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Objective:To analyze the clinicopathological features of de novo early colorectal cancer and to evaluate the efficacy of endoscopic treatment.Methods:Patients with de novo early colorectal cancer who underwent endoscopic resection in Beijing Friendship Hospital, Capital Medical University from June 2020 to May 2022 were enrolled. The baseline data, endoscopic manifestations, treatment methods, postoperative pathological results and prognosis of the patients were collected retrospectively.Results:A total of 33 patients with de novo early colorectal cancer were enrolled with the age of 62.67 ± 8.62 years, and the male to female ratio was 7.25∶1. The long diameter of lesions was 0.96 ± 0.36 cm. The lesion morphology was mainly superficial phenotype (type 0-Ⅱ), accounting for 72.7% (24/33). Endoscopic submucosal dissection (ESD) was performed in 29 cases and endoscopic mucosal resection (EMR) was performed in 4 cases. Postoperative pathology showed that 11 cases (33.3%) were well differentiated tubular adenocarcinoma, of which the superficial submucosal layer was invaded in 2 cases. Twenty cases (60.6%) were moderately differentiated tubular adenocarcinoma, of which the superficial submucosa layer was invaded in 5 cases and the deep submucosa layer in 15 cases. Two cases (6.1%) were moderately-poorly differentiated tubular adenocarcinoma, where the deep submucosa layer was invaded in both. There was significant correlation between the depth of invasion and the degree of differentiation ( P<0.001), and moderately and moderately-poorly differentiated lesions were more likely to invade the deep submucosa layer. The en bloc resection rate was 100.0% (33/33), the complete resection rate was 97.0% (32/33), and the curative resection rate was 42.4% (14/33). Among the 19 patients who did not achieve curative resection, 13 patients received supplementary surgical treatment. No tumor residue or lymph node metastasis was found in the postoperative pathology. All patients were followed up for 3-25 months, and no signs of local recurrence or metastasis were found. Conclusion:Most de novo early colorectal cancers are superficial phenotype under endoscopy. The pathology is mainly moderately differentiated tubular adenocarcinoma. Endoscopic resection of de novo early colorectal cancer shows encouraging short-term efficacy.
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Objective:To evaluate the effects of single spay of L-menthol (NPO-11) on suppressing gastric peristalsis during upper gastrointestinal endoscopy and the influencing factor.Methods:This study was a multicenter, randomized, double-blind, placebo-parallel controlled study. The eligible patients were randomly divided into two groups by randomized blocks. Patients received local spray of either NPO-11 (160 mg L-menthol) or placebo 20 mL during upper gastrointestinal endoscopy. The gastric peristalsis was recorded and evaluated before, 2 minutes after and at the end of endoscopy. The complexity of the procedure was evaluated by the researchers. The influencing factors for antiperistaltic effect of NPO-11 were analyzed.Results:A total of 220 patients were enrolled from five research centers. There were 109 cases in the NPO-11 group and 111 cases in the placebo group. The baseline data of the two groups were similar and comparable. The proportion of patients with grade 1 peristalsis at 2 minutes after the treatment and at the end of endoscopy was significantly higher in the NPO-11 group than that in the placebo group [40.37% (44/109) VS 16.22% (18/111), χ2=15.93, P<0.001]. Compared with the placebo group, the proportions of weak peristalsis (grade 1 and 2) were higher in the NPO-11 group at 2 minutes after the treatment [67.89% (74/109) VS 46.85% (52/111)] and at the end of endoscopy [79.82% (87/109) VS 48.65% (54/111)]. Subgroup analysis showed that the inhibitory effect of NPO-11 on gastric peristalsis was more significant in Helicobacter pylori antibody positive group. Conclusion:Local spray of NPO-11 can effectively inhibit gastric peristalsis during upper gastrointestinal endoscopy, and its effect is more significant in Helicobacter pylori antibody positive group. It could be recommended for no obvious adverse reactions , its safety, and the convenient procedure.
