Application of blood/fluid warmer during plateletpheresis in winter and its nursing / 中国输血杂志

【Objective】 To study the safety, effectiveness and nursing of blood/fluid warmer during the process of plateletpheresis in winter. 【Methods】 The blood re-transfusion speed during plateletpheresis in winter and the time of blood passing through the blood return pipeline was counted. The vitro blood was heated with a blood/fluid warmer under different temperature settings, and the rising speed of blood temperature was recorded. The blood samples were tested for blood routine examination, free Hb and erythrocyte morphology at 0, 15 and 30 minutes. In the process of plateletpheresis in winter, the blood donors′ ear temperature and the skin temperature near the reinfusion needle in the observation group and the controls were measured, and the blood donors were observed for shivering, arm chills, pain or other discomfort. After the blood donation, the thermal comfort was evaluated. 【Results】 There was no difference in the results of routine blood test and plasma free Hb test of vitro blood after warming at 41℃, 42℃ and 43℃ for 0, 15 and 30 minutes (P>0.05), and no change in erythrocyte morphology was found. The skin temperature near the reinfusion needle (before vs. after the start of phlebotomy) was statistically different by applying blood/fluid warmer or not(P0.05). The vitro blood heating experiment showed that when the room temperature was within 22~24℃, the blood retransfusion speed was (100-120) mL/min; after the application of blood/fluid warmer, the temperature of reinfusion blood could be raised from 27℃ to 33~37℃. The proportion of feeling comfortable and very comfortable and the score of thermal comfort in the blood donors who used the warmer were higher than those in the controls (P<0.05). When the temperature of the warmer was set above 38℃, the average score of thermal comfort of blood donors was above 8. 【Conclusion】 It is safe to apply the blood/fluid warmer during the plateletsapheresis in winter, which can significantly improve the comfort of blood donors and reflect the humanized service of blood stations, and is worth popularizing.

Value of brain-expressed X-linked family genes in the diagnosis and prognosis prediction of pan-cancer / 肿瘤研究与临床

Objective:To investigate the differential expression of brain-expressed X-linked (BEX) family genes in pan-cancer and its value in diagnosis and prognosis of pan-cancer.Methods:RNA sequencing (RNA-seq) data, survival data, immune subtypes, the stem cell scores based on RNA and DNA methylation of 33 different tumors from The Cancer Genome Atlas (TCGA) database were downloaded from the online database of University of California, Santa Cruz (UCSC Xena) on April 10, 2022. The limma package of R software (V.4.2.0) was used to analyze the expression of BEX family genes in the TCGA database. The differential expression of BEX family genes in pan-cancer tissues and normal tissues was compared by using Wilcox test. Pan-cancer patients were divided into high expression group and low expression group according to the median expression level of BEX family genes; Kaplan-Meier survival analysis was used to evaluate the relationship between the expression of BEX family genes and the overall survival (OS) of patients; Cox proportional risk model was used to analyze the effect of the expression of BEX family genes on OS in pan-cancer patients and then the forest map was drawn. The correlation of the expression of BEX family genes with tumor microenviroment and tumor stem cells in pan-cancer patients was analyzed based on the correlation index Cor value. Spearman correlation analysis was used to analyze the correlation between the expression of BEX family genes and tumor microenviroment and cancer stem cell index in gastric cancer tissues. The RNA-seq of different tumor cell lines and drug sensitivity data download from the CellMiner database were used to analyze the correlation between the expression of BEX family genes and drug sensitivity. The correlation of pan-cancer and gastric cancer immune subtypes with the expression of BEX family genes was analyzed by using Kruskal test.Results:BEX3 was highly expressed in pan-cancer tissues in TCGA database, BEX2 and BEX4 were moderately expressed in pan-cancer tissues, and BEX1 and BEX5 were relatively low expressed in pan-cancer tissues. The expressions of BEX2, BEX3 and BEX4 were the highest in cholangiocarcinoma, the expression of BEX5 was the highest in endometrial neoplasms, and the expression of BEX1 was the highest in invasive breast cancer. Compared with normal tissue samples, the expressions of BEX family genes were up-regulated or down-regulated in various cancers (all P < 0.05). Survival analysis showed that the expressions of BEX family genes were associated with the OS of various cancers. Some tumor patients with high expressions of BEX1, BEX3, BEX4 and BEX5 had better OS compared with those with low expressions, and the differences were statistically significant (all P < 0.05). Other patients with high expression of BEX family genes had worse OS compared with those with low expressions, and the differences were statistically significant (all P < 0.05). Cox regression analysis showed that the high expression of BEX1 for stomach neoplasms; the high expression of BEX2 for acute myeloid leukemia, thymoma and endometrial neoplasms; the expression high of BEX3 for squamous cell carcinoma of head and neck,sarcoma, stomach neoplasms and endometrial neoplasms; the high expression of BEX4 for rectal adenocarcinoma, stomach neoplasms and endometrial neoplasms; the high expression of BEX5 for renal suspicious cell carcinoma and thymoma were risk factors for OS (all P < 0.05).The expression of BEX family genes was negatively correlated with the stromal score of most cancers (all P < 0.05), and positively correlated with the stem cell score (all P < 0.05). The expression of BEX family genes was negatively correlated with cancer stem cell index of gastric cancer ( P < 0.05), and was positively correlated with matrix score and estimated total score (all P < 0.05). Among different tumor cell lines in CellMiner database, BEX family genes were closely related to drug resistance of vemurafenib (Cor = -0.368, P = 0.004), Kahalide f (Cor = -0.391, P = 0.002), O-6-benzylguanine (Cor = -0.375, P = 0.003) and other drugs. All genes in the BEX family were related to the immune subtypes of pan-cancer and were highly expressed in C5 subtype (all P < 0.05).For gastric cancer, all genes showed high expression in the C3 subtype (all P < 0.05), except BEX5 ( P = 0.24). Conclusions:The expression of BEX family genes is closely related to the prognosis of pan-cancer patients, and has an impact on the tumor microenvironment, cancer stem cells and drug sensitivity. BEX family genes may be potential biomarkers for diagnosis and prognosis of pan-cancer.

