Effect of Neoadjuvant Treatment on TRG, Surgical Complications and LARS in Patients with Rectal Cancer / 肿瘤防治研究

Objective To investigate the effects of different neoadjuvant treatments on tumor regression, surgical complications and low anterior resection syndrome (LARS) in patients with rectal cancer. Methods We included 127 patients with rectal cancer receiving neoadjuvant treatments, and they were divided into long-term concurrent chemoradiotherapy group (n=42), short-term radiotherapy+chemotherapy group (n=39) and chemotherapy group (n=46). The pathological results, clinical data and follow-up results were collected. The factors that may affect tumor regression, surgical complications and low anterior resection syndrome after rectal cancer surgery were statistically analyzed and concluded. Results The pCR rates were 28.51%, 10.3% and 8.6% in long-term concurrent chemoradiotherapy group, short-term radiotherapy+chemotherapy group and chemotherapy group, respectively. There were 14 (33.33%), 9 (23.07%) and 10 (21.74%) patients with perioperative complications in three groups, respectively. A total of 91 patients were enrolled in the LARS study. There were 49 (53.84%) cases with LARS symptoms, including 17 (18.68%) cases with severe LARS. In three groups, there were 27 cases (including 13 cases of severe LARS), 12 cases (including 2 cases of severe LARS) and 9 cases (including 2 cases of severe LARS) of LARS symptoms, respectively. Conclusion Three neoadjuvant treatments have good surgical safety. Long-term concurrent chemoradiotherapy and short-term radiotherapy+chemotherapy have advantages in tumor regression, but the former is more likely to cause LARS symptoms and affect the quality of life.Comprehensive consideration is needed in the choice of clinical treatments.

SWOT analysis of medical online teaching in X hospital during COVID-19 epidemic / 中华医学教育探索杂志

SWOT theory can be used to analyze the internal and external competitive environment and conditions of online teaching in teaching hospitals during the epidemic prevention and control. Conducting online education of clinical medicine courses in a hospital affiliated toa hospital affiliated to a comprehensive university has advantages in resources, administrations and platforms. However, disadvantages of online medical education lie in the professionalism, specificity of doctors as teacher and request of special teaching tools, all of which may not be available online. Online education meets the need of constructing top level courses national wide, carrying out the dominant role of ideological work in medical education field, and promoting the autonomous learning. Meanwhile, online education also challenges the future reform of teaching mode, management, and space. Based on this, it's proposed to promote the informatization construction of hospital medical education, improve IT literacy of all teachers, build an educational informatization platform matching the hospital management, construct a multiple evaluation system based on intelligent teaching space, build an online and offline mixed curriculum system based on multi-disciplinary, and take it as a breakthrough to promote the construction of "new medicine".

Analysis and reflection on the current construction of massive open online course of medical humanities under the epidemic situation / 中华医学教育探索杂志

This study aims to analyze the current construction of massive open online course (MOOC) of medical humanities in China, promote the sharing of high-quality curriculum resources, and provide information reference for curriculum design and planning. Mathematical statistics and mind map analysis were used to analyze 42 medical humanities MOOCs on 17 online course platforms during the epidemic, and the results showed that: ①the scale and quantity of medical humanities MOOCs need to be expanded; ②there is regional imbalance in MOOCs construction, with the largest number in East China; ③most of the courses are taught by teachers in a team, teachers with senior professional titles are the main force of the team, and some teams have multidisciplinary backgrounds; ④there are rich teaching contents related to humanistic knowledge and ability, but the content related to medical humanistic spirit cognition needs to be added appropriately. According to the above analysis, it's suggested that the construction of MOOC should focus on systematism and standardization, equip a team of teachers with multidisciplinary backgrounds, value curriculum design and planning, and pay full attention to the feedback and evaluation of learners to find out deficiencies.