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Objective:To compare the efficacy of oral sulfate solution (OSS) and polyethylene glycol (PEG) electrolyte powder for colonoscopy bowel preparation.Methods:A total of 283 randomized patients from 9 centers in China taking OSS ( n=143) or PEG ( n=140) using two-day split bowel preparation regimen received colonoscopy and assessment. The primary index was the bowel preparation success rate [global Boston bowel preparation scale (BBPS)≥ 6 by independent assessment center]. Secondary indices included BBPS global and segmental scores, investigator satisfaction (5-point Likert scale) with the quality of bowel preparation, patient satisfaction assessed by questionnaires, and patient tolerance assessed by Sharma scale. Compliance and safety were compared between the two groups. Results:The bowel preparation success rates were 100.0% for OSS and 99.3% for PEG [adjusted difference 0.7% (95% CI: -5.3% - 6.7%), P<0.001 for non-inferiority]. The BBPS global score in OSS group was significantly higher than that in PEG group (8.1 VS 7.7, P<0.001). The segment BBPS scores were also higher in OSS group than those in PEG group for all 3 segments (right colon: 2.4 VS 2.3, P=0.002; transverse colon: 2.8 VS 2.7, P=0.018; left colon: 2.8 VS 2.7, P=0.007). Investigator Likert score in the OSS group was significantly higher than that in the PEG group (2.6 VS 2.3, P<0.001). There was no significant difference in compliance between OSS and PEG, except for the second dose (90.9% VS 82.6%, P=0.039). There was no significant difference in patient satisfaction, Sharma score or proportion of patients with tolerance-related symptoms between the two groups. Safety was comparable between the two groups, and all adverse events were mild to moderate. Conclusion:OSS has comparable efficacy with PEG, with higher BBPS scores in all segments, better investigator satisfaction, better compliance in split dose, and comparable patient tolerance and safety.
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Objective:To investigate the role of ineffective esophageal motility (IEM) in non-erosive acid reflux related diseases, and the influence of the fourth edition Chicago classification (CC v4.0) on the diagnosis of IEM.Methods:From January 2018 to January 2020, 63 patients with acid reflux related symptoms who underwent gastroscopy and showed no abnormal changes in esophageal mucosa or structure, and underwent high resolution esophageal manometry (HRM) and 24-hour esophageal pH monitoring in the Department of Gastroenterology of Beijing Friendship Hospital were included in the case-control study. According to the HRM results, the third edition Chicago classification standard (CC v3.0) and CC v4.0 were used to divided patients into IEM group and normal dynamic group. The HRM results, 24-hour esophageal pH monitoring results and final diagnosis of the two groups under the two editions of Chicago classification standard were mainly compared and analyzed.Results:Among the 63 patients, there were 14 cases of non-erosive gastroesophageal reflux disease (NERD), 19 cases of reflux hypersensitivity (RH), and 30 cases of functional heartburn (FH). When using CC v3.0, there were 20 cases in the IEM group, including 9 cases of NERD, 5 cases of RH and 6 cases of FH, and 43 cases in the normal dynamic group, including 5 cases of NERD, 14 cases of RH and 24 cases of FH. When using CC v4.0, there were 16 cases in the IEM group, including 