Objective To investigate the charateristics of neuroendoscopic anatomy of the pineal region,discuss the anatomy passage and surgical tips of 2 different procedures,and provide anatomical application fundamentals for neuroendoscope-assisted operation of the pineal region.Methods Fifteen specimens of Chinese adult cadaveric head were selected randomly to simulate neuroendoscope-assisted microneurosurgery via suboccipital transtentorial and infratentorial supracerebellar routes.The exposure range and endoscopic adjustable degrees of anatomical structure of the pineal region through different routes were obsevred,and the related data of the anatomical structure via different routes were measured.Results In the simulating operation through suboccipital transtentorial route,the regulation of neuroendoscopy was flexible and both lateral anatomical structures of the pineal region were exposed clearly; in the simulating operation through inffatentorial supracerebellar route,inferior colliculis were not exposed clearly and the view of this route was stiffness and fixed with difficult regulation of the endoscope.The lengh of Galen's vein (GV) is (10.2±4.1) mm,that of internal cerebral vein (ICV) is (35.0±2.8) mm,that of basal vein (BV) is (35.4±6.4) mm and that of straight sinus is (51.1 ±5.2) mm; the angle GV and straight sinus formed (75.20±10.4)°,including acute angle in 14 cases and obtuse angle in 1.The imaginary extension of straight sinus located inferiorly to the splenium of corpus callosum was observed in 3 cases,located tangently to the splenium of corpus callosum in 11 cases,and located superiorly to the splenium of corpus callosum in 1 case.Conclusion Anatomic structures of the pineal region via neuroendosopic suboccipital transtentorial approach are exposed clearly than those via infratentorial supracerebellar approach,however,dissection oftentorium can improve the regulation ofneuroendoscope and exposition ofcontralateral anatomic structure.

OBJECTIVETo investigate the expression and clinical impact of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) in hepatocellular carcinoma (HCC).

METHODSNinety specimens obtained from HCC patients were examined immunohistochemically using anti-VEGF and anti-MMP-2 monoclonal antibodies.

RESULTSThe positive rates of VEGF and MMP-2 expression in HCC tissues were 76.7% and 60%, respectively. The expression of MMP-2 in HCC tissues was positively correlated with the expression of VEGF (r(s) = 0.32) and both were positively correlated with recurrence (or metastasis) after hepatectomy (r(s) = 0.31, r(s) = 0.32). 2-year tumor-free survival rates of VEGF- group, VEGF+ group and VEGF++ group were 71.4%, 43.5%, 30.4%, respectively, (P < 0.01), while MMP-2- group 66.7% and MMP-2+ group 32.8% (P < 0.01). Multivariate analysis revealed that the expression of VEGF and MMP-2 in HCC tissues, tumor microthrombus and pre-operative dissemination to lymph nodes were independent recurrence (or metastasis) risk factors.

CONCLUSIONThe expression of VEGF and MMP-2 in HCC tissues, and clinicopathological features (tumor microthrombus and pre-operative dissemination to lymph nodes), could be regarded as valuable indicators for prediction of recurrence (or metastasis) risk in HCC patients.

Adult ; Aged ; Carcinoma, Hepatocellular ; metabolism ; mortality ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver Cirrhosis ; complications ; Liver Neoplasms ; metabolism ; mortality ; surgery ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplastic Cells, Circulating ; metabolism ; Prognosis ; Proportional Hazards Models ; Survival Rate ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo investigate the expression and clinical significance of some apoptosis and angiogenesis factors in hepatocellular carcinoma (HCC).

METHODSThe expression of p53, Survivin, matrix metalloproteinases (MMP)-2, MMP-9 and vascular endothelial growth factor (VEGF) in 90 specimens of HCC was detected by immunohistochemistry. Correlations of the factors to the recurrence of HCC after hepatectomy were analyzed.

