Publications by authors named "Jian Tan"

281 Publications

Vertical profiling of black carbon and ozone using a multicopter unmanned aerial vehicle (UAV) in urban Shenzhen of South China.

Sci Total Environ 2021 Aug 17;801:149689. Epub 2021 Aug 17.

Department of Civil and Environmental Engineering and Centre for Regional Oceans, Faculty of Science and Technology, University of Macau, Taipa, Macau. Electronic address:

Existing studies on vertical profiling of black carbon (BC) and ozone (O) were mainly conducted in the rural areas, leading to limited knowledge of their vertical distributions in the urban area. To fill this knowledge gap, vertical profiling (0-500 m and 0-900 m, AGL) of BC and O was conducted in a highly urbanized area of Shenzhen in subtropical South China using a multicopter unmanned aerial vehicle (UAV) platform. In total 32 flights were conducted from the 10th to 15th, December 2017 (winter campaign) and 42 flights from the 19th to 28th, August 2018 (summer campaign) with 4 time slots per day, including morning, afternoon, evening, and midnight. In general, equivalent BC (eBC) concentration decreased as the height increased with an overall slope of -0.13 μg m per 100 m in the winter campaign and -0.08 μg m per 100 m in the summer campaign. On the contrary, an increase of O level with altitude was observed (7.8 ppb per 100 m). Absorption Ångström exponent (AAE) exhibits a slightly increasing trend with height. Seasonality of eBC vertical profiles was observed in morning, afternoon and midnight flights, but not for evening flights. The analysis showed the shape of vertical profiles of eBC and O can be affected by planetary boundary layer height (PBLH) and air mass origin. Calculated heating rates due to BC show distinct seasonal variability for morning but not for afternoon, because of the counteracting effects by solar irradiance in the subtropical afternoon and eBC concentration in urban South China influenced by the monsoon climate.
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http://dx.doi.org/10.1016/j.scitotenv.2021.149689DOI Listing
August 2021

Dietary carbohydrate, particularly glucose, drives B cell lymphopoiesis and function.

iScience 2021 Aug 10;24(8):102835. Epub 2021 Jul 10.

Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.

While diet modulates immunity, its impact on B cell ontogeny remains unclear. Using mixture modeling, a large-scale isocaloric dietary cohort mouse study identified carbohydrate as a major driver of B cell development and function. Increasing dietary carbohydrate increased B cell proportions in spleen, mesenteric lymph node and Peyer's patches, and increased antigen-specific immunoglobulin G production after immunization. This was linked to increased B lymphopoiesis in the bone marrow. Glucose promoted early B lymphopoiesis and higher total B lymphocyte numbers than fructose. It drove B cell development through glycolysis and oxidative phosphorylation, independently of fatty acid oxidation and reduced B cell apoptosis in early development via mTOR activation, independently of interleukin-7. Ours is the first comprehensive study showing the impact of macronutrients on B cell development and function. It shows the quantitative and qualitative interplay between dietary carbohydrate and B cells and argues for dietary modulation in B cell-targeting strategies.
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http://dx.doi.org/10.1016/j.isci.2021.102835DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8333167PMC
August 2021

Incorporation of an intercostal catheter into a multimodal analgesic strategy for uniportal video-assisted thoracoscopic surgery: a feasibility study.

J Cardiothorac Surg 2021 Jul 31;16(1):210. Epub 2021 Jul 31.

Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, National University Health Systems, Singapore, Singapore.

Background: Well-controlled postoperative pain is essential for early recovery after uniportal video-assisted thoracoscopic surgery (UVATS). Conventional analgesia like opioids and thoracic epidural anaesthesia have been associated with hypotension and urinary retention. Intercostal catheters are a regional analgesic alternative that can be inserted during UVATS to avoid these adverse effects. This feasibility study aims to evaluate the postoperative pain scores and analgesic requirements with incorporation of an intercostal catheter into a multimodal analgesic strategy for UVATS.

Methods: In this observational study, 26 consecutive patients who underwent UVATS were administered a multilevel intercostal block and oral paracetamol. All of these patients received 0.2% ropivacaine continuously at 4 ml/h via an intercostal catheter at the level of the incision. Rescue analgesia including etoricoxib, gabapentin and opioids were prescribed using a pain ladder approach. Postoperative pain scores and analgesic usage were assessed. The secondary outcomes were postoperative complications, days to ambulation and length of stay.

Results: No technical difficulties were encountered during placement of the intercostal catheter. There was only one case of peri-catheter leakage. Mean pain score was 0.31 (range 0-2) on post-operative day 1 and was 0.00 by post-operative day 5. 16 patients (61.6%) required only oral rescue analgesia. The number of patients who required rescue non-opioids only increased from 1 in the first 7 months to 8 in the next 7 months. There were no cases of hypotension or urinary retention. Median time to ambulation was 1 day (range 1-2). Mean post-operative length of stay was 4.17 ± 2.50 days.

Conclusions: Incorporation of an intercostal catheter into a multimodal analgesia strategy for UVATS is feasible and may provide adequate pain control with decreased opioid usage.
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http://dx.doi.org/10.1186/s13019-021-01590-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325303PMC
July 2021

A Randomized, Phase III Study of Lenvatinib in Chinese Patients with Radioiodine-Refractory Differentiated Thyroid Cancer.

Clin Cancer Res 2021 Jul 29. Epub 2021 Jul 29.

Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.

Purpose: Lenvatinib has shown efficacy in treating radioiodine-refractory differentiated thyroid cancer (RR-DTC) in the multinational phase III SELECT study; however, it has not been tested in Chinese patients with RR-DTC.

Experimental Design: Chinese patients with confirmed RR-DTC ( = 151) were randomly assigned 2:1 to receive lenvatinib 24 mg/day or placebo in 28-day cycles. The primary endpoint was progression-free survival, and key secondary endpoints included objective response rate and safety. Analyses for progression-free survival and objective response rate were conducted using Response Evaluation Criteria in Solid Tumors v1.1 and confirmed by independent imaging review. All adverse events were assessed and monitored.

