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2014 Year 29 Volume 4 Issue
- Abstract：Objective To investigate the correlation between BRAF V600E mutation and anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (MoAbs) therapeutic effects in metastatic colorectal cancer. Methods Studies were included into meta-analysis to investigate the association between BRAF V600E mutation and clinical outcome in metastatic colorectal cancer patients treated with anti-EGFR MoAbs. Results A total of 7 studies were included in this meta-analysis. The 7 studies included 1352 patients in total, sample sizes ranged from 67 to 493. Objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) were collected from included studies and were used to assess the strength of the relation. In patients with wild-type KRAS, the pooled odds ratio for ORR of mutant BRAF over wild-type BRAF was 0.27 (95% CI=0.10-0.70). BRAF mutation predicted a deterioration in PFS and OS in wild-type KRAS patients treated with anti-EGFR MoAbs (hazard ratio=2.78, 95% CI=1.62-4.76; hazard ratio=2.54, 95% CI=1.93-3.32). Conclusion BRAF V600E mutation is related to lack of response and worse survival in wild-type KRAS metastatic colorectal cancer patients treated with anti-EGFR MoAbs.Keywords：colorectal neoplasms;meta-analysis7|2010|0Updated：2024-04-10
- Abstract：Objective To assess the agreement between gonioscopy and ultrasound biomicroscopy (UBM) in detecting angle closure in Chinese patients with shallow anterior chamber. Methods An observational comparative study of the two different examination methods was conducted. Patients with normal intraocular pressure and temporal peripheral anterior chamber depth less than a quarter of corneal thickness based on slit lamp examination were included in this study from December 2007 to May 2009 in the outpatient clinic of First Hospital of Tsinghua University. Gonioscopy was performed with a Goldman goniolens in dark room first and followed by full beam light and indentation. If the filtering trabecular meshwork was invisible or any peripheral anterior synechia was found, that quadrant of the angle was considered closed. UBM was first undertaken in a darkened room then repeated with normal room lighting. If iridotrabecular apposition was showed, that quadrant of the angle was considered closed. The status of angle closure of each quadrant with different methods was recorded. Results 85 eyes of 46 patients were included in this study. The agreement between gonioscopy and UBM was poor (κ<0.4) with Kappa analysis in both dark and light conditions in each quadrant. The accordance of agreement between gonioscopy and UBM was hardly affected by age or sex, while in dark condition, eyes with deeper anterior chamber (P=0.005) or plateau iris configuration tended to produce different results (P=0.075) in the 2 methods. Conclusion Gonioscopy and UBM are both indispensable methods for detecting angle closure, neither can completely replace the other.Keywords：gonioscopy;ultrasound biomicroscopy;angle closure glaucoma6|921|1Updated：2024-04-10
- Abstract：Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection (DSWI) following median sternotomy. Methods Between January 2009 and December 2013, 19 patients with DSWI after median sternotomy for cardiac surgery were admitted to our hospital, including 14 males (73.7%) and 5 females (26.3%), aged 55±13 (18-78) years. According to the Pairolero classification of infected median sternotomies, 3 (15.8%) patients were type II, and the other 16 (84.2%) were type III. Surgical procedure consisted of adequate debridement of infected sternum, costal cartilage, granulation, steel wires, suture residues and other foreign substances. Sternal reconstruction used the bilateral pectoralis major or plus rectus abdominis muscle flaps to obliterate dead space. The drainage tubes were placed and connected to a negative pressure generator for adequate drainage. Results There were no intraoperative deaths. In 15 patients (78.9%), bilateral pectoral muscle flaps were mobilized sufficiently to cover and stabilize the defect created by wound debridement. 