The role of intestinal microorganism in tumor treatment / 医学研究生学报

The intestinal microbiota plays a crucial role in the innate and acquired immune responses. It regulates cancer initiation, progression, and response to therapies. This article focuses on the effect of intestinal microbiota on chemotherapy and immunotherapy. Intestinal microorganisms can activate the peripheral immune system, induce anti-tumor immune surveillance. Specific bacteria significantly affects anti-tumor immunity and the response to chemotherapy and immunotherapy. Proliferation, metastasis of specific bacteria or using of antibiotics induced intestinal microbiota disorders can change the efficacy of chemotherapy and immunotherapy. In the future, precision medicine can predict the patients’ response to drugs through the composition of intestinal microbes, regulate the initiation and development of tumors and the response to treatment by changing the composition of intestinal microbiome.

Effects of cordyceps acid and cordycepin on the inflammatory and fibrogenic response of hepatic stellate cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effects of cordyceps acid and cordycepin on the inflammatory phenotype and fibrogenic property of hepatic stellate cells (HSCs).</p><p><b>METHODS</b>An immortalized mouse HSC line (JS1) was stimulated with lippolysaccharide (LPS; 100 ng/ml) to induce an inflammatory response with or without co-administration of cordyceps acid or cordycepin in various concentrations (10, 50, or 200 mumol/L). Effects of the treatments on the chemokine monocyte chemotactic protein-1 (MCP-1) mRNA expression in the cells and the protein secretion in the cell culture supernatants were determined by reverse transcription and real-time quantitative PCR (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. In addition, JS1 cells were treated with transforming growth factor-b1 (TGFb1; 10 ng/ml) to induce a fibrogenic response with or without co-administration of cordyceps acid or cordycepin in various concentrations (10, 50, or 200 mumol/L). Effects on the expression of fibrogenic proteins including collagen type I and a-smooth muscle actin (a-SMA), were investigated by Western blot.</p><p><b>RESULTS</b>High-concentration (200 mumol/L) treatments of both cordyceps acid and cordycepin significantly inhibited the LPS-induced up-regulation of MCP-1 transcription and secretion (mRNA: 2.07 +/- 0.29 vs. 3.35 +/- 0.26, t = 15.90 and 1.15 +/- 0.23 vs. 4.17 +/- 0.61, t = 8.93; protein: 1.88 +/- 0.06 vs. 2.33 +/- 0.06, t = 10.39 and 1.47 +/- 0.25 vs. 1.97 +/- 0.04, t = 4.60; all P less than 0.05). All concentrations of cordyceps acid and cordycepin inhibited the TGFb1-induced up-regulation of collagen type I and a-SMA protein expression. However, the effects were more robust with the 200 mumol/L concentrations (P less than 0.05).</p><p><b>CONCLUSION</b>Cordyceps acid and cordycepin ameliorate the LPS-induced inflammatory phenotype and TGFb1-induced fibrogenic response of cultured HSCs. These effects may contribute significantly to the drugs' therapeutic mechanisms to inhibit and resolve liver fibrosis.</p>

HMGB1-mediated activation of TLR4 signaling in hepatic stellate cells / 中华肝脏病杂志

To determine the potential of the high mobility group box-1 protein 1 (HMGB1) to activate Toll-like receptor 4 (TLR4) signaling in hepatic stellate cells (HSCs) and investigate the subsequent transition of HSC towards the inflammatory phenotype. Three immortalized mouse HSC cell lines, wild-type (JS1), TLR4-/- (JS2) and MyD88-/- (JS3), were subcultured in plates and divided into groups of normal control (untreated), postive control (lipopolysaccaride, LPS treatment), and experimental (HMGB1 treatment). All groups were transfected with luciferase reporter plasmids carrying responsive elements for either the nuclear factor-kappa B (NF-kB) or activator protein-1 AP-1 transcription factors. Following stimulation with normal saline, LPS (100 ng/mL) or HMGB1 (100 ng/mL), the activation of NF-kB or AP-1 was detected by a dual-luciferase reporter assay system. The induction of monocyte chemotactic protein-1 (MCP-1) transcription was determined by measuring the mRNA levels using real time quantitative reverse transcription PCR (qRT-PCR). The secreted protein levels of MCP-1 were determined by enzyme-linked immunosorbent assay (ELISA) of the culture supernatants. Activation of NF-kB- and AP-1-responsive reporters was significantly up-regulated in JS1 cells treated with HMGB1 or LPS, and the activation was coincident with markedly up-regulated transcription and secretion of MCP-1. However, HMGB1 and LPS treatment produced no responsive of the NF-kB and AP-1 reporters, and no increase in expression or secretion of MCP-1, in JS2 or JS3 cells. As an endogeous ligand of TLR4, HMGB1 may activate TLR4 signaling and the TLR4-mediated inflammatory response of HSC.

