Objective To investigate the effect of postoperative TSH suppression on bone mineral density (BMD) in postmenopausal women with DTC.Methods Postmenopausal women with postoperative DTC underwent thyroid residual ablation or 131I treatment for metastases at Xin Hua Hospital between September 2009 and December 2014 were enrolled and followed for 2 years.They were divided into suppressive TSH group (median TSH＜0.30 mU/L;group 1) and non-suppressive group (median TSH≥0.30 mU/L;group 2).Lumber 1-4 BMD levels (T scores) were measured by a dual energy X-ray absorptiometry bone densitometer at baseline,1 year and 2 years after treatment.All patients had calcium and vitamin D supplementation after TSH suppression.The T scores were compared with Mann-Whitney u test and Kruskal-Wallis test.Results A total of 126 patients were enrolled and followed up for 2 years,including 65 with average age (57.65±6.65) years in group 1 and 61 with average age (56.19±7.17) years in group 2.The T scores in group 1 and group 2 at baseline were-1.70(-2.30,-0.55) and-1.30(-2.10,-0.30) (z=-1.660,P＞ 0.05).The difference of T scores was significant in group 1 at baseline,1-year follow-up and 2-year follow-up (-2.25(-2.48,-0.83),-1.95(-2.70,-0.60);H=6.244,P＜0.05),but not significantly different in group 2 (H=1.102,P＞0.05).The T values were different between the 2 groups both in 1-year follow-up and 2-year follow-up (z values:-2.170,-2.160,both P＜0.05).Conclusions TSH suppression significantly increases the risk of postoperative osteoporosis.The BMD should be followed up annually in postmenopausal DTC patients.

As a type of neuroendocrine tumors, neuroblastoma (NB) is the most common extra-cranial solid tumor of childhood.123/131I-MIBG scintigraphy is a standard imaging modality in staging and evaluating therapeutic effect of pediatric NB with high accuracy.131I-MIBG treatment is effective for children with high-risk and relapsed/refractory NB.Combined with chemotherapy, stem cell transplantation, 131I-MIBG treatment shows efficacy in decreasing the relapse of pediatric NB.This review summarizes the application of MIBG scintigraphy and 131I-MIBG treatment for pediatric NB.

As a type of neuroendocrine tumors,neuroblastoma (NB) is the most common extra-cranial solid tumor of childhood.123/131I-MIBG scintigraphy is a standard imaging modality in staging and evaluating therapeutic effect of pediatric NB with high accuracy.131I-MIBG treatment is effective for children with high-risk and relapsed/refractory NB.Combined with chemotherapy,stem cell transplantation,131I-MIBG treatment shows efficacy in decreasing the relapse of pediatric NB.This review summarizes the application of MIBG scintigraphy and 131I-MIBG treatment for pediatric NB.

Objective:To discuss the protective effect of Syringin (SYR) on myotube cell atrophy induced by lipopolysaccharide (LPS) and its molecular mechanism.Methods:After C2C12 myoblasts were differentiated into myotubes, they were divided into normal control group, model group and syringin group according to the random number table method. The cultured medium of model group and syringin group were added with LPS with a concentration of 200 ng/ml; the cultured medium of the syringin group was also added with 10 μmol/L syringin for 24 h. CCK8 was used to detect cell viability. In cell supernatant, NO release was detected with Griess and TNF-α level was detected by ELISA kit. The expression of NF-κB, PPAR γ1, MyHC were detected by Western blot.Results:Compared with the model group, the viability of cells [(101.08±8.92)%, (79.53±5.19)% vs. (69.07±7.16)%] in the 10 μmol/L and 100 μmol/L syringin groups were significantly increased ( P<0.01 or P<0.01), of which 10 μmol/L syringin had better effect. Compared with the model group, the level of NO [(2.92±0.33) μmol/L vs. (3.57±0.41) μmol/L] in the syringin group was significantly decreased after 6 hours of intervention ( P<0.01), and the cells in the syringin group after 24 hours of intervention, the level of TNF-α [(2.73±0.29) pg/ml vs. (4.15±0.29) pg/ml] was significantly decreased ( P<0.01), and the protein expression of cellular NF-κB (0.95±0.24 vs. 1.16±0.28) was significantly decreased ( P<0.05), the protein expression of MyHC (0.79±0.15 vs. 0.70±0.16) was increased ( P<0.05). Conclusion:SYR could inhibit the inflammatory response induced by LPS, promote the activity of myotubes, and antagonize the damage of LPS to myotube cells.

