Correlation between neoadjuvant radiotherapy and chemotherapy efficacy and changes in peripheral blood T lymphocytes in patients with advanced mid-to-low rectal cancer / 中国基层医药

Objective:To correlate neoadjuvant radiotherapy and chemotherapy efficacy with changes in peripheral blood T lymphocytes in patients with advanced mid-to-low rectal cancer.Methods:A total of 106 patients with rectal cancer who received treatment in Jinhua Municipal Central Hospital from January 2019 to December 2020 were included in this study. Fasting venous blood was taken before neoadjuvant radiotherapy and chemotherapy and 7 days before surgery to measure the numbers of CD3 +, CD4 +, CD8 +, CD45RA + and CD45RO + cells using flow cytometry. The optimal cut-off point was determined using the receiver operating curve. The influential factors of tumor regression grade were analyzed using logistic regression analysis. Results:After neoadjuvant radiotherapy and chemotherapy, the numbers of CD3 +, CD4 +, CD8 + cells were (401.86 ± 138.65), (225.83 ± 87.17), and (155.84 ± 71.19) respectively, which were significantly decreased compared with before neoadjuvant radiotherapy and chemotherapy [(477.33 ± 141.74), (647.38 ± 203.19), (348.22 ± 113.75), t = 10.78, 11.17, 9.49, all P < 0.05]. There were no significant differences in the percentages of CD3 +, CD4 +, CD8 +, CD45RA + and CD45RO + cells between before and after treatment (all P > 0.05). The percentage of CD45RO + cells was significantly increased after neoadjuvant radiotherapy and chemotherapy. A higher percentage of CD45RO + cells led to a lower tumor regression grade ( P < 0.05). The receiver operating characteristic curve showed that the optimal cut-off point of the percentage of CD45RO + cells was 1.08. The area under the receiver operating characteristic curve was 0.774 ( P = 0.029), with a sensitivity of 82.5% and specificity of 69.6%. The logistic regression analysis revealed that the percentage of CD45RO + cells was significantly correlated with tumor regression grade ( P < 0.05). Conclusion:The percentage of CD45RO + cells in T lymphocyte subsets before and after neoadjuvant radiotherapy and chemotherapy is closely related to tumor regression grade. It can be used as an indicator to predict the sensitivity of neoadjuvant radiotherapy and chemotherapy. This study is of great innovation and science and provides a new idea for clinical practice.

The standardization construction and quality management of colorectal neoplasm tissue sample database in the era of precision medic / 中华医学科研管理杂志

Objective:To establish a standard colorectal neoplasm tissue biobank with complete clinical information to provide high quality samples for fundamental and clinical research of colorectal neoplasm.Methods:Based on Affiliated Jinhua Hospital, Zhejiang University School of Medicine, to conduct structural design of colorectal neoplasm tissues, normal tissues and related information. Establish standard operating procedures from the collection and storage of tissue samples, standardize the entry of basic information, medical history, pathology and other relevant clinical information of the patients, and conduct random quality inspections on the pathological morphology and molecular level on a regular basis.Results:A tissue biobank of colorectal neoplasm was successfully constructed. During the establishment and improvement of this tissue biobank, standardized quality control was implemented during the whole-process including sample collection, warehousing, storage and delivery. According to the random sampling quality inspection, the RNA preservation effect was good, the rates of neoplasms in cancer tissue was >80%, and the clinical data of samples were complete.Conclusions:The preliminary construction of colorectal neoplasm tissue biobank not only improves the utilization value of tissue samples, but also provides a guarantee for realizing the bidirectional transformation of fundamental research and clinical application.

