BACKGROUND Sepsis is a serious infectious disease caused by various systemic inflammatory responses and is ultimately life-threatening.Patients usually experience depression and anxiety,which affect their sleep qualit...BACKGROUND Sepsis is a serious infectious disease caused by various systemic inflammatory responses and is ultimately life-threatening.Patients usually experience depression and anxiety,which affect their sleep quality and post-traumatic growth levels.AIM To investigate the effects of sepsis,a one-hour bundle(H1B)management was combined with psychological intervention in patients with sepsis.METHODS This retrospective analysis included 300 patients with sepsis who were admitted to Henan Provincial People’s Hospital between June 2022 and June 2023.According to different intervention methods,the participants were divided into a simple group(SG,n=150)and combined group(CG,n=150).H1B management was used in the SG and H1B management combined with psychological intervention was used in the CG.The changes of negative emotion,sleep quality and post-traumatic growth and prognosis were compared between the two groups before(T0)and after(T1)intervention.RESULTS After intervention(T1),the scores of the Hamilton Anxiety scale and Hamilton Depression scale in the CG were significantly lower than those in the SG(P<0.001).Sleep time,sleep quality,sleep efficiency,daytime dysfunction,sleep disturbance dimension score,and the total score in the CG were significantly lower than those in the SG(P<0.001).The appreciation of life,mental changes,relationship with others,personal strength dimension score,and total score of the CG were significantly higher than those of the SG(P<0.001).The scores for mental health,general health status,physiological function,emotional function,physical pain,social function,energy,and physiological function in the CG were significantly higher than those in the SG(P<0.001).The mechanical ventilation time,intensive care unit stay time,and 28-d mortality of the CG were significantly lower than those of the SG(P<0.05).CONCLUSION H1B management combined with psychological intervention can effectively alleviate the negative emotions of patients with sepsis and increase their quality of sleep and life.展开更多
Objective To evaluate the impact of major causes of death on changes of life expectancy in China. Methods Life expectancy was calculated by standard life table techniques using mortality data from the national censuse...Objective To evaluate the impact of major causes of death on changes of life expectancy in China. Methods Life expectancy was calculated by standard life table techniques using mortality data from the national censuses in 1990 and 2000 and the 1% National Population Sampling Surveys in 1995 and 2005. Mortality data about the major causes of death from VR-MOH were used as reference values to estimate their death proportions of the specific age groups by sex and regions, as well as all-cause mortality and age-specific mortality rates of major causes of death. Decomposition method was used to quantitatively evaluate the impact. Results Three key findings were identified in our study. First, China's health challenge was shifted from diseases related to living conditions to those related to behavior and lifestyle, with rural areas relatively lagged behind urban areas. Second, the impacts of cardiovascular diseases and neoplasm on the middle aged and elderly population were stressed. Third, compared to the urban population, the rural population tended to have increasing mortality of neoplasm and cardiovascular diseases, especially in adults at the age of 15-39 years. Conclusion Further efforts should be made to reduce the incidence of neoplasm and cardiovascular diseases, especially in rural areas, by promoting healthy behavior and lifestyle and providing appropriate therapies for all patients in need.展开更多
BACKGROUND The biological behavior of carcinoma of the esophagogastric junction(CEGJ)is different from that of gastric or esophageal cancer.Differentiating squamous cell carcinoma of the esophagogastric junction(SCCEG...BACKGROUND The biological behavior of carcinoma of the esophagogastric junction(CEGJ)is different from that of gastric or esophageal cancer.Differentiating squamous cell carcinoma of the esophagogastric junction(SCCEG)from adenocarcinoma of the esophagogastric junction(AEG)can indicate Siewert stage and whether the surgical route for patients with CEGJ is transthoracic or transabdominal,as well as aid in determining the extent of lymph node dissection.With the development of neoadjuvant therapy,preoperative