OBJECTIVETo evaluate the feasibility and utility of an ex vivo sentinel lymph node (SLN) identification and ultrastaging for colorectal cancer (CRC).

METHODSCRC patients undergoing resection of a primary colorectal cancer were considered for inclusion. Following resection, SLN identification was performed. The SLN was dissected from the mesentery and submitted separately for pathologic analysis. All lymph nodes were stained with HE. Blue lymph nodes, when negative by routine HE staining, were further analyzed.

RESULTSA total of 62 tumors from 60 patients with colorectal cancer were studied. 95.2% (59/62) specimens was successfully identified. In these 59 specimens, a total of 1114 (18.9 per specimens) lymph nodes were examined; of these, 157 (14.9%) were designated as SLNs. The number of blue-stained lymph nodes removed ranged from 1 to 9, with a mean of 2.7 blue nodes identified. The sensitivity of a blue-stained lymph node identifying metastatic disease was 39.1%. The false-negative was 23.7%. In 4 specimens micrometastases were detected only by immunohistochemistry with cytokeratin.

CONCLUSIONSEx vivo sentinel lymph nodes mapping in colorectal cancer is feasible and can identify the SLNs with a very high success rate. Ex vivo SLN mapping improves pathologic staging of patients with CRC. The SLN evaluation should not replace attempts to harvest large number of nodes for standard processing. SLN mapping can help improving the number of nodes for pathological examination.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Immunohistochemistry ; Keratins ; analysis ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Rosaniline Dyes ; Sentinel Lymph Node Biopsy ; methods

【Objective】 To study the differentiate expression genes and regulation signaling pathways related to the occurrence and development of dilated cardiomyopathy with heart failure, we used bioinformatics methods to explore gene chip in gene expression omnibus(GEO) and genes related to dilated cardiomyopathy in online mendelian inheritance in man(OMIM) . 【Methods】 GSE21610 and GSE29919 chip gene sets sequenced by Herz- &Diabeteszentrum NRW laboratory of the University of Bochum, Germany with myocardial biopsy specimens from clinical cases under the platform GPL570 and uploaded to GEO public database were selected to perform our study. Myocardial biopsy specimens from dilated cardiomyopathy with heart failure and normal cardiac function were regarded as the experimental group(14 and 21 cases, respectively) and the control group(12 and 8 cases, respectively). Up-regulated expression genes with the criteria: P < 0.05, were screened in GEO2R with the selected samples of two chips, which were then used to perform kyoto encyclopedia of genes and genomes(KEGG) pathways analysis, gene ontology(GO) function analysis, and protein-protein interaction(PPI) analysis, and the results were displayed through Volcano map, Venn map, Heat map, and Bubble charts with enrichment pathways drawn by R language packages. Meanwhile, KEGG pathways with the criteria: NOM. P < 0.05, and core genes relating to dilated cardiomyopathy with heart failure were performed through gene set enrichment analysis (GSEA). All candidate genes were then intersected with the reported genes in the OMIM, respectively, and clinical significance of these candidate genes was explored in relevant literatures. 【Results】 A total of 173 up-regulated expression genes with P < 0.05, were obtained by GEO2R, which are mainly related to inflammatory signals, cell proliferation and differentiation regulating, and classical apoptotic signaling pathways. These genes were intersected with the 754 reported genes in OMIM, and three reported up-regulated expression genes were obtained: NPPA for diagnosis of heart failure, APOA1 that associates with cytokine action, and COL6A1 that regulates lateral tubular remodeling. 158 and 46 core genes from KEGG pathways with NOM. P < 0.05 were obtained by GSEA, respectively, which were then intersected with the 754 reported genes in OMIM, and two core genes were obtained: PRKCA, enhancing myocardial contractility, and BMP2, promoting the development of heart failure. 【Conclusions】 Based on bioinformatics analysis, we found that the candidate genes PRKCA, BMP2, NPPA, and COL6A1 are likely to be closely related to the occurrence and development of dilated cardiomyopathy with heart failure, which can be used to reveal meaningful therapeutic clues and directions for the clinical treatment of dilated cardiomyopathy with advanced cardiac dysfunction.

OBJECTIVETo compare the clinical efficacy and safety of sublingual nifedipine and intravenous urapidil in the treatment of acute postoperative hypertension.

METHODSThe clinical data of 215 patients with APH after tumorectomy were retrospectively analyzed, among whom 165 were treated with sublingual nifedipine and 50 with intravenously urapidil.

