Immune-related long noncoding RNA zinc finger protein 710-AS1-201 promotes the metastasis and invasion of gastric cancer cells

BACKGROUND Gastric cancer(GC)is a prevalent malignant tumor of the gastrointestinal system.ZNF710 is a transcription factor(TF),and zinc finger protein 710(ZNF710)-AS1-201 is an immune-related long noncoding RNA(lncRNA)that is upregulated in GC cells.AIM To assess the correlation between ZNF710-AS1-201 and immune microenvir-onment features and to investigate the roles of ZNF710-AS1-201 in the invasion and metastasis processes of GC cells.METHODS We obtained data from The Cancer Genome Atlas and Wujin Hospital.We assessed cell growth,migration,invasion,and programmed cell death using cell counting kit-8,EdU,scratch,Transwell,and flow cytometry assays.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to identify the potential downstream targets of ZNF710-AS1-201.RESULTS In GC tissues with low ZNF710-AS1-201 expression,immunoassays detected significant infiltration of various antitumor immune cells,such as memory CD8 T cells and activated CD4 T cells.In the low-expression group,the half-maximal inhibitory concentrations(IC_(50)s)of 5-fluorouracil,cisplatin,gemcitabine,and trametinib were lower,whereas the IC_(50)s of dasatinib and vorinostat were higher.The malignant degree of GC was higher and the stage was later in the high-expression group.Additionally,patients with high expression of ZNF710-AS1-201 had lower overall survival and disease-free survival rates.In vitro,the overexpression of ZNF710-AS1-201 greatly enhanced growth,metastasis,and infiltration while suppressing cell death in HGC-27 cells.In contrast,the reduced expression of ZNF710-AS1-201 greatly hindered cell growth,enhanced apoptosis,and suppressed the metastasis and invasion of MKN-45 cells.The expression changes in ZNF710 were significant,but the corresponding changes in isocitrate dehydrogenase-2,Semaphorin 4B,ARHGAP10,RGMB,hsa-miR-93-5p,and ZNF710-AS1-202 were not consistent or statistically significant after overexpression or knockdown of ZNF710-AS1-201,as determined by qRT-PCR.CONCLUSION Immune-related lncRNA ZNF710-AS1-201 facilitates the metastasis and invasion of GC cells.It appears that ZNF710-AS1-201 and ZNF710 have potential as effective targets for therapeutic intervention in GC.Nevertheless,it is still necessary to determine the specific targets of the ZNF710 TF.

Surgical outcomes of mini-open Wiltse approach and conventional open approach in patients with single-segment thoracolumbar fractures without neurologic injury

This study aimed to introduce a novel mini-open pedicle screw fixation technique via Wiltse approach, and com- pared it with the traditional posterior open method. A total of 72 cases of single-segment thoracolumbar fractures without neurologic injury underwent pedicle screw fixation via two different approaches. Among them, 37 patients were treated using posterior open surgery, and 35 patients received mini-open operation via Wiltse approach. Crew placement accuracy rate, operative time, blood loss, postoperative drainage, postoperative hospitalization time, radiation exposure time, postoperative improvement in R value, Cobb＇s angle and visual analog scale （VAS） scores of the two methods were compared. There were no significant differences in the accuracy rate of pedicle screw placement, radiation exposure and postoperative R value and Cobb＇s angle improvement between the two groups. However, the mini-open method had obvious advantages over the conventional open method in operative time, blood loss, postoperative drainage, postoperative hospitalization time, and postoperative improvement in VAS. The mini-open pedicle screw technique could be applied in treatment of single-segment thoracolumbar fracture without neurologic injury and had advantages of less tissue trauma, short operative and rehabilitative time on the premise of guaranteed accuracy rate and no increased radiation exposure.

lncRNACNN3-206 activates intestinal epithelial cell apoptosis and invasion by sponging miR-212, an implication for Crohn’s disease