4 patients (21.0%) needed bilateral pectoral muscle flaps plus rectus abdominis muscle flaps because their pectoralis major muscle flaps could not reach the lowest portion of the wound. 2 patients (10.5%) presented with subcutaneous infection, and 3 patients (15.8%) had hematoma. They recovered following local debridement and medication. 17 patients (89.5%) were examined at follow-up 12 months later, all healed and having stable sternum. No patients showed infection recurrence during the follow-up period over 12 months. Conclusion DSWI following median sternotomy may be effectively managed with adequate debridement of infected tissues and reconstruction with bilateral pectoralis major muscle or plus rectus abdominis muscle flap transposition.Keywords：median sternotomy;deep sternal wound infections;sternal osteomyelitis;sing-stage;pectoralis major muscle flap;rectus abdominis muscle flap5|2149|1Updated：2024-04-10
- Abstract：Objective To investigate the image quality, radiation dose and diagnostic value of the low-tube-voltage high-pitch dual-source computed tomography (DSCT) with sinogram affirmed iterative reconstruction (SAFIRE) for non-enhanced abdominal and pelvic scans. Methods This institutional review board-approved prospective study included 64 patients who gave written informed consent for additional abdominal and pelvic scan with DSCT in the period from November to December 2012. The patients underwent standard non-enhanced CT scans (protocol 1) [tube voltage of 120 kVp/pitch of 0.9/filtered back-projection (FBP) reconstruction] followed by high-pitch non-enhanced CT scans (protocol 2) (100 kVp/3.0/SAFIRE). The total scan time, mean CT number, signal-to-noise ratio (SNR), image quality, lesion detectability and radiation dose were compared between the two protocols. Results The total scan time of protocol 2 was significantly shorter than that of protocol 1 (1.4±0.1 seconds vs. 7.6±0.6 seconds, P<0.001). There was no significant difference between protocol 1 and protocol 2 in mean CT number of all organs (liver, 55.4±6.3 HU vs. 56.1±6.8 HU, P=0.214; pancreas, 43.6±5.9 HU vs. 43.7±5.8 HU, P=0.785; spleen, 47.9±3.9 HU vs. 49.4±4.3 HU, P=0.128; kidney, 32.2±2.3 HU vs. 33.1±2.3 HU, P=0.367; abdominal aorta, 44.8±5.6 HU vs. 45.0±5.5 HU, P=0.499; psoas muscle, 50.7±4.1 HU vs. 50.3±4.5 HU, P=0.279). SNR on images of protocol 2 was higher than that of protocol 1 (liver, 5.0±1.2 vs. 4.5±1.1, P<0.001; pancreas, 4.0±1.0 vs. 3.6±0.8, P<0.001; spleen, 4.7±1.0 vs. 4.1±0.9, P<0.001; kidney, 3.1±0.6 vs. 2.8±0.6, P<0.001; abdominal aorta, 4.1±1.0 vs. 3.8±1.0, P<0.001; psoas muscle, 4.5±1.1 vs. 4.3±1.2, P=0.012). The overall image noise of protocol 2 was lower than that of protocol 1 (9.8±3.1 HU vs. 11.1±3.0 HU, P<0.001). Image quality of protocol 2 was good but lower than that of protocol 1 (4.1±0.7 vs. 4.6±0.5, P<0.001). Protocol 2 perceived 229 of 234 lesions (97.9%) that were detected in protocol 1 in the abdomen and pelvis. Radiation dose of protocol 2 was lower than that of protocol 1 (4.4±0.4 mSv vs. 7.3±2.4 mSv, P<0.001) and the mean dose reduction was 41.4%. Conclusion The high-pitch DSCT with SAFIRE can shorten scan time and reduce radiation dose while preserving image quality in non-enhanced abdominal and pelvic scans.Keywords：high pitch;dual-source computed tomography;iterative reconstruction;image quality;radiation dose5|1966|0Updated：2024-04-10
- Abstract：Objective To investigate the risk factors for postoperative arytenoid dislocation. Methods From September 2003 to August 2013, the records of 16 patients with a history of postoperative arytenoid dislocation were reviewed. Patients matched in terms of date and type of procedures were chosen as the controls (n=16). Recorded data for all patients were demographics, smoking status, alcoholic status, preoperative physical status, airway evaluation, intubation procedures, preoperative laboratory test results, anesthetic consumption and intensive care unit stay. For arytenoid dislocation cases, we further analyzed the incidences of the left and right arytenoid dislocation, and the outcomes of surgical repair and