Objective: To investigate the feasibility of one-stage total spondylectomy by anterior and posterior approaches for treating solitary plasmacytoma (SP) of cervical spine.

Objective:To study the antitumor mechanism of W40,a monomer purified from Wedelia prostrate (Hook.et Arn.) Hemsl.Methods:The effects of W40 on the cell proliferative of GLC-82 cells were detected by MTT assay and colony formation assay.The migratory abilities of GLC-82 cells were observed by wound healing assay.Cell apoptosis was evaluated by Annexin V-FITC/PI staining analysis.The levels of apoptosis-relative proteins and cell proliferation-related proteins,such as Caspase-3,PARP,Stat3 and ERK,were detected by Western blotting.Results:MTF assay showed that W40 had a significant cytotoxic effect on non-small cell lung cancer GLC-82 cells.Colony formation assays showed that W40 significantly inhibited GLC-82 cells proliferation.The migration of GLC-82 cells was inhibited by W40 in a dose-dependent manner.Flow cytometry showed that the apoptotic rate increased gradually in a concentration-dependent manner.W40 down-regulated Stat3 as decreasing p-Stat3 and downstream proteins of Bcl-2 and Mcl-1.At the same time,W40 up-regulated the expression of pro-apoptotic protein Bax,and increased the cleavaged Caspase-9,Caspase-3 and PARP.W40 also down-regulated BRAF / MAPK / ERK signal pathway as decreasing p-BRAF,p-MEK and p-ERK.Conclusions:W40 induced apoptosis by inhibiting BRAF / MAPK / ERK and Stat3 signaling pathways.

Objective: To explore the clinical and cytogenetic characteristics and risk factors of multiple myeloma (MM) patients with renal impairment (RI). Methods: A total of 113 newly diagnosed patients with MM in the department of nephrology and hematology in Zhongnan Hospital of Wuhan University from January 2013 to December 2017 were enrolled. The patients were divided into RI group and non-renal impairment (NRI) group according to whether serum creatinine (Scr) at the time of diagnosis was higher than 177 μmol/L. The clinical and laboratory data of two groups were compared. The risk factors of RI in MM patients were analyzed by binary logistic regression, and then the receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of these risk factors. Results: The incidence of RI in 113 MM patients was 34.5%. Compared with NRI group, levels of white blood cells, serum uric acid, blood urea nitrogen, neutrophil-to-lymphocyte ratio (NLR), cystatin C, β₂-microglobulin (β₂-MG), blood phosphorus, urine light chain, bone-marrow plasma cell percentage, International Staging System (ISS) stage III percentage, light chain type percentage, positive urinary Bence-Jones protein percentage and positive urinary protein percentage were higher in RI group, while levels of estimated glomerular filtration rate (eGFR), serum bicarbonate concentration and globulin were lower in RI group (all P<0.05). There were no significant differences in other clinical variables between the two groups (all P>0.05). Fluorescence in situ hybridization (FISH) was applied to 42 MM patients to detect the following five genetic abnormalities: IgH rearrangement, 1q21 amplification, RB1 deletion, D13S319 deletion and P53 deletion. Among them, 29 (69.0%) patients were abnormal. The incidence of RB1 deletion in RI group was higher than NRI group (P<0.05), and there were no significant differences in the incidences of other genetic abnormalities (all P>0.05). Further logistic regression analysis showed that increase of NLR (OR=1.589, 95%CI 1.115-2.266, P=0.010), bone-marrow plasma cell percentage (OR=1.053, 95%CI 1.008-1.101, P=0.021) and β₂-MG (OR=22.166, 95%CI 2.146-228.927, P=0.009), light chain type (OR=15.399, 95%CI 1.002-236.880, P=0.049), and hyperuricemia (OR=11.707, 95%CI 1.580-86.717, P=0.016) were the independent risk factors for RI in MM patients. The comparison of area under the ROC (AUC) among these risk factors showed the AUC of β₂-MG was larger than that of NLR or uric acid (both P<0.05), while there were no significant differences in the rest of pairwise comparison (all P>0.05). The AUC of β₂-MG predicting RI was the largest (AUC=0.907, 95%CI 0.853-0.962, P<0.001). Conclusions MM patients have high morbidity of RI, and there are more RI patients with RB1 deletion in RI patients. Light chain type, hyperuricemia, high level of NLR, high bone-marrow plasma cell percentage and increased β₂-MG are the independent risk factors for RI in MM patients. Among them, β₂-MG is the best predictor for RI, and NLR plays an important role in predicting RI as a convenient and effective inflammatory marker.

