7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide ; toxicity ; Carcinogens ; toxicity ; Cell Line, Tumor ; DNA Damage ; drug effects ; Dose-Response Relationship, Drug ; HSP70 Heat-Shock Proteins ; biosynthesis ; Humans

OBJECTIVETo summarize the new knowledge of the anaplastic thyroid carcinoma (ATC).

METHODSThe clinical data of 58 patients (35 men, 23 women, aged 28 to 79 years) with ATC that were treated with various therapeutic modalities from 1981 to 2005 were retrospectively analyzed. Among them, 25 patients received surgery alone (SA group) and 33 received surgery plus radiation (S + R group). The dosage of postoperative radiotherapy was 40-70 Gy. Four patients received biopsy, 24 received palliative surgery, and 30 received radical surgery. Only 2 patients received complete chemotherapy.

RESULTSATC invaded trachea in 40 patients (69.0%), esophagus in 32 patients (55.2%), and carotid in 17 patients (29.3%). The cervical lymph node metastases occurred in 19 patients (32.8%). The overall 1-year survival rate was 37.8%, 3-year survival rate 31.2%, and 5-year survival rate 25.9%. The 5-year survival rate was 37.8% in S + R group but was only 9.9% in SA group (P = 0.0000). The 5-year survival rate was 41.4% in radical surgery subgroup but was only 12.4% in palliative surgery subgroup (P = 0.0023). In < or = 45-year-old subgroup (n = 4), the 5-year survival rate was 50.0%; however, in > 45-year-old subgroup, it was only 21.3%. In postoperative radiation < 60 Gy subgroup , the 5-year survival rate was 19.3%; however, in > or = 60 Gy group, it was 53.7% (P = 0.0000). Among all the 58 patients, some patients received palliative surgery because of tumor invasion in trachea (n = 16, 27.6%), esophagus (n = 8, 13.8%), carotid (n = 8, 13.8%), and other sites (n = 13, 22.4%). Twenty-four patients (61.5%) died of localrelapse, 2 (5.1%) of cervical lymphnode failure, 9 (23.1%) of metastasis, and 4 (10.3%) of other reasons.

CONCLUSIONSThe prognosis of ATC is poor. Radical surgery and postoperative radiation > or = 60 Gy can improve the survival rate. Tumor invasion in trachea, esophagus, and carotid are the main reasons of palliative surgery. Local relapse is lethal.

Adult ; Aged ; Carcinoma ; pathology ; surgery ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Thyroid Neoplasms ; pathology ; surgery

OBJECTIVETo explore the influence of oxidized high-density lipoprotein (oxHDL) on the maturation and migration of bone marrow-derived dendritic cells (BMDCs) from C57BL/6J mice.

METHODSThe C57BL/6J mice bone marrow cell suspension was prepared and purified. Recombinant granulocyte-macrophage colony-stimulating factor (rmGM-CSF) and recombinant interleukin-4 (rmIL-4) were used to promote monocytes to differentiate and suppress lymphocytes. Then 50 microg/mL oxHDL was added to stimulate BMDCs, using 50 microg/mL high-density lipoprotein (HDL) as homologous protein control, PBS as negative control, and 1 microg/mL lipopolysaccharide (LPS) as positive control. The CD86 and MHCII expression rates were detected with fluorescence-activated cell sorting (FACS). Liquid scintillation counting (LSC) was used in mixed lymphocyte reactions (MLRs) to reflect the ability of BMDCs in stimulating the proliferation of homologous T cells. Levels of cytokines IL-12 and IL-10 were detected by ELISA. The cell migration was evaluated with the transwell system.

RESULTSCompared with PBS group, the expressions of CD86 and MHCII, counts per minute of MLRs, secretion of IL-12 and IL-10, and number of migrated cells in oxHDL group and LPS group significantly increased (all P<0.05), while the increment was less in oxHDL group than LPS group. The number of migrated cells in oxHDL group was about twice of that in HDL group.

CONCLUSIONOxHDL may promote the maturation and migration of BMDCs in vitro.