determination of pathological type can help in the selection of neoadjuvant radiotherapy and chemotherapy regimens.AIM To establish and evaluate computed tomography(CT)-based multiscale and multiphase radiomics models to distinguish SCCEG and AEG preoperatively.METHODS We retrospectively analyzed the preoperative contrasted-enhanced CT imaging data of single-center patients with pathologically confirmed SCCEG(n=130)and AEG(n=130).The data were divided into either a training(n=182)or a test group(n=78)at a ratio of 7:3.A total of 1409 radiomics features were separately extracted from two dimensional(2D)or three dimensional(3D)regions of interest in arterial and venous phases.Intra-/inter-observer consistency analysis,correlation analysis,univariate analysis,least absolute shrinkage and selection operator regression,and backward stepwise logical regression were applied for feature selection.Totally,six logistic regression models were established based on 2D and 3D multi-phase features.The receiver operating characteristic curve analysis,the continuous net reclassification improvement(NRI),and the integrated discrimination improvement(IDI)were used for assessing model discrimination performance.Calibration and decision curves were used to assess the calibration and clinical usefulness of the model,respectively.RESULTS The 2D-venous model(5 features,AUC:0.849)performed better than 2D-arterial(5 features,AUC:0.808).The 2D-arterial-venous combined model could further enhance the performance(AUC:0.869).The 3D-venous model(7 features,AUC:0.877)performed better than 3D-arterial(10 features,AUC:0.876).And the 3D-arterial-venous combined model(AUC:0.904)outperformed other single-phase-based models.The venous model showed a positive improvement compared with the arterial model(NRI>0,IDI>0),and the 3D-venous and combined models showed a significant positive improvement compared with the 2D-venous and combined models(P<0.05).Decision curve analysis showed that combined 3D-arterial-venous model and 3D-venous model had a higher net clinical benefit within the same threshold probability range in the test group.CONCLUSION The combined arterial-venous CT radiomics model based on 3D segmentation can improve the performance in differentiating EGJ squamous cell carcinoma from adenocarcinoma.展开更多
Revealing the relations among robotic comprehensive performance,configuration,scales and working tasks is the basis to optimize robotic mechanism. Due to the correlation and diversity of the single performance indexes...Revealing the relations among robotic comprehensive performance,configuration,scales and working tasks is the basis to optimize robotic mechanism. Due to the correlation and diversity of the single performance indexes,statistical principles of linear dimension reduction and nonlinear dimension reduction are introduced into comprehensive performance analysis and evaluation for typical serial robot. The robotic mechanism's configuration,scales and task with the best comprehensive performance can be obtained by principal component analysis( PCA) and kernel principal component analysis( KPCA) respectively. The results show that KPCA can reveal the nonlinear relations among different single performance indexes more effectively and provide more comprehensive performance information than PCA. Thus,task-oriented method of serial robot for mechanism analysis and evaluation is proposed,which also provides scientific research basis for the mechanism synthesis and optimum task order.展开更多
BACKGROUND Giant cell tumor of soft tissue(GCT-ST)is an extremely rare low-grade soft tissue tumor that is originates in superficial tissue and rarely spreads deeper.GCT-ST has unpredictable behavior.It is mainly beni...BACKGROUND Giant cell tumor of soft tissue(GCT-ST)is an extremely rare low-grade soft tissue tumor that is originates in superficial tissue and rarely spreads deeper.GCT-ST has unpredictable behavior.It is mainly benign,but may sometimes become aggressive and potentially increase in size within a short period of time.CASE SUMMARY A 17-year-old man was suspected of having a fracture,based on radiography following left shoulder trauma.One month later,the swelling of the left shoulder continued to increase and the pain was obvious.Computed tomography(CT)revealed a soft tissue mass with strip-like calcifications in the left shoulder.The mass invaded the adjacent humerus and showed an insect-like area of destruction at the edge of the cortical bone of the upper humerus.The marrow cavity of the upper humerus was enlarged,and a soft tissue density was seen in the medullary cavity.Thoracic CT revealed multiple small nodules beneath the pleura of both lungs.A bone scan demonstrated increased activity in the left shoulder joint and proximal humerus.The mass showed mixed moderate hypointensity and hyperintensity on T1-weighted images,and mixed hyperintensity on T2-weighted fat-saturated images.The final diagnosis of GCT-ST was confirmed by pathology.CONCLUSION GCT-STs should be considered in the differential diagnosis of soft tissue tumors and monitored for large increases in size.展开更多
