Research progress on long-term outcomes of endoscopic surgery for esophageal diseases / 中国胸心血管外科临床杂志

@#Esophageal diseases include esophageal malignant diseases and benign diseases, with a high incidence in our country. Along with the development of the endoscopic technique, many of them which required medical treatment or surgery in the past can now be cured by endoscopic surgery. This article is an overview of long-term follow-up of endoscopic surgery for the common esophageal disease, such as early squamous cell carcinoma, esophageal stricture, achalasia and submucosal tumor of the esophagus.

Early esophageal cancer: Endoscopic resection or surgical resection? / 中国胸心血管外科临床杂志

@#Endoscopic resection and surgical resection are the two major therapeutic methods for early esophageal cancer. Endoscopic resection is safe and minimally invasive, but lymph node dissection can not be performed. Although surgery provides a rather thorough resection of the lesions and affected lymph nodes, surgical trauma brings certain negative impact on patients' long-term life quality. A comprehensive assessment of the patient's general condition, the risk of diseased lymph node metastasis, and the risk of the treatment itself is an important measure to optimize treatment decisions and formulate personalized treatment plans.

Development and clinical evaluation of an equipment with artificial intelligence real-time assistance in detection of gastrointestinal protruding lesions under endoscopy / 中华消化杂志

Objective:To develop an diagnostic equipment with artificial intelligence (AI) real-time assistance under endoscopy (endoscopic AI equipment) for the detection of gastrointestinal protruding lesions, and to evaluate its performance and safety.Methods:From January to December 2017, at Endoscopy Center of West China Hospital, Sichuan University, the endoscopic images of individuals who underwent routine gastroscopy and colonoscopy were collected. The model was established based on convolutional neural network and the endoscopic AI equipment was developed. From June to December 2019, a prospective, single center, blinded and parallel controlled study was conducted to compare the differences in evaluation of protruding lesions of the same patient under gastroscopy or colonoscopy between endoscopist and the endoscopic AI equipment and to evaluated the impact of lesion size (lesions <5 mm and ≥5 mm) on the detection of endoscopic AI equipment. The main outcome measure was the detection time difference in reporting the protruding lesion between endoscopic AI equipment and endoscopist; and the secondary indicator was the accuracy of endoscopic AI equipment in detecting the protruding lesion. Wilcoxon rank sum test and chi-square test were used for statistical analysis.Results:A total of 71 582 white light endoscopy images were used for endoscopic AI equipment training, which included 41 376 images of protruding lesions. The endoscopic AI equipment was successfully developed and obtained the registration certificate of medical devices of the People′s Republic of China (Sichuan Instrument Standard, 20202060049). The accuracy, sensitivity, and specificity of endoscopic AI equipment in detecting protruding lesions were 96.4%, 95.1% and 92.8%, respectively. The detection time of each protruding lesions under gastroscopy of endoscopic AI equipment was 1.524 seconds faster than that of endoscopist; but the detection time of each protruding lesions under colonoscopy was 0.070 seconds slower than that of endoscopist, and the differences were statistically significant ( Z=-5.505 and -4.394, both P<0.01). The detection time of each protruding lesions under gastroscopy or colonoscopy of endoscopic AI equipment was not inferior to that of endoscopist. The detection rate of protruding lesions under colonoscopy by endoscopic AI equipment was 89.9% (249/277) and the sensitivity was 89.9%; the detection rate of protruding lesions under colonoscopy was 87.0% (450/517) and the sensitivity was 86.9%. There were no statistically significant differences in the detection time difference, sensitivity and missed diagnostic rate between the lesions <5 mm and ≥5 mm detected by endoscopic AI equipment under gastroscopy (all P>0.05). The sensitivity of endoscopic AI equipment in detecting the lesions ≥5 mm under colonoscopy was higher than that of lesions <5 mm (96.8% vs. 84.9%), and the missed diagnostic rate was lower than that of lesions <5 mm (3.2%, 3/94 vs. 15.1%, 61/405), and the differences were statistically significant ( χ2=9.615 and 9.612, both P=0.002). No adverse events on patients and medical staffs occurred, and there were no cases of equipment electricity leakage, and abnormal work reported during the use of endoscopic AI equipment. Conclusions:The endoscopic AI equipment can report the protruding lesions simultaneously with endoscopists, and the accuracy is close to 90%, which is expected to be a practical assistant for endoscopists to avoid missed detection of protruding lesions.

