AIM: To investigate the mechanism underlying the promoting role of CD97 in gastric cancer cell proliferation and invasion. METHODS: Two types of exosomes released by gastric cancer cells with high(SGC/wt) or low(SGC/k...AIM: To investigate the mechanism underlying the promoting role of CD97 in gastric cancer cell proliferation and invasion. METHODS: Two types of exosomes released by gastric cancer cells with high(SGC/wt) or low(SGC/kd) CD97 expression were isolated by ultracentrifugation and identified by electron microscopy and western blot analysis. The influences of the two exosomes on gastric cancer cell proliferation and invasion were investigated by proliferation and Matrigel invasion assays. Exosomal mi RNAs were subsequently isolated from the two samples and their mi RNA profiles were compared via microarray assay analysis. Reverse transcriptionquantitative real-time polymerase chain reaction was used to validate the microarray assay. Target genes of the differently expressed micro RNAs were predicted based on five independent algorithms and were then subjected to gene oncology enrichment and Kyoto encyclopedia of genes and genomes(KEGG) pathway analysis. After identifying the pathway that was the most likely altered, tumor cells were treated with the two exosomes at different concentrations, and the pathway activation was identified through western blot analysis.RESULTS: Exosomes isolated from SGC/wt cells significantly promoted tumor cell proliferation in a dose-dependent manner in vitro. SGC/wt exosomesalso significantly elevated the invasiveness of both SGC/wt(129.67 ± 8.327 vs 76.00 ± 5.292, P < 0.001) and SGC/kd(114.52 ± 9.814 vs 45.73 ± 4.835, P < 0.001) cells as compared to the exosomes released by SGC/kd cells. Microarray assay of the two exosomes revealed that 62 mi RNAs were differently regulated with a signal intensity of > 500 and a false discovery rate < 0.05. The following KEGG analysis defined the MAPK signaling pathway as the most likely candidate pathway that regulated tumor cell proliferation and invasion. Through western blot analysis, significant up-regulations of phosphorylated MAPKs, including extracellular signal-regulated kinase, Jun NH2-terminal kinase, and p38 mitogen-activated protein kinase, were detected in a dose-dependent manner in the SGC/wt exosomes treated groups, confirming activation of the MAPK signaling pathway stimulated by SGC/wt exosomes.CONCLUSION: CD97 promotes gastric cancer cell proliferation and invasion in vitro through exosomemediated MAPK signaling pathway, and exosomal mi RNAs are probably involved in activation of the CD97-associated pathway.展开更多
Objective:To observe reinforcing effect of calcium sulfate cement(CSC) bovine bone morphogenetic protein(bBMP) on vertebral in the rabbit model of osteoporosis.Methods:A total of 48 New Zealand white rabbits were rand...Objective:To observe reinforcing effect of calcium sulfate cement(CSC) bovine bone morphogenetic protein(bBMP) on vertebral in the rabbit model of osteoporosis.Methods:A total of 48 New Zealand white rabbits were randomly divided into group Ⅰ(blank control group),groupⅡ(CSC injection group),group Ⅲ(CSC/bBMP injection group) and control group.White rabbit osteoporosis model was established rapidly by using castration mcthod+methylprcdnisolone candidate.After modeling,groups Ⅱ.Ⅲ were given corresponding vertebral body injection material,and 4 animals were sacrificed respectively at 24 h,6 weeks,12 weeks after vertebral plasty.Tissue pathological status,vertebral mineral density and vertebral body bone mechanical strength were observed.Results:Vertebral body structure form was normal in the groups Ⅱand Ⅲ.Trabecular bone coarsens,connection and repair were observed in micro fracture and bone defects,bone trabecular connectivity was superior to group I significantly;vertebral body compression strength in the group I was on the decline,vertebral compression strength in the groups Ⅱ and Ⅲ was on the rise,the largest vertebra.Postoperative BMC and BMD in groups Ⅱand Ⅲ were incresed,and significantly higher than group I after 6 weeks(P<0.05),BMC and BMD in group Ⅲ after 12 weeks were higher than the other three groups.Conclusion:Compound bBMP CSC has good bone induction.It can improve the three-dimensional construction effect for osteoporosis vertebral trabecula,and can significantly improve the vertebral strength,as a vertebral packing material with good application prospect.展开更多