The purpose of this study was to determine the expression levels of IL-17 in serum and IL-17 receptor (IL-17R) in intestinal mucosa tissue in patients with ulcerative colitis (UC) and controls, and evaluate their relationship with disease activity and explore the role of IL-17 in the patho-genesis of UC. A total of 36 Chinese UC patients and 60 healthy controls were enrolled in this study. Serum IL-17 and C-reactive protein (CRP) levels were determined by ELISA and immunonephelometry, respectively. The IL-17R mRNA expression levels were detected by quantitative PCR. Serum IL-17 levels were significantly elevated in UC patients as compared with those in the healthy controls (P<0.05). Among UC patients, serum IL-17 levels were significantly increased in active phase as compared with those in inactive phase (P<0.05), and correlated with CRP levels (r=0.578, P<0.01). IL-17R expression levels were higher in active UC patients than in healthy controls (P<0.05). It was concluded that IL-17 levels were highly expressed in UC, especially in active phase, and correlated with CRP levels in UC patients.
Adult ; Biomarkers ; blood ; C-Reactive Protein ; metabolism ; Case-Control Studies ; Colitis, Ulcerative ; blood ; pathology ; Female ; Humans ; Interleukin-17 ; blood ; Male ; Middle Aged ; RNA, Messenger ; blood ; Receptors, Interleukin-17 ; genetics ; metabolism

【Objective】 To investigate the efficacy and safety of double-sheath vacuum suction microchannel percutaneous nephrolithotomy (MPCNL) in the treatment of complex renal stones. 【Methods】 The clinical data of 139 patients with complicated renal stones who received MPCNL during Aug. 2019 and Jul.2020 were retrospectively analyzed. According to the operation modes, the patients were divided into the double-sheath vacuum suction group (dsVS group, n=72) and conventional nephrostomy sheath group (cNS group, n=67). The perioperative indexes and the first-stage stone clearance rate of the two groups were compared. 【Results】 In the dsVS group and cNS group, the mean operation time was (46.72±9.55) min and (57.22±11.31) min, respectively (P<0.05). The first-stage stone clearance rate was 83.33% and 70.15%, respectively (P<0.05). The BUN value was (5.07±1.65) mmol/L and (5.75±1.83) mmol/L, respectively (P<0.05). The WBC value was (9.45±2.46)×10⁹/L and (10.71±3.14)×10⁹/L, respectively (P<0.05). The incidence of postoperative fever was 1.39% and 11.94%, respectively (P<0.05). There was no significant difference in other clinical data between the two groups (P>0.05). 【Conclusion】 The double-sheath vacuum suction MPCNL is safe and effective to manage complex renal stones, which can shorten the operation time, reduce postoperative complications, and improve the stone clearance rate.

Objective To retrospectively analyze the clinical and pathological data of 48 patients with adenoid cystic carcinoma of the head and neck and screen out related factors that affect the patient's prognosis. Methods The overall survival rate of patients is used as the main indicator for observing prognosis. We selected 11 clinical and pathological factors as observation indicators that may have an impact on the survival and prognosis of patients. The relation between observation factors and the overall survival rate of patients was analyzed by Cox multivariate regression. Results The median follow-up time was 33.5(1-98) months. The 1-, 2- and 5-years overall survival rates were 95%, 91% and 87%. Local recurrence occurred in 14(29.2%) patients. Distant metastasis occurred in 22(45.8%) patients. Cox regression analysis showed that recurrence, distant metastasis and primary site were correlated with the overall survival rate of patients with head and neck adenoid cystic carcinoma (P < 0.05). Conclusion Adenoid cystic carcinoma is a relatively rare tumor of the head and neck with a low degree of malignancy. However, recurrence, distant metastasis and primary site have relatively great impact on the prognosis of patients.

Objective  To study the effects of fine particulate matter(PM_2.5) on the autophagy in human melanocytes. Methods PM_2.5 was collected in Huanggang city. Then the water-soluble extracts and non-water-soluble extracts were isolated and the melanocytes were exposed to a W-PM_2.5 or NW-PM_2.5 with various concentrations. Autophagy of melanocytes was observed by MDC staining, and the expression of LC3-II /I were detected by immunohistochemistry and western blot. Results With the increase of concentration of W-PM_2.5 and NW-PM_2.5, the expression of melanocyte autophagosome and LC3-II /I increased, and the autophagy response was significantly enhanced（P<0.01）.In addition, the results of western blot showed that, at the same concentration, NW-PM_2.5 components had a stronger effect on promoting LC3II/I expression than W-PM_2.5 components（P<0.01）.Conclusion PM_2.5 can induce oxidative stress injury and excessive autophagy of melanocytes.