Effects of transjugular intrahepatic portosystemic shunt combined with left gastric vein embolization on the liver function of patients with liver cirrhosis / 中华消化杂志

Objective To compare the difference in the effects on liver function between transjugular intrahepatic portosystemic shunt (TIPS) alone and the combination of TIPS and left gastric vein embolization (LGVE) in patients with liver cirrhosis.Methods This research was a retrospective study.From September 2014 to September 2015,31 patients with liver cirrhosis underwent TIPS (TIPS group) and 29 patients with liver cirrhosis underwent TIPS combined with LGVE (TIPS+LGVE group) were enrolled.The data of the liver function of patients before and after operation were collected and the Child-Pugh score and model for end-stage liver disease (MELD) were also calculated.Student's t test and chi-squared test were performed for statistical analysis.Results The preoperative portal vein pressures of TIPS group and TIPS+LGVE group were (28.48±2.77) mmHg (1 mmHg=0.133 kPa) and (28.38± 2.92) mmHg,respectively.And after operation,the portal vein pressures decreased to (17.81 ± 1.47) mmHg and (17.97 ± 2.04) mmHg,respectively,and the differences were both statistically significant (t=18.908 and 11.648,both P＜0.01).At 12 months after operation,Child-Pugh score of TIPS+ LGVE group was 5.69 ± 1.19,which was significantly lower than that before operation (7.03±1.76),and the difference was statistically significant (t=3.398,P=0.001),which was also lower than that of TIPS group at the same time point (6.52 ± 1.54),and the difference was statistically significant (t =2.303,P=0.025).At 12 months after operation,the component ratio of patients with Child-Pugh grade A of TIPS±LGVE group was 89.7％ (26/29),which was higher than that before operation (44.8％,13/29),and the difference was statistically significant (x2=13.228,P＜0.01).The component ratio of patients with Child-Pugh grade B was 6.9 ％ (2/29),which was lower than that before operation (41.4 ％,12/29),and the difference was statistically significant (x2 =9.416,P＜ 0.01).Conclusions TIPS significantly reduces portal vein pressure in patients with liver cirrhosis and it does not deteriorate liver function of patients in the long term.The combination of TIPS and LGVE is better than TIPS alone in improving liver function in patients with liver cirrhosis,especially in improvig long-term liver function in patients of Child-Pugh A and B grade.

Application Progress of DNA Nanostructures in DrugDelivery and Smart Drug Carriers / 分析化学

Nanocarrier systems have been widely used for improving solubility, stability and therapeutic activity of drugs due to their high drug-loading efficiency, good target specificity and long circulation time.To achieve precisely controlled loading and tumor-selective release of drugs, extensive research efforts have been focused on developing nanocarriers with low toxicity, excellent biocomapatibility and biodegradability.As a type of nano-biomaterials with various functions and applications, self-assembled DNA nanostructures explored new ways to develop drug carriers in smart drug delivery based on their well-defined structures, good biocompatibility and stability, high cell membrane permeability and controlled drug releasing property.In this review, we summarized the developing course and the recent advances of DNA nanostructures for drug delivery, including the application of both static and dynamic DNA nanostructures.The application of dynamic DNA nanostructures for controlled drug release showed great potential in smart drug delivery.

Clinical observation of different minimally invasive surgeries for the treatment of impacted upper ureteral calculi

To compare the clinical effects of three minimally invasive surgeries on the treatment of impacted upper ureteral calculi. 135 patients with impacted upper ureteral calculi were selected and randomly divided into three groups [Group A-C] [n=45], which were treated with transurethral ureteroscopic lithotripsy, minimally invasive percutaneous nephrolithotomy, and retroperitoneal laparoscopic ureterolithotomy respectively. Relevant results of the three groups were compared. The surgery time of Group C was significantly longer than those of Group A and Group B [P < 0.05]. The postoperative hospitalization time of Group B was significantly longer than those of Group A and Group C [P < 0.05]. 37.78% [17/45] of Group A patients required extracorporeal shock wave lithotripsy, being significantly more than those in Group B [6.67%, 3/45] and Group C [0, 0/45] [P < 0.05]. The postoperative calculus clearance rate of Group A [51.11%, 82.22%] was significantly lower than those of Group B [91.11%, 97.78%] and Group C [93.33%, 100%]]P < 0.05]. The incidence rates of postoperative complications in Group A-C were 11.11% [5/45], 8.89% [4/45] and 6.67% [3/45] respectively without significant differences [P>0.05]. The three surgical methods for impacted upper ureteral calculi should be selected according to practical conditions to improve therapeutic effects and to ensure safe surgery

The incidence and clinical characteristics of gastroenteropancreatic neuroendocrine neoplasm in Chengdu City in 2010 / 中华消化杂志

Objective To investigate the incidence of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) in Chengdu City in 2010 and summarize clinical characteristics of GEP-NEN.Methods The incidence of GEP-NEN was estimated with the data in 2010 from the databases of West China Hospital and Chengdu Health Information Centre.Results A total of 77 cases of GEP-NEN were diagnosed in West China Hospital in 2010.Ten cases from other hospitals or non-Chengdu citizenship were excluded,so a total of 67 cases were included in this study.In 2010,the incidence of GEP-NEN was 1.86/105 in Chengdu City.Among 67 GEP-NEN cases,most lesions were located in pancreas and rectum (38 cases,56.7％),followed by stomach (10 cases),esophagus (seven cases) and duodenum (four cases).Among 57 GEP-NEN cases which had pathotogial grading,26 cases (45.6 ％) had neuroendocrine carcinomas or mixed adenoneuroendocrine carcinomas when diagnosed.Conclusions In 2010,the incidence of GEP-NEN in Chengdu City is similar to the reports from other countries.Pancreas,rectum and upper gastrointestinal tract are predilection sites of GEP-NEN.The diagnosis rate of early GEP NEN needs to be raised.