RESULTSThe positive rate of p53, Survivin, MMP-2, MMP-9 and VEGF in HCC tissue was 33.3%, 51.1%, 60.0%, 37.8% and 76.7%, respectively. Of the 5 factors, positive correlation only occurred between the expression of MMP-2 and VEGF, MMP-9 and VEGF. The expression of MMP-2, MMP-9 and VEGF was correlated to the recurrence of HCC. The 1-, 2-, and 3-year tumor-free survival rates were significantly higher in MMP-2 (-) group than in MMP-2 (+) group, and the same results were found with MMP-9 and VEGF. Multivariate analysis revealed that macroscopically disseminated nodules, tumor micrometastasis, serum alpha fetal protein (AFP) level, the expression of MMP-9 and VEGF were independent recurrence risk factors in HCC.

CONCLUSIONSNeither p53 nor Survivin is correlated to the recurrence of HCC; MMPs and VEGF are correlated to the recurrence, and can be used to estimate the risk of postoperative recurrence of HCC.

Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Liver Neoplasms ; metabolism ; pathology ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Microtubule-Associated Proteins ; metabolism ; Middle Aged ; Multivariate Analysis ; Neoplasm Proteins ; metabolism ; Neoplasm Recurrence, Local ; Tumor Suppressor Protein p53 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo investigate the clinicopathological features and immunophenotypes of male genitourinary system lymphoma.

METHODSWe retrospectively studied the histopathological characteristics and immunohistochemical markers of 35 cases of male genitourinary system lymphoma, and reviewed the relevant literature.

RESULTSThe 35 patients of male genitourinary system lymphoma were aged from 4 to 83 (mean 56.5) years, 28 (80%) of them > or = 50 years. Twenty-eight cases (80%) involved the testis, 3 (8.6%) the prostate, 1 (2.9%) the spermatic cord, 1 the seminal vesicles, 1 the penis and 1 the epididymis. Histologically, 22 cases (62.9%) were diffused large B cell lymphoma (DLBCL), 6 (17.1%) mucosa associated lymphoid tissue (MALT) lymphoma, 4 (11.4%) Burkitt lymphoma, 2 (5.7%) peripheral T cell lymphoma, and 1 (2.9%) plasmacytoma.

CONCLUSIONMale genitourinary system lymphomas are rare tumors clinically, which occur more often in the elderly. The majority of them are B cell lymphomas, of which the most common is DLBCL, followed by MALT lymphoma and Burkitt lymphoma. T cell lymphoma and plasmacytoma are rare. The diagnosis of male genitourinary system lymphoma relies on the histopathology, and immunohistochemical markers are of high value for its definite diagnosis, classification and differential diagnosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Genital Neoplasms, Male ; pathology ; Humans ; Lymphoma ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Atherosclerosis ; etiology ; prevention & control ; Cytokines ; secretion ; Dendritic Cells ; drug effects ; immunology ; Endocytosis ; Fenofibrate ; pharmacology ; Humans ; Immunophenotyping ; Lipoproteins, LDL ; toxicity ; Monocytes ; cytology ; PPAR alpha ; agonists ; physiology

OBJECTIVETo investigate the value of the HCT-CI score in chemotherapy risk assessment and prognosis of elderly patients with acute myeloid leukemia (AML).

METHODSThe clinical data of 116 AML patients older than 60 years in the department of Hematology, Henan Provincial People's Hospital from January 2000 to December 2010 were analyzed retrospectively. All patients received cytarabine-based regimens, including protocol DA, MA, IA, AA or CAG, followed by cytarabine-based postremission treatment. (1) Comorbidities were evaluated by using HCT-CI score, the early death rates and median survival time were compared among these different groups. (2) These prognostic factors were analyzed by univariate and multivariate analyses.

RESULTS(1) All 116 cases were followed-up. The patient cohort was divided into those with HCT-CI scores of 0, 1 or 2, or ≥ 3. Early death rates were 3.7%, 12.1% and 23.21% in above three groups, respectively (P < 0.01). Overall survival were 345, 225 and 113 days, respectively (P < 0.01). (2) HCT-CI score ≥ 3 (P < 0.01), antecedent MDS history (P = 0.035), high-risk karyotype (P = 0.018), white blood cells at diagnosis ≥ 100×10(9)/L (P = 0.041) were independent adverse prognostic factors with multivariate analysis.