Differentiated thyroid cancer (DTC) is prone to relapse and metastasize. In addition to thyroglobulin (Tg) and its antibodies, ultrasound and 131I whole-body scan (WBS), 18F-FDG PET/CT gains more use in the setting of recurrent or metastatic DTC and shows promise. This article mainly reviews the value of 18F-FDG PET/CT in the location of recurrent or metastasized DTC with negative 131I WBS but positive Tg ( 131I WBS-/Tg+ ), evaluating their differentiation, predicting the prognosis, guiding 131I treatment and its value in restaging DTC with moderate and high risk of relapse and guiding treatment decision.

The clinical,molecular and pathological features of pediatric differentiated thyroid cancer (DTC),and the advances in its surgery,postoperative staging,risk stratification,131I treatment were summarized based on the management Guidelines for children with thyroid nodules and DTC from the American Thyroid Association (ATA)

Paraneoplastic neurological syndromes (PNS) are a rare group of immune-mediated disorders that affect the central and peripheral neuromuscular system in association with cancer.If the limbal lobe system of the brain is involved,it will show paraneoplastic limbal encephalitis(PLE).The discern of patients with PNS is challenging since tumors causing paraneoplastic neurologic disorders are often asymptomatic and sometimes occult.We report a case of PLE with double positive anti-Hu and Yo antibodies,and further analyze and discuss it in conmbination with relevant literature to improve the understanding of the disease.

Objective The incidence of coronary microvascular disease(CMVD)is increasing annually.According to traditional Chinese medicine(TCM),CMVD belongs to the category of"collaterals",and qi deficiency and blood stasis are the main syndrome type of CMVD.Notably however,no studies have reported on the use of animal models of CMVD with qi deficiency and blood stasis.The current study therefore aimed to establish and evaluate a rat model of CMVD with qi deficiency and blood stasis syndrome.Methods Forty-five male SD rats were divided randomly into sham group,CMVD group,and CMVD + QXXY group(n = 15 rats per group).Rats in the CMVD + QXXY group were randomly deprived of sleep for 14～16 h/day for 6 weeks,and the model of qi deficiency syndrome was established.Animals in the sham group and the CMVD group were fed normally for 6 weeks.After 6 weeks,rats in the CMVD and CMVD + QXXY groups were anesthetized,their chests were opened,and embolic microspheres(40～120 μm)were injected into the left ventricle.Rats in the sham group underwent thoracotomy without injection of embolic microspheres.On day 7 after operation,relevant detection indicators were measured in each group.Results Compared with the sham group,the CMVD group showed a significant decrease in left ventricular ejection fraction and left ventricular shortening rate,while the activities of creatine kinase MB isoenzyme(CK-MB)and lactate dehydrogenase(LDH)were significantly increased.Heart function,hemorheology,myocardial enzyme index,and the degree of myocardial cell damage differed significantly between the CMVD + QXXY group compared with the sham group.Conclusions A rat model of CMVD + qi deficiency + blood stasis syndrome can be successfully established by sleep deprivation combined with intraventricular injection of embolic microspheres.This model will be suitable for the study of the pathogenesis of CMVD and the mechanisms of TCM.

