The advancement of research work on the carcinogenicity and its inhibition of 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK), a tobacco-specific N-nitrosamine, was reviewed in the present paper. Carbonyl reduction and ?-hydroxylation were the major routes of NNK metabolic activation, the main target organ of NNK carcinogenicity was the lung and the carcinogenic probability related to the individual, organic isothiocyanates were the most potent inhibitors for NNK carcinogenicity. Eating more cruciferae vegetables and fruit and drinking more green and black tea would be helpful for smokers and passive smokers. Research about the nosogenesis and carcinogenicity and its inhibition of the harmful components in cigarette smoke should be further reinforced.

Objective:To explore the tracing effect of nano-carbon in the cervical lymph nodes of papillary thyroid carcinoma (PTC) and the guiding role of the dissection strategy of the contralateral lymph nodes.Methods:The medical records of 516 patients with PTC in Department of Endocrine and Breast Surgery, the First Affiliated Hospital of Chongqing Medical University from Jan. 2013 to Dec. 2017, including cN0 patients (436 cases) and cN1 patients (80 cases) , were retrospectively analyzed. There were 137 males and 379 females, the male to female ratio was 1.00:2.76. During the operation, nano-carbon was used to trace lymph nodes, and the number of lymph nodes in each lateral area (area II, III, IV) was collected, and the rate of black stained and non-black stained lymph node metastasis (LNM) was calculated based on the postoperative pathological results. SPSS 22.0 statistical software was used for analysis, t test was used for measurement data, and χ2 test was used for count data. Results:In 436 patients with cN0, the black-stained LNM rate in zone II ( P=0.002) , the black-stained LNM rate in zone III ( P=0.000) , and the black-stained LNM rate in zone IV ( P=0.002) were higher than those of non-black stained LNM. The rate of black-stained LNM in 80 cN1 patients (Ⅱ, Ⅲ, Ⅳ) was also higher than that of non-black-stained LNM (0.011, 0.019, 0.015) . The rate of black-stained LNM in cN0 patients affected the LNM in areas Ⅱ and Ⅳ ( P=0.000, P=0.000) . In patients with cN1, the black-stained LNM rate in zone Ⅲ had an effect on zone Ⅱ (0.030) ; it had no effect on the black-stained LNM rate in zone Ⅳ (0.315) . Conclusion:The black-stained LNM rate of the posterior zone (zone Ⅱ, Ⅲ, Ⅳ) with nano-carbon can represent the LNM rate of the lateral zone and help guide the lymph node dissection in the lateral zone. In addition, the black-stained LNM rate of zone Ⅲ can affect zone Ⅱ. The LNM rate in zone IV has the role of sentinel lymph nodes in the lateral zone.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Calbindin 2 ; metabolism ; Cholecystitis ; pathology ; Cisplatin ; administration & dosage ; Cystitis ; pathology ; Diagnosis, Differential ; Female ; Glutamates ; administration & dosage ; Guanine ; administration & dosage ; analogs & derivatives ; Humans ; Inflammation ; pathology ; Keratins ; metabolism ; Lung Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Male ; Mesothelioma ; drug therapy ; metabolism ; pathology ; surgery ; Middle Aged ; Pemetrexed ; Peritoneal Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Survival Rate ; Vimentin ; metabolism

BACKGROUND: Three kinds of donor meniscus are commonly used at present, namely cryopreserved, fresh and deep-frozen meniscus, which,however, almost invariably give rise to degenerative changes of various degrees after transplantation.OBJECTIVE: To compare the outcome of transplantation of allograft deep-frozen meniscus and meniscal acellular matrix to determine the most preferable means of allograft meniscus preservation.DESIGN: Randomized controlled experiment with rabbits.SETTING: Department of Orthopedics, Second Hospital Affiliated to Harbin Medical University.MATERIALS: Sixty-four male Japanese white rabbits with body mass of 3.0 - 3.5 kg.METHODS: This experiment was carried out in the Animal Experimental Center, Second Hospital Affiliated to Harbin Medical University between September 2002 and September 2003. Totally 64 adult rabbits were assigned into 32 pairs according to the body weight to served as the donor and the recipient animals, respectively. The medial menisci was obtained from the bilateral knees of the donor animals with the right one cryopreserved at -80 ℃ and the left prepared into acellular matrix for deep-frozen preservation. The donor menisci were respectively transplanted into the corresponding knee joints of the recipient animal's hindlimbs, with the left side taken as the experimental side and right as control. Gross observation,X-ray examination, and histological examination of the tissues were carried out at postoperative 4, 8, 12 and 16 weeks, respectively.MAIN OUTCOME MEASURES: Findings in X-ray, gross observation and histological observation of the grafted meniscus with meniscal measurement and findings in abdominal aorta perfusion.RFSULTS: All the 64 rabbits were observed for result analysis. X-ray examination of the grafted meniscus revealed no obvious changes in either the experimental and control side at 4 and 8 weeks postoperatively, but mild changes occurred on the control side at 12 weeks, which became obvious at 16 weeks, presented by joint space narrowing, hyperostosis and osteosclerosis below the cartilage of varied severities (with scores of 1.3 and 0.6, respectively, P ＜ 0.05). By gross observation, meniscal atrophy on the experimental side was milder and slower than the control side, with al so lower atrophy rate [(15.14±4.62) % vs (20.97±4.72) % at week 4, P ＜ 0.001, and (19.23±11.27) % vs (32.74±10.43) % at week 16, P ＜ 0.05].Perfusion of the abdominal aorta revealed no revascularization in the surrounding tissues of the meniscus by gross observation in either groups, but histologically, the experimental side showed more favorable structure than the control side at postoperative weeks 4, 8, 12 and 16.CONCLUSION: Meniscal acellular matrix may produce better outcome than deep-frozen meniscus after transplantation and can be a more practical means for preservation of the meniscus.

