Primary cardiac tumours are rare, and few studies have examined large samples. The aim of this study was to review a single institution's 15 years of experience with primary cardiac tumours.We conducted a retrospective analysis of 119 consecutive patients admitted to the Nanjing Drum Tower Hospital from April 2002 to January 2017. Five patients declined surgery due to illness or for financial reasons, and one patient underwent a second operation due to tumour recurrence 10 years after the first operation. In total, 115 patients underwent surgery. The surgeons used median sternotomy and a right atrial approach to complete the gross total resection. The patients were separated into three groups according to their tumour pathology (myxomas, other benign tumours, or malignant tumours). A total of 84 patients were followed up for an average of 34.8±31.2 months (range 2-141 months).The sites of the cardiac tumours included the left atrium (n=93, 80.1%), right atrium (n=14, 14.0%), left ventricle (n=2, 1.7%), valves (n=7, 6.0%), and other sites (n=1, 0.8%). According to the postoperative pathology, 99 (86.0%) tumours were classified as myxomas, 8 (7.0%) were other types of benign tumours, and 8 (7.0%) were malignant tumours. Patients with malignant tumours had a longer surgical time (P=0.035) and postoperative hospitalization time (P=0.009). Patients with myxoma tumours exhibited better 5-year survival than patients with malignant tumours (95.7% vs. 57.1%, P<0.001).In the Chinese population, the incidence of primary cardiac tumours is mainly attributable to myxomas. Gross total resection is a safe and effective treatment for both benign and malignant tumours. Long-term survival is satisfactory for benign tumours but low for malignant tumours, and a risk of recurrence exists. Postoperative chemotherapy or radiotherapy may be needed to achieve better outcomes.
To better understand the contribution of the chemokine system in immune senescence, we determined the aging effect on CD4+ and CD8+ T-cell chemokine expression by microarray screening and ribonuclease protection assays. Compared with young C57BL/6 mice, freshly isolated CD4+ cells from aged mice express increased level of interferon-gamma-inducible protein 10 (IP-10), macrophage inflammatory protein (MIP)-1alpha, MIP-1beta, regulated upon activation, normal T-cell expressed and secreted (RANTES), and lymphotactin (Ltn). T-cell receptor (TCR)/coreceptor stimulation up-regulates MIP-1alpha, MIP-1beta, and Ltn, and down-regulates IP-10 and RANTES expression in CD4+ T cells. A similar increase in chemokine expression was demonstrated in the CD8+ T cell. Enzyme-linked immunosorbent assays confirmed increased T-cell chemokine protein production in old CD4+ and CD8+ T cells. Finally, supernatant of cultured T cells from old animals caused an enhanced leukocyte chemotaxis response compared with that from young animals, suggesting that the age-related difference in T-cell chemokine expression has an important functional consequence.
Neuroinflammation plays a pivotal part in the pathogenesis of stroke. Orphan nuclear receptor NR4A1 is involved in the inflammatory response of microglia and macrophages. In this study, we discovered an old drug, 9-aminoacridine (9-AA), as a novel NR4A1 activator from our in-house FDA-approved drug library, which exhibited anti-inflammatory activities through an NR4A1/IL-10/SOCS3 signaling pathway and modulated the microglia activation. To improve the druggability of 9-AA, different liposomal formulations were screened and investigated. 9-AA-loaded liposome (9-AA/L) was prepared to reduce the adverse effect of 9-AA. Furthermore, 9-AA-loaded PEG/cRGD dual-modified liposome (9-AA/L-PEG-cRGD) was obtained, which displayed prolonged circulation, improved biodistribution, and increased brain accumulation. In the transient middle cerebral artery occlusion (tMCAO) rat model, 9-AA/L-PEG-cRGD significantly reduced brain infarct area, ameliorated ischemic brain injury, and promoted long-term neurological function recovery. This "from drug discovery to drug delivery" methodology provides a potential therapeutic strategy using the liposomal 9-AA, the NR4A1 activator to suppress neuroinflammation for treatment of ischemic stroke.