OBJECTIVE: To evaluate the safety and feasibility of neoadjuvant chemotherapy prior elective surgery following self-expanding metallic stents (SEMS) for complete obstructive left hemicolon cancer. METHODS: This prospective, multicenter, open-labelled trial was approved by the Ethics Committee of Beijing Chaoyang Hospital, Capital Medical University(2016-ke-161-1) and registered in Clinicaltrials.gov (NCT02972541). INCLUSION CRITERIA: (1)age between 18 and 75 years old;(2) adenocarcinoma confirmed by pathology;(3) left hemicolon cancer confirmed by clinical manifestations and imaging examinations with the distance to anal verge > 15 cm; (4) resectable cancer evaluated by imaging examination without distant metastasis; (5) Eastern Cooperative Oncology Group (ECOG) score ≤ 1 or Karnofsky Performance Scale (KPS) > 70, indicating tolerance of neoadjuvant chemotherapy and operation; (6) absence of chemotherapy or radiotherapy within past six months; (7) bone marrow system and hepatorenal function: hemoglobin ≥ 90 g/L, neutrophil ≥ 1.5×10/L, platelet ≥ 80×10/L, total bilirubin ≤ 1.5×ULN(upper limits of normal), serum transaminase ≤ 2.5×ULN, serum creatinine ≤ 1.0×ULN, endogenous creatinine clearance rate > 50 ml/min; (8) sign for informed consent. EXCLUSION CRITERIA: (1) multiple primary colorectal cancer; (2) rejection of operation;(3) presenting peritonitis or bowel perforation before SEMS; (4) unqualified conditions proved by inspector from registration data. According to inclusion criteria, 62 consecutive patients receiving neoadjuvant chemotherapy prior to elective surgery following SEMS for complete obstructive left hemicolon cancer from Beijing Chaoyang Hospital of Capital Medical University (n=31), Qilu Hospital of Shandong University (n=14), the Third Xiangya Hospital of Central South University (n=13), Zhongnan Hospital of Wuhan University (n=2), the Fourth Hospital of Hebei Medical University (n=2) between December 2015 and December 2017 were prospectively enrolled in this study. Patients were divided into neoadjuvant chemotherapy group and elective surgery group according to the investigator's clinical experience and patient's preference. Patients in the elective surgery group received surgery within one to two weeks after SEMS placement without neoadjuvant chemotherapy. Those in the neoadjuvant chemotherapy group received 2 cycles of CapeOX or 3 cycles of mFOLFOX6 neoadjuvant chemotherapy within one to two weeks after SEMS placement, and then underwent surgery within 3 weeks after finishing neoadjuvant chemotherapy. Data between groups were compared using Student t-test, chi-square analysis or Fisher exact test analysis, including basic clinical informations, operational conditions and postoperative complications. The adverse reactions during the neoadjuvant chemotherapy were recorded. Surgical difficulty was assessed using visual analog scales ranging from 1 to 10, where 1 represented the lowest and 10 the highest degree of surgical difficulty, as judged by the surgeon. RESULTS: The study included 38 males and 24 females with mean age of (64.8±8.8) years. The clinical baseline data between 2 groups were not significantly different (all P>0.05) except the average time interval between SEMS and surgery was significantly longer in neoadjuvant chemotherapy group [(61.6±13.5) days vs. (10.4±5.2) days, t=16.679, P<0.001]. There was no stent migration in either group. Three patients had perforation in the elective surgery group; one patient had perforation and one had obstruction in the neoadjuvant chemotherapy group; and all these patients received emergent surgery. Adverse reactions of neodajuvant chemotherapy were mainly degree 1 and 2 except one patient with degree 3 diarrhea. Patients in neoadjuvant chemotherapy group had significantly lower rate of stoma [4.8%(1/21) vs. 34.1%(14/41), χ²=6.538, P=0.011], higher rate of laparoscopic surgery [71.4%(15/21) vs. 36.6%(15/41), χ²=6.751, P=0.009], shorter mean operative time (147 minutes vs. 178 minutes, t=-3.255, P=0.002), less mean intraoperative blood loss (47 ml vs. 127 ml, t=-4.129, P<0.001), lower degree of surgical difficulty(3.3 vs. 5.6, t=-5.091, P<0.001), shorter mean postoperative exhausting time (56.2 hours vs. 69.0 hours, t=-2.891, P=0.006), and shorter mean postoperative hospital stay (8.5 days vs. 13.5 days, t=-2.246, P=0.028) as compared with patients in the elective surgery group. Surgical site infection rate and anastomotic leakage rate did not differ significantly between two groups(all P>0.05). CONCLUSION Neoadjuvant chemotherapy prior elective surgery following SEMS is a relatively safe and feasible approach in the treatment for obstructive left hemicolon cancer, and is associated with less stoma, more laparoscopic surgery, shorter operative time, less blood loss, lower surgical difficulty, and faster postoperative recovery as compared with conventional elective surgery.
Aged ; Colorectal Neoplasms ; surgery ; therapy ; Female ; Humans ; Intestinal Obstruction ; Male ; Middle Aged ; Neoadjuvant Therapy ; Prospective Studies ; Stents ; Treatment Outcome