Objective:To analyze the factors related to metastasis of contralateral central lymph node (CLN) in cN0 papillary thyroid car-cinoma (PTC) and discuss the indications for CLN dissection. Methods:We enrolled 149 unilateral PTC patients who underwent total thyroidectomy and prophylactic bilateral (CLN) dissection. This work analyzed the relationship of gender, age, extrathyroidal extension, multifocality, thyroiditis, ipsilateral central lymph nodes, and prelaryngeal lymph node with CLNs. Results:The rates of metastasis to ip-silateral and contralateral central compartments were 73.2%and 23.5%, respectively. In univariate analysis, gender, age, tumor size, multifocality, and thyroiditis were not important in predicting contralateral central compartment lymph node metastasis (P=0.792, 0.097, 0.531, 0.269, and 1.000, respectively);by contrast, extrathyroidal extension (P=0.017), prelaryngeal lymph nodes (P=0.006), and ipsilateral CLNs (P<0.001) are related to CLN metastasis. However, multivariate analysis showed that ipsilateral central metastasis was an independent risk factor for lymph node metastasis in the contralateral central region when the number of ipsilateral central metas-tases is≥3 (P=0.010). Conclusion:Extracapsular invasion, prelaryngeal lymph nodes, and ipsilateral CLN influence the metastases of CLN. Bilateral CLN dissection should be performed when the number of ipsilateral central metastases is≥3 and there is merger of ex-tra-laryngeal lymph nodes or capsule invasion.

Objective To review the outcome of coronary artery bypass grafting (CABG) using left internal thoracic artery (LITA) grafts in these patients aged more than 70 years old.Methods 1471 patients aged more than 70 years old[mean (73.3 ± 3.9) years] from July 2010 through August 2012,who underwent CABG in Anzhen hospital,form the cohort of this study.Among them,1395 cases underwent off-pump CABG,while 76 cases underwent on-pump CABG which includes onpump beating heart CABG in 12 cases.The average number of the grafts is 3.12 ±0.68.All of the patients were divided into two groups on base of the graft:Group A:only saphenous vein graft was used in 564 cases; Group B:The left internal thoracic artery to the left anterior descending artery was used in 907 cases,which also include total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 42 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.12％ in group A and 2.09％ in group B.There was no significance between the 2 groups.The volume of blood drainage was larger in group B than that in group A.At the same time,there was no significance in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of IABP between the 2 groups.Conclusion It did not increase the mortality and morbidity of serious complications using the left internal thoracic artery to the left anterior descending artery in those elderly patients aged more than 70 years old during the CABG operation.With consideration of the obvious advantages in the long term patency,LITA was proposed to be used in CABG even in those age ＞ 70 patients.

Objective This study reviews the 198 consecutive mitral valve operations for elderly patients(＞ 65 y) with ischemic mitral insufficiency performed at Anzhen Hospital between January 2000 and june 2016.The results for mitral valve reconstruction are compared with those for biological mitral valve replacement.Methods From January 2000 to June 2016,198 elderly patients with ischemic mitral insufficiency underwent mitral valve reconstruction (n =150) or biological mitral valve replacement(n =48).All of them coronary artery bypass gafting was performed at the same time.Preoperative clinical characteristics,procedural characteristics,major and minor complications after surgery,preoperative and postoperative left ventricular ejection fraction (LVEF) by echocardiography,and outcome (survivor or death,mitral regurgitation,NYHA degree) were assessed.Results There was no significant difference between the two groups in the rate of mortality during hospitalization and early postoperative cardiac function.The proportion of severe MR in 1,3,and 5 years after MVP were 5.1％ 、6.3％、7.7％ respectively.There was no MVR due to the recurrent moderate-to-severe reflux.There were 2 SBE but no reflux appeared after MVR.There was no significant difference in cardiac function and mortality between the two groups within 5 years.Conclusion There is no significant difference between CABG + MVP and CABG + MVR(BV) in cardiac function and mortality in the treatment of elderly patients with IMR.,There was a possibility of MR recurrence after CABG + MVP.There was no MR after CABG + MVR(BV),but the risk of SBE is higher than MVP.We can select operation mode personalized according to the type of mitral valve disease and cardiac function.