BACKGROUND Statistics indicate that the incidence of Crohn’s disease(CD)is rising in many countries.The poor understanding on the pathological mechanism has limited the development of effective therapy against this disease.Previous studies showed that long noncoding RNAs(lncRNAs)could be involved in autoimmune diseases including CD,but the detailed molecular mechanisms remain unclear.AIM To identify the differentially expressed lncRNAs in the intestinal mucosa associated with CD,and to characterize their pathogenic role(s)and related mechanisms.METHODS The differential expression of lncRNAs was screened by high-throughput RNA sequencing,and the top candidate genes were validated in an expanded cohort by real-time PCR.The regulatory network was predicted by bioinformatic software and competitive endogenous RNA analysis,and was characterized in Caco-2 and HT-29 cell culture using methods of cell transfection,real-time PCR,Western blotting analysis,flow cytometry,and cell migration and invasion assays.Finally,these findings were confirmed in vivo using a CD animal model.RESULTS The 3'end of lncRNACNN3-206 and the 3’UTR of Caspase10 contain highaffinity miR212 binding sites.lncRNACNN3-206 expression was found to be significantly increased in intestinal lesions of CD patients.Activation of the lncRNACNN3-206-miR-212-Caspase10 regulatory network led to increased apoptosis,migration and invasion in intestinal epithelial cells.Knockdown of lncRNACNN3-206 expression alleviated intestinal mucosal inflammation and tissue damage in the CD mouse model.CONCLUSION lncRNACNN3-206 may play a key role in CD pathogenesis.lncRNACNN3-206 could be a therapeutic target for CD treatment.

Inhibition of Invasion and Up-regulation of E-cadherin Expression in Human Malignant Melanoma Cell Line A375 by(-)-Epigallocatechin-3-gallate

The inhibitory effects of （-）-epigallocatechin-3-gallate （EGCG） on the invasion of human malignant melanoma cell line A375 and the possible molecular mechanisms of this effect were investiaged. A375 cells were pretreated with 20 μg/mL EGCG for 24, 48 and 72 h respectively and the E-cadherin expression was detected by Western blot analysis. A375 cells were also pretreated with different concentrations of EGCG （1, 5, 10 and 20 μg/mL） for 72 h and the expression of E-cadherin was measured by RT-PCR. The adhesion and invasion of A375 cells were tested by cell-matrigel adhesion assay and matrigel invasion assay respectively. The results showed that EGCG could significantly up-regulate the expression of E-cadherin time-and concentration-dependently （both P〈0.05）. Statistical analysis showed that A375 cells invasion was inhibited by EGCG and correlated with the up-regulation of E-cadherin expression. It was suggested that EGCG strongly inhibited invasion of A375 cells, and the inhibition mechanism was possibly associated with the up-regulation of E-cadherin expression.

Unexpected metastasis of intraductal papillary neoplasm of the bile duct without an invasive component to the brain and lungs:A case report

BACKGROUND Despite an expanding number of studies on intraductal papillary neoplasm of the bile duct(IPNB),distant metastasis remains unexplained especially in cases of carcinoma in situ.In the present study,we report a rare and interesting case of IPNB without invasive components that later metastasized to lungs and brain.CASE SUMMARY A 69-year-old male was referred to our hospital due to suspected cholangiocarcinoma.Laboratory tests on admission reported a mild elevation of alkaline phosphatase,γ-glutamyl transpeptidase,and total bilirubin in serum.Endoscopic retrograde cholangiography revealed a filling defect in the common bile duct(CBD)extending to the left hepatic duct.Peroral cholangioscopy delineated a tumor in the CBD that had a papillary pattern.Multidetector computed tomography and magnetic resonance cholangiopancreatography detected partial blockage ot interlude in the CBD leading to cholestasis without evidence of metastasis.Therefore,a diagnosis of IPNB cT1N0M0 was established.Left hepatectomy with bile duct reconstruction was performed.Pathological examination confirmed an intraepithelial neoplasia pattern without an invasive component and an R0 resection achievement.The patient was monitored carefully by regular examinations.However,at 32 mo after the operation,a 26 mm tumor in the lungs and a 12 mm lesion in the brain were detected following a suspicious elevated CA 19-9 level.Video-assisted thoracoscopic surgery of left upper lobectomy and stereotactic radiotherapy are indicated.In addition to histopathological results,a genomic profiling analysis using whole exome sequencing subsequently confirmed lung metastasis originating from bile duct cancer.CONCLUSION This case highlights the important role of genomic profiling analysis using whole exome sequencing in identifying the origin of metastasis in patients with IPNB.

