[Retrospective analysis of 760 laryngeal squamous cell carcinoma patients treated with open laryngeal function-preserving operations]

Objective:To explore the fundamental clinical characteristics and survival prognostic factors of laryngeal squamous cell carcinoma (LSCC) patients treated with open laryngeal function-preserving operations. Method: The collected clinical data and the follow-up survival information from 760 patients with LSCC undergoing open laryngeal function-preserving operations between January 2005 and December 2010 in Eye & ENT Hospital of Fudan University were retrospectively analyzed. Kaplan-Meier was applied to calculate survival rates. Log-rank test and Cox regression model were performed to evaluate the survival prognostic factors for univariate and multivariate analysis. Result: Among the enrolled 760 cases, 697 patients were glottic cancer, followed by 59 cases in supraglottis and 4 cases in subglottis. The number of laryngeal cancer patients staged in T1 to T4 was 222, 420, 112 and 6, respectively. 27 patients had positive cervical lymph nodes. There were 220, 408, 111 and 21 patients with clinical stage Ⅰ to Ⅳ, respectively. The 5-year overall survival (OS), disease free survival (DFS) and disease specific survival (DSS) rates were 89.3%, 83.9% and 89.8%, respectively. Multivariate Cox analysis indicated that clinical stage and second primary tumor were independent influencing factors for the OS rate, while, age, primary site, pathological differentiation, T stage, clinical stage and surgical margin were independent risk factors for tumor recurrence and progression (P<0.05). Conclusion: Open laryngeal function-preserving operation is a crucial therapeutic strategy applicable to LSCC patients in early and selected advanced stage in China. Early diagnosis and therapy, and sufficient safety surgical margin are keys for improving the survival rate and reducing the risk of relapse for laryngeal cancer patients.

[Clinical analysis of neuroendocrine carcinoma of the larynx]

Objective:To evaluate the clinical manifestation, therapy and prognosis of neuroendocrine carcinoma of the larynx. Method:Twenty-six cases with neuroendocrine carcinoma of the larynx were analyzed retrospectively. Four pathological types were found in our series: typical carcinoid (1/26), atypical carcinoid (15/26), small cell carcinoma, neuroendocrine type (9/26) and combined small cell carcinoma, neuroendocrine type (1/26). In this series, 12 cases were received total laryngectomy, 2 cases supracricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP), 4 cases horizontal partial laryngectomy, 5 cases vertical partial laryngectomy, 1 case transoral CO₂ laser microsurgery, and 2 cases radiotherapy and/or chemotherapy. Result:Three-year and five-year overall survival rates were 76.9% and 69.2% respectively. Conclusion:The neuroendocrine carcinoma of the larynx was rare, which was more common in the supraglottis. Atypical carcinoid was the most common pathological type. Compared to SCC, the clinical feature of neuroendocrine carcinoma of the larynx was non-specific. The clinical behavior, treatment,and prognosis were correlative to the tumor pathological.The diagnosis depended on comprehensive immunohistochemistry examination.

Effects of TNF-α in rheumatoid arthritis via attenuating α1 (I) collagen promoter

OBJECTIVE

To explore the role of TNF-α in the peripheral blood of patients with rheumatoid arthritis (RA) and its underlying mechanism.

PATIENTS AND METHODS

32 patients diagnosed with RA in our hospital from July 2016 to March 2017 were selected in the experimental group. Meanwhile, 32 normal healthy people were selected in the healthy control group and 21 patients with other autoimmune diseases in the same period were selected in the disease control group. Serum samples of the subjects in the experimental group and the control group were collected. The content of serum tumor necrosis factor-α (TNF-α) was detected by enzyme-linked immunosorbent assay (ELISA), and the correlation between TNF-α and RA activity was analyzed. We then constructed rat RA model. The effect of different doses of TNF-α on the RA progression was evaluated by measuring the foot paw thickness of both hind limbs of rats. Fibroblast-like synoviocytes (FLS) were treated with different concentrations of TNF-α cytokine in vitro. Cell counting kit-8 (CCK-8) assay was carried out to detect the cell viability after TNF-α treatment. Serum levels of VEGF (vascular endothelial growth factor) and hydroxyproline were detected. Moreover, the α1 (I) collagen overexpression recombinant was constructed and transfected into MH7A cells. The activation of α1 (I) collagen promoter was reflected by the CAT reporter gene activity.