Expression of four-jointed box kinase 1 gene in colorectal cancer and its clinical significance / 肿瘤研究与临床

Objective:To investigate the differential expression of four-jointed box kinase 1 (FJX1) gene in colorectal cancer and its relationship with prognosis and the related mechanisms.Methods:On July 16, 2021, the transcriptome data and clinical data of colorectal cancer were downloaded from The Cancer Genome Atlas (TCGA) database to analyze the expressions of FJX1 mRNA in colorectal cancer tissues and paracancerous tissues, and the relationship between FJX1 mRNA and clinicopathological characteristics and prognosis of patients. Receiver operating characteristic (ROC) curve was drawn to evaluate the value of FJX1 mRNA in predicting the survival of patients with colorectal cancer. Cox proportional hazards model was used to evaluate whether FJX1 mRNA was an independent influencing factor for prognosis of colorectal cancer. The overall survival (OS) time and survival status of colorectal cancer patients were downloaded from the Gene Expression Omnibus (GEO) database, and the relationship between FJX1 mRNA and prognosis of patients was analyzed. The methylation data of colorectal cancer was downloaded from the University of California, Santa Cruz (UCSC xena) database to determine the degree of methylation at each site of FJX1 mRNA and the correlation between the expression of FJX1 mRNA and the degree of methylation at each site. Signaling pathways associated with FJX1 mRNA in colorectal cancer were analyzed by using the Gene Set Enrichment Analysis (GSEA) (4.1.0). The correlation between FJX1 mRNA and tumor-infiltrating immune cells was investigated by using the Tumor Immunity Evaluation Resource (TIMER) database. Spearman analysis and small molecule/drug sensitivity analysis were used to explore the correlation between FJX1 mRNA expression and drug sensitivity.Results:In the transcriptome data of 612 colorectal cancer cases in TCGA database, the expression of FJX1 mRNA in colorectal cancer tissues was higher than that in the paracancerous tissues ( P < 0.001). In 549 colorectal cancer patients with complete data, FJX1 mRNA expression was correlated with M stage ( P = 0.007), pathological stage (stage Ⅳ vs. stage Ⅰ, P = 0.016; stage Ⅳ vs. stage Ⅱ, P = 0.03; stage Ⅳ vs. stage Ⅲ, P = 0.012), but it was not correlated with age, gender, T stage and N stage (all P > 0.05). In TCGA database and GEO database, the patients were divided into high expression group and low expression group according to the median expression of FJX1 mRNA. The OS in FJX1 mRNA high expression group was worse than that in low expression group (all P<0.05). The ROC curve of FJX1 mRNA expression on the 1-, 3-, and 5-year OS rates of colorectal cancer patients was drawn by using the data in TCGA database, and the areas under the curve (AUC) were 0.595, 0.625 and 0.764, respectively. Multivariate Cox regression analysis showed that age ( HR = 1.050, 95% CI 1.028-1.073, P < 0.001), T stage ( HR = 1.787, 95% CI 1.090-2.927, P = 0.021) and high FJX1 mRNA expression ( HR = 1.160, 95% CI 1.049-1.282, P = 0.004) were independent influencing factors for poor OS in colorectal cancer. The gene set enrichment analysis found that FJX1 mRNA was related to colorectal cancer, TGF-β signaling pathway, VEGF signaling pathway, Wnt signaling pathway, etc. The expression of FJX1 mRNA in colon cancer was negatively correlated with the degree of methylation of FJX1 mRNA ( r = -0.16, P < 0.001), and the expression of FJX1 mRNA in rectal cancer was positively correlated with the degree of methylation of FJX1 mRNA ( r = 0.33, P < 0.001). The expression of FJX1 mRNA was related to the infiltration of resting memory CD4 + T cells, M0 macrophages and resting dendritic cells. FJX1 mRNA was significantly associated with the resistance of various chemotherapeutic drugs and tumor-targeted drugs such as methotrexate, 5-fluorouracil, gefitinib, etc. Conclusions:FJX1 mRNA may be a potential biomarker of colorectal cancer and is associated with the infiltration of immune cells.