Young Patients with Hormone Receptor-Positive Breast Cancer Have a Higher Long-Term Risk of Breast Cancer Specific Death / 한국유방암학회지

PURPOSE: Although it is widely accepted that hormone receptor (HR) status is associated with later post-diagnostic periods, a debate exists as to whether the association is independent of age. The aim of our study was to confirm the impact of HR status on later period breast cancer-specific death (LP-BCSD) and later period non-breast cancer-specific death (LP-non-BCSD) in different age subgroups. METHODS: Surveillance, Epidemiology, and End Results databases were utilized to identify 181,108 breast cancer patients with > 5 years survival. The cumulative incidence of LP-BCSD and LP-non-BCSD was calculated using the Gray method. The subdistribution hazard ratio (SHR) of variables was estimated via the Fine and Gray proportional hazard regression model. Subgroup analyses for LP-BCSD and LP-non-BCSD were performed according to the HR status. RESULTS: The risk of LP-BCSD was exceeded by that of LP-non-BCSD at > 5 years since the diagnosis, particularly in old women. The competing risk regression model indicated that hormone receptor-positive (HR+) was an independent factor for more LP-BCSD (hazard ratio, 1.54; 95% confidence interval, 1.44–1.54; p < 0.001). However, stratified analysis indicated that HR+ was only associated with more LP-BCSD in the young women subgroup. Although HR+ was associated with more LP-non-BCSD, the predictive value of HR+ for LP-non-BCSD was eliminated after adjusting for age. CONCLUSIONS: HR+ was related to LP-BCSD in the premenopausal population. LP-BCSD should be an optimal endpoint in future trials designed to evaluate the role of extended adjuvant endocrine therapy.

Experimental study on the hospital-college cooperation for scientific research improvement / 中华医学科研管理杂志

Objective Based on the experience of the first round cooperation between Jinhua Municipal Central Hospital and School of Medicine,Zhejiang University,to evaluate the effects of this collaboration and provide reference for the next round cooperation.Methods A database of research performance from 2008-2017 was established to compare the scientific research situation of collaborating disciplines and non-collaborating disciplines before and after the cooperation between.Results The quality and quantity of scientific research projects,funds,papers were promoted after cooperation,and the improvement of collaborating disciplines was greater than non-collaborating disciplines.Conclusions The hospital college cooperation was helpful to promote the scientific research situation in a district hospital.It should be paid attention to the balance of disciplines development and improve the quality of scientific research in the next round cooperation.

Sub-health status among migrant workers in Dongguan City and its influencing factors study / 重庆医学

Objective To explore the influencing factors of sub-health status among the migrant workers in Dongguan City.Methods A total of 740 migrant workers in Dongguan city were extracted by the stratified random sampling method.The SubHealth Measurement Scale Version 1.0(SHMS V 1.0) was adopted to test the health status.The data were analyzed by Logistic regression analysis.Results The univariate analysis showed that the marital status,average daily working time,monthly family per capita income,living conditions,drinking,breakfast,nutritional status,vigils,living conditions satisfaction,sedentary desk operation and experiencing negative events had statistical significance(P＜0.05).In the Logistic regression analysis:average daily working time,vigils and experiencing negative events were the risk factors of sub-health status occurrence,their odds ratio(OR) and 95 ％ confidence interval(CI)were 1.971(1.211,3.205),2.183(1.378,3.459) and 2.135(1.353,3.369),respectively.Breakfast and nutritional status were the protective factors of sub-health status occurrence,their OR and 95 ％ CI were 0.706 (0.526,0.947) and 0.386(0.239,0.625),respectively.Conclusion The unhealthy living habits and experiencing negative events affect the health of migrant workers in Dongguan City.

Hypoxia-inducible factor-1α and CD133 predicts pathological complete response and survival for locally advanced rectal cancer patients after neoadjuvant chemoradiotherapy / 浙江大学学报·医学版

