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Objective:To investigate the clinical effect of W-shaped genioplasty in the correction of broad and short chin deformity.Methods:Thirty-eight patients (5 males, 33 females, aged 20 to 41 years, mean 27.3 years) complained with broad and short chin were admitted to the Affiliated Friendship Plastic Surgery Hospitalof Nanjing Medical University from January 2019 to December 2021. CBCT scan and three-dimensional reconstruction were performed to design osteotomy line and determine the distance of chin lengthening, narrowing and advancing or retrocession preoperatively. Under general anesthesia, the W-shaped osteotomy was performed using an intraoral incision, and the angle between the bilateral free bone fragments, the distance of downward and forward movement were adjusted to change the curvature, width, length and prominence of the lower edge of the chin according to the preoperative designs. The results were evaluated by clinical appearances and image analyses at a follow-up of 3-24 months.Results:The amount of vertical lengthening of the chin in 38 cases were 2 mm to 5 mm, with an average of 3.02 mm. The horizontal narrowing width distances were 3-7 mm, with an average of 5.6 mm. The patients were followed up for 3-24 months, with an average of 10.6 months. There were no complications such as hematoma, wound dehiscence, accidental fracture, surgical area infection and permanent neurosensory disorder. 38 patients had transient sensory loss in the lower lip region of varying degrees, but all recovered spontaneously during routine follow-up period. All patients were satisfied with the improvement of facial contour.Conclusions:W-shaped geinoplasty preserves the central bone of the chin and the attachment of genioglossus muscle, which does not affect the normal anatomy and physiological function of the oral cavity. After osteotomy, the bone is removed and the bilateral bone fragments move flexibly. It can effectively change the radian, width, length and protrusion of the lower edge of the chin in three dimensions, so as to correct the wide and short deformity of the chin.
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Ferroptosis (FPT), a novel form of programmed cell death, is characterized by overwhelming iron/reactive oxygen species (ROS)-dependent accumulation of lipid peroxidation (LPO). However, the insufficiency of endogenous iron and ROS level limited the FPT therapeutic efficacy to a large extent. To overcome this obstacle, the bromodomain-containing protein 4 (BRD4)-inhibitor (+)-JQ1 (JQ1) and iron-supplement ferric ammonium citrate (FAC)-loaded gold nanorods (GNRs) are encapsulated into the zeolitic imidazolate framework-8 (ZIF-8) to form matchbox-like GNRs@JF/ZIF-8 for the amplified FPT therapy. The existence of matchbox (ZIF-8) is stable in physiologically neutral conditions but degradable in acidic environment, which could prevent the loaded agents from prematurely reacting. Moreover, GNRs as the drug-carriers induce the photothermal therapy (PTT) effect under the irradiation of near-infrared II (NIR-II) light owing to the absorption by localized surface plasmon resonance (LSPR), while the hyperthermia also boosts the JQ1 and FAC releasing in the tumor microenvironment (TME). On one hand, the FAC-induced Fenton/Fenton-like reactions in TME can simultaneously generate iron (Fe3+/Fe2+) and ROS to initiate the FPT treatment by LPO elevation. On the other hand, JQ1 as a small molecule inhibitor of BRD4 protein can amplify FPT through downregulating the expression of glutathione peroxidase 4 (GPX4), thus inhibiting the ROS elimination and leading to the LPO accumulation. Both in vitro and in vivo studies reveal that this pH-sensitive nano-matchbox achieves obvious suppression of tumor growth with good biosafety and biocompatibility. As a result, our study points out a PTT combined iron-based/BRD4-downregulated strategy for amplified ferrotherapy which also opens the door of future exploitation of ferrotherapy systems.
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With a large number of patients, nonalcoholic fatty liver disease (NAFLD) has become one of the major chronic liver diseases that jeopardize the health of people worldwide. This article introduces the major factors in glucagon-like peptide-1 (GLP-1) system that are associated with the production, decomposition, and receptor effect of GLP-1, summarizes the regulatory mechanism of GLP-1 system on NAFLD, and proposes the main problems of GLP-1 system in the treatment of NAFLD, so as to provide a reference for the research and clinical treatment of NAFLD.