Research on the relationship between pathological features of the uveal melanoma and prognosis / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the pathological features of uveal melanoma and to evaluate their influence on patients' prognosis.</p><p><b>METHODS</b>Paraffin embedded uveal melanoma tissues of 115 cases were examined using routine pathologic methods. Three histological types were classified according to the modified Callender system and patients were followed clinically. The data were done regression and survival analysis by SPSS statistic soft.</p><p><b>RESULTS</b>The patient with epithelial cell type, mixed type, and spindle cell type uveal melanoma have different life times, the average life time is 35.6 +/- 21.5 months, 63.7 +/- 37.0 months, 69.5 +/- 36.5 months in turn, patients with epithelial uveal melanoma had shorter survival time than other two types. The survival time was negatively related to the largest diameter of contact area with the sclera, the largest height and the depth of tumor invasion to the sclera.</p><p><b>CONCLUSIONS</b>Epithelial uveal melanoma is more malignant than the other two types. Histological classification of this tumor combined with other pathologic features can indicate the patient's prognosis.</p>

Relationship of the gene of multidrug and drug resistance and the patients′ prognosis in uveal melanoma / 中华眼底病杂志

Objective To probe the relationship between the patients′ prognosis and the gene of multidrugs and drug resistance in uveal melanoma. Methods The gene expression of cyclin D1, epithelial growth factor receptor (EGFR), non metastasis gene 23 (nm 23), P glucose protein (P gp), multidrug resistance relation protein (MRP) and lung resistance protein (LRP) expression in 96 cases of uveal melanoma were detected by depigment immunohistochemistry. The patients with complete anamnesis data were observed continuously, and the follow up results were classified. Results Among the 96 cases of uveal melanoma, the epithelioid cell type was in 21, the mixed cell type in 56, and the spindle cell type in 19; including 76 at intraocular stage and 20 at extraocular stage. As the level of metastasis suppress gene nm 23 expression decreased and the level of cyclin D1 and EGFR expression increased, the expression level of drug resistance genes increased. The levels of LRP and MRP had negative correlation to the expressions of nm 23 and postive correlation to the expressions of nm 23, Cyclin D1 and EGFR. In 58 patients′ who were observed continuously, 19 died in 5 years and 26 survived over 5 years. Conclusion There are significant association between patients′ prognosis and multidrug and drug resistance gene in uveal melanoma.

To induce uveal melanoma cells apoptosis by mixed structure bcl-2 antisense oligodeoxynucleotides multidrug resistance / 中华眼底病杂志

Objective To investigate the role of anti apoptosis gene bcl 2 in the survival of cultured uveal melanoma UM cells. Methods Antisense oligodeoxynucleotides (AS ODN) bcl 2 were delivered with cationic lipid to primary cultured UM cells. The inhibitory effect of AS ODN bcl 2 on proliferation of UM cells was examined by 3, 4,5 Dimethyliazol 2,5 diphenyl tetrazolium bromide (MTT) method. Using DNA ladder to determine if the UM cells had been apoptotic. Bcl 2 expression was detected by RT PCR and Westernblot technics. Results The effect of AS ODN bcl 2 in inhibiting the proliferation of cultured UM cells had opposite relation to dosage. It down regulated the mRNA and protein level of bcl 2 gene, and the sense ODN didn′t have this effect. Conclusion AS ODN bcl 2 can down regulate bcl 2 expression, inhibits UM cells proliferation and induces apoptosis.

The expression and significance of the cell cycle related genes in uveal melanoma / 中华眼底病杂志

Objective To evaluate the role of the cell cycle related genes cyclinD1 and Bcl-2 protein expression in the pathogenesis and infiltration of the uveal melanoma. Methods Using immunohistochemistry to detect the cyclinD1 and bcl-2 protein expression in 96 cases of uveal melanoma. Results The expression content of bcl-2 was high in uveal melanoma, and there wasnt any relationship between bcl-2 cell positivity and tumor cell type and extrascleral extension. In contrast, cyclinD1 expression was higher in epithelial cell uveal melanoma than mix cell and spindle cell varieties. There was a positive correlation between cyclinD1 cell positivity and extrascleral extension. Conclusion The expression of bcl-2 protein is important for the survival of the uveal melanoma. CyclinD1 may serve as a sensitive index of its malignancy.

Construction and sequence analysis of eukaryotic expression vector of Chinese prostate-specific membrane antigen / 中国病理生理杂志

AIM: To obtain eukaryotic expression vector of Chinese prostate-specific membrane antigen. METHODS: Chinese prostate-specific membrane antigen (PSMA) cDNA was amplified by RT-PCR from prostate cancer tissues, then cloned into eukaryotic expression vector pcDNA3 0 and sequenced. RESULTS: Seven bases in Chinese PSMA cDNA sequence were found different from those reported by Israeli, which lead to two different amino acids. CONCLUSION: We have obtained the PSMA cDNA, and the recombinant eukaryotic expression vector was successfully constructed. The study lays foundation for DCs vaccine modified by PSMA gene for the treatment of prostate neoplasms.