BackgroundCompelling evidence has shown that the incidence of lumbar disc herniation (LDH) increases with age. In this study, retrospective clinical analysis of 601 cases of LDH has been conducted to investigate the role of age in the incidence of LDH in the elderly. The aim of the study is to investigate the relationship between the process of aging and the occurrence of LDH in old adults.MethodsClinical cases (n = 601) of LDH were retrospectively analyzed.ResultsThe imaging examination with computed tomography and/or magnetic resonance imaging showed the occurrence of degeneration in LDH patients over 65 years of age. The most common site of LDH is toward the bottom of the spine at L4–L5 and/or L5–S1. The incidence of LDH drops with age in the elderly, especially after the age of 80 years. There is an obvious decrease in LDH in the elderly female.ConclusionA decreasing incidence of LDH with aging occurs in the elderly. This investigation indicates that aging is not a contributor to the performance of LDH in the elderly although the incidence of LDH is proportional to age.
Background
Pleckstrin Homology Like Domain Family Member 2 (PHLDB2) is an important protein with a PH-domain for interaction with partners to regulate cell migration. However, the role of PHLDB2 in human cancer metastasis, especially in colon cancer, still remains elusive.
Methods
The RNA-seq and clinical data of colorectal cancer patients from the Cancer Genome Atlas (TCGA) were analyzed for correlations between PHLDB2 and clinical outcomes as well as epithelial–mesenchymal transition (EMT) markers. Wound healing and transwell invasion assays were used to determine the effects of PHLDB2 on cell migration and invasiveness. Western blot and qRT-PCR analyses were employed to detect protein and mRNA changes, respectively. Co-immunoprecipitation was performed to assess protein–protein interaction.
Results
In the present report, by following our previous study, we found that PHLDB2 expression is associated with poorer prognosis, including disease-free survival, tumor stage, nodes pathology, as well as lymphatic and vascular invasion through TCGA data analysis. In addition, PHLDB2 expression is highly correlated with multiple epithelial–mesenchymal transition (EMT) markers involving cell-surface proteins (N-cadherin and OB-cadherin), cytoskeletal markers (α-SMA and Vimentin), ECM proteins (Fibronectin and Laminin 5), and transcription factors (Snail2, ZEB1, and Ets-1). We also demonstrated that PHLDB2 knockdown mediated by siRNA was sufficient to attenuate colon cancer cell migration and invasion, as well as E-Cadherin reduction, by TGF-β treatment. Interestingly, PHLDB2 expression levels were significantly elevated in response to EMT induction by TGF-β and EGF. Moreover, we found that PHLDB2 could bind to MDM2 and facilitate MDM2-mediated E-Cadherin degradation.
Conclusions
Our findings suggest that PHLDB2 is a downstream effector of EMT pathway and may present as an important biomarker for colon cancer prognosis and a target for colon cancer intervention.
Electronic supplementary material
The online version of this article (10.1186/s12935-019-0903-1) contains supplementary material, which is available to authorized users.
Rationale:
Foreign body ingestion is often encountered in clinical practice; however, intestinal perforation owing to foreign body ingestion is rare.
Patient concerns:
Here, we present the cases of 2 patients who accidentally swallowed foreign bodies and later presented with pain in the right lower abdominal quadrant.
Diagnoses:
Both patients were initially diagnosed with acute appendicitis and underwent immediate emergency laparotomy.
Interventions:
During the operation, the appendix was found to be only mildly inflamed. On transection of the appendix, the mucosa was found to be inflamed, and yellow-white exudate was noted. We, therefore, decided to explore the entire bowel. The bowel examination revealed small bowel perforations, and palpation of the adjacent bowel revealed a hard, sharp object. The object was removed through the perforation site, the perforation was repaired, and the abdomen was closed in layers.
Outcome:
The postoperative recovery, in both cases, was uneventful.
Lessons:
Patients who swallow sharp or large foreign bodies should undergo endoscopy as soon as possible to avoid intestinal perforation. Clinicians should inquire about a history of foreign body ingestion. The preoperative diagnosis of intestinal perforation secondary to foreign body ingestion requires a high degree of clinical suspicion and awareness.
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