The mechanism of effective fractions from Xiongma decoction in the treatment of migraine model rats with hyperactivity of liver-yang and blood stasis / 中国药房

OBJECTIVE To expl ore the mechanism of effe ctive fractions from Xiongma decoction in the treatment of migraine with hyperactivity of liver-yang and blood stasis. METHODS Totally 70 male SD rats were randomly divided into normal group ， model group ，positive control group （Flunarizine hydrochloride capsules 0.9 mg/kg），low-dose and high-dose groups of Xiongma decoction effective fractions （ethyl acetate extract 0.87，3.46 g/kg，n-butanol extract 1.80，7.20 g/kg）. Except for normal group ， rats in other groups were given aconite decoction （2 g/kg），once a day ，for 4 consecutive weeks to establish the hyperactivity model of liver-yang. On the 15th day of modeling ，all administration groups were given corresponding drugs intragastrically at the same time ，once a day ，for 2 consecutive weeks. On the 29th day of modeling ，rats trigeminal ganglion was stimulated to establish the migraine model with hyperactivity of liver-yang and blood stasis ，then the medication was maintained for another time according to the above method. The macroscopic signs and behavior of the rats were observed ；positive expression ，mRNA and protein expression of transient receptor potential vanilloid 1 （TRPV1），calcitonin generelated peptide （CGRP），calcitonin receptor-like receptor （CRLR） and receptor-associated membrane proteins 1 （RAMP1） in trigeminal cervical spinal complex （TCC） were detected by immunohistochemistry ，RT-qPCR and Western blot assay. RESULTS Rats in model group showed macrophysical signs and behaviora l manifestations related to migraine with hyperactivity of liver-yang and blood stasis. Thirty minutes after last administration ，the above conditions of rats in Xiongma decoction effective fraction groups were improved significantly. Compared with normal group ， positive expression，mRNA and protein expression of TRPV 1，CGRP， CRLR and RAMP 1 in TCC of rats in the model group were significantly increased （P＜0.05）. Compared with model zengguirong@hnse.org group， most of above indicators in Xiongma decoction effective fraction groups were significantly decreased （P＜0.05）. CONCLUSIONS The mechanism of Xiongma decoction in preventing and treating migraine with hyperactivity of liver-yang and blood stasis may be related to inhibit the activity of TRPV1-CGRP/CGRP receptor signaling pathway in TCC.

Progress of tumor-associated neutrophils in colorectal cancer / 肿瘤研究与临床

Colorectal cancer is one of the most common causes of cancer death worldwide. In recent years, the number of patients with colorectal cancer has gradually increased. It has been proved that inflammation plays a special role in the occurrence and development of cancer. As important inflammatory cells, the role of neutrophils in tumors has gradually become research hotspots. It has been found that tumor-associated neutrophils can be polarized into pro-tumor and anti-tumor phenotypes in the tumor microenvironment, and have the ability to promote angiogenesis and tumor cell migration. This article reviews the role of tumor-associated neutrophils in the occurrence, development and metastasis of colorectal cancer, and the possibility of tumor-associated neutrophils as potential targets for cancer treatment.

Progress of oral probiotics in adjuvant treatment of colon cancer / 肿瘤研究与临床

In recent years, the incidence of colon cancer has increased year by year, but the pathogenesis of colon cancer is still unclear. With the in-depth research on the cause of colon cancer, people have found that there's a close relationship between intestinal flora and the occurrence and development of colon cancer. According to the research results, clinical attempts have been made to use probiotics for colon cancer patients to regulate the intestinal flora, thereby assisting in the treatment of colon cancer, and these attempts have achieved certain results and are worthy of clinical promotion.

Therapeutic Efficacy of Conservative Treatment Combined with Water-soluble Contrast Agents for Adhesive Small Bowel Obstruction ：A Meta-analysis / 中国药房