Detection of D2-40 monoclonal antibody-labeled lymphatic vessel invasion in esophageal squamous cell carcinoma and its clinicopathologic significance

Objective： This study aims to investigate the clinicopathologic significance of lymphatic vessel invasion （LVI） labeled by D2-40 monoclonal antibody in esophageal squamous cell carcinoma （ESCC）. Methods： Immunohistochemical assay was used to detect the expression of D2-40 and LVI in 107 ESCC patients. Then, the correlation between the clinicopathologic feature and the overall survival time of the patients was analyzed. Results： The lymph node metastasis rates were 70% and 21% in the LVI-positive and LVI-negative groups, respectively. The nodal metastasis rate was higher in the LVI-positive group than in the LVI-negative group. Multivariate regression analysis showed that LVI was related to nodal metastasis （P〈0.001）. The median survival time of the patients was 26 and 43 months in the LVI-positive and LVI-negative groups, respectively. Mthough univariate regression analysis showed significant difference between the two groups （P=0.014）, multivariate regression analysis revealed that LVI was not an independent prognostic factor for overall survival in the ESCC patients （P=0.062）. Lymphatic node metastasis （P=0.031）, clinical stage （P=0.019）, and residual tumor （P=0.026） were the independent prognostic factors. Conclusion： LVI labeled by D2-40 monoclonal antibody is a risk factor predictive of lymph node metastasis in ESCC patients.

Silencing Filamin A Inhibits the Invasion and Migration of Breast Cancer Cells by Up-regulating 14-3-3σ

Filamin A and 14-3-3-σ are closely associated with the development of breast cancer. However, the exact relationship between them is still unknown. The present study aimed to examine the interaction of filamin A with 14-3-3-σ in the invasion and migration of breast cancer. RNA interference technology was employed to silence filamin A in MDA-MB-231 cells. Real-time PCR and Westem blotting were used to detect the expression of filamin A and 14-3-3-σ at mRNA and protein levels, respectively. Double immunofluorescence was applied to show their colocalization morphologically. Wound healing assay and Trans-well assay were used to testify the migration and invasion of MDA-MB-231 cells in filamin A-silenced cells. The results showed that silencing filamin A significantly increased the mRNA and protein levels of 14-3-3σ. In addition, double immunofluorescence displayed that filamin A and 14-3-3σ were predominantly colocalized in the cytoplasm of MDA-MB-231 cells. Silencing filamin A led to the enhanced fluorescence of 14-3-3σ. Furthermore, cell functional experiments showed that silencing filamin A inhibited the migration and invasion of MDA-MB-231 cells in vitro. In conclusion, silencing filamin A may inhibit the invasion and migration of breast cancer cells by upregulating 14-3-3σ.

Analysis of Clinical Characteristics and Diagnostic Value of Fungal Serology in Patients with Invasive Candidiasis

Objective: To evaluate the diagnostic value of (1 - 3)-β-D glucan and mannan assay for invasive candidiasis. Methods: A retrospective study was conducted on 32 cases in the disease group (18 proven invasive candidiasis and 14 probable invasive candidiasis) and 48 cases in the control group. The subjects were recruited from January 2018 to March 2019 in Clinical Laboratory of Hainan General Hospital. All subjects were detected by (1 - 3)-β-D glucan and mannan assay. Results: The mean concentration of (1 - 3)-β-D glucan in the disease group was 97.45 (43.23, 224.35) pg/ml and it was significantly higher than the mean concentration of the control group which was 49.85(41.91, 56.07) pg/ml (P = 0.005). The mean concentration of mannan in the disease group and the control group were 161.36 (34.96, 224.49) pg/ml and 25.80 (25.00, 29.31) pg/ml, respectively, which were significantly different (P < 0.001). The sensitivity, specificity, positive predictive value and negative predictive value of (1 - 3)-β-D glucan assay were 59.38%, 89.58%, 79.17%, 76.79%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of mannan assay were 65.63%, 95.83%, 91.30%, 80.70%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of combination of two types of assays were 81.25%, 85.42%, 78.79% and 87.23%, respectively. Conclusions: Combination of (1 - 3)-β-D glucan and mannan assay can improve diagnostic specificity and it has essential clinical diagnostic value for invasive candidiasis.