BACKGROUND Clear cell sarcoma-like tumor of the gastrointestinal tract(CCSLGT)is a rare malignant gastrointestinal mesenchymal soft tissue tumor.Its genetic feature is EWSR1 gene rearrangement.Histologically,it is oft...BACKGROUND Clear cell sarcoma-like tumor of the gastrointestinal tract(CCSLGT)is a rare malignant gastrointestinal mesenchymal soft tissue tumor.Its genetic feature is EWSR1 gene rearrangement.Histologically,it is often accompanied by a varying number of CD68-positive osteoclast-like giant cells.CCSLGT mostly occurs in the small intestinal wall of young people and children.In terms of clinical manifestations,there is no significant difference between it and other gastrointestinal tumors,and the diagnosis depends on immunohistochemistry and gene detection.CASE SUMMARY A 16-year-old man developed dizziness and fatigue 2 mo ago,and 10 d ago showed progressive exacerbation of paroxysmal epigastric pain and stopped flatulence and defecation.Computed tomography showed a soft tissue mass in the distal ileum.After complete resection of the lesion,it was diagnosed by combined immunohistochemical and genetic examination as CCSLGT.After surgery,the patient gradually developed lymph node,liver,lung,bone,left thigh,pleura and adrenal metastasis.The survival time was 4 years and 8 mo.CONCLUSION Whole abdominal computed tomography enhancement is recommended for patients with gastrointestinal symptoms.There is no effective treatment for CCSLGT with multiple metastases via the lymphatic system and bloodstream after surgical resection.展开更多
BACKGROUND Myoepithelial carcinoma(MC)is a clinically rare malignancy,there is controversy regarding its etiology and its biological behavior is not fully elucidated.Extensive surgical resection is the main treatment ...BACKGROUND Myoepithelial carcinoma(MC)is a clinically rare malignancy,there is controversy regarding its etiology and its biological behavior is not fully elucidated.Extensive surgical resection is the main treatment method.We describe a case of pleomorphic adenoma(PA)with multiple postoperative recurrences after malignant transformation,and the history of the disease in this patient was more than 20 years.Complete resection during the first surgery of PA and long-term postoperative follow-up is necessary.CASE SUMMARY A 34-year-old male with PA and a history of 5 postoperative recurrences over 21 years,each surgically removed,presented 15 d ago with headache,nasal congestion,protrusion of the right eyeball and loss of vision in the right eye,with progressively worsening symptoms.The patient underwent surgery,and MC was confirmed by pathology examination.A small PA component was locally visible under light microscope.The patient had a recurrence of the tumor 2 mo after surgery and underwent surgical resection.CONCLUSION During the first operation for PA,care should be taken not to rupture the envelope to prevent tumor cell implantation,and when complete resection is not possible due to the anatomical site,postoperative radiotherapy is necessary to control the lesion and prevent infiltration and malignant transformation of the tumor to MC.Computed tomography and magnetic resonance imaging is important for establishing diagnosis and developing a treatment plan.展开更多
BACKGROUND The preoperative prediction of peritoneal metastasis(PM)in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.AIM To explore the predictive value of viscera...BACKGROUND The preoperative prediction of peritoneal metastasis(PM)in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.AIM To explore the predictive value of visceral fat(VF)parameters obtained from preoperative computed tomography(CT)images for occult PM and to develop an individualized model for predicting occult PM in patients with gastric carcinoma(GC).METHODS A total of 128 confirmed GC cases(84 male and 44 female patients)that underwent CT scans were analyzed and categorized into PM-positive(n=43)and PM-negative(n=85)groups.The clinical characteristics and VF parameters of two regions of interest(ROIs)were collected.Univariate and stratified