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@#Objective To analyze and compare the perioperative efficacy difference between full-port Da Vinci robotic surgery and thoracoscopic surgery in patients with mediastinal tumor resection. Methods The data of 232 patients with mediastinal tumors treated by the same operator in the Department of Thoracic Surgery of the Second Affiliated Hospital of Harbin Medical University were included. There were 103 (44.4%) males and 129 (55.6%) females, with an average age of 49.7 years. According to the surgical methods, they were divided into a robot-assisted thoracic surgery (RATS) group (n=113) and a video-assisted thoracoscopic surgery (VATS) group (n=119). After 1 : 1 propensity score matching, 57 patients in the RATS group and 57 patients in the VATS group were obtained. Results The RATS group was better than the VATS group in the visual analogue scale pain score on the first day after the surgery [3.0 (2.0, 4.0) points vs. 4.0 (3.0, 5.0) points], postoperative hospital stay time [4.0 (3.0, 5.5) d vs. 6.0 (5.0, 7.0) d] and postoperative catheterization time [2.0 (2.0, 3.0) d vs. 3.0 (3.0, 4.0) d] (all P<0.05). There was no statistical difference between the two groups in terms of intraoperative blood loss, postoperative complications, postoperative thoracic closed drainage catheter placement rate or postoperative total drainage volume (all P>0.05). The total hospitalization costs [51 271.0 (44 166.0, 57 152.0) yuan vs. 35 814.0 (33 418.0, 39 312.0) yuan], operation costs [37 659.0 (32 217.0, 41 511.0) yuan vs. 19 640.0 (17 008.0, 21 421.0) yuan], anesthesia costs [3 307.0 (2 530.0, 3 823.0) yuan vs. 2 059.0 (1 577.0, 2 887.0) yuan] and drug and examination costs [9 241.0 (7 987.0, 12 332.0) yuan vs. 14 143.0 (11 620.0, 16 750.0) yuan] in the RATS group was higher than those in the VATS group (all P<0.05). Conclusion Robotic surgery and thoracoscopic surgery can be done safely and effectively. Compared with thoracoscopic surgery, robotic surgery has less postoperative pain, shorter tube-carrying time, and less postoperative hospital stay, which can significantly speed up the postoperative recovery of patients. However, the cost of robotic surgery is higher than that of thoracoscopic surgery, which increases the economic burden of patients and is also one of the main reasons for preventing the popularization of robotic surgery.
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Objective:To investigate the effect of electroporation-mediated local gene therapy on the expression of Wnt3a and β-catenin in callus of distraction gap during mandibular distraction osteogenesis of rabbits.Methods:The experiments were conducted in the laboratory of the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from September 2019 to December 2019. Forty eight New-Zealand rabbits were randomly divided into control group (group A), gene therapy group (group B) and normal saline group (group C), with 16 rabbits in each group. After bilateral mandible osteotomy and distractors were implanted, the distractors were activated at a speed of 0.8 mm/d on 4th day, postoperatively, and lasted for 7 days, followed by consolidation period. Group A distracted only, group B was subject to local injection of recombinant plasmid pIRES-hBMP2-hVEGF165 in the distraction gap and electroporation stimulation at the beginning of activation distractors; and group C local injection of the same dose of normal saline in the distraction gap and electroporation stimulation at the beginning of activation distractors. Four animals in each group were sacrificed on the day at the end of distraction, 7th, 14th, 28th days of consolidation period, respectively. The callus in the distraction gap was taken for immunohistochemical staining and RT-PCR to detect the expression of Wnt3a and β-catenin, and image analysis was performed. SPSS 22.0 statistical software was used for data analysis.Results:Immunohistochemical staining showed that Wnt3a and β-catenin were mainly located in the cytoplasm and nuclei of fibroblasts, chondrocytes and osteoblasts in callus tissue. Immunohistochemistry and RT-PCR showed that the expression of Wnt3a and β-catenin reached a peak at the end of distraction. With the disappearance of distraction tension, the expression of Wnt3a and β-catenin gradually decreased. After gene therapy intervention, the expression of Wnt3a and β-catenin was significantly increased, and the expression of Wnt3a and β-catenin in group B was the highest at each time point, with statistically significant difference compared with groups A and C ( F=96.3, P<0.01). Conclusions:Gene therapy promotes the expression of Wnt3a and β-catenin in the callus of distraction gap, regulating the balance of the bone reconstruction system and thus promoting the formation of new bone in the distraction gap.
