2 cm) according to the size of lesions. Large wound sections were sutured with metal clips. Results Histopathologic investigation showed that among 54 lesions,there were 13 cases of adenoma,38 cases of adenoma with atypical hyperplasia (10 cases with mild dysplasia,23 with moderate dysplasia and 5 with severe dysplasia )and 3 cases of mucosal cancer. We followed forty cases,local recurrence was found in none of 29 cases after 6 months of EMR. However,the recurrence was found in 2 of 11 cases after 1 month of EPMR and 1 each after 3 and 6 month of EPMR. There was no recurrence after further endoscopic re-treatment. Among 3 cancer patients,2 patients shifted to surgery due to patient's preference and 1 patient was followed up for 6 months. All of them were found without local recurrence by endoscopic biopsies or surgical results. Conclusions Chromoscopy,magnifying colonoscopy and EUS have benefits in diagnosis of early large bowel tumors,and it is also helpful in selecting the proper treatment so as to reduce the complication and recurrence.

Objective To evaluate the effects of thalidomide in combination with dexamethasone (ID) in patients with relapsed or refractory multiple myeloma and in patients on stable phase. Methods Sixty-two patients with multiple myeloma were studied, include 25 with relapsed or refractory multiple myeloma, and 37 in stable phase. For the relapsed or refractory patients, thalidomide and dexamethasone was given at first three cycles, and then other regiments were given to no-response patients. For the all response patients, the second three cycles TD were enforced. On stable phase patients, thalidomide and dexamethasone were given as the second three cycles of relapsed or refractory patients. Then, thalidomide was given persistently until the disease relapse. Results All of the 25 relapsed or refractory patients were accepted the first 3 cycle TD treatment. The total response rate (VGPR+PR+MR) was 80 %. No complete remission (CR) and near CR(nCR) was gained. For the all response patients, the second three cycles TD were enforced. One patient achieved nCR. Thalidomide was given to all response patients. The median remission time was 6.8 (4～12) months. TD regimen was used to the 37 stable phase patients. The median remission time was 17.5 (8～26) months. The remission time of stable remission patients is longer then that of relapsed or refractory patients (P <0.001). Conclusion The combination of thalidomide and dexamethasone is a feasible and active regimen in the treatment of relapsed or refractory, and stable phase myeloma patients.

Objective To investigate the related factors of postoperative hypocalcemia after thyroid carc-er surgery.Methods 346 cases of thyroid carcer patients undergoing surgery from Jan .2013 to Dec.2013 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed .Results 129 cases developed hepocalcemia after thyroid surgery .Among the related factors that may cause postoperative hypocalcemia , the scope of surgery , parathyroid injury and secondary surgery might play important roles .Conclusions The inci-dence of postoperative hypocalcaemia is high after total thyroidectomy .Patients with reoperation and lymph node dissection have an increased rate of postoperative hypocalcaemia .In order to reduce hypocalcaemia incidence ,sur-gons need to protect parathyroid blood supply in thyroid surgery and give calcium after surgery .

Objective To retrospectively analyze the outcomes and adverse effects of sequential therapy of BTD and MPT regimen for the newly-diagnosed multiple myeloma patients no eligible for high dose chemotherapy and stem cell transplantation. Methods Thirty-six patients were involved in this study and the patients were treated with tandem therapy of BTD and MPT regimen. The patients were treated with BTD regimen as induced therapy no less than 2 cycles. When the patients got PR or above PR,they were treated with MPT regimen as consolidation therapy which was no less than 2 cycles. Then,the patients who achieved PR or partial PR were received MPT chemotherapy regimen as consequent treatment. After that,low dose thalidomide was used as maintenance therapy. The outcomes and adverse effects were retrospectively evaluated. Results Thirty-six patients were treated with BTD regimen as induced therapy. The results were that 7 patients (19.4 %) achieved CR,8 (22.2 %) VGPR,14 (38.9 %) PR and the OR rate was 80.6 %. The patients (n=29) who achieved no less than PR was treated with MPT regimen as consequent therapy. The results were that four patients were in progression and the others were stable. Twenty-five patients were treated with low dose thalidomide as maintenance therapy. The median progression-free survival (PFS) did not reached yet until last follow-up (median follow-up time was 16.5 months). One-year overall survival rate was expected 86.0 % and 3-year expected overall survival rate was 77.0 %. The main regimen-associated toxicities included thrombocytopenia,peripheral neuropathy (PN),Herpes Zoster,gastrointestinal symptoms,anemia,neutropenia,constipation,fatigue,rash and so on. The incidence of grade 3 and 4 adverse events was low. Conclusion Sequential therapy of BTD and MPT regimen can be used as the front-line therapy for the newly-diagnosed multiple myeloma patients no eligible for high dose chemotherapy and stem cell transplantation.