analyses based on VF volume were performed to screen for predictive characteristics for occult PM.Prediction models with and without VF parameters were established by multivariable logistic regression analysis.RESULTS The mean attenuations of VF_(ROI 1)and VF_(ROI 2)varied significantly between the PM-positive and PMnegative groups(P=0.044 and 0.001,respectively).The areas under the receiver operating characteristic curves(AUCs)of VF_(ROI 1)and VF_(ROI 2)were 0.599 and 0.657,respectively.The mean attenuation of VF_(ROI 2)was included in the final prediction combined model,but not an independent risk factor of PM(P=0.068).No significant difference was observed between the models with and without mean attenuation of VF(AUC:0.749 vs 0.730,P=0.339).CONCLUSION The mean attenuation of VF is a potential auxiliary parameter for predicting occult PM in patients with GC.展开更多
BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT...BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT) in early diagnosis of AMI patients.METHODS:From May 2011 to May 2012,plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic(ROC) curve was established to discriminate the AMI patients from the controls.RESULTS:In the present study,the expression of plasma miR-1 was signifi cantly increased in the AMI patients compared with the healthy controls(P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days(P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population(P>0.05). ROC curve analyses demonstrated that miR-1 was specifi c and sensitive for the early diagnosis of AMI,but not superior to cTnT.CONCLUSION:Plasma miR-1 could be used in the early diagnosis of AMI,but it is similar to cTnT.展开更多
Ultraviolet B is regarded as an important factor in many skin diseases,especially skin cancers.Increasingly more evidence is showing that changes in DNA methylation occur in patients with skin cancers.Changes in DNA m...Ultraviolet B is regarded as an important factor in many skin diseases,especially skin cancers.Increasingly more evidence is showing that changes in DNA methylation occur in patients with skin cancers.Changes in DNA methylation have also been observed in ultraviolet B-irradiated cells and mouse models.DNA methylation modifier enzymes are simultaneously affected.We herein review the evidence to date showing that Ultraviolet B affects changes in DNA methylation modifier enzymes in skin cancers.However,the mechanism of how ultraviolet B regulates the changes in DNA methylation modifier enzymes remains to be further elucidated.Understanding the mechanism by which ultraviolet B modulates DNA methylation modifier enzymes can help to identify potential therapeutic markers or targets and develop novel strategies for preventing or treating ultraviolet B-induced skin damage.展开更多
Introduction Cutaneous squamous cell carcinoma (CSCC),a keratinocyte-derived skin neoplasm with malignant potential,1 represents 20%-50% of skin cancers and currently has an increasing incidence in the United States.2...Introduction Cutaneous squamous cell carcinoma (CSCC),a keratinocyte-derived skin neoplasm with malignant potential,1 represents 20%-50% of skin cancers and currently has an increasing incidence in the United States.2 Ultraviolet (UV)solar radiation is the primary risk factor for the development of CSCC,and the cumulative exposure received over a lifetime plays a major role in this development.3 Mutations in the p53 gene are the most common genetic abnormalities,causing nonfunctional p53 protein production and cells with damaged DNA replicate in CSCC.展开更多
Introduction Cutaneous squamous cell carcinoma(CSCC)is the secondmost common non-melanoma skin cancer after basal cell carcinoma,accounting for 20%of all cutaneous malignancies.CSCC originates from epidermal keratinoc...Introduction Cutaneous squamous cell carcinoma(CSCC)is the secondmost common non-melanoma skin cancer after basal cell carcinoma,accounting for 20%of all cutaneous malignancies.CSCC originates from epidermal keratinocytes or adnexal structures such as eccrine glands or pilosebaceous units.1 According to several studies focused on Caucasian populations in Europe,the USA and Australia,about 15–35 per 100,000 individuals are diagnosed with CSCC each year,and the incidence of CSCC is expected to increase by 2%–4%per year.2 The incidence of primary CSCC has increased by 50%–300%globally,especially amongst Caucasian populations in New Zealand,Australia,and North America over the last 3 decades.展开更多
基金Supported by Key R&D and Promotion Special Project(Science and Technology Research)in Henan Province in 2023,No.232102310089.