RESULTS

ELISA results showed higher content of TNF-α in the peripheral blood of the experimental group than that of the control group. In the RA rat model, the foot paw thickness of the hind limbs was increased with the increase of TNF-α concentration. CCK-8 and colony formation assay demonstrated that the proliferation of MH7A cells was elevated after TNF-α treatment. Higher levels of VEGF and IL-6 secreted by FLS and decreased collagen synthesis ability of MH7A cells were found after TNF-α treatment. Transfection of the α1 (I) collagen overexpression recombinant in MH7A cells led to the reduced activity of CAT after TNF-α treatment, suggesting that the activation of α1 (I) collagen promoter was inhibited.

CONCLUSIONS

TNF-α participates in RA by inhibiting the activation of the promoter of α1 (I) collagen, as well as enhancing the secretion of VEGF and IL-6 in MH7A cells.

Automatic Conflict Monitoring by Event-Related Potentials Could be used to Estimate Visual Acuity Levels

Numerous studies have explored the physical attribute features or face perceptions in conflict processing, while complicate gradient conflicts were rarely discussed. The aim of the study was to discuss the relationship between the event-related potential (ERP) component features and different visual acuity levels by using the modified S1-S2 task under non-attention status. Three visual acuity levels were applied, each with four orientations of "E" optotype stimuli randomly presented in the center of the visual field while participants were required to concentrate on listening to stories. The results showed that the amplitudes of P1 and P3 as well as difference P3 were larger in supra-threshold condition. In threshold condition, larger amplitudes for both N2 and difference N2 exhibited in frontal and central areas. In sub-threshold condition, there was no endogenous component elicited by mismatch stimuli except smaller anterior N1. Meanwhile, the specific distributions of N1 and N2 were presented and compared with previous face processing. The findings showed that visual conflict processing took place not only at an early stage but also at the late period, which might be as the consequences of interaction between conflict strength and involuntary attention. We concluded that automatic conflict detecting of visual icons by the serial ERP components could distinguish different visual acuity levels. The involvement of endogenous components could reveal the specific mechanism of more precise and fine conflict identification of complex physical attributes under non-attention status, furthermore could be used as valid markers to estimate the magnitude of visual acuity objectively.

Investigation of Bilirubin Removal by NK-110 Resin Hemoperfusion in Jaundiced Dogs

A jaundiced dog model was made by common bile duct-inferior vena cava shunt with a silicon rubber tube. Blood bilirubin levels increased from 0.25 ± 0.16 (SD) mg% to 15 ± 1.4 (SD) mg%. These dog models were treated with a column containing 200 gm of macroreticular resin NK-110 which was linked between the femoral artery and vein. The rate of blood flow through the column was 200 ml/min.

It was shown that total bilirubin reduced from 15 ± 1.4 (SD) to 7.4 ± 0.61 (SD), conjugated bilirubin decreased from 6.97 ± 0.63 to 3.5 ± 0.33 (SD) and unconjugated bilirubin from 7.8 ± 2.1 to 4.2 ± 0.4 (SD). There were no significant changes in protein, electrolyte, blood gases and acid base balance. Results show that NK-110 resin has good blood-compatible and adsorption properties.

[Long-term efficacy of supracricoid partial laryngectomy for 298 patients with laryngeal carcinoma]

