BACKGROUND Whether regional lymphadenectomy(RL)should be routinely performed in patients with T1b gallbladder cancer(GBC)remains a subject of debate.AIM To investigate whether RL can improve the prognosis of patients ...BACKGROUND Whether regional lymphadenectomy(RL)should be routinely performed in patients with T1b gallbladder cancer(GBC)remains a subject of debate.AIM To investigate whether RL can improve the prognosis of patients with T1b GBC.METHODS We studied a multicenter cohort of patients with T1b GBC who underwent surgery between 2008 and 2016 at 24 hospitals in 13 provinces in China.The logrank test and Cox proportional hazards model were used to compare the overall survival(OS)of patients who underwent cholecystectomy(Ch)+RL and those who underwent Ch only.To investigate whether combined hepatectomy(Hep)improved OS in T1b patients,we studied patients who underwent Ch+RL to compare the OS of patients who underwent combined Hep and patients who did not.RESULTS Of the 121 patients(aged 61.9±10.1 years),77(63.6%)underwent Ch+RL,and 44(36.4%)underwent Ch only.Seven(9.1%)patients in the Ch+RL group had lymph node metastasis.The 5-year OS rate was significantly higher in the Ch+RL group than in the Ch group(76.3%vs 56.8%,P=0.036).Multivariate analysis showed that Ch+RL was significantly associated with improved OS(hazard ratio:0.51;95%confidence interval:0.26-0.99).Among the 77 patients who underwent Ch+RL,no survival improvement was found in patients who underwent combined Hep(5-year OS rate:79.5%for combined Hep and 76.1%for no Hep;P=0.50).CONCLUSION T1b GBC patients who underwent Ch+RL had a better prognosis than those who underwent Ch.Hep+Ch showed no improvement in prognosis in T1b GBC patients.Although recommended by both the National Comprehensive Cancer Network and Chinese Medical Association guidelines,RL was only performed in 63.6%of T1b GBC patients.Routine Ch+RL should be advised in T1b GBC.展开更多
BACKGROUND:The efficacy of clinical islet transplanta-tion has been demonstrated with autografts,and although islet allografts have established insulin independence in a small number of IDDM patients,the treatment is ...BACKGROUND:The efficacy of clinical islet transplanta-tion has been demonstrated with autografts,and although islet allografts have established insulin independence in a small number of IDDM patients,the treatment is con-founded by the necessity of central cell damage immuno-suppression,the lack of donor tissue,and recurring islet immunogenicity.These limitations underscore a need to develop therapies to serve the large population of diabetic patients.This study was designed to document central cell damage to isolated islets of Langerhans in hamsters and its prevention.METHODS:Islets were cultured at 37°C for 7-14 days after isolation,and then at 26°C for 2,4 and 7 days before addi-tional culture at 37°C for an additional 7 days.Central cell damage in the isolated islets was monitored by video-mi-croscopy and analyzed quantitatively by a computer-assis-ted image analysis system.The analysis included daily measurement of the diameter and the area of the isolated is-lets and the area of the central cell damage that developed in those islets over time during culture.Histological exami-nation and TdT-mediated dUTP-biotin nick end labeling(TUNEL)assay were used to characterize cell damage and to monitor islet function.RESULTS;Microscopic analysis showed that during the 7 to 14 days of culture at 37°C,central cell damage appeared in the larger islets with diameters greater than 200μm,which included both necrotic and apoptotic cell death.Low temperature(26°C)culture prevented central cell damage of isolated islets.The 7-day culture procedure at 26°C could inhibit most of the central cell(excluding diameters greater than 300μm)damage when the islets were re-warmed to 37°C.CONCLUSIONS:Our results indicate that central cell da-mage to isolated islets of Langerhans correlates with the size of the islets.Low temperature(26°C)culture can preventcentral cell damage to the isolated islets,and is capable to successfully precondition these islets for 37°C culture.These novel findings may help to understand the patho-physiology of early loss of islet tissue after transplantation,and may provide a new strategy to improve graft function in the clinical setting of islet transplantation.展开更多
Objective:To investigate the precise species of tick vector and the Borrelia spirochete pathogen at the Heilongjiang Province international border with Russia.Methods:In dus study,ticks were collected from 12 Heilongj...Objective:To investigate the precise species of tick vector and the Borrelia spirochete pathogen at the Heilongjiang Province international border with Russia.Methods:In dus study,ticks were collected from 12 Heilongjiang border crossings(including grasslands,shrublands,forests,and plantantions) to determine the rate and species type of spirochete-infected ticks and the most prevalent spirochete genotypes.Results:The ticks represented three genera and four species of the Ixodidae family[Ixodes persidcatus,Dermacentor silvarum,Haemapkysalis concinna and Haemaphysalis japonica].Ixodes persulcatus had the highest amount of Borrelia burgdorferi sensu lata infection of 25.6%and the most common species of Borrelia isolated from Ixodes persulcatus mas Borrelia garinii,strain PD91.Conclusions:Our results suggest that Borrelia garinii PD91- infected Ixodes persulcatus may be the principal cause of Lyme disease in the border crossing areas of Heilongjiang Province.展开更多
基金National Natural Science Foundation of China(General Program),No.31620103910National Natural Science Foundation of China(Key Program),No.81874181+3 种基金National Health Commission of China,No.2019ZX09301158Shanghai Municipal Commission of Economy and Informatization,No.2019RGZN01096Shanghai Shenkang Hospital Development Center,No.12018107and Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,No.19XHCR13D.