OBJECTIVE： To systematically evaluate th e ther apeutic effects of conservative treatment combined with water-soluble contrast agents for adhesive small bowel obstruction ，and to provide evidence-based reference for clinical medication. METHODS：Retrieved from Cochrane library ，PubMed，Embase，Wanfang database and CNKI during the inception to Sept. 2020，RCTs about conservative treatment combined with water-soluble contrast agents in the therapeutic efficacy for adhesive small bowel obstruction were collected. After literature screening and data extraction ，the quality of included literatures were evaluated with Cochrane system evaluator manual 5.1.0 and Jadad scale. Meta-analysis was conducted by using Rev Man 5.3 and Stata 16 software. RESULTS ：A total of 15 RCTs were included ，with 1 429 patients in total. Results of Meta-analysis showed that the use of water-soluble contrast agents significantly reduced the surgical needs of patients with adhesive small bowel obstruction [OR ＝ 0.64，95％CI（0.50，0.81），P＜0.001]；reduced the remission time of non-surgical patients [MD ＝－23.37， 95％CI（－32.17， －14.57），P＜0.001]，hospital stay days of non-surgical patients [MD ＝－2.21，95％CI（－2.52，－1.90），P＜0.001] and hospital stay days of all patients [MD ＝－2.43，95％CI（－3.93，－0.92），P＝0.002]，and would not increase the incidence of complications [OR ＝1.15，95％CI（0.63，2.10），P＝0.65]，but could not reduce mortality [OR ＝1.26，95％CI（0.94，3.24），P＝ 0.63] or the probability of bowel resection [OR ＝0.93，95％CI（0.57，1.52），P＝0.78]. CONCLUSIONS ：The combined use of water-soluble contrast agents for patients with adhesive small bowel obstruction is safe and effective ，can reduce the patient ’s surgical requirements ，and is beneficial to reduce the length of hospital stay and time for symptom relief.

Effects of the Extract of Xiongmatang on 5-HT and CGRP in Brain Tissue of Rats with Liver-yang Hyperactivity and Blood Stagnation Migraine / 中国药房

ABSTRACT OBJECTIVE：To study the effects of the extract of Xiongmatang on 5-HT and CGRP in brain tissue of rats with liver-yang hyperactivity and blood stagnation migraine. METHODS：Fifty male spontaneously hypertension （SHR） rats were randomly divided into model control group，Zhengtian pill positive control group （1.6 g/kg），the extract of Xiongmatang low-dose，medium-dose and high-dose groups（4.5，9.0，18.0 g/kg，by crude drug），with 10 rats in each group. Another 10 normal rats were taken as normal control group. Administration group was given relevant medicine intragastrically，once a day，for consecutive 28 d. Normal control group and model control group were given equal volume normal saline intragastrically. After last administration，except for normal control group，other groups were used to stimulate trigeminal ganglia（10 min）to establish liver-yang hyperactivity and blood stagnation migraine model，and maintained the administration once more after making the model. 30 min later，general behavior and tongue quality of rats were observed，and the blood pressure was measured；the contents of 5-HT and CGRP in cerebral tissue of rats were determined by ELISA. The protein expression of CGRP in cerebral tissue of rats were determined by Western blot method. RESULTS： Compared with the normal control group， the rats in the model control group had behavioral symptoms，such as the color of conjunctiva deepened and reddened， excessive hairdressing，head flicking，and most of the rats had purple tongue；the systolic pressure and the content and protein expression of CGRP were all increased obviously（P＜0.05 or P＜0.01）， while the content of 5-HT in cerebral tissue was decreased obviously（P＜0.01）. Compared with model control group，general behavior and tongue quality of rats were improved significantly in administration groups. Systolic pressure，the content and the protein expression of CGRP in cerebral tissue of rats were decreased significantly in Zhengtian pill positive control group and the extract of Xiongmatang high-dose group （P＜0.05），while the content of 5-HT in cerebral tissue of rats were increased significantly in Zhengtian pill positive control group，the extract of Xiongmatang medium-dose and high-dose groups（P＜0.05）.CONCLUSIONS：The extract of Xiongmatang has obvious protective effect on liver-yang hyperactivity and blood stagnation migraine model rats，the mechanism of which may be associated with reducing the content of CGRP in cerebral tissue and raising the content of 5-HT in cerebral tissue

Application of single-port laparoscopy in colorectal cancer surgery / 肿瘤研究与临床

At present, laparoscopic colorectal cancer resection is safe and feasible. Compared with traditional open surgery, laparoscopic colorectal cancer resection has less postoperative pain, earlier recovery, and similar oncology outcomes. However, traditional laparoscopic surgery has more puncture holes and requires additional incision to remove specimens, which may potentially increase the complications and weaken the minimally invasive effects in patients. In recent years, single-port laparoscopy technology has been proposed and applied in clinical practice which can be used to supplementing the shortcomings of traditional multi-port laparoscopy technology. However, the proposal of any new technology will be followed by controversy. This article reviews the application status of single-port laparoscopy surgery in colorectal cancer surgery in recent years.

Efficacy and Safety of Octreotide Combined with Conventional Therapy in Alleviating MBO ：a Meta-analysis / 中国药房

