Background： The Aurora-A （AurA） gene, a key regulator of mitosis, has been proved as an oncogene in a variety of cancers. The Aur-A overexpression has been proved correlated with aggressiveness of cancer cells. How...Background： The Aurora-A （AurA） gene, a key regulator of mitosis, has been proved as an oncogene in a variety of cancers. The Aur-A overexpression has been proved correlated with aggressiveness of cancer cells. However, the frequency of Aur-A protein overexpression, as well as its association with clinicopathologic parameters and prognosis remain unclear in lung adenocarcinoma （ADC）. This study tried to clarify the clinical significance of Aur-A in patients with resected lung ADC. Patients and methods： A total of 142 informative patients with surgically resected lung ADC and 20 normal lung tissues were enrolled. Western blot and immunohistochemistry （IHC） were utilized to assess protein expression of Aur-A. Result： The expression of Aur-A was elevated in most of tumor tissues compared with the adjacent tissues by western blot. The IHC results showed that Aur-A protein was over-expressed in 98 of 142 （69.0%） tumor sections, while Aur-A was low-expressed in all normal lung sections. A positive correlation between Aur-A overexpression rate and ascending pathologic stages was observed （P〈0.05）. Kaplan-Meier analysis demonstrated that patients with Aur-A high expression had significantly inferior survival compared to those with Aur-A low expression. Both overall survival （OS） and disease-free survival （DFS） of positive overexpression patients were shorter than the negative group （P=0.036, P=0.041, respectively）. Multivariate analysis confirmed that Aur-A expression, as an independent and significant factor for both DFS and OS, could predict a poor prognosis in patients with resected lung ADC （P=0.022, P=0.049, respectively）. Conclusions： Aur-A was overexpressed in lung ADC and overexpression of Aur-A might be a novel predictor for poor prognosis and potential therapeutic target in lung ADC.展开更多
PURPOSE: Small-volume bowel preparation is better tolerated than 4-liter polyethylene glycol lavage. However, the efficacy of various small-volume bowel preparation agents for colonoscopy has not been clearly defined....PURPOSE: Small-volume bowel preparation is better tolerated than 4-liter polyethylene glycol lavage. However, the efficacy of various small-volume bowel preparation agents for colonoscopy has not been clearly defined. This randomized, controlled trial was designed to compare oral sodium phosphate (Fleet) with Picoprep(sodium picosulfate-based preparation). METHODS: Two hundred twenty-five outpatients, aged 65 years or younger, who would undergo colonoscopy by two endoscopists were randomized to receive two bottles of oral sodium phosphate or three sachets of Picoprep. A standardized questionnaire was completed by all patients and the endoscopists. The endoscopists were blinded to the preparation used. RESULTS: One hundred three patients were randomized to oral sodium phosphate (Fleet) (Group 1) and 122 patients to Picoprep(Group 2). Three patients were excluded because of colonic strictures. The groups were similar in age and gender, indications for colonoscopy, and previous colonic surgery. The quality of bowel cleansing in patients taking oral sodium phosphate (Fleet) was significantly better than Picoprepas assessed by the endoscopists (P = 0.0014). Both types of bowel preparation were associated with similar incidence of nausea (P = 0.4927), dizziness (P= 0.9663), abdominal cramps (P = 0.7157), and patient acceptability (P = 0.0767). Equal majority from either group would use the same bowel preparation again (91 percent of oral sodium phosphate (Fleet) and 93 percent of Picoprepgroup; P = 0.6172). Although Picoprepwas better tasting (P = 0.0273), oral sodium phosphate (Fleet) was perceived to be a good preparation agent by a greater (although not significant) proportion of patients (P = 0.0853). CONCLUSIONS: Oral sodium phosphate (Fleet) is more effective in bowel cleansing than Picoprepas a bowel preparation agent. Both agents have similar side effects and patient acceptance.展开更多
