1.Papillary thyroid microcarcinoma should not be used as the basis for postoperative 131I therapy
Xiaoyu CAI ; Ruiguo ZHANG ; Yujing HU ; Renfei WANG ; Yanzhu BIAN
Journal of Surgery Concepts & Practice 2023;28(6):529-535
Objective To analyze the clinicopathological data of patients with papillary thyroid microcarcinoma(PTMC)and papillary thyroid non-microcarcinoma(non-PTMC)who received 131I therapy retrospectively,and compare the therapeutic response of the two groups of patients,so as to guide 131I therapy decisions for PTMC patients.Methods A total of 1 118 patients with papillary thyroid carcinoma(PTC)underwent 131I therapy in the Department of Nuclear Medicine,Tianjin Medical University General Hospital from January 2015 to December 2020 were enrolled.Chi-square test and Mann-Whitney U test were used to compare the differences of clinicopathological features and 131I therapy,therapeutic response between two groups.The incomplete response(IR)rate curves of the two groups were plotted by Kaplan-Meier analysis.Results The proportion of patients with multifocal,involvement of bilateral thyroid lobes in PTMC group were higher than those in non-PTMC group,and the proportion of patients with extra-thyroid extension,T4,N1b,stimulated thyroglobulin(sTg)>10 μg/L,and high risk stratified were lower than those in non-PTMC group(P<0.05).Most patients in PTMC group received remnant ablation for the first time,while more patients in non-PTMC group received adjuvant therapy and therapy for known disease(P<0.05).There was no statistically significant difference in 131I therapeutic response,the rates of excellent response(ER)and IR in two groups,and the differences in curves of IR rate between the two groups were also no statistically significance(P>0.05).Conclusions PTMC has a certain degree of invasiveness.As long as the patients were comprehensively evaluated and the standard 131I therapy was adopted,the treatment outcomes of patients with PTMC and non-PTMC were roughly the same.Therefore,the clinical value of the definition of PTMC is extremely limited in the formulation of 131I therapeutic dose regimens.
2.Current status and influencing factors of supportive care needs for postoperative patients with glioblastoma
Pengwei LU ; Jinglian LI ; Rui ZHAO ; Na HUANG ; Linlin WANG ; Yanzhu FAN
Chinese Journal of Modern Nursing 2023;29(18):2446-2450
Objective:To investigate the current situation of supportive care needs for patients with glioma after surgery and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 168 postoperative patients with glioblastoma admitted to Beijing Tiantan Hospital Affiliated with Capital Medical University from January to May 2022 were selected as the research objects. The general information questionnaire, Supportive Care Need Survey-34-item Short Form (SCNS-SF34), M.D.Anderson Symptom Inventory Brain Tumor Module (MDASI-BT) and Cancer Fatigue Scale (CFS) were used to investigate them. The multiple linear regression analysis was used to explore the influencing factors of supportive care needs in patients with glioma after surgery.Results:The score for supportive care needs in 168 postoperative patients with glioblastoma was (71.68±25.28). The results of multiple linear regression analysis showed that place of residence, occupational status, degree of symptom distress and fatigue degree were the influencing factors for supportive care needs of glioma patients after surgery ( P<0.05) . Conclusions:Patients with glioma after surgery have unmet supportive care needs, which are influenced by their place of residence, work status, disease symptoms and fatigue levels. Medical staff provide personalized guidance to postoperative patients to help them cope with postoperative symptoms, reduce fatigue levels and meet their supportive care needs.
3.Retrograde nerve growth factor signaling modulates tooth mechanical hyperalgesia induced by orthodontic tooth movement via acid-sensing ion channel 3.