Objective: To evaluate the oncologic and functional outcomes of supracricoid partial laryngectomy (SCPL) in the treatment of laryngeal carcinoma. Methods: A total of 298 laryngeal carcinoma patients who underwent SCPL treatment from January 2005 to December 2013 were reviewed retrospectively. Clinical data of demographic and clinical characteristics, postoperative complications, rehabilitation information, recurrence and metastasis were analysed. Survival and local control were used to evaluate the clinical outcome.Data were analyzed by SPSS 23.0 software. Results: Thirty-one patients with supraglottic carcinoma underwent cricohyoidoepiglottopexy (CHEP)and 267 with glottic carcinoma underwent cricohyoidopexy (CHP) were enrolled in this study. The mean duration of followed up was 74 months, ranging from 12 to 146 months. Fifty-four cases died at last follow-up. With respect to 31 patients with supraglottic carcinoma, 5- and 10-year overall survival rates and disease specific survival rates all were 78.1%; 5- and 10-year disease free survival rates were 72.1% and 63.7% respectively; and 5- and 10-year local control rates were both 84.2%. In 267 patients with glottic carcinoma, 5- and 10-year overall survival rates were 85.8% and 77.1% respectively; 5- and 10-year disease specific survival rates were 86.6% and 78.4% respectively; 5- and 10-year disease free survival rates were 80.6% and 74.2% respectively; and 5- and 10-year local control rates were 90.0% and 89.4% respectively. The survival rate of patients with glottic carcinoma at stage T1 was higher than that at stage T2 or T3, and the disease free survival rate of patients with early stage was superior than that of patients with advance stage. Cox regression analysis showed that tumor stage T2, and T3, tumor recurrence, and tumor metastasis were independent risk factors for survival. Furthermore, nasogastric feeding tube removal rate was 100% and the decannulation rates of SCPL were 96% in the patients with SCPL. Conclusions: SCPL is a safe procedure with tumor resection for laryngeal carcinoma, with preserving of swallowing, respiration, and phonation functions, and has excellent survival and local control rates. This procedure could be considered as a standard function-sparing treatment for selected patients with laryngeal carcinoma of stages T1b-T3.

Abstract P1-03-05: Not presented

This abstract was not presented at the symposium.

Changes in carbohydrate and protein fractions during ensiling of alfalfa treated with previously fermented alfalfa juice or lactic acid bacteria inoculants

The effects of previously fermented juice (PFJ) prepared from alfalfa and lactic acid bacteria (LAB) inoculants on the dynamic changes of nutritive components in ensiled alfalfa after various ensiling periods were investigated by using the Cornell Net Carbohydrate and Protein System. The third-cut alfalfa was harvested at the budding stage, exposed to sunlight, weighed occasionally to estimate the dry matter (DM) content until the actual DM finally obtained was 347.8 g/kg fresh weight, and then chopped to 1–2-cm lengths. Chopped forages were treated with (1) distilled water (control), (2) alfalfa PFJ or (3) LAB at 1 mL/50 g fresh weight. The application amounts of PFJ and LAB to the fresh forage were 8.73 log (colony-forming units/mL) and 7.32 log (colony-forming units/mL) respectively. All silages were prepared in mini-silos of 100-mL polypropylene centrifuge tubes and kept in an incubator at 30°C, and triplicate silos from each treatment were opened after 1, 3, 7, 14 and 35 days of ensiling. Results suggested that silage treated with LAB and PFJ was of better quality than was the control silage, as evidenced by lower volatile fatty acid concentrations, as well as higher lactic acid, sugar, starch, soluble fibre and digestible natural detergent fibre production at various ensiling periods (P < 0.05), and a lower protein degradation as suggested by the low non-protein nitrogen production (P < 0.05). The effect of PFJ on alfalfa fermentation quality and protein degradation was greater than that of LAB, as evidenced by the lower pH value and volatile fatty acid content and the higher concentrations of lactic acid (P < 0.05). In addition, the cost of PFJ for 1 tonne of alfalfa silage is ~1/7–1/5 of that of LAB. In conclusion, adding PFJ to alfalfa forages before preservation as silage is a cost-effective way to improve the silage formation quality; in addition, its effect as a fermentation stimulant may be comparable to, or even better than, that of LAB inoculants at various ensiling periods.

Trends of Activities of Daily Living Disability Situation and Association with Chronic Conditions among Elderly Aged 80 Years and Over in China

OBJECTIVES

In China, few studies reported the disability situation and the association between disabilities with chronic conditions in aged people. This study investigates the cross-sectional trends of prevalence and severity of activities of daily living disability (ADL) in Chinese oldest-old people from 1998 to 2008, and identified the potential risk factors of disability.

DESIGN

A combination of population-based longitudinal prospective study and probabilistically sampling cross-sectional studies.

SETTING

The Chinese Longitudinal Healthy Longevity Survey (CLHLS) was based on a random sampling of aged people from twenty-two provinces in China.

