【Abstract】ObjectiveTo investigate the molecular mechanism of peritoneal dissemination of gastric cancer. MethodsLiteratures in recent years about mechanisms of peritoneal metastasis in gastric cancer were reviewed and summarized.ResultsPeritoneal metastasis related to viability of cancer cells and peritoneal characteristics. Moreover, it is necessary that many adhesive moleculars, protein hydrolase, cell factors and vascular factors involved in peritoneal metastasis.ConclusionPeritoneal metastasis of gastric cancer was induced by multiple factors together.
ObjectivesTo evaluate the therapeutic effect of argon laser photocoagulation combined with intravitreous injection of triamcinolone acetonide (TA) on ischemic central retinal vein occlusion (CRVO).MethodsArgon laser photocoagulation combined with intravitreous injection of TA was performed on 17 patients (17 eyes) with CRVO between December 2003 and July 2004.ResultsDuring the follow-up of 4-10 months, the visual acuity improved in 16 patients, including alleviated or even disappeared cystoid macular edema (CME) in 5, and recurred macular edema in 5 with decreased visual acuity after 3 months. Six patients had increased ocular pressure after intra-ocular injection which alleviated after treated suitably. No neovascularization in angle or secondary neovascular glaucoma was found.ConclusionArgon laser photocoagulation combined with intravitreous injection of TA may improve the visual acuity and reduce complications in ischemic CRVO, though macular edema may recur in some cases. (Chin J Ocul Fundus Dis, 2005,21:224-225)
Objective To summarize the research progress of pathogenetic and development mechanism of phyllodes tumor of breast (PTB). Method Summarizing the studies on pathogenetic and development mechanism of PTB by searching PubMed, Web of Science, CNKI, and Wanfang databases, and then make a review. Results Currently, there was no uniform conclusion on the pathogenetic and development mechanism of PTB, though many factors may involve in the pathogenesis of PTB. PTB may be derived from fibroadenoma, and some studies suggested that it was closely related to hormonal receptor disorders, epithelial mesenchymal transition mechanism, gene mutation, and so on. Conclusion The pathogenetic and development mechanism of PTB is not clear yet and more researches are needed to confirm it.
Objective To investigate feasibility and preliminary oncological safety of surgical innovations in breast cancer patients who have undergone nipple-skin-sparing mastectomy (NSSM) for nipple discharge or central lesions and tumors that do not involve the nipple-areola skin. MethodsBetween May 2018 and November 2023, patients diagnosed with breast cancer presenting nipple discharge or lesions in the central area underwent NSSM. The imaging assessment revealed no involvement of the nipple-areola-skin by the tumor. We performed a surgical removal of the affected mammary duct and simultaneously made a circular incision measuring 3-4 mm in diameter at the apex of the nipple. The study also involved the collection of clinical data, early complications, oncological outcomes and conducting aesthetic analysis of the nipple using the BREAST-Q scale. Results The surgical procedure was conducted on a cohort of 39 female patients at age of 27-57(39.0±7.6) years. The postoperative pathological stages of breast cancer were distributed as follows: stage 0 in 2 patients (5.1%), stageⅠ in 1 patients (2.6%), ⅡA stage in 15 patients (38.5%), ⅡB stage in 21 patients (53.8%). Tumor type: simple carcinoma in situ in 5 patients (12.8%), invasive carcinoma in 14 patients (35.9%), including invasive carcinoma with carcinoma in situ in 20 patients (51.3%). During the median follow-up period of 15.0 (2-66) months, 3 patients (7.7%) developed decolorization caused by mild nipple ischemia; there was no nipple necrosis; 1 patient (2.6%) failed nipple reconstruction (no milk column, the milk column disappeared due to external dressing compression after operation). There were no incision complications, subcutaneous emphysema or intramammary hematoma in all patients. Two patients (5.1%) underwent prosthesis removal and nipple areola excess skin resection because of prosthesis cavity infection and final exposure caused by debridement, dressing change, redrainage and so on. As of April 2024, no tumor recurrence or metastasis was found during the follow-up period. The satisfaction of patients with nipple was 97.4% according to BREAST-Q score. ConclusionThe satisfaction of breast cancer patients diagnosed with nipple discharge or lesions in the central area, but without involvement of the nipple areola skin, and who underwent subcutaneous mastectomy with immediate reconstruction is significantly enhanced. Furthermore, there is no increased risk of tumor recurrence or metastasis in short-term.
ObjectiveTo explore the proper time to initiation of adjuvant chemotherapy after radical resection for gastric cancer. MethodsWe searched electronically in PubMed, Embase, China National Knowledge Infrastructure, Wangfang database, and Chongqing VIP database for all relevant studies published before May 1st, 2018. The references included in eligible trials were also searched. All eligible studies were assessed and evaluated by two investigators working independently. The Meta-analysis was conducted using Stata 14 software. ResultsOur literature search included a total of 10 studies. There were 9 studies reporting overall survival (OS), in which 3 studies used a 4-week cutoff for delay from surgery to adjuvant chemotherapy, 4 shared a 6-week cutoff, and 2 studies shared an 8-week cutoff. There were 4 studies reporting disease-free survival (DFS). Initiating adjuvant chemotherapy beyond 4 weeks after surgery was significantly associated with worse OS [hazard ratio (HR)=0.42, 95% confidence interval (CI) (0.27, 0.65), P<0.001]. No significant benefit was found by starting adjuvant chemotherapy within 6 weeks or 8 weeks after surgery [HR=0.91, 95%CI (0.66, 1.26), P=0.577; HR=1.02, 95%CI (0.91, 1.14), P=0.744; respectively]. Four trials reporting DFS did not share a same cutoff delay from surgery to adjuvant chemotherapy, thus it was impossible to conduct a combined Meta-analysis. ConclusionThe initiation of adjuvant chemotherapy within 4 weeks after radical resection for gastric cancer may obtain better OS.
