Humans ; Aged ; Patient Readmission ; Pulmonary Disease, Chronic Obstructive ; Malnutrition/complications* ; Risk Factors ; Retrospective Studies

Objective To analyze the efficacy and safety of PD-1 inhibitor combined with anlotinib on advanced neuroendocrine carcinoma. Methods We collected the data of patients with advanced neuroendocrine carcinoma who had failed the first-line standard chemotherapy and treated with PD-1 inhibitor combined with anlotinib from the First Affiliated Hospital of Zhengzhou University. Results A total of 45 patients, including 24 males and 21 females, were included. The median age was 57 years old. The primary tumor sites were lung (23 cases, 51.1%), esophagus (8 cases, 17.8%), pancreas (7 cases, 15.6%) and rectum (7 cases, 15.6%). Eighteen cases (40%) had failed the first- and second-line treatments, and 27 cases (60%) had failed the third-line and above treatments. All patients received 2-15 cycles of treatment, 3 cases died due to disease progression, overall objective response rate was 11.1%, disease control rate was 53.5%, median progression-free survival was 5.8 months, and 10-month progression-free survival rate was 25.5%. Adverse events were mainly grade 1-2 myelosuppression and digestive tract reactions. Conclusion PD-1 combined with anlotinib show better efficacy and good tolerance on advanced neuroendocrine carcinoma. It can be used as a choice after the failure of standard first-line treatment of advanced neuroendocrine carcinoma.

Increased microglial activation and neuroinflammation within autonomic brain regions such as the rostral ventrolateral medulla (RVLM) have been implicated in stress-induced hypertension (SIH). Prorenin, a member of the brain renin-angiotensin system (RAS), can directly activate microglia. The present study aimed to investigate the effects of prorenin on microglial activation in the RVLM of SIH rats. Rats were subjected to intermittent electric foot-shocks plus noise, this stress was administered for 2 h twice daily for 15 consecutive days, and mean arterial pressure (MAP) and renal sympathetic nerve activity (RSNA) were monitored. The results showed that MAP and RSNA were augmented, and this paralleled increased pro-inflammatory phenotype (M1) switching. Prorenin and its receptor (PRR) expression and the NLR family pyrin domain containing 3 (NLRP3) activation were increased in RVLM of SIH rats. In addition, PLX5622 (a microglial depletion agent), MCC950 (a NLRP3 inhibitor), and/or PRO20 (a (Pro)renin receptor antagonist) had antihypertensive effects in the rats. The NLRP3 expression in the RVLM was decreased in SIH rats treated with PLX5622. Mito-tracker staining showed translocation of NLRP3 from mitochondria to the cytoplasm in prorenin-stimulated microglia. Prorenin increased the ROS-triggering M1 phenotype-switching and NLRP3 activation, while MCC950 decreased the M1 polarization. In conclusion, upregulated prorenin in the RVLM may be involved in the pathogenesis of SIH, mediated by activation of the microglia-derived NLRP3 inflammasome. The link between prorenin and NLRP3 in microglia provides insights for the treatment of stress-related hypertension.

Objective To evaluate the significance of the expression of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) as prognostic indicators for patients with stage Ⅱ colorectal cancer. Methods A total of 285 patients with stage Ⅱcolorectal cancer who underwent potentially curative surgery were enrolled in the study. A high CEA level was defined as a level exceeding 5 ng/ml and a high CA19-9 level was defined as a level exceeding 37 U/ml. Patients were followed up every 3 months to review CEA and CA19-9 levels. Two years later, the chest and abdominal CT examination were performed every 3 months, and then every 6 months until 5 years. Results Out of these 285 patients, 99 (42.60%) patients had high CEA levels, 25 (8.77 %) patients had high CA19-9 levels, and 12 (4.21 %) patients had both high CEA and CA19-9 levels. The overall survival rates of patients with both high CEA and CA19-9 levels were significantly worse than those of others (P< 0.05). During the study, 51 recurrences were diagnosed. There were 22 hepatic recurrences, 10 pulmonary recurrences, 9 local recurrences, 8 lymph node recurrences, and 2 peritoneal recurrences. CT, CEA and CA19-9 were the first abnormal examinations in 30, 5 and 8 recurrent patients, respectively. In 27 % of recurrent patients, the recurrence was detected earlier by CEA and CA19-9 than that by CT. Conclusions The detection of preoperative CEA and CA19-9 levels is useful for predicting the prognosis after potentially curative surgery in patents with stage Ⅱ colorectal cancer. For early detection of occult recurrence of colorectal cancer, tumor markers are relevant.