Objective: This work aimed to study the safety and efficacy of preoperative intestinal stent decompression combined with laparoscopic surgery to treat left-sided colorectal cancer with obstruction (LCCO). Methods: Ret...Objective: This work aimed to study the safety and efficacy of preoperative intestinal stent decompression combined with laparoscopic surgery to treat left-sided colorectal cancer with obstruction (LCCO). Methods: Retrospective analysis was conducted on data obtained from 21 LCCO patients admitted to The First Affiliated Hospital of Zhejiang Chinese Medicine University during March 2008 and December 2011. To remove the intestinal obstruction, preoperative intestinal stent placement under colonoscopic guidance was performed. Approximately 7 to 10 days after the operation, laparoscopic radical surgery of colorectal cancer was conducted. Results: Among the 21 cases studied, laparoscopic surgery was successful in 20 patients. Emergent laparotomy was conducted in one patient because of tumor invasion in the ureter. The duration of the operation ranged from 180 to 320 min, and the average time was 220 min. The recovery time for bowel function ranged from 2 to 5 days with an average time of 3 days. Postoperative infection of the incision occurred in one case. No anastomotic leakage was observed in any of the cases. Conclusion: Preoperative intestinal stent decompression, combined with primary stage laparoscopic surgery, is a safe and effective method for the treatment of LCCO.展开更多
AIM: To report the outcome of Chinese patents with non-cystic adenocarcinoma in pancreatic body and tail (NCAPBT) after resection and to discuss its surgical strategy. METHODS: Resection of NCAPBT was performed in eig...AIM: To report the outcome of Chinese patents with non-cystic adenocarcinoma in pancreatic body and tail (NCAPBT) after resection and to discuss its surgical strategy. METHODS: Resection of NCAPBT was performed in eight Chinese patients with complete clinical-pathological data in our hospital from January 2000 to May 2004. The surgical strategy was explored by analyzing the results of these patients. RESULTS: The resection rate of NCAPBT in patients without back pain was higher than that in patients with back pain (66.67% vs 20%, 2/3 vs 1/5). The prognosis in the group receiving palliative resection was poorer than that in the group receiving curative resection. The median survival time was 12 mo in the curative resection group and 6 mo in the palliative resection group, respectively. CONCLUSION: The overall survival time of the Chinese patients with NCAPBT is dismal. The Chinese patients after curative resection of NCAPBT have a longer survival time. The Chinese NCAPBT patients with back pain trend to have a lower curative resection rate, but back pain should not be considered a contraindication for curative resection.展开更多
To realize the commercialize of rechargeable Zn-air battery(RZAB),developing metal-free bifunctional electrocatalysts with satisfactory activity for oxygen reduction reaction(ORR)and oxygen evolution reaction(OER)is o...To realize the commercialize of rechargeable Zn-air battery(RZAB),developing metal-free bifunctional electrocatalysts with satisfactory activity for oxygen reduction reaction(ORR)and oxygen evolution reaction(OER)is one of the emerging issues.Herein,a prawn shells-derived N-enriched porous carbon(PSNC)is synthesized via an ion exchange coupled biomimetic selfsacrificing template strategy.The resulting PSNC displays unique functional components,including the interconnected macro-meso-micropores structure to shorten charge and mass transfer pathway,high content of pyridinic and graphitic nitrogen to construct rich catalytic active site and improve conductivity.As electrocatalysts in alkaline condition,the optimized PSNC-0.8 achieves excellent bifunctional catalytic propriety with a narrow potential gap(ΔE)value of 0.80 V.Meanwhile,PSNC-0.8-based RZAB displays a high peak power density of 176.5 mW·cm^(-2)and considerable cycling durability with a small battery efficiency delay of 6.5%after 480 cycles(320 h).This study enlightens a simple and effective conception to design high-performance metal-free bifunctional electrocatalysts from seafood waste.展开更多
Left-sided portal hypertension(LSPH)followed by acute pancreatitis is a rare condition with most patients being asymptomatic.In cases where gastrointestinal(GI)bleeding is present,however,the condition is more complic...Left-sided portal hypertension(LSPH)followed by acute pancreatitis is a rare condition with most patients being asymptomatic.In cases where gastrointestinal(GI)bleeding is present,however,the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment.A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article.The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography(CT)scan and CT-angiography.After embolization,the bleeding stopped and stabilized for the entire follow-up period without any severe complications.In conclusion,embolization of the splenic artery is a simple,safe,and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.展开更多