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Objective:To evaluate the clinical effects of the dissection of the implant pockets with ultrasonic scalpel or traditional electroscalpel through the axillary approach under endoscopic assistant.Methods:A total of 125 female patients with an average of 32.5 years, ranged from 21 to 44 years, underwent endoscopic-assisted transaxillary breast augmentation in the Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, from January 2019 to December 2020, were analyzed retrospectively. The implant pockets were dissected with ultrasonic scalpel (ultrasonic scalpel group) in 64 patients or with traditional electroscalpel (electroscalpel group) in 61 patients. The operation time, operation speed, postoperative drainage, drainage tube removal time and hospital stay of the two groups were compared and analyzed statistically.Results:Compared with the electroscalpel group, the average operation time of the ultrasonic scalpel group 75(71-90) min was significantly shorter than that of the electroscalpel group 105(80-135) min ( t=4.10, P<0.001), the operation speed (3.27±0.44 ml/min) was faster than that of the electroscalpel group (2.52±0.72 ml/min) ( t=4.71, P<0.001), the postoperative drainage 130.5(98.8-193.3) ml was significantly less than that of the electroscalpel group 281.75(145.5-328.3) ml ( t=2.21, P<0.05), and the drainage tube removal time 3 (3-4) d and hospital stay 3 (3-4) d were remarkablely shorter than that of the electroscalpel group 4 (3-4) d, 5 (4-6) d ( t=3.58; t=4.06, P<0.05). Conclusions:The application of ultrasonic scalpel in endoscopic-assisted transaxillary breast augmentation is safe and reliable. In addtion to improving the surgical efficiency, ultrasonic scalpel can reduce blood loss, shorten the time of hospital stay and reduce complications, which is worthy of further promotion in clinical application.
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Objective:To investigate the effect of eyebrow arch augmentation with personalized polyether ether ketone (PEEK) implant assisted by endoscope.Methods:From January 2019 to August 2021, 9 patients with low and flat eyebrow arch requiring eyebrow arch augmentation were treated in the plastic surgery department of the Friendship Plastic Surgery Hospital Affiliated to Nanjing Medical University. The cranial and maxillofacial CT scanning data were obtained before operation, the eyebrow arch elevation range and height were designed according to the patient's requirements, and personalized peek implants were manufactured. During the operation, a small temporal hairline incision was used to accurately separate the implantation cavity of individualized peek implants under the periosteum of the eyebrow arch implantation area with the aid of endoscope. Personalized PEEK implants were implanted under endoscope to make them fully fit with the eyebrow arch bone and fixed with titanium nails. Photos were taken and analyzed before and after operation.Results:All patients were followed up for 3 months to 2 years. Their facial expressions were normal, and there were no motor nerve injury, rejection and iatrogenic infection. The patients were satisfied with the postoperative effect. Compared with before operation, the low level of orbital bone in eyebrow area was improved, and the facial contour was three-dimensional and harmonious.Conclusions:The eyebrow arch augmentation with individualized peek implant assisted by endoscope is safe and effective. It can greatly reshape the upper contour of the face, deepen the upper eyelid fossa and improve the convex eye phenomenon, so as to achieve the cosmetic effect of enhancing the three-dimensional sense of the eyebrow orbital area, which is worthy of clinical application.