OBJECTIVETo evaluate the result of colorectal cancer screening for high-risk groups in Harbin, China from 2012 to 2015.

METHODSAccording to the Project of National Colorectal Cancer Screening in Urban Area, epidemiological investigation and cancer risk evaluation established by National Cancer Center were performed among 40-69 years old residents in Harbin. Questionnaires were issued to assess high-risk groups for clinical screening, including colonoscope examination. The results of colorectal screening were evaluated in detail.

RESULTSProject of Colorectal Cancer Screening in Urban Area was completed successfully from 2012 to 2015 in various districts of Harbin. The accomplishment of high-risk assessment included 3 017 people, while 2 996 people received the clinical screening, including 1 376 males and 1 629 females, from 40 to 69 (53.3±7.1) years old. Among 2 996 people, 1 158 cases of colorectal polyps(38.7%) were screened, including 36.6%(901/2 465) cases of age<60 and 48.4%(257/531) cases of age>60 years old with significant difference (χ=19.19, P<0.01), and 47.6% (651/1 367) cases of male and 31.1%(507/1 629) cases of female with significant difference (χ=85.33, P<0.01). Of 1 158 polyps patients, 141 received the pathological examination and 11 patients were diagnosed as colorectal cancer, accounting for 0.4% of overall screening people (11/2 996). All these 11 patients underwent operation by advice and the postoperative pathology results all indicated early adenocarcinoma. Furthermore, among 141 polyps patients, 97 cases of tubular adenoma were found, which were distributed as follows: 2 cases of cecum (2.1%), 14 cases of ascending colon(14.4%), 12 cases of transverse colon (12.4%), 15 cases of descending colon (15.5%), 35 cases of sigmoid colon (36.1%) and 19 cases of rectum(19.6%).

CONCLUSIONWith the increase in age, the risk of colorectal polyps is significantly elevated. The males have higher incidence of colorectal polyps than the females. Adenoma mainly locates in the distal colon and rectum, especially in the sigmoid colon. Early screening for high-risk group can find out colorectal precancerosis and cancer, so the patients can receive early treatment.

Adenocarcinoma ; diagnosis ; Adenoma ; diagnosis ; Aged ; Cecum ; China ; Colon, Ascending ; Colon, Sigmoid ; Colon, Transverse ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; Early Detection of Cancer ; Female ; Humans ; Incidence ; Intestinal Polyps ; Male ; Middle Aged ; Rectum ; Risk ; Surveys and Questionnaires

Objective To explore the best operation method in the patients with papillary thyroid microcarcinoma.Methods A total of 139 patients with papillary thjroid microcarcinoma were treated at our institute between Jan.2000 and Jan.2010.The data on the clinicopathological characteristics of patients and treatment were collected.Results The mean tumor size was (0.45 ± 0.24) cm.Of the 139 patients,30.2％ had multifocal tumors,19.4％ had bilateral tumors,42.4％ neck lymph node metastases.The number of eases of lymph node metastasis in level Ⅵ,Ⅱa,Ⅲ and Ⅳ was 58(41.7％),3(2.2％),10(7.9％),5(3.6％),respectively.Only one had lymph node metastasis in Level Ⅲ Microscopic extrathyroid extension was associated with neck lymph node metastases in papillary thyroid microcareinoma patients (x2 =38.39,P ＜0.001).No one developed permanent hypoparathyroidism.The median follow-up time was 103 (range,30-154) months,and local recurrence in the thyoid was diagnosed in 2 patients who underwent hemi-or subtotal thyroidectomy.Follow-up of 10 years was done in 16 cases,and the survival rate of 139 patients for 10-year was 100％.Conclusions It suggested that patients with papillary thyroid microcarcinoma has uniform clinicopathologic characteristics and the pattern of lymph node metastasis from those with papillary thyroid carcinoma.Total thyroidectomy plus level Ⅵ dissection is the optimal surgical treatment of papillary thyroid microcarcinoma.

The study included 24 patients of lung cancer with bone metastasis, 26 patients of lung cancer without bone metastasis and 27 healthy controls. The serum levels of β-crosslaps of type Ⅰ collagen (β-CTX), M-MID and urinary β-CTX/creatinine (CTX/CR) were measured by ELISA. Results showed that the serum levels of β-CTX and urinary CTX/CR in lung cancer patients with bone metastasis were significantly higher than those without bone metastasis (P ＜ 0. 01 ). The findings suggest that the measurement of serum β-CTX and urinary CTX/CR may indicate bone metastasis in lung cancer.