7 cases of NERD, 4 cases of RH and 5 cases of FH, and 47 cases in the normal dynamic group, including 7 cases of NERD, 15 cases of RH and 25 cases of FH. When using CC v3.0, compared with the normal dynamic group, the acid exposure time (AET) of the IEM group was significantly higher [3.45 (1.55, 6.40)% VS 1.20 (0.40, 2.30)%, Z=-2.940, P=0.003], the DeMeester score was also significantly higher [13.8 (5.8, 21.4) VS 5.3 (2.9, 10.0), Z=-2.851, P=0.004], the lower esophageal sphincter pressure (LESP) [10.15 (7.52, 13.65) mmHg (1 mmHg=0.133 kPa) VS 15.40 (11.20, 21.60) mmHg, Z=-3.241, P=0.001], 4-second integrated relaxation pressure (4sIRP) (3.79±0.57 mmHg VS 6.05±0.50 mmHg, t=2.727, P=0.008), and distal contraction integral (DCI) [334.65 (208.25, 438.92) mmHg·s·cm VS 1 258.70 (919.00, 1 750.10) mmHg·s·cm, Z=-6.305, P<0.001] were significantly lower than those of the normal dynamic group. When using CC v4.0, AET and Demeester scores in the IEM group were also significantly higher than those in the normal dynamic group (both P<0.05), and LESP, 4sIRP and DCI were also significantly lower than those in the normal dynamic group (all P<0.05). In addition, upper esophageal sphincter pressure was significantly lower than that in normal dynamic group [34.60 (21.50, 48.05) mmHg VS 49.67 (36.75, 61.10) mmHg, Z=-2.140, P=0.032]. Conclusion:IEM is associated with impaired anti-reflux barrier function and esophageal acid exposure in patients with non-erosive acid reflux related diseases. Compared with CC v3.0, CC v4.0 can reduce the heterogeneity of IEM patients to some extent.
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Objective:To investigate the independent predictors for malignancy in colorectal laterally spreading tumors (LSTs) by therapeutic endoscopy.Methods:Data of consecutive patients with colorectal LSTs who underwent endoscopic treatment in Beijing Friendship Hospital between June 2013 and March 2019 were collected for retrospective analysis. Patients′ gender, age, body mass index, smoking history, and endoscopic and histological results were reviewed. Univariate analysis was used to identify the associated factors for malignancy of colorectal LSTs. Factors with statistical significance in univariate analysis were used in multivariate logistic regression to determine the independent predictors.Results:A total of 323 patients with 341 colorectal LSTs were involved in the study. The rate of malignancy was highest in non-granular pseudo depressed (NG-PD) subtype [85.48% (53/62)], followed by granular nodular mixed (G-NM) subtype [76.97% (117/152)]. Both of the above rates were significantly higher than that of granular homogenous (G-H) subtype [29.51% (18/61), P<0.001] and non-granular flat elevated (NG-FE) subtype [24.24% (16/66), P<0.001]. Univariate analysis showed that NG-PD subtype ( P<0.001, OR=18.40, 95% CI: 7.46-45.42), G-NM subtype ( P<0.001, OR=10.45, 95% CI: 5.30-20.58), rectosigmoid location ( P<0.001, OR=2.33, 95% CI: 1.47-3.69) and size ≥2 cm ( P<0.001, OR=2.60, 95% CI: 1.60-4.00) associated with malignancy for colorectal LSTs. In multivariate logistic regression, NG-PD subtype ( P<0.001, OR=17.51, 95% CI: 7.06-43.43), G-NM subtype ( P<0.001, OR=8.25, 95% CI: 4.07-16.73) and size ≥2 cm ( P=0.032, OR=1.80, 95% CI: 1.05-3.08) remained to be independent predictors. Conclusion:LSTs of NG-PD subtype, G-NM subtype or size ≥2 cm are high risk factors of malignancy, in which cases, en bloc resection is required.
