头颈肿瘤组织标本库构建的初步研究

目的 探讨头颈肿瘤组织标本的采集、保存,组织库构建方法,以及信息化管理技术。方法 收集手术切除和活检的头颈肿瘤组织、癌旁组织、远端正常组织及患者和正常人外周血标本(分离出血清、血浆、淋巴细胞、干细胞等),置于液氮或-80℃低温冰箱冷冻保存;同时建立一套系统管理组织标本库,使标本库规模化、信息化、智能化。结果 共收集新鲜组织标本220份,血液标本476份。其中肿瘤组织120份(包括肿瘤组织、癌旁组织);非肿瘤组织100份。肿瘤患者血液标本316份,非肿瘤患者血液标本160份。结论 标本库的建立使少见的头颈肿瘤组织标本集约化、规模化,极大提高了标本利用的效率,达到了资源共享的目的。     

Prognostic factors of neck node metastasis

A retrospective clinico-pathological study has been carried out in a series of 405 patients with squamous cell carcinoma of the head and neck who underwent a total of 484 radical neck dissections. The recurrence rate in the neck in 327 patients who had histological positive nodes was 21.1%, Recurrence in the neck after a standard radical neck dissection almost invariably proved fatal. A statistical analysis has been carried out to evaluate the clinical and pathological factors which are of importance in regards to recurrence in the neck. Histological factors such as extra-nodal spread and the number of histological positive nodes have been shown to be of much more prognostic importance than clinical parameters. When corrections are made for interdependencies between variables, histological extra-nodal spread proved to be the most important single prognostic factor (P < 10^?7).     

头颈部肿瘤患者自然杀伤细胞活性及计数分析

本文对25例头颈部肿瘤患者的外周血NK细胞杀伤活性及NK细胞计数进行测定，其中有15例患者手术治疗切除肿瘤，于术后三周复查NK活性及NK计数，并与正常人组对照。实验结果显示：头颈部肿瘤患者NK活性及NK计数均低于正常人，两组比较均有极显著性差异（P＜0．01）；术后患者的NK活性比术前有明显提高，配对t检验P＜0．01，NK计数比术前也有所提高，配对t检验P＜0．05，有显著性差异；NK活性的水平与肿瘤的分期有相关性，晚期（T4期）癌症患者NK活性明显低于早期（T1、T2）患者，可以看出NK活性随着肿瘤的发展而降低，肿瘤对宿主有免疫抑制作用；NK活性与NK数量之间无显著的相关性，二者之间的相关系数r＝0．344。     

爱维治治疗前部缺血性视神经病变的疗效观察

目的 观察爱维治治疗前部缺血性视神经病变（AION）的疗效。 方法 临床确诊的AION患者58例60只眼，其中29例30只眼接受爱维治1200 mg/d静脉滴注治疗（治疗组）；另外29例30只眼接受1～2种溶栓抗凝剂或血管扩张剂1次/d静脉滴注治疗（对照组）。均以15 d为1个疗程。对照组中20只眼还同时进行眼局部药物注射，包括糖皮质激素、654-2球后或球旁注射，1次/d或1次/2 d，用药3～5次。两组患者用药后每天观察视力、眼底变化，治疗前有视野检查者复查视野。 结果 治疗组视力提高程度明显好于对照组，两组间差异有统计学意义(t=2.74, P<0.01); 用药第3天，两组视力提高程度差异无统计学意义(t=1.34, P＞0.05); 第5、10、15天，治疗组视力提高程度明显好于对照组，其差异有统计学意义（t=2.01, P<0.05; t=2.07, P<0.05; t=2.74, P<0.01）；治疗组有视野检查的15只眼中，13只眼治疗后视野好转，占87.00%；2只眼无变化，占13.00%。对照组有视野检查的13只眼中，4只眼治疗后视野好转，占31.00%；9只眼无变化，占69.00%。两组视野变化的差异比较有统计学意义（χ2=9.66,P<0.01）。 结论 爱维治治疗AION有效。 (中华眼底病杂志, 2006, 22: 97-99)     

