Expression of PGE2 and COX-2 in colorectal cancer and the clinical significance / 中华普通外科杂志

Objective To investigate the expressions of PGE2 and COX-2 between colorectal cancer tissue and normal colorectal mucosa tissue,and its relation to clinical pathology and significance.Methods 115 colon cancerous tissues and 69 normal colon tissues were collected in our hospital from Jan 2010 to Sept 2011.Immunohistochemistry was used to detect the PGE2 and COX-2 expression in both of the colorectal cancer and normal tissues.Results Positive expressions of PGE2 and COX-2 were 87.8％ (101/115) and 80.9％ (93/115) in the colorectal cancer tissue,and 8.7％ (6/69),21.7％ (15/69) in normal colorectal mucosa tissue respectively (x2 =110.96,62.194,all P ＜ 0.05).Expressions of PGE2 and COX-2 were closely associated with,tumor invasion,differentiation,lymph node metastasis and TNM stage (P ＜ 0.05).The Spearman rank correlation analysis indicated that the PGE2 and COX-2 expressions in tissues were closely correlated (r =0.987,P ＜ 0.05).Survival rate of the patients in both negative expressions of PGE2 and COX-2 (63.6％) were higher than that of both positive expressions (37.8％,P ＜ 0.05).Conclusion High PGE2 and COX-2 expressions in colorectal cancer tissues predicts poor patients' survival.

CXCL12 promotes CXCL8 secretion and co-operatively enhance metastatic potential of colon cancer cell lines / 中华普通外科杂志

Objective To investigate the effect of CXCL12 on the secretion of CXCL8 from colon cancer cells and the mechanism of co-regulation of proliferation and metastasis of colon cancer.Methods The expression levels of CXCL8 and CXCl12 in 5 human colon cancer cell lines (DLD-1,HT29,WiDr,CaCo-2,Colo320),fibroblasts,and human umbilical vein endothelial cells (HUVEC) were studied by Western blotting,respectively.ELISA,proliferation and invasion assay were used to explore the role of CXCL12 and CXCL8 for metastatic process of colon cancer and interaction between colon cancer cell and stromal cell in the microenvironment,respectively.Results The expression of CXCL8 was detected in all colon cancer cell lines,fibroblasts and HUVEC,while CXCL12 was expressed only in DLD-1 cell and fibroblast.The secretion level of CXCL8 in CaCo-2,WiDr,HT-29 and HUVEC (2.54-fold vs.control,2.07-fold vs.control,1.87-fold vs.control,2.79-fold vs.control) was enhanced by CXCL12 that derived from fibroblasts(P ＜ 0.01).CXCL8 could significantly promote the proliferation,migration of HUVEC (P ＜0.01).CXCL8 and CXCL12 enhanced proliferation of HUVEC (P ＜ 0.01),invasion of HUVEC and HT-29 (P ＜ 0.01) in a concentration-dependent manner.Conclusion Fibroblasts derived CXCL12 enhanced the CXCL8 secretion in colon cancer cells,and CXCL8 and CXCL12 can promote the proliferation and invasion of colon cancer cells.

Comparison of carbon dioxide laser versus high-frequency electroacupuncture in the treatment of steatocystoma multiplex: a self-controlled clinical study / 中华皮肤科杂志

Objective To compare the clinical efficacy and safety of carbon dioxide (CO2) versus high-frequency electroacupuncture based on the assistance of drilling and blunt dissection in the treatment of steatocystoma multiplex.Methods A randomized,self-controlled study was performed in 15 patients.The median line of the body served as the dividing line,and the lesions on the two sides of the median line of the body were randomly divided into 2 groups to be treated with CO2 laser or high-frequency electroacupuncture,which left micropathways into the cyst cavity.After the above treatment,contents in the cysts were squeezed out or drawn out with a mosquito clamp,and the cysts were bluntly dissected.The decrustation time,erythema subsiding time,adverse reactions and recurrence were compared among lesions at different sites or with different sizes.Results For the lesions at the same sites or with similar sizes after treatment,the decrustation time and erythema subsiding time were both significantly shorter in the CO2 laser group than in the high-frequency electroacupuncture group (both P ＜ 0.05).There were significant differences in the decrustation time and erythema subsiding time among lesions at different sites or with different sizes (all P ＜ 0.05).Mild pain occurred in the 2 groups,and no hematoma or secondary infection occurred.There were significant differences in the incidence of scar formation or pigmentation between the 2 groups (both P ＜ 0.05).During the follow-up of 6-18 months,relapse occurred in 1 patient in each group.Conclusion Compared with the high-frequency electroacupuncture,CO2 laser assisted by drilling and blunt dissection shows better efficacy in the treatment of steatocystoma multiplex,and it can remove lesions at various sites at one time.