RESULTSTreatment with sublingual nifedipine caused a reduction of the systolic blood pressure by 5.9% and diastolic blood pressure by 5.2%. Urapidil treatment resulted in significantly greater reductions in the systolic and diastolic blood pressures (by 12.1% and 8.6%, respectively) (P(s)<0.001, P(d)=0.019). Urapidil treatment was associated with a significantly higher rate of adequate antihypertensive effect than nifedipine treatment (68% vs 35.8%, P<0.001).

CONCLUSIONAlthough both urapidil and nifedipine are associated with minimal adverse effects, intravenous urapidil shows better therapeutic effect than sublingual nifedipine and is more suitable for the treatment of APH.

Administration, Sublingual ; Aged ; Antihypertensive Agents ; administration & dosage ; Female ; Humans ; Hypertension ; drug therapy ; etiology ; Injections, Intravenous ; Male ; Middle Aged ; Neoplasms ; surgery ; Nifedipine ; administration & dosage ; Piperazines ; administration & dosage ; Postoperative Complications ; drug therapy ; Retrospective Studies

【Objective】 To compare the diagnostic efficacy of full-field digital mammography(FFDM), digital breast mammography(DBT) and dynamic enhanced magnetic resonance imaging(DCE-MRI) for breast tumors in different gland types. 【Methods】 Retrospective analyses of 56 breast lesions in 49 patients who underwent FFDM, DBT and MRI in the Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from October 2018 to December 2019 were performed. The breasts were divided into the non-dense or dense pattern, according to FFDM images. The breast lesions were diagnosed as benign(BI-RADS grade 4a and below) or malignant(BI-RADS grade 4b and above), based on the images of FFDM, DBT and MRI, respectively. All patients underwent surgery or biopsy to get a pathological diagnosis. The kappa consistency tests and receiver operating characteristics(ROC) analyses were used to compare the efficacy of FFDM, DBT and MRI in the diagnosis of breast tumor in different gland patterns. 【Results】 In all breasts, MRI (kappa = 0.66) was moderately consistent with pathological diagnosis, which was higher than DBT(kappa = 0.44), while there was no significant difference between FFDM(kappa = 0.14) and pathological diagnosis. In non-dense breasts, MRI (kappa = 0.88) was moderately consistent with pathological diagnosis, which was higher than DBT(kappa = 0.51), while there was no significant difference between FFDM(kappa = 0.18) and pathological diagnosis. In dense breasts, MRI(kappa = 0.54) was moderately consistent with pathological diagnosis, which was higher than DBT(kappa = 0.37), while there was no significant difference between FFDM(kappa = 0.10) and pathological diagnosis. In all breasts, the diagnostic efficacy of MRI, DBT and FFDM for breast tumor decreased gradually(AUC = 0.83; 0.73; 0.58). Specifically, the specificity of MRI, DBT and FFDM increased sequentially(77%, 82%, 86%), but the sensitivity decreased(88%, 65%, 29%). In non-dense breasts, the diagnostic efficacy of MRI, DBT and FFDM for breast tumor decreased gradually(AUC = 0.97; 0.84; 0.66). Specifically, the sensitivity of MRI(94%) was higher than that of DBT(69%) and FFDM(31%). In dense breasts, the diagnostic efficacy of MRI, DBT and FFDM for breast tumor decreased gradually(AUC = 0.77; 0.69; 0.55). Specifically, the specificity of MRI, DBT and FFDM increased sequentially(71%, 76%, 82%), but the sensitivity decreased(83%, 61%, 28%) . 【Conclusions】 In both dense and non-dense breasts, FFDM has the lowest diagnostic ability. In non-dense breasts, the diagnostic efficacy of MRI is higher than DBT. DBT shows its advantage over MRI in dense breasts, as it has a higher diagnostic specificity.

OBJECTIVETo investigate the regulatory effect of miR-181a with abnormal expression on the expression of c-fos in cochlear hair cells undergoing oxidative damage.

METHODSHouse Ear Institute-Organ of Corti1 (HEI-CO1) cells were assigned to 50, 100, and 200 µmol/L tert-butyl hydroperoxide (t-BHP) exposure groups and control group. The HEI-CO1 cells in the exposure groups were exposed to 50, 100, or 200 µmol/L t-BHP for 12 h. Then, total RNA and total protein were extracted from the HEI-CO1 cells, and the expression of miR-181a/-181d was measured by qPCR. The miR-181a with abnormal expression was selected as the subject of study. The putative miR-181a target sequence in the 3' untranslated region (3'-UTR) of c-fos was predicted by searching on a bioinformatics website. The HEI-CO1 cells were transfected with miR-181a mimics by lipofection, and the transfection efficiency was measured by qPCR. The mRNA and protein expression of c-fos was measured by qPCR and Western blot. The pGL3-c-fos-3'UTR-WT plasmid was constructed, and the luciferase activity of the plasmid in the case of high miR-181a expression was measured using the Dual-Luciferase Reporter Assay System.