OBJECTIVE： To systematically evaluate the efficacy and safety of octreotide combined with conventional therapy in alleviating malignant bowel obstruction （MBO）， and provide evidence-based reference for clinical medication. METHODS： Retrieved from Cochrane Library， PubMed， Embase， CNKI， Wanfang database and Google academic， RCTs about octreotide combined with conventional therapy （trial group） vs. conventional therapy （control group） for relieving MBO were collected. After literature screening， data extraction and quality evaluation with Cochrane system evaluator manual 5.0 risk evaluation tool， Meta-analysis was conducted by using Rev Man 5.3 statistical software. RESULTS： A total of 13 items of RCT were included， with a total of 850 patients. Meta-analysis results showed that total response rate of trial group was significantly higher than control group [OR＝5.30，95％CI（3.47，8.10），P＜0.000 01]. Results of subgroup analysis showed that total response rate of single administration patients [OR＝6.88，95％CI（3.22，4.68），P＜0.000 01] and continuous administration patients [OR＝4.60， 95％CI（2.76，7.68）， P＜0.000 01] in trial group were significantly higher than control group. The abdominal distension relief time [MD＝－3.92， 95％CI（－4.15， －3.70）， P＜0.000 01]， abdominal pain relief time [MD＝－3.37， 95％CI（－3.61，－3.14）， P＜0.000 01]， nausea and vomiting relief time [MD＝－2.46， 95％CI（－2.81，－2.21）， P＜0.000 01] and exhaust relief time [MD＝－2.88， 95％CI（－3.31， －2.46）， P＜0.000 01] in trial group were significantly shorter than control group. Subgroup analysis of exhaust relief time showed that exhaust relief time of single administration patients [MD＝－2.90，95％CI（－3.48，－2.32），P＜0.000 01] and continuous administration patients [MD＝－2.71， 95％CI（－3.14，－2.29）， P＜0.000 01] in trial group were significantly shorter than control group. After treatment， the gastrointestinal decompression volume （P＜0.05） and the incidence of ADR [OR＝0.28，95％CI（0.13，0.62），P＝0.001] in trial group were significantly lower than in control group. CONCLUSIONS： Octreotide combined with conventional treatment is safe and effective in alleviating MBO.

Efficacy and Safety of Thalidomide Combined with Conventional Chemotherapy in the Treatment of Advanced Gastric Cancer ： a Meta-analysis / 中国药房

OBJECTIVE： To systematically evaluate the efficacy and safety of thalidomide combined with conventional chemotherapy in the treatment of advanced gastric cancer， and to provide evidence-based reference for clinical drug use. METHODS： Retrieved from PubMed， Embase， Cochrane library， CNKI， Wanfang database and VIP， RCTs about thalidomide combined with conventional chemotherapy （observation group） vs. conventional chemotherapy （control group） in the treatment of advanced gastric cancer were collected. After data extraction and quality evaluation of included literatures with Cochrane system evaluator manual 5.0 risk evaluation tool， Meta-analysis was conducted by using Rev Man 5.3 statistical software. The evidence qualities of outcome indexes were evaluated by using Grade evidence quality classification system. RESULTS： A total of 13 studies were included， involving 761 patients. Results of Meta-analysis showed that the total response rate [OR＝1.72， 95％CI（1.29，2.31），P＝0.000 2]， complete remission rate [OR＝1.90，95％CI（1.05，3.44），P＝0.03]， disease control rate [OR＝2.66， 95％CI（1.92，3.68），P＜0.001]， improvement rate of survival quality [OR＝3.09， 95％CI（1.82，5.24），P＜0.001] and the incidence of constipation [OR＝2.64， 95％CI（1.74，4.01），P＜0.001] of observation group were significantly higher than those of control group， while disease progression rate [OR＝0.39， 95％CI （0.28，0.54）， P＜0.001] and the incidence of nausea and vomiting [OR＝0.32， 95％CI（0.18，0.56）， P＜0.001] of observation group were significantly lower than those of control group. Results of quality evaluation of Grade evidence showed that total response rate， complete remission rate， the incidence of leucopenia， thrombocytopenia， hemoglobin reduction and liver dysfunction were recommended for advanced evidence. Disease control was recommended for moderate-level evidence. The incidence of disease progression， peripheral neuritis， nausea and vomiting， diarrhea， constipation and hand-foot syndrome were recommended for low-level evidence. Improvement rate of survival was recommended for very low-level evidence. CONCLUSIONS： Thalidomide combined with conventional chemotherapy show significant therapeutic efficacy for advanced gastric cancer， can improve the quality of life but increase the risk of constipation.

Progress of robotic-assisted rectal cancer surgery / 肿瘤研究与临床

In recent years,with the rapid development of minimally invasive surgery,some scholars have advocated laparoscopic surgery as a standard surgical procedure.Because of the physiological position of rectum and the limitations of pelvic space,the robot's fine operation and other advantages are very suitable for radical rectal cancer surgery.Although robot-assisted rectal cancer surgery is highly regarded by many scholars,there are still a few medical centers with Da Vinci robots at home and abroad.At this stage,the research on Da Vinci robotic surgery for rectal cancer is still in the exploratory stage.This article reviews the latest progress of Da Vinci robotic-assisted rectal cancer surgery.