Animals ; Bone Marrow Cells ; cytology ; drug effects ; physiology ; Cell Differentiation ; drug effects ; Cell Movement ; drug effects ; Cells, Cultured ; Dendritic Cells ; cytology ; drug effects ; physiology ; Humans ; Lipoproteins, HDL ; metabolism ; pharmacology ; Lipoproteins, LDL ; metabolism ; pharmacology ; Mice ; Mice, Inbred C57BL

Massive open online courses(MOOCs)have a major influence on modern higher education."Anatomy and clinics"course was offered on Chinese University MOOC from November,2015.The course already has run 4 ver-sions,with over 60 000 registrants.This paper analyzed the data of 4 versions and results of questionnaire survey, suggests that offering MOOC of anatomy plays a role in continuing professional and interprofessional medical educa-tion.Combining MOOC to traditional anatomy teaching is also suggested.

Objective To analyze the results of malaria focus investigation and disposal in Tengchong City,Yunnan Prov-ince between 2015 and 2016,so as to provide evidences for interrupting potential malaria transmission. Methods The malaria foci were investigated and disposed according to the malaria cases reported from"China Information System for Disease Control and Prevention"in Tengchong City between 2015 and 2016. The mosquitoes were captured by mosquito-lured lamp overnight to investigate the malaria vector in local. The peripheral blood samples were collected from the local residents with a febrile history in the foci within two weeks and the accompanists of the cases,and then the rapid malaria diagnosis tests were used to screen the malaria carriers. Results Totally 145 imported malaria cases were reported in Tengchong City between 2015 and 2016,and the focus investigation and disposal rate within 7 d was 100%(145/145). A total of 16186 mosquitoes of 12 species of Anopheles were captured,among which An. sinensis was the predominant,accounting for 64.31%(10410/16186),followed by An. kun-mingensis and An. minimus,with the constituent ratios of 14.15%(2291/16186)and 11.66%(1887/16186),respectively. One person(1.96%,1/51)in the 51 accompanists of the cases was positive in the malaria rapid diagnosis test. Conclusions The malaria transmission vectors such as An. sinensis,An. kunmingensis,An. minimus etc. are still distributed in Tengchong City,and An. sinensis is the predominant species. Therefore,the relevant authorities should continue to strengthen the focus in-vestigation and disposal to interrupt the potential introduced malaria transmission by imported cases in the future.

OBJECTIVEWhether statins can slow down the progression of chronic kidney disease (CKD) remains controversial. We performed a meta-analysis to evaluate the effects of statin therapy on disease progression in adult patients with CKD who did not require dialysis therapy.

METHODSWe searched the electronic databases for relevant randomized controlled trials (RCTs) published by February 2015. Random-effects meta-analysis of RCTs was used to pool the renal outcomes of the patients.

RESULTSTwenty-eight studies (30 RCTs) involving a total of 45 688 participants were included in the analysis. Compared with the control groups, statins produced no effects in preventing end-stage renal disease (ESRD) [relative risks (RR) 0.98, 95% confidence intervals (CI): 0.91-1.05] and in reducing the risk of doubling of the serum creatinine level (RR 1.43, 95% CI: 0.26-7.79). Statin therapy was associated with a lowered risk of estimated glomerular filtration rate (eGFR) reduction by 25% or more (RR 0.91, 95% CI: 0.83-0.99) and delayed the reduction of eGFR [standardized mean differences (SMD) 0.04, 95% CI: 0.02-0.07]. In subgroup analyses, the benefit of statins on changes in eGFR was statistically significant in patients with moderate CKD (SMD 0.09, 95% CI 0.04-0.13). Among different statins, atorvastatin was associated with a beneficial effect on kidney function (SMD 0.10, 95% CI 0.03-0.17). Patients who received high-intensity statin therapy showed significant changes in eGFR (SMD 0.12, 95% CI: 0.02-0.21).

CONCLUSIONStatin therapies may not prevent ESRD or doubling of serum creatinine level, but can improve GFR or delay the reduction of GFR in CKD patients. The therapeutic effects are associated with the patients' baseline eGFR levels, statin types and therapy intensity.

Adult ; Disease Progression ; Glomerular Filtration Rate ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Kidney Failure, Chronic ; drug therapy ; Randomized Controlled Trials as Topic ; Renal Insufficiency, Chronic ; drug therapy

OBJECTIVETo evaluate the role of parathyroid hormone (PTH) and serum calcium in prediction for hypocalcaemia after total thyroidectomy.

METHODSOne 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 value and decline level predicting for symptomatic hypocalcaemia were analyzed by receiver operator characteristics (ROC) curve.