Mini versus ultra-mini percutaneous nephrolithotomy in a paediatric population

Objective:To evaluate whether there would be a difference in outcome when the smaller ultra-mini 12 Fr sheath was used instead of the mini 16 Fr sheath for percutaneous nephrolithotomy(PCNL)in paediatric patients for stones less than 25 mm.Methods:This was a prospective cohort study of patients who underwent PCNL in our hospital in a 2-year period from July 2016 to June 2018 by a single surgeon.PCNL was performed in a prone position and tract was dilated to the respective size using single step dilatation.Laser was used to fragment the stone.Stone-free outcome was defined as absence of stone fragment at 3 months on kidney,ureter,and bladder X-ray.Results:There were 40 patients in each group.Mean stone size was comparable between the two groups(14.5 mm vs.15.0 mm).The procedure was completed faster in the 16 Fr group compared to 12 Fr group(24.5 min vs.34.6 min).Stone clearance was highly successful in both groups(97.5%vs.95.0%).There was no difference in complications between the two groups.The decrease in hemoglobin was minimal in both groups(0.2 g/dL vs.0.3 g/dL).Conclusion:We found that the success rates were similar in both mini PCNL and the smaller ultra-mini PCNL groups.No significant difference in bleeding was noted in our pilot study,however,operative time was longer in the ultra-mini group as compared to the mini sheath group.

mini-Swashbuckler入路与股骨前外侧入路联合LISS治疗C型股骨远端骨折患者的效果比较

目的:比较mini-Swashbuckler入路与股骨前外侧入路联合微创内固定系统(LISS)治疗C型股骨远端骨折患者的效果。方法:选取2019年4月至2021年4月该院收治的60例C型股骨远端骨折患者进行前瞻性研究,按照随机数字表法分为对照组和观察组各30例。对照组采用股骨前外侧入路联合LISS治疗,观察组采用mini-Swashbuckler入路联合LISS治疗,比较两组骨折复位优良率,围术期指标水平,手术前后膝关节功能[美国特种外科医院(HSS)膝关节评分]评分及并发症发生率。结果:观察组手术时间长于对照组,术中出血量少于对照组,透视次数多于对照组,差异均有统计学意义(P<0.05);两组住院时间比较,差异无统计学意义(P>0.05);术后3个月,观察组HSS膝关节评分高于对照组,差异有统计学意义(P<0.05);两组骨折关节面复位有效率、并发症发生率比较,差异无统计学意义(P>0.05)。结论:mini-Swashbuckler入路联合LISS钢板治疗C型股骨远端骨折患者可减少术中出血量和提高HSS膝关节评分的效果优于股骨前外侧入路联合LISS钢板治疗,但需延长手术时间和增加透视次数。

Expression of mir-34c-5p and mir-150-5pin nasopharyngeal carcinoma and up-regulated expression after invasion and apoptosis of nasopharyngeal carcinoma cells