Objective To explore the pattern of cervical nodal metastasis and the clinical significance of total thyroidectomy plus functional neck lymphadenectomy in papillary thyroid carcinoma patients. Methods Clinical and pathological data of 172 patients with papillary thyroid cancer who underwent total thyroidectomy plus functional neck lymph node dissection at Jinan Military General Hospital were retrospectively reviewed, including patient demographics, extent of surgery, parathyroid hormone level,recurrence, tumor pathology, such as tumor size, multifocality, capsular invasion, vascular invasion,extrathyroidal extension, and lymph node status. Results Of the 172 functional neck dissection patients (47 ambilateral), the incidence of lymphonodus metastasis in regions Ⅵ, Ⅳ and Ⅲ was 96. 3% ,78. 5%and 62.1% respectively. Rate of nodal metastasis was higher in patients with extracapsular invasion than in patients with no invasion ( P ＜ 0. 05 ). Serum parathyroid hormone levels significantly decreased immediately postoperatively in total thyroidectomy plus functional neck dissection and remained low for several weeks thereafter ( P ＜ 0. 01 ). The 5-, 10- and 15-year survival rate was ( 98. 83 ± 0. 82) %, (98. 23 ± 1.02 ) % and (96. 42 ± 1.43 )%, respectively. Conclusions Therapeutic neck lymph node dissection for papillary thyroid cancer is recommended for cervical nodal metastasis patients. Total thyroidectomy plus functional neck dissection is important in the treatment of papillary thyroid cancer.

Objective To evaluate the value of post-processing techniquos of multi-slice spiral CT(MSCT) in diagnosis of small peripheral lung cancer. Methods 36 patients with small peripheral lung cancer(≤20mm in di-ameter) who had been proved by pathology were eoueeted. After MSCT scanning ,3D reconstruction images were made by MPR,SSD and VR,then compared with axial thin-slice images. Results The sensitivity of MPR on vascularnotch sign,lobulation and spiculated sign was higher than that of axial thin-slice images. The sensitivity of SSD on peural sign was higher than that of axial thin-slice images. The sensitivity of VR on vascularnotch sign and lobulation was higher than that of axial thin-slice images. Conclusion The post-processing techniques of MSCT have high value on diagnosis of small peripheral lung cancer. More information could be collected when many kinds of post-processing techniques were used.

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used on clinic; however, there are still few reports addressing rhBMP-2-induced osteogenesis in intervertebral disc.OBJECTIVE: To verify the effect of rhBMP-2 to induce interbody fusion in rabbits.DESIGN, TIME AND SETTING: Randomized controlled animal study and multi-level evaluation, which was performed in Affiliated Hospital of Medical College of Qingdao University from February to July 2007.MATERIALS: 24 adult New-Zealand rabbits weighing 3.5-4.5 kg were used to expose L4-5 and L5-6 intervertebral disc; rhBMP-2 (1 mg/ampoule, purity≥95%) was provided by Beijing Bailingke Biological Products Co., Ltd.METHODS: 24 rabbits were randomly divided into experimental group and control group with 12 rabbits for each. In the experimental group, saline (20 μL, containing 200 μg rhBMP-2) was injected into nucleus pulposus of L4-5 intervertebral disc; equivalent saline was inserted into nucleus pulposus of L5-6 intervertebral disc as controls. Rabbits in the control group were injected with saline (20 μL) into nucleus pulposus of L4-5 intervertebral disc.MAIN OUTCOME MEASURES: Morphological changes of injected segments were observed by hand-feeling check together with histological and imaging tests at 10, 30, 60, and 90 days postoperatively.RESULTS: 24 rabbits were included in the final analysis. ①In the experimental group, the motion range of L4-5 segment was not limited at 10 days postoperatively, and lightly limited at 30 days, but severely limited at 60 days postoperatively; L4-5 segment was fixed tightly at 90 days postoperatively. Moreover, motion range of L5-6,segment and articular motion range in the control group were not changed remarkably. ② L4-5 interbedy space was narrowed at 10 days or even disappeared at 90 days postoperatively, and then osteogenesis fusion was formed. Transmittance of intervertebral space in the L5-6 segment and in the control group was not changed obviously. ③ Nucleus pulposus was gradually shrunk at 10 days postoperatively; partial cartilage endplate transformed into mature woven bone, and collagen fiber structure of annulus fibrosus gradually disappeared at 90 days postoperatively. A lot of mesenchymal cells were aggregated surrounding annulus fibrosus at 10 and 30 days postoperatively. Moreover, mature woven bone was formed in annulus fibrosus near to cartilage endplate at 90 days postoperatively. However, histological and morphological changes were not found in the control group at those four time points.CONCLUSION: rhBMP-2 can induce intervertebral disc osteogenesis so as to achieve interbody fusion.