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Objective:To investigate the application value of endoscopic ultrasound (EUS) in tumor staging of adenocarcinoma of the esophagogastric junction (AEG) after neoadjuvant concurrent chemoradiotherapy.Methods:The clinical data of 40 patients diagnosed with stage Ⅲ AEG and treated with neoadjuvant concurrent chemoradiotherapy from January 2016 to December 2021 in the First Affiliated Hospital of Hebei North University were retrospectively analyzed. EUS was used to perform preoperative tumor staging after neoadjuvant concurrent chemoradiotherapy to evaluate the therapeutic effect, and the consistency between EUS and postoperative pathological staging was analyzed.Results:In 40 AEG patients after neoadjuvant chemoradiotherapy, the EUS staging was stage yp-uT 2 in 12 cases, stage yp-uT 3 in 18 cases, and stage yp-uT 4 in 10 cases. The postoperative pathological staging was stage pT 1 in 2 cases, stage pT 2 in 14 cases, stage pT 3 in 12 cases, and stage pT 4 in 12 cases. Taking postoperative pathological results as the gold standard, the accuracy of EUS for T staging after neoadjuvant chemoradiotherapy was 62.5%, and the accuracy, sensitivity and specificity for stage T 2 were 58.3%, 50.0% and 80.8%, respectively. The accuracy, sensitivity and specificity for stage T 3 were 61.1%, 91.7% and 75.0%, respectively. The accuracy, sensitivity and specificity for stage T 4 were 70.0%, 58.3% and 89.3%, respectively. The Kappa value of the consistency test between yp-uT staging and pT staging was 0.453. The EUS staging of lymph nodes was stage yp-uN 0 in 15 cases, stage yp-uN 1 in 10 cases, stage yp-uN 2 in 10 cases, and stage yp-uN 3 in 5 cases. The postoperative pathological staging was stage pN 0 in 18 cases, stage pN 1 in 7 cases, stage pN 2 in 7 cases, and stage pN 3 in 8 cases. Taking postoperative pathological results as the gold standard, the accuracy rate of EUS for N staging after neoadjuvant chemoradiotherapy was 57.5%, and the accuracy, sensitivity and specificity of EUS for stage N 0 were 73.3%, 61.1% and 81.8%, respectively. The accuracy, sensitivity and specificity for stage N 1 were 50.0%, 71.4% and 84.8%, respectively. The accuracy, sensitivity and specificity for stage N 2 were 40.0%, 57.1% and 81.8%, respectively. The accuracy, sensitivity and specificity for stage N 3 were 60.0%, 37.5% and 93.8%, respectively. The Kappa value of the consistency test between yp-uN staging and pN staging was 0.409. Conclusions:EUS is not accurate for T staging in patients with stage Ⅲ AEG after neoadjuvant therapy, but has high sensitivity for stage T 3 and high specificity for stage T 4. EUS has low sensitivity for N staging in patients with stage Ⅲ AEG after neoadjuvant therapy, but has high specificity for stage N 3.
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Chronic hepatitis B is a world-wide health problem and now at least 250 million people have been infected with hepatitis B virus. Current treatment of hepatitis B rarely achieves a cure because the viral replication template which called covalently closed circular DNA (cccDNA) are resistant to conventional therapies. The phenotype and function of natural killer cells from chronic hepatitis B patients are different to those from acute hepatitis B patients, suggesting that the function of NK cells may be related to clearance of HBV. Some studies have suggested that the differentiation, development and activation of natural killer cells are controlled by the mammalian target of rapamycin. The present review will mainly focus on the biology of hepatitis B virus, the differentiation and development of natural killer cells, and the progress of metabolism of natural killer cells.
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Objective To explore the changes of serum interleukin-6 (IL-6),and interleukin-8 (IL-8) in patients with gastric cancers and the clinical relationships with Helicobacter pylori (Hp) infection.Methods Totally 62 cases of patients who were diagnosed gastric cancer in our hospital from January 2013 to September 2015 were selected as the study group,who did not accept anti-tumor therapy.The patients were divided into the Hp positive group (with 53 cases) and Hp negative group (with 9 cases) according to whether the merger of Hp infection.Another 60 normal healthy volunteers of the same age in our hospital for health examination during the same period were selected as the control group.The serum IL-6 and IL-8 levels were detected,and the changes of the factors in the study group and control group were compared and analyzed,as well as the U values of Hp infection.The clinical relationships between the expression levels of the two in patients with gastric cancer and the U values of Hp infection were confirmed.Results The serum IL-6 and IL-8 levels and the U values of Hp infection of the study group were significantly higher than those of the control group (P ＜ 0.05),which in the Hp positive group were significantly higher than those in the Hp negative group (P ＜ 0.05).The levels of serum IL-6 and IL-8 in patients with gastric cancer showed positive correlations with the U value of Hp infection (r =0.457,0.531,P ＜ 0.05).Conclusions The serum IL-6 and IL-8 levels in patients with gastric cancer are much higher than those in normal healthy people,and there are significant positive relationship with Hp infection.It can improve the curative effect of gastric cancer patients by improving the eradication rate of Hp.
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Objective To investigate the expression of proliferating cell nuclear antigen ( PCNA) and the level of 8-hydroxydeoxyguanosine (8-OhdG) in gastric carcinoma and their clinical significance. Methods PCNA protein expression of 63 tumor tissues , 36 paracancerous tissues and 9 chronic gastritis mucosa were ana-lyzed by immunohistochemistry and 8-O HdG of hydrolysates was determined by HPLC. Results The expression of PCNA and the level of 8-OHdG were upregulated in chronic gastrits mucosa adjacent tissues and gastric carci-noma raised gradually and these two metrics were associated with tumor differentiation and TNM stage. Conclu-sions Up-regulation of PCNA protein expression and 8-O HdG levels are observed in gastric carcinoma. Detec-tion of PCNA protein expression and 8-O HdG levels can be used to evaluate malignant biological behavior and prognosis of gastric cancer.
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Objective To compare the efficacy of sequential therapy combined with probiotics,pure sequen-tial therapy and standard triple therapy for Helicobacter pylori eradication.Methods Selected the clinical data of 240 patients admitted.The 240 patients were randomly divided into 3 groups.Group A received standard triple thera-py,group B received sequential therapy and Group C received sequential therapy in combination with probiotics. Then,we compared the eradication rate,the score of gastrointestinal tract symptoms before and after treatment,and the side effects among 3 groups.Results The eradication rate was 72.5% in groupA,87.5% in group B,and 96.3% in group C.The eradication rate of group C was significantly better than group A and group B (χ2 =18.531,P 0.05),but they all significantly decreased after treatment among 3 groups(P <0.05),with group C a better result(F =25.581,P <0.05).The side effects of 3 groups were 16.3%,13.8%,3.8%,respectively.There were a significantly differencec between group C and the other 2 groups(χ2 =7.011,P =0.030).Conclusion Sequential therapy in combination with probiotics can achieve a higher eradication rate,improve the score of gastrointestinal tract symptoms, and decrease side effects.