Les classifications moléculaires des cancers colorectaux (CCR) ont été significativement modifiées depuis 20 ans. Initialement répartis en trois groupes moléculaires, les CCR font maintenant l’objet ...d’une classification consensus (ou CMS pour consensus molecular subtype). Seules certaines altérations moléculaires issues de ces classifications sont régulièrement recherchées et utilisées en pratique clinique, principalement en situation métastatique. Les classifications concernant la réponse immune sont plus récentes et essentiellement morphologiques. Leur impact clinique est fort, mais elles n’ont pas encore pénétré le domaine de la pratique quotidienne. Cet article a pour but de proposer une synthèse des classifications moléculaires et immunes pertinentes et d’en souligner les applications cliniques réelles ou potentielles.
But de l’étude : Le traitement du cancer colorectal (CCR) repose avant tout sur la détermination du stade tumoral, déterminé par la classification TNM. Malgré des avancées dans la prise en charge de ...la maladie métastatique et de ses différentes localisations, cette classification n’a pas bénéficié d’amélioration notable. Dans ce cadre, le rôle des dépôts tumoraux (DT) reste très débattu. Nous avons étudié la relation entre la présence de DT et les localisations métastatiques des CCR, afin de déterminer s’ils apportaient une information significative et nouvelle dans l’établissement du stade TNM.Méthodes : Une recherche systématique de la littérature a été réalisée, centrée sur le rôle des DT dans le CCR. Les études comportant des patients ayant reçu un traitement néoadjuvant n’ont pas été retenues. Les données concernant le stade, les paramètres histologiques et l’évolution ont été recueillies. Les données de quatre cohortes importantes ont été finalement analysées compte tenu de l’impact majeur des DT, des métastases ganglionnaires lymphatiques et des invasions veineuses extramurales sur le type de localisation métastatique et de l’évolution.Résultats : Parmi les 10 106 inclus dans cette analyse, 22 % présentaient des DT. Les DT étaient invariablement associés à une évolution défavorable. La présence de DT était associée à la présence de métastases ganglionnaires lymphatiques et d’invasions veineuses extramurales. Dans une comparaison appariée, l’impact des DT était plus important que celui des métastases ganglionnaires lymphatiques et des invasions veineuses extramurales. En utilisant un modèle de régression logistique, les DT combinés aux métastases ganglionnaires lymphatiques constituaient le facteur prédictif le plus puissant concernant la présence de métastases hépatiques (odds ratio OR : 5,5), pulmonaires (OR : 4,3) et péritonéales (OR : 7,0). La présence d’invasions veineuses extramurales était informative pour la présence de métastases hépatiques et pulmonaires, mais pas péritonéales.Conclusion : Nous avons montré que les DT ne sont pas équivalents aux métastases ganglionnaires lymphatiques et aux invasions veineuses extramurales, tant sur le plan biologique que clinique. L’intégration des DT à la seule catégorie N1c et leur prise en considération, uniquement en l’absence de métastase ganglionnaire lymphatique conjointe, entraînent une perte d’information pronostique. Par conséquent, nous proposons que le nombre de DT soit additionné au nombre de métastases ganglionnaires lymphatiques pour aboutir à un stade N final.
This study aims to characterize the rate of two specific resistance genes (KPC and NDM-1) and determine the route of transmission between the sites to implement infection control measures ...effectively.
This study was carried out at Viet Duc hospital in Vietnam. Bacterial isolates (Klebsiella pneumoniae) were collected between January 2018 and June 2019. Bacterial strains and antimicrobial susceptibility testing were performed in the VITEK 2 system.
A total of 100 samples from 25 patients were taken. From each patient, we collected 4 samples from 4 sites. 25 isolated strains resisted 100% to amoxicillin/acid clavulanic, piperacillin/Tazobactam, and antibiotics in the cephalosporine group. Particularly in the carbapenem group, they resisted 100% to ertapenem, 96% to imipenem, and eropenem (rest was intermediate level). They have 76% sensitivity to aminoglycosides, 76% to amikacin, 60% to gentamycin, and 60% to tigecycline. Klebsiella pneumoniae carbapenemase (KPC) (+) was 24% and NDM-1 (+) was 28%. There was no case in all four sites. Positive-KPC strains were mainly in two sites (4/6 = 66.67%) and positive-NDM-1 strains were mainly in three sites (4/7 = 57.14%). Negative to both KPC and NDM-1 strains were in one site (4/12 = 33.3%) and two sites (6/12 = 50%).
The rate of KPC and NDM-1 was 24% and 28%. In accordance with high antibiotic resistance rates to common antibiotics used in Vietnam, the high rate of transmission possibility between the sites contributed to strengthen the implementation of infection control measures in the ICU setting.