To investigate the expression of hypoxia-inducible factor 1α (HIF-1α) and CD133 in predicting pathologic remission and survival of patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy.One hundred and fourteen patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy from January 2010 to December 2015 in Jinhua Municipal Central Hospital were enrolled in the study. RT-PCR and immunohistochemistry methods were used to detect the mRNA and protein expression of HIF-1α and CD133 before and after chemoradiotherapy. Spearman rank correlation was used to analyze the correlation between HIF-1α and CD133 mRNA expression. Univariate and logistic multivariate analyses were used to determine the factors related to pathological complete response (pCR). Logistic regression analysis and Cox's proportional hazard model were used to determine factors related to overall survival and recurrence-free survival.The expression of HIF-1α and CD133 mRNA was correlated with pT, ypTNM, pCR, recurrence and metastasis of rectal cancer, while not correlated with sex, age and BMI of patients. HIF-1α mRNA expression was positively correlated with CD133 mRNA expression (=0.579,=0.000). Immunohistochemistry analysis showed that residual cancer cells strongly expressing HIF-1α also expressed CD133 strongly. Univariate analysis showed that HIF-1α mRNA and CD133 mRNA were significantly correlated with pCR (=0.001,=0.022, respectively). Multivariate analysis showed that HIF-1α and CD133 mRNA expression were independent prognostic factors of pCR (=0.012,=0.047, respectively). Cox regression analysis showed that the expression of HIF-1α mRNA and CD133 mRNA were independent predictors of recurrence-free survival and overall survival (=0.025,=0.033, respectively).The study indicates that HIF-1α and CD133 can predict pathological complete remission and survival of patients with locally advanced rectal cancer.

Investigation on the sub-health status of migrant workers in Dongguan City / 重庆医学

Objective To investigate the prevalence and influencing factors of sub-health status of the migrant workers in Dongguan City,in order to provide scientific preferences for preventing sub-health status.Methods Using the stratified random sampling method,740 migrant workers from ten towns(disetricts) in Dongguan city from August 2015 to August 2016 were recruited in this study.The sub-health measurement scale version 1.0 (SHMS V1.0) was applied to evaluate the sub-health status of migrant workers.The SHMS V1.0 scores were compared among migrant workers with different demographic characteristics,and the multivariate linear regression analysis was utilized to explore the influencing factors.Results A total of 718 valid questionnaires were collected,and the effective recovery rate was 97.03％.The sub-health status was detected in 483 migrant workers,and the prevalence rate of sub-health status was 81.6％.The migrant workers' subscale scores of physical sub-health (PS),mental subhealth (MS),social sub-health (SS) and total scale (TS) were (70.25-4-12.25),(64.21± 13.83),(62.21-4-13.87) and (66.114-11.15),respectively.The PS scale scores among migrant workers with different monthly household incomes per capita,and different inhabit situations;the MS scale scores among migrant workers with different ages,educations,marital status,monthly household incomes per capita,and inhabit situations;the SS scale scores among migrant workers with different genders,educations,and inhabit situations;and TS scores mong migrant workers with different educations,monthly household incomes per capita,and inhabit situations were statistically significant different (P＜0.05).The multivariate linear regression analysis showed that educations and inhabit situations were the influencing factors for TS score (P＜0.05).Conclusion The sub-health status of migrant workers in Dongguan City is serious,and the influencing factors are educations and inhabit situations.

Effect of silencing of poly(ADP-ribose) polymerase-1 on cell apoptosis induced by hydroquinone in rat bone marrow mesenchymal stem cells / 中国职业医学

