OBJECTIVETo investigate the clinical, endoscopic and pathological features in primary colorectal non-Hodgkin lymphoma.

METHODSTwenty-four cases of primary colorectal non-Hodgkin lymphoma were studied retrospectively.

RESULTSThe main clinical symptoms were abdominal pain, abdominal mass, loss of weight, fever, bloody stools and altered bowel habits. There were 6 cases (25.0%) involving two or more lesion sites, including three cases showing continuous skip-distribution from sigmoid colon to ascending colon, one case showing the homologous manifestation from rectum to cecum, one case involving ascending colon and rectum, and the last one involving sigmoid colon and rectum. There were 18 cases involving single lesion site and the caecum was the most frequently affected site (44.4%, 8 cases). The major endoscopic phenotypes were ulcer (39.1%), bossing (43.5%) and infiltrating (17.4%). The major pathology types were diffuse large B-cell lymphoma (11/24, 45.8%), intestinal T-cell lymphoma (8/24, 33.3%), and mucosa-associated lymphoid tissue lymphoma (MALT) (3/24, 12.5%). 2 of 24 cases (8.3%) were not decided. Twenty-one patients were treated surgically, containing fifteen radical excisions, one local excision, four palliative excisions and one exploratory laparotomy. Sixteen postoperative patients accepted CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or COP (cyclophosphamide, vincristine, prednisone) chemotherapy, and three patients abandoned treatment. Twenty-one patients were followed up and the 5-year survival rate was 37.7%.

CONCLUSIONThe clinical features of primary colorectal non-Hodgkin's lymphoma have no specificity. Ulcer and bossing are the two major morphologic manifestations of endoscopic. Diffuse large B-cell lymphoma and intestinal T-cell lymphoma are the main pathological types. Comprehensive treatment of surgery and chemotherapy are effective methods for primary colorectal non-Hodgkin lymphoma.

Adult ; Aged ; Biopsy ; Colorectal Neoplasms ; diagnosis ; pathology ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; Lymphoma, T-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Young Adult

A total of 127 type 2 diabetic patients were divided into low glycemic index meal replacements (intervention) group and standard food-based diet (reference) group in an experiment for 12 weeks.The results showed that fasting plasma glucose,postprandial 2 h plasma glucose,fasting insulin,and homeostasis model assessment insulin resistance(HOMA-IR) in the intervention group decreased significantly after 12 weeks trial ( P＜0.05 or P＜0.01 ).However,there were no significant changes in lipid profile and HbA1C in intervention group.In addition,percentage of body fatty,visceral fatty area,and waist-hip ratio also decreased in intervention group( all P＜0.01 ).Superoxide dismutase and glutathione levels increased significantly in intervention group by the end of trial (both P＜0.01 ),while malondialdehyde was decreased (P＜0.01 ).There were no significant changes in the aforementioned indices in the reference group.Weight,body mass index,and waist circumferences were decreased in both groups,but without significant difference between the two groups.

Health self-management group adopts the mode of chronic disease self-management and offers a series of courses for community residents in order to help them carry out health self-management. For healthy people, the program aims at disease prevention by means of improving health literacy, acquiring health knowledge and skills, and developing a healthy lifestyle.While for patients, the program aims to prevent or slow the progression of diseases by means of helping them deal with their condition, achieving disease self-management. By nearly ten years of exploration and practice in Shanghai communities, with the program a working system had been established which was dominated by patriotic health campaign committee office at the levels of city and district, and technologically supported by centers for disease control and prevention with support and cooperation of the town government.The program was implemented by community health service centers and neighborhood ( village ) committee.A large-scale and whole-society promotion had been really achieved in community residents with health self-management. By the end of 2015, health self-management groups had covered all of the city's streets ( town ) and neighborhood ( village ) committee, 26 thousand groups set up and nearly 440 thousand community residents participated in group activities.