文摘BACKGROUND Whether regional lymphadenectomy(RL)should be routinely performed in patients with T1b gallbladder cancer(GBC)remains a subject of debate.AIM To investigate whether RL can improve the prognosis of patients with T1b GBC.METHODS We studied a multicenter cohort of patients with T1b GBC who underwent surgery between 2008 and 2016 at 24 hospitals in 13 provinces in China.The logrank test and Cox proportional hazards model were used to compare the overall survival(OS)of patients who underwent cholecystectomy(Ch)+RL and those who underwent Ch only.To investigate whether combined hepatectomy(Hep)improved OS in T1b patients,we studied patients who underwent Ch+RL to compare the OS of patients who underwent combined Hep and patients who did not.RESULTS Of the 121 patients(aged 61.9±10.1 years),77(63.6%)underwent Ch+RL,and 44(36.4%)underwent Ch only.Seven(9.1%)patients in the Ch+RL group had lymph node metastasis.The 5-year OS rate was significantly higher in the Ch+RL group than in the Ch group(76.3%vs 56.8%,P=0.036).Multivariate analysis showed that Ch+RL was significantly associated with improved OS(hazard ratio:0.51;95%confidence interval:0.26-0.99).Among the 77 patients who underwent Ch+RL,no survival improvement was found in patients who underwent combined Hep(5-year OS rate:79.5%for combined Hep and 76.1%for no Hep;P=0.50).CONCLUSION T1b GBC patients who underwent Ch+RL had a better prognosis than those who underwent Ch.Hep+Ch showed no improvement in prognosis in T1b GBC patients.Although recommended by both the National Comprehensive Cancer Network and Chinese Medical Association guidelines,RL was only performed in 63.6%of T1b GBC patients.Routine Ch+RL should be advised in T1b GBC.
文摘BACKGROUND:The efficacy of clinical islet transplanta-tion has been demonstrated with autografts,and although islet allografts have established insulin independence in a small number of IDDM patients,the treatment is con-founded by the necessity of central cell damage immuno-suppression,the lack of donor tissue,and recurring islet immunogenicity.These limitations underscore a need to develop therapies to serve the large population of diabetic patients.This study was designed to document central cell damage to isolated islets of Langerhans in hamsters and its prevention.METHODS:Islets were cultured at 37°C for 7-14 days after isolation,and then at 26°C for 2,4 and 7 days before addi-tional culture at 37°C for an additional 7 days.Central cell damage in the isolated islets was monitored by video-mi-croscopy and analyzed quantitatively by a computer-assis-ted image analysis system.The analysis included daily measurement of the diameter and the area of the isolated is-lets and the area of the central cell damage that developed in those islets over time during culture.Histological exami-nation and TdT-mediated dUTP-biotin nick end labeling(TUNEL)assay were used to characterize cell damage and to monitor islet function.RESULTS;Microscopic analysis showed that during the 7 to 14 days of culture at 37°C,central cell damage appeared in the larger islets with diameters greater than 200μm,which included both necrotic and apoptotic cell death.Low temperature(26°C)culture prevented central cell damage of isolated islets.The 7-day culture procedure at 26°C could inhibit most of the central cell(excluding diameters greater than 300μm)damage when the islets were re-warmed to 37°C.CONCLUSIONS:Our results indicate that central cell da-mage to isolated islets of Langerhans correlates with the size of the islets.Low temperature(26°C)culture can preventcentral cell damage to the isolated islets,and is capable to successfully precondition these islets for 37°C culture.These novel findings may help to understand the patho-physiology of early loss of islet tissue after transplantation,and may provide a new strategy to improve graft function in the clinical setting of islet transplantation.
文摘Objective:To investigate the precise species of tick vector and the Borrelia spirochete pathogen at the Heilongjiang Province international border with Russia.Methods:In dus study,ticks were collected from 12 Heilongjiang border crossings(including grasslands,shrublands,forests,and plantantions) to determine the rate and species type of spirochete-infected ticks and the most prevalent spirochete genotypes.Results:The ticks represented three genera and four species of the Ixodidae family[Ixodes persidcatus,Dermacentor silvarum,Haemapkysalis concinna and Haemaphysalis japonica].Ixodes persulcatus had the highest amount of Borrelia burgdorferi sensu lata infection of 25.6%and the most common species of Borrelia isolated from Ixodes persulcatus mas Borrelia garinii,strain PD91.Conclusions:Our results suggest that Borrelia garinii PD91- infected Ixodes persulcatus may be the principal cause of Lyme disease in the border crossing areas of Heilongjiang Province.
