OBJECTIVETo observe the effect of acupuncture along affected meridian on the mem- brane metallo-endopeptidase (MME) gene expression of migraine patients without aura (MO) of Gan-yang hyperactivity syndrome (GYHS).

METHODSTotally 20 MO patients of GYHS were randomly assigned to the acupoint group (acupuncture along affected meridian) and the non-acupoint group, 10 cases in each group. Needling was performed once per day for 10 consecutive days. Gene chip technology was used to obtain two sets of gene expression profiles and analyzed using Gene Ontology (GO).

RESULTSIn the acupoint group, MME gene expression decreased after needling (P = 0.0023).That gene was rich in the beta-amyloid metabolic process (P = 3.16E-05) and the peptide metabolic process (P = 0.009612). Its expression was not seen in the non-acupoint group.

CONCLUSIONThe effect of point selection along affected meridian could be achieved possibly by regulating the MME gene expression.

Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; Endrin ; analogs & derivatives ; metabolism ; Humans ; Meridians ; Migraine Disorders ; therapy ; Syndrome

Since the publication of a high-throughput DNA sequencing technology based on PCR reaction was carried out in oil emulsions in 2005, high-throughput DNA sequencing platforms have been evolved to a robust technology in sequencing genomes and diverse DNA libraries. Antibody libraries with vast numbers of members currently serve as a foundation of discovering novel antibody drugs, and high-throughput DNA sequencing technology makes it possible to rapidly identify functional antibody variants with desired properties. Herein we present a review of current applications of high-throughput DNA sequencing technology in the analysis of antibody library diversity, sequencing of CDR3 regions, identification of potent antibodies based on sequence frequency, discovery of functional genes, and combination with various display technologies, so as to provide an alternative approach of discovery and development of antibody drugs.
Animals ; Antibody Diversity ; genetics ; Base Sequence ; Complementarity Determining Regions ; chemistry ; genetics ; DNA ; genetics ; DNA, Complementary ; genetics ; Drug Discovery ; methods ; Gene Library ; High-Throughput Nucleotide Sequencing ; methods ; Humans ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; methods

OBJECTIVETo investigate the feasibility of involved-field irradiation (IFI ) for stage III non-small cell lung cancer (NSCLC).

METHODSFrom September 1997 to November 2001, 200 stage-III NSCLC patients were randomly divided into two groups-- IFI and ENI (elective node irradiation). The IFI group was irradiated by 3DCR to a dose of 68-74 Gy/34-37f/7-9 w including the primary tumor and the lymph nodes of > or = 10 mm in short axis. The ENI group was irradiated to a dose of 60-64 Gy/30-32f/6-7.5 w including the primary tumor, ipsilateral hilum, subcarinal and mediastinal lymph nodes, even the supraclavicular area when the lymph nodes of superior mediastinum were involved.

RESULTSThe overall response (CR + PR) rates were 90.0% in IFI group and 79.0% in ENI group. Radiation pneumonitis developed in 29.0% of the patients in ENI group and 17.0% in IFI group (P = 0.04). The 1-year primary tumor failure rate in IFI group (13.0%) was lower than that (23.0%) in ENI group. The 1-year involved nodal failure rate was 20.0% in ENI group and 10.0% in IFI group (P = 0.048). The 1-year elective node failure rate was 16.0% in ENI group versus 21.0% in IFI group (P = 0.39). The 1-, 2-and 3-year overall survival rate was 67.2% , 38.7% , 27.3% , respectively, in IFI group; versus 59.7% , 25.6% , 19.2% in ENI group, with a difference significant in the 2-year overall survival rate between IFI and ENI group (P = 0.048).

CONCLUSIONInvolved-field 3D-CRT for stage-III non-small cell lung cancer is well tolerated. It does not increase the rate of lymph node failure in the elective node irradiation field, and may improve the survival due to dose escalation.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; radiotherapy ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; pathology ; radiotherapy ; Lymphatic Irradiation ; methods ; Male ; Middle Aged ; Neoplasm Staging ; Radiotherapy Dosage ; Radiotherapy, Conformal ; methods ; Remission Induction ; Survival Analysis ; Treatment Outcome

OBJECTIVETo investigate the relationship between the expressions of integrin alpha5 beta1 and E-CD, and clinicopathological characteristics and prognosis of patients with non-small cell lung carcinoma (NSCLC).

