Objective: To analyze the clinical pathology status of minor differentiated thyroid cancer (DTC). Methods: The clinical pathology data of 107 cases of DTC patients aging≤18 years old who accepted operations at Department of General Surgery, Peking Union Medical College Hospital from January 2000 to December 2016 were collected. There were 27 males and 80 females, aged (15.4±2.7) years (range: 6 to 18 years). And a randomly selected sample′s data was collected as control group, concluded 110 adult DTC patients. There were 35 males and 75 females, aged (43.2±11.8) years (range: 21 to 77 years). The clinical and pathological data of the two groups were retrospectively analyzed. The t test, Mann-Whitney U test, χ² test and Fisher exact test was used to analyze the data, respectively. Results: The minor patients had larger diameter of tumors ((16.5±9.9) mm vs. (8.7±5.1) mm, t=7.369, P=0.000), higher rate of lymph node metastasis (68.2% vs. 50.0%, χ²=7.446, P=0.006) and higher rate of lateral lymph node metastasis (36.4% vs. 11.8%, χ²=18.059, P=0.000) than adult patients. The rate of lateral lymph node metastasis was significantly higher when minor presented multiple fociin primary lesions (54.3% vs. 27.8%, χ²=7.144, P=0.008) than those with single foci lesions. Adult patients presented more capsular invasion than minor patients in primary lesions (55.6% vs. 19.2%, χ²=28.942, P=0.000). Conclusions The minor DTC patients present more progress disease status when they receive operations compared with the adult DTC patients. Minor DTC patients appeared as multiple foci should be alert to lateral lymph node metastasis.

Objective To investigate the clinical effect of endovascular interventional treatment of intracranial peripheral aneurysms. Methods From January 2013 to December 2016,the clinical data of 31 patients with intracranial peripheral aneurysm admitted to the Department of Neurosurgery,Anhui Provincial Hospital were analyzed retrospectively.Among them,12 patients had saccular aneurysms,10 had narrow-neck aneurysms,and 2 lacked clear aneurysm necks;19 patients had fusiform aneurysms,they all lacked clear aneurysm necks.Ten patients with narrow-neck saccular aneurysm were treated with coil embolization, of the 2 lacked clear neck saccular aneurysms,1 was treated with stent-assisted coil embolization,1 was treated with coil occlusion of the aneurysm and parent artery;4 patients with fusiform aneurysm were treated with coil occlusion of the aneurysms and parent arteries,11 with fusiform aneurysm were treated with Onyx glue occlusion of the aneurysms and parent arteries,and 4 with fusiform aneurysm were treated with coils in combination with Onyx glue occlusion of the aneurysms and parent arteries.They were followed up for 6 to 36 months after procedure. Results All patients were successfully treated with endovascular intervention,no rebleeding cases were found.Immediate postoperative angiography showed that 11 patients with saccular aneurysm were totally occluded.The aneurysms and parent arteries in 1 patient with saccular aneurysm and 19 with fusiform aneurysm were totally occluded.The aneurysms and parent arteries of 8 patients were occluded with Onyx glue,cranial CT revealed different degrees of cerebral infarction (6 patients without new neurological deficits,2 new neurologic deficits).CT revealed cerebral infarction in 1 patient treated with coils in combination with Onyx glue for occlusion of the aneurysm and parent artery(no new neurologic deficit),other patients did not have cerebral infarction and new neurologic deficits.DSA follow-up revealed aneurysm neck recurrence in 1 patient with saccular aneurysm,no obvious aneurysm recurrence was observed in all other patients. Conclusions Endovascular treatment of intracranial peripheral aneurysms is safe and effective.Choose what specific intervention therapy base on the aneurysm morphology,location, tortuous degree of the parent artery,and the importance of the blood supply area.

Objective To analyze the risk factors related to incidence of shunt dependent hydrocephalus in patients with intracranial aneurysmal subarachnoid hemorrhage so as to provide guidance for clinical diagnosis and treatment.Methods The clinical data were retrospectively analyzed of the 451 patients who had been treated in our hospital for ruptured intracranial aneurysmal subarachnoid hemorrhage from January 2013 to December 2016.Of them,67 were complicated with shunt dependent hydrocephalus and 384 were not.The 2 groups were compared in terms of related clinical variables.Multivariate Logistic regression was conducted to analyze risk factors associated with incidence of shunt dependent hydrocephalus.Results The proportions of patients ＞60 years old,intraventricular hemorrhage,posterior circulation aneurysm,acute hydrocephalus and central nervous system infection were significantly higher in the patients with complicated shunt dependent hydrocephalus than in those without (P＜0.05).There were significant differences between the 2 groups in Hunt-Hess grade and Fisher grade at admission (P＜0.05).Multivariate Logistic regression analysis revealed that posterior circulation aneurysm,acute hydrocephalus and central nervous system infection were independent risk factors for incidence of shunt dependent hydrocephalus in patients with intracranial aneurysmal subarachnoid hemorrhage.Conclusion If the patients with intracranial aneurysmal subarachnoid hemorrhage are complicated with posterior circulation aneurysm,acute hydrocephalus and central nervous system infection,they are more likely to develop shunt dependent hydrocephalus.

