Colectomy ; Colorectal Neoplasms/surgery* ; Humans ; Laparoscopy ; Treatment Outcome

Combined hepatocellular-cholangiocarcinoma (CHC) is a mixed tumor containing elements of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC).Its remarkable histological heterogeneity has been linked to putative hepatic progenitor cell (HPC) origin.However,detailed histological or phenotypic description is rarely documented.In the present study,we reassessed 68 cases previously diagnosed as hepatitis B-related CHCs by immunohistochemistry and double-fluorescence immunostaining,focusing on HPC associated phenotypic observation of intermediate area of the tumor.It was found that tumor cells showed remarkable heterogeneity in intermediate area.Tumor cells with intermediate morphology between hepatocytes and cholangiocytes were oval-shaped and small with scant cytoplasm and hyperchromatic nuclei,arranging in solid nests mostly.By Keratin 7 (K7) staining,it appeared that the nests of tumor cells represented a maturation process from the undifferentiated small cells to mature hepatocytes through the "transitional" cells.Then,these small cells were further confirmed with intermediate phenotype as HPC by exploring immature hepatocellular marker and HPC/biliary markers co-localization.In conclusion,the HPC associated trait in CHC can be interpreted by HPC origin or gain of"stemness" by dedifferentiation.It is still too soon to give a final word that it is innate or acquired signature of HPC associated trait in CHC.

Objective To investigate the clinical relevant factors causing laryngeal stenosis after partial laryngectomy and the its nursing intervention. Methods A retrospective study was carded out to review the history clinical data from 138 patients of partial laryngectomy in the First Affiliated Hospital of Sun Yat-Sen University between January 1994 to October 2004. The clinical relevant factors causing laryngeal stenosis included age,sex,TNM stage, original position tumor, resects extension of thyroid cartilage, resects extension of larynx parenchyma, repair model, larynx pattern, duration of using bacteriophage postoperative, postoperative radiotherapy, lung infection postoperative, gastroesophageal reflux, diabetes. Multivariate stepwise logistic regression model was used for the analysis. Results Among 138 cases after partial laryngectomy, stenosis developed in 25 cases, incidence rate was 18.12%. In multivariate analysis,it was confirmed that the following variable correlated to laryngeal stenosis, resects extension of thyroid cartilage, postoperative radiotherapy, lung infection postoperative, and gastroesophageal reflux. Conclusions The clinical relevant factors causing laryngeal stenosis after partial laryngectomy were various. Statistical analysis showed that resects extension of thyroid cartilage, postoperative radiotherapy, lung infection postoperative, gastroesophageal reflux were risk factors which may cause laryngeal stenosis. The prophylactic nursing interventions should be taken to cut down the rate of laryngeal stenosis after partial laryngectomy and improve the quality of life.

To investigate the spatiotemporal properties of epileptiform activity in vitro, 400 microm-thick transverse hippocampal slices were prepared from juvenile rat and planar multi-electrode array (MEA) containing 60 electrodes was used to record the electrical activity induced by bath application of high potassium artificial cerebrospinal fluid (ACSF) on slices. Following successful induction of epileptiform bursts, phenobarbital sodium was applied to test for its inhibitory effects on bursting activity in different regions of slice. Region-specific characteristics of epileptiform activity and anticonvulsant actions of phenobarbital sodium in the hippocampal network were determined by comparing the population activity obtained from MEA. The results showed that: (1) 15 min after high-K+ ACSF application, rhythmic and synchronous epileptiform bursts could be detected from all CA sub-regions. Quantitative analysis indicates that the firing patterns of different CA sub-regions were not statistically different (P>0.05). However, no bursting activity was recorded from granular cells in dentate gyrus, only sparse spikes were observed, with frequency significantly lower than that in CA regions (P<0.05). (2) The high-K+-induced bursting activity could last for more than 40 min with stable bursting activities. (3) Bath application of 60 micromol/L phenobarbital sodium inhibited the bursting activities on hippocampal slice. Bursting activities in CA3c and CA1 were firstly suppressed. 10 min after the phenobarbital sodium application, strong bursting activities persisted only in some of pyramidal cells in CA3a and CA3b. These results show that MEA could be applied for studying the spatial and temporal properties of epileptiform activity in vitro, as well as the region-specific effects of anti-epileptic drugs.
Action Potentials ; physiology ; Animals ; Electrodes ; Electroencephalography ; Electrophysiological Phenomena ; physiology ; Epilepsy ; physiopathology ; Hippocampus ; physiopathology ; In Vitro Techniques ; Male ; Rats ; Rats, Sprague-Dawley ; Signal Processing, Computer-Assisted

OBJECTIVETo evaluate the accuracy of sentinel lymph node mapping(SLM) in patients with rectal cancer by single-photon emission computed tomography (SPECT-CT) lymphoscintigraphy and carbon nanoparticles suspension injection.