Carcinoma ; diagnosis ; surgery ; Chylothorax ; diagnosis ; Humans ; Lymph Node Excision ; Thyroid Neoplasms ; diagnosis ; surgery

Objective To evaluate the curative effects of carbon nanoparticles on central lymphnode dis -section in papillary thyroid carcinoma ( PTC) .Methods 72 PTC patients were randomly divided into two groups:carbon nanoparticle group(n=32)and the control group(n=32).Patients in the carbon nanoparticle group were injected with carbon nanoparticles during surgery .Patients in the control group had conventional surgery .The number of lymph nodes being dissected ,lymph node metastasis , and the rate of hypoparathyroidism were compared between the two groups .Results The number of lymph nodes dissected in nanoparticle group ( n =312 ) was much bigger than that in the control group (n=189)(P<0.01;t=8.476).The incidence of hypoparathyroidism in nanoparticle group(n=1)was much lower than that in the control group (n=8)(P<0.05;χ2 =4.571).The metastasis of lymph nodes has no significant difference between the two groups (P>0.01;χ2 =1.048).Conclu-sions The lymphatic tracer technique may improve the number of lymph nodes dissected in central region of PTC and reduce parathyroid gland damage .

OBJECTIVETo investigate the frequency of p16 and p15 gene methylation in multiple myeloma (MM), and its relationship with bone marrow cell apoptosis and clinical outcome.

METHODSTwenty-two patients with MM were studied to detect p16 and p15 gene methylation. Methylation-specific polymerase chain reaction (MSP) was used to detect gene methylation, and terminal transferase-mediated dUTP nick end-labeling (TUNEL) was used to detect cell apoptosis.

RESULTSp16 and/or p15 gene methylatoin was detected in 10 of 22 patients (45.4%). There were 3 patients with p16 gene methylation, 9 patients with p15 gene methylation, and 2 patients with both genes methylation. The incidence of methylation of p15 gene was higher than that of p16 gene (P < 0.05). The patients with p16 and/or p15 gene methylation had a delayed cell apoptosis, poor response to chemotherapy, and a short over-all survival (OS).

CONCLUSIONThe methylation of p16 and/or p15 gene plays a key role in MM apoptosis pathogenesis. The patients with both p16 and p15 gene methylation had a poor prognosis.

Apoptosis ; Cell Cycle Proteins ; Cyclin-Dependent Kinase Inhibitor p15 ; Cyclin-Dependent Kinase Inhibitor p16 ; genetics ; DNA Methylation ; DNA, Neoplasm ; genetics ; Gene Silencing ; Genes, p16 ; Humans ; Multiple Myeloma ; genetics ; pathology ; Prognosis ; Transcription Factors ; genetics ; Tumor Suppressor Proteins

Angiogenesis is a necessary step in tumor progression, and it correlates an unfavorable prognosis. In multiple myeloma, bone marrow microvessel density and angiogenesis grading correlated with plasma cell labeling index and are poor survival predictors, but the study of myeloma's angiogenesis is very rare. This article was to study the effect of multiple myeloma cell line conditioned media on the proliferation, migration and angiogenesis of human bone marrow endothelial cells (HBMEC). The multiple myeloma cell line conditioned media were obtained by using RPMI 1640 media containing 2% fetal bovine serum (FBS) to cultivate myeloma cell lines for 18 hours. Proliferation and migration of HBMEC were detected by using those media to cultivate HBMEC. Capillary tube formation was performed by using microcarriers cytodex-3 covered with HBMEC in three-dimensional fibrin matrices. The results showed that myeloma conditioned media induced HBMEC's proliferation and migration (P < 0.001), and those media induced capillary tube formation (length and width) of HBMEC (P < 0.001). It was concluded that myeloma cell lines induce HBMEC's proliferation, migration, and capillary tube formation by secreting several cytokines.
Bone Marrow Cells ; cytology ; Cell Division ; Cell Movement ; Endothelial Growth Factors ; analysis ; physiology ; Humans ; Intercellular Signaling Peptides and Proteins ; analysis ; physiology ; Lymphokines ; analysis ; physiology ; Multiple Myeloma ; blood supply ; chemistry ; pathology ; Neovascularization, Pathologic ; etiology ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