METHODSThe expression of integrin alpha5 beta1 and E-CD were analyzed in 53 NSCLC and 12 control specimens by immunohistochemical assay.

RESULTSThe expression of integrin alpha5 beta1 was significantly higher in NSCLC (58.5%) than that in normal lung tissue (16.7%), and also positively related with pathological characteristics (P = 0.021), lymph node metastasis (P = 0.006), and clinical stage (P = 0.002). The 3-year survival rate in NSCLC group was significantly lower than that in control group (22.3% vs 40.6% , P = 0.041). The positive expression of E-CD in NSCLC and control group was 32.1% and 91.7%, respectively, and negatively correlated with pathological characteristics (P = 0.010) and lymph node metastasis (P = 0.002). The 3-year survival rate in control group was 19.9%, lower than that in NSCLC group (41.2%, P > 0.05), but the difference is not significant.

CONCLUSIONThe overexpression of integrin alpha5 beta1 may contribute to lymph node metastasis and play an inverse role, while E-CD may be a beneficial prognostic factor in patients with NSCLC.

Adult ; Aged ; Cadherins ; metabolism ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Integrin alpha5beta1 ; metabolism ; Lung Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Smoking ; Survival Analysis

OBJECTIVETo investigate the mRNA expressions of RASSF1A, Galectin-3 and TPO in papillary thyroid carcinoma and some other thyroid benign lesions, and evaluate their diagnostic significance.

METHODSReverse transcription polymerase chain reaction (RT-PCR) was used to detect the mRNA expression of RASSF1A, galectin-3 and TPO in the samples from 73 cases, including 23 cases with papillary thyroid cancer, 16 with nodular goiter, 29 with thyroid adenoma and 5 with Hashimoto's disease.

RESULTSA statistically significant difference in the mRNA expression of RASSF1A, Galectin-3 and TPO was observed between papillary thyroid carcinoma and follicular benign lesions (P<0.05). However, there was no significant difference among various kinds of benign lesions (P>0.05). A negative correlation of the expression of RASSF1A and Galectin-3 mRNA was found between thyroid benign lesions and malignant ones (P = 0.000). While the mRNA expression of RASSF1A and TPO was positively correlated between benign and malignant lesions (P = 0.028).

CONCLUSIONLoss of expression of RASSF1A and TPO mRNA but high expression of Galectin-3 mRNA in papillary thyroid carcinoma are common. Therefore, the products of these three genes may be closely related to the development of thyroid papillary carcinoma, and may be used as useful markers in differential diagnosis of papillary thyroid carcinoma from the benign lesions. The results are more reliable if this detection method is used in combination with other techniques.

Adolescent ; Adult ; Aged ; Autoantigens ; genetics ; metabolism ; Biomarkers, Tumor ; metabolism ; Carcinoma, Papillary ; genetics ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Galectin 3 ; genetics ; metabolism ; Goiter, Nodular ; genetics ; metabolism ; pathology ; Hashimoto Disease ; genetics ; metabolism ; pathology ; Humans ; Iodide Peroxidase ; genetics ; metabolism ; Iron-Binding Proteins ; genetics ; metabolism ; Male ; Middle Aged ; RNA, Messenger ; metabolism ; Thyroid Neoplasms ; genetics ; metabolism ; pathology ; Tumor Suppressor Proteins ; genetics ; metabolism ; Young Adult

Objective To evaluate the commonly used consciousness scales according to longitudinal study on small-sample patients with minimally conscious state. Method Eleven patients with minimally consciousness, who were scanned using fMRI, were selected and scored by the commonly used consciousness scales in Wujing Hangzbeu Hospital. The 11 patients were classified into 2 groups according to the scores of CRS-R scale couple with the results of the fMRI study. The One-Way ANOVA method was used to analyze the inter-group difference of the commonly used consciousness scales and their subscales. Results Despite the communicative subscale of the CRS-R scales, other iterms lack of statistic significance in classification of the conscious state. Among the commonly used consciousness scales, the Wessex Head Injury Matrix (WHIM) scale presented the highest diagnostic value in consciousness state, whereas the Chinese Vegetative State Scale (CVSS) presented the lowest diagnostic value. Conclusions It indicated that the total scores of the consciousness scales and the scores of subscales of them presented poor diagnostic value in general, and big discrepancy of diagnostic value existed between the iterms of the scales by using objective tools.

