Objective To preliminarily explore the difference of body fat distribution between Tibetan and Han people in our endocrinology outpatient clinic.Methods From Sep.to Nov.in 2014,535 Tibetan and 276 Han outpatients in the department of endocrinology and metabolism,Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region were included to the present study.The data including gender,age,height,body weight,waist circumference(WC),diabetes diagnosis and fasting blood-lipids were collected.After the adjustment of mass index body (BMI),age and diabetes mellitus,the differences in WC and lipid profiles between Tibetan and Han people were analyzed by t test and multiple regression analysis. Results There was no difference in WC between Tibetan and Han females ［(93.29±11.513) cm vs. (88.64±10.8) cm,P=0.396］ after the adjustment of BMI.However,Tibetan males WC was larger than Han males ［(94.89±9.08) cm vs. (89.81±9.53) cm,P<0.001］,especially in the subjects of normal weight and overweight by stratified analysis ［(86.61±6.43) cm vs. (82.71±7.21) cm;(94.36±6.07) cm vs. (91.22±6.82) cm,P all<0.001］.While the difference of WC in obese males didn’t have statistical significance between the two groups ［(102.88±8.31) cm vs. (100.41±7.27) mmol/L,P=0.112］. Compared with Han people after the adjustment of BMI,diabetes,gender and age,triglyceride (TG) level in Tibetan was lower ［(1.52±0.91) mmol/L vs.(1.79±1.64) mmol/L］,high density lipoprotein cholesterol (HDC-c) level was lower ［(1.12±0.26) mmol/L vs.(1.21±0.35) mmol/L,P=0.019］,and low density lipoprotein cholesterol (LDL-c) level was higher ［(2.81±0.90) mmol/L vs. (2.55±0.87) mmol/L,P<0.001］.Conclusions Tibetan males had larger WC than Han males after the adjustment of BMI,however,the difference was declined with the increase of obesity degree.In comparison with Han people,Tibetan people had significant lower triglyceride levels after the adjustment of BMI,gender and age.
Objective To study the clinical value of transvaginal color Doppler ultrasonography in diagnosis of placental site trophoblastic tumor (PSTT).Methods The clinical features and findings on transvaginal sonography (TVS) of PSTT proved by operation and pathology were investigated retrospectively in 12 cases.Results The most frequent symptoms associated with PSTT were abnormal vaginal bleeding with varying periods of amenorrhea,presented in 8 cases,and abnormal vaginal bleeding,presented in 4 cases.The interval from antecedent pregnancy to diagnosis was 4-21 (median,8) months.The serum level of beta-human chorionic gonadotropin (β-hCG) at the time of ultrasound examination was generally low,with a median of 132 IU/L (range,2.01-3 098 IU/L).Sonographic presentation of PSTT was classified into two types according to the site of the lesions with poorly defined margins observed on TVS:Type I,heterogeneous solid mass with unclear border in the uterine cavity (4 cases),with minimal (2 cases) to a high degree (2 cases) of Doppler signals from blood flow;type II,heterogeneous solid (2 cases),alveolate (4 cases) or cystic mass (2 cases) with unclear border in the myometrium,with minimal (1 case) to a high degree (7 cases) of Doppler signals from blood flow.Doppler waveform analysis of vessels within the PSTT of 10 cases typically demonstrated low impedance.The mean resistance index was 0.49 (range,0.28-0.7).Conclusions Combined with clinical features,the findings described on sonographic examination could be helpful in early detection of PSTT and could contribute to making clinical decision timely and accurately.
Objective To evaluate the safety and efficacy of the laryngeal mask airway (Bailey manoeuvre) for airway management during the postanaesthetic recovery period in pediatric patients undergoing cochlear implantation.Methods Fifty pediatric patients were enrolled and randomly assigned to receive either a laryngeal mask airway (LMA,n=25) or a endo tracheal tube (ETT,n=25) during the recovery period after electric cochlear implantation.The extent of coughing and pluse oxygen saturation (SpO2) were recorded.Hemodynamic profiles was recorded at different time points:baseline (T0),before extubation (T1) and after extubation immediately (T2).Results In LMA group,the incidence of coughing was lower than that in ETT group (12% vs. 80%,P<0.000 1),The median SpO2 at the 1st min after extubation in LMA group was higher than that in ETT group (P<0.05).No patient presented oxygen desaturation after extubation in LMA group.In ETT group,one child experienced transient oxygen desaturation (89%) because of severe coughing.Mean arterial pressure (MAP) at T1 and T2 were both significantly less than those at T0 in LMA group (P<0.05).In ETT group,MAP and HR at T2 was significantly higher than those at T0 (P<0.05).MAP and HR were significantly higher in ETT group than those in LMA group at T1 and T2 (P<0.05).Conclusions The Bailey manoeuvre provided less coughing,higher median SpO2 and more stable hemodynamic profiles when compared with the endo tracheal tube in the postanaesthetic recovery period.