This study aimed to evaluate the change of morphology and hemodynamics in a relatively large number of patients with atrial septal defect (ASD) and provide the initial result in Vietnamese patients.
...This longitudinal, prospective case-control study was done at the Vietnam National Heart Institute from January 2012 to December 2017. The participants were divided into two groups: the ASD group, which included patients with ASDs, and the control group, which included healthy individuals or individuals without cardiac-related disorders.
There were 94 participants in the ASD group and 83 participants in the control group. Most patients with ASDs in the study group were female, and the average age was 38.65 ± 14.8. The success rate of the ASD group was 98.9%. The right ventricle morphology and function showed right ventricular diameter, pulmonary trunk gradually decreased, FAC and ET increased, IVCT and IVRT decreased, and Tei index gradually decreased after each examination. Morphology and function of the left ventricle after ASD closure showed that the left ventricular diameter gradually increased, and EF% in 3 months after ASD closure increased statistically significantly. IVCT, IVRT, and LV Tei index decreased, and ET increased statistically significantly. After six months from ASD closure, the proportion of patients with NYHA I was 90.3%, with no patient with NYHA IV, and pulmonary vascular resistance gradually decreased.
Percutaneous trans-catheter closure in Vietnamese adult atrial septal defect was an effective technique. Ventricle morphological and hemodynamic abnormalities following closure recovered statistical significance over time, particularly in the left ventricle.
Cuticular hydrocarbons (HCs) play important roles in insect communication but few studies clearly demonstrate the direct link between HCs and nestmate recognition. Therefore, cuticular lipids were ...extracted from ants, their HC and
non-HC fractions as well as the three principal classes of HCs (
n-alkanes, branched alkanes and alkenes) were purified and tested using an immobilizing “joust” device which allowed quantification of early pairwise behavioural responses, mandibular opening and antennal retraction, without occurrence of subsequent damages as in classic dyadic encounters.
Chemical recognition of ants was studied at three levels of interactions (intra-colonial, intra-specific and inter-specific). Three closely related species already chemically characterized were used:
Pachycondyla villosa (Pv),
P. inversa (Pi) and
P. subversa (Ps). Each species had its own behavioural responses. Moreover, responses of Pi and Ps towards Pv were significantly longer, than they were between themselves whereas Pv ants were equally aggressive towards Pi and Ps. These differences are in agreement with the results of the cluster analysis of the cuticular HCs profiles that place Pi closer to Ps. In support of the idea that components of cuticular lipids profiles are important for recognition, we found that only the HC fraction and its branched subfraction elicited a behavioural response of Ps workers. It is suggested that internally branched methyl- and dimethylalkanes are involved in recognition behaviour.
In ants, both cuticular and postpharyngeal gland (PPG) hydrocarbons (HCs) have been involved in nestmate recognition. However, no detailed comparison is available. A comparative study including also ...high density lipophorin (HDLp), an internal HC carrier, was therefore undertaken on
Pachycondyla villosa. Purified HDLp is an 820 kDa lipoprotein with a density of 1.114 g/ml and two 245 and 80 kDa apo-proteins. Its hydrocarbon profile is very similar with the cuticular one, in agreement with its hydrocarbon carrier function. Conversely,
n-alkanes and externally branched monomethylalkanes are markedly decreased in the PPG. According to their physical properties, this suggests that they are involved in waterproofing on the cuticle. The PPG actually contains only internally branched mono-, dimethylalkanes or monomethylalkenes; their greater fluidity is more adequate for chemical communication. The percentages of some of them are statistically not different between the cuticle and PPG. Their mixtures vary with colonies and they may thus be involved in colonial signature. A scheme for hydrocarbon circulation is discussed, involving lipophorin, cuticle, PPG and self-grooming in one individual, a pathway complementary or alternative to the selective delivery by lipophorin in some other insects. HCs are then distributed between nestmates’ cuticles through allo-grooming and physical contacts.