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Objective:To evaluate the effects of peroral endoscopic myotomy (POEM) on esophageal motility in patients with achalasia(AC) after POEM.Methods:Demographics, clinical and manometric data, and outcomes were collected from the medical records of patients who received POEM as the primary therapy for AC in Beijing Friendship Hospital from January 2012 to June 2016. The rate of treatment success and change in esophageal dynamics before and after treatment were compared in different types of AC.Results:At 6 months′ follow-up of POEM, the symptom remission rate of AC patients with type Ⅰ, type Ⅱ, and type Ⅲ was 100.0% (13/13), 95.5% (42/44) and 90.1% (10/11), respectively. Within 6 months after POEM, lower esophageal sphincter resting pressure [10.5 (6.9, 15.8) mmHg VS 24.6 (18.3, 35.1) mmHg, 1 mmHg=0.133 kPa], 4 s integrated relaxation pressure [6.0 (3.7, 8.8) mmHg VS 21.8 (15.3, 28.0) mmHg], upper esophageal sphincter (UES)resting pressure [43.4 (33.7, 57.3) mmHg VS 45.3 (33.2, 71.1) mmHg] and UES residual pressure [1.5 (0.0, 4.6) mmHg VS 3.9 (1.1, 6.9) mmHg] were significantly improved compared with those of pre-operation (all P<0.05). At 6 months after POEM, esophageal dilatation diameter (3.0±0.7 cm VS 3.9±1.1 cm) and Eckardt scores [1 (0, 2) VS 6 (5, 8)] were also significantly improved compared with those of pre-operation (all P<0.001). After POEM, the esophageal body peristalsis did not recover in type Ⅰ AC patients. Four patients (9.1%, 4/44) of type Ⅱ AC recovered weak peristalsis or premature contraction, and 10 patients (90.9%, 10/11) of type Ⅲ AC recovered with more normal peristaltic wave, and the rate of pre-systolic contraction or weak peristalsis increased. Conclusion:POEM can improve the esophagogastric junction outflow tract obstruction and change the esophageal body motility.After POEM, part patients have recovery of esophageal body motility, which is most obvious in type Ⅲ AC, followed by type Ⅱ, and type Ⅰ AC patients have no significant change.
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Objective:To explore the value of ex- vivo porcine stomach model for endoscopic submucosal dissection (ESD) training for international trainees. Methods:Fifteen international students received ESD training and learning for twenty days. Firstly, students learned basic theory of ESD and completed a questionnaire. Then they were randomized to receive endoscopic training either on the vitro animal (group A) or on training experience (group B) of the clinical observation. At last, one case was assessed by an experienced endoscopist. The total and step-by-step operating time, complete resection, size of specimen and complications were recorded. All students completed the questionnaire once again. SPSS 20.0 was used for t test and chi-square test. Results:There was significant difference in total ESD operation time between group A and group B ( P<0.05). There were significant differences between the two groups on cutting time and dissection time, but there was no difference on marking time, injection time and operating speed. There was only one case of block resection and perforation in each group. For group A, their mastery and clinic confidence of ESD had been obviously increased after the animal training course. Compared with the operation before the training in group A, it was found that the total time and cutting time of the ESD after the training were also significantly improved. Conclusion:Theory combined with endoscopic training on vitro animal model can make the trainees familiar with the basic theory and master the operational skills, which is helpful and valuable for them to perform ESD in further clinic practice.
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Objective To evaluate the clinical efficacy of laparoscopic radical hysterectomy and pelvic lymph node dissection (PLND) in cervical squamous cell carcinoma (CSCC). Methods The clinical data of 83 CSCC patients in our hospital were retrospectively analyzed. The open surgery group (n = 43) underwent traditional transabdominal radical hysterectomy and PLND, while the laparoscopy group (n = 40) underwent laparoscopic radical hysterectomy and PLND. Intraoperative and postoperative indices were compared between the two groups. Results The intraoperative bleeding volume in stage ⅠB1 and ⅡAl patients in the open surgery group was greater than in the laparoscopy group. The operative duration was shorter and fewer lymph nodes were dissected in the open surgery group than in the laparoscopy group (P ＜ 0.05). The time to flatus, fever duration, and hospital stay in stage ⅠB1 and ⅡA1 patients in the open surgery group were longer than in the laparoscopy group (P ＜ 0.05). The frequency of painkiller use in stage ⅡA1 patients in the open surgery group was greater than in the laparoscopy group (P ＜ 0.05). There was no statistical difference in the incidence of intraoperative and postoperative complications between the ⅠB1 and ⅡA1 groups (P＞ 0.05). The physical fitness and social function scores and the adverse effects were significantly different in the open surgery group from those in the laparoscopy group (P ＜ 0.05). Conclusion Laparoscopic radical hysterectomy and PLND for CSCC can reduce intraoperative bleeding volume, increase the number of lymph nodes dissected, shorten the fever duration and hospital stay, and increase the quality of life.