Objective： To evaluate the comparative therapeutic efficacy of radiofrequency ablation （RFA） and hepatic resection （HR） for breast cancer liver metastases （BCLMs）. Methods： Studies that had examined the outcom...Objective： To evaluate the comparative therapeutic efficacy of radiofrequency ablation （RFA） and hepatic resection （HR） for breast cancer liver metastases （BCLMs）. Methods： Studies that had examined the outcomes for both RFA and HR for BCLM were identified by searching the electronic databases PubMed, EMBASE, and the Cochrane Library. Pooled analyzes of the overall survival （OS）, disease-free survival （DFS）, and short-term outcomes of BCLM were performed. Results： Patients with BCLM gained many more survival benefits from HR than from RFA with regard to the 3-year OS rate （combined odds ratio （OR） 0.41, 95% confidence interval （CI） 0.29-0.59, P〈0.001）, 5-year OS rate （combined OR 0.38, 95% CI 0.32-0.46, P〈0.001）, 3-year DFS （combined OR 0.36, 95% CI 0.27-0.49, P〈0.001）, and 5-year DFS （combined OR 0.51, 95% CI 0.40-0.66, P〈0.001）. RFA had fewer postoperative compli- cations （combined OR 0.30, 95% CI 0.20-0.44, P〈0.001） and shorter hospital stays （combined OR -9.01, 95% CI -13.49-4.54, P〈0.001） than HR. Conclusions： HR takes precedence over RFA in the treatment of patients with BCLM, considering the better survival rate. RFA gives rise to fewer complications and can be carried out with a shorter hos- pital stay, compared to HR. RFA should be reserved for patients who are not optimum candidates for resection.展开更多
Objective:To define the roles of gray-scale,color-Doppler ultrasound,and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignan...Objective:To define the roles of gray-scale,color-Doppler ultrasound,and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignant.Methods:A total of 243 consecutive subjects(214 women,29 men) with 329 thyroid nodules were examined by gray-scale,color-Doppler ultrasound,and sonoelastography in this prospective study.All patients underwent surgery and the final diagnosis was obtained from histopathological examination.Results:Three hundred and twenty-nine nodules(208 benign,121 malignant) were divided into small(SNs,5-10 mm,n=137) and large(LNs,>10 mm,n=192) nodules.Microcalcifications were more frequent in malignant LNs than in malignant SNs,but showed no significant difference between benign LNs and SNs.Poorly-circumscribed margins were not significantly different between malignant SNs and LNs,but were less frequent in benign LNs than in benign SNs.Among all nodules,marked intranodular vascularity was more frequent in LNs than in SNs.By comparison,shape ratio of anteroposterior to transverse dimensions(A/T) ≥1 was less frequent in LNs than in SNs.Otherwise,among all nodules,marked hypoechogenicity and elasticity score of 4-6 showed no significant difference between LNs and SNs.Conclusions:The predictive values of microcalcifications,nodular margins,A/T ratio,and marked intranodular vascularity depend on nodule size,but the predictive values of echogenicity and elastography do not.展开更多
Objective： The aim of this study was to evaluate the safety and efficiency of enucleation（EU） for proximal pancreatic non-invasive neoplasms.Methods： Patients with solitary non-invasive neoplasms in the proximal p...Objective： The aim of this study was to evaluate the safety and efficiency of enucleation（EU） for proximal pancreatic non-invasive neoplasms.Methods： Patients with solitary non-invasive neoplasms in the proximal pancreas from January 1998 to April 2014 at the Second Affiliated Hospital of Zhejiang University, Hangzhou, China were included.Different operations and outcomes were analyzed.Results： A total of 123 patients were enrolled.Forty patients（32.5%） underwent EU including 18 patients who had tumors close to the main pancreatic duct（MPD）.Sixty-one patients（49.6%） had pancreaticoduodenectomy（PD） performed and 22（17.9%） underwent central pancreatectomy（CP）.Pathological outcomes included neuroendocrine tumors, cystic lesions, and solid pseudopapillary tumors.Operation time, intra-operative blood loss, and duration of hospital stay were significantly reduced in the EU group.PD was associated with the greatest complication rate（55.7%）, followed by EU（50%） and CP（40.9%）, though the pancreatic fistula rate after EU was the highest（50%）, especially in patients with tumors larger than 3 cm and tumors close to the MPD.EU had advantages in the preservation of pancreatic parenchyma and endocrine and exocrine function.Conclusions： EU can be carried out safely and effectively for tumors in the proximal pancreas with improved outcomes compared with standard resections, even if the tumor is larger than 3 cm and close to the MPD.展开更多