OBJECTIVE: To explore the effect of silencing of poly( ADP-ribose) polymerase-1( PARP-1) on cell apoptosis induced by hydroquinone( HQ) in rat bone marrow-derived mesenchymal stem cells( BMMSCs). METHODS: i) The RNA expression vectors for PARP-1 gene were transfected into BMMSCs. Neomycin was used to select the transfected cells that stably expressed PARP-1-shRNA. Western blotting was used to examine the gene silencing efficiency. ii) BMMSCs with PARP-1 silencing were sorted as the treated group,while BMMSCs with empty vector were considered as the control group.HQ dissolved in phosphate buffer solution at the concentrations of 0. 0,2. 5,5. 0,10. 0,20. 0,40. 0,80. 0,160. 0 and320. 0 μmol / L were given to both groups for 24 hours. The cell viability was detected by methyl thiazolyl tetrazolium assay,and the concentration of HQ was chosen for the following study based on cell viability. iii) Both groups were treated by HQ at concentrations of 0. 0-20. 0 μmol / L for 24 hours,then the apoptosis of BMMSCs was detected by flow cytometry. The PARP-1 mRNA expression was determined by real-time fluorescent quantitative polymerase chain reaction assay. RESULTS: i) PARP-1 silencing cells and empty vector control cells were successfully screened with a mass concentration of 400 mg / L neomycin,and confirmed by level of protein expression. The interference efficiency of PARP-1 gene and inhibition efficiency was 85. 00%. ii) Based on the result of cell viability,HQ at concentrations of 0. 0-20. 0 μmol / L was chosen for the following study. iii) Compared with the group treated by HQ at concentration of 0. 0 μmol / L,the rate of early apoptosis of control group increased significantly with HQ at concentration of 10. 0 μmol / L while that of treated group was increased significantly at concentration of 5. 0 μmol / L( P < 0. 05). In addition,at concentrations of 0. 0-10. 0 μmol / L,the rates of early apoptosis in both groups increased in a dose-dependent manner( P < 0. 01). Compared with the group treated by HQ at concentrations of 0. 0 μmol / L,the expression of PARP-1 mRNA of both groups increased significantly at the concentration of 5. 0 μmol / L( P < 0. 05). The expression of PARP-1 mRNA of treated group was less than that of control group with HQ at every concentration( P < 0. 05). At concentrations of 0. 0-20. 0 μmol / L,the expression of PARP-1 mRNA of both groups increased in a dose-dependent manner( P < 0. 01). CONCLUSION: Silencing PARP-1 in BMMSCs caused cell apoptosis. PARP-1 may participate in cell apoptosis induced by HQ.

Investigation on the sub-health status of migrant workers in Dongguan City / 重庆医学

Objective To investigate the prevalence and influencing factors of sub-health status of the migrant workers in Dongguan City,in order to provide scientific preferences for preventing sub-health status.Methods Using the stratified random sampling method,740 migrant workers from ten towns(disetricts) in Dongguan city from August 2015 to August 2016 were recruited in this study.The sub-health measurement scale version 1.0 (SHMS V1.0) was applied to evaluate the sub-health status of migrant workers.The SHMS V1.0 scores were compared among migrant workers with different demographic characteristics,and the multivariate linear regression analysis was utilized to explore the influencing factors.Results A total of 718 valid questionnaires were collected,and the effective recovery rate was 97.03％.The sub-health status was detected in 483 migrant workers,and the prevalence rate of sub-health status was 81.6％.The migrant workers' subscale scores of physical sub-health (PS),mental subhealth (MS),social sub-health (SS) and total scale (TS) were (70.25-4-12.25),(64.21± 13.83),(62.21-4-13.87) and (66.114-11.15),respectively.The PS scale scores among migrant workers with different monthly household incomes per capita,and different inhabit situations;the MS scale scores among migrant workers with different ages,educations,marital status,monthly household incomes per capita,and inhabit situations;the SS scale scores among migrant workers with different genders,educations,and inhabit situations;and TS scores mong migrant workers with different educations,monthly household incomes per capita,and inhabit situations were statistically significant different (P＜0.05).The multivariate linear regression analysis showed that educations and inhabit situations were the influencing factors for TS score (P＜0.05).Conclusion The sub-health status of migrant workers in Dongguan City is serious,and the influencing factors are educations and inhabit situations.