ObjectiveTo review the research progress of adipose-derived stem cells (ADSCs) in skin scar prevention and treatment.MethodsThe related literature was extensively reviewed and analyzed. The recent in vitro and in vivo experiments and clinical studies on the role of ADSCs in skin scar prevention and treatment, and the possible mechanisms and biomaterials to optimize the effect of ADSCs were summarized.ResultsAs demonstrated by in vitro and in vivo experiments and clinical studies, ADSCs participate in the whole process of skin wound healing and may prevent and treat skin scars by reducing inflammation, promoting angiogenesis, or inhibiting (muscle) fibroblasts activity to reduce collagen deposition through the p38/mitogen-activated protein kinase, peroxisome proliferator activated receptor γ, transforming growth factor β1/Smads pathways. Moreover, bioengineered materials such as hydrogel from acellular porcine adipose tissue, porcine small-intestine submucosa, and poly (3-hydroxybutyrate-co-hydroxyvalerate) scaffold may further enhance the efficacy of ADSCs in preventing and treating skin scars.ConclusionRemarkable progress has been made in the application of ADSCs in skin scar prevention and treatment. While, further studies are still needed to explore the application methods of ADSCs in the clinic.
CT texture analysis (CTTA) can objectively evaluate the heterogeneity of tissues and their lesions beyond the ability of subjective visual interpretation by extracting the texture features of CT images, then performing analysis and quantitative and objective evaluation, reflecting the tissue micro environmental information. This article reviews the recent studies on the applications of CTTA in gastric cancers, in the aspects of identification of gastric tumors, prediction of stage, correlation with Lauren classification, prediction of occult peritoneal carcinomatosis, evaluation of efficacy and prognosis, and prediction of biomarkers. It is regarded that CTTA has a good application prospect in gastric cancers.
Objective To assess the benefits and harms of routine primary suture (LBEPS) versus T-tube drainage (LCHTD) following laparoscopic common bile duct stone exploration. Methods The randomized controlled trials (RCTs) or quasi-RCTs were electronically searched from the Cochrane Controlled Trials Register (The Cochrane Library, Issue 2, 2010), PubMed (1978 to 2010), EMbase (1966 to 2010), CBMdisc (1978 to 2010), and CNKI (1979 to 2010); and the relevant published and unpublished data and their references were also searched by hand. The data were extracted and the quality was evaluated by two reviewers independently, and the RevMan 5.0 software was used for data analysis. Results Four studies including 3 RCTs and 1 quasi-RCT involving 274 patients were included. The meta-analysis showed that compared with LCHTD, LBEPS was better in shortening operation time (WMD= –17.11, 95%CI –25.86 to –8.36), abdominal drainage time (WMD= –0.74, 95%CI –1.39 to –0.10) and post-operative hospitalization time (WMD= –3.30, 95%CI –3.67 to –2.92), in lowering hospital expenses (WMD= –2 998.75, 95%CI –4 396.24 to –1 601.26) and in reducing the complications due to T-tube such as tube detaching, bile leakage after tube drawing, and choleperitonitis (RR=0.56, 95%CI 0.29 to 1.09). Conclusion LBEPS is superior to LCHTD in total effectiveness for common bile duct stone with the precondition of strictly abiding by operation indication. Due to the low quality of the included studies which decreases the reliability of this conclusion, more reasonably-designed and strictly-performed multi-centered RCTs with large scale and longer follow up time are required to further assess and verify the efficacy and safety of this treatment.
Objective To assess the effectiveness and the safety of clinical use of growth hormone (GH) in burn patients. Method Search were applied to the following electronic databases: Chinese Bio-medicine Database (CBM), MEDLINE, EMBASE and Cochrane Library. Language was restricted in Chinese and English. Data were extracted and evaluated by the two reviewers independently of each other. Applied RevMan 4.1 for statistical analyse. Results Nine trials involving 732 patients were included. The combined results showed that GH can shorten wound healing time [weighted mean difference (WMD) = -11.25, 95%CI (-14.84 to -7.66), Plt;0.000 01], donor site healing times [WMD= -1.87, 95%CI (-2.28 to -1.47), P＜0.000 01), and length of hospital stay [WMD= -8.10, 95%CI (-10.40 to -5.79), P＜0.000 01]. There was no statistical significance on resting energy expenditure [WMD= -0.04, 95%CI ( -0.08 to 0.00), P=0.06], mortality [odds ratio (OR) =1.15, 95%CI (0.15 to 8.53), P=0.9], sepsis [OR=1.08, 95%CI (0.50 to 2.34), P=0.8] and ventilatory support required [OR=1.51, 95%CI (0.72 to 3.16), P=0.3]. Nevertheless, the plasma levels of glucose [standardized mean difference (SMD) =0.98, 95%CI (0.54 to1.42), P＜0.000 01] and insulin [SMD=0.86, 95%CI (0.43 to1.30), P=0.000 1] were increased in GH groups. Conclusions GH for burn patients is effective and safe if blood glucose can be controlled well.