Results: Progression-free survival was significantly longer with lenvatinib treatment [ = 103; median 23.9 months; 95% confidence interval (CI), 12.9-not estimable] versus placebo ( = 48; median 3.7 months; 95% CI, 1.9-5.6; hazard ratio = 0.16; 95% CI, 0.10-0.26; < 0.0001). The objective response rate was 69.9% (95% CI, 61.0-78.8) in the lenvatinib arm and 0% (95% CI, 0-0) in the placebo arm. At data cutoff, 60.2% of patients receiving lenvatinib remained on treatment; treatment-emergent adverse events led to lenvatinib discontinuation in 8.7% of patients. Overall, treatment-emergent adverse events of grade ≥3 occurred in 87.4% of patients in the lenvatinib arm, the most common being hypertension (62.1%) and proteinuria (23.3%).

Conclusions: Lenvatinib at a starting dose of 24 mg/day significantly improved progression-free survival and objective response rate in Chinese patients with RR-DTC versus placebo. There were no new or unexpected toxicities. Results are consistent with those from SELECT involving patients with RR-DTC.
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http://dx.doi.org/10.1158/1078-0432.CCR-21-0761DOI Listing
July 2021

The maternal gut microbiome during pregnancy and offspring allergy and asthma.

J Allergy Clin Immunol 2021 Sep 24;148(3):669-678. Epub 2021 Jul 24.

Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Child Health Research Unit, Barwon Health, Geelong, Australia; the Centre For Food Allergy Research, Murdoch Children's Research Institute, Parkville. Electronic address:

Environmental exposures during pregnancy that alter both the maternal gut microbiome and the infant's risk of allergic disease and asthma include a traditional farm environment and consumption of unpasteurized cow's milk, antibiotic use, dietary fiber, and psychosocial stress. Multiple mechanisms acting in concert may underpin these associations and prime the infant to acquire immune competence and homeostasis following exposure to the extrauterine environment. Cellular and metabolic products of the maternal gut microbiome can promote the expression of microbial pattern recognition receptors, as well as thymic and bone marrow hematopoiesis relevant to regulatory immunity. At birth, transmission of maternally derived bacteria likely leverages this in utero programming to accelerate postnatal transition from a T2- to T1- and T17-dominant immune phenotype and maturation of regulatory immune mechanisms, which in turn reduce the child's risk of allergic disease and asthma. Although our understanding of these phenomena is rapidly evolving, the field is relatively nascent, and we are yet to translate existing knowledge into interventions that substantially reduce disease risk in humans. Here, we review evidence that the maternal gut microbiome impacts the offspring's risk of allergic disease and asthma, discuss challenges and future directions for the field, and propose the hypothesis that maternal carriage of Prevotella copri during pregnancy decreases the offspring's risk of allergic disease via production of succinate, which in turn promotes bone marrow myelopoiesis of dendritic cell precursors in the fetus.
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http://dx.doi.org/10.1016/j.jaci.2021.07.011DOI Listing
September 2021

[Effect of CT localization of upper airway obstruction site after inducing sleep on the value of obstructive sleep apnea hypopnea syndrome and the effect of surgery].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Aug;35(8):683-688

Department of Otolaryngology,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430014,China.

To explore the value of CT location of the upper airway obstruction site after inducing sleep on the condition of obstructive sleep apnea(OSA) and its surgical efficacy. Forty patients with moderate-to-severe OSA diagnosed by polysomnography, first performed awake CT scan, then, the patient was slowly injected intravenously with dexmedetomidine to induce sleep, when the patient was apnea during sleep, CT scan of the corresponding part of the upper airway was performed. Compare and measure the cross-sectional area of the upper airway stenosis level in the two states, and evaluate the correlation between the cross-sectional area of the stenosis level after induction of sleep and the patient's AHI, blood oxygen saturation<90% of the time(CT90). According to the change value of the cross-sectional area of each plane, it was divided into 2 groups, 22 cases in first group underwent hypothermia plasma uvulapalatopharyngoplasty, and 18 cases in second group underwent multi-plane combined surgery. After 12 months of follow-up, compare the post-long-term efficacy, changes in cross-sectional area values of various narrow planes before and after surgery, and changes in indicators related to sleep quality between the two groups. Compared with the cross-sectional area of the nasopharyngeal area, posterior soft palate area, the posterior tongue area, and the epiglottis area measured by upper airway CT under awake breathing state, the cross-sectional area of each obstruction plane during sleep state decreased(<0.01). The minimum cross-sectional area of the upper airway plane sleep phase was negatively correlated with AHI and CT90, and the posterior soft palate and the posterior lingual base were highly correlated with AHI and CT90.12 months after treatment, the minimum cross-sectional area of each phase of the sleep phase in the experimental group 1 was significantly improved(<0.01) compared with that before treatment, followed by the posterior tongue area(<0.05). There was no statistical difference between the nasopharyngeal area and the epiglottis area. The differences in nasopharyngeal area, posterior soft palate area, posterior tongue area, and epiglottis area in experimental group 2 after treatment were statistically significant(<0.01 or <0.05), compared with that before treatment. The sleep-related indexes ESS, CT90, AHI, and LSaO₂ of the two groups were better than those before treatment after 12 months of treatment(<0.01). Comparison of experiment group 1 and 2, the effective rates were 72.72% and 95.23%(χ²=10.62, <0.01), the significant efficiency was 58.33% and 80.45%(χ²=8.62, <0.01), and the cure rates were 12.37% and 17.48%(x²=7.62, <0.01). CT examination of OSA patients after drug-induced sleep is safe and feasible, and it has important value for the accurate location of the upper airway obstruction site. 64-slice spiral CT upper airway scanning under induced sleep has guiding significance for the evaluation of OSA patients' condition and long-term surgical efficacy.
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http://dx.doi.org/10.13201/j.issn.2096-7993.2021.08.003DOI Listing
August 2021

Urinary iodine concentration and radioactive iodine therapeutic response in patients with differentiated thyroid cancer.

Biomark Med 2021 Aug 9;15(11):879-890. Epub 2021 Jul 9.

Tianjin University of Traditional Chinese Medicine, Jian Kang Chan Ye Yuan, Tianjin, PR China.

