Objective: To evaluate the analgesic effect of pregabalin combined with intrathecal sufentanil infusion for the treatment of breakthrough pain in patients with bone metastases. Methods: A total of 60 breakthrough pain patients with bone metastases were randomly divided to 3 groups: group A (pregabalin combined with intrathecal sufentanil infusion group,n=20), group B (placebo combined with intrathecal sufentanil infusion group,n=20) and group C (oral morphine sulfate controlled-release tablet group,n=20). The differences in visual analogue scale (VAS)between background pain and breakthrough pain, the seizure frequency of breakthrough pain, general satisfaction and side effects of the 3 groups were observed. Results: hTe seizure frequency and VAS of breakthrough pain in group A decreased signiifcantly after the treatment (P<0.05) and the general satisfaction was the best among the the 3 groups (P<0.05), with less nausea and vomiting, constipation, drowsiness and fewer other side effects. Conclusion: Pregabalin combined with intrathecal sufentanil infusion can effectively relieve breakthrough pain in patients with bone metastases.

A 12-year-old boy was admitted for complaint of progressive urination disorder for over 2 years. Physical examination found dysesthesia in the perineal region and disappearance of anal reflex with anal relaxation and a spinal cleft in the sacrococcygeal region. Lumbosacral magnetic resonance imaging MRI showed a low-set of the spinal cord, tethered cord, spina bifida of sacral vertebrae, and meningocele combined with lipoma inside and outside of the spinal canal. Ultrasonography displayed a significantly increased residual urine volume. The diagnosis of tethered-cord syndrome resulting from mixed lipoma was thus established. During the microsurgery, the adhesions between the spinal cord, coccygeal nerve and lipoma were released with a laser scalpel, and the lipoma inside and outside of the spinal canal was excised, after which the dural defect was repaired. The patient recovered smoothly, and the urinary function was normal at the follow-up 6 months after the surgery. Spinal cord lipoma can be classified into 2 types based on the integrity of the dura mater, and in this case, a combined dural defect was found. A definite diagnosis can be derived from the clinical manifestations and MRI findings. Microsurgery remains the currently only effective treatment, and a favorable prognosis can be expected after an early surgical intervention, especially before the functional lesion of the spinal cord. The integrity of the local dura mater considerably affects the outcome of the treatment, and dural defect often leads to surgical difficulty and poor results. The key to a successful operation lies in a full release of the adhesion and avoidance of injury to the conus medullaris and cauda equina. A reoperation in case of recurrence should be carefully evaluated for its benefits.
Child ; Humans ; Lipoma ; complications ; surgery ; Male ; Microsurgery ; Neural Tube Defects ; etiology ; surgery ; Spinal Cord Neoplasms ; complications ; surgery ; Treatment Outcome

OBJECTIVETo explore the role of fatty acid binding protein 4 (FABP4) in regulating lung cancer cell metastasis and identify miRNAs that target FABP4.

METHODSThe expression of FABP4 in lung cancer cells with different metastatic potentials was detected using enzyme-linked immunosorbent assay (ELISA) and Western blotting. The effects of FABP4 knockdown or overexpression by shRNA or a recombinant lentivirus, respectively, on lung cancer cells metastasis were assessed. The miRNAs that targeted FABP4 were screened using target prediction algorithms and the results were verified with Q-PCR.

RESULTSFABP4 expression was significantly higher in lung cancer cell lines with high metastatic potentials (NL9980, H661, and 95C) than in those with low metastatic potentials (L9981, A549, and PC13) (P<0.05). FABP4 knockdown in NL9980 cells resulted in significantly inhibited metastasis of the cells (P<0.05), while FABP4 overexpression obviously promoted the metastasis of A549 cells (P<0.05). The expressions of miR-203, miR-361 and miR-539 were significantly higher in highly metastatic lung cancer cells than in the cells with low metastatic potentials (P<0.05). In NL9980 cells, FABP4 expression was most obviously suppressed by miR-203 (P<0.05), and target site mutational FABP4 overexpression significantly attenuated the inhibitory effect of miR-203 on NL9980 metastasis (P<0.05).

CONCLUSIONFABP4 can promote lung cancer metastasis, and by targeting FABP4 to inhibit its expression, miR-203 can suppress the metastasis of lung cancer cells.

An esophageal squamous cell carcinoma measuring 18.3 cm in length and 5 cm in diameter was found in the mediastinum of a 53-year man. The patient underwent a modified 3-stage esophagectomy and an esophagogastrostomy at the cervical level (Wu's method). The operation was performed smoothly and the patient recovered uneventfully after the operation. The patient was followed up for 6 months after discharge and reported no difficulties in eating with improved quality of life. This case represents the world's longest esophageal cancer that had been surgically removed. Local advanced esophageal cancer should be removed immediately to prevent potential occurrence of esophageal obstruction, tracheoesophageal fistula or aorto-esophageal fistula.
Carcinoma, Squamous Cell ; surgery ; Esophageal Fistula ; Esophageal Neoplasms ; surgery ; Esophageal Stenosis ; Esophagectomy ; Female ; Humans ; Male ; Middle Aged ; Quality of Life

OBJECTIVETo investigate the features of intraductal papilloma of the breast in mammography and magnetic resonance imaging (MRI) and assess the diagnostic values of the two imaging modalities.

METHODSFifteen patients with intraductal papilloma of the breast confirmed surgically and pathologically underwent X-ray examination of the breast, and 11 of them also received enhanced MRI. The imaging findings by mammography and MRI were compared.