Retrospective analysis of preoperative localization of insulinomas on CT / 中南大学学报(医学版)

OBJECTIVE@#To compare the value of CT using different equipment and scanning methods in preoperative localization of insulinoma and to investigate the possible causes that might influence the detection ratio on CT.@*METHODS@#A total of 47 patients with insulinomas confirmed by operation and pathologic examination from 1990 were collected, and the related clinical information and imaging data of CT were retrospectively analyzed.@*RESULTS@#The diagnostic accuracy for conventional CT with conventional enhancement scanning, spiral CT with pancreatic phase scanning, and multislice spiral CT with dual phasic enhancement scanning were 35.3%, 57.1%, and 81.3%, respectively, and the overall diagnostic accuracy of CT was 57.4%. The diagnostic accuracy of multislice spiral CT was greater than that of conventional CT (P or =1.5 cm was significantly higher than that of <1.5 cm (76.2%vs. 42.3%). Typical appearance of the lesions on CT was isoattenuation on plain scanning, and enhanced considerably after contrast enhancement.@*CONCLUSION@#The size of lesion is the major factor that influences the detection of insulinoma on CT. Multislice spiral CT with dual phasic enhancement scanning has a relatively high detection rate and is recommended for preoperative localization of insulinoma.

A clinical analysis of unsuspected gallbladder carcinoma:a report of 37 cases / 中国普通外科杂志

0.05).However,the percentage of patients with cholecystolithiassis was 86.5% in IGC group,and 50.6% in GC group(P=0.000).Besides the percentage of IA stage in IGC group(29.7%) was relatively higher than that(9.0%)in GC group(P=0.03);the surgical resection rate of tumor in IGC group was 56.8% and 32.6% in GC group(P=0.01).Nevertheless,the percentage of advance stage in IGC group(43.2%) was relatively lower than that in GC group(74.2%)(P=0.001).The overall 1,3,and 5-year survival rate of IGC group was 70.0%,31.2% and 26.8% repectively,and the mean survival time was17 months(51?13);which were significantly higher than those in GC group,in which the 1,3,5-year survival rate was 27.0%,17.7% and 15.1% repectively and the mean survival time was(25?8),5 months(all P=0.006).Single factor analysis showed that the survival time in IGC patients was influenced by the TNM stage(P=0.000),pT-category(P=0.000),operation-category(P=0.008);however,postoperative pathological grade(P=0.080),age(P=0.188) and sex(P=0.234) had no influence on survival rate.According to multivariate analysis,pT-category(P=0.000)was an independent factor for the survival time of IGC.Conclusions Comparing with GC group,IGC has a higher percentage of cholecystolithiassis,IA tumor stage and surgical resection rate,and thus,it has relatively better progonosis.pT-category is the vital independent prognostic factor in IGC.If a patient in ICG has been misdiagnosed during the primary operation,the patient should be re-operated for radical excision as soon as possible,except when the tumor is in stage Tis or T1a.

Prognostic factor analysis of patients with gastrointestinal stromal tumor undergoing radical operation over 5 years:a report of 97 cases / 中国普通外科杂志

Objective To analyze the independent factors affecting the prognosis of gastrointestinal stromal tumor(GIST) patients undergoing radical operation.Methods The clinical characteristics and follow up data of the 97 patients with GIST underwent radical opsration from January,2001 to January,2003 in our hospital were retrospectively analyzed by univariate and multivariate methods.Results In the univariate analysis of the 97 cases,gender,tumor location,tumor size,tumor cell type,necrosis,mitotic count,and Gleevec administration postoperatively were found to be related to the prognosis of GIST.Multivariate Cox model analysis showed that tumor location,tumor size,tumor cell type,necrosis,mitotic count,and Gleevec administration postoperatively were independent prognostic factors for patients with GIST.Conclusions Tumor location,tumor size,tumor cell type,necrosis,mitotic count are important prognostic factors for patients with GIST undergoing radical operation.