文摘BACKGROUND Sepsis is a serious infectious disease caused by various systemic inflammatory responses and is ultimately life-threatening.Patients usually experience depression and anxiety,which affect their sleep quality and post-traumatic growth levels.AIM To investigate the effects of sepsis,a one-hour bundle(H1B)management was combined with psychological intervention in patients with sepsis.METHODS This retrospective analysis included 300 patients with sepsis who were admitted to Henan Provincial People’s Hospital between June 2022 and June 2023.According to different intervention methods,the participants were divided into a simple group(SG,n=150)and combined group(CG,n=150).H1B management was used in the SG and H1B management combined with psychological intervention was used in the CG.The changes of negative emotion,sleep quality and post-traumatic growth and prognosis were compared between the two groups before(T0)and after(T1)intervention.RESULTS After intervention(T1),the scores of the Hamilton Anxiety scale and Hamilton Depression scale in the CG were significantly lower than those in the SG(P<0.001).Sleep time,sleep quality,sleep efficiency,daytime dysfunction,sleep disturbance dimension score,and the total score in the CG were significantly lower than those in the SG(P<0.001).The appreciation of life,mental changes,relationship with others,personal strength dimension score,and total score of the CG were significantly higher than those of the SG(P<0.001).The scores for mental health,general health status,physiological function,emotional function,physical pain,social function,energy,and physiological function in the CG were significantly higher than those in the SG(P<0.001).The mechanical ventilation time,intensive care unit stay time,and 28-d mortality of the CG were significantly lower than those of the SG(P<0.05).CONCLUSION H1B management combined with psychological intervention can effectively alleviate the negative emotions of patients with sepsis and increase their quality of sleep and life.
文摘Objective To evaluate the impact of major causes of death on changes of life expectancy in China. Methods Life expectancy was calculated by standard life table techniques using mortality data from the national censuses in 1990 and 2000 and the 1% National Population Sampling Surveys in 1995 and 2005. Mortality data about the major causes of death from VR-MOH were used as reference values to estimate their death proportions of the specific age groups by sex and regions, as well as all-cause mortality and age-specific mortality rates of major causes of death. Decomposition method was used to quantitatively evaluate the impact. Results Three key findings were identified in our study. First, China's health challenge was shifted from diseases related to living conditions to those related to behavior and lifestyle, with rural areas relatively lagged behind urban areas. Second, the impacts of cardiovascular diseases and neoplasm on the middle aged and elderly population were stressed. Third, compared to the urban population, the rural population tended to have increasing mortality of neoplasm and cardiovascular diseases, especially in adults at the age of 15-39 years. Conclusion Further efforts should be made to reduce the incidence of neoplasm and cardiovascular diseases, especially in rural areas, by promoting healthy behavior and lifestyle and providing appropriate therapies for all patients in need.