【Objective】To investigate the sleep status of patients with chronic HBV infection【Methods】From January 2019 to June 2019 ，353 patients with chronic hepatitis B virus infection in the outpatient department of the Third Affiliated Hospital of Sun Yat-sen University，using the sleepiness scale，insomnia scale，sleep quality scale，anxiety self- rating form and depression self- evaluation ，patients were scored and grouped according to sleep grading criteria. Patients were collected for gender，age，disease diagnosis，antiviral therapy，and educational level. Chi-square correlation test and multivariate logistic regression were applied to analyze the influencing factors of sleep. 【Results】 The overall sleepiness rate was 47.88%. The overall insomnia rate was 53.26%. There were 6.8% patients who had poor sleep quality. The risk factor of lethargy was the degree of anxiety（P = 0.000，OR = 3.076，95% CI 1.706~5.545）. The risk factor of insomnia was anxiety（P = 0.000，OR = 14.693，95% CI 5.046~42.782）and depression（P = 0.002，OR = 2.279，95% CI1.340~3.877）. The risk factor of sleep quality was anxiety（P = 0.000，OR = 9.990，95% CI 4.031~24.758）.【Conclusions】 Patients with chronic HBV infection have a high proportion of subjective sleep disorders. The main influencing factor is mental state of the patient. A full understanding of the patients′ sleep status will help the patients′ treatment.

【Objective】 To analyze characteristics of ocular surface damage in inactive mild and moderate-severe Graves' Orbitopathy(GO) . 【Methods】 In this retrospective study, the clinical characteristics of GO patients at Sun Yatsen Memorial Hospital between April 2017 and April 2019 were reviewed. Data were collected from 192 eyes of 192 cases. There were 121 eyes of 121 cases with mild GO, and 71 eyes of 71 cases with moderate-severe GO. All patients were divided into corneal-damage and non-corneal-damage groups. The ocular surface irritation, tear film breakup time(TFBUT), marginal reflex distance 1(MRD1), marginal reflex distance 2(MRD2), Schirmer's test Ⅱ, and proptosis of the two groups were compared. 【Results】 Grittiness(21 cases, 52.5%) and photophobia(23 cases, 57.5%) were higher, in cornealdamage group of inactive mild GO patients, compared with non-corneal-damage group(23 cases, 28.4%, 29 cases, 35.8%, respectively) (P ≤ 0.05); but there was no statistical difference in symptoms between the two groups of moderate-severe GO patients. There was statistical difference in increased MRD1 between corneal-damage group [5.1(S = 1.9) mm] and non-corneal-damagegroup [4.4(S = 1.5) mm] of inactive mild GO patients(P ≤ 0.05). Besides, decreased TFBUT in moderate-severe corneal-damage GO patients was 3.2(S = 2.3) s, shorter than non-corneal-damage group [6.2(S = 3.2) s, (P ≤ 0.05) ] . In corneal-damage groups, there was no significant difference in symptoms and signs between mild and moderate-severe GO. 【Conclusions】 Grittinessand photophobia are common symptoms in patients with mild GO ocular surface damage, and MRD1 is related with ocular surface damage. There is no difference in symptom between corneal-damage group and non-corneal-damage group of moderate-severe GO patients, and TFBUT is related with ocular surface damage.

OBJECTIVETo investigate the feasibility of the endoscope-assisted styloidectomy.

METHODSSixty patients with Eagle's syndrome undergoing the endoscope-assisted styloidectomy via postauricular incision, including 7 unilateral and 53 bilateral, between June 2010 and March 2013 were reviewed.