Objective MiRNAs are closely related to tumors,and we hypothesized there is specific miR expression in nasopharyngeal carcinoma(NPC).We intended to investigate the expression of mir-34c-5p and mir-150-5p in NPC and to investigate the effects of mir-34c-5p and mir-150-5p on apoptosis and invasion following up-regulated expression in HNE1 NPC cells.Methods MiR-34c-5p and miR-150-5p expression levels in 30 individual cases of NPC and nasopharyngitis were detected with gene chip and qRT-PCR techniques.miR-34c-5p and miR-150-5p were transfected into the NPC cell line HNE1 via liposomes.Their expression levels were detected with qRT-PCR,apoptosis was evaluated by flow cytometry,and invasion ability was assessed via Transwell migration assay.Results MiR-150-5p expression levels in NPC and nasopharyngitis were 0.165±0.092 and 1.062±0.280 respectively,and miR-34c-5p expression levels in NPC and nasopharyngitis were 0.417±0.220 and 1.385±0.739,respectively,which indicated miR-34c-5p and miR-150-5p were weakly expressed in NPC.Apoptosis rates in HNE1 cells transfected by miR-34c-5p and miR-150-5p were increased,by 12.7%and 7.6%,respectively,which were significantly higher compared to blank control(3.9%).The Transwell assay demonstrated that invasive HNE1 cell counts were 32.00±2.00 and 28.33±2.08,respectively,compared to 60.66±8.50 in the blank control(P<0.001).Conclusion MiR-34c-5p and miR-150-5p are lowly expressed in NPC,and their down-regulation may be associated with NPC.

mini-Swashbuckler入路联合股骨外侧微创内固定系统治疗股骨远端骨折患者的效果

目的:观察mini-Swashbuckler入路联合股骨外侧微创内固定系统(LISS)治疗股骨远端骨折患者的效果。方法:选取80例股骨远端骨折患者为研究对象,按照随机数字表法分为对照组与观察组各40例。对照组采用传统Swashbuckler入路联合LISS治疗,观察组采用mini-Swashbuckler入路联合LISS治疗,比较两组临床相关指标水平、膝关节功能[美国特种外科医院膝关节功能(HSS)]评分、并发症发生率和生命质量[简明健康状况调查量表(SF-36)]评分。结果:观察组手术时间长于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组住院时间和骨折愈合时间比较,差异无统计学意义(P>0.05);术后3、6个月时,观察组HSS评分均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.00%(2/40),与对照组的10.00%(4/40)比较,差异无统计学意义(P>0.05);术后6个月,两组SF-36评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:mini-Swashbuckler入路联合LISS治疗股骨远端骨折患者可减少术中出血量,提高HSS和SF-36评分,效果优于传统Swashbuckler入路联合LISS治疗,但手术时间长于传统Swashbuckler入路联合LISS治疗。

CircROBO1 promotes retinal Y79 cell tumor invasion by targeting KLF5

Objective:To explore the role of circROBO1 in promoting the invasion of retinal Y79 cells by targeting KLF5 and its possible regulatory mechanism.Methods:RNase R enzyme digestion and qRT-PCR experiments were used to detect the structural stability of circular circROBO1 in retinal Y79 cells;cytoplasmic and nuclear RNAs of retinal Y79 cells were extracted for localization analysis of circROBO1;The expression of circROBO1 in retinal Y79 cells were silenced by siRNA.The effect of circROBO1 on the migration and invasion ability of HT-29 cells was detected by scratch assay,Transwell cell invasion and migration assay.The target binding sites of circROBO1 and its downstream miRNA and that of miRNA and its downstream target gene KLF5 were predicted by CircInteractome and TargetScan online software respectively,and the target regulation relationship between them was verified by double luciferase reporter gene experiment.Western blot was used to detect the effect of siRNA silencing the expression of circROBO1 in Y79 cells on the expression of KLF5.Results:Compared with the control group without RNase R enzyme treatment,relative circROBO1 levels did not change significantly after treatment,while relative linear ROBO1 levels decreased significantly after treatment(t=16.18,P<0.05);the content of circROBO1 in the cytoplasm was significantly higher than that in the nucleus(P<0.05);compared with si-control group,the migration rate and the invasion and migration abilities of Transwell cells were all lower in the si-circROBO1 group(t=22.54,P<0.05);circROBO1 can adsorb miR-885-5p,and there is a target binding site between miR-885-5p and KLF5(t=11.39,P<0.05);compared with the si-control group,the KLF5 protein expression in the si-circROBO1 group was significantly decreased(t=17.26,P<0.05).Conclusions:circROBO1 promotes retinalY79 cell tumor invasion by targeting KLF5.