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Objective To evaluate the clinical and esophageal dynamics characteristics, and initial treatment effect of patients with untreated achalasia using high resolution manometry. Methods From January 2012 to June 2016, patients newly diagnosed with achalasia were retrospectively recruited. Clinical information, endoscopy and X-ray findings, manometric variables and treatment outcomes were collected and compared among manometric subtypes. Results Among 133 patients with achalasia, 32 ( 24. 0%) were classified as type Ⅰ, 84 ( 63. 2%) as typeⅡ and 17 ( 12. 8%) as typeⅢ. Compared with the typeⅢ, the symptom of regurgitation was more common in the types I and typeⅡachalasia patients ( P=0. 020) . While compared with the type Ⅰ, the score of chest pain was higher in the patients with type Ⅱ and type Ⅲ ( P=0. 006) , as well as the basal lower esophageal sphincter pressure ( P=0. 015, P=0. 023 for type Ⅱ and type Ⅲ, respectively) . Integrated relaxation pressure was similar among the 3 subtypes ( P=0. 158) . Forty-five and 47 patients received pneumatic dilation ( PD ) and peroral endoscopic myotomy ( POEM ) respectively, and all of the patients were followed-up for at least 6 months. The success rate was higher in the POEM group than that of the PD group in all the 3 manometric subtypes, but only the difference between POEM and PD in the type Ⅲ was statistically significant ( 90. 0% VS 40. 0%, P = 0. 041 ) . Conclusion The clinical characteristics and treatment response are different among the 3 achalasia subtypes. Patients with type Ⅲ achalasia are probably the best candidates for POEM.
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Objective:To observe the clinical efficacy of Pingxiao capsules in the treatment of benign thyroid nodules. Methods:Totally 240 patients with benign thyroid nodules were randomly divided into the treatment group and the control group with 120 ones in each. The control group received levothyroxine at low dose, the treatment group received Pingxiao capsules, and the treatment course was 3 months. The type B ultrasonic inspection and lab inspection ( for thyroid hormones and blood lipid) were carried out, the cura-tive effect was compared and the adverse reactions were recorded as well. Results:Three patients in the treatment group and five ones in the control group were lost during the follow-up. After the treatment, the max diameter of thyroid nodule and the thyroid volume de-creased in both groups (P<0. 05), and those in the treatment group were smaller than those in the control group (P<0. 05). The levels of TSH and TC in the control group decreased after the treatment, which were significantly lower than those in the treatment group (P<0. 05). The total effective rate in the treatment group was higher than that in the control group, and the incidence of ad-verse reactions was lower than that in the control group, and both had significant differences between the groups (P<0. 05). Conclu-sion:Pingxiao capsules are effective and safe in the treatment of benign thyroid nodules.
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Objective To evaluate the clinical and esophageal dynamics characteristics, and initial treatment effect of patients with untreated achalasia using high resolution manometry. Methods From January 2012 to June 2016, patients newly diagnosed with achalasia were retrospectively recruited. Clinical information, endoscopy and X-ray findings, manometric variables and treatment outcomes were collected and compared among manometric subtypes. Results Among 133 patients with achalasia, 32 ( 24. 0%) were classified as type Ⅰ, 84 ( 63. 2%) as typeⅡ and 17 ( 12. 8%) as typeⅢ. Compared with the typeⅢ, the symptom of regurgitation was more common in the types I and typeⅡachalasia patients ( P=0. 020) . While compared with the type Ⅰ, the score of chest pain was higher in the patients with type Ⅱ and type Ⅲ ( P=0. 006) , as well as the basal lower esophageal sphincter pressure ( P=0. 015, P=0. 023 for type Ⅱ and type Ⅲ, respectively) . Integrated relaxation pressure was similar among the 3 subtypes ( P=0. 158) . Forty-five and 47 patients received pneumatic dilation ( PD ) and peroral endoscopic myotomy ( POEM ) respectively, and all of the patients were followed-up for at least 6 months. The success rate was higher in the POEM group than that of the PD group in all the 3 manometric subtypes, but only the difference between POEM and PD in the type Ⅲ was statistically significant ( 90. 0% VS 40. 0%, P = 0. 041 ) . Conclusion The clinical characteristics and treatment response are different among the 3 achalasia subtypes. Patients with type Ⅲ achalasia are probably the best candidates for POEM.