RESULTSThe styloid processes in all patients were resected successfully via this approach, with the incision length range of 2.0 to 2.5 cm. The mean operative time was (21.3 ± 4.8) min(X(-) ± s), for unilateral surgery and (48.5 ± 11.4) min for bilateral surgery. Fifty-four patients symptom showed complete remission of symptom, 3 cases with decrease in symptom and other 3 cases with no significant relief of symptom after surgery. None case recurred for follow-up of 3 to 70 months. There were 3 sides with ear numbness after surgery for 3 months, and one case had transient facial paralysis and recovered after 3 months.

CONCLUSIONSThe endoscope-assisted styloidectomy via postauricular incision is effective and feasible.

Adult ; Aged ; Endoscopes ; Female ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic ; surgery ; Osteotomy ; methods ; Temporal Bone ; surgery

Objective: To investigate surgical strategies and the corresponding benefits for patients with perihilar cholangiocarcinoma(pCCA). Methods: A total of 81 patients with pCCA who underwent radical excision in the Department of Biliary and Pancreatic Surgery of Sun Yat-Sen Memorial Hospital between January 2014 and December 2021 were retrospectively collected.The cohort consisted of 50 male and 31 female patients,with an age of (62.5±11.5)years(range:26 to 83 years).Seventy-five cases were diagnosed with jaundice,60 of whom received preoperative biliary drainage,while 20 patients received portal vein embolization.Their serum bilirubin level within one week before the operation(M(IQR)) was 44.3 (41.9) μmol/L(range:8.0 to 344.2 μmol/L).Preoperative imaging examinations were performed to evaluate the Bismuth-Corlette type of pCCA,showing 3,6,21,27,and 24 cases of Bismuth-Corlette type Ⅰ,Ⅱ,Ⅲa,Ⅲb,and Ⅳ,respectively.The primary outcome was overall survival (OS),and the secondary outcomes were relapse-free survival (RFS),90-day postoperative morbidity and 90-day postoperative mortality.OS and RFS were estimated using the Kaplan-Meier method and compared by the Log-rank test.Significant prognostic factors were determined using univariate and multivariable Cox proportional hazard regression analyses. Results: In the cohort of 81 pCCA patients,67 cases(82.7%) underwent major hepatectomy while 3 cases received major hepatectomy combined with pancreaticoduodenectomy.Thirty-four patients underwent hepatectomy combined with vascular resection and reconstruction(18 cases of portal vein resection and reconstruction alone;9 cases of hepatic artery resection and reconstruction alone;7 cases of combination of portal vein and hepatic artery resection and reconstruction).Margin negative(R0 excision) were achieved in 53.1%(43/81) of these patients.The operation duration was (627±136)minutes(range:565 to 940 minutes),and the intraoperative blood loss was 400(455)ml(range:200 to 2 800 ml).The 90-day postoperative mortality was 3.7%(3/81).Grade 3-4 postoperative morbidity was 23.4% (19/81) according to the Clavien-Dindo classification of surgical complications.Up to the last follow-up at September 2022,the follow-up time was 34.0(24.2)months (range:0.4 to 103.6 months).Three patients who died within 90 days after surgery were excluded from the survival analysis.The median OS was 36.10 months (95%CI:18.23 to 42.97 months) and the 1-,3-and 5-year OS rates were 85.3%,46.8% and 27.3%,respectively.The median OS of 41 patients with negative margins was 47.83 months(95%CI:36.90 to 58.80 months) and that of 37 patients with positive margins was 20.47 months(95%CI:10.52 to 30.58 months).The median RFS of 70 patients with R0 and R1 resection was 24.50 months(95%CI:12.15 to 31.85 months)and the 1-,3-and 5-year RFS rates were 65.2%,45.7% and 29.9%,respectively.The median RFS of 41 patients with R0 resection was 38.57 months(95%CI:21.50 to 55.63 months) and that of 29 patients with R1 resection was 10.83 months(95%CI:2.82 to 19.86 months). Conclusions: The primary therapy for pCCA is radical surgical resection.A precise preoperative evaluation and sufficient preparation can reduce postoperative morbidity.Surgical treatment can achieve a better survival outcome by increasing the radical resection rate.