Objective:To retrospectively analyze the correlation between blood lipoprotein levels and the risk of osteoporosis (OP) development in postmenopausal patients with RA and its influencing factors.Methods:Patients hospitalized with a definite diagnosis of RA from July 2017 to May 2020 were retrospectively collected and analyzed by bone mineral density (BMD) in subgroups, using correlation analysis, di-chotomous Logistic regression to quantify independent associations between laboratory test results and out-comes, and restrictive cubic spline (RCS) to fit the relationship of OP risk occurrence.Results:Six hundred and sixty-six eligible RA patients were included according to inclusion criteria, including 253 RA-OP and 413 RA-non-OP patients. After exclusion of relevant influencing factors by comparing demographic characteristics, a significant correlation was found between blood HDL-C ( r=-0.11, P=0.006) LDL-C ( r=0.12, P=0.003) levels and RA-OP( P<0.05), and dichotomous Logistic regression showed that as BMI ( OR(95% CI)=0.81(0.77, 0.86), P<0.001], calcium [ OR(95% CI)=0.24(0.10, 0.63), P<0.001], HDL-C[ OR(95% CI)=0.38(0.22, 0.66), P<0.001] increased, the risk of developing OP in RA patients decreased. In contrast, the risk of developing OP increased with increasing age [ OR(95% CI)=1.10(1.07, 1.21), P<0.001), disease duration [ OR(95% CI)=1.00(1.00, 1.00), P=0.020], and LDL-C[ OR(95% CI)=1.71(1.38, 2.12), P<0.001]. Conclusion:Blood HDL-C and LDL-C levels are significantly correlated with the development of RA-OP, and can be used as predictors of OP development and good indicators for disease monitoring in RA patients.

Objective To assess the efficacy and safety of carotid ligation in the treatment of the carotid artery rupture(CAR). Methods A series of 30 patients who had CAR treated with carotid ligation were reviewed. There were 24 males and 6 females ranging in age from 32 to 76 years, with a mean of 53.9 years. The original sites of tumours were hypopharynx(n=11), larynx(n=5), thyroid (n= 6) and others(n =8). Of the 30 patients, 24 patients had received radiotherapy from 40 - 126 Gy and 10 patients underwent one or more surgical treatments. CAR in all cases occurred after surgical operation. CAR occurred in 5 -21 days after operation. Results By pressing the carotid and keeping breathe of the patients immediately after CAR, 25 patients were conscious, 2 patients in coma, and 3 patients died before carotid ligation. Seven cases were applied with carotid ligation, 3 cases with the combined ligation of carotid and brachiophatic arteries, and 17 cases with carotid ligation plus the repair by pectoralis major myocutaneous flap. The causes of CAR concluded fistula, wound dehiscence, wound infection and transferred flap necrosis. The omende hemorrhage occurred in 14 patients. Of 25 cases with the treatments of carotid ligation, 22 patients survived with no complication, 1 with brief muscle weakness and 2 with unconscious.Clinical follow-up period lasted more than 5 years at least in 6 patients. Conclusions CAR is the most dangerous complication in advanced carcinoma of the head and neck. The prompt hemostasis and carotid ligation are effective methods to rescue patients of CAR. It is important to keep patients conscious before carotid ligation surgery, with low rates of death and hemiplegia postoperatively.

OBJECTIVETo explore the expressions of P33ING1, P53 and their relationships with apoptosis in anal canal carcinoma (ACC).

METHODSThe expressions of P33ING1, P53 proteins were measured by immunohistochemistry method (SP method), and apoptosis was detected in 42 cases with ACC, 36 cases with anal canal adenoma (ACA) or anal canal papilloma (ACP), and 40 cases with paraanal inflammatory mass(PAIM).

RESULTSThe positive expression rates of P33ING1 and P53 proteins were 40.5% (17/42), 97.2% (35/36) and 97.5% (39/40), 50.0% (21/42), 22.2% (8/36) and 27.5% (11/40) respectively, and the average apoptosis indexes(AI) were (10.27+/- 1.23) per thousand, (42.75+/- 0.98) per thousand and (42.67+/- 1.04) per thousand respectively in ACC, ACA or ACP and PAIM. There were significant differences in the positive expression rates of P33ING1, P53 and apoptosis index between ACC and the other two groups respectively (P< 0.05). Among 21 cases of ACC with positive expression of P53 protein,there were 18 cases with P33ING1 negative expression.