RESULTSEnhanced MRI clearly displayed the location and morphology of the intraductal papilloma, and 7 patients showed smooth tumor margins and 2 showed irregular margins. On T(1)WI, the lesions were isointense or slightly hypointense, and appeared isointense or slightly hyperintense on T(2)WI. Some of the intraductal papillomas were seen encapsulated in the dilated ductal. The varying enhancement features of the lesions increased the difficulty in distinguishing from carcinoma. Mammography identified intraductal papillomas only in 2 of the 15 cases (13%) with lesion feature similar to that found by MRI. Fine cluster calcification was found in 1 case.

CONCLUSIONMRI can more accurately define the location of the lesion than X-ray. In spite of some resemblance in the MRI findings between intraductal papillomas and breast carcinoma, MRI still serves as a useful diagnostic modality for intraductal papilloma that shows some characteristic findings.

Adult ; Aged ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Mammography ; Middle Aged ; Papilloma, Intraductal ; diagnostic imaging ; pathology ; Sensitivity and Specificity

OBJECTIVETo compare the immunomodulatory effects of human amniotic mesenchymal stem cell (hAMSCs) and human bone marrow mesenchymal stem cells (hBMSCs) on peripheral blood T lymphocytes in an in vitro co-culture system.

METHODShAMSCs and hBMSCs isolated using enzymatic digestion and Ficoll-Hypaque density gradient centrifugation, respectively, were culture-expanded in vitro to obtain the 4th-generation cells. The two MSCs were co-cultured separately with human peripheral blood mononuclear cells stimulated with phytohemagglutinin (PHA-PBMSC) to investigate the changes in T lymphocyte subsets using flow cytomety and the production of interleukin-2 (IL-2) and IL-10 by the T lymphocytes using enzyme-linked immunosorbent assay (ELISA).

RESULTSCo-culture with either hAMSCs or hBMSCs significantly increased the proportions of Treg, Th2 and Tc2 and decreased Th1 and Tc1 cell subsets in the PBMCs as compared with the PBMCs cultured alone (P<0.05), and the changes in the PBMCs were similar between the two co-culture systems (P>0.05). In both of the two co-culture systems, IL-2 production by the lymphocytes was significantly lowered (P<0.05) and IL-10 production was significantly increased (P<0.05) as compared with their levels in the PBMCs cultured alone; no significant difference was found in IL-2 or IL-10 levels between the two co-culture systems (P>0.05).

CONCLUSIONThe MSCs derived from human amnion and bone marrow have similar immunomodulatory effects on the T lymphocytes, suggesting the possibility of using hAMSCs in the treatment of graft-versus-host disease after allogeneic hematopoietic stem cell transplantation.

OBJECTIVETo analyze the clinical manifestations, laboratory findings, treatment and prognosis of patients with hemophagocytic syndrome (HPS).

METHODSA retrospective study was carried out to analyze the underlying disease, clinical characteristics, laboratory findings and outcomes of 46 patients with HPS.

RESULTSThis cohort included 19 cases of HPS secondary to cancer, 11 cases of HPS secondary to infection, 10 cases of suspected malignant lymphoma based on PET-CT findings (without biopsy), and 6 cases of unknown etiology. The coincidence rate of the clinical characteristics of the patients with the indices listed in HPS-2004 criteria were: fever (100%), elevated serum ferritin (100%), cytopenias (93.48%), splenomegaly (91.30%), hemophagocytosis in the bone marrow, spleen or lymph nodes (84.78%), hypofibrinogenemia (67.39%), and hypertriglyceridemia (54.05%). The cases of cancer, infections and unknown etiology showed significant differences in serum levels of ferritin and β2MG (P<0.05), and significant differences were found in triglycerides, LDH, and fibrinogenemia between the nonfatal and fatal cases (P<0.05).

CONCLUSIONHPS can be secondary to various underlying diseases, many associated with Epstein-Barr virus infection. Cancer, especially NK/T-cell lymphoma, is the main cause of HPS. Persistent fever, elevated serum ferritin level and cytopenias are the most sensitive indicators for diagnosis of HPS, and early diagnosis and treatment are critical to lower the mortality rate of this disease.

OBJECTIVETo develop a rapid preimplantation genetic diagnosis method for -thalassemia SEA deletion based on blastocyst cell whole genome amplification (WGA) combined with short fragment Gap-PCR.

METHODSUsing multiple displacement amplification (MDA) WGA technique, we established a double-fluorescent PCR system of the housekeeping genes GAPDH and β-actin for WGA quality testing, and a genotyping PCR system of mutant and normal short sequences for α-thalassemia SEA deletion. The sensitivity and accuracy of this method for diagnosis of -thalassemia SEA deletion were evaluated by detecting lymphocyte samples containing different cell numbers from carriers of SEA deletion. The applicability of this method was evaluated by testing of 12 blastocyst biopsy samples.

RESULTSDetection of lymphocyte samples with different cell numbers using the method developed in this study revealed no ADO in 3-cell samples, and the product quantity of WGA became stable for 4-cell samples. Genotyping of the 10 blastocyst biopsy samples with successful WGA showed a genotype of --/ in 5 samples and / in the other 5 samples, which were consistent with the verification results.

CONCLUSIONSThe method developed in this study is a complete testing process for 4-6 blastocyst biopsy cells to allow rapid, accurate, and cost-effective PGD genotyping of -thalassemia SEA deletion using short fragment gap-PCR.

Acute Disease ; Allografts ; Humans ; Kidney ; Kidney Transplantation ; Nephritis ; Pyelonephritis ; Transplantation, Homologous

Adult ; Anemia, Hemolytic ; diagnosis ; drug therapy ; Anti-Bacterial Agents ; therapeutic use ; Humans ; Male ; Mycoplasma pneumoniae ; pathogenicity ; Pneumonia, Mycoplasma ; diagnosis ; drug therapy