Gastric duplication cyst (GDC) lined by pseudostratified columnar ciliated epithelium (PCCE) is an uncommon lesion stemming from a foregut developmental malformation.Its clinical and radiological presentation is usual...Gastric duplication cyst (GDC) lined by pseudostratified columnar ciliated epithelium (PCCE) is an uncommon lesion stemming from a foregut developmental malformation.Its clinical and radiological presentation is usually nonspecific.In this study,we reported a 76-year-old man who presented with an incidentally found perigastric mass.An exploratory laparotomy revealed a non-communicating cyst below the gastroesophageal junction,measuring 4 cm×4 cm in size.Microscopically,the gastric cyst was lined merely by PCCE.Although rare,GDC lined by PCCE should be included in the differential diagnosis of gastric wall masses.Surgical intervention is warranted in patients who have clinical symptoms,or who are aged more than 50 years.展开更多
Somatostatinoma is a very rare neuroendocrine tumor that originates from D cells and accounts for less than 1% of all gastrointestinal endocrine tumors. The duodenum is the most frequent site for this tumor, followed ...Somatostatinoma is a very rare neuroendocrine tumor that originates from D cells and accounts for less than 1% of all gastrointestinal endocrine tumors. The duodenum is the most frequent site for this tumor, followed by the pancreas. We here describe a 46-year-old Chinese woman who developed pancreatic somatostatinoma presenting with the characteristic "inhibitory" syndrome, but the symptoms were obscure and seemingly uncorrelated. This case is also unique for its large tumor size and mixed pathological pattern. Distal pancreatectomy was performed, and the patient has remained well since operation. As the syndromes of somatostatinoma may be obscure and atypical, clinicians should review all clinical findings to obtain an accurate diagnosis. Aggressive surgery is preferred to improve the survival.展开更多
基金Supported by National Natural Science Foundation of China,No.81101837Research Fund for the Doctoral Program of Higher Education of China,No.20110101120129Zhejiang Medical Health Science and Technology Plan,No.2013KYB124
文摘AIM: To investigate the mechanism underlying the promoting role of CD97 in gastric cancer cell proliferation and invasion. METHODS: Two types of exosomes released by gastric cancer cells with high(SGC/wt) or low(SGC/kd) CD97 expression were isolated by ultracentrifugation and identified by electron microscopy and western blot analysis. The influences of the two exosomes on gastric cancer cell proliferation and invasion were investigated by proliferation and Matrigel invasion assays. Exosomal mi RNAs were subsequently isolated from the two samples and their mi RNA profiles were compared via microarray assay analysis. Reverse transcriptionquantitative real-time polymerase chain reaction was used to validate the microarray assay. Target genes of the differently expressed micro RNAs were predicted based on five independent algorithms and were then subjected to gene oncology enrichment and Kyoto encyclopedia of genes and genomes(KEGG) pathway analysis. After identifying the pathway that was the most likely altered, tumor cells were treated with the two exosomes at different concentrations, and the pathway activation was identified through western blot analysis.RESULTS: Exosomes isolated from SGC/wt cells significantly promoted tumor cell proliferation in a dose-dependent manner in vitro. SGC/wt exosomesalso significantly elevated the invasiveness of both SGC/wt(129.67 ± 8.327 vs 76.00 ± 5.292, P < 0.001) and SGC/kd(114.52 ± 9.814 vs 45.73 ± 4.835, P < 0.001) cells as compared to the exosomes released by SGC/kd cells. Microarray assay of the two exosomes revealed that 62 mi RNAs were differently regulated with a signal intensity of > 500 and a false discovery rate < 0.05. The following KEGG analysis defined the MAPK signaling pathway as the most likely candidate pathway that regulated tumor cell proliferation and invasion. Through western blot analysis, significant up-regulations of phosphorylated MAPKs, including extracellular signal-regulated kinase, Jun NH2-terminal kinase, and p38 mitogen-activated protein kinase, were detected in a dose-dependent manner in the SGC/wt exosomes treated groups, confirming activation of the MAPK signaling pathway stimulated by SGC/wt exosomes.CONCLUSION: CD97 promotes gastric cancer cell proliferation and invasion in vitro through exosomemediated MAPK signaling pathway, and exosomal mi RNAs are probably involved in activation of the CD97-associated pathway.