文摘BACKGROUND The biological behavior of carcinoma of the esophagogastric junction(CEGJ)is different from that of gastric or esophageal cancer.Differentiating squamous cell carcinoma of the esophagogastric junction(SCCEG)from adenocarcinoma of the esophagogastric junction(AEG)can indicate Siewert stage and whether the surgical route for patients with CEGJ is transthoracic or transabdominal,as well as aid in determining the extent of lymph node dissection.With the development of neoadjuvant therapy,preoperative determination of pathological type can help in the selection of neoadjuvant radiotherapy and chemotherapy regimens.AIM To establish and evaluate computed tomography(CT)-based multiscale and multiphase radiomics models to distinguish SCCEG and AEG preoperatively.METHODS We retrospectively analyzed the preoperative contrasted-enhanced CT imaging data of single-center patients with pathologically confirmed SCCEG(n=130)and AEG(n=130).The data were divided into either a training(n=182)or a test group(n=78)at a ratio of 7:3.A total of 1409 radiomics features were separately extracted from two dimensional(2D)or three dimensional(3D)regions of interest in arterial and venous phases.Intra-/inter-observer consistency analysis,correlation analysis,univariate analysis,least absolute shrinkage and selection operator regression,and backward stepwise logical regression were applied for feature selection.Totally,six logistic regression models were established based on 2D and 3D multi-phase features.The receiver operating characteristic curve analysis,the continuous net reclassification improvement(NRI),and the integrated discrimination improvement(IDI)were used for assessing model discrimination performance.Calibration and decision curves were used to assess the calibration and clinical usefulness of the model,respectively.RESULTS The 2D-venous model(5 features,AUC:0.849)performed better than 2D-arterial(5 features,AUC:0.808).The 2D-arterial-venous combined model could further enhance the performance(AUC:0.869).The 3D-venous model(7 features,AUC:0.877)performed better than 3D-arterial(10 features,AUC:0.876).And the 3D-arterial-venous combined model(AUC:0.904)outperformed other single-phase-based models.The venous model showed a positive improvement compared with the arterial model(NRI>0,IDI>0),and the 3D-venous and combined models showed a significant positive improvement compared with the 2D-venous and combined models(P<0.05).Decision curve analysis showed that combined 3D-arterial-venous model and 3D-venous model had a higher net clinical benefit within the same threshold probability range in the test group.CONCLUSION The combined arterial-venous CT radiomics model based on 3D segmentation can improve the performance in differentiating EGJ squamous cell carcinoma from adenocarcinoma.
基金Sponsored by the National Natural Science Foundation of China(Grant No.51075005)the Beijing City Science and Technology Project(Grant No.Z131100005313009)
文摘Revealing the relations among robotic comprehensive performance,configuration,scales and working tasks is the basis to optimize robotic mechanism. Due to the correlation and diversity of the single performance indexes,statistical principles of linear dimension reduction and nonlinear dimension reduction are introduced into comprehensive performance analysis and evaluation for typical serial robot. The robotic mechanism's configuration,scales and task with the best comprehensive performance can be obtained by principal component analysis( PCA) and kernel principal component analysis( KPCA) respectively. The results show that KPCA can reveal the nonlinear relations among different single performance indexes more effectively and provide more comprehensive performance information than PCA. Thus,task-oriented method of serial robot for mechanism analysis and evaluation is proposed,which also provides scientific research basis for the mechanism synthesis and optimum task order.
文摘BACKGROUND Giant cell tumor of soft tissue(GCT-ST)is an extremely rare low-grade soft tissue tumor that is originates in superficial tissue and rarely spreads deeper.GCT-ST has unpredictable behavior.It is mainly benign,but may sometimes become aggressive and potentially increase in size within a short period of time.CASE SUMMARY A 17-year-old man was suspected of having a fracture,based on radiography following left shoulder trauma.One month later,the swelling of the left shoulder continued to increase and the pain was obvious.Computed tomography(CT)revealed a soft tissue mass with strip-like calcifications in the left shoulder.The mass invaded the adjacent humerus and showed an insect-like area of destruction at the edge of the cortical bone of the upper humerus.The marrow cavity of the upper humerus was enlarged,and a soft tissue density was seen in the medullary cavity.Thoracic CT revealed multiple small nodules beneath the pleura of both lungs.A bone scan demonstrated increased activity in the left shoulder joint and proximal humerus.The mass showed mixed moderate hypointensity and hyperintensity on T1-weighted images,and mixed hyperintensity on T2-weighted fat-saturated images.The final diagnosis of GCT-ST was confirmed by pathology.CONCLUSION GCT-STs should be considered in the differential diagnosis of soft tissue tumors and monitored for large increases in size.
