【Abstract】ObjectiveTo study the distal intramural spread of rectal carcinoma, and provide evidence for modification of rectal carcinoma surgery. MethodsSixty patients with rectal carcinoma admitted to the first affiliated hospital of Chongqing university of medical science from November 2001 to October 2002 were included. The specimens were extended to its original size and shape by the fat clearing method. Mesenteric lymph nodes were dissected by using transillumination to examine metastases histologically, then a lymph nodes map was produced which including the site of the primary lesion, the vascular distribution, and the sites of dissected nodes. The specimen below the distal margin of the tumor was cut continuously with 0.5 cm interval then sectioned for histopathological examination. ResultsTumor spread to the distal intramural was observed in 11 of 60 patients (18.3%) with the range within 1.5 cm, of which less than 0.5 cm in 5 case, 5 cm to 1.0 cm in 2 cases, 1.0 cm to 1.5 cm in 4 cases. The tumor invasion was correlated with gross type, histological type and infiltrative depth, but not with sex, age, location of the tumor, size of the tumor, lymph nodes metastases and Dukes stage. Conclusion The range of distal mural excision should exceed 1.5 cm to tumor margin in radical surgery for rectal carcinoma. This rule should be emphasized for patients with poor cell differentiation and deep infiltration.
ObjectiveTo study the abnormal biological pathways of intrahepatic cholangiocarcinoma (ICC) from the transcriptomics level and identify genes associated with the prognosis of ICC.MethodsThe differentially expressed genes were screened by t test and fold change method, then KEGG functional enrichment analysis was performed on related genes. The STRING database was applied to construct protein interaction network and find the hub nodes of the network by calculating the degree, betweenness, and closeness of each node. Kaplan-Meier survival analysis was performed using log-rank test to identify prognostic genes related to ICC.ResultsAll of 1 134 differentially expressed genes were overlapped in 3 datasets, which were mainly involved in 15 pathways, including DNA replication, cell cycle, drug metabolism, RNA transport, etc. signaling pathways and amino acid synthesis. According to protein interaction network analysis, TAF1, GRB2, E2F4, HNF4A, MYC, and TP53 genes were hub nodes. As GRB2 and TP53 genes were also the death related genes of ICC, it was found that patients with lower GRB2 gene expression had a better overall survival than those with higher GRB2 gene expression (P=0.040 9), while patients with lower TP53 had a worse overall survival than those with higher TP53 gene expression (P=0.027 3), which were also verified in the TCGA database.ConclusionsThe abnormal cell metabolism is notably related to the tumorigenesis of ICC. TAF1, GRB2, E2F4, HNF4A, MYC, and TP53 are the key genes in the carcinogenesis and progression of ICC. Expressions of GRB2 and TP53 genes are associated with the prognosis of ICC.
Objective To investigate the feasibility of bacterial cellulose patch to repair and reconstruct rabbit tracheal defect, so as to lay the foundation for the development of bacterial cellulose artificial trachea. Methods Thirty adult rabbits (weighing, 2.5-3.5 kg) were selected to establish full-thickness defect of the cervical trachea (1.0 cm×0.6 cm in size) which involved the anterior and side walls and 2-3 rings. Defect was repaired with sheet bacterial cellulose (1.2?cm in diameter and 6 layers) in experimental group (n=15), and with autologous cervical fascia in control group (n=15). The general condition of the animals was observed after operation; after 4, 8, and 12 weeks, the samples were obtained for measuring the tracheal stenosis degree, counting new microvessels, and observing lumen reconstruction situation by scanning electron microscope. Results Three rabbits died of infection, tracheal stenosis, or asphyxia caused by airway secretions retention in 2 groups respectively, and the other rabbits survived to the end of experiment. Gross observation showed that reconstruction materials gradually adhered?to?adjacent?tissue and were enwrapped?by connective tissue, small blood vessels like nutrient vessel were seen in 2 groups; no significant difference was found in the tracheal lumen stenosis degree between 2 groups (P > 0.05). Histological observation showed that the continuous growth of mucosal epithelial cells was observed near patch and anastomosis site with time, and cell morphology gradually turned mature in experimental group; while mucosal epithelial cells arranged loosely in control group. At each time point, new capillaries of experimental group were significantly more than those of control group (P < 0.05). Scanning electron microscope observation showed the continuous epithelioid cells were observed at anastomosis site with time, and gradually grew into the middle of the patch in experimental group; while less and discontinuous epithelioid cells were observed in control group. Conclusion Bacterial cellulose patch is feasible to reconstruct cervical tracheal defect in rabbits, and the new mucosa is formed early and completely, so it is expected to be used as artificial trachea material.