Urinary iodine concentration (UIC) may assess radioactive iodine ablation. According the 2015 American Thyroid Association guidelines, patients were categorized into low- to intermediate-risk or high-risk groups. The iodine concentration in the morning urine specimens was measured by the ceric ion-arsenious acid method. In the low- to intermediate-risk group (113 cases), nonexcellent response (non-ER) was associated with higher UIC, higher UIC subgroups (p < 0.05), higher pre-ablative stimulated thyroglobulin levels (p < 0.01). In the high-risk group (68 cases), the non-ER rate was higher in the higher pre-ablative stimulated thyroglobulin group (p < 0.01), but not significantly different between the UIC and UIC subgroups (p > 0.05). The non-ER rate was related to UIC in the low- to intermediate-risk group; however, UIC did not affect the non-ER rate in the high-risk group.
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http://dx.doi.org/10.2217/bmm-2020-0745DOI Listing
August 2021

The Influences of TSH Stimulation Level, Stimulated Tg Level and Tg/TSH Ratio on the Therapeutic Effect of I Treatment in DTC Patients.

Front Endocrinol (Lausanne) 2021 11;12:601960. Epub 2021 Jun 11.

Department of Otolaryngology Head and Neck Surgery, Tianjin Fourth Central Hospital, Tianjin, China.

Purpose: To study the influences of pre-ablation TSH stimulation level, sTg and sTg/TSH ratio on the therapeutic effect of the first I treatment in DTCs.

Methods: According to the thyroid stimulating hormone (TSH) levels (mU/l), all the 479 differentiated thyroid cancer (DTC) patients were divided into two groups: TSH < 30 and TSH ≥ 30. The TSH ≥ 30 group was divided into three subgroups: 30 ≤ TSH < 60, 60 ≤ TSH < 90 and TSH ≥ 90. The clinical features and the therapeutic effects of the first I treatment were analyzed. The cutoffs of stimulated thyroglobulin (sTg) and sTg/TSH ratio were calculated to predict the therapeutic effect of I treatment.

Results: Among the three subgroups, the TSH ≥ 90 subgroup was younger and less likely to be associated with cervical lymph node metastasis (LNM). The postoperative levothyroxine (L-T) dose in the 60 ≤ TSH < 90 subgroup was the lowest. Between the two groups, patients in the TSH < 30 group had higher postoperative L-T dose and longer thyroid hormone withdrawal (THW) time. The excellent response rates six months after the first I treatment among the three subgroups and between the two groups were not of statistical significance. The distribution of different TSH stimulation levels among each response group was similar. The cutoffs for the better therapeutic effect of the first I treatment in sTg and sTg/TSH were < 9.51 ng/ml and < 0.11, respectively. Both univariate and multivariate logistic regressions showed that cervical LNM, distant metastasis, higher sTg and higher sTg/TSH ratio predicted poorer therapeutic effect.

Conclusions: There was no significant influence of TSH stimulation levels before the first I treatment on the therapeutic effect of DTC. The sTg/TSH ratio can be considered as another predictor of I therapeutic effect.
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http://dx.doi.org/10.3389/fendo.2021.601960DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8232882PMC
June 2021

Tryptophan in the diet ameliorates motor deficits in a rotenone-induced rat Parkinson's disease model via activating the aromatic hydrocarbon receptor pathway.

Brain Behav 2021 Aug 9;11(8):e2226. Epub 2021 Jun 9.

Department of Neurology, The First Affiliated Hospital, University of South China, Hengyang, PR China.

Background And Purpose: Parkinson's disease (PD), a common neurodegenerative disorder with motor and nonmotor symptoms, does not have effective treatments. Dietary tryptophan (Trp) supplementation has potential benefits for the treatment of multiple disorders. However, whether additional Trp in the diet could be beneficial for PD remains to beinvestigated. In the present study, the neuroprotective role of dietary Trp on a rotenone-induced rat model of PD was determined.

Methods: The rotenone was injected to build the PD model, and then the rats were treated with Trp in the diet. And then, an open field test, western blot analysis, and enzyme linked immunosorbent assay (ELISA) were performed.

Results: We observed that dietary Trp significantly ameliorated impaired motor function, upregulated tyrosine hydroxylase expression, inhibited the nuclear transport of Nuclear factor-kappa B (NF-κB) in substantia nigra (SN), and downregulated the protein levels of IL-1β, IL-6, and TNF-α in serum in rotenone-treated rats. However, these patterns were reversed in response to treatment with ampicillin, an agent that can clean intestinal Trp metabolism flora. Moreover, after using CH223191, an inhibitor of the aromatic hydrocarbon receptor (AhR) pathway, dietary Trp could not exert neuroprotective roles in the rotenone-induced rat model of PD.

Conclusion: These results suggest that Trp in the diet can protect against rotenone-induced neurotoxicity to ameliorate motor deficits, which may be mediated through activating AhR pathway.
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http://dx.doi.org/10.1002/brb3.2226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413809PMC
August 2021

Predictive Value of Thyroglobulin Changes for the Curative Effect of Radioiodine Therapy in Patients With Metastatic Differentiated Thyroid Carcinoma.

Front Endocrinol (Lausanne) 2021 10;12:667544. Epub 2021 May 10.

Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China.

Background: Serum thyroglobulin (Tg) serves as a sensitive and easily available tumor marker for patients with metastatic differentiated thyroid carcinoma (m-DTC). The aim of the present study was to evaluate the predictive value of suppressed Tg changes (Δsup-Tg) and/or stimulated Tg changes (Δsti-Tg) to evaluate the efficacy of radioiodine therapy (RT).

Methods: We studied 117 patients with m-DTC who received RT. Δsup-Tg and Δsti-Tg were compared after the first RT in different therapeutic response groups and a receiver-operating characteristic (ROC) curve was used to determine the cut-off values to predict non-remission. Univariate and multivariate analyses were used to investigate the effects of 17 observed factors on the efficacy of RT.

Results: A total of 218 RT events in 117 patients with m-DTC were analyzed. After the last RT, the remission rate was 70.94% (83/117), and the proportion of remission events accounted for 74.77% (163/218). ROC curve analysis showed that the cut-off values for Δsup-Tg and Δsti-Tg after the first RT to predict the non-remission of RT were 21.54% and 27.63%, respectively. Age, the size of the metastasis, the maximum count of target metastatic lesions and the average count of contralateral non-target tissue on tomographic imaging (T/NT) of the first RT, and Δsup-Tg after the first RT were identified as independent factors associated with RT efficacy.