文摘BACKGROUND Clear cell sarcoma-like tumor of the gastrointestinal tract(CCSLGT)is a rare malignant gastrointestinal mesenchymal soft tissue tumor.Its genetic feature is EWSR1 gene rearrangement.Histologically,it is often accompanied by a varying number of CD68-positive osteoclast-like giant cells.CCSLGT mostly occurs in the small intestinal wall of young people and children.In terms of clinical manifestations,there is no significant difference between it and other gastrointestinal tumors,and the diagnosis depends on immunohistochemistry and gene detection.CASE SUMMARY A 16-year-old man developed dizziness and fatigue 2 mo ago,and 10 d ago showed progressive exacerbation of paroxysmal epigastric pain and stopped flatulence and defecation.Computed tomography showed a soft tissue mass in the distal ileum.After complete resection of the lesion,it was diagnosed by combined immunohistochemical and genetic examination as CCSLGT.After surgery,the patient gradually developed lymph node,liver,lung,bone,left thigh,pleura and adrenal metastasis.The survival time was 4 years and 8 mo.CONCLUSION Whole abdominal computed tomography enhancement is recommended for patients with gastrointestinal symptoms.There is no effective treatment for CCSLGT with multiple metastases via the lymphatic system and bloodstream after surgical resection.
文摘BACKGROUND Myoepithelial carcinoma(MC)is a clinically rare malignancy,there is controversy regarding its etiology and its biological behavior is not fully elucidated.Extensive surgical resection is the main treatment method.We describe a case of pleomorphic adenoma(PA)with multiple postoperative recurrences after malignant transformation,and the history of the disease in this patient was more than 20 years.Complete resection during the first surgery of PA and long-term postoperative follow-up is necessary.CASE SUMMARY A 34-year-old male with PA and a history of 5 postoperative recurrences over 21 years,each surgically removed,presented 15 d ago with headache,nasal congestion,protrusion of the right eyeball and loss of vision in the right eye,with progressively worsening symptoms.The patient underwent surgery,and MC was confirmed by pathology examination.A small PA component was locally visible under light microscope.The patient had a recurrence of the tumor 2 mo after surgery and underwent surgical resection.CONCLUSION During the first operation for PA,care should be taken not to rupture the envelope to prevent tumor cell implantation,and when complete resection is not possible due to the anatomical site,postoperative radiotherapy is necessary to control the lesion and prevent infiltration and malignant transformation of the tumor to MC.Computed tomography and magnetic resonance imaging is important for establishing diagnosis and developing a treatment plan.
基金Supported by Henan Province 2023 Scientific Research Projects Focused on Higher Education Project,China,No.23A320059.
文摘BACKGROUND The preoperative prediction of peritoneal metastasis(PM)in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.AIM To explore the predictive value of visceral fat(VF)parameters obtained from preoperative computed tomography(CT)images for occult PM and to develop an individualized model for predicting occult PM in patients with gastric carcinoma(GC).METHODS A total of 128 confirmed GC cases(84 male and 44 female patients)that underwent CT scans were analyzed and categorized into PM-positive(n=43)and PM-negative(n=85)groups.The clinical characteristics and VF parameters of two regions of interest(ROIs)were collected.Univariate and stratified analyses based on VF volume were performed to screen for predictive characteristics for occult PM.Prediction models with and without VF parameters were established by multivariable logistic regression analysis.RESULTS The mean attenuations of VF_(ROI 1)and VF_(ROI 2)varied significantly between the PM-positive and PMnegative groups(P=0.044 and 0.001,respectively).The areas under the receiver operating characteristic curves(AUCs)of VF_(ROI 1)and VF_(ROI 2)were 0.599 and 0.657,respectively.The mean attenuation of VF_(ROI 2)was included in the final prediction combined model,but not an independent risk factor of PM(P=0.068).No significant difference was observed between the models with and without mean attenuation of VF(AUC:0.749 vs 0.730,P=0.339).CONCLUSION The mean attenuation of VF is a potential auxiliary parameter for predicting occult PM in patients with GC.