Objective: To explore the values of intraoperative fine-needle aspiration (IFNA) and parathyroid hormone (PTH) detection in the eluate of aspirated tissue during parathyroidectomy. Methods: Fifty-four patients with secondary hyperparathyroidism (SHPT) including 24 males and 30 females, aged 20-83 years, admitted to Zhongnan Hospital of Wuhan University from January 2019 to October 2019, were included. All patients received subtotal parathyroidectomy with autologous transplantation, during surgery, IFNA and PTH detection in the eluate of aspirated tissue were performed, and also routine postoperative pathological examination was performed. The results of PTH detection in the eluate of aspirated tissue and postoperative pathological examinations were compared and analyzed by SPSS and R software for evaluating of the sensitivity, specificity, positive predictive value, negative predictive value, misdiagnosis rate, missed diagnosis and accuracy. Results: Surgery was completed successfully in all patients. After surgery, the symptoms were improved in the patients except two who were asymptomatic. None had any serious postoperative complications such as hypocalcaemia or hoarseness. A total of 231 aspirated tissue samples were tested, of which 216 were identified as parathyroid and 15 non-parathyroid based on intraoperative PTH detection in tissue eluate; while 217 were confirmed as parathyroid tissues and 14 non-parathyroid tissues with postoperative pathological examinations. The specificity and sensitivity of intraoperative IFNA and PTH detection in tissue eluate for identifying parathyroid tissues were 99.5% and 100.0%, respectively. Conclusion: The IFNA and PTH detection in tissue eluate is a rapid, simple, and accurate procedure, which helps the surgeon to identify parathyroid tissue and to ensure the endocrine activity of preserved or autografted parathyroid tissue during parathyroidectomy.
Female ; Humans ; Hyperparathyroidism, Secondary/surgery* ; Male ; Parathyroid Glands/surgery* ; Parathyroid Hormone ; Parathyroidectomy ; Predictive Value of Tests

Objective: To investigate the application efficacy of the "classification of external branch of superior laryngeal nerve (EBSLN)" combined with intraoperative neuromonitoring (IONM) in the dissection of EBSLN for protecting the nerve from injuery, compared with ligation of branches of the superior thyroid vessels without attempts to visually identify the nerve. Methods: A prospective randomized controled study was performed in our center. Patients subjected to thyroidectomy from January 2017 to June 2019 were randomly divided into 2 groups, patients in experimental group underwent thyroidectomy and "classification of EBSLN" with IONM to dissect EBSLN, and patients in control group received synchronous surgery without attempts to visually identify the nerve. The anatomical subtypes of EBSLN in experimental group were recorded. The voice handicap index 10 (VHI-10) score was evaluated and the movement of bilateral vocal cords was examined by laryngoscope before surgery, 1 month, 3 months, and 6 months after surgery, respectively. SPSS 26.0 statistical software was used for statistical analysis. Results: Among the 1 377 EBSLN from 827 patients (317 males and 510 females, aged 24-58 years old), 691 EBSLNs in experimental group and 686 EBSLNs in control group. Totally 98.3% of EBSLNs in experimental group were identified by IONM including 16.4% (113/691) for type Ⅰ, 21.3% (147/691) for type Ⅱa, 31.4% (217/691) for type Ⅱb, 10.4% (72/691) for type Ⅲa, 3.9% (27/691) for type Ⅲb, 16.6% (115/691) for type Ⅲc. There was no statistical significance difference in baseline data between 2 groups (all P>0.05). All patients were followed up for more than 6 months. The postoperative nerve injury rate of experimental group was significantly lower than that of control group (1.2% vs. 7.5%, χ²=12.659, P<0.001), and the VHI-10 scores and laryngoscope results of experimental group were better than those of control group in three follow-up visits (P<0.001). With postoperative laryngoscope examination, 3 patients in the experimental group and 23 patients in the control group showed vocal cord relaxation, bilateral oblique asymmetry and other phenomena, which were considered as the results of permanent injury. Other patients with symptoms were relieved to varying degrees during the follow-up, and their symptoms were considered as the results of temporary injury. Conclusion: IONM combined with "classification of EBSLN" can reduce significantly the risk of EBSLN injury in thyroidectomy, which is better than direct ligation of branches without attempts to visually identify the nerve.
Adult ; Female ; Humans ; Laryngeal Nerve Injuries ; Laryngeal Nerves ; Male ; Middle Aged ; Monitoring, Intraoperative ; Prospective Studies ; Thyroid Gland ; Thyroidectomy ; Young Adult

By analyzing the main problems existing in the current management of medical devices for clinical trials, this study proposes a feasible management model and specific requirements for acceptance, distribution, storage and recovery combining with the characteristics of medical consumable equipment and diagnostic reagent, which provides a favorable guarantee for the authenticity and reliability of clinical trials.
Clinical Trials as Topic ; Equipment and Supplies/standards* ; Indicators and Reagents/standards* ; Reproducibility of Results ; Research Design/standards*