A randomized controlled trial comparing the efficacy and toxicities between neoadjuvant concomitant boost intensity-modulated radiotherapy (IMRT) and 3-dimensional conformal radiotherapy (3-DCRT) for locally advanced rectal cancer / 中华放射医学与防护杂志

Objective To compare the efficacy and toxicities between preoperative concomitant boost intensity-modulated radiotherapy (IMRT) and 3-dimensional conformal RT (3-DCRT) for locally advanced rectal cancer.Methods A prospective study from May 2010 to May 2015.A total of 130 patients with histologically confirmed,newly diagnosed,locally advanced rectal adenocarcinoma (cT3-T4 and/or cN +) located within 10 cm from the anal verge were included in this study.The patients were divided into IMRT and 3D-CRT groups by random number table method.Sixty-six patients were treated with IMRT,and the other sixty-four patients were treated with 3-DCRT.In the IMRT group,the prescription dose was 1.8 Gy/fraction to 45 Gy to the pelvis and 2.2 Gy/fraction to 55 Gy to the gross tumor volume simultaneously.The 3D-CRT prescription was 45 Gy in 25 fractions to the pelvis.Capecitabine (1 650 mg· m 2 · d-1) was given twice daily from days 1 to 14 and days 22 to 35 during RT in both arms.Total mesorectal excision (TME) was scheduled 6-8 weeks after the completion of chemoradiation.Results There were no significant differences in age,gender,tumor location,pathological differentiation degree and clinical stage between the two groups.Two patients withdrew from the study:one for grade 3 radiation dermatitis in IMRT group and the other for grade 3 fatigue in 3D-CRT.There was no significant difference in hematologic or nonhematologic toxicities between the two groups.No grade 4 or 5 toxicity was observed in either group.Compared with conformal radiotherapy,IMRT did not increase the difficulty of surgery.No significant difference was found in type of surgery or postoperative complications between the two groups.The rate of tumor regression grade (TRG) 4 (pathologic complete response,pCR) was 22.7％ for IMRT and 15.6％ for 3D-CRT,respectively(P ＞ 0.05).The rate of both TRG4 and 3 was 42.4％ for IMRT and 25.0％ for 3D-CRT,respectively (x2 =4.406,P=0.036).Conclusions Neoadjuvant concomitant boost IMRT is feasible and has a higher histopathological regression for patients with locally advanced rectal cancer.Trial registration Chinese clinical trial registry,ChiCTR-IN R-16008004.

Inhibitory effect of miR-204 on corneal epithelial cell proliferation in vitro / 中华实验眼科杂志

Background As the main cellular constituent of corneal epithelium,corneal epithelial cells play critical roles in regulating and controlling the migration, proliferation and differentiation of cells during the repair of damage.MicroRNA (miRNA) is endogenously expressed small non-coding RNAs, which participates in a variety of biological processes.Previous studies demonstrated that miR-204 is highly expressed in normal corneal epithelium,but its function is still unclear.Objective This study was to investigate the function and mechanism of miR-204 in corneal epithelial cell proliferation.Methods Corneal epithelial tissue was collected during the corneal refractive surgery from the patients with refractive error under the informed consent, and human corneal epithelial cells(HCECs) were cultured and passaged.The relative expressing levels of miR-204 mRNA in the normal corneal epithelium and HCECs were detected by real time quantitative PCR.Cultured HCECs were evenly divided into three groups.The liposome with miR-204 mimic was transfected into the cells of the miR-204 mimic group, and blank liposome was transfected in the cells of the positive control group,and regularly cultured cells served as the normal control group.Cell proliferation capability was evaluated by colony-forming assay, and the percentage of the cells in different cell cycles was analyzed by flow cytometry.Western blot assay was employed to detect the expression levels of p-RB, E2F1 ,p27,CyclinA, CDC2, p-CDC2 and CDK2 proteins in the cells.Results The relative expression levels of miR-204 mRNA were 1.077 ±0.268 in the normal corneal epithelium and 0.041 ±0.018 in the HCECs, showing a significant difference between them (t =7.700,P＜0.001).The cloning cell number was evidently decreased in the miR-204 mimic group in comparison with the positive control group and normal control group.The percentage of cells in the G1 phase was 47.75％ in the miR-204 mimic group, which was significantly higher than 37.23％ in the positive control group and 40.72％ in the normal control group.The expression levels of E2F1 and p27 proteins in the cells were elevated (t=14.87,25.11;both at P＜0.01) and those of CDK2 and p-CDC2 proteins were decreased (t=5.39,10.65;both at P＜0.01) in the miR-204 mimic group in comparison with the positive control group.Conclusions The overexpression of miR-204 in the normal corneas probably is associated with non-proliferation status of corneal epithelial cells.Transfection of miR-204 into corneal epithelial cells can inhibit the proliferation of corneal epithelial cells probably by up-regulating the expression of E2F1 and p27 and suppressing the expression of CDK2/CyclinA and p-CDC2/CyclinA,which lead to cell arrest in G1 phase.