经椎旁肌间隙入路与经皮入路椎弓根螺钉内固定治疗无神经症状胸腰椎骨折的疗效比较

目的比较经椎旁肌间隙入路与经皮入路椎弓根螺钉内固定术治疗无神经症状胸腰椎骨折的临床疗效。方法收集2017年2月至2018年10月期间苏州大学附属第一医院收治的59例无神经症状的单节段胸腰椎骨折病人的临床资料,进行回顾性分析,其中男51例,女8例,平均年龄为46.8岁(19~67岁)。均采用椎弓根螺钉内固定手术,24例采用经椎旁肌间隙入路的病人纳入经肌间隙入路组,35例采用经皮入路的病人纳入经皮入路组。比较两组病人的手术相关指标(术中出血量、手术时间、切口总长度、住院总时间、术后下床时间),术前、术后1周及术后6个月的疼痛视觉模拟量表(VAS)评分,术前及术后椎体前缘高度百分比、Cobb角以及螺钉置入精确度。结果病人获得(16.1±4.2)月(12~28个月)随访。经肌间隙入路组的手术时间显著少于经皮入路组[(114.00±48.56)min vs.(153.29±52.46)min],住院总时间显著多于经皮入路组[(12.92±4.97)d vs.(10.40±4.14)d],差异有统计学意义(P<0.05)。两组术后的VAS评分均较术前显著降低,椎体前缘高度百分比均较术前明显增加,术后Cobb角均较术前明显减小,但两组间比较,差异均无统计学意义(P>0.05)。术后经肌间隙入路组的螺钉置入精确度:Ⅰ级128钉,Ⅱ级13钉,Ⅲ级3钉;经皮入路组为:Ⅰ级177钉,Ⅱ级22钉,Ⅲ级1钉,组间差异无统计学意义(P>0.05)。结论经椎旁肌间隙入路与经皮入路椎弓根螺钉内固定术治疗无神经症状的胸腰椎骨折均具有较好的临床疗效,前者在手术时间更有优势,后者在住院总时间更有优势。

碱激发碳酸盐-矿渣复合灌浆材料的工作性能

在碱激发碳酸盐-矿渣复合灌浆材料试验研究中引入浆液Marsh时间与Mini扩展度试验方法,以表征浆液的表观粘度和屈服应力,并结合传统的凝胶时间试验方法,综合研究了不同配方浆液的工作性能。结果表明:硅酸钠溶液浓度和矿渣掺量对浆液工作性能的影响相似,其值增大,浆液凝胶时间缩短,Marsh时间延长,扩展度减小,即浆液的表观粘度和屈服应力随之增大,并且发现其将随时间而进一步显著增大,说明浆液保持良好流动性的时间缩短。硅酸钠溶液模数或缓凝剂掺量增加时,浆液凝胶时间延长,且保持良好流动性的时间增加,但其起始表观粘度和屈服应力变化不大。

Danis-WeberA/B型踝关节骨折关节镜辅助复位经皮微创内固定治疗16例报告

目的探讨利用关节镜辅助复位经皮微创内固定Danis-WeberA/B踝关节骨折的疗效。方法选择16例Danis-WeberA/B型踝关节骨折患者在关节镜可视条件下进行关节清理复位,同时经皮微创内固定。在关节镜可视条件下,清除嵌插撕裂韧带、水肿滑膜,摘除游离体,修整损伤关节软骨面,然后用顶棒及克式针撬拨复位固定,用克式针或在克式针导向下,改空心螺钉固定。结果术后根据Burwell-Charnley骨折放射标准,全部骨折解剖复位,术后平均随访7.5个月,按照Kofoed功能评分标准:优14例,良2例,平均93.5分,无功能障碍、疼痛等并发症,患者恢复术前正常的体力活动。结论利用关节镜辅助复位Danis-WeberA/B型踝关节骨折经皮内固定创伤小,骨折复位精确,并发症少,是一项值得推广的微创技术。