Purpose: Fecal incontinence caused by a weak or disrupted internal anal sphincter is common but there has been no effective treatment. This prospective study evaluates the medium-term clinical effects of an injectable...Purpose: Fecal incontinence caused by a weak or disrupted internal anal sphincter is common but there has been no effective treatment. This prospective study evaluates the medium-term clinical effects of an injectable silicone biomaterial, PTPTM (Bioplastique), used to augment the internal anal sphincter. Method: Eighty-two patients (64 females; median age, 66 years) with severe fecal incontinence and a low anal resting pressure caused by internal anal sphincter dysfunction (defect, n = 11; intact, n = 71) were randomized to PTPTM injection into intersphincteric space and internal anal sphincter with (Group A, n = 42) or without (Group B, n = 40) guidance by endoanal ultrasound. Both groups were similar in terms of age, gender, past anorectal surgery,duration of follow-up (median,6 months; range, 1-12 months), and baseline continence score. Sixty-two percent of Group A and 55 percent of Group B had prolonged pudendal nerve terminal motor latency. Results: There was no significant complication. Two patients in Group A and four patients in Group B noted minor discomfort at injection sites. At one month postprocedure, endoanal ultrasound confirmed retention of silicone biomaterial without migration. In both groups, fecal continence was significantly improved by PTPTM implants 1 month after injection, but continued to improve significantly for up to 12 months in Group A and 6 months in Group B (P< 0.001). Improvement in fecal continence and maximum anal resting pressure was significantly greater in Group A, in whom injection was guided by endoanal ultrasound, than in Group B. At three months after injection, significantly more Group A patients than Group B patients achieved >50 percent improvement in Wexner’s continence score (69 percent vs. 40 percent; P=0.014). Ninety-three percent of Group A and 92 percent of Group B had >50 percent improvement in global quality of life scores (visual analog scale). At a median followup of 6 months, all domains of the fecal incontinence quality of life scale improved significantly in both groups; however, the physical function and mental health scores of Short Form-12 only improved in Group A. A prolonged pudendal nerve terminal motor latency had no effect on functional outcome in either group. Conclusion: Injection of silicone biomaterial provided amarked improvement in fecal continence and quality of life in patients with internal sphincter dysfunction, despite the presence of pudendal neuropathy.展开更多
基金supported by grants from the Guangdong Provincial Science &Technology Project of China (no 2009B060700036)the Guangdong Provincial Nature Foundation for Doctor Initiative of China (no S2011040002465)
文摘Background： The Aurora-A （AurA） gene, a key regulator of mitosis, has been proved as an oncogene in a variety of cancers. The Aur-A overexpression has been proved correlated with aggressiveness of cancer cells. However, the frequency of Aur-A protein overexpression, as well as its association with clinicopathologic parameters and prognosis remain unclear in lung adenocarcinoma （ADC）. This study tried to clarify the clinical significance of Aur-A in patients with resected lung ADC. Patients and methods： A total of 142 informative patients with surgically resected lung ADC and 20 normal lung tissues were enrolled. Western blot and immunohistochemistry （IHC） were utilized to assess protein expression of Aur-A. Result： The expression of Aur-A was elevated in most of tumor tissues compared with the adjacent tissues by western blot. The IHC results showed that Aur-A protein was over-expressed in 98 of 142 （69.0%） tumor sections, while Aur-A was low-expressed in all normal lung sections. A positive correlation between Aur-A overexpression rate and ascending pathologic stages was observed （P〈0.05）. Kaplan-Meier analysis demonstrated that patients with Aur-A high expression had significantly inferior survival compared to those with Aur-A low expression. Both overall survival （OS） and disease-free survival （DFS） of positive overexpression patients were shorter than the negative group （P=0.036, P=0.041, respectively）. Multivariate analysis confirmed that Aur-A expression, as an independent and significant factor for both DFS and OS, could predict a poor prognosis in patients with resected lung ADC （P=0.022, P=0.049, respectively）. Conclusions： Aur-A was overexpressed in lung ADC and overexpression of Aur-A might be a novel predictor for poor prognosis and potential therapeutic target in lung ADC.