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Objective: To compare and analyze the perioperative clinical effects of minimally invasive Ivor-Lewis esophagectomy (MIE-Ivor-Lewis) and minimally invasive McKeown esophagectomy (MIE-McKeown). Methods: A total of 147 patients who underwent endoscopic esophageal cancer surgery from April 2018 to August 2019 were selected, including 85 patients undergoing MIE-McKeown surgery and 62 patients undergoing MIE-Ivor-Lewis surgery. The measurement data were expressed as (x±s), the comparison of normally distributed measurement data was performed by independent sample t-test, and the comparison of count data was performed by χ(2) test or Fisher's exact test. Results: The operation time of McKeown (M) group and Ivor-Lewis (IL) group were (219.2±72.4) minutes and (225.8±65.3) minutes. The mediastinal lymph node dissection number of M and IL groups were 13.3±4.8 and 11.6±6.5, respectively. The number of left recurrent laryngeal nerve lymph node dissection were 3.5±1.2 and 3.1±1.4, respectively. The intraoperative blood loss were (178.3±41.3) ml and (163.2±64.1) ml, respectively. The number of patients reoperated for postoperative bleeding were 1 and 0, respectively. The number of patients with postoperative gastric bleeding were 0 and 1, respectively. The postoperative chest tube retention time were (2.8±1.3) days and (3.1±1.2) days, respectively. The number of patients with anastomotic leakage were 7 and 1, respectively. The number of patients with lung infection were 13 and 5, respectively, and with chylothorax were 2 and 1, respectively, without statistically significant difference (P>0.05). The number of patients with hoarseness were 11 and 3, respectively. The total incidence of complication were 41.2% (35/85) and 17.7% (11/62), and the postoperative hospital stay were (14.7±6.5) days and (12.3±2.3) days, with statistical difference (P<0.05). Conclusion: MIE-Ivor-Lewis and MIE-McKeown are safe and effective in treating esophageal cancer, but the complication of MIE-Ivor-Lewis is less than that of MIE-Mckeown, and the perioperative clinical effect of MIE-Ivor-Lewis is better than that of MIE-McKeown.
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Humans , Anastomotic Leak/etiology , Esophageal Neoplasms/surgery , Esophagectomy/adverse effects , Minimally Invasive Surgical Procedures/adverse effects , Postoperative Complications/epidemiology , Retrospective Studies , Treatment OutcomeABSTRACT
Objective:To explore the teaching effect of organ-system-based curriculum (OSBC) on cultivating the post competency of radiologists.Methods:Based on the teaching design of OSBC, our study has completed the teaching practice for imaging diagnosis of prostate diseases, focal liver lesions, small pulmonary nodules and intestinal obstruction. The imaging diagnosis of prostate diseases was taken as teaching point. Fifty-two trainees were divided into four groups: junior standardized residents and clinical-type postgraduates (JSRCP) group, senior grade of standardized residents and clinical-type postgraduates (SG-SRCP), advanced training radiologist (ATR) group, intern doctors (ID) group. The teaching framework of pre-training assessment, training and post-training test was designed, and the teaching effect and the operability evaluation of OSBC was compared in terms of test scores and subjective evaluation before and after the training. SPSS 18.0 was used for t test. Results:The test scores after training of four groups were significantly improved compared to the test scores before training. The test scores of SG-SRCP group and ATR group were significantly higher than those of ID group ( F=16.609, P<0.001). The results of subjective evaluation showed that the SG-SRCP and ATR group had the highest degree of satisfaction. Conclusion:OSBC education mode has a good training effectiveness of middle and advanced stages course of medical imaging. In the future teaching, OSBC teaching should be explored among different levels of students.
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Objective:To explore the mechanism of Dahuangfuzi decoction on intestinal motility disorder by observing its effect on serum motilin, Cajal interstitial cells and motilin receptor in rats with severe acute pancreatitis (SAP).Methods:Eighteen clean male Sprague-Dawley rats were randomly divided into the control group, SAP group and Dahuangfuzi group ( n=6 each group). The SAP rat model was prepared by retrogradely injected 4% sodium taurocholate into cholangiopancreatic duct. The rats in the SAP group were given 2 mL normal saline (37℃) enema at 12 and 24 h after operation. The rats in the Dahuangfuzi group was given 2 mL Dahuangfuzi decoction (37℃) enema at 12 and 24 h respectively. For the control group, the pancreas was exposed in the same way and then the abdomen was closed. Forty-eight h after operation, the abdominal aorta blood samples were taken for determination of serum endotoxin and amylase, and for detection of serum motilin by enzyme-linked immunosorbent assay (ELISA); the pathological changes of pancreas and ileum were observed by hematoxylin-eosin (HE) staining. The expression of c-kit and motilin receptor protein in ICC in ileum tissue was detected by immunohistochemistry. Results:Compared with the control group, the levels of serum endotoxin and amylase in the SAP group were significantly higher [(504.98±88.81) pg/mL vs. (17.76±5.01) pg/mL; (532.28±66.53) vs. (69.45±3.61) U/L, P<0.05], while the levels of serum motilin were significantly lower [(195.4±6.7) ng/L vs. (301±8.10) ng/L, P<0.05], and the scores of c-kit and motilin receptor protein were decreased ( P<0.05); compared with the SAP group, the levels of serum endotoxin and amylase in the Dahuangfuzi group were significantly reduced [(189.9±38.23) pg/mL vs. (504.98±88.81) pg/mL; (294.23±25.66) vs. (532.28±66.53) U/L, P<0.05], while the levels of serum motilin were significantly increased [(264.2±8.3) ng/L vs. (195.4±6.7) ng/L, P<0.05], and the scores of c-kit and motilin receptor protein were increased ( P<0.05). Conclusions:Dahuangfuzi decoction can improve the intestinal motility of SAP rats by promoting the secretion of motilin, increasing the activity of ICC cells and the expression of motilin receptor.