OBJECTIVETo establish a prognostic model for predicting extracorporeal circulation clotting in patients with continuous renal replacement therapy (CRRT).

METHODS425 patients with CRRT were involved in the study. We built a predictive risk model of extracorporeal blood clotting with the 302 participants, and 103 participants were used to validate the model. The primary endpoint of CRRT was extracorporeal circulation pipe blockage.

RESULTSWe used a score of 0-5 point evaluating system to predict the risk of 24 hours CRRT integral model of cardiopulmonary bypass clogging. The area under the CRRT predictive model of cardiopulmonary bypass clogging integral system ROC curve was 0.790 (95% CI 0.719-0.826) (P<0.001). The evaluating system can determine the blockage of 24 hours CRRT extracorporeal circulation. The results showed that CRRT extracorporeal plugging prediction fitted the integral model and could predict the chance of plugging. The actual plugging rate showed no significant difference from the predicted rate (R² = 0.301, P=0.232). The cardiopulmonary pipe survival time between the 3 groups(low risk, intermediate risk, and high risk) showed a significant difference (P<0.05).

CONCLUSIONWe established a continuity extracorporeal blood purification plugging risk score model, to predict plugging risks during CRRT treatment.

Objective To investigate the correlation of plasma interleukin ( IL)-17 level and IL-17 receptor (IL-17R) expression in the thymus of patients with myasthenia gravis (MG).Methods The blood samples of 63 patients (38 with glucocorticoid treatment, 25 with thymus removal) who admitted to Henan Provincial People′s Hospital between 2010 and 2014 were collected at three different stages: pre-treatment, 1 week post-treatment and 1 month post-treatment.The blood samples of 42 healthy controls were also collected.Enzyme linked immunosorbent assay was used to evaluate the levels of IL-17 in plasma.Twenty-five thymus tissues from MG patients and another 12 thymus tissues from patients with congenital heart disease who had surgery therapy were also collected.Reverse transcription polymerase chain reaction was used to evaluate the mRNA levels of IL-17R.The possible correlation between the expression of IL-17 and IL-17R with MG was analyzed.Results Before treatment, the levels of IL-17 in the plasma were much higher in all the MG patients ( both ocular and generalized) when compared to the healthy controls ( controls (3.2 ±0.7) pg/ml, MG patients (8.5 ±1.7) pg/ml, t =2.450, P <0.01; generalized type patients (9.7 ±1.4) pg/ml, t =2.532, P <0.01).In the patients with glucocorticoid treatment, IL-17 levels began to reduce after 1 week treatment and a statistically significant difference was found when compared to the pre-treatment samples (pre-treatment (8.3 ±1.2) pg/ml, 1 week after treatment (6.3 ±0.7) pg/ml, t=2.052, P<0.05) and healthy controls (t =1.933, P<0.05).One month after the glucocorticoid treatment, the levels of IL-17 decreased to the normal level (1 month after treatment (3.9 ±0.6) pg/ml, t=2.630, P <0.01, compared to the pre-treatment; t =1.395, P >0.05, compared to the healthy controls).In the surgery therapy cases, the IL-17 levels were also reduced after the thymus removal ( pre-surgery (8.8 ±1.4) pg/ml, 1 week after surgery (5.3 ±0.7) pg/ml, t=1.950, P<0.05;1 month after surgery (3.0 ±0.4) pg/ml, t=2.683, P<0.01).In the thymus tissues of the MG patients, the mRNA levels of IL-17R were much higher than that of the controls ( relative level 2.31 folds, t =2.682, P <0.01).Meanwhile, a positive correlation was found between the plasma IL-17 levels and the relative IL-17R levels in thymus tissues ( r =0.945 4, P <0.01 ).Furthermore, IL-17 was positively correlated with quantitative myasthenia gravis scores (QMGS) either pre-treatment (r =0.798 1, P <0.01) or post-treatment (r=0.906 5, P<0.01).And IL-17R was positively correlated with QMGS pre-treatment (r=0.775 5, P<0.01).Conclusions IL-17 is increased in the plasma of MG patients (both ocular and generalized) , and is decreased upon the glucocorticoid treatment or surgery therapy, suggesting that it can be used as a parameter to determine the therapeutic effects.IL-17R is increased in the thymus tissues of MG patients, suggesting that it can potentially be used as a pathological diagnosis parameter.