Clinical Application of Percutaneous Gallbladder Drainage in Severe Acute Pancreatitis / 中国医科大学学报

Objective To investigate the clinical value of percutaneous gallbladder drainage in the treatment of severe acute pancreatitis(SAP). Methods A total of 65 patients treated for SAP in our hospital between January 2014 and April 2017 were analyzed retrospectively. The patients were divided into a gallbladder puncture group and a control group. Follow-up was performed for at least 6 months to monitor mortality and the incidence of complications, including pancreatic abscess, pseudocyst, renal failure, respiratory failure, heart failure, gastrointestinal bleeding, sepsis, and disseminated intravascular coagulation (DIC), The differences in mortality and complication rates between the two groups were statistically analyzed. Results Mortality in the gallbladder puncture group was significantly lower than in the control group (P ＜ 0. 05); the incidence of renal failure, respiratory failure, heart failure, gastrointestinal bleeding, and sepsis in the gallbladder puncture group was lower than in the control group (P ＜ 0. 05); the incidence of pancreatic abscess and pseudocyst in the gallbladder puncture group was similar to that in the control group, showing no significant difference (P ＞ 0. 05); the incidence of DIC in the gallbladder puncture group was lower than in the control group, but the difference was not statistically significant (P ＞ 0. 05). Conclusion Percutaneous gallbladder drainage can effectively reduce the incidence of renal failure, respiratory failure, heart failure, gastrointestinal bleeding, and sepsis in SAP, thereby reducing mortality. However, the incidence of DIC, pancreatic abscess, and pseudocyst is not reduced.

Percutaneous Puncture to Treat Malignant Obstructive Jaundice in Patients Who Fail Endoscopic Drainage / 中国医科大学学报

Objective To study the efficacy of percutaneous transhepatic cholangiodrainage (PTCD),percutaneous gallbladder drainage,and percutaneous transhepatic biliary stent implantation for the treatment of malignant obstructive jaundice in patients who are observed to fail endoscopic drainage. Methods We retrospectively analyzed 17 patients diagnosed with obstructive jaundice between August 2015 and July 2017 who were observed to have failed endoscopic drainage. Percutaneous puncture drainage had been performed in all patients-different methods were chosen based on the type of lesion and the patient's intraoperative condition. Among these patients, 9 underwent percutaneous transhepatic biliary stent implantation (53％),5 underwent PTCD (29％),and 3 underwent percutaneous gallbladder drainage (18％). The serum levels of total bilirubin (TBIL) and alanine aminotransferase (ALT) were assessed a day preoperatively and a week postoperatively. The postoperative decrease (or drop) in the serum TBIL and ALT levels was used as a parameter to assess the efficacy of treatment. Patients were divided into a stent and a tube group. The therapeutic effects were compared between the groups in terms of the drop in the serum TBIL and ALT levels and the survival time of patients. Results The postoperative serum TBIL and ALT levels were significantly decreased in all patients (P < 0. 05). No statistically significant difference was observed between the stent and the tube group in terms of the decrease in serum TBIL and ALT levels (P > 0. 05). However,a statistically significant difference was observed between the stent and the tube group in terms of the survival time of patients (P < 0. 05). Conclusion Percutaneous puncture is an effective treatment modality to manage malignant obstructive jaundice in patients who fail endoscopic drainage. Compared to tube drainage,stent placement can prolong patient survival time. Regarding the decrease in serum TBIL and ALT levels,we conclude that stent implantation is not significantly better than tube drainage.

Correlation between MSCT findings and pathological classification of thymic neuroendocrine tumors / 实用放射学杂志

Objective To study the MSCT appearances of thymic neuroendocrine tumors (NETs)and its correlation with the WHO histological grade.Methods MSCT features of 16 patients with thymic NETs confirmed by pathology were analyzed retro-spectively.The patients were divided into 2 groups according to tumor's grade,i.e.low and intermediate grade,high grade.Results There were 8 patients in low and intermediate grade,8 in high grade.No difference was found among tumor location,size,tumor morphology,calcification,pericardiac thickening,pericardial effusion,pleural thickening,pleural effusion,disappearance of fat line around tumor and mass-pulmonary interface with irregular shape,but significant difference was detected in lymph node metastasis. On enhanced MSCT scanning,statistical difference was detected in linear enhancement of the blood vessels in the tumors,but no difference was found between necrosis and peripheral vessel invasion.Conclusion MSCT findings of different grades in thymic NETs have some characteristics and can be helpful in the grades of predictability.