ObjectiveTo explore the effect of Buyang Huanwutang （BYHWT） on platelet function and inflammatory cytokines in the rat model of acute blood stasis. MethodThe model of acute blood stasis was established with SD rats by ice water bath combined with injection of epinephrine. Rats were randomly assigned into four groups： normal group， model group， BYHWT （3.2 g·kg^-1） group， and aspirin （60 mg·kg^-1） group. The rats were injected with epinephrine hydrochloride on day 8 after 7 days of modeling. The macroscopic indexes of triditional Chinese medicine （TCM） syndrome including tongue manifestation and pulse manifestation were observed， while hemorheological indexes， blood coagulation， and platelet aggregation were detected. The serum levels of the inflammatory cytokine matrix metalloprotein-9 （MMP-9） and the adhesion factor intercellular adhesion molecule-1 （ICAM-1） and were determined by enzyme-linked immunosorbent assay （ELISA）. ResultThe pulse distention of rats in the model group was lower than that in the normal group （P<0.01）， while BYHWT improved the pulse distention of the rats with the syndrome of blood stasis （P<0.01）. In the model group， the tongue showed the characteristics of blood stasis syndrome， with dark purple veins at the tongue bottom and lower values of R， G， B on the tongue surface than those in the normal group （P<0.01）， which， however， can be recovered by BYHWT （P<0.01）. The blood viscosity at high， medium， and low shear stress and the plasma viscosity in the model group were higher than those in the normal group （P<0.01， P<0.05）. Compared with the model group， BYHWT restored the whole blood viscosity under high， medium and low shear stress and plasma viscosity （P<0.05，P<0.01）. The model group had shorter prothrombin time （PT）， shorter thrombin time （TT）， and higher fibrinogen （FIB） than the normal group （P<0.05， P<0.01）. BYHWT improved the TT and reduced the FIB in the rats with blood stasis syndrome （P<0.01）. The platelet aggregation rate induced by arachidonic acid （AA） and adenosine diphosphate （ADP） in the model group was higher than that in normal group （P<0.01） and BYHWT decreased the platelet aggregation rate of the rats with blood stasis syndrome （P<0.01）. The results of scanning electron microscopy showed that the model group exhibited excessive platelet activation， obvious pseudopodia， and increased aggregation of platelets compared with the normal group， while platelet activation and aggregation were rare in the BYHWT group. The serum levels of MMP-9 and ICAM-1 in the model group were higher than those in the normal group （P<0.01）， which were decreased in the BYHWT group （P<0.05， P<0.01）. ConclusionThe SD rats with the syndrome of acute blood stasis induced by ice water bath combined with injection of epinephrine demonstrate obvious changes in platelet function and morphology， inflammation， and abnormal cell adhesion. In the treatment of acute blood stasis in rats， BYHWT may reduce thrombosis and improve blood consistency and cohesion by mitigating inflammation， down-regulating cell adhesion factor overexpression， and improving platelet shape and function.