Conclusions: Tg response was valuable to predict RT efficacy for patients with m-DTC. Age, the size of the metastasis, T/NT and Δsup-Tg after the first RT were verified as independent predictive factors of RT efficacy.
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http://dx.doi.org/10.3389/fendo.2021.667544DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142149PMC
May 2021

The perioperative application of continuous cerebral autoregulation monitoring for cerebral protection in elderly patients.

Ann Palliat Med 2021 Apr;10(4):4582-4592

Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.

Background: The majority of surgical patients aged 65 years and over are accompanied with underlying conditions, making them susceptible to perioperative cerebral complications. Here, we investigated the clinical value of continuous cerebral autoregulation (CA) monitoring in protecting against cerebral dysfunction in elderly patients undergoing surgery.

Methods: This study enrolled 40 elderly patients (aged ≥65 years) and 40 middle-aged patients (aged 45 to 64 years) selected to undergo robotic-assisted laparoscopic radical prostatectomy. Cerebral oxygenation was assessed by regional cerebral oxygen saturation (rScO2) using near-infrared spectroscopy (NIRS). CA function was estimated using the cerebral oximetry index (COX), which is the rolling correlation between rScO2 and the mean arterial pressure (MAP). With the patient in the Trendelenburg position, the rScO2, MAP, calculated COX, HR, end-tidal CO2, and sevoflurane concentrations were continuously recorded. Standardized anesthesia was administered to all patients (sevoflurane, propofol, remifentanil, and rocuronium). Postoperative delirium (POD) was screened for daily using the Confusion Assessment Method (CAM). The primary outcome was the difference in periods of CA dysfunction between the elderly and middle-aged groups. Secondary outcomes included the incidence of POD and the optimal MAP range in the 2 groups.

Results: Taking positive COX values (cutoff ≥0.3) to reflect periods of CA dysfunction, we found that the cumulative duration of CA dysfunction in the Trendelenburg position was longer in elderly patients than in middle-aged patients [ratio of cumulative time of CA dysfunction: middle-aged group, 32.8% (26.3%, 43.1%) vs. elderly group, 42.2% (33.1%, 51.2%)] (P<0.01), which showed that CA function was less efficient in elderly patients. Three patients (7.5%) in the elderly group and 1 patient (2.5%) in the middle-aged group screened positive for POD on at least 1 day during their hospital stay. Additionally, using the COX-based method, we estimated the optimal MAP targets in the middle-aged and elderly groups to be (67.8±8.9, 116.4±10.5) and (71.2±12.5, 111.3±8.9) mmHg, respectively.

Conclusions: The brains of patients ≥65 years are more vulnerable to systemic insult compared with those of middle-aged patients. POD may be associated with CA dysfunction. NIRS-derived COX can be used to identify the optimal MAP range.
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http://dx.doi.org/10.21037/apm-21-707DOI Listing
April 2021

How Changes in the Nutritional Landscape Shape Gut Immunometabolism.

Nutrients 2021 Mar 2;13(3). Epub 2021 Mar 2.

The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia.

Cell survival, proliferation and function are energy-demanding processes, fuelled by different metabolic pathways. Immune cells like any other cells will adapt their energy production to their function with specific metabolic pathways characteristic of resting, inflammatory or anti-inflammatory cells. This concept of immunometabolism is revolutionising the field of immunology, opening the gates for novel therapeutic approaches aimed at altering immune responses through immune metabolic manipulations. The first part of this review will give an extensive overview on the metabolic pathways used by immune cells. Diet is a major source of energy, providing substrates to fuel these different metabolic pathways. Protein, lipid and carbohydrate composition as well as food additives can thus shape the immune response particularly in the gut, the first immune point of contact with food antigens and gastrointestinal tract pathogens. How diet composition might affect gut immunometabolism and its impact on diseases will also be discussed. Finally, the food ingested by the host is also a source of energy for the micro-organisms inhabiting the gut lumen particularly in the colon. The by-products released through the processing of specific nutrients by gut bacteria also influence immune cell activity and differentiation. How bacterial metabolites influence gut immunometabolism will be covered in the third part of this review. This notion of immunometabolism and immune function is recent and a deeper understanding of how lifestyle might influence gut immunometabolism is key to prevent or treat diseases.
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http://dx.doi.org/10.3390/nu13030823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999246PMC
March 2021

Thyroidectomy for thyroid cancer via transareola single-site endoscopic approach: results of a case-match study with large-scale population.

Surg Endosc 2021 Mar 29. Epub 2021 Mar 29.

Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.

Background: Due to technical challenges, single-site endoscopic thyroidectomy (SSET) is seldom reported and has been attempted in only limited cases. This large-scale study aimed to compare the clinical outcomes of standardized transareola SSET (TASSET) with those of conventional open thyroidectomy (COT) for thyroid cancer.

Methods: The data were prospectively collected, and case-match study was performed at a ratio of 1:1 according to age, sex, body mass index, lesion size, number of lesion foci, lesion side, recurrent laryngeal nerve (RLN) exploration and pathology. Two hundred eligible patients underwent TASSET, and the same number of patients was selected for propensity score matching from 2256 patients who underwent COT. Perioperative data, including surgical profile, oncological and traumatic burdens, and cosmetic satisfaction, were analyzed.

Results: No significant differences were observed in blood loss or drainage between TASSET and COT groups. There were no differences in operation time between TASSET and COT (106.39 ± 28.44 vs 102.55 ± 23.10 min, p = 0.154). A total of 3.63 ± 1.82 lymph nodes (LNs) were retrieved from CND with 0.96 ± 1.42 positive in TASSET. In COT, the total and positive LN yields were 3.77 ± 1.91 and 0.99 ± 1.40 (p = 0.445, p = 0.802). Cancer recurrence was not observed in either group. There were no differences in the occurrence of permanent and transient hoarseness or RLN injuries. Postoperative flap seroma or hematoma occurred in 12 TASSET patients and 58 COT patients (p < 0.001). The pain score, CRP level and ESR in TASSET group were lower than those in COT group. TASSET yielded significantly better incision recovery and cosmetic scores than did COT at both the proliferation and stabilization stages.