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Objective To investigate the biological effects of Wnt gene in kidney cancer Caki?2 cells. Methods The Wnt gene was silenced in kidney cancer Caki?2 cells by lentivirus vector. The cell proliferate ability of cells in each group were assayed by CCK?8 kit at different time points. The apoptosis of Caki?2 cells was observed after silencing Wnt gene by transmission electron microscope. The invasion ability of each group cells was tested using Transwell chambers. The genes expression changes of Wnt/β?catenin signaling pathway and apoptosis related gene were determined by realtime PCR. Results Compared with the other two groups,the cell proliferate ability of the cells after silencing Wntgene was suppressed,and the difference was statistically significant(P<0.05). Apoptosis increased significantly in shRNA+Caki?2+Wnt group cells with silencing of Wntgene, and apoptotic body appeared in these cells. In invasive experiment,the number of emigrated cells in shRNA+Caki?2+Wnt group were significantly lower than other groups(P<0.05). The expression of Wnt mRNA,β?catenin mRNA and Bcl?2 mRNA in shRNA+Caki?2+Wnt group cells was lower than other groups(P<0.05). Conclusion Silencing of Wnt gene of kidney cancer Caki?2 cells can affect the proliferation rate of the cells, promote the cell apoptosis,and inhibit the invasion ability,which provide certain theoretical basis for the research and development of new drugs and new therapeutic targets.
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BacKground:AchaIasia of cardia is categorized into 3 subtypes by Chicago cIassification criteria defined by high-resoIution manometry( HRM). These different subtypes present different cIinicaI and esophageaI dynamic characteristics. Aims:To study the cIinicaI and esophageaI dynamic characteristics of patients with achaIasia of cardia categorized by Chicago cIassification criteria. Methods:Twenty-five untreated achaIasia of cardia patients from January 2012 to ApriI 2014 at Beijing Friendship HospitaI,CapitaI MedicaI University were enroIIed. CIinicaI data incIuding cIinicaI symptoms, manifestations of endoscopy and barium meaI radiography and data of HRM were anaIyzed retrospectiveIy. Results:Of the 25 patients,5 patients(20. 0%)were cIassified as type Ⅰ,15(60. 0%)as type Ⅱ and 5(20. 0%)as type Ⅲ. AII patients compIained as having dysphagia,and 26. 7%( 4/15 ) of type Ⅱ patients had chest pain. Incidences of regurgitation in typeⅠ,ⅡandⅢwere 60. 0%(3/5),53. 3%(8/15)and 20. 0%(1/5),respectiveIy,no significant difference was found among the three types(P>0. 05). Incidences of diIatation of esophagus in type Ⅰ,ⅡandⅢwere 60. 0%(3/5),73. 3%(11/15)and 20. 0%(1/5),respectiveIy,no significant difference was found among the three types (P=0. 11). No differences in Iength of Iower esophageaI sphincter(LES),abdominaI LES Iength,LES resting pressure, upper esophageaI sphincter( UES)resting pressure and integrated reIaxation pressure( IRP)among the three types were found(P>0. 05). Incidences of muItipIe swaIIowing and spontaneous UES reIaxation were 32. 0%(8/25)and 24. 0%(6/25),respectiveIy,no significant difference was found among the three types(P>0. 05). Conclusions:Of the patients with achaIasia of cardia ,typeⅡis more common. Large-sampIe muIticenter studies are needed for further research.