Effect of polyunsaturated fatty acids ω-3 and ω-6 on angiogenesis formation in human gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of polyunsaturated fatty acids (PUFA) ω-3 and ω-6, and their middle metabolites PGE2 and PGE3 on angiogenesis formation of gastric cancer, and to explore associated mechanism.</p><p><b>METHODS</b>The effects of ω-3, ω-6, PGE2, PGE3 on the proliferation and migration of human umbilical vein endothelial cell (HUVEC) were measured by proliferation and migration assay respectively. The angiogenesis assay in vivo was used to measure the effects of ω-3, ω-6, PGE2 and PGE3 on neovascularization. In all the assays, groups without ω-3, ω-6, PGE2 and PGE3 were designed as the control.</p><p><b>RESULTS</b>With the increased concentration of ω-6 from 1 μmol/L to 10 μmol/L, the proliferation ability of HUVECs enhanced, and the number of migration cells also increased from 28.2±3.0 to 32.8±2.1, which was higher than control group (21.2±3.2) respectively (both P<0.05). With the increased concentration of ω-3 from 1 μmol/L to 10 μmol/L, the proliferation ability of HUVECs was inhibited, and the number of migration cells decreased from 15.8±2.0 to 11.0±2.1, which was lower than control group (22.1±3.0) respectively (both P<0.05). In the angiogenesis assay, compared with control group (standard number: 43 721±4 654), the angiogenesis ability of HUVECs was significantly enhanced by ω-6 in concentration-dependent manner (1 μmol/L group: 63 238±4 795, 10 μmol/L group: 78 166±6 123, all P<0.01). Meanwhile, with the increased concentration of ω-3 from 1 μmol/L to 10 μmol/L, the angiogenesis ability was significantly decreased from 30 129±3 102 to 20 012±1 541(all P<0.01). The proliferation and migration ability of HUVECs were significantly promoted by ω-6 metabolites PGE2 (P<0.05) in a concentration-dependent manner. In contrast, ω-3 metabolites PGE3 significantly inhibited the proliferation and migration ability of HUVECs in a concentration-dependent manner (all P<0.05). After rofecoxib (a COX-2 specific inhibitor) inhibited the expression of COX-2, the expression level of PGE2 was significantly decreased in a dose-dependent manner. In co-culture system, whose gastric cancer cells expressed positive COX-2, ω-6 could increase angiogenesis of gastric cancer cells(P<0.01), but ω-3 could inhibit such angiogenesis(P<0.01). In co-culture system, whose gastric cancer cells did not express COX-2, ω-3 could inhibit the angiogenesis of gastric cancer cells (P<0.05), but ω-6 had no effect on angiogenesis.</p><p><b>CONCLUSIONS</b>The PUFA ω-6 can enhance the angiogenesis via the promotion of proliferation and migration of HUVECs, and COX-2 and PGE2 may play an important role in this process, whereas, the ω-3 can inhibit the angiogenesis through its middle metabolites PGE3 to inhibit the proliferation and migration of HUVECs. Results of this experiment may provide a new approach to inhibit and prevent the spread of gastric cancer.</p>

Correlation of CT features and pathological characteristics with EGFR gene mutations in invasive peripheral pulmonary adenocarcinoma / 实用放射学杂志

Objective To investigate the correlation of CT features and pathological characteristics with epidermal growth factor receptor(EGFR)gene mutations in invasive peripheral pulmonary adenocarcinoma.Methods The amplification refractory mutation system was used to determine EGFR mutations in 1 9 3 surgically resected invasive peripheral pulmonary adenocarcinomas.CT features and pathological characteristics were analyzed retrospectively.Results The total EGFR mutation rate was 62.2% (120/193).Among the features on CT,the maximum tumor diameter (Dmax)in axial plane CT images was significantly smaller in patients with EGFR mutations than that with wild-type EGFR patients [(2.52 ± 1.01)cm vs (3.11 ± 1.34)cm,P0.05).Among pathological characteristics,compared with other subtypes,EGFR mutations occurred most frequently in lepidic predominant adeno-carcinomas (77.5% vs 58.2% in other subtypes,P<0.05),and the least frequently in solid predominant adenocarcinomas(26.3%vs 66.1% in other subtypes,P<0.05).The EGFR mutation rate was significantly higher in tumors without lymph node metastases than that with lymph node metastases (66.9%vs 50.9%,P<0.05).Conclusion The CT features and pathological characteristics may be useful indicators to predict EGFR mutation status in invasive peripheral pulmonary adenocarcinoma.