目的 觀察鹽酸氨基葡萄糖對Pilon骨折的輔助治療作用。 方法 2007年6月－2010年9月，將43例接受手術治療的Pilon骨折患者隨機分成兩組，A組術后口服鹽酸氨基葡萄糖，B組作為對照組（僅服用安慰劑）。A組21例患者，平均年齡（35.7± 8.0）歲，B組22例患者，平均年齡（36.7 ± 7.1）歲。兩組患者年齡、性別、骨折分型及手術時機相比較，無統計學差異（P＞0.05）。定期隨診（術后6、12、18個月），根據美國足與踝關節協會踝與后足功能評分（AOFAS）評分系統對患者進行功能評分，進行前瞻、對照、雙盲研究。 結果 術后6、12、18個月，A組患者的AOFAS評分均明顯高于B組，差異有統計學意義（t=2.530，2.856，2.881；P=0.015，0.007，0.006）；術后18個月，A組臨床療效優良率為95.2%，B組優良率為72.3%，差異有統計學意義（χ2=3.995，P=0.046）。A組2例患者分別發生輕度頭暈及惡心，無嚴重不良反應發生。 結論 鹽酸氨基葡萄糖輔助治療Pilon骨折可改善踝關節功能，減少創傷性骨關節炎的發生。
ObjectiveA two-sample Mendelian randomization analysis was used to explore the causal associations between four basic body indices (basal metabolic rate, body fat percentage, BMI and hip circumference) and myasthenia gravis (MG). MethodsPooled gene-wide association study (GWAS) data were obtained from large publicly searchable databases, and four basic body indices were selected as the exposure factors and myasthenia gravis as the outcome factors, and single nucleotide polymorphisms (SNPs), which were strongly correlated with the phenotype of the exposure factors, were screened as the instrumental variables, and two-sample Mendelian randomization analyses were performed in order to assess the potential causal relationship between the exposure and the disease. ResultsInverse variance weighting (IVW) analysis showed that increased basal metabolic rate (OR=1.39, 95%CI 1.00 to 1.93, P=0.047), body fat percentage (OR=1.61, 95%CI 1.06 to 2.44, P=0.024), and hip circumference (OR=1.67, 95%CI 1.29 to 2.17, P<0.001) increased the risk of MG. But there was no significant causal relationship between BMI and MG. ConclusionBasal metabolic rate, body fat percentage and hip circumference have a positive causal relationship with MG, while BMI does not have a significant causal relationship with MG.
【Abstract】ObjectiveTo prospectively study the effects of recombinant human growth hormone (rhGH) on the changes of liver function and nutritional metabolism in postoperative patients with cirrhosis and portal hypertension. MethodsFortyeight cases with liver cirrhosis and portal hypertension who were collected from February 2003 to January 2004 were randomly divided into 2 groups (24 patients in each group). All patients were given the low calorie parenteral nutrition support and exogenous albumen after operations. Patients in the study group received rhGH from the second day after operations and physiological saline was used in the control group instead. The effects were evaluated in terms of protein metabolism, liver function, blood glucose level at different phases before and after the intervene. Death rates of in patients were also recorded in both groups. ResultsThe rising amplitude of albumen in the study group had been significantly larger than that of the control group from the seventh day after intervene (P＜0.05). The blood transaminase levels (ALT，AST) in the study group were significantly lower than that of the control group (P＜0.05). The blood glucose level of both groups decreased over time and returned to normal on day 14 after intervene, but there was no significant difference for both glucose and plasma bilirubin level between the two groups before and after the intervene (Pgt;0.05). The rates of death were similar, although the length of stay in the study group was much shorter than that of the control group. ConclusionrhGH may inhibit the catabolism, correct hypoproteinemia, improve liver function for postoperative patients with cirrhosis and portal hypertension, and reduce their length of stay.