PARTICIPANTS

A total of 52,667 participants aged from 80 years old to 105 years old sampled in the year of 1998 (n=8,768), 2000 (n=10,940), 2002 (n=10,905), 2005 (n=10,396) and 2008 (n=11,658) were analyzed respectively.

RESULTS

The prevalence of ADL disability decreased from the year of 1998 (18%) to 2008 (12%). The disability prevalence significantly increased in 2002 and decreased in 2008 (P<0.001) in total participants than the year of 1998. The prevalence trends of low ADL disability level were almost identical with that of the total ADL disability. Stroke/cerebrovascular disease (CVD) and cognitive impairment were the strongest risk factors of disability. Vision impairment became less associated with ADL disability (P=0.045), while the association between multimorbidity and ADL disability became stronger (P=0.033).

CONCLUSIONS

The prevalence of ADL disability declined among the oldest-old population in China from the year of 1998 to 2008 without obeying a linear pattern. Temporal trends of ADL disability mainly attributed to the change of low disability level prevalence. Stroke/CVD and cognitive impairment were the most common risk factors of disability. Vision impairment caused disability has become less common, while risks of multimorbidity related disability increased.

Development of Chrysomya megacephala at constant temperatures within its colony range in Yangtze River Delta region of China

Chrysomya megacephala (Fabricius, 1794) is the most abundant and predominant species which arrives and colonizes a cadaver first in most parts of China. Therefore, its growth and development patterns have great implications in the estimation of the minimum postmortem interval (PMImin). In this study, C. megacephala was collected from the Yangtze River Delta region and reared at seven constant temperatures ranging from 16 °C to 34 °C. The developmental duration and accumulated degree hours, larval body length and morphological changes of C. megacephala were examined. Furthermore, we constructed three developmental models, isomorphen diagram, isomegalen diagram and thermal summation model, which can be used for estimating PMImin. The developmental durations of C. megacephala at 16 °C, 19 °C, 22 °C, 25 °C, 28 °C, 31 °C and 34 °C are (794.8 ± 14.7), (533.2 ± 10.1), (377.8 ± 16.8), (280.8 ± 15.1), (218.9 ± 8.5), (190.8 ± 10.1) and (171.8 ± 6.8) h, respectively. The developmental threshold temperature D 0 is (11.41 ± 0.32) °C, and the thermal summation constant K is (3 418.7 ± 137.0) degree hours. Regression analysis was conducted to obtain equations of the variation in larval body length with time after hatching, and variation in time after hatching with body length. Moreover, our study divides the intra-puparial morphological changes of C. megacephala into 11 sub-stages, and provides the time range experienced by each sub-stage. The results of this study provide fundamental development data for the use of C. megacephala in PMImin estimations.

[Research Progress on Estimation of Early Postmortem Interval]

Estimation of postmortem interval （PMI） is very important for judging the nature of cases, restricting the scope of investigation and suspect, which is always the emphasis and difficulty for forensic pathology. Early postmortem interval is the time between 0 and 24 hours after death. Due to the shorter time after the case occurred, precisely estimating early postmortem interval can help solve crimes, which has important significance in forensic medicine. In recent years, series of advanced methods and technologies are used to estimate the early PMI by the internal and overseas scholars who work in the forensic area. This paper reviews the research progress on fluids biochemistry, supravital reactions, metabolomics, imageology and the degradation rule of genetic material to provide a new idea to the study and application for estimation of early PMI.

Assessment of cognitive dysfunction in traumatic brain injury patients: a review

Traumatic brain injury (TBI) is one of the major causes of human mortality and morbidity in the world. Brain injury could affect the core of a person's being - their thinking, memory, personality and behaviour. Electrophysiological markers from the human electroencephalogram and brain imaging provide a rich source of data which helps to elucidate specific processing impairments in TBI patients. To assess the cognitive and social function in traumatic brain injury patients, this review will focus on some of methods for assessing the disabling cognitive and social function deficits induced by TBI. There are many new technologies available to address TBI and recognition related questions. Integration of the various techniques will help to facilitate our comprehending of TBI, cognitive function and social function, and improve treatment and rehabilitation.