Meiya GAO ; Xinyu YAN ; Yanzhu LU ; Linghuan REN ; Shizhen ZHANG ; Xiaoqi ZHANG ; Qianyun KUANG ; Lu LIU ; Jing ZHOU ; Yan WANG ; Wenli LAI ; Hu LONG
International Journal of Oral Science 2021;13(1):18-18
Orthodontic tooth movement elicits alveolar bone remodeling and orofacial pain that is manifested by tooth mechanical hyperalgesia. Nerve growth factor (NGF) is upregulated in periodontium and may modulate tooth mechanical hyperalgesia. The objectives were to examine the role of NGF in tooth mechanical hyperalgesia and to elucidate the underlying mechanisms. Tooth mechanical hyperalgesia was induced by ligating closed coil springs between incisors and molars in Sprague-Dawley rats. Retrograde labeling was performed by periodontal administration of fluor-conjugated NGF and the detection of fluorescence in trigeminal ganglia (TG). Lentivirus vectors carrying NGF shRNA were employed to knockdown the expression of NGF in TG. The administration of agonists, antagonists, and virus vectors into TG and periodontium was conducted. Tooth mechanical hyperalgesia was examined through the threshold of biting withdrawal. Our results revealed that tooth movement elicited tooth mechanical hyperalgesia that could be alleviated by NGF neutralizing antibody and that NGF was upregulated in periodontium (mainly in periodontal fibroblasts) and TG. Retrograde labeling revealed that periodontal NGF was retrogradely transported to TG after day 1. Acid-sensing ion channel 3 (ASIC3) and NGF were co-expressed in trigeminal neurons and the percentage of co-expression was significantly higher following tooth movement. The administration of NGF and NGF neutralizing antibody into TG could upregulate and downregulate the expression of ASIC3 in TG, respectively. NGF aggravated tooth mechanical hyperalgesia that could be alleviated by ASIC3 antagonist (APETx2). Moreover, NGF neutralizing antibody mitigated tooth mechanical hyperalgesia that could be recapitulated by ASIC3 agonist (GMQ). NGF-based gene therapy abolished tooth mechanical hyperalgesia and downregulated ASIC3 expression. Taken together, in response to force stimuli, periodontal fibroblasts upregulated the expressions of NGF that was retrogradely transported to TG, where NGF elicited tooth mechanical hyperalgesia through upregulating ASIC3. NGF-based gene therapy is a viable method in alleviating tooth-movement-induced mechanical hyperalgesia.
4.Pathological study of the levator palpebrae superioris muscle in patients with different severities of simple congenital ptosis
Yanzhu LUO ; Dongping LI ; Na ZHOU ; Junping LI ; Yuhong WANG
Chinese Journal of Experimental Ophthalmology 2021;39(12):1038-1045
Objective:To observe the pathological changes of levator palpebrae superiors muscle in patients with different severities of simple congenital ptosis (SCP).Methods:Levator palpebrae superiors muscle specimens from 102 eyes of 68 patients with SCP who received levator palpebrae superiors muscle shortening surgery at Wuhan Aier Hankou Eye Hospital from August 2018 to October 2019 were collected as the observation group.According to the severity of ptosis, the specimens were divided into three groups, coverage ≤4 mm group (n=35), coverage >4 mm to ≤6 mm group (n=30), and coverage >6 mm group (n=37). Fresh levator palpebrae superiors muscle tissues from 8 normal donors in Aier Eye Bank of Wuhan Red Cross were selected as the control group.All specimens were performed with Masson trichrome staining and immunohistochemical staining for α-smooth muscle actin (α-SMA), and ImageJ software was used to measure the collagen fiber area ratio, skeletal muscle fiber area ratio and the integrated absorbance (IA) value of α-SMA.Seventeen specimens (2 from the control group, 5 from coverage ≤4 mm group/coverage >4 mm to ≤6 mm group/coverage >6 mm group) were observed with a transmission electron microscope (TEM). This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Wuhan Aier Hankou Eye Hospital (No.HKAIER2018IRB-005-01). All patients and their legal guardians were well informed about the treatment method and the purpose of sampling and voluntarily signed informed consent.Results:Compared with the control group, the skeletal muscle fiber was reduced in number and was in disordered arrangement, and the striation of some muscle fibers disappeared, and hyperplastic fibrous connective tissue was found in intercellular substances in the observation group.The collagen fiber area ratio of the coverage ≤4 mm group, coverage >4 mm to ≤6 mm group, coverage >6 mm group were significantly higher than that of the control group, and the skeletal muscle fiber area ratio of the three groups was significantly lower than that of the control group (all at P<0.008 3). There were more smooth muscle fibers and positive expression of α-SMA found in the specimens of the observation group.The IA value of α-SMA of the coverage ≤4 mm group, coverage >4 mm to ≤6 mm group, coverage >6 mm group was 7 195.28(5 935.69, 14 058.29), 55 584.18(33 861.88, 80 419.32), 166 507.76(119 121.95, 187 890.86), respectively, which were all higher than 5 543.03(4 867.67, 8 312.02) of the control group, among which, there were statistically significant differences between the control group and the coverage >4 mm to ≤6 mm group, coverage >6 mm group (both at P<0.008 3). Abundant organelles and some damaged mitochondria were found in smooth muscle cytoplasm in the observation group with a TEM.But no characteristic structure of smooth muscle cells such as dense patch and dense body was detected.Conclusions:There are abnormal smooth muscle cells in the levator palpebrae superiors muscle of SCP patients, and the dysgenesis of the levator palpebrae superiors muscle may be related to this abnormal muscle cell.