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Objective To explore the effect of linraglutide on expressions of plasminogen activator inhibitor 1 (PAI-1) and intercellular adhesion molecule 1 (ICAM-1) in cultured rat glomerular mesangial cells (RGMCs) stimulated by tumor necrosis factor α (TNF-α).Methods Cultured HBZY21 RGMCs were divided into 6 groups:normal control cells,TNF-α stimulated cells,liraglutide low (10 nmol/L),median (100 nmol/L) and high (1000 nmol/L) concentration incubated cells stimulated with TNF-α,PDTC intervention cells.The expressions of PAI-1 and ICAM-1 of each group were measured by ELISA and RT-PCR.Results The levels of PAI-1 and ICAM-1 protein and mRNA were remarkably increased by TNF-α (P＜0.05),and liraglutide could inhibit above up-regulated expressions (all P＜0.05).Compared with TNF-α-stimulated group,the expressions of PAI-1 and ICAM-1 were decreased by PDTC intervention (all P＜0.05).Conclusion Liraglutide can partly down-regulate the expressions of PAI-1 and ICAM-1 induced by TNF-α in RGMCs.
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Objective To observe whether hepatitis B vaccine enhance the treating effect of cyto-kine induced kill(CIK) cells on hepatitis B virus transgenic(HBV-Tg) mice. Methods The HBV-Tg mice were treated with CIK cells by peritoneal injection and hepatitis B vaccine by hypodermic injection. The HBV DNA level were tested by real-time PCR,T lymphocyte subgroup were detected by flow cytometry and the pathological diversify of hepatic tissue were observed by HE staining. Results The HBV DNA loading in peripheral blood of HBV-Tg mice decreased after CIK cells were treated and CD3~+ , CD4~+ and CD8~+ cells increased which were enhanced after CIK cells combined with hepatitis B vaccine. Conclusion Hepa-titis B vaccine enhanced the treating effect of CIK on HBV-Tg mice which may be implemented by increased the blood level of CD3~+, CD4~+ and CD8~+ cells, especially CD8~+ cells level.
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<p><b>OBJECTIVE</b>To investigate the therapeutic efficacy of compound immunotherapy of tumor-derived heat shock protein 70 (HSP70) and interleukin-2 (IL-2) on tumor-bearing mice, and to provide reference for translating this strategy to human cancer.</p><p><b>METHODS</b>Cell culture, techniques for protein extraction and purification, SDS-PAGE, Western blot and capillary electrophoresis for HSP70 detection and purity analysis, and animal experiments were used. Mice were treated with HSP70 5 or 10 microg and IL-2 50 kU, 100 kU or 2 kU (maintaining dosage) at previously designated intervals.</p><p><b>RESULTS</b>Both the mono-administration of either HSP70 or IL-2 and the compound immunotherapy of HSP70 and IL-2 obviously inhibited the growth of the implanted tumor and prolonged the life span of the mice to different extents. However, long periods of tumor-free survival (over 90 days) were demonstrated only in HSP70 10 micro g group, HSP70 10 microg-IL-2 50 kU group, and HSP70 10 microg-IL-2 100 kU group (40%, 40%, 60% respectively). On the other hand, none of the mice in the rest groups achieved long-term survival. Statistical significance was apparent in comparison with the groups without long period survival (P < 0.025 - 0.05).</p><p><b>CONCLUSION</b>Our research revealed that tumor-derived HSP70 immunotherapy was much more effective than IL-2 alone. And in compound immunotherapy, HSP70 was the main factor in delaying or eradicating the tumors. The proper combination of HSP70 and IL-2 (10 microg HSP70 and 100 kU IL-2 in this experimental mouse model) clearly enhanced the immunotherapy efficacy which indicated that the specific immunotherapy as a main part of tumor immunotherapy assisted by cytokine immunotherapy would be a promising strategy in cancer treatment.</p>
Subject(s)