RESULTSCompared with those in the control group, the expression of miR-181a in 100 and 200 µmol/L t-BHP exposure groups was significantly decreased, with expression ratios of 0.744 and 0.766 (P < 0.01), while the expression of miR-181d in 50 µmol/L t-BHP exposure group was significantly increased, with an expression ratio of 1.29 (P < 0.01). There was no significant difference in miR-181a expression between the 100 and 200 µmol/L t-BHP exposure groups (P > 0.05). The predication results revealed that c-fos was regulated by miR-181a in humans and mice, with complete complementarity to the seed region of miR-181a, and there was high degree of target sequence conservation across species. The expression of miR-181a in the HEI-OC1 cells transfected with miR-181a mimics was elevated 892.979 times at 24 hours after transfection. As compared with those of controls, the mRNA and protein expression levels of c-fos in the transfected HEI-OC1 cells were significantly increased (P < 0.05 and P < 0.01). The luciferase activity of pGL3-c-fos-3'UTR-WT plasmid was not suppressed but increased in the case of high miR-181a expression.

CONCLUSIONmiR-181a has no direct inhibitory effect on the mRNA and protein expression of c-fos, which may not be the target gene of miR-181a. Bioinformatic prediction might produce false-positive results.

Animals ; Apoptosis ; drug effects ; genetics ; Cell Line ; Hair Cells, Auditory ; cytology ; drug effects ; metabolism ; Mice ; MicroRNAs ; genetics ; Proto-Oncogene Proteins c-fos ; genetics ; metabolism ; RNA, Messenger ; genetics ; Transfection ; tert-Butylhydroperoxide ; toxicity

Objective To analyze retrospectively the clinico-pathological features that influencing the occurrence of anastomotie leakage after low anterior resection of rectal cancer, as well as its management and outcome of patients. Methods The data of 513 patients underwent anterior resection for low rectal cancer from june 1999 to June 2007 were reviewed. Results The incidence of anastomotic leakage was 4.5 %(23/ 513). 20 patients underwent conservative therapy,while 3 patients underwent reoperation, all patients were cured without ileostomy or colostomy.Conclusion The occurrence rate of anastomotie leakage is closely re- lated to the type of operation,the Dukes staging,Diabetes Mellitus and Diarrhea. Local irrigation via the drainage tube is the main strategic point to manage the leakage.

OBJECTIVESTo investigate the carious dissolution mechanism of enamel apatite nano-crystals at lattice fringe level and the possible correlation between the carious dissolution and the appearance of central dark line (CDL) in enamel crystals.

METHODSThe body of the lesion in incipient enamel caries was observed by high resolution transmission electron microscopy (HRTEM, JOEL-2010 operating at 200 kv), combined with selected-area argon-ion-beam thinning technique.

RESULTSIn the body of the lesion, the preferential core dissolution was found in most of enamel nano-crystals, whereas the peripheral dissolution of individual crystal could be occasionally observed. The initial carious dissolution of individual enamel apatite crystal occurred as a number of small electron-lucent spots along the central dark line with blurry, bent or disconnected lattice fringes. These small electron-lucent spots fused with each other to form large electron-lucent areas. Finally the central perforation was frequently seen in the crystals. The CDL always appeared in the same place with central perforation in carious crystals, which could be seen to extend along the CDL.

CONCLUSIONSThe initial carious dissolution is directly related to the lattice defects in the enamel nano-crystals. The preferential core dissolution can be partly ascribed to the CDL, which is presumed to be particularly susceptible area to caries.

Dental Caries ; metabolism ; Dental Enamel Solubility ; Humans ; Microscopy, Electron, Scanning

OBJECTIVETo investigate the functional reconstruction technique for partial lower lip defects.

METHODS7 patients with lower lip cancer (3 cases of basal cell carcinoma, 2 cases squamous cell carcinoma and 2 cases papillary carcinoma) underwent excision. The full-thickness lower lip defects were one-third to two-third of the total lower lip length. All the defects were reconstructed with V-Y island advancement flaps based on the mental neurovascular bundle.