OBJECTIVE: Early responses to COVID-19 have been conducted by Vietnam’s government in both the speed and the stringency of the interventions used. To evaluate the effect of these policies, we built ...the predictive model to compare the actual cases and estimated cases in Vietnam. SUBJECTS AND METHODS: We applied the predictive model with two parameters at three points before the travel restriction policy, after one week, and after the policy’s end (2 weeks). After each time of evaluation, two parameters in the model were adjusted to estimate new cases in the following time. Nonlinear Least Squares determined the nonlinear (weighted) least-squares estimates of the parameters of a nonlinear model. RESULTS: Many measures were applied to prevent the spread of the pandemic, and two highlighted measures were quarantine and social distancing policy. Parameters were estimated before the policy (a = 20.686, b = 0.098), after the promulgation of policy (a = 23.179, b = 0.089), and after one week (a = 30.759, b = 0.072). The difference between expected and observed cases was statistically significant (p = 0.01), showing positive results of the policies. After one week (the incubation period), suspected and infected cases have been detected and managed, facilitating the reduction of new cases. CONCLUSIONS: The effects of early policy response on the COVID-19 pandemic were significant after each stage of serial measurements, according to the parameters of the predictive model. Our model can be considered in the next wave of the COVID-19 pandemic or another pandemic to predict progress and take measures effectively.
This study evaluated the effectiveness and safety of C1-C2 transarticular screw fixation (transarticular screw fixation com-bined with bone grafting) and C1 lateral mass-C2 pedicle screw fixation ...(modified Harms technique) in patients with C1-C2 instability.
This prospective, self-controlled, single-center study evaluated two fixation techniques for the treatment of atlantoaxial instability injury. From June 2006 to February 2017, 118 patients were admitted to our hospital because of atlantoaxial instability injury. These patients were divided into two groups: group 1, including 52 patients who underwent C1-C2 transarticular screw fixation (C1C2-TAS group), and group 2, including 66 patients who underwent C1 lateral mass-C2 pedicle screw fixation (C1LM-C2PS group).
There were significant differences in the operation time, blood loss amount, and hospital stay length between the groups (p<0.001). The mean operation time (78.94 vs. 110.91 min; p=0.0003) and hospital stay length (5.31 vs. 8.34 days; p=0.0003) were shorter, and the mean blood loss amount during surgery (122.31 vs. 258.33 mL; p<0.0001) was smaller in the C1C2-TAS group than in the C1LM-C2PS group. The surgical complication rate was low and no vertebral artery injury was observed. After surgery, the clinical presentations were significantly reduced in both groups. The patients showed sati-sfactory internal fixation on postoperative radiography and computed tomography.
Both C1-C2 transarticular screw fixation and C1 lateral mass-C2 pedicle screw fixation are effective and safe in treat-ing atlantoaxial instability injury. Notably, C1-C2 transarticular screw fixation yields a shorter operation time and hospital stay length and a smaller intraoperative blood loss amount than does C1 lateral mass-C2 pedicle screw fixation.
Lipophorin was isolated from homogenized adult Drosophila melanogaster. It is stained by Sudan Black and has a native molecular mass of 640 kD and a density of 1.12 g/ml. It consists of two ...glycosylated apoproteins of 240 and 75 kDa. Gas chromatography and mass spectrometry showed that lipophorins isolated separately from virgin 3-day-old male and female flies were associated with specific hydrocarbons, and that these were the same hydrocarbons found in male and female cuticles, respectively. Moreover, a pool of internal hydrocarbons was demonstrated for the first time, with chain lengths similar to those of the cuticular pool. Studies on the fate of the hydrocarbons synthesized de novo after topical applications of radiolabelled fatty acid precursors showed a decrease of the internal pool of hydrocarbons with time, concomitant with an increase of the cuticular pool. These results suggest that hydrocarbons synthesized at an internal site, possibly in oenocytes, may be transported to the cuticle of the flies by lipophorin.
To evaluate the preemptive analgesic effect of combination pregabalin with celecoxib for lumbar spine surgery.
A prospective, randomized study was conducted among 60 lumbar spine surgery patients and ...divided into two groups. Postoperative pain relief was achieved with intravenous patient-controlled analgesia with morphine. The preemptive analgesia group received oral pregabalin (150 mg) and celecoxib (200 mg) 2 hrs before surgery, and the control group received a placebo. Pain was assessed by visual analogue scale (VAS). Side effects and morphine consumption were monitored until 48 hrs after surgery.
VAS score at rest and during movement was statistically significantly lower in the preemptive analgesia group at most time points (
<0.05). Morphine consumption was significantly lower in the preemptive analgesia group compared with control group in the 24 first hours (29.03±4.38 mg vs 24.43±4.94) and 48 hrs (52.23±9.57 mg vs 44.20±10.21 mg),
<0.05. Hemodynamics, respiratory rate, and SpO
were similar for both groups. The sedation score was only statistically significant at H8 time point. The incidence of nausea/vomiting in the preemptive group did not statistically differ from the control group.
Preoperative administration of pregabalin combined with celecoxib had a good preemptive analgesia effect and reduced intravenous morphine consumption after lumbar spine surgery. Side effects were mild and transient.
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