To confirm the structure validity of the job satisfaction questionnaire of the rear service personnel / 重庆医学

Objective To confirm the structure validity of questionnaire through a probe into latent factorial structure of the rear service personnel′s job satisfaction from polyclinics hospitals .Methods The questionnaire′s construct validity was estimated by ex‐ploratory factor analysis (EFA) and confirmatory factor analysis(CFA) .Results Exploratory factor analysis made the question‐naire including six factors which belonged to job satisfaction and occupation loyalty .Every factor had reasonable explanation and six factors remained 70 .306% information .Exploratory factor analysis of job satisfaction showed five factors ,explaining 70 .514% in‐formation .The confirmatory factor analysis model 1 and model 2 were conducted by LISREL8 .70 software .The results showed that X2 freedom degree was less than 5 .In addition to adjust the goodness of fit index was less than 0 .9 ,all other fit indices were greater than 0 .9 .At the same time ,SRMR and RMSEA were less than 0 .08 .Conclusion The results of exploratory factor analysis(EFA) and confirmatory factor analysis(CFA) both reveal that the questionnaire′s construct validity was good .

Effects of protective transverse colostomy on the incidence of postoperative anastomotic leakage and stricture after laparoscopic resection for rectal cancer / 中华消化外科杂志

Objective To investigate the value of protective transverse colostomy in decreasing postoperative anastomotic leakage and stricture after laparoscopic resection for rectal cancer.Methods The clinical data of 128 patients with rectal cancer who were admitted to the Jinhua Hospital of Zhejiang University from March 2008 to February 2012 were retrospectively analyzed.All the patients received laparoscopic anterior resection of rectal cancer after neoadjuvant chemoradiotherapy.Sixty-one patients received protective transverse colostomy (colostomy group) and 67 patients did not receive protective transverse colostomy (non-colostomy group).The incidences of postoperative anastomotic leakage and stricture,condition of the patients and the prognosis of the patients in the 2 groups were compared.Patients were followed up via out-patient examination,in-patient chemotherapy or phone call till May 2013.All data were analyzed using the t test,chi-square test or Fisher exact probability.Results The overall incidence of postoperative anastomotic leakage was 7.03％ (9/128).The incidences of postoperative anastomotic leakage in the colostomy group and non-colostomy group were 6.56％ (4/61) and 7.46％ (5/67),with no significant difference between the 2 groups (x2 =0.000,P ＞ 0.05).The systemic condition of 4 patients who were complicated with anastomotic leakage in the colostomy group was comparatively better,and all of them were cured by conservative treatment.The condition of 5 patients who were complicated with anastomotic leakage in the non-colostomy group was severe,and 4 of them received reoperation,with the reoperation rate of 4/5 ; the other patient received conservative treatment.There was significant difference in the reoperation rate between the 2 groups (P ＜0.05).The overall incidence of postoperative anastomotic stricture was 13.28％ (17/128).The incidences of postoperative anastomotic stricture in the colostomy group and the non-colostomy group were 19.67％ (12/61) and 7.46％ (5/67),with significant difference between the 2 groups (x2=4.133,P ＜ 0.05).The incidences of severe anastomotic stricture of the colostomy group and the non-colostomy group were 8.20 (5/61) and 0,respectively.Conclusion Protective transverse colostomy could not reduce the incidence of postoperative anastomotic leakage,but could mitigate the symptoms followed anastomotic leakage and reduce the reoperation rate.Protective transverse colostomy may improve the incidence of anastomotic stricture,therefore it should be applied cautiously.