Conclusions: TASSET is technically feasible and yields enhanced recovery with minimally invasive and cosmetic advantages without compromising the level of safety or cancer eradication.
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http://dx.doi.org/10.1007/s00464-021-08424-yDOI Listing
March 2021

Calcium-binding and coiled-coil domain 2 promotes the proliferation and suppresses apoptosis of prostate cancer cells.

Exp Ther Med 2021 Apr 25;21(4):405. Epub 2021 Feb 25.

Department of Urology, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212012, P.R. China.

Prostate cancer (PCa) is considered to be one of the most common tumors in men. Calcium-binding and coiled-coil domain 2 (CALCOCO2) is a known important xenophagy receptor, which mediates intracellular bacterial degradation. To the best of the authors' knowledge, the present study is the first to demonstrate that CALCOCO2 functions as an oncogene in PCa. The results of the current study indicated that CALCOCO2 knockdown suppressed cell proliferation and colony formation, whereas it promoted apoptosis of PCa cells. In addition, knockdown of CALCOCO2 in PCa cells reduced cyclin-E1 and increased p53 protein expression. Bioinformatics analysis revealed that CALCOCO2 was associated with 'autophagosome assembly', 'nucleophagy' and 'nucleic acid metabolic process' biological processes and interacted with sequestosome-1, microtubule-associated proteins 1A/1B light chain 3 (MAP1LC3)B, γ-aminobutyric acid receptor-associated protein, IκB kinase subunit γ and MAP1LC3C. Moreover, CALCOCO2 protein levels were indicated to be significantly increased in PCa samples compared with normal prostate tissues. These results suggested that CALCOCO2 may be of value as a diagnostic and therapeutic target in PCa.
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http://dx.doi.org/10.3892/etm.2021.9836DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938445PMC
April 2021

Ectopic sphenoid sinus pituitary adenoma masquerading as metastatic head and neck cancer.

BMJ Case Rep 2021 Mar 10;14(3). Epub 2021 Mar 10.

Otorhinolaryngology, Tan Tock Seng Hospital, Singapore.

A 68-year-old Chinese man was found to have a lobular mass in the sphenoid sinus which extended to the clivus and the roof of the nasopharynx on a staging MRI scan performed for his high-grade parotid salivary duct carcinoma. Further positron emission tomography scan showed that this lesion was fluorodeoxyglucose (FDG) avid. This proved to be a diagnostic dilemma. The patient underwent a total parotidectomy, left selective neck dissection and a transphenoidal biopsy of his nasal lesion. Final histology revealed that this lesion was a synchronous ectopic sphenoid sinus pituitary adenoma (ESSPA). Initial differential diagnoses that were considered included a chordoma, metastatic carcinoma and nasopharyngeal carcinoma. However, an important differential with a neoplastic appearance and a tendency for positive FDG uptake is an ESSPA. It requires dedicated immunohistochemical staining to diagnose, and its mainstay of treatment is surgical excision.
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http://dx.doi.org/10.1136/bcr-2020-240411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7949438PMC
March 2021

MiR-199a-5p-HIF-1α-STAT3 Positive Feedback Loop Contributes to the Progression of Non-Small Cell Lung Cancer.

Front Cell Dev Biol 2020 18;8:620615. Epub 2021 Feb 18.

Department of Thoracic Surgery, Thoracic Cancer Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Non-small cell lung cancer (NSCLC) is the most common malignancy worldwide. MiR-199a-5p has been reported to play important roles in multiple tumors, inclusive of NSCLC. However, little is definitively known pertaining to its explicit mechanism of action in NSCLC. The expressions of miR-199a-5p and hypoxia-inducible factor-1α (HIF-1α) mRNA were quantified employing qRT-PCR. H1299 and A549 cells were transiently transfected with miR-199a-5p mimics or inhibitors. Then, CCK-8 assays, flow cytometry analysis, and Transwell assay were performed for detecting cell proliferation, cell cycle, apoptosis, migration, and invasion of NSCLC cells, respectively. HIF-1α, signal transducer and activator of transcription 3 (STAT3), and p-STAT3 expressions were detected via Western blotting. Bioinformatic analysis and dual-luciferase assay were performed to investigate the interactions among miR-199a-5p, HIF-1α, and STAT3. Xenograft models were established with nude mice for further analyzing the bevacizumab resistance of NSCLC cells. MiR-199a-5p expression was markedly attenuated in NSCLC tissues and cell lines. Overexpression of miR-199a-5p repressed the proliferation, migration, and invasion but induced the apoptosis of NSCLC cells. HIF-1α was identified as a direct target of miR-199a-5p. There was a positive feedback loop among miR-199a-5p, HIF-1α, and STAT3. Co-transfection of HIF-1α or STAT3 overexpression plasmids counteracted the effects of miR-199a-5p. experiments indicated that the feedback loop was in association with the bevacizumab resistance of NSCLC cells. MiR-199a-5p blocked the progression of NSCLC and sensitized NSCLC cells to bevacizumab by suppressing HIF-1α and STAT3, while the HIF-1α/STAT3 axis suppressed the expression of miR-199a-5p, which forms a positive feedback loop to promote the sustaining progression of NSCLC.
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http://dx.doi.org/10.3389/fcell.2020.620615DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929999PMC
February 2021

A Systematic Review of the Omohyoid Muscle Syndrome (OMS): Clinical Presentation, Diagnosis, and Treatment Options.

Ann Otol Rhinol Laryngol 2021 Oct 25;130(10):1181-1189. Epub 2021 Feb 25.

Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore.

Objective: Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition.

Data Sources: Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020.

Review Methods: A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed.

Results: Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively.

Conclusion: OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography establishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.
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http://dx.doi.org/10.1177/0003489421995037DOI Listing
October 2021

Resuming otolaryngology services following a COVID-19 lockdown in Singapore.

Ann Acad Med Singap 2021 Jan;50(1):99-102

Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore.

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January 2021

Genistein exerts a cell-protective effect via Nrf2/HO-1/ /PI3K signaling in Ab25-35-induced Alzheimer's disease models in vitro.

Folia Histochem Cytobiol 2021 19;59(1):49-56. Epub 2021 Feb 19.

The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, PR China.