Objective:To analyze the effect and influencing factors of embolotherapy on headache in elderly patients with unruptured intracranial aneurysms.Methods:A retrospective analysis of clinical data of elderly patients(aged≥61 years)with unruptured intracranial aneurysms admitted to our hospital from January 2018 to December 2020 was performed.Headache assessment was performed by a quantitative 11-point headache scale in all patients preoperatively and at 6 months after endovascular treatment, and the difference between them was analyzed.Univariate analysis was applied to test the association between headache outcomes and clinical variables.Results:A total of 73 patients(mean age: 68.4 years old; age range: 61-86 years; 47 women)fulfilled the inclusion criteria.There were 53 patients(72.6%)who presented with preoperative headache(headache score≥1). Among them, 39 cases(73.6%)had an improvement in headache, 11(20.8%)remained unchanged, and 3(5.7%)aggravated, after endovascular treatment.The average preoperative headache score was 5(4, 6) vs.postoperative 3(1, 4), with statistical significance( Z=-5.036, P=0.000). Only the preoperative headache score was associated with outcomes of headache, and a higher headache score predicted a lack of headache relief( Z=-2.819, P=0.005). Conclusions:Embolotherapy of unruptured intracranial aneurysms can relieve headache in most elderly patients.Preoperative headache severity is correlated with postoperative headache outcomes.

Objective:To investigate the application value of electroencephalogram (EEG) combined with regional cerebral oxygen saturation (rSO 2) in monitoring cerebral perfusion during carotid endarterectomy (CEA). Methods:A retrospective analysis of clinical data of 42 patients with atherosclerotic carotid artery stenosis admitted to and accepted CEA in our hospital from January 2018 to December 2019 was performed. CEA was performed under EEG combined with rSO 2 monitoring. The efficacy and safety of EEG combined with rSO 2 in monitoring cerebral perfusion abnormalities during CEA were analyzed. Results:After carotid artery occlusion, 24 patients (57.1%) had normal EEG and rSO 2; 15 (35.7%) had abnormal changes of EEG, among whom 13 (31.0%) were accompanied by rSO 2 anomaly; 16 (38.1%) had abnormal rSO 2, among whom 13 (31.0%) were accompanied by EEG anomaly. Of these 18 patients with abnormal EEG and/or rSO 2 monitoring, 17 patients recovered after increasing their blood pressure and 1 patient recovered after diverter tube usage. Intraoperative EEG and rSO 2 monitoring results were consistent (Kappa=0.745, P=0.000). The positive rates of combined monitoring, EEG alone or rSO 2 alone were 42.9%, 35.7% and 38.1%, respectively. All patients were evaluated clinically and radiologically before discharge, and no new ischemic lesions or clinical symptoms were found. Conclusions:EEG and rSO 2 monitoring are well consistent in CEA; the combined monitoring can make up for the deficiency of single monitoring to increase surgical safety.

OBJECTIVES: Lung cancer is one of the most common malignant tumors in the world, and its lethality ranks the first among many malignant tumors. For non-small cell lung cancer (NSCLC) patients, due to the high mortality rate, the overall 5-year survival rate is less than 15%. When NSCLC undergoes local invasion, the 5-year survival rate is only 20%, and it is even lower when distant metastasis occurs up to 4%. Almonertinib is an innovative drug independently researched and developed by China with independent intellectual property rights. As an epidermal growth factor receptor tyrosine kinase inhibitor, almonertinib is mainly used for locally advanced or metastatic NSCLC patients with epidermal growth factor receptor (EGFR) T790M mutation. This study aims to investigate the effects of almonertinib on the proliferation, invasion and migration of NSCLC cells in vitro. METHODS: NSCLC cells H1975 and PC-9 were cultured in vitro. The effects of almonertinib on the proliferation, apoptosis, invasion, and migration of H1975 and PC-9 cells were detected by CCK-8 assay, apoptotic assay and Transwell assay. The expression of invasion and migration related proteins was detected by Western blotting. RESULTS: The CCK-8 experiment showed that almonertinib inhibited the proliferation of H1975 and PC-9 cells in a time- and dose-dependent manner. The IC CONCLUSIONS Almonertinib can inhibit the proliferation, invasion, and migration of NSCLCH1975 and PC-9 cells in vitro and vivo, and promote the apoptosis of H1975 and PC-9 cells. The underlying mechanism may be related to the inhibition of tumor cell epithelial mesenchymal transformation and metalloproteinase expression.
Acrylamides ; Animals ; Apoptosis ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Cell Line, Tumor ; Cell Proliferation ; Drug Resistance, Neoplasm ; ErbB Receptors/genetics* ; Humans ; Indoles ; Lung Neoplasms ; Mice ; Mice, Nude ; Mutation ; Protein Kinase Inhibitors/pharmacology* ; Pyrimidines