Neuroprotective effects of hydrogen sulfide on sodium azide-induced oxidative stress in PC12 cells

Alzheimer's disease (AD) is the most common neurodegenerative disorder, responsible for >50% of all dementia cases. Sodium azide (NaN₃) inhibits cytochrome oxidase by irreversibly binding to the heme cofactor and selectively reducing the complex IV activity, which is present in post-mortem AD brains. Previous data demonstrated that hydrogen sulfide (H₂S), the third endogenous gaseous mediator, exerted protective effects against neuronal damage. Therefore, it was hypothesized that H₂S may be able to scavenge excess reactive oxygen species (ROS), thereby protecting against oxidative stress and cell death. In the present study, it was observed that cell viability decreased in a concentration-dependent manner 12 h after NaN₃ treatment (20, 30 and 50 mmol/l). A decrease in cell viability (to 51±3%) was observed 12 h after treatment with 30 mM NaN₃. NaN₃ treatment also led to decreased mitochondrial membrane potential, increased lipid peroxidation (excessive production of malondialdehyde), and increased the protein expression levels of caspase-3. Pretreatment with H₂S (200 μmol/l) attenuated NaN₃-mediated apoptosis, and the anti-apoptotic action of H₂S was partially dependent on suppressing the production of ROS. The findings of the present study suggested that H₂S exerted a neuroprotective effect against NaN₃-induced neurotoxicity through mechanisms related to anti-oxidation and anti-apoptosis. Therefore, the findings of the present study suggest there may be a promising future for H₂S-based preventions and therapies for neuronal damage following exposure to NaN₃.

Neuroprotective effects of hydrogen sulfide on sodium azide‑induced autophagic cell death in PC12 cells

Sodium azide (NaN3) is a chemical of rapidly growing commercial importance. It is very acutely toxic and inhibits cytochrome oxidase (COX) by binding irreversibly to the heme cofactor. A previous study from our group demonstrated that hydrogen sulfide (H2S), the third endogenous gaseous mediator identified, had protective effects against neuronal damage induced by traumatic brain injury (TBI). It is well‑known that TBI can reduce the activity of COX and have detrimental effects on the central nervous system metabolism. Therefore, in the present study, it was hypothesized that H2S may provide neuroprotection against NaN3 toxicity. The current results revealed that NaN3 treatment induced non‑apoptotic cell death, namely autophagic cell death, in PC12 cells. Expression of the endogenous H2S‑producing enzymes, cystathionine‑β‑synthase and 3‑mercaptopyruvate sulfurtransferase, decreased in a dose‑dependent manner following NaN3 treatment. Pretreatment with H2S markedly attenuated the NaN3‑induced cell viability loss and autophagic cell death in a dose‑dependent manner. The present study suggests that H2S‑based strategies may have future potential in the prevention and/or therapy of neuronal damage following NaN3 exposure.

Meta-analysis of hypertension and osteoporotic fracture risk in women and men

The present meta-analysis synthesized evidence from 10 articles encompassing 28 independent studies to verify the association between hypertension and osteoporotic fracture risk in women and men. Our results indicate that the risk of osteoporotic fracture among individuals with hypertension was higher than that among individuals without hypertension.

INTRODUCTION

Epidemiological studies have suggested that hypertension is related to osteoporotic fracture. However, discrepancies exist in the reported findings. In this study, a systematic review of relevant published articles was conducted to verify the association between hypertension and osteoporotic fracture risk in women and men.

METHODS

PubMed (1953_October 5th, 2016) and Embase (1974_October 5th, 2016) were systematically searched for relevant articles. Odds ratios (ORs) and confidence intervals (CIs) were derived using random effect models. Categorical, subgroup, heterogeneity, publication bias, and meta-regression analyses were conducted.

RESULTS

We analyzed 10 articles encompassing 28 independent studies, 1,430,431 participants, and 148,048 osteoporotic fracture cases. The risk of osteoporotic fracture among individuals with hypertension was higher (pooled OR = 1.33, 95% CI 1.25-1.40; I ² = 72.3%, P < 0.001) than that among individuals without hypertension. The association between hypertension and fracture risk was slightly stronger in women (pooled OR = 1.52, 95% CI 1.30-1.79) than in men (pooled OR = 1.35, 95% CI 1.26-1.44). Studies conducted in Asia revealed results that were consistent with those of studies performed in Europe.