conservative treatment. Categorical variables were presented as frequencies and percentages, and were compared using the chi-squared test. Continuous variables were expressed as means±SD and compared using the Student’s unpaired t-test. To determine the predictors of arytenoid dislocation, a logistic regression model was used for multivariate analysis. Results Sixteen patients with postoperative arytenoid dislocation were enrolled, with a median age of 52 years. Most postoperative arytenoid dislocation patients (15/16, 93.75%) received surgical repair, except one patient who recovered after conservative treatment. None of the postoperative arytenoid dislocation patients were smokers. Red blood cell (P=0.044) and hemoglobin (P=0.031) levels were significantly lower among arytenoid dislocation cases compared with the controls. Conclusions Non-smoking and anemic patients may be susceptible to postoperative arytenoid dislocation. However, neither of them was independent risk factor for postoperative arytenoid dislocation.Keywords：arytenoid dislocation;complication;endotracheal intubation5|2097|2Updated：2024-04-10
- Abstract：Objective To evaluate the inhibitory effect of Gnaphalium affine extracts on xanthine oxidase (XO) activity in vitro and to analyze the mechanism of this effect. Methods In this in vitro study, Kinetic measurements were performed in 4 different inhibitor concentrations and 5 different xanthine concentrations (60, 100, 200, 300, 400 μmol/L). Dixon and Lineweaver-Burk plot analysis were used to determine Ki values and the inhibition mode for the compounds isolated from Gnaphalium affine extract. Results Four potent xanthine oxidase inhibitors were found in 95% ethanolic (v/v) Gnaphalium affine extract. Among them, the ?avone Eupatilin exhibited the strongest inhibitory effect on XO with a inhibition constant (Ki) of 0.37 μmol/L, lower than the Ki of allopurinol (4.56 mol/L), a known synthetic XO inhibitor. Apigenin (Ki of 0.56 μmol/L, a proportion of 0.0053‰ in Gnaphalium affine), luteolin (Ki of 2.63 μmol/L, 0.0032‰ in Gnaphalium affine) and 5-hydroxy-6,7,3’,4’-tetramethoxyflavone (Ki of 3.15 μmol/L, 0.0043‰ in Gnaphalium affine) also contributed to the inhibitory effect of Gnaphalium affine extract on XO activity. Conclusions These results suggest that the use of Gnaphalium affine in the treatment of gout could be attributed to its inhibitory effect on XO. This study provides a rational basis for the traditional use of Gnaphalium affine against gout.Keywords：xanthine oxidase;gout;uric acid;gnaphalium affine5|2668|4Updated：2024-04-10
- Abstract：Liver fibrosis is a common pathological consequence of a variety of chronic stimuli, including viral, autoimmune, drug-induced, cholestatic and metabolic diseases. Fibrosis is driven by a dynamic process involving increased synthesis of matrix components and a failure of physiological mechanisms of matrix turnover. Activation of hepatic stellate cells (HSCs) remains a central event in fibrosis. HSCs are the main source of extracellular matrix (ECM). Transforming growth factor-beta (TGF-β), which is the fibrogenic master cytokine, can induce the activation of HSCs to produce a large amount of ECM, and is capable of inducing apoptosis of liver cells. RNA interference (RNAi) is a novel gene disruption technology. Studies have shown that small interfering RNA (siRNA) targeting TGF-β1 may inhibit the activation and proliferation of HSCs, suppress ECM synthesis and block liver fibrosis. TGF-β1 siRNA-mediated gene silencing therapy provides a new avenue for liver fibrosis. This review summarizes recent progresses in research on HSCs, TGF-β1 and TGF-β1 siRNA in liver fibrosis.Keywords：liver fibrosis;hepatic stellate cells;transforming growth factor-β;small interfering RNA5|814|2Updated：2024-04-10
- Abstract：LONG non-coding RNAs (lncRNAs) are a class of RNAs whose transcripts are longer than 200 nt. These molecules do not encode proteins but have a structure resembling that of mRNA and show polyA tails and promoter structure through splicing. Most lncRNAs show a distinct spatial and temporal specificity during histological differentiation and development. Dynamic expression and different splicing methods may appear during the differentiation process.Keywords：long non-coding RNAs;plasmacytoma variant translocation 1 gene;expression;characteristics5|1007|4Updated：2024-04-10