RESULTSAfter 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 less than 50% had the good negative predicting value of 97.6%, 90.3% and 96.5%, respectively.

CONCLUSIONSPostoperative 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.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Calcium ; blood ; Child ; Female ; Humans ; Hypocalcemia ; blood ; diagnosis ; Male ; Middle Aged ; Parathyroid Hormone ; analysis ; Postoperative Period ; Retrospective Studies ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; adverse effects ; Young Adult

OBJECTIVETo investigate the effects of Scutellaria barbata extract (ESB) in suppressing tumor growth and modulating the immune functions in mice bearing tumors derived from hepatocarcinoma H22 cells.

METHODSFifty mice inoculated subcutaneously with H22 cells were equally divided into the model group, high-, moderate-, and low-dose ESB groups, and 5-Fu group, with corresponding treatments for 10 days. Another 10 mice with only saline injection served as the normal control group. The body weight, tumor mass, thymus index and spleen index of the mice were measured, and the lymphocyte proliferation activity, NK cell activity and interleukin-2 (IL-2) production by the splenocytes were detected.

RESULTSModerate- and high-dose ESB significantly suppressed the tumor growth with tumor inhibition rate of 28.68% and 36.98%, respectively. ESB treatment at moderate and high doses significantly increased the thymus index and spleen index (P < 0.01), which were decreased significantly in 5-Fu group. The lymphocyte proliferation activity, NK cell activity and IL-2 production by the splenocytes were significantly lower in the model group than in the normal group (P < 0.05). Compared with the model group, ESB at the high dose obviously increased the three indexes above mentioned. The NK cell activity was also significantly improved in moderate-dose ESB group (P < 0.05).

CONCLUSIONESB can suppress the growth of H22 implant tumor and enhance the immune function of the tumor-bearing mice.

Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Female ; Interleukin-2 ; metabolism ; Killer Cells, Natural ; immunology ; Liver Neoplasms, Experimental ; immunology ; pathology ; Lymphocytes ; immunology ; Male ; Mice ; Mice, Inbred ICR ; Random Allocation ; Scutellaria ; chemistry

OBJECTIVETo study the patterns of cervical lymph nodes metastasis and the surgical managements of cervical lymph nodes in clinical N0 (cN0) papillary thyroid carcinoma.

METHODSFifty-one consecutive patients with papillary carcinomas without clinical evidence of cervical lymph node involvement were included in the study between August 2007 and September 2010, in which 53 sides underwent neck lymph node dissection. Preoperative lymphoscintigraphy intra-operative hand-held gamma probe detecting and blue dye technique were used to detect the sentinel lymph node (SLN). SLNs were sent to frozen-section and the results were compared with specimen of routine selective neck dissection. All the pathologic specimens were reviewed by pathologists, counting the numbers of pathologic positive nodes and mapping the localization of positive nodes in level II, III, IV, V and VI respectively. The following criteria were used to study the predictive value of lateral neck compartment lymph node metastasis: age, multifocality of the tumor, extracapsular spread (ECS), tumor size, and the number of central compartment metastasis nodes. Univariate analysis with the χ2 test was used to analyze the statistical correlation between lateral neck compartment lymph node metastasis and the other clinical factors. Multiple logistic regression analysis was used to identify the multivariate correlates of lateral neck compartment metastasis.

RESULTSThe occult lymph node metastasis and lateral neck metastasis rates were 77.4% and 58.5% respectively, central compartment metastasis ≥3 nodes was the only independent predictive factor for the metastasis in lateral neck. Twelve sides were pN0 and other 41 sides were pN+ in all 53 side specimens. Of 41 sides with pN+, 17 sides (41.5%) involved single site and 24 sides (58.5%) involved multi-sites. The distribution of metastasis lymph nodes:level VI 62.3%, level III 52.8%, level IV 30.2%, level II 18.9%, and level V 0%.

CONCLUSIONSCervical occult lymph node metastasis in cN0 papillary thyroid carcinoma mainly localizes in level VI, level III, level IV and level II.Selective neck dissection including level VI, III, IV, II is enough for papillary carcinoma without clinical evidence of cervical lymph node involvement.

Adolescent ; Adult ; Aged ; Carcinoma ; Carcinoma, Papillary ; Female ; Humans ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prospective Studies ; Thyroid Neoplasms ; pathology ; Young Adult

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