IntroductionPrevious studies on the surgical outcomes of aldosterone-producing adenoma (APA) patients were mainly based on the histopathological diagnosis of HE staining or adrenal venous sampling (AVS) instead of the functional pathology. The aim of the present study was to evaluate the surgical outcomes of APA patients based on the functional pathological diagnosis of APA according to HISTALDO (histopathology of primary aldosteronism) consensus.MethodsClinical data of 137 patients with suspected APA were analyzed retrospectively. All patients had hypertension and spontaneous hypokalemia. In all patients, CT showed a unilateral solitary hypodense adrenal lesion, and a contralateral adrenal gland of normal morphology. Tumors were removed and immunostained for CYP11B2, and their pathology were identified based on HISTALDO consensus. Patients were followed up 6 to 24 months after operation.ResultsAmong 137 cases of presumptive APA diagnosed by CT, 130 (95%) cases were pathologically diagnosed with classical pathology, including 123 APA(90%) and 7 aldosterone-producing nodule (APN) (5%). 7 cases (5%) had non-functioning adenoma (NFA) with aldosterone-producing micronodule (APM) or multiple aldosterone-producing micronodule (MAPM) in the surrounding adrenal tissue. In all 137 patients, hypertension was complete or partial clinical success postoperatively. Complete clinical success was achieved in 73 (53%), and partial clinical success was achieved in 64 (47%) cases. Serum potassium level recovered to normal in all. In 123 patients with APA, complete clinical success was reached in 67 (54%), and partial clinical success was reached in 56 (46%) cases. Gender, duration of hypertension and the highest SBP were significant independent predictors for cure of APA after surgery. A multiple logistic regression model integrating the three predictors was constructed to predict the outcome, which achieved a sensitivity of 72.4% and a specificity of 73.1%.ConclusionThe specificity of CT in the diagnosis of APA and APN patients with hypokalemia was 95%. All patients achieved complete or partial clinical success after surgery. Gender, duration of hypertension and the highest SBP were independent predictors for the postoperative cure of APA.
The goals of our study were to evaluate the biomechanical properties and cellular biocompatibility of 3D printed tracheal graft fabricated by polycaprolactone (PCL). Compared with native tracheal patch, there was a significant increase in maximum stress and elastic modulus for 3DP tracheal graft (p < 0.05). BMSCs were co-cultured under four different conditions to investigate cytotoxicity of the graft: (1) co-cultured with normal culture medium, as blank control; (2) co-cultured with perfluoropropylene, as negative control; (3) co-cultured with 3DP tracheal graft; and (4) co-cultured with polyvinyl chloride, as positive control. Moreover, the results of SRB assay showed that compared with blank and negative control group, there was no significant difference in the cell proliferation of 3DP tracheal graft group for 21 days (p > 0.05). These results revealed that 3DP tracheal graft in our study has favorable cellular biocompatibility and biomechanical properties, and, therefore, will be a promising alternative for tissue-engineered trachea.
Background: With the development of novel surgical techniques and instruments over the recent years, more and more surgeons consider single-port video-assisted thoracoscopic surgery (VATS) as a feasible option. However, whether single-port thoracoscopic surgery has more potential advantages than two-port thoracoscopic surgery for non-small cell lung cancer remains unknown. We conducted this systematic review and meta-analysis to compare the perioperative efficacy between single-port and two-port VATS anatomical lung resection for non-small cell lung cancer (NSCLC). Methods: Eleven studies were identified from the databases of The Cochrane Library, PubMed, Embase, Web of science, and China Biology Medicine disc (CBMdisc). Prospective studies and retrospective studies that evaluated the perioperative efficacy of single-port VATS compared with two-port VATS were analyzed.We used 95% confidence intervals (CIs) to calculate the odds ratio (OR), and the weight mean difference (WMD). Results: A total of 11 studies (3 prospective studies and 8 retrospective studies), including 1,592 patients, were included. We found that the duration of the operation in single-port VATS anatomical lung resection for NSCLC was shorter (P=0.02). Also, the bleeding volume amount was lower (P=0.01), the length of postoperative drainage was shorter (P<0.00001), the amount of postoperative hospital stay was lower (P<0.0001), and the visual analogue score 24 and 72 h after operation time was lower (P<0.0001, P<0.00001).However, the number of lymph nodes retrieved (P=0.92) and the rates of complications (P=0.15) had no statistical differences between the two groups. Conclusions: These studies show that single-port VATS anatomical lung resection has certain advantages in the treatment of NSCLC compared with two-port VATS. It may be an alternative option for surgeons.
A number of case-control studies have been conducted to investigate the relationship between the ATP-binding cassette transporter A1 (ABCA1) gene polymorphisms and risk of coronary heart disease (CHD). However, the results have been inconclusive. The purpose of the present study is to investigate whether this polymorphism confers significant susceptibility to CHD using a meta-analysis. We conducted searches of the published literature in PubMed, Embase, and CBM databases. 13 studies were included in our meta-analysis, involving a total of 11,678 individuals. Subgroup analyses were performed by ethnicity and cancer type. Statistically significant association between ABCA1 gene R219K polymorphism and increased CHD risk was found in total population analyses in all four genetic comparison models (OR(C vs. T) 1.19, 95% CI 1.07-1.31; P = 0.001; OR(Homozygote model) 1.28, 95% CI 1.07-1.52; P = 0.007; OR(Recessive genetic model) 1.22, 95% CI 1.04-1.44, P = 0.015; OR(Dominant model) 1.21, 95% CI 1.07-1.35; P = 0.001). In subgroup analyses based on ethnicity, the association was still significant in Asians (All P values < 0.001), but not in Caucasians (All P values > 0.05). ABCA1 R219K polymorphism is associated with CHD susceptibility, and individuals with ABCA1 have a significantly higher risk of cancer particularly in Asians.
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