OBJECTIVE: To explore the clinical characteristics and genetic basis of a child with autism spectrum disorder (ASD) in conjunct with congenital heart disease (CHD). METHODS: A child who was hospitalized at the Third People's Hospital of Chengdu on April 13, 2021 was selected as the study subject. Clinical data of the child were collected. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). A GTX genetic analysis system was used to analyze the WES data and screen candidate variants for ASD. Candidate variant was verified by Sanger sequencing and bioinformatics analysis. Real-time fluorescent quantitative PCR (qPCR) was carried out to compare the expression of mRNA of the NSD1 gene between this child and 3 healthy controls and 5 other children with ASD. RESULTS: The patient, an 8-year-old male, has manifested with ASD, mental retardation and CHD. WES analysis revealed that he has harbored a heterozygous c.3385+2T>C variant in the NSD1 gene, which may affect the function of its protein product. Sanger sequencing showed that neither of his parent has carried the same variant. By bioinformatic analysis, the variant has not been recorded in the ESP, 1000 Genomes and ExAC databases. Analysis with Mutation Taster online software indicated it to be disease causing. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be pathogenic. By qPCR analysis, the expression level of mRNA of the NSD1 gene in this child and 5 other children with ASD was significantly lower than that of the healthy controls (P < 0.001). CONCLUSION The c.3385+2T>C variant of the NSD1 gene can significantly reduce its expression, which may predispose to ASD. Above finding has enriched the mutational spectrum the NSD1 gene.
Male ; Child ; Humans ; Autism Spectrum Disorder/genetics* ; Heart Defects, Congenital/genetics* ; Computational Biology ; Genomics ; Mutation ; RNA, Messenger/genetics* ; Histone-Lysine N-Methyltransferase/genetics*

Objective To investigate the effects of berberine in combination with bortezomib on proliferation and apoptosis of multiple myeloma (MM) cell line.Methods MM cell line U266 cells were treated with berberine and/or bortezomib.The effects of berberine and/or bortezomib on proliferation of cells were measured by methylthiazolyl tetrazolium bromide (MTT).Flow cytometric Annexin Ⅴ/PI double staining method was used to detect effect of either drug alone or in combination on apoptosis of MM cell line U266.ELISA was used to measure the expression of casepase-3,-8,-9 affected by the two drugs.Western blot was used to detect the expression of the apoptosis-related protein TRADD and FADD.King formula was used to determine if there was a synergistic effect of berberine in combination with bortezomib.Results ① Both berberine and bortezomib as single agent had dose-and time-dependent effects of proliferation inhibition on U266 cells.Berberine (20 μmol/L) and bortezomib (5 nmol/L) had a synergistic effect of proliferation inhibition (Q value:1.31-1.65).②The proportion of early stage apoptosis in both single agent groups and combination group significantly increased compared to control group (P＜ 0.05).Berberine and bortezomib had a synergistic effect on cell apoptosis (Q value after 6 h and 12 h were 0.896 and 1.197,respectively).③Berberine in combination with bortezomib significantly upregulated expressions of caspase-3,-8 and-9,which were statistically significant (P＜0.05).④Berberine in combination with bortezomib significantly upregulated expressions of TRADD (0.91±0.01,0.70±0.01) and FADD (0.98±0.01,0.98±0.01) compared with control group (both P＜0.05).Conclusion Berberine in combination with bortezomib had synergistic effects on proliferation inhibition and apoptosis,which were mediated by up-regulated levels of TRADD and FADD.