Introduction: Alzheimer's disease (AD), a very common neurodegenerative disorder, is mainly characterized by the deposition of b-amyloid protein (Ab) and extensive neuronal cell death. Currently, there are no satisfactory therapeutic approaches for AD. Although neuroprotective effects of genistein against Ab-induced toxicity have been reported, the underlying molecular mechanisms remain unclear. Furthermore, the PI3K/Akt/Nrf2 signaling pathway is associated with AD. The aim of the study was to investigate whether genistein can modulate Nrf2/HO-1/PI3K signaling to treat AD.

Materials And Methods: Cell viability assay, the measurement of heme oxygenase-1 (HO-1) expression by reverse transcription-polymerase chain reaction (RT-qPCR), and western blot were performed on the SH-SY5Y cells induced by Ab25-35 in response to the treatment with genistein. Moreover, PI3K p85 phosphorylation was measured.

Results: Genistein enhanced the HO-1expression at both the mRNA and protein levels, as well as the PI3K p85 phosphorylation level. In addition, genistein increased the survival of SH-SY5Y cells treated with Ab25-35via HO-1 signaling. However, following transfection with Nrf2 small interfering RNA (siRNA) and treatment with LY294002, an inhibitor of PI3K p85, genistein could not upregulate HO-1 to exert neuroprotective effects on SH-SY5Y cells treated with Ab25-35.

Conclusions: These results suggest that genistein exerts a neuroprotective effect on SH-SY5Y cells in vitro via Nrf2/ HO-1/PI3K signaling, providing a foundation for the application of genistein in the treatment of neurodegenerative diseases related to Nrf2/HO-1/PI3K signaling.
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http://dx.doi.org/10.5603/FHC.a2021.0006DOI Listing
August 2021

The efficacy of artificial dermis combined with continuous vacuum sealing drainage in deep neck multiple spaces infection treatment.

Medicine (Baltimore) 2021 Feb;100(5):e24367

Department of Otolaryngology, Head and Neck Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract: Deep neck abscesses are dangerous. Artificial dermis combined with seal negative pressure drainage is a new technique for treating refractory wounds.To compare the efficacy of vacuum sealing drainage (VSD) with that of traditional incision drainage approaches for treating deep neck multiple spaces infections.This retrospective analysis includes patient data from our hospital collected from January 2010 to March 2020. A total of 20 cases were identified. Based on the treatment methods, the patients were divided into the VSD group and the traditional group. Inflammation indicators (white blood count, WBC), duration of antibiotic use, hospitalization time, doctors' workload (frequency of dressing changes) and treatment cost were analyzed and compared between the two groups.Of the 20 patients, 11 patients underwent treatment with VSD, while the other 9 underwent traditional treatment. All patients were cured after treatment. Compared with the traditional group, the VSD group had a slower decline in the inflammation index, shorter duration of antibiotic use, shorter hospital stay, and lower doctor workloads (P < .001). There was no significant difference in treatment cost between the two groups (P > .05).VSD technology can markedly improve the therapeutic effect of deep neck multiple spaces infection. This treatment method can be used to rapidly control infections and is valuable in the clinic (P > .05).
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http://dx.doi.org/10.1097/MD.0000000000024367DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870261PMC
February 2021

Effect of ¹³¹I Therapy on Complete Blood Count in Patients with Differentiated Thyroid Cancer.

Med Sci Monit 2021 Feb 11;27:e929590. Epub 2021 Feb 11.

Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China (mainland).

BACKGROUND The aim of this study was to investigate the effects of ¹³¹I therapy on complete blood count (CBC) in patients with differentiated thyroid cancer (DTC). MATERIAL AND METHODS We analyzed CBC in 542 patients with DTC who were grouped according to treatment cycles and cumulative dose and then subdivided by sex and age. The effects of ¹³¹I therapy among the different groups and subgroups were analyzed. RESULTS After sorting patients by treatment cycles and doses, ¹³¹I therapy was found to have different effects on CBC depending on patient sex and age. The effect on white blood cell (WBC) counts persisted longer in women, while increases in hemoglobin (Hb) were more significant in men. The influence on red blood cell (RBC) counts was short-lived in patients aged 45 to 54 years. Monocyte counts were significantly decreased only in patients aged 55 years and older who had undergone 3 or 4 treatment cycles. In men, CBC was more affected by cumulative dose. ¹³¹I therapy only influenced platelet and monocyte counts in patients aged 55 years or older. Hb was significantly decreased and increased in the high- and low-dose groups, respectively. No significant complications were observed during follow-up. CONCLUSIONS ¹³¹I therapy had a greater impact on WBC counts in women, while changes in RBC counts and Hb were more obvious in men. During ¹³¹I therapy, clinicians should pay attention to different CBC indicators based on a patient's sex and age, but risks associated with an altered CBC are unlikely to outweigh the benefits of 131I. The results of the present study may help alleviate the concerns of a large proportion of patients with DTC and their families about the effects of ¹³¹I therapy on CBC.
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http://dx.doi.org/10.12659/MSM.929590DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885292PMC
February 2021

Life Prediction of Battery Using a Neural Gaussian Process with Early Discharge Characteristics.

Sensors (Basel) 2021 Feb 5;21(4). Epub 2021 Feb 5.

Chongqing Gas Field, PetroChina Southwest Oil and Gas Field Company, Chongqing 400021, China.

The state of health (SOH) prediction of lithium-ion batteries (LIBs) is of crucial importance for the normal operation of the battery system. In this paper, a new method for cycle life and full life cycle capacity prediction is proposed, which combines the early discharge characteristics with the neural Gaussian process (NGP) model. The cycle data sets of commercial LiFePO(LFP)/graphite cells generated under different operating conditions are analyzed, and the power characteristic is extracted from the voltage and current curves of the early cycles. A Pearson correlation analysis shows that there is a strong correlation between and cycle life. Our model achieves 8.8% test error for predicting cycle life using degradation data for the 20th to 110th cycles. Based on the predicted cycle life, capacity degradation curves for the whole life cycle of the cells are predicted. In addition, the NGP method, combined with power characteristics, is compared with other classical methods for predicting the remaining useful life (RUL) of LIBs. The results demonstrate that the proposed prediction method of cycle life and capacity has better battery life and capacity prediction. This work highlights the use of early discharge characteristics to predict battery performance, and shows the application prospect in accelerating the development of electrode materials and optimizing battery management systems (BMS).
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http://dx.doi.org/10.3390/s21041087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915406PMC
February 2021

Curcumin suppresses the stemness of non-small cell lung cancer cells via promoting the nuclear-cytoplasm translocation of TAZ.