METHODSTwelve patients with clinical T(1-2)N(0)M(0) rectal cancer were selected and locally injected with technetium-(99m)sulfur-colloid and carbon nanoparticles suspension by endoscope one day before surgery, followed by SPECT-CT scanning 1, 3 and 5 hours later. Radioactive isotope(RI) uptake of each sentinel node(SN) basin with location preoperatively determined by SPECT-CT was postoperatively calculated using gamma probe. Nodes with the highest RI uptake, the number of which was also pre-determined by SPECT-CT, was defined as SNs. Immunohistochemical cytokeratin staining was performed for all the SNs and non-SNs.

RESULTSThe rate of sentinel node detection was 91.7%(11/12) with at least one SN(1-3) per patient. Ten cases showed metastasis-negative in SNs as well as all the resected regional nodes by immunohistochemical cytokeratin staining. Only one patient had positive nodes in both SN and non-SNs. The accuracy of SLM was 100%.

CONCLUSIONSPECT-CT lymphoscintigraphy and carbon nanoparticles suspension injection can effectively detect the anatomic location and number of sentinel nodes, and improve the accuracy of SLM for rectal cancer.

Adult ; Aged ; Carbon ; Female ; Humans ; Male ; Middle Aged ; Nanostructures ; Rectal Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Sentinel Lymph Node Biopsy ; methods ; Tomography, Emission-Computed, Single-Photon ; methods ; Tomography, X-Ray Computed ; methods

Objective: To explore the correlation among carotid atherosclerosis, ankle-brachial index (ABI) and urinary microalbumin (UMA) level in patients with essential hypertension (EH). Methods: A total of 215 EH patients treated in our hospital from Apr 2014 to Aug 2015 were selected. According to 24h UMA level, patients were divided into normal UMA group (n=116) and microalbuminuria (MAU) group (n=99). General data, UMA level, carotid intima-media thickness (CIMT), carotid artery lumen diameter, incidence rate of plaque and ABI were measured and compared between two groups. Correlation among CIMT, ankle-brachial index (ABI) and urinary microalbumin (UMA) level was analyzed in EH + MAU patients. Results: There were no significant difference in age, gender, levels of blood pressure, fasting blood glucose, blood lipids and serum creatinine between two groups, P＞0. 05 all. Compared with normal UMA group, there were significant rise in UMA level [21. 25 (15. 75, 25. 75) mg/d vs. 86. 50 (56. 50, 104. 50) mg/d], CIMT [(1. 20± 1. 09) mm vs. (1. 76±0. 81) mm]and incidence rate of plaque (55. 17％ vs. 75. 76％), and significant reduction in ABI [(1. 12±0. 11) vs. (0. 97±0. 11)] in MAU group, P＜0. 01 all. Linear correlation analysis indicated that UMA level was significant positively correlated with CIMT (r=0. 551, P=0. 001), and significant inversely correlated with ABI (r=-0. 266, P=0. 008) in EH + MAU patients. Conclusion: In EH+ MAU patients, MAU is significant positively correlated with CIMT, and significant inversely correlated with ABI, suggesting MAU is not only related to hypertensive renal disease, but also an early sign of subclinical atherosclerosis.

Objective To analyze the biochemical characteristics and clinical characteristics of heart failure patients with intermediate ejection fraction.Methods From June 2012 to June 2017,nine hundred and thirty patients with heart failure who were hospitalized and treated in Beijing Anzhen Hospital were selected.According to left ventricular ejection fraction (LVEF),the patients were divided into heart failure with reduced left ventricular ejection fraction group (LVEF＜40％),heart failure with midrange left ventricular ejection fraction group (LVEF 40％-49％) and heart failure with preserved left ventricular ejection fraction group (LVEF ≥ 50％).The number of cases of acute heart failure and chronic stable heart failure was recorded.The general patient information (gender,age,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),NYHA classification) laboratory test results (Brain Brain natriuretic peptide (BNP)) and echocardiography (left ventricular end-diastolic diameter (LVEDD),left atrium diameter (LAD),septal thickness (interventricular septum thickness,IVSD),left ventricle posterior wall thickness (LVPWT) were collected.Results The proportion of patients with acute heart failure in the midrange left ventricular ejection fraction heart failure was similar to the heart failure with reduced left ventricular ejection fraction (38.0％ (35/92) vs.45.4％ (210/463),P＞0.05),but significantly higher than the heart failure with preserved left ventricular ejection fraction (38.0％ (35/92) vs.10.4％(210/463),P=0.000).The proportion of NYHA class IV patients in the heart failure with midrange left ventricular ejection fraction was lower than the heart failure with reduced left ventricular ejection fraction(10.9％(10/92) vs.24.6％(114/463),P=0.000),and higher than the heart failure with preserved left ventricular ejection fraction (10.9 (10/92) ％ vs.2.9％ (11/375),P =0.000).Left atrial diameter,left ventricular end diastolic diameter in the heart failure with reduced left ventricular ejection fraction were maximum ((47 ± 8) mm,(67.3 ± 9.0) mm),the heart failure with midrange left ventricular ejection fraction were medium ((44 ± 7) mm,(60.0 ± 7.5) mm),the heart failure with preserved left ventricular ejection fraction were minimum((42±7) mm,(41.7±6.1)mm),and the difference between the three groups was statistically significant (F =44.200,F =648.426,P ＜ 0.05).Conclusion Some biochemical and echocardiographic features of heart failure with midrange left ventricular ejection fraction patients are located between heart failure with reduced left ventricular ejection fraction and heart failure with preserved left ventricular ejection fraction.The LVEDD is significantly increased in heart failure with midrange left ventricular ejection fraction and heart failure with reduced left ventricular ejection fraction group.The ventricular remodeling in heart failure with midrange left ventricular ejection fraction is similar to that of heart failure with reduced left ventricular ejection fraction.

