Medicine
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Observational Study
Lymph node metastasis characteristics of papillary thyroid carcinoma located in the isthmus: A single-center analysis.
The frequency and pattern of lymph node metastasis and the extent of dissection for isthmic papillary thyroid carcinoma (PTC) remain unclear, and the aim of this present study was to evaluate these characteristics and to attempt to detect the best surgical protocol for isthmic PTCs. A total of 3185 consecutive patients with PTCs were reviewed. Of these patients, 47 with a single isthmic PTC were enrolled in our study, and matched 47 patients with a single PTC located in the unilateral lobe were randomly selected and added for comparison of their baseline tumor characteristics and lymph node metastasis characteristics. ⋯ The isthmic PTCs showed a higher rate of capsule invasion (P = .013) and advanced pathological N stage (P = .038) compared to the PTCs located in the lobe; meanwhile, pathological evidence of central lymph node metastasis (P = .040) was more frequent in the isthmic PTC group than in the control group. The univariate and multivariate analyses indicated that the tumors located in the isthmus (hazard ratio [HR]: 2.769; 95% confidence interval [CI]: 1.124-6.826; P = .027) and those with advanced (T2-4) pathological classifications (HR: 4.282; 95% CI: 1.224-14.976; P = .023) were independent risk factors for central lymph node metastasis in PTC patients. Due to the higher rate of pathological central lymph node metastasis and independent risk factors for central lymph node metastasis, total thyroidectomy, and bilateral central lymph node dissection should be considered the standard surgical protocol for isthmic PTCs.
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Comparative Study Observational Study
Effect of dexmedetomidine and midazolam for flexible fiberoptic bronchoscopy in intensive care unit patients: A retrospective study.
This study aimed to investigate the clinical effectiveness of dexmedetomidine and midazolam for sedation of intensive care unit (ICU) patients requiring flexible fiberoptic bronchoscopy (FFB). This retrospective cohort study included 148 patients from the third ICU ward of the Second Affiliated Hospital of Harbin Medical University (Harbin, China) who received simultaneous invasive mechanical ventilation and FFB between March 2012 and December 2014. Patients were divided into dexmedetomidine (n = 72) and midazolam (n = 76) groups according to sedative mode. ⋯ However, the incidence of other adverse events was not significantly different between groups. In addition, bronchoscopist satisfaction scores were significantly higher in the midazolam compared with dexmedetomidine group (7.72 ± 1.65 vs 7.08 ± 1.77; P = .030). For sedation of ICU patients during FFB, combination of midazolam and dexmedetomidine demonstrated an enhanced sedative effect, lower incidence of adverse events, and higher bronchoscopist satisfaction score compared with dexmedetomidine alone, thus represents a suitable alternative sedative for FFB patients.
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The aim of this study is to identify which possessed the best stem-cell-like characteristics in 3 kinds of cell in human degenerative intervertebral disc: NPSCs (nucleus pulposus-derived stem cells), AFSCs (annulus fibrosus-derived stem cells), or CESCs (cartilage endplate-derived stem cells). ⋯ In conclusion, we found that the cell morphology was not significantly different among NPSCs, AFSCs, and CESCs. Both differentiation and RT-PCR tests demonstrated that AFSCs had the best stem-cell-like characteristics in the human degenerative intervertebral disc.
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Case Reports
Familial lumbar Scheuermann disease with idiopathic scoliosis in China: First case report.
Given that Scheuermann disease rarely occurs in the lumbar region and that the co-occurrence of Scheuermann disease and idiopathic scoliosis (IS) has not been reported-the etiology of Scheuermann disease and IS is not clear. In this case report, we present familaiar lumbar Scheuermann disease with IS, in a Chinese proband, who was successfully treated with surgery. ⋯ This series of lumbar Scheuermann patients with IS in a pedigree support the genetic contribution to Scheuermann disease. Therefore, this study provides some insight into the genetic etiology of Scheuermann disease with IS.