胞ASPC-1,qRT-PCR检测转染效果,细胞免疫荧光、Western blot检测转染后目的蛋白的表达,Transwell、划痕实验检测细胞迁移侵袭能力,MTT法检测细胞的增殖活性,流式细胞术检测细胞周期分布的改变.结果 成功构建稳定下调MiR-21的胰腺癌细胞亚系ASPC-1-MiR-21,荧光定量PCR结果显示MiR-21表达量明显下调,抑制MiR-21表达后ASPC细胞的侵袭和增殖能力均受到明显抑制;抑制MiR-21能明显增强PTEN蛋白和减低p-AKT蛋白表达水平,对AKT蛋白水平无明显影响.结论 抑制MiR-21表达可能通过调控PTEN/AKT通路抑制胰腺癌细胞AS-PC-1增殖和侵袭.     

安置肠梗阻导管与支架治疗梗阻性结直肠癌的Meta分析

目的通过Meta分析评价术前安置肠梗阻导管与支架治疗梗阻性结直肠癌的便捷性与有效性。 方法利用PubMed、The Cochrane Library、FMRS、维普数据库、万方数据库和中国知网数据库,检索时间均为从数据库建库至2020年3月,利用RevMan5.3软件对两种治疗方法的便捷性和有效性指标进行Meta分析。 结果最终纳入17篇随机对照研究文献,共1 136例患者。其中导管组566例,支架组570例。导管组安置时间、安置费用、安置成功率均优于支架组,差异有统计学意义（Z=28.70,4.66,3.22;P<0.05）;支架组腹痛腹胀缓解时间、肠道准备时间、住院时间均优于导管组,差异有统计学意义（Z=4.15,2.31,2.92;P<0.05）。两组安置前后肠管内径减小差异、安置后手术并发症比较,差异无统计学意义（P>0.05）。腹痛腹胀缓解时间的漏斗图提示无发表偏倚（P=0.075）。 结论现有证据表明,安置肠梗阻导管较支架在梗阻性结直肠癌的治疗过程中,具有经济、快捷和高成功率优势,但缓解腹痛腹胀较慢、术前肠道准备时间和住院时间更久。     

Reduced expression of circRNA novel_circ_0005280 and its clinical value in the diagnosis of non-small cell lung cancer

BackgroundCircular RNAs (circRNAs) are a class of novel RNAs with important biologic functions. The aberrant expression of circRNAs has been implicated in human diseases; however, the clinical significance of circRNAs in non-small cell lung cancer (NSCLC) is still unclear. The aim of the present study was to evaluate the expression and clinical implications of novel_circ_0005280 in patients with NSCLC.MethodsWe evaluated differential circRNA expression in cancer and adjacent normal tissues from 3 patients with NSCLC via RNA sequencing. Among these circRNAs, 17 and 64 circRNAs showed higher and lower expressions, respectively. Novel_circ_0005280 expression in cancer tissues (n=41) was examined using quantitative real-time polymerase chain reaction, and the results are presented in the form of paired graph and scatter graph and its correlation with clinicopathological features and patient prognosis was analyzed by drawing receiver-operating characteristic (ROC) curve and Kaplan-Meier survival analysis.ResultsNovel_circ_0005280 expression was significantly decreased in NSCLC tumor tissues (n=41, obtained via biopsies), compared with adjacent normal tissues (n=27). Novel_circ_0005280 expression was correlated with tumor diameter and age. The area under the receiver-operating characteristic curve, cutoff, sensitivity, and specificity of novel_circ_0005280 were 0.944, 10.23, 85.2%, and 95.1%, respectively. Low novel_circ_0005280 expression was associated with a worse prognosis.ConclusionsNovel_circ_0005280 may be a useful biomarker for the diagnosis and prognosis of NSCLC.