Expression and correlation of phosphorylation extracellular signal-regulated kinase and monopolar spindle 1 in colorectal cancer with wild type or BRAF V600E mutation / 肿瘤研究与临床

Objective To determine the correlation between phosphorylation extracellular signal-regulated kinase (p-Erk) and monopolar spindle 1 (Mps1) in colorectal cancer patients with the BRAF V600E mutation or not, and to explore the relationship between the expression of p-Erk and Mps1 with the clinicopathological features and prognosis of colorectal cancer patients. Methods Two hundred and eighty-eight paraffin-embedded tissue sections containing both the carcinoma and its adjacent non-neoplastic colorectal tissue were collected from January 2009 to June 2015 in the First Hospital of Shanxi Medical University. BRAF mutation was detected by Sanger sequencing. Kaplan-Meier survival analysis was used to analyze the correlation between BRAF V600E and prognosis. Immunohistochemistry was used to detect the expression level of p-Erk and Mps1 in colorectal cancer with wild type or BRAF V600E mutation. The correlation between p-ERK and Mps1 expression was analyzed by using linear regression analysis. Results The BRAF V600E mutation rate was 5.2 % in colorectal carcinomas. In addition, the poorly differentiated tumours and mucinous tumours had higher incidence of BRAF mutations than well differentiated tumours and non-mucinous tumours respectively [14.3 % (9/63) vs. 2.7 % (6/225),χ 2= 11.208,P = 0.001; 25.0 % (6/24) vs. 3.4 %(9/264),χ 2=16.630,P <0.001). The positive rate of p-Erk and Mps1 in colorectal carcinomas with BRAF V600E was significantly higher than that in colorectal carcinomas with BRAF WT (14/15 vs. 3/15, P <0.05; 15/15 vs. 3/15, P < 0.05]. It was found that the p-Erk expression correlated positively to the Mps1 expression (R2= 0.419,P < 0.001). The expressions of p-Erk protein in poorly differentiated adenocarcinoma was significantly higher and mucinous adenocarcinoma than those in high differentiated adenocarcinoma and non-mucinous adenocarcinoma (χ 2= 6.679, P = 0.01; χ 2= 5.735, P = 0.017), as well as in the group with lymph node metastasis than without lymph node metastasis (χ 2=5.436, P =0.02). Positive rate of Mps1 in poorly differentiated carcinoma was higher than that in well differentiated adenocarcinoma of colorectal carcinomas (χ 2=7.950, P =0.009). The Kaplan-Meier survival analysis indicated that patients with BRAF V600E had a worse survival rate than BRAF WT patients. Conclusions BRAF V600E may play an important role in specific pathological kinds of colorectal carcinomas, which is expected to be an independent prognostic factor. The expression of p-Erk is significantly correlated with Mps1 in colorectal carcinomas, suggesting that Mps1 may become a new potential target for targeted therapy.

Pathologic and molecular characteristics of colorectal cancer in patients with type 2 diabetes / 中华内分泌代谢杂志

Objective Type 2 diabetes increases the risk of colorectal cancer and reduces the survival rate of the patients. Therefore, analyzing the characteristics of colorectal cancer in patients with type 2 diabetes may help to develop precise medical measures and to improve the prognosis of patients. Methods The pathological characteristics of 123 colorectal cancer cases with or without type 2 diabetes were analyzed. In addition, PCR and pyrosequencing method were used to test the common gene mutation status of colorectal cancer, including KRAS( codons 12, 13, 61, and 146) , BRAF( codon 600) , and PIK3CA ( exons 9 and 20) , in order to investigate the molecular characteristics of colorectal cancer in diabetic patients which may provide some clues to clinical decision. Results The mean age and body mass index of patients with diabetes were higher than those of patients without diabetes, but there was no difference in the location, the degree of cell differentiation and the grade of colorectal cancer between these 2 groups. The rate of PIK3CA mutation in patients with type 2 diabetes mellitus, especially in patients with long term type 2 diabetes was significantly higher than that in patients without diabetes (28.6％vs 10.3％, P<0.05). There was no significant difference between the two groups in common BRAF and KRAS mutation sites. Conclusion Diabetes does not alter the clinical pathological characteristics of colorectal cancer, but long course type 2 diabetes increases PIK3CA mutation rate. Therefore, using medicine targeting PIK3CA gene mutation may help to improve the prognosis of patients.

Finite element analysis of the effects of individual extralevator abdominoperineal excision for rectal neoplasms below levator hiatus on pelvic floor / 天津医药