基金supported by Scientific Research Project of People's Hospital number IN Xinjiang Uygur Autonomous Region(20130255)
文摘Objective:To observe reinforcing effect of calcium sulfate cement(CSC) bovine bone morphogenetic protein(bBMP) on vertebral in the rabbit model of osteoporosis.Methods:A total of 48 New Zealand white rabbits were randomly divided into group Ⅰ(blank control group),groupⅡ(CSC injection group),group Ⅲ(CSC/bBMP injection group) and control group.White rabbit osteoporosis model was established rapidly by using castration mcthod+methylprcdnisolone candidate.After modeling,groups Ⅱ.Ⅲ were given corresponding vertebral body injection material,and 4 animals were sacrificed respectively at 24 h,6 weeks,12 weeks after vertebral plasty.Tissue pathological status,vertebral mineral density and vertebral body bone mechanical strength were observed.Results:Vertebral body structure form was normal in the groups Ⅱand Ⅲ.Trabecular bone coarsens,connection and repair were observed in micro fracture and bone defects,bone trabecular connectivity was superior to group I significantly;vertebral body compression strength in the group I was on the decline,vertebral compression strength in the groups Ⅱ and Ⅲ was on the rise,the largest vertebra.Postoperative BMC and BMD in groups Ⅱand Ⅲ were incresed,and significantly higher than group I after 6 weeks(P<0.05),BMC and BMD in group Ⅲ after 12 weeks were higher than the other three groups.Conclusion:Compound bBMP CSC has good bone induction.It can improve the three-dimensional construction effect for osteoporosis vertebral trabecula,and can significantly improve the vertebral strength,as a vertebral packing material with good application prospect.
文摘AIM: To develop a method to differentiate pancreatic cancer patients from healthy or benign individuals when carbohydrate antigen (CA) 19-9 is normal.
文摘Objective: This work aimed to study the safety and efficacy of preoperative intestinal stent decompression combined with laparoscopic surgery to treat left-sided colorectal cancer with obstruction (LCCO). Methods: Retrospective analysis was conducted on data obtained from 21 LCCO patients admitted to The First Affiliated Hospital of Zhejiang Chinese Medicine University during March 2008 and December 2011. To remove the intestinal obstruction, preoperative intestinal stent placement under colonoscopic guidance was performed. Approximately 7 to 10 days after the operation, laparoscopic radical surgery of colorectal cancer was conducted. Results: Among the 21 cases studied, laparoscopic surgery was successful in 20 patients. Emergent laparotomy was conducted in one patient because of tumor invasion in the ureter. The duration of the operation ranged from 180 to 320 min, and the average time was 220 min. The recovery time for bowel function ranged from 2 to 5 days with an average time of 3 days. Postoperative infection of the incision occurred in one case. No anastomotic leakage was observed in any of the cases. Conclusion: Preoperative intestinal stent decompression, combined with primary stage laparoscopic surgery, is a safe and effective method for the treatment of LCCO.