The failure and resistant of treatment,and metastatic recurrence of tumor are mainly due to the existing of a very small number of so-called cancer stem cells (CSCs).This group of cells has the characteristics of self-renewal and high invasive potential and eventually formed the heterogeneity of several tumors.Whether it is in the primary tumor,circulating tumor cells,or in the formation of metastases,CSCs always play important roles,and are closely related to the patients′ prognosis.Therefore,from a therapeutic standpoint,a better understanding of CSCs is helpful for developing effective therapeutic strategies targeting CSCs and their microenvironment,which could be ideal ways to combating cancer metastasis.
Metastasis and metabolic deregulation are two of the major essential hallmarks of cancer.In the initiation and development of cancer,tumor cells are known to undergo metabolic alterations to sustain faster proliferation.Recent studies indicated that metabolic changes of tumors are also closely related to tumor metastasis.In this review,we summarize the research progress about the roles and related mechanism of tumor metabolism in tumor metastasis from the aspects of both the tumor cell and microenvironment.
Circulating tumor cells (CTCs) are necessary for tumor recurrence and distal metastasis.With the development and progress in the detection technologies of CTCs,more and more attentions have been focused on the biological characteristics and their potential clinical application of CTCs.Cumulating evidence suggests that CTCs are closely related to the prognosis of cancer patients,and may be used in personized cancer treatment.
Exosomes are a kind of microvesicles with diameters of about 30-100 nm,which are released by most living cells,and are made up of membrane structure with lipid bilayer and rich of functional contents.The tumor-derived exosomes were discovered for the first time in 1981.In recent 10 years,exosomes are found to contain functional proteins as well as functional nucleic acids,both of which acted as powerful promoters for tumor metastases.Depending on the unique way of loading and transporting proteins and nuclear acids,exosomes stably and effectively mediated intercellular communication.To better understand the mechanisms how exosomes promote tumor metastases might facilitate to identify the key issues for tumor metastases,which might further contribute to develop novel strategies to combat cancer metastases.
Tumor metastasis is mainly responsible for cancer mortality.It is promoted by both accumulation of intrinsic alterations and interaction of cancer cells with various stromal cells in tumor microenvironment.Tumor-infiltrating immune cells including tumor-associated macrophages (TAMs),myeloid-derived suppressor cells (MDSCs) and regulatory T cells (Treg),have been shown to support immune suppression and the metastasis of tumor cells.The dissemination of tumor cells to distant organ sites necessitates a treacherous journey,which requires immune escape,pre-metastatic niche formation,tumor cell egress into blood circulation finally arrival at the target organ and persistent metastatic growth.Each step of tumor metastasis is fostered by the communication between tumor and immune cells.This review focuses on the interactions between tumor cells and tumor-infiltrating immune cells,and potential immune strategies.
Cancer therapy targeting immune checkpoints such as programmed cell death protein 1 (PD-1),programmed cell death 1 ligand 1 (PD-L-1) and cytotoxic T lymphocyte antigen 4 (CTLA-4) has achieved noteworthy benefit in multiple cancers by blocking immune-inhibitory signals and enabling patients to produce an effective antitumor immune response.The Cancer therapy of the monoclonal antibodies against CTLA-4,PD-1 and PD-L-1 has brought a promising future for cancer treatment.In this review,we mainly discuss the progress in the tumor immune checkpoint-targeted immunotherapy in recent years.
In recent decade,a number of targeted therapies have been discovered and proven effective in a variety of human hematological and solid malignancies.However,the relatively rapid acquisition of resistance to such treatments which is observed in virtually all cases significantly limits their utility and remains a substantial challenge to their clinical application.As molecular mechanisms of resistance have begun to be elucidated,new strategies to overcome or prevent the development of resistance have been emerging.Here,we summarize the characteristics of these targeted therapies and provide an overview of the key clinical trials that led to approval of these drugs,the various mechanisms of drug resistance and potential ways to overcome that.
Metastasis is one of the biological hallmarks of malignancy and the principal cause of death of patients.Recent years,metastatic potential is thought at least to be due to tumor heterogeneities which origin from the differences generated in the evolution process of cancer itself as well as host microenvironment.Derived from traditional theories,tumor heterogeneity includes more than gene mutations.The changes of non-genetic levels like epigenetic regulation and post-translational modification are widely considered.Based on the “seed and soil” theory about metastasis,this review summarizes the advances of studies in cancer metastasis from the perspective of evolution and heterogeneity,hoping to promote the study of metastasis and clinical control application.