文摘PURPOSE: Small-volume bowel preparation is better tolerated than 4-liter polyethylene glycol lavage. However, the efficacy of various small-volume bowel preparation agents for colonoscopy has not been clearly defined. This randomized, controlled trial was designed to compare oral sodium phosphate (Fleet) with Picoprep(sodium picosulfate-based preparation). METHODS: Two hundred twenty-five outpatients, aged 65 years or younger, who would undergo colonoscopy by two endoscopists were randomized to receive two bottles of oral sodium phosphate or three sachets of Picoprep. A standardized questionnaire was completed by all patients and the endoscopists. The endoscopists were blinded to the preparation used. RESULTS: One hundred three patients were randomized to oral sodium phosphate (Fleet) (Group 1) and 122 patients to Picoprep(Group 2). Three patients were excluded because of colonic strictures. The groups were similar in age and gender, indications for colonoscopy, and previous colonic surgery. The quality of bowel cleansing in patients taking oral sodium phosphate (Fleet) was significantly better than Picoprepas assessed by the endoscopists (P = 0.0014). Both types of bowel preparation were associated with similar incidence of nausea (P = 0.4927), dizziness (P= 0.9663), abdominal cramps (P = 0.7157), and patient acceptability (P = 0.0767). Equal majority from either group would use the same bowel preparation again (91 percent of oral sodium phosphate (Fleet) and 93 percent of Picoprepgroup; P = 0.6172). Although Picoprepwas better tasting (P = 0.0273), oral sodium phosphate (Fleet) was perceived to be a good preparation agent by a greater (although not significant) proportion of patients (P = 0.0853). CONCLUSIONS: Oral sodium phosphate (Fleet) is more effective in bowel cleansing than Picoprepas a bowel preparation agent. Both agents have similar side effects and patient acceptance.
文摘Purpose: Fecal incontinence caused by a weak or disrupted internal anal sphincter is common but there has been no effective treatment. This prospective study evaluates the medium-term clinical effects of an injectable silicone biomaterial, PTPTM (Bioplastique), used to augment the internal anal sphincter. Method: Eighty-two patients (64 females; median age, 66 years) with severe fecal incontinence and a low anal resting pressure caused by internal anal sphincter dysfunction (defect, n = 11; intact, n = 71) were randomized to PTPTM injection into intersphincteric space and internal anal sphincter with (Group A, n = 42) or without (Group B, n = 40) guidance by endoanal ultrasound. Both groups were similar in terms of age, gender, past anorectal surgery,duration of follow-up (median,6 months; range, 1-12 months), and baseline continence score. Sixty-two percent of Group A and 55 percent of Group B had prolonged pudendal nerve terminal motor latency. Results: There was no significant complication. Two patients in Group A and four patients in Group B noted minor discomfort at injection sites. At one month postprocedure, endoanal ultrasound confirmed retention of silicone biomaterial without migration. In both groups, fecal continence was significantly improved by PTPTM implants 1 month after injection, but continued to improve significantly for up to 12 months in Group A and 6 months in Group B (P< 0.001). Improvement in fecal continence and maximum anal resting pressure was significantly greater in Group A, in whom injection was guided by endoanal ultrasound, than in Group B. At three months after injection, significantly more Group A patients than Group B patients achieved >50 percent improvement in Wexner’s continence score (69 percent vs. 40 percent; P=0.014). Ninety-three percent of Group A and 92 percent of Group B had >50 percent improvement in global quality of life scores (visual analog scale). At a median followup of 6 months, all domains of the fecal incontinence quality of life scale improved significantly in both groups; however, the physical function and mental health scores of Short Form-12 only improved in Group A. A prolonged pudendal nerve terminal motor latency had no effect on functional outcome in either group. Conclusion: Injection of silicone biomaterial provided amarked improvement in fecal continence and quality of life in patients with internal sphincter dysfunction, despite the presence of pudendal neuropathy.