畸变产物耳声发射在唇腭裂婴幼儿听力检查中的应用

目的探讨唇腭裂婴幼儿畸变产物耳声发射（distortion product otoacoustic emission,DPOAE）的特点,并将其与听性脑干反应（auditory brainstem response,ABR）阂值检查的结果加以对照,以探讨DPOAE在这类患儿听力检查中的应用价值。方法DPOAE检查63例（126耳）,年龄2个月-42个月,平均11.83个月。其中单纯腭裂组（以下简称腭裂组）23例（46耳）,腭裂并发唇裂及牙槽裂组（以下简称唇腭裂组）30例（60耳）,单纯唇裂组（以下简称唇裂组）10例（20耳）,每耳均检查8个频率,若2-5kHz4个频点有≥3个频点通过即为该耳通过。在上述患儿中,ABR阈值检查腭裂组17例（34耳）,唇腭裂组10例（20耳）,唇裂组6例（12耳）,以能重复引出V波的最小刺激强度为ABR阈值。结果DPOAE检查：腭裂组通过7耳,未通过39耳,通过率为15.22％;唇腭裂组通过6耳,未通过54耳,通过率为10.00％;唇裂组通过18耳,未通过2耳,通过率为90％。统计分析腭裂组与唇腭裂组无显著差异,而腭裂组与唇裂组,唇腭裂组与唇裂组均有显著差异。ABR阈值检查统计分析结果与DPOAE一致。将各组DPOAE通过率与ABR正常率进行比较,腭裂组及唇腭裂组中二者无差异（P〉0.05）,虽然唇裂组中二者有差异（P〈0.05）,但唇裂组ABR阈值反应的听力下降较轻（均≤50dB nHL）。从总体趋势上说,DPOAE与ABR阈值检查在检测的结果上是一致的。结论唇腭裂患儿DPOAE和ABR检测结果一致,与ABR相比,DPOAE具有快速、简便、易实施等特点,因此DPOAE可以作为唇腭裂婴幼儿听力检查的手段,但仍需进一步结合ABR及其他相关的听力检查,以明确听力损害的程度和类型。     

Body Fat Moderates the Association of Olfactory Dysfunction with Dietary Intake in U.S. Middle-Aged and Older Adults: A Cross-Sectional Analysis of NHANES 2013–2014

Background: Obesity relates to impaired olfactory function. Abnormal olfactory function is also associated with poor diet; however, whether obesity-related markers shape this relationship is unknown. Methods: Cross-sectional analysis (n = 1415, age > 40 years) of NHANES 2013–2014 examined body fat percent (BF%) and waist circumference (WC) as moderators of the relationship between olfactory function and diet. The olfactory function test identified adults with olfactory dysfunction (OD) or normal olfaction (NO). Validated 24 h recall captured nutrient intake and Healthy Eating Index-2010 scores. BF% and WC were measured. We tested adjusted linear regression models, with an interaction term between olfactory function and BF%/WC, for each nutrient or HEI score, and reported coefficients (β), standard errors (SE), and p-values for significant interaction terms. Results: In OD (9.5%; mean age 50.9 years, 95% CI 49.6, 52.2) compared with NO (mean age 49.3 years, 95% CI 48.8, 49.9), higher BF% was associated with higher intake of saturated fat (β (SE): 0.2 (0.1) g; p = 0.06) and percent of total calories from total fat (0.2 (0.1); p = 0.07), saturated (0.1 (0.004); p = 0.02), and monounsaturated fat (0.1 (0.1); p = 0.08); lower percent of total calories from carbohydrates (−0.2 (0.1); p = 0.09) and mg of sodium (−17.8 (09.6); p = 0.08); and a higher (healthier) refined grain score (0.1 (0.1); p = 0.04). Higher WC was associated with higher refined grain scores (0.01 (0.02); p = 0.01) in OD. Conclusion: BF% may shape dietary intake and quality in OD. Longitudinal studies are needed to elucidate the directionality of these relationships and develop strategies to improve dietary intake among OD.     

头颈部遗传性肿瘤概述

头颈部遗传性肿瘤主要包括家族性头颈部副神经节瘤、多发性内分泌腺瘤病1型、多发性内分泌腺瘤病2型、家族性甲状旁腺功能亢进、家族性甲状腺乳头状癌、神经纤维瘤病I型、神经纤维瘤病II型、家族性鼻咽癌及家族性鳞状细胞癌。本文从头颈部遗传性肿瘤的分类、临床特征、遗传学和治疗等方面做一综述。     

Fetal stroke and cerebrovascular disease: Advances in understanding from lenticulostriate and venous imaging,alloimmune thrombocytopaenia and monochorionic twins

Fetal stroke is an important cause of cerebral palsy but is difficult to diagnose unless imaging is undertaken in pregnancies at risk because of known maternal or fetal disorders. Fetal ultrasound or magnetic resonance imaging may show haemorrhage or ischaemic lesions including multicystic encephalomalacia and focal porencephaly. Serial imaging has shown the development of malformations including schizencephaly and polymicrogyra after ischaemic and haemorrhagic stroke. Recognised causes of haemorrhagic fetal stroke include alloimmune and autoimmune thrombocytopaenia, maternal and fetal clotting disorders and trauma but these are relatively rare. It is likely that a significant proportion of periventricular and intraventricular haemorrhages are of venous origin. Recent evidence highlights the importance of arterial endothelial dysfunction, rather than thrombocytopaenia, in the intraparenchymal haemorrhage of alloimmune thrombocytopaenia. In the context of placental anastomoses, monochorionic diamniotic twins are at risk of twin twin transfusion syndrome (TTTS), or partial forms including Twin Oligohydramnios Polyhydramnios Sequence (TOPS), differences in estimated weight (selective Intrauterine growth Retardation; sIUGR), or in fetal haemoglobin (Twin Anaemia Polycythaemia Sequence; TAPS). There is a very wide range of ischaemic and haemorrhagic injury in a focal as well as a global distribution. Acute twin twin transfusion may account for intraventricular haemorrhage in recipients and periventricular leukomalacia in donors but there are additional risk factors for focal embolism and cerebrovascular disease. The recipient has circulatory overload, with effects on systemic and pulmonary circulations which probably lead to systemic and pulmonary hypertension and even right ventricular outflow tract obstruction as well as the polycythaemia which is a risk factor for thrombosis and vasculopathy. The donor is hypovolaemic and has a reticulocytosis in response to the anaemia while maternal hypertension and diabetes may influence stroke risk. Understanding of the mechanisms, including the role of vasculopathy, in well studied conditions such as alloimmune thrombocytopaenia and monochorionic diamniotic twinning may lead to reduction of the burden of antenatally sustained cerebral palsy.     

Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed?

Neutropenia and febrile neutropenia (FN) are common complications of myelosuppressive chemotherapy. This review provides an up-to-date assessment of the patient and cost burden of chemotherapy-induced neutropenia/FN in the US, and summarizes recommendations for FN prophylaxis, including the interim guidance that was recommended during the coronavirus disease 2019 (COVID-19) pandemic. This review indicates that neutropenia/FN place a significant burden on patients in terms of hospitalizations and mortality. Most patients with neutropenia/FN presenting to the emergency department will be hospitalized, with an average length of stay of 6, 8, and 10 days for elderly, pediatric, and adult patients, respectively. Reported in-hospital mortality rates for neutropenia/FN range from 0.4% to 3.0% for pediatric patients with cancer, 2.6% to 7.0% for adults with solid tumors, and 7.4% for adults with hematologic malignancies. Neutropenia/FN also place a significant cost burden on US healthcare systems, with average costs per neutropenia/FN hospitalization estimated to be up to $40 000 for adult patients and $65 000 for pediatric patients. Evidence-based guidelines recommend prophylactic granulocyte colony-stimulating factors (G-CSFs), which have been shown to reduce FN incidence while improving chemotherapy dose delivery. Availability of biosimilars may improve costs of care. Efforts to decrease hospitalizations by optimizing outpatient care could reduce the burden of neutropenia/FN; this was particularly pertinent during the COVID-19 pandemic since avoidance of hospitalization was needed to reduce exposure to the virus, and resulted in the adaptation of recommendations to prevent FN, which expanded the indications for G-CSF and/or lowered the threshold of use to >10% risk of FN.     

RING finger and WD repeat domain 3 regulates proliferation and metastasis through the Wnt/β-catenin signalling pathways in hepatocellular carcinoma

BACKGROUNDHepatocellular carcinoma (HCC) exhibits high invasiveness and mortality rates, and the molecular mechanisms of HCC have gained increasing research interest. The abnormal DNA damage response has long been recognized as one of the important factors for tumor occurrence and development. Recent studies have shown the potential of the protein RING finger and WD repeat domain 3 (RFWD3) that positively regulates p53 stability in response to DNA damage as a therapeutic target in cancers. AIMTo investigate the relationship between HCC and RFWD3 in vitro and in vivo and explored the underlying molecular signalling transduction pathways. METHODS RFWD3 gene expression was analyzed in HCC tissues and adjacent normal tissues. Lentivirus was used to stably knockdown RFWD3 expression in HCC cell lines. After verifying the silencing efficiency, Celigo/cell cycle/apoptosis and MTT assays were used to evaluate cell proliferation and apoptosis. Subsequently, cell migration and invasion were assessed by wound healing and transwell assays. In addition, transduced cells were implanted subcutaneously and injected into the tail vein of nude mice to observe tumor growth and metastasis. Next, we used lentiviral-mediated rescue of RFWD3 shRNA to verify the phenotype. Finally, the microarray, ingenuity pathway analysis, and western blot analysis were used to analyze the regulatory network underlying HCC. RESULTSCompared with adjacent tissues, RFWD3 expression levels were significantly higher in clinical HCC tissues and correlated with tumor size and TNM stage (P < 0.05), which indicated a poor prognosis state. RFWD3 silencing in BEL-7404 and HCC-LM3 cells increased apoptosis, decreased growth, and inhibited the migration in shRNAi cells compared with those in shCtrl cells (P < 0.05). Furthermore, the in vitro results were supported by the findings of the in vivo experiments with the reduction of tumor cell invasion and migration. Moreover, the rescue of RFWD3 shRNAi resulted in the resumption of invasion and metastasis in HCC cell lines. Finally, gene expression profiling and subsequent experimental verification revealed that RFWD3 might influence the proliferation and metastasis of HCC via the Wnt/β-catenin signalling pathway.CONCLUSIONWe provide evidence for the expression and function of RFWD3 in HCC. RFWD3 affects the prognosis, proliferation, invasion, and metastasis of HCC by regulating the Wnt/β-catenin signalling pathway.