文摘AIM: To report the outcome of Chinese patents with non-cystic adenocarcinoma in pancreatic body and tail (NCAPBT) after resection and to discuss its surgical strategy. METHODS: Resection of NCAPBT was performed in eight Chinese patients with complete clinical-pathological data in our hospital from January 2000 to May 2004. The surgical strategy was explored by analyzing the results of these patients. RESULTS: The resection rate of NCAPBT in patients without back pain was higher than that in patients with back pain (66.67% vs 20%, 2/3 vs 1/5). The prognosis in the group receiving palliative resection was poorer than that in the group receiving curative resection. The median survival time was 12 mo in the curative resection group and 6 mo in the palliative resection group, respectively. CONCLUSION: The overall survival time of the Chinese patients with NCAPBT is dismal. The Chinese patients after curative resection of NCAPBT have a longer survival time. The Chinese NCAPBT patients with back pain trend to have a lower curative resection rate, but back pain should not be considered a contraindication for curative resection.
基金financially supported by the Innovative Youth Talents of Guangdong Education Department Support Program(No.2021KQNCX027)the Youth Innovative Talents Project of Zhanjiang(No.2021E05016)the Program forScientific Research Start-Up Funds of Guangdong Ocean University(Nos.060302122010 and R19047)。
文摘To realize the commercialize of rechargeable Zn-air battery(RZAB),developing metal-free bifunctional electrocatalysts with satisfactory activity for oxygen reduction reaction(ORR)and oxygen evolution reaction(OER)is one of the emerging issues.Herein,a prawn shells-derived N-enriched porous carbon(PSNC)is synthesized via an ion exchange coupled biomimetic selfsacrificing template strategy.The resulting PSNC displays unique functional components,including the interconnected macro-meso-micropores structure to shorten charge and mass transfer pathway,high content of pyridinic and graphitic nitrogen to construct rich catalytic active site and improve conductivity.As electrocatalysts in alkaline condition,the optimized PSNC-0.8 achieves excellent bifunctional catalytic propriety with a narrow potential gap(ΔE)value of 0.80 V.Meanwhile,PSNC-0.8-based RZAB displays a high peak power density of 176.5 mW·cm^(-2)and considerable cycling durability with a small battery efficiency delay of 6.5%after 480 cycles(320 h).This study enlightens a simple and effective conception to design high-performance metal-free bifunctional electrocatalysts from seafood waste.
基金Project supported by the National Natural Science Foundation of China (No. 30901445)the Zhejiang Provincial Natural Science Foundation (No. Y2100285)the Specialized Research Fund for the Doctoral Program of Higher Education (No. 20090101120122),China
文摘Left-sided portal hypertension(LSPH)followed by acute pancreatitis is a rare condition with most patients being asymptomatic.In cases where gastrointestinal(GI)bleeding is present,however,the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment.A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article.The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography(CT)scan and CT-angiography.After embolization,the bleeding stopped and stabilized for the entire follow-up period without any severe complications.In conclusion,embolization of the splenic artery is a simple,safe,and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.
文摘Objective： To evaluate the comparative therapeutic efficacy of radiofrequency ablation （RFA） and hepatic resection （HR） for breast cancer liver metastases （BCLMs）. Methods： Studies that had examined the outcomes for both RFA and HR for BCLM were identified by searching the electronic databases PubMed, EMBASE, and the Cochrane Library. Pooled analyzes of the overall survival （OS）, disease-free survival （DFS）, and short-term outcomes of BCLM were performed. Results： Patients with BCLM gained many more survival benefits from HR than from RFA with regard to the 3-year OS rate （combined odds ratio （OR） 0.41, 95% confidence interval （CI） 0.29-0.59, P〈0.001）, 5-year OS rate （combined OR 0.38, 95% CI 0.32-0.46, P〈0.001）, 3-year DFS （combined OR 0.36, 95% CI 0.27-0.49, P〈0.001）, and 5-year DFS （combined OR 0.51, 95% CI 0.40-0.66, P〈0.001）. RFA had fewer postoperative compli- cations （combined OR 0.30, 95% CI 0.20-0.44, P〈0.001） and shorter hospital stays （combined OR -9.01, 95% CI -13.49-4.54, P〈0.001） than HR. Conclusions： HR takes precedence over RFA in the treatment of patients with BCLM, considering the better survival rate. RFA gives rise to fewer complications and can be carried out with a shorter hos- pital stay, compared to HR. RFA should be reserved for patients who are not optimum candidates for resection.