5.Sliding tarso-conjunctival flap combined with allogeneic sclera transplantation for one-stage posterior eyelid defect
Junping LI ; Dongping LI ; Na ZHOU ; Yanzhu LUO ; Yuhong WANG
Chinese Journal of Plastic Surgery 2021;37(12):1364-1369
Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were collected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1-2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm). The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts. The postoperative follow-up was performed to observe the morphology of the eyelid margin, the repair of the eyelid defect area, the degree of movement of the eyelid and the function of opening and closing, and lifting.Results:A total of 8 cases were included, 3 males and 5 females, aged 31-76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Aside from the absence of eyelashes in the reconstructed area, the eyelids were in good shape. The movement of eyelid was good, the functions of opening and closing and lifting were normal. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.
6.Clinical effect of one-stage reconstruction of sliding tarso-conjunctival flap combined with allogeneic sclera transplantation for posterior eyelid defect
Junping LI ; Dongping LI ; Na ZHOU ; Yanzhu LUO ; Yuhong WANG
Chinese Journal of Plastic Surgery 2021;37(8):964-969
Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.
7.Clinical effect of one-stage reconstruction of sliding tarso-conjunctival flap combined with allogeneic sclera transplantation for posterior eyelid defect
Junping LI ; Dongping LI ; Na ZHOU ; Yanzhu LUO ; Yuhong WANG
Chinese Journal of Plastic Surgery 2021;37(8):964-969
Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.
8.Sliding tarso-conjunctival flap combined with allogeneic sclera transplantation for one-stage posterior eyelid defect
Junping LI ; Dongping LI ; Na ZHOU ; Yanzhu LUO ; Yuhong WANG
Chinese Journal of Plastic Surgery 2021;37(12):1364-1369
Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were collected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1-2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm). The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts. The postoperative follow-up was performed to observe the morphology of the eyelid margin, the repair of the eyelid defect area, the degree of movement of the eyelid and the function of opening and closing, and lifting.Results:A total of 8 cases were included, 3 males and 5 females, aged 31-76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Aside from the absence of eyelashes in the reconstructed area, the eyelids were in good shape. The movement of eyelid was good, the functions of opening and closing and lifting were normal. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.
9.Clinical effect of one-stage reconstruction of sliding tarso-conjunctival flap combined with allogeneic sclera transplantation for posterior eyelid defect
Junping LI ; Dongping LI ; Na ZHOU ; Yanzhu LUO ; Yuhong WANG
Chinese Journal of Plastic Surgery 2021;37(8):964-969
Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.
10.Clinical effect of one-stage reconstruction of sliding tarso-conjunctival flap combined with allogeneic sclera transplantation for posterior eyelid defect
Junping LI ; Dongping LI ; Na ZHOU ; Yanzhu LUO ; Yuhong WANG
Chinese Journal of Plastic Surgery 2021;37(8):964-969
Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

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