CT differentiation between vertebral multiple myeloma and osteolytic metastasis / 实用放射学杂志

Objective To explore the imaging differences of vertebral multiple myeloma(VMM)and vertebral osteolytic metastasis on CT. Methods Review the imaging signs of 32 patients with VMM and 52 patients with vertebral osteolytic metastasis,then record and finally statistical analysis was carried out.Results Compare to 1 67 vertebras involved in 52 cases of vertebral metastasis,the patents with VMM had 220 vertebras involved.The incidence of the multiple small circular type of bone destruction in VMM was 42.66%(93/218),which was higher than that in vertebral metastasis 0.00% (0/165)(χ2 =92.963,P =0.000).The incidence of the irregular shape type of bone destruction in VMM was 23.39% (5 1/218),while it was higher in patients with vertebral metastasis 45.45%(75/165)(χ2 =20.704,P=0.000).It was also found that the incidence of the fragmentary type of bone destruction and the involvement of the unilateral pedicle in VMM were lower than that in patients with vertebral metastasis 8.7% (19/218 )& 27.27% (45/165)(χ2 =23.238,P =0.000), 6.82% (1 5/220)& 1 7.96% (30/1 67)(χ2 =1 1.477,P =0.001).The incidence of the crest protrusion type of bone destruction in patients with VMM was 16.06% (35/218),however it was 9.10% (15/165)(χ2 =4.013,P =0.045)in vertebral osteolytic metastasis. Conclusion The imaging features of VMM and vertebral osteolytic metastasis had certain characteristic.And they can be differentiated from each other,combining with clinical traits.

CT differentiation between tuberculous spondylitis and pyogenic spondylitis / 实用放射学杂志

Objective This study was to investigate the computed tomography(CT)features differentiating tuberculous spondyli-tis from pyogenic spondylitis.Methods The CT features in 32 patients with tuberculous spondylitis and 30 patients with pyogenic spondylitis were retrospectively reviewed,and statistically analyzed.Results In 32 cases of tuberculous spondylitis,71 vertebra were involved.In 30 cases of pyogenic spondylitis,59 vertebra were involved.The incidence of thoracic vertebra involvement in tuberculous spondylitis was 60.56% (43/71),which was higher than that in pyogenic spondylitis (25.42%,1 5/59)(P <0.05).The incidence of lumbar vertebra involvement in tuberculous spondylitis was 33.80% (24/71 ),which was lower than that in pyogenic spondylitis (61.02%,36/59)(P <0.05).The incidence of the worm-eaten type of bone destruction in tuberculous spondylitis was 9.90% (7/71),which was lower than that in pyogenic spondylitis (44.07%,26/59)(P <0.05).The incidence of the fragmentary type of bone destruction in tuberculous spondylitis was 1 9.72%(14/71 ),which was higher than that of in pyogenic spondylitis (3.39%,2/59) (P <0.05).The incidence of large osteosclerosis in tuberculous spondylitis was 52.1 1%(37/71),which was higher than that in pyo-genic sp-ondylitis (22.03%,13/59),(P <0.05).The incidence of the involved vertebral height on sagital CT scan (less than the 1/2 of the normal vertebral height)in tuberculous spondylitis was 1 6.9% (12/71),which was lower than that in pyogenic spondylits (62.71%,37/59)(P <0.05).The incidence of patchy high density shadow in tuberculous spondylitis was 50.7% (36/71 ),which was higher than that in pyoge-nic spondylitis (20.34%,12/59)(P <0.05.)The incidence of the involvement of the appendages in tu-berculous spondylitis was 25.35% (18/71),which was higher than that in pyogenic spondylitis (8.47%,5/59)(P <0.05).The inci-dence of paravertebral abnormal soft tissue with calcification in tuberculous spondylitis was 60.00%(18/30),which was higher than that in pyogenic spondylitis(20.00%,5/25 )(P < 0.05 ).Conclusion Tuberculous spondylitis and pyogenic spondylitis have some characteristic imaging features,combined with the clinical signs differentiation diagnosis can be made each other.

Study on Methylation of DBC2 in Gastric Cancer / 中国医科大学学报

Objective To detect the expression of DBC2 and the methylation status of its gene promoter region in gastric cancer,so as to analyze their correlation. Methods Gastric cancer tissues and adjacent normal tissues were collected from 92 cases as research subjects. The DBC2 mRNA expression and the methylation status of DBC2 gene promoter region in gastric cancer were detected by using RT?PCR and MS?PCR respectively. In addition,the correlation of DBC2 gene methylation status with clinicopathological parameters was analyzed. Results In comparison with adjacent normal tissues,gastric cancer tissues displayed a low expression level of DBC2mRNA and a high methylation level of gene promoter region. Besides, the methylation level was significantly correlated with tumor invasion depth,differentiation and TNM staging(P<0.05). With deep invasion,poor differentiation or higher TNM staging,methylation level of gene promoter region was more significant in gastric cancer tissues. Conclusion High methylation of DBC2 gene promoter region may be a significant contributing factor leading to low DBC2 expression.