RESULTSThere was no flap loss. No recurrence was observed during the follow-up period of 3 months to one year. Both the aesthetic appearance, muscle function and sensation of the reconstructed lower lip were satisfactory.

CONCLUSIONSMental neurovascular V-Y island advancement flap is an ideal method for functional repair of partial lower lip defect.

Aged ; Carcinoma, Basal Cell ; surgery ; Chin ; innervation ; Female ; Humans ; Lip ; injuries ; Lip Neoplasms ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; blood supply

Objective To find out the iodine nutritional status of Longyan downtown residents,evaluate the effectiveness of control measures and provide a scientific basis for developing control strategies.Methods Infants aged 0 to 2 year-old,children aged 8 to 10,adults aged 18 to 45 and pregnant and lactating women were selected as survey subjects.Children goiter was detected with B ultrasound.Residents per capita daily salt intake was investigated by weighing method.Three urinary samples and a milk sample of lactating women were randomly collected.Urinary iodine and milk iodine content were determined by arsenic cerium catalytic spectrophotometric assay.Blood samples were collected and thyroid function (including serum TT3,FT3,TT4 and FT4) and thyroid stimulating hormone(TSH) were measured with direct chemiluminescence immunoassay,and thyroglobulin antibody(TgAb),thyromicrosome antibody(TMAb),and thyroglobulin (Tg) were measured with radioimmunoassay (RIA) in serum.ResultsThe goiter rate of children aged 8 to 10 was 1.8％ (2/110),and median thyroid volume was 2.75 ml.Household iodized salt coverage rate was 100.00％(318/318),and qualified iodized salt was 94.03％ (299/318).The daily per capita salt intake was (6.13 ± 3.56)g.The average medians of urinary iodine of the infants,children,adults,pregnant and lactating women were 181.8,315.2,196.6,158.7,136.4 μg/L,respectively.The median of milk iodine of lactating women was 155.6 μg/L.The proportions of serum TT3,FT3,TT4,FT4 and TSH which higher than normal were 3.6％ (11/308),0.6％ (2/309),23％ (7/309),1.0％ (3/313) and 1.3％ (4/312),respectively.While the proportions of serum TT3,FT3,TT4,FT4 and TSH that lower than normal were 2.3％ (7/308),11.7％(36/309),2.3％(7/309),12.8％(40/313),and 1.6％(5/312),respectively,of which 16 cases of both TgAb and TMAb were higher than normal.ConclusionsExisting salt iodine level is appropriate for 0 to 2 year-old infants and young children,18 to 45 year-old adults,pregnant and lactating women in downtown Longyan city.The iodine intake of children aged 8 to 10 is excessive.Thyroid function monitoring is recommended to be included in the routine monitoring.

OBJECTIVETo compare the effect of 5-fluorouracil (5-FU) portal vein infusion (PVI) for 7 days after radical resection, with intraluminal chemotherapy during operation for eliminating liver metastasis and elevating long-term prognosis in colorectal cancer.

METHODS162 colorectal cancer patients with radical resection were divided into portal vein chemotherapy group (group A, 82 cases) and intraluminal chemotherapy group (group B, 80 cases) randomly. In group A, 5-fluorouracil were infused with 1g per day constantly for 7 days after operation through portal vein catheters, which placed into greater omental vein and fixed on the abdominal wall. In group B, intraluminal chemotherapy was given and 5-fluorouracil 0.5 g was injected into the greater omental vein during operation.

RESULTSThe short-term complications and long-term effect in the two groups were compared by statistical software SPSS 8.0. Group A had more operative complications, and no statistical differences was found in hospital time and survival rate of the two groups. The 5-year survival rate is 76.7% (group A: 74.3%, group B: 79.2%), and the liver metastasis rate is 19.8%. There is no significant difference between the two group-survival curves. Multiple variable analysis suggested that Dukes' stage was the prognosis factor (P < 0.05).

CONCLUSIONSThe present study demonstrated that the two chemotherapy methods play an important role in preventing liver metastasis and improving the survival rate, and the intraluminal chemotherapy would be easier and simpler. The result should be further improved by using combined chemotherapy.

Adult ; Aged ; Antimetabolites, Antineoplastic ; administration & dosage ; Chemotherapy, Adjuvant ; Chemotherapy, Cancer, Regional Perfusion ; methods ; Colorectal Neoplasms ; drug therapy ; mortality ; therapy ; Combined Modality Therapy ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Portal Vein ; Survival Rate ; Treatment Outcome