文摘Objective:To define the roles of gray-scale,color-Doppler ultrasound,and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignant.Methods:A total of 243 consecutive subjects(214 women,29 men) with 329 thyroid nodules were examined by gray-scale,color-Doppler ultrasound,and sonoelastography in this prospective study.All patients underwent surgery and the final diagnosis was obtained from histopathological examination.Results:Three hundred and twenty-nine nodules(208 benign,121 malignant) were divided into small(SNs,5-10 mm,n=137) and large(LNs,>10 mm,n=192) nodules.Microcalcifications were more frequent in malignant LNs than in malignant SNs,but showed no significant difference between benign LNs and SNs.Poorly-circumscribed margins were not significantly different between malignant SNs and LNs,but were less frequent in benign LNs than in benign SNs.Among all nodules,marked intranodular vascularity was more frequent in LNs than in SNs.By comparison,shape ratio of anteroposterior to transverse dimensions(A/T) ≥1 was less frequent in LNs than in SNs.Otherwise,among all nodules,marked hypoechogenicity and elasticity score of 4-6 showed no significant difference between LNs and SNs.Conclusions:The predictive values of microcalcifications,nodular margins,A/T ratio,and marked intranodular vascularity depend on nodule size,but the predictive values of echogenicity and elastography do not.
基金Project supported by the National Natural Science Foundation of China(Nos.30672072 and 30872531)the Foundation of Science and Technology Department of Zhejiang Province,China(Nos.2014C 33187)the National High-Tech R&D Program(863)of China(No.2007AA02Z476)
文摘Objective： The aim of this study was to evaluate the safety and efficiency of enucleation（EU） for proximal pancreatic non-invasive neoplasms.Methods： Patients with solitary non-invasive neoplasms in the proximal pancreas from January 1998 to April 2014 at the Second Affiliated Hospital of Zhejiang University, Hangzhou, China were included.Different operations and outcomes were analyzed.Results： A total of 123 patients were enrolled.Forty patients（32.5%） underwent EU including 18 patients who had tumors close to the main pancreatic duct（MPD）.Sixty-one patients（49.6%） had pancreaticoduodenectomy（PD） performed and 22（17.9%） underwent central pancreatectomy（CP）.Pathological outcomes included neuroendocrine tumors, cystic lesions, and solid pseudopapillary tumors.Operation time, intra-operative blood loss, and duration of hospital stay were significantly reduced in the EU group.PD was associated with the greatest complication rate（55.7%）, followed by EU（50%） and CP（40.9%）, though the pancreatic fistula rate after EU was the highest（50%）, especially in patients with tumors larger than 3 cm and tumors close to the MPD.EU had advantages in the preservation of pancreatic parenchyma and endocrine and exocrine function.Conclusions： EU can be carried out safely and effectively for tumors in the proximal pancreas with improved outcomes compared with standard resections, even if the tumor is larger than 3 cm and close to the MPD.
文摘Gastric duplication cyst (GDC) lined by pseudostratified columnar ciliated epithelium (PCCE) is an uncommon lesion stemming from a foregut developmental malformation.Its clinical and radiological presentation is usually nonspecific.In this study,we reported a 76-year-old man who presented with an incidentally found perigastric mass.An exploratory laparotomy revealed a non-communicating cyst below the gastroesophageal junction,measuring 4 cm×4 cm in size.Microscopically,the gastric cyst was lined merely by PCCE.Although rare,GDC lined by PCCE should be included in the differential diagnosis of gastric wall masses.Surgical intervention is warranted in patients who have clinical symptoms,or who are aged more than 50 years.
基金Project (Nos.30672072 and 30872531) supported by the National Natural Science Foundation of China
文摘Somatostatinoma is a very rare neuroendocrine tumor that originates from D cells and accounts for less than 1% of all gastrointestinal endocrine tumors. The duodenum is the most frequent site for this tumor, followed by the pancreas. We here describe a 46-year-old Chinese woman who developed pancreatic somatostatinoma presenting with the characteristic "inhibitory" syndrome, but the symptoms were obscure and seemingly uncorrelated. This case is also unique for its large tumor size and mixed pathological pattern. Distal pancreatectomy was performed, and the patient has remained well since operation. As the syndromes of somatostatinoma may be obscure and atypical, clinicians should review all clinical findings to obtain an accurate diagnosis. Aggressive surgery is preferred to improve the survival.