CONCLUSIONSP33ING1 expression decrease in ACC, which may play an important role in the carcinogenesis and progression of ACC. P33ING1 and P53 may have an synergistic effect of suppressing cell growth and accelerating cell apoptosis.

Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms ; metabolism ; pathology ; Apoptosis ; Carcinoma ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Inhibitor of Growth Protein 1 ; Intracellular Signaling Peptides and Proteins ; metabolism ; Male ; Middle Aged ; Neoplasm Staging ; Nuclear Proteins ; metabolism ; Tumor Suppressor Protein p53 ; metabolism ; Tumor Suppressor Proteins ; metabolism

OBJECTIVETo present the treatment results and to analyze the causes of recurrence in patients with papillary thyroid carcinoma.

METHODSA retrospective review of 600 patients with papillary thyroid carcinoma treated between 1994 and 1999 was conducted. The primary lesions were originated from the left lobe in 188 cases, the right lobe in 290 cases, the isthmus in 8 cases, and multicentric in 114 cases. From the 600 cases, 584 were well-differentiated and 16 poorly differentiated. TNM stage:385 cases of stage I, 37 cases of stage II, 17 cases of stage III, and 161 cases of stage IV. Three hundred and one patients was N1b stage. All patients received surgical treatment. Among them, 19 cases received radiotherapy, 71 received (131)I-therapy and one case received concomitant radiotherapy and (131)I-therapy.

RESULTSThere were 94 recurrent cases. Twenty-seven cases died of recurrence, metastasis and other diseases. The overall 10-year survival rate was 93.2%. The overall 10 year survival rates of stage I, II, III, and IV patients were 99.1%, 94.7%, 93.8%, and 78.5%, respectively (P < 0.01). The 10-year survival rate of lower-age group (< 45 years) was 99.4% and higher-age group (≥ 45 years) 82.1% (P < 0.01). The 10-year survival rate of patients with trachea invasion was 66.5%, significantly lower than the 95.1% in patients without trachea invasion (P < 0.01). The 10-year survival rate of well-differentiated cases was 94.9%, significantly higher than the 38.9% in the poorly differentiated cases (P < 0.01). Multivariate analysis showed that the TNM stage, differentiation degree and the thorough going surgical operation were independent risk factors for the prognosis of papillary thyroid carcinoma.

CONCLUSIONSThe TNM stage, differentiation degree and the thorough going surgical operation are independent risk factors for the prognosis of papillary thyroid carcinoma.

Adolescent ; Adult ; Aged ; Carcinoma, Papillary ; pathology ; surgery ; therapy ; Child ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes ; therapeutic use ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thyroid Neoplasms ; pathology ; surgery ; therapy ; Thyroidectomy ; methods ; Young Adult

OBJECTIVETo summarize the clinicopathological characteristics of primary anorectal malignant melanoma (AMM).

METHODSClinical data of nine patients with AMM were reviewed retrospectively from January 1999 to March 2005.

RESULTSAnorectal malignant melanoma had a female predominance. The average age was 56 years old and average course of disease was 5.8 months. The onset of symptom was hematochezia, then anus prolapses. 94.7% of patients had AMM within 5 cm from anus margin; the average tumor size was (3.3+/- 2.1) cm. The polyp and ulcer were most common types. More than a half (54.5%) of the tumor was movable, 19.1% smooth surfaced, 6.6% soft textured. Synchronous metastasis was found in 14.0% of the patients, the first common metastasis was found in liver, the secondary was superficial inguinal lymph node metastasis. Half of the patients were misdiagnosed,and over 50% of patients were misdiagnosed as benign disease. Mile's operation was performed in most of patients (63%), while anal resection was performed in 30% of the patients.

CONCLUSIONSAnorectal malignant melanoma is often misdiagnosed,surgical procedure is the first choice for patients with AMM.

Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms ; diagnosis ; pathology ; surgery ; Female ; Humans ; Male ; Melanoma ; diagnosis ; pathology ; surgery ; Middle Aged ; Rectal Neoplasms ; diagnosis ; pathology ; surgery ; Retrospective Studies

OBJECTIVETo investigate the reliability and feasibility of sentinel lymph node biopsy (SLNB) of papillary thyroid carcinoma using combination of lymphoscintigraphy, the gamma probe and methylene blue staining techniques.

METHODSTwenty-three consecutive patients with thyroid papillary carcinoma were entered in the study between August 2007 and August 2009. All cases were without clinical evidence of cervical lymph node involvement. The (99)Tc(m)-dextran of 74 MBq (2mCi) was injected intratumorally under ultrasound guidance about 2 h to 5 h prior to surgery. Methylene blue was injected around the tumor during surgery. Preoperative lymphoscintigraphy, intra-operative hand-held gamma probe detecting and methylene blue staining techniques were used to detect the sentinel lymph node (SLN). SLN biopsies were sent to prepare frozen sections and the results were compared with specimen of routine selective neck dissection.

RESULTSThe SLNs were identified in all cases with the combination techniques. The SLN identification rates were 87.0% and 100% with methylene blue staining and lymphoscintigraphy plus probe scanning, respectively. Metastases in SLNs were revealed by frozen-section histology in 12 patients. In one case, SLNs frozen-section were negative, but metastasis was detected in routine histology. In other case both SLN and routine histology were negative, but metastasis was detected in non-SLN (level VI) neck dissection. The overall accuracy of the SLN biopsy was 91.3%, positive predictive value 100% and negative predictive value 81.8%.

CONCLUSIONThe results seem the SLN biopsy technique is a feasible and valuable method for detecting cervical lymph node metastasis and is helpful to decide performing neck dissection in patients with cN0 papillary thyroid carcinoma.

Adult ; Aged ; Carcinoma, Papillary ; diagnostic imaging ; pathology ; surgery ; Dextrans ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; Male ; Methylene Blue ; Middle Aged ; Neoplasm Staging ; Organotechnetium Compounds ; Radionuclide Imaging ; Sentinel Lymph Node Biopsy ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; surgery ; Young Adult

Objective To evaluate the role of parathyroid hormone(PTH)and serum calcium in prediction for hypocalcaemia after total thyroidectomy.Methods One hundred and sixty-five patients undergoing total or complete total thyroidectomy were reviewed retrospectively.The indications included bilateral carcinoma,undifferential carcinoma,surroundings invasion,distant metastasis and huge benign lesions.Preoperative and postoperative PTH,calcium concentrations and their decline levels were compared between Jan.2005 and May 2009.The role of PTH valne and decline level predicting for symptomatic hvpocalcaemia were analyzed by receiver operator characteristics(ROC)curve.Results After total thyroidectomy,85 patients(51.5%)developed hypocalcemia.Symptoms were reported by 36 patients (21.8%).The mean concentration of PTH for normocalcaemia(80 cases),asymptomatic hypocalcaemia (49 cases)and symptomatic patients(36 cases)were 31.0 ng/L,19.6 ng/L and 11.9 ng/L,respectively.The mean decline level for the three groups were 28.6%,52.6% and 78.0%,respectively.PTH value and its decline level had a poor predicting value for symptomatic hypocalcaemia and high negative predicting value for asymptomatic patients.The serum calcium concentration more than 2.0 mmoL/L,PTH level higher than 15 ng/L and PTH decline les8 than 50% had the good negative predicting value of 97.6%,90.3% and 96.5%.respectively.Conclusions Postoperative PTH and its decline level were significantly correlated with postoperative serum calcium concentration but had a low accuracy for predicting symptomatic hypocalcaemia.The serum calcium concentration more than 2.0 mmol/L,PTH level higher than 15 ng/L and PTH decline less than 50% had the good predicting value for asymptomatic patients.Calcium should be routinely supplemented in the first 24 h after total thyroidectomy to reduce the rate of hypocalcemia and the severity of hypocalcemia symptoms.