CONCLUSION(1) The HCT-CI score can objectively assess elderly AML patients with comorbidities and predict chemotherapy risk in older patients receiving AML induction therapy. (2) Antecedent MDS history, high-risk karyotype, high white blood cell, and HCT-CI score ≥ 3 are independent adverse prognostic factors of elderly AML patients.

Aged ; Aged, 80 and over ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Leukemia, Myeloid, Acute ; diagnosis ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Treatment Outcome

Objective To explore the application effect of new improved 3D printing individualized guidance(3D psi)in total knee arthroplasty(TKA)for knee osteoarthritis(KOA).Methods A total of 100 patients with KOA in 920th Hospital of Joint Logistics Support Force,PLA from January 2021 to January 2022 were selected,and were divided into 2 groups of 50 patients each using the randomized numerical table method.The control group was treated with conventional TKA,and the study group was treated with new improved 3D psi assisted TKA.The operation conditions,postoperative rehabilitation,complications,prosthesis component position deviation,knee range of motion(ROM),lower limb force line parameters[coronal distal femoral mechanical axis lateral angle(mldfa),lower limb mechanical axis angle(HKA)],gait parameters(percentage of support time,stride,pace),knee function(HSS score),quality of life(AIMS2 score)were observed.Results Com-pared with control group,the amount of intraoperative and postoperative blood loss and drainage volume 2 days after operation were less in the study group,and the operation time and hospital stay were shorter(P<0.05).The deviations of LTC Angle,FFC Angle,HKA Angle,LFC Angle and FTC Angle in the study group were smaller than those in the control group(P<0.05).At 3 months,6 months and 12 months after surgery,the percentage of knee ROM,supporting time,stride length and walking speed of the research group were higher than those of the control group,while the coronal-position mLDFA and HKA were lower than those of the control group(P<0.05).The proportion of WBC and PMN in joint fluid at 3 months,6 months and 12 months after surgery was lower than that in control group(P<0.05).The HSS score of the study group was higher than that of the control group at 3 months,6 months and 12 months after operation,and the AIMS2 score was lower than that of the control group(P<0.05).There was no statistically significant difference in the incidence of complications between the study group and the control group(P>0.05).Conclusion The new improved 3D PSI-assisted TKA treatment of KOA can optimize the surgical situation,improve operating accuracy,improve the patient's lower limb alignment,promote limb function recovery,help improve the quality of life,and has high safety.

Bortezomib/therapeutic use* ; CD56 Antigen ; Humans ; Multiple Myeloma ; Prognosis ; Proto-Oncogene Proteins c-kit

Purpose: In patients with acute left-sided colonic obstruction, stenting can convert an emergency operation into a semi-elective procedure. However, its use continues to be debated. We performed a cost-effective analysis using our institution’s experiences. Methods: Endoscopic, surgical, and financial details were prospectively collected for patients who presented with acute colonic obstruction and underwent stenting between 2019 and 2022. Outcomes were defined as technical/clinical success and successful surgical resection. The financial cost of stenting was compared with the expected cost without stenting. Results: Forty patients were included, with 29 undergoing definitive resection. The most common pathology was primary colon cancer (27 patients, 93%). Endoscopic stenting had high technical (90%) and clinical (83%) success rates, with low rates of complications such as perforation (2 patients, 7%) and migration (0 patients, 0%). As a bridge to surgery, the median procedure time was 226 minutes and the surgical outcomes also showed a low rate of complications (3 patients, 11%), such as anastomotic leakage (0 patients, 0%), intraabdominal abscesses (2 patients, 7%), and 30-day postoperative mortality (0 patients, 0%). The cumulative costs with colonic stenting were $32,900, while the expected costs with emergency surgery, including stoma reversal, were $40,700 (healthcare cost-savings of $7,800 per person). The difference was mainly due to the avoidance of upfront emergency surgery. The incremental cost-effectiveness ratio was 0.81, favoring colonic stenting over upfront emergency surgery. Conclusion Colonic stenting as a bridge to surgery is safe and cost-effective for treating left-sided colonic obstruction with high success rates and low complication rates.