- Abstract：NEOPLASMS derive from small intestine are rare and most cases are adenocarcinomas and carcinoid.1 Squamous cell carcinoma of small intestine is even rarer and only few cases reported in literature.1 In this article, we report a case of a 68-year-old male who underwent a laparotomy due to perforation of the small intestine and was diagnosed with squamous cell carcinoma of the small intestine.Keywords：squamous cell carcinoma;small intestine;perforation5|744|0Updated：2024-04-10
- Abstract：ULCERATIVE colitis is a chronic inflammatory disease characterized by diffuse mucosal inflammation involving the rectum and extending proximally to involve all or part of the colon. A step-up approach for medical therapy is routinely applied, from 5-aminosalicylic acid (ASA) compounds, corticosteroids, immunomodulators, and biologics.1 Thrombosis, mainly venous, is a rare and well-recognized extra-intestinal manifestation of inflammatory bowel disease.2 In this article, we report the use of thrombolytic and antithrombotic therapy for the venous thrombosis in a 55-year-old male patient with refractory and active ulcerative colitis with excellent outcome.Keywords：venous thrombosis;refractory ulcerative colitis;active ulcerative colitis5|891|0Updated：2024-04-10
- Abstract：MULTIPLE myeloma (MM) is a hematologic malignancy of differentiated plasma cells that accumulate and proliferate in the bone marrow. MM patients often develop bone disease that results in severe bone pain, osteolytic lesions, and pathologic fractures,1 presenting with unexplained backache or bone pain in the long bones, ribs, skull, or pelvis.2 However, the low backache mimicking spondyloarthritis in MM is uncommon during clinical practice. Spondyloarthritis is a chronic systemic inflammatory disorder of the axial skeleton, mainly affecting the sacroiliac joint and spine causing low backache.3 Here we report a patient with MM which was initially misdiagnosed and treated as spondyloarthritis.Keywords：multiple myeloma;ankylosing spondylitis;spondyloarthritis;misdiagnosis5|1958|0Updated：2024-04-10
- Abstract：PRIMARY synovial chondromatosis is a rare condition in which foci of cartilage develop in the synovial membrane of joints, bursae and tendon sheaths. It typically involves a single large joint in a young adult male. The ectopic foci of cartilage can result in painful joint effusion, and the generation of loose bodies can cause mechanical symptoms. The etiology of primary synovial chondromatosis remains unknown, but metaplastic theory is the most popular hypothesis. The commonly involved joints are knee, elbow, and hip. The shoulder is a rare site of synovial chondromatosis and the extra-articular involvement even rarer, with only few cases presented in literature. This report presents a rare case of primary combined intra-articular and extra-articular synovial chondromatosis of shoulder joint treated with arthroscopy.Keywords：synovial chondromatosis;shoulder;intra-articular;extra-articular;arthroscopy5|2773|0Updated：2024-04-10
- Abstract：NARCOTREND index (NI) is based on studies of normal human brain electrical data. It uses an ordinary electrode to collect and analysis brain electrical signals immediately at any position of the head, to display the state of consciousness and depth of anesthesia of patients on the touch screen after automatic analysis and classification, so as to guide dose adjustment of anesthetics. NI may make the consciousness and depth of anesthesia monitoring safe, simple, accurate, and economic. It is important that NI is more accurate than classical electroencephalographic variables.1 Weber et al2 believed that the NI was an objective and true index in the evaluation of propofol sedation in children.Keywords：narcotrend index;anesthesia;diabetics5|1601|0Updated：2024-04-10
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