BACKGROUND: Catheter ablation is effective in restoring sinus rhythm and left atrial appendage closure (LAAC) is increasingly used for stroke prevention in patients with atrial fibrillation (AF). We aimed to observe the feasibility and safety of performing AF ablation and LAAC in a single (one-stop) procedure. METHODS: Consecutive AF patients who underwent the combined procedure of AF ablation and LAAC with WATCHMAN device between March 2017 and September 2018 were prospectively enrolled. Baseline and intra-procedural parameters were evaluated. Three-month and subsequent 1-year follow-up were performed in all and earlier-enrolled subjects, respectively. RESULTS: A total of 178 AF patients (94 males, 68.9 ± 8.1 years) underwent the one-stop procedure with CHA2DS2-VASc score 3.3 ± 1.5 and HAS-BLED score 1.6 ± 1.0, respectively. Pulmonary vein isolation was achieved in all patients while additional linear ablation was applied if the operator deemed necessary, yielding immediate ablation success rate of 98.9% (176/178). In the subsequent LAAC, satisfactory seal (residual leak <5 mm) was achieved in all patients. One stroke and four cardiac perforations occurred peri-operatively. At 3-month follow-up, sinus rhythm and satisfactory seal were maintained in 153/178 (86.0%) and 178/178 (100%) patients, respectively. One stroke and one delayed cardiac tamponade occurred, while no device-related thrombus or device migration was observed. During the 1-year follow-up for the earlier enrolled subjects, 52/72 (72.2%) of the patients maintained sinus rhythm. There was no stroke or systemic embolism observed. CONCLUSION Combining catheter ablation and LAAC in a single procedure can be successfully and safely performed in non-valvular AF patients of Chinese population.

OBJECTIVES: To study the early clinical efficacy of combined therapy of stage 4 neuroblastoma. METHODS: A retrospective analysis was performed on the medical data and follow-up data of 14 children with stage 4 neuroblastoma who were diagnosed in Hong Kong University-Shenzhen Hospital from January 2016 to June 2021. RESULTS: The median age of onset was 3 years and 7.5 months in these 14 children. Among these children, 9 had positive results of bone marrow biopsy, 4 had N-Myc gene amplification, 13 had an increase in neuron-specific enolase, and 7 had an increase in vanilmandelic acid in urine. Based on the results of pathological examination, differentiated type was observed in 6 children, undifferentiated type in one child, mixed type, in one child and poorly differentiated type in 6 children. Of all the children, 10 received chemotherapy with the N7 regimen (including 2 children receiving arsenic trioxide in addition) and 4 received chemotherapy with the Rapid COJEC regimen. Thirteen children underwent surgery, 14 received hematopoietic stem cell transplantation, and 10 received radiotherapy. A total of 8 children received Ch14.18/CHO immunotherapy, among whom 1 child discontinued due to anaphylactic shock during immunotherapy, and the other 7 children completed Ch14.18/CHO treatment without serious adverse events, among whom 1 child was treated with Lu177 Dotatate 3 times after recurrence and is still undergoing chemotherapy at present. The median follow-up time was 45 months for all the 14 children. Four children experienced recurrence within 2 years, and the 2-year overall survival rate was 100%; 4 children experienced recurrence within 3 years, and 7 achieved disease-free survival within 3 years. CONCLUSIONS Multidisciplinary combined therapy is recommended for children with stage 4 neuroblastoma and can help them achieve better survival and prognosis.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Child ; Child, Preschool ; Combined Modality Therapy ; Humans ; Infant ; Neuroblastoma/drug therapy* ; Positron-Emission Tomography ; Radionuclide Imaging ; Retrospective Studies ; Treatment Outcome