Safety and Short-term Efficacy of Laparoscopic Assisted Distal Gastrectomy versus Open Distal Gastrectomy in D2 Radical Surgeries for Locally Advanced Distal Gastric Cancer:A Meta-analysis / 中国医科大学学报

Objective To conduct a Meta?analysis to compare the safety and short?term efficacy of laparoscopic assisted distal gastrectomy (LADG)and open distal gastrectomy(ODG)in D2 radical surgeries for locally advanced distal gastric cancer. Methods The literatures from Janurary,1990 to August,2014 on the evaluation of safety and short?term efficacy of LADG versus ODG in D2 radical surgeries for locally advanced distal gastric cancer were collected. The quality of the enrolled articles was evaluated and the software Revman 5.2 was adopted to analyze the cura?tive effect. Results Totally 25 articles met the inclusion criteria,including 5 044 patients with treatment of D2 radical surgeries for locally advanced distal gastric cancer. There was no significant difference in the cleaning number of lymph nodes between LADG and ODG in patients undergoing D2 radical surgeries for locally advanced distal gastric cancer. The operation time was longer for LADG than ODG,but the postoperative evaluation in?dexes such as the intraoperative blood loss and the short?term efficacy of LADG were superior to ODG. Conclusion In the treatment of locally ad?vanced distal gastric cancer,there were differences in the safety and short?term efficacy between LADG and ODG,and surgeons should give concern to these differences in clinical practice to select appropriate surgical approaches. Further research is still needed to explore the long?term efficacy.

Covered metallic stents for individualized treatment of proximal esophageal strictures / 中华消化内镜杂志

Objective To evaluate the efficacy and safety of covered metallic stents in the management of proximal esophageal strictures.Methods Retrievable covered self-expanding metallic stents were inserted individually in 43 patients with malignant strictures of the proximal esophagus.Main outcome measures included improvement of dysphagia,sealing of fistula and complications were evaluated.Results A total of 45 stents were placed in 43 patients,with a success rate of 95.6％ (43/45) at the first stent placement attempt.The dysphagia score improved significantly from 3.3 ± 0.6 to 1.8 ± 0.9 (P ＜ 0.001),with 18 having an excellent response and 25 having a good response.Improvement rate of dysphagia was 95.6％ (43/45).Fistula sealing was achieved in 7 of 9 patients (77.8％).Early complications included severe pain (n =5),mediastinal emphysema (n =1),moderate fever (n =9) and collapse of the proximal end of the stent (n =1),while late complications included migration (n =3) and tissue overgrowth (n =6).Conclusion Retrievable covered metallic stent placement is effective and safe for the palliation of obstructive dysphagia and sealing of fistulas in malignant proximal esophageal strictures.

Association of interleukin-23 receptor gene polymorphisms with susceptibility and phenotypes of inflamumatory bowel diseases in Jiangsu Han population / 中华内科杂志

ObjectiveTo investigate the possible association of interleukin-23 receptor(IL-23R) polymorphisms with the susceptibility and phenotype of inflammatory bowel diseases (IBD) in Jiangsu Han population.MethodsWe genotyped 178 IBD patients including 135 patients with ulcerative colitis ( UC),43 patients with Crohn's disease (CD),and 134 headthy controls for rs11805303,rs1343151,rs11465804,rs11209032,rs17375018,rs11465788.ResultsComparing with the controls (50.4％ ),there was a significant increase in the carriage of the T allele of rs11805303 in UC (60.4％) ( P =0.020).In genotypephenotype correlation of rs17375018 in UC,clinical severity(UCDAI) was associated with the prevalence of the G allele showed a trend to mild activity.Genotype polymorphisms of rs17375018A was observed more in younger than 25 in the genotype-phenotype correlation in CD(41.7％ vs 22.0％,P =0.050,OR =2.532,95％ CI 0.988-6.494),while rs11805303 was associated with age at diagnose and disease lesion (P =O.039 and 0.044).The risk of extra intestinal manifestation in rs17375018A allele carriers was lower (23.1％ vs46.7％,P=0.040,OR =2.917,95％CI 1.027-8.283).ConclusionsWe confirmed the susceptibility of rs11805303polymorphisms with UC and first demonstrated the genotype-phenot correlation of rs11805303,rs17375018 with UC,CD in Jiangsu Han population.