Environ Toxicol 2021 Jun 4;36(6):1135-1142. Epub 2021 Feb 4.

Department of Thoracic Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Curcumin has been shown to suppress the progression of lung cancer, however, the underlying mechanisms are largely unknown. Here, we aimed to investigate the effects of curcumin on the stemness of non-small cell lung cancer (NSCLC) cells. We found that curcumin reduced the sphere formation ability at the concentrations without affecting the cell viability of NSCLC cells and normal pulmonary epithelial cells, which is evident by the decrease of sphere size and number. In addition, curcumin decreased ALDH activity and the expression of stemness markers (CD133, EpCAM, Oct4). RNA sequencing analysis revealed that the Hippo pathway was mostly enriched in cells with curcumin treatment. Indeed, the expression of cancer stem cell markers was significantly decreased by curcumin treatment by analyzing the RNA sequencing data. Gene set enrichment analysis (GSEA) showed that curcumin negatively regulated the cancer stem cell function and positively modulated cancer stem cell differentiation ability. Furthermore, curcumin enhanced the cisplatin sensitivity of NSCLC cells. Mechanistically, it was found that curcumin promoted the nuclear-cytoplasm translocation of TAZ, but not YAP, the critical effectors of Hippo pathway. In addition, curcumin destabilzed TAZ protein stability and promoted TAZ protein degradation in lung cancer cells, which is dependent on the proteasome degradation system, not by autophagy lysosome degradation system. Overexpression of TAZ rescued the inhibition of curcumin on the stemness of lung cancer cells. Thus, our results suggest that curcumin can attenuate the stemness of lung cancer cells through promoting TAZ protein degradation and thus activating Hippo pathway.
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http://dx.doi.org/10.1002/tox.23112DOI Listing
June 2021

Mitochonic acid 5 regulates mitofusin 2 to protect microglia.

Neural Regen Res 2021 Sep;16(9):1813-1820

Department of Neurology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China.

Microglial apoptosis is associated with neuroinflammation and no effective strategies are currently available to protect microglia against inflammation-induced apoptosis. Mouse microglial BV-2 cells (5 × 10) were incubated with 10 μg/mL lipopolysaccharides for 12 hours to mimic an inflammatory environment. Then the cells were co-cultured with mitochonic acid 5 (MA-5) for another 12 hours. MA-5 improved the survival of lipopolysaccharide-exposed cells. MA-5 decreased the activity of caspase-3, which is associated with apoptosis. MA-5 reduced the number of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling-positive cells, and increased adenosine triphosphate levels in cells. MA-5 decreased the open state of the mitochondrial permeability transition pore and reduced calcium overload and diffusion of second mitochondria-derived activator of caspase (Smac). MA-5 decreased the expression of apoptosis-related proteins (mitochondrial Smac, cytoplasmic Smac, pro-caspase-3, cleaved-caspase-3, and caspase-9), and increased the levels of anti-apoptotic proteins (Bcl2 and X-linked inhibitor of apoptosis protein), mitochondria-related proteins (mitochondrial fusion protein 2, mitochondrial microtubule-associated proteins 1A/1B light chain 3B II), and autophagy-related proteins (Beclin1, p62 and autophagy related 5). However, MA-5 did not promote mitochondrial homeostasis or decrease microglial apoptosis when Mitofusin 2 expression was silenced. This shows that MA-5 increased Mitofusin 2-related mitophagy, reversed cellular energy production and maintained energy metabolism in BV-2 cells in response to lipopolysaccharide-induced inflammation. These findings indicate that MA-5 may promote the survival of microglial cells via Mitofusin 2-related mitophagy in response to lipopolysaccharide-induced inflammation.
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http://dx.doi.org/10.4103/1673-5374.306094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328753PMC
September 2021

Unique case of a post-traumatic nasoseptal arteriovenous malformation.

BMJ Case Rep 2021 Jan 26;14(1). Epub 2021 Jan 26.

Otorhinolaryngology, Tan Tock Seng Hospital, Singapore.

Extracranial manifestation of arteriovenous malformations (AVMs) is uncommon. Nasoseptal AVMs are an even rarer entity. In this case report, we present an interesting and first-of-its-kind case of the development of a left nasoseptal AVM in a 60-year-old man after a fall. This was likely post-traumatic, unlike the usual congenital AVMs described in the literature. The patient was managed conservatively with regular follow-up for the AVM as he was asymptomatic.
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http://dx.doi.org/10.1136/bcr-2020-239482DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839863PMC
January 2021

Predictive Value of a Thyroid-Absorbed Dose with a Shorter Effective Half-Life on Efficacy in Graves Disease Patients Receiving Iodine-131 Therapy.

Med Sci Monit 2021 Jan 26;27:e928796. Epub 2021 Jan 26.

Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China (mainland).

BACKGROUND Although radioiodine therapy (RIT) efficacy is thoroughly validated for Graves disease (GD), there is a lack of research on the predictive factors of RIT, especially the optimal thyroid-absorbed dose (TD) with a shorter effective half-life (Teff ≤5 days). The goal of this study was to explore the predictive value of TD in GD patients receiving RIT with a shorter Teff. MATERIAL AND METHODS We studied 208 GD patients receiving RIT with a shorter Teff. Plotting the receiver-operating characteristic (ROC) curve verified the accuracy of TD for predicting RIT efficacy in GD patients. In addition, we conducted univariate and multivariate analyses to investigate the influence of 14 factors, including thyroid weight, TD, 24-h radioiodine uptake rate (RAIU), the highest RAIU, thyrotrophin receptor antibody level, thyroglobulin antibody level, thyroid peroxidase antibody level, and others, on curative effects of RIT. RESULTS Of the 208 study participants, complete remission and the total effectiveness rates were 68.3% and 92.3%, respectively. The threshold value of TD to predict RIT efficacy was 70.2 Gy, based on ROC analysis. Univariate analysis showed that 24-h RAIU, Teff, total iodine dose, iodine dose per gram of thyroid tissue, TD, and thyrotropin receptor antibody level were significantly associated with RIT efficacy. Multivariate analysis indicated that 24-h RAIU, total iodine dose, iodine dose per gram of thyroid tissue, and TD were significant independent predictors of RIT efficacy. CONCLUSIONS Predicting RIT efficacy from TD with a shorter Teff was feasible in GD patients, and TD above 70.2 Gy had an especially high predictive accuracy.
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http://dx.doi.org/10.12659/MSM.928796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847087PMC
January 2021

Downregulation of miR-146b-3p Inhibits Proliferation and Migration and Modulates the Expression and Location of Sodium/Iodide Symporter in Dedifferentiated Thyroid Cancer by Potentially Targeting MUC20.