For cervical and higher-level esophageal tumors, the choice of cervical anastomosis or thoracic anastomosis is still controversial. The goal of this study was to explore the optimal surgical approach for cervicothoracic esophageal squamous tumors.We retrospectively analyzed 3,802 consecutive patients with esophageal squamous cell tumors in Nanjing Drum Tower Hospital from Jan 2001 to Jan 2017. Twenty-six patients with cervical anastomosis and twenty-eight patients with thoracic anastomosis were evaluated.The cervical anastomosis group exhibited a greater number of resected lymph nodes (36.5±7.3 vs. 19.9±5.7, P<0.001). In addition, the cervical anastomosis group exhibited a higher recurrence rate (71.4% vs. 41.7%, P=0.047) and increased locoregional recurrence (P=0.040). Overall survival was not significantly different between groups (P=0.331). Moreover, multivariate Cox regression analysis revealed that postoperative locoregional recurrence is an independent risk factor for survival (P=0.031, 95% CI: 1.114-8.952).Thoracic anastomosis led to satisfactory results in patients with cervicothoracic esophageal squamous tumors.
Objective:To explore the feasibility and cosmetology of transcervical minimally incisional thyroidectomy assisted with endoscopic.Method:128 patients with various thyroid diseases were randomly divided into three groups.The three groups underwent traditional surgery,laparoscopic surgery via breast and minimally incisional endoscopic thyroidectomy respectively.Finally,We compared the effect of the three groups.Result:All of the three groups had been performed successfully.The group of minimally incisional endoscopic thyroidectomy had completed 40 cases.The mean operative time was 76 min,135 min and 65 min.The mean blood loss was 38mL,32 mL and 26 mL.The postoperative drainage was 76±12.5 mL,93±21.6 mL,34±11.8 mL.the Hoarseness and cough after operation was 0 case,1 case and 0 case in three group respectively.The whole group did not appear limb numbness or convulsions.Conclusions:Minimally incisional endoscopic thyroidectomy has short operation time and small intraoperative and postoperative drainage.All operations have no adverse complications.This procedure is safety,feasibility and with cosmetic results.
Acid/redox dual-activated liposomes support enhanced therapeutic efficacy by overcoming multiple barriers to the intravenous delivery of an anticancer drug.
A bioinspired cocoon-like anticancer drug delivery system consisting of a deoxyribonuclease (DNase)-degradable DNA nanoclew (NCl) embedded with an acid-responsive DNase I nanocapsule (NCa) was developed for targeted cancer treatment. The NCl was assembled from a long-chain single-stranded DNA synthesized by rolling-circle amplification (RCA). Multiple GC-pair sequences were integrated into the NCl for enhanced loading capacity of the anticancer drug doxorubicin (DOX). Meanwhile, negatively charged DNase I was encapsulated in a positively charged acid-degradable polymeric nanogel to facilitate decoration of DNase I into the NCl by electrostatic interactions. In an acidic environment, the activity of DNase I was activated through the acid-triggered shedding of the polymeric shell of the NCa, resulting in the cocoon-like self-degradation of the NCl and promoting the release of DOX for enhanced therapeutic efficacy.
The 8th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging system released in 2017 reclassified the pTNM stage of early esophageal adenocarcinoma from stage IA in the 7th edition to stage IA and IB and from stage IB in the 7th edition to stage IC. In this study, we analyzed the reliability of the new staging system through clinical data analysis.We selected patient data from the Surveillance, Epidemiology, and End Results (SEER) database. From 2004 to 2014, data for a total of 714 patients were included in the study and were divided into groups representing stage IA (n=84), IB (n=386) and IC (n=244) according to the 8th edition.In the 8th edition, there was no significant difference between groups IA and IB in overall survival (OS) (P=0.331) or esophageal cancer-specific survival (ECSS) (P=0.341). However, the long-term survival rates of groups IA and IB were significantly higher than those of group IC. Cox regression analysis indicated that the use of new staging system does not affect prognosis. We also attempted to stratify the tumors by T stage and histological grade but found no significant difference.We used the SEER database to compare the staging of early esophageal adenocarcinomas between the 8th and 7th editions of the AJCC/UICC TNM staging system. Based on our data, the 8th edition is not superior to the 7th edition.
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