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Objective:To investigate the clinical outcomes of personalized polyetheretherketone (PEEK) implant in the correction of nasolabial fold depression.Methods:A total of 30 patients with nasolabial fold depression (5 males, 25 females, aged 26 to 52 years, mean 36.3 years) admitted to the Affiliated Friendship Plastic Hospital of Nanjing Medical University who want to undergo nasolabial fold augmentation from January 2019 to January 2021. All patients underwent CBCT scan and three-dimensional simulation, the personalized PEEK implant was designed and produced with CAD/CAM technique, the personalized PEEK was implanted during the operation. The patients were followed up for 3-12 months, and the wrinkle score and satisfaction were compared before operation and 3 months and 6 months after operation.Results:The depressions of nasolabial fold were significantly improved in all patients, and there were no complications such as hematoma and infection after operation. During the follow-up, there was no implant displacement or exposure, and the effect was stable and lasting. The scores of wrinkles at 3 months after operation (2.30±0.47) and 6 months after operation (2.17±0.38) were significantly lower than those before operation (4.03±0.67), and the scores of satisfaction were significantly higher than those before operation ( P<0.05). The scores of satisfaction at 3 months after operation (3.97±0.56) and 6 months after operation (4.23±0.57) were significantly higher than those before operation (1.70±0.60). The difference was statistically significant ( P<0.05). Conclusions:3D printing personalized PEEK prosthesis is effective in correcting nasolabial fold depression, and it is safe and stable, so it is recommended for clinical application.
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Objective:To investigate the expression of long-chain noncoding RNA (lncRNA) CTA-796E4.4 in bladder cancer tissues and cell lines, and to observe its effect on the proliferation and invasion of bladder cancer cells and to explore its possible molecular mechanism.Methods:The expression of CTA-796E4.4 in 73 bladder cancer tissues and adjacent tissues, 4 kinds of bladder cancer cell lines (UM-UC-3, BIU-87, 5637, T24) and normal bladder epithelial cells in the First People′s Hospital of Tianmen City from November 2016 to January 2019 were detected by qPCR. UM-UC-3 cells infected with recombinant lentivirus (LV-CTA-796E4.4) carrying the CTA-796E4.4 gene were taken as an experimental group, and UM-UC-3 cells infected with negative control lentivirus (LV-NC) were as a control group. The effect of over expression of CTA-796E4.4 on the expression of Forkhead box transcription factor O1 (FOXO1) mRNA was detected by qPCR. The expression of FOXO1 protein was detected by Western blotting, Thiazolyl blue (MTT) method Transwell invasion assay was respectively used to examine the effect of high expression of CTA-796E4.4 on proliferation and invasion of UM-UC-3 cells.Results:The expression level of CTA-796E4.4 in bladder cancer tissue was lower than that in para cancerous tissue (1.22 ± 0.33 vs. 4.30 ± 0.64) and the difference was statistically significant ( P < 0.01). The expression of CTA-796E4.4 in bladder cancer cells was lower than that in bladder cancer epithelial cells (0.11 ± 0.03, 0.61 ± 0.03, 0.33 ± 0.03, 0.73 ± 0.04 vs.1.01 ± 0.10) ( P < 0.01). After LV-CTA-796E4.4 infection, the expression of CTA-796E4.4 was significantly increased ( P < 0.01) and the expression of FOXO1 gene was increased ( P < 0.01). High expression of CTA-796E4.4 significantly inhibited cell proliferation and invasion of UM-UC-3 cells ( P < 0.05). Conclusions:