Front Oncol 2020 8;10:566365. Epub 2021 Jan 8.

Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China.

The dedifferentiation of differentiated thyroid cancer (DTC) is a challenging problem for radioactive iodine (I) treatment, also known as radioiodine refractory differentiated thyroid cancer (RAIR-DTC). The purpose of this study was to further explore the mechanism of the redifferentiation of dedifferentiated thyroid cancer. Ineffective and effective groups of I therapy were analyzed and compared in both our clinical and TCGA samples. Whole-exome sequencing, mutation analysis, transcriptome analysis, and functional experiments were conducted. , , , , and were overlapping mutation genes between our clinical cases, and the TCGA cases only appeared in the ineffective group. The expression of target was explored. The expression levels of and were significantly increased, and the inhibition of expression significantly inhibited proliferation and migration, promoted apoptosis, regulated the expression and location of thyroid differentiation-related genes, and sodium/iodide symporter (NIS) in dedifferentiated thyroid cancer cells (WRO). Thus, potentially targets participation in the formation of DTC dedifferentiation, resulting in resistance to I and the loss of the iodine uptake ability of DTC cancer foci, promoting refractory differentiated thyroid cancer. may be a potentially therapeutic target for the reapplication of I therapy in dedifferentiated thyroid cancer patients.
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http://dx.doi.org/10.3389/fonc.2020.566365DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7821393PMC
January 2021

A retrospective study of the risk factors and the prognosis in patients with papillary thyroid carcinoma depending on the number of lymph node metastasis.

Clin Exp Med 2021 May 1;21(2):277-286. Epub 2021 Jan 1.

Department of Nuclear Medicine, Tianjin Medical University General Hospital, 154 Anshan Road, He ping, Tianjin, 300052, People's Republic of China.

To retrospectively analyze the risk factors and the prognosis according to the number of lymph node metastases (LNMs) in different neck compartments in papillary thyroid carcinoma (PTC) patients. In total, 962 patients with PTC were enrolled in this study. According to the methods of the 2015 American Thyroid Association, the treatment response of the patients was divided into a good prognosis and a poor prognosis. First, their clinical characteristics were summarized. Then, according to whether they had LNMs and the number of LNMs in different neck compartments, their risk factors and their prognosis were analyzed. Male sex, younger (< 45 years), extrathyroid extension (ETE), T staging and higher stimulated thyroglobulin (sTg) levels were the risk factors for LNM. The cutoff for a poor prognosis of the number of LNMs was > 4. Male sex, younger age, higher sTg levels and ETE were correlated with LNM > 4. Furthermore, the cutoffs for a poor prognosis of central lymph node metastasis (CLNM), lateral lymph node metastasis (LLNM) and CLNM + LLNM were > 6, > 1 and > 5, respectively. Younger age and ETE were strongly correlated with CLNM > 6. Male sex, younger age, higher sTg levels and ETE were correlated with LLNM > 1. Younger age, ETE and higher sTg levels were correlated with CLNM + LLNM > 5. Further analysis revealed a positive correlation between CLNM and LLNM. We should pay more attention to LNMs in PTC patients who are male, are of a younger age, have ETE, T staging and have higher sTg levels. The neck regional LNMs should be correctly evaluated to guide the surgical options for the neck LNMs in PTC. When the number of LNMs in different neck compartments has exceeded the cutoff value, they can be considered as predictors of the outcome of I treatment.
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http://dx.doi.org/10.1007/s10238-020-00675-8DOI Listing
May 2021

Impact of COVID-19 on a Tertiary Otolaryngology Practice in Singapore.

Ann Acad Med Singap 2020 11;49(11):897-901

Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore.

The COVID-19 pandemic has had a major impact in healthcare systems across the world, with many hospitals having to come up with protocols and measures to contain the spread of the virus. This affects various specialties' clinical practices in many ways. Since early 2020 in Singapore, the Department of Otorhinolaryngology at Tan Tock Seng Hospital had to rapidly adapt to this pandemic as we provided services to the main healthcare facility combating the virus in our country. We had to design new workflows and also remain flexible in view of the ever-changing situation. There are 6 important domains for an otolaryngology department or any clinical department in general to consider when making adjustments to their practices in an outbreak: (1) clinical work, (2) education, (3) research, (4) safety of patients and staff, (5) morale of medical staff and (6) pandemic frontline work. We hope that the sharing of our experiences and the lessons learnt will be useful for both our local and international colleagues.
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November 2020

Impact of COVID-19 on a Tertiary Otolaryngology Practice in Singapore.

Ann Acad Med Singap 2020 11;49(11):897-901

Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore.

The COVID-19 pandemic has had a major impact in healthcare systems across the world, with many hospitals having to come up with protocols and measures to contain the spread of the virus. This affects various specialties' clinical practices in many ways. Since early 2020 in Singapore, the Department of Otorhinolaryngology at Tan Tock Seng Hospital had to rapidly adapt to this pandemic as we provided services to the main healthcare facility combating the virus in our country. We had to design new workflows and also remain flexible in view of the ever-changing situation. There are 6 important domains for an otolaryngology department or any clinical department in general to consider when making adjustments to their practices in an outbreak: (1) clinical work, (2) education, (3) research, (4) safety of patients and staff, (5) morale of medical staff and (6) pandemic frontline work. We hope that the sharing of our experiences and the lessons learnt will be useful for both our local and international colleagues.
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November 2020
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