OBJECTIVE: To investigate the inhibitory effect of epidermal growth factor receptor tyrosine kinase inhibitor (EGFRTKI) HS-10296 on the proliferation of triple-negative breast cancer (TNBC) MDA-MB-231 cells and explore the possible molecular mechanism. METHODS: MDA-MB-231 cells were treated with HS-10296 for 24, 48, or 72 h, and CCK-8 assay was used to assess the changes in the cell viability. The inhibitory effect of HS-10296 on cell proliferation was determined by clonogenic assay. JC-1 and flow cytometry were employed for analyzing the cell apoptosis, and the ultrastructure of the cells was observed under electron microscope. After pretreatment with autophagy inhibitor chloroquine (CQ), MDA-MB-231 cells were divided into control group, CQ treatment group, HS-10296 (4 and 6 μmol/L) treatment groups and combined treatment groups, and the sensitivity of the treated cells to HS-10296 was determined using CCK-8 assay. The effects of HS-10296 on EGFR pathway and apoptosis- and autophagy-related proteins in MDA-MB-231 cells were investigated using Western blotting. RESULTS: HS-10296 significantly inhibited the proliferation of MDA-MB-231 cells with IC values at 24, 48 and 72 h of 8.393, 2.777 and 2.016 μmol/L, respectively. JC-1 and flow cytometry showed that HS-10296 induced obvious apoptosis of MDA-MB-231 cells, which showed an apoptosis rate of (21.63 ± 2.97)% following treatment with 8 μmol/L HS-10296. Autophagy vesicles were observed in the cells treated with HS-10296 under electron microscope. In MDA-MB-231 cells pretreated with CQ, inhibition of autophagy significantly enhanced HS-10296-induced cell death. Western blotting showed that the apoptosis-related protein caspase-3 was activated after HS-10296 treatment to cut its substrate PARP. The expression of autophagy-related protein light chain 3B (LC3B) was significantly enhanced after HS-10296 treatment ( < 0.01), which also resulted in inhibited phosphorylation of EGFR and AKT proteins in the cells. CONCLUSIONS HS-10296 can inhibit the proliferation and induce autophagy and apoptosis of MDA-MB-231 cells by inhibiting the EGFR/PI3K/AKT signaling pathway.
Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Autophagy ; drug effects ; Breast Neoplasms ; drug therapy ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; ErbB Receptors ; metabolism ; Humans ; Protein Kinase Inhibitors ; pharmacology ; Signal Transduction ; drug effects

OBJECTIVE: To investigate the inhibitory effect of epidermal growth factor receptor tyrosine kinase inhibitor (EGFRTKI) HS-10296 on the proliferation of triple-negative breast cancer (TNBC) MDA-MB-231 cells and explore the possible molecular mechanism. METHODS: MDA-MB-231 cells were treated with HS-10296 for 24, 48, or 72 h, and CCK-8 assay was used to assess the changes in the cell viability. The inhibitory effect of HS-10296 on cell proliferation was determined by clonogenic assay. JC-1 and flow cytometry were employed for analyzing the cell apoptosis, and the ultrastructure of the cells was observed under electron microscope. After pretreatment with autophagy inhibitor chloroquine (CQ), MDA-MB-231 cells were divided into control group, CQ treatment group, HS-10296 (4 and 6 μmol/L) treatment groups and combined treatment groups, and the sensitivity of the treated cells to HS-10296 was determined using CCK-8 assay. The effects of HS-10296 on EGFR pathway and apoptosis- and autophagy-related proteins in MDA-MB-231 cells were investigated using Western blotting. RESULTS: HS-10296 significantly inhibited the proliferation of MDA-MB-231 cells with IC values at 24, 48 and 72 h of 8.393, 2.777 and 2.016 μmol/L, respectively. JC-1 and flow cytometry showed that HS-10296 induced obvious apoptosis of MDA-MB-231 cells, which showed an apoptosis rate of (21.63 ± 2.97)% following treatment with 8 μmol/L HS-10296. Autophagy vesicles were observed in the cells treated with HS-10296 under electron microscope. In MDA-MB-231 cells pretreated with CQ, inhibition of autophagy significantly enhanced HS-10296-induced cell death. Western blotting showed that the apoptosis-related protein caspase-3 was activated after HS-10296 treatment to cut its substrate PARP. The expression of autophagy-related protein light chain 3B (LC3B) was significantly enhanced after HS-10296 treatment ( < 0.01), which also resulted in inhibited phosphorylation of EGFR and AKT proteins in the cells. CONCLUSIONS HS-10296 can inhibit the proliferation and induce autophagy and apoptosis of MDA-MB-231 cells by inhibiting the EGFR/PI3K/AKT signaling pathway.
Apoptosis ; Autophagy ; Breast Neoplasms ; Cell Line, Tumor ; Cell Proliferation ; ErbB Receptors ; Humans ; Phosphatidylinositol 3-Kinases ; Protein Kinase Inhibitors