微创血肿清除术对脑出血血清TNF-α和IL-6动态变化的影响

目的研究脑出血病人血清肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的动态变化及微创血肿清除术对两者的影响。方法73例急性脑出血病人分为微创术组和内科组,测定入院时及治疗后2d、7d、14d血清TNF-α和IL-6含量,并测定两组治疗前、发病后第14天中国中风神经功能缺损评分(CSS)。结果治疗前两组TNF-α、IL-6含量及CSS比较无统计学意义(P>0.05),术后14d时微创术组的TNF-α、IL-6水平和CSS分值明显低于内科组(P<0.05)。结论脑出血病人急性期血清TNF-α及IL-6明显升高,微创术治疗可抑制或减轻急性脑出血病人TNF-α和IL-6的急剧增加,对改善脑损伤程度,减少炎症及免疫反应具有较好的临床价值。

MA-OTIF与MIS-TLIF治疗对老年性腰椎退行性病变疗效和脊柱形态的影响

目的研究小切口开放经椎间孔腰椎椎体间融合术(MA-OTIF)与微创经椎间孔入路腰椎椎体间融合术(MIS-TLIF)治疗对老年性腰椎退行性病变疗效和脊柱形态的影响。方法选取2016年3月至2018年1月本院收治的老年性腰椎退行性病变患者90例为研究对象,根据治疗方法的不同分为MA-OTIF组和MIS-TLIF组,每组45例。比较两组患者的手术时间,术中出血量,术后引流量,住院时间,术后卧床时间,术前和术后7 d、1个月、12个月的视觉模拟评分(VAS),Oswestry功能障碍评分(ODI),并发症发生率,随访12个月,观察两组患者椎间植骨融合率、脊柱侧弯情况。结果与MIS-TLIF组比较,MA-OTIF组手术时间更短,X线曝光次数更少(P均<0.05),而术中出血量、术后引流量、住院时间、术后卧床时间、并发症发生率差异无统计学意义(P均>0.05);两组术后7 d、1个月、12个月的VAS评分和ODI评分均较术前降低(P<0.05),但两组间比较差异无统计学意义(P>0.05);随访12个月,两组患者椎间植骨融合率、脊柱侧弯发生率差异均无统计学意义(P均>0.05)。结论MA-OTIF与MIS-TLIF治疗老年性腰椎退行性病变疗效相当,但MA-OTIF手术时间更短,X线曝光次数更少。

mini器械在胸乳径路内镜甲状腺手术中的应用(附40例报告)

目的探讨mini器械在胸乳径路内镜甲状腺手术(breast approach endoscopic thyroidectomy,BAET)中的临床应用价值。方法回顾性分析第二军医大学长征医院普外三科2012年9月至2013年12月间在BAET中使用mini器械的40例患者,年龄(33.53±8.76)岁,肿块大小(21.10±10.96)mm。根据术中冰冻病理结果,行单侧腺叶切除19例,甲状腺次全切除术6例,甲状腺全切除术7例,甲状腺癌根治术8例。结果 40例使用mini器械的腔镜手术均顺利完成,无中转开放病例,均达到完整肿瘤切除的目的;手术时间(112.25±31.52)min,VAS-12h(2.48±1.13)分,VAS-24h(0.85±0.80)分,VAS-48h(0.25±0.44)分,RSS(美容评分)为(8.75±1.26)分。术后出现暂时性低钙血症4例和喉返神经麻痹1例。结论在BAET中使用mini器械使传统内镜手术的微创、美学效果等更加优化,同时并未增加手术难度及并发症发生的风险。

局部进展期胃癌新辅助免疫治疗后微创外科治疗的应用现状与进展

新辅助免疫治疗已成为提升局部进展期胃癌(locally advanced gastric cancer,LAGC)治疗效果的有效方式。在微创外科时代,新辅助免疫治疗带来的良好肿瘤学响应、治疗相关不良事件及对术区组织的潜在影响与围手术期安全性及远期生存关系密切。现有证据认为LAGC新辅助免疫治疗后行微创手术尽管操作难度较大,但整体安全可行,远期生存相当。在此基础上,应积极推动临床合作,聚焦新辅助免疫治疗后手术时机选择、淋巴结个体化清扫、功能保留性微创手术等关键问题,以规范及拓展微创手术在LAGC新辅助免疫治疗后外科治疗的适应证。