CONCLUSIONS

Hypertension is associated with osteoporotic fracture risk. However, the biological mechanisms underlying the effect of hypertension on osteoporotic fracture remain to be elucidated.

[The clinical characteristics and treatment outcomes of 386 patients with hypopharyngeal cancer]

OBJECTIVE

To investigate the clinical characteristics, surgical treatment outcomes and prognostic factors of hypopharyngeal carcinoma.

METHODS

A retrospective review of the Eye & ENT Hospital of Fudan University patients' database between January 2003 and June 2013 was conducted and a total of 386 patients were enrolled in the study. Patients' clinical and oncological information was collected and survival rates were analyzed using Kaplan-Meier curves. Prognostic factors were evaluated with multivariate Cox model survival analysis.

RESULTS

Among the 386 patients 95.9% were males and 4.1% were females, with an average age of (58.4±9.4) years. The primary tumor sites were pyriform sinus (76.7%), posterior hypopharyngeal wall (17.3%) and postcricoid region (6.0%). There were 31(8.0%), 83(21.5%), 175(45.3%) and 97(25.1%) patients with stage T1 to T4, respectively, 99(25.6%), 74(19.2%), 181(46.9%) and 32(8.3%) patients with stage N0 to N3, respectively , and 3 patients with distant metastasis to lung on initial diagnosis. Second primary cancers were found in 28 cases (7.3%). The 5-year overall survival (OS), disease specific survival (DSS) and disease free survival (DFS) were 45.8%, 48.1% and 46.0% respectively according to Kaplan-Meier survival curves. Multivariate Cox regression model showed significant association between 5-year overall survival rate and T stage (P<0.001), N stage (P=0.003) and second primary tumors (P=0.017). Advanced T stage and lymphovascular invasion were associated with a higher rate of recurrence (P<0.001).

CONCLUSIONS

Hypopharyngeal squamous cell carcinoma has a dismal prognosis, with high rates of submucosal infiltration, cervical lymph node metastasis and distant metastasis. Treatment choices should be made according to TNM stage and overall health conditions in order to achieve ideal oncologic and functional results. Surgery with postoperative chemoradiation therapy is the main treatment for advanced-stage hypopharyngeal cancer.

[A dual PI3K/mTOR inhibitor, PI-103, cooperates with TRAIL in laryngeal squamous carcinoma cells in vitro]

OBJECTIVE

To investigate the effects of a dual phosphoinosmde-3-kinase (PI3K)/ mammalian target of rapamycin (mTOR) inhibitor, PI-103, cooperating with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on the laryngeal squamous carcinoma Hep-2 cells.

METHODS

Hep-2 cells were divided into 7 groups: LY294002 group, Rapamycin group, PI-103 group, LY294002+ TRAIL group, Rapamycin+ TRAIL group, PI-103+ TRAIL group and control group.The cell cycle and apoptosis of Hep-2 cells were assessed by flow cytometry.For PI-103 group, PI-103+ TRAIL group and control group, migration and invasion ability were measured by transwell migration and invasion assay respectively.The expression of relative proteins in apoptosis and PI3K/AKT/mTOR signal pathway was examined by Western blotting.

RESULTS

Combination of PI-103 and TRAIL could make cell cycle arrest at S phase (G1: 1.80%±0.30%; G2: 0.00), inhibit cell proliferation, and enhance apoptosis (66.78%±2.93%) (P<0.05). Combination of PI-103 and TRAIL could statistically decrease the migration and invasion number of Hep-2 cells (17.0±3.4, 18.4±5.4) than that of PI-103 group (41.2±3.8, 41.6±4.7). PI-103 could inhibit PI3K/AKT/mTOR signal pathway by decreasing the protein expression of p-AKT and p-4E-BP1.Comparing with the control group, the expression of cysteinyl aspartate specific proteinase (Caspase) 9, 8, 3 were increased while the expression of Cyclin D1, Cyclin E1, p-AKT, p-4E-BP1 were decreased in PI-103 and PI-103+ TRAIL group (P<0.05).

CONCLUSION

Enhanced anti-tumor effects was observed by combination of PI-103 and TRAIL on laryngeal cancer cells in vitro and this combined administration might be a promising strategy for clinical treatment of laryngeal cancer.