Objective To evaluate the effects of individual extralevator abdominalperineal excision (ELAPE) for rectal neoplasms below levator hiatus on pelvic floor by finite element analysis. Methods MIMICS 10.01, GeoMagic Studio 12 and ANSYS Workbench 14.0 were used to deal with magnetic resonance data of 27 healthy nulliparous volunteers'pelvic, and then three types of finite element models were developed:intact models, ELAPE models and individual ELAPE models. The maximum stress in non levator ani tissue under the same load were measured in three types of models, and levator ani 's maximal stresses were measured in intact model and individual ELAPE and their stress distributions under the same pressure were analyzed and compared. Results The maximal stresses of non-levator ani tissue were (1.963±0.061) MPa, (5.127±0.070) MPa and (4.703±0.110) MPa for intact model, ELAPE model and individual ELAPE model respectively. The maximal stress was lower in individual ELAPE model than that in ELAPE model, but which was higher than that of intact model (P<0.01). The high-stress zone was found at the joints with surrounding structures on both sides of intact model and ELAPE model. The high-stress zone was found in front of the joints with surrounding structures on both sides in individual ELAPE model. The maximal stresses of three types of models were found in front of both sides. In intact model levator ani 's maximal stress was (0.812 ± 0.042) MPa, which was higher than that of individual ELAPE model (0.719 ± 0.027) MPa (P<0.01). The high-stress zone of intact model was found in front of the joints on both sides. The maximal stress was showed at ventral ends on both sides. For the individual ELAPE model the high-stress zone was found at the anterior part of the levator ani muscle and the surrounding structure. The maximum stress appeared at the top end of the left and right sides. Conclusion This individual ELAPE is able to decrease the stress of non-levator ani tissue, which suggests that the risk of postoperative pelvic floor hernia is relatively reduced.

Clinical analysis of nine patients with laparoscopic pancreaticoduodenectomy / 中国医师进修杂志

Objective To investigate the safety and feasibility of laparoscopic pancreaticoduodenectomy (LPD). Methods Clinical data of 9 patients who underwent LPD operation from September 2014 to February 2017 in the first hospital of Shanxi Medical University were analyzed retrospectively. Results 9 patients attempted LPD, while one required conversation to open procedure. Two cases underwent hand assisted laparoscopic surgery .The average operative time was (553 ± 86.1) minutes, the average amount of bleeding was (333.3 ± 304.1) ml, and the average hospitalization time after operation was (25.3 ± 8.9) d. Postoperative bowel sound recovery time was (3.5 ± 1) d. Postoperative complications included pancreatic leakage in 4 cases (A grade pancreatic leakage in 1 cases, B grade in 3 case), lymph leakage in 1 case, abdominal hemorrhage in 1 case , gastric emptying in 2 cases , and bile leakage in 1 case. All patients with postoperative complications were cured by non operative treatment. Postoperative pathological examination showed that 5 cases had duodenal papillary adenocarcinoma, 1 case had pancreatic ductal carcinoma, 2 cases had common bile duct disruption differentiation of carcinoma, and 1 case had pancreatic head retention cyst. Patients were followed up 3 to 24 months after operation. 1 case of pancreatic duct died 17 months after operation. One case of middle bile duct carcinoma 12 months after surgery had liver and retroperitoneal lymph node metastasis. The remaining 7 cases had no complications. Conclusions laparoscopic pancreaticoduodenectomy is minimally invasive, safe and feasible.

Effects of the bioactive parts of Xiongma Decoction on CGRP-CRLR/RAMP1 pathway in TCC of rats with nitroglycerin-induced migraine / 西安交通大学学报(医学版)

Objective To explore the effects of bioactive parts of Xiongma Decoction (parts of ethyl acetate and n-butanol extract) on the CGRP-CRLR/RAMP1 signal pathway so as to clarify its therapeutic mechanism on migraine.Methods We randomly divided 36 male SD rats into 6 groups with 6 in each:blank group,model group,groups of low-,medium-and high-dose Xiongma Decoction bioactive parts,and Sumatriptan group.By giving hypodermic injection of 10 mg/kg nitroglycerin,the migraine rat model was copied;Only 18 rats were found to have positive expressions of CGRP,CRLR,and RAMP1 in TCC with immunohistochemistry staining after heart perfusion.For the remaining 18 rats,TCC was stripped directly from the whole brain and divided into two parts,one part used to detect CGRP,CRLR,RAMP1 mRNA expressions by qPCR,and the other part to detect CGRP,CRLR,RAMP1 protein expressions by Western blot.Results The number of CGRP,CRLR and RAMP1 immunoreactive cells,the mRNA and protein expressions on TCC in model group were effectively increased,compared with those in the blank group (P＜0.05),indicating that the model copying was successful.Compared with those in the model group,the number of CGRP,CRLR and RAMP1 immunoreactive cells in Xiongma Decoction bioactive parts was significantlv decreased,and the expressions of CGRP,CRLR and RAMP1 mRNA and protein were reduced (P＜0.05).Conclusion The bioactive parts of Xiongma Decoction can reduce the activity of CGRP-CRLR/RAMP1 signal pathway in TCC of migraine rats.