基金supported by grants from the National Natural Science Foundation of China(81071030)the Science and Technology Foundation of Guangdong Province(2011B080701006)
文摘BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT) in early diagnosis of AMI patients.METHODS:From May 2011 to May 2012,plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic(ROC) curve was established to discriminate the AMI patients from the controls.RESULTS:In the present study,the expression of plasma miR-1 was signifi cantly increased in the AMI patients compared with the healthy controls(P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days(P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population(P>0.05). ROC curve analyses demonstrated that miR-1 was specifi c and sensitive for the early diagnosis of AMI,but not superior to cTnT.CONCLUSION:Plasma miR-1 could be used in the early diagnosis of AMI,but it is similar to cTnT.
基金supported by the Natural Science Foundation of Jiangsu Province(No.BK20191136)Fundamental Research Funds for the Central Universities(No.3332019104)Open Project of Jiangsu Biobank of Clinical Resources(No.JSSWYB2020-05-003)
文摘Ultraviolet B is regarded as an important factor in many skin diseases,especially skin cancers.Increasingly more evidence is showing that changes in DNA methylation occur in patients with skin cancers.Changes in DNA methylation have also been observed in ultraviolet B-irradiated cells and mouse models.DNA methylation modifier enzymes are simultaneously affected.We herein review the evidence to date showing that Ultraviolet B affects changes in DNA methylation modifier enzymes in skin cancers.However,the mechanism of how ultraviolet B regulates the changes in DNA methylation modifier enzymes remains to be further elucidated.Understanding the mechanism by which ultraviolet B modulates DNA methylation modifier enzymes can help to identify potential therapeutic markers or targets and develop novel strategies for preventing or treating ultraviolet B-induced skin damage.
基金supported by Grants from the Chinese Academy Medical Sciences Initiative for Innovative Medicine (No. 2016I2M-3-021)National Natural Science Foundation of China (No. 31470274)+1 种基金Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs (No. 2012ZD006)Jiangsu provincial SixTalent Peaks (No. 2013-WSW-060)
文摘Introduction Cutaneous squamous cell carcinoma (CSCC),a keratinocyte-derived skin neoplasm with malignant potential,1 represents 20%-50% of skin cancers and currently has an increasing incidence in the United States.2 Ultraviolet (UV)solar radiation is the primary risk factor for the development of CSCC,and the cumulative exposure received over a lifetime plays a major role in this development.3 Mutations in the p53 gene are the most common genetic abnormalities,causing nonfunctional p53 protein production and cells with damaged DNA replicate in CSCC.
基金supported by grants from the Chinese Academy Medical Sciences Initiative for Innovative Medicine(2016-I2M-3-021)National Natural Science Foundation of China(31470274)+1 种基金Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs(2012ZD006)Jiangsu provincial SixTalent Peaks(2013-WSW-060).
文摘Introduction Cutaneous squamous cell carcinoma(CSCC)is the secondmost common non-melanoma skin cancer after basal cell carcinoma,accounting for 20%of all cutaneous malignancies.CSCC originates from epidermal keratinocytes or adnexal structures such as eccrine glands or pilosebaceous units.1 According to several studies focused on Caucasian populations in Europe,the USA and Australia,about 15–35 per 100,000 individuals are diagnosed with CSCC each year,and the incidence of CSCC is expected to increase by 2%–4%per year.2 The incidence of primary CSCC has increased by 50%–300%globally,especially amongst Caucasian populations in New Zealand,Australia,and North America over the last 3 decades.