Animals , Mice , Drug Therapy, Combination , HSP70 Heat-Shock Proteins , Therapeutic Uses , Interleukin-2 , Therapeutic Uses , Mice, Inbred Strains , Neoplasms, Experimental , Mortality , Therapeutics , Survival Rate , T-Lymphocytes, Cytotoxic , Allergy and Immunology , Tumor Cells, CulturedABSTRACT
<p><b>OBJECTIVE</b>To study the efficacy and explore the mechanism of the anti-tumor immunity elicited by heat shock protein 70-peptide complexes (HSP70-PC) derived from tumor cells.</p><p><b>METHODS</b>Cells culture, flow cytometric analysis, affinity chromatography for protein purification, SDS-PAGE, Western-blotting and animal experiment were used.</p><p><b>RESULTS</b>HSP70-PC immunization rendered protective effect to both naive tumorl-bearing mice. All of the naive mice obtained complete resistance to Hcaf cell attack; 40% of the tumor-bearing mice survived for over 90 days, whereas the mice of control group died within 2 weeks (P < 0.01). CD8+ subset of T lymphocytes in the peripheral blood of immunized mice increased by 12%.</p><p><b>CONCLUSION</b>HSP70-PC induces anti-tumor immunity via activation of cytotoxic T lymphocytes (CTLs), and it possesses strong tumor vaccine effect. Our research adds more evidence to support the clinical use of HSP70-PC to fight human cancers.</p>
Subject(s)
Animals , Mice , CD8 Antigens , Blood , Cell Membrane , Chemistry , HSP70 Heat-Shock Proteins , Therapeutic Uses , Liver Neoplasms, Experimental , Chemistry , Drug Therapy , Allergy and Immunology , Pathology , Neoplasm Transplantation , T-Lymphocytes, Cytotoxic , Allergy and Immunology , Tumor Cells, CulturedABSTRACT
Objective To systematically review the Helicobacter pylori eradication efficacy with ranitidine bismuth citrate(RBC) and two antibiotics,and to conduct a meta-analysis of randomized clinical trials comparing the efficacy of proton pump inhibitor(PPI)vs RBC with two antibiotics for 1 week.Methods Selection of studies:studies evaluating RBC plus two antibiotics were considered.For the meta-analysis,randomized controlled trials comparing PPI vs.RBC plus two antibiotics for 1 week were included.Data Source:RCTs were identified from CBM,handsearching,and personal contact with pharmaceutical companies.Inclusion criteria:data were extracted independently by two reviewers.The methodological quality of trials was assessed by the Jadad-scale.Statistics analysis was managed by using RevMan 4.2.Results Twelve randomized clinical trials including 1254 patients were included.The meta-analysis showed comparable efficacy with RBC and PPI (OR=1.30,95% CI:0.94～1.81,P=0.12).Conclusion The efficacy of RBC and PPI-based triple regimens were comparable.
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Objective: To investigate the successive fluctuation of some Thl type cytokines in the peripheral blood of tumor-bearing mice treated with tumor-derived heat shock protein 70 ( HSP70) , explore the mechanism of HSP 70 in breaking through the tumor-immunity tolerance of the organism with tumor-burden and in inducing effective anti-tumor immune response, and provide valuable reference for tumor-derived HSP70 administration in treating human cancer. Methods : Cell culture, techniques for protein extraction and purification, SDS-PAGE, Western-blot, capillary electrophoresis, ELISA technique and animal experiment were applied. Results: HSP70 could result in apparent tumor-inhibitory effect and upregulate some Thl type cytokines(IL-2, TNF-?, and IFN-?) in the peripheral blood of the treated mice gradually to the frequency of HSP70 administration, and showed no reduction trend in two weeks after the final treatment. Statistically significant difference was observed contrasted with those of the control group (P
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90 days),obvious difference( P