Finite element analysis of the effects of individual extralevator abdominoperineal exci-sion of rectal neoplasms in the low posterior wall on the pelvic floor / 中国肿瘤临床

Objective:To evaluate the effects of individual extralevator abdominoperineal excision (ELAPE) of rectal neoplasms in the low posterior wall on the pelvic floor by finite element analysis. Methods:MIMICS 10.01, Geo Magic Studio 12, and ANSYS Workbench 14.0 were used to analyze the magnetic resonance data obtained from the pelvic region of 27 healthy nulliparous volunteers. Three types of finite element models (intact model, ELAPE model, and individual ELAPE model) were developed. The maximal stress on non levator ani tissues were analyzed using the three models, while the maximal stress on levator ani tissues were analyzed using the in-tact model and the individual ELAPE model. Their stress distributions under the same pressure were analyzed and compared. Results:The maximal stress on non levator ani tissues obtained using the intact model, ELAPE model, and individual ELAPE model were (1.963± 0.061), (5.127 ± 0.070), and (3.667 ± 0.126) MPa, respectively, with P<0.01. High-stress zones were obtained at the joints with pelvic walls on both sides using the three models, while the maximal stresses were obtained at the joints with pubis on both sides. The maxi-mal stress on levator ani tissues obtained using the intact model and individual ELAPE model were (0.812 ± 0.042) MPa and (1.437 ± 0.043) MPa, respectively. Thus, the individual ELAPE model yielded higher values of maximal stress compared to the intact model. Both models generated high-stress zones at the joints with tendinous arch of levator ani tissues on both sides, and maximum stresses at the joints with pubis on both sides. Conclusion:Individual ELAPE decreases the stress on non levator ani tissues. This suggests that the risk of postoperative pelvic floor hernia is relatively reduced.

Expression of MUC15 and PI3K/Akt in gastric carcinoma and its association with clini-copathological characteristics and prognosis / 中国肿瘤临床

Objective:To analyze the expression of MUC15 and PI3K/Akt in gastric carcinoma and its association with clinicopathologi-cal characteristics and prognosis. Methods:The expression of MUC15 and Akt was detected in 144 cases of gastric carcinoma tissues and corresponding para-carcinoma tissues by tissue microarray and immunohistochemistry. Results:The positive expression rate of MUC15 in gastric carcinoma was 79.8%, higher than that of para-carcinoma tissues (22.2%, P<0.01). The positive expression rate of Akt protein in gastric carcinoma was 80.6%, higher than that of para-carcinoma tissues (16.7%, P<0.01). The expression of MUC15 and Akt was statistically associated with the grades of differentiation, invasion depth, lymphatic metastasis, TNM stage of tumor tissues (P<0.05), and the positive correlation between the two protein expression that appear in the gastric tumor tissue (P=0.001). Univariate survival analysis showed that the over-expression of either MUC15 or Akt was inversely correlated with the survival time (P<0.05 and P<0.01, respectively). Cox multiple regression analysis indicated that patients with over-expression of both MUC15 and Akt had the worst prognoses (HR=3.115, P<0.05). Conclusion:MUC15 may be involved in the occurrence, development, invasion, and metastasis of gastric cancer through the PI3K/Akt cell signaling pathway, and the expression of MUC15 combined with Akt is a powerful predictor for the prognosis of gastric cancer.

The survey about HIV infections among voluntary blood donors of Shaoguan in the recent ten years / 国际检验医学杂志

Objective To analyze the voluntary blood donors of Shaoguan city in recent 10 years HIV infection status and distri‐bution characteristics ,and to take effective prevention and control measures ,in order to reduce the risk of HIV infection through blood transfusion .Methods HIV screening test in the early by the reagent of two different manufacturers ,from 2005 to 2014 vol‐untary blood donors specimens of 265 771 doses of blood donation in Shaoguan ,and early screening positive specimens confirmed by Center for Disease Control of Shaoguan .Results The voluntary blood donors of Shaoguan in the 10 years that initial screening test anti‐HIV positive were 310 cases ,and 35 cases confirmed positive;The confirmed positive rate was 1 .317/10 000;The HIV infec‐tion rate in 2012 was highest (2 .867/10 000) and there were 9 cases ,which was significant difference (P<0 .05) .The district of the maximum rate was New Fengxian ,which was 5 .369/10 000 ,and different districts had significant difference (P<0 .05) .The epidemiology survey about HIV infections found that male were 30 cases(85 .71% ) ,which was significantly more than women;By age distribution ,most HIV infections were 18 to 35 years old young adults ,which accounted 26 cases(74 .29% ) .Married and un‐married people infected respectively accounted 28 .57% and 71 .43% .The occupations of HIV infections were scattered with farm‐ers ,staffers ,the service industry ,cadres in the majority .The HIV infection rate with low education was relative higher ,which had some relationship to educational level .The residents and the non‐residents infected respectively accouted 71 .43% and 28 .57% ;Blood donors for the first time of HIV infections were 24 cases (68 .57% ) .Blood donors for the second time of HIV infections were 11 cases (31 .43% );Other virus co‐infection respectively were 2 HBV infections ,1 HCV infection and 3 syphilis infections .The route of transmission was mainly through sexual transmission that was mainly heterosexual transmission ,which was 33 cases (94 .58% ) .Conclusion The voluntary blood donors of Shaoguan with HIV is on the rise ,and give priority to with male youths spread through heterosexual sex .It should be pay high attention to by the government ,society and blood stations ,and strengthen the propaganda work of AIDS prevention and control checks ,and minimize the risk of HIV transmission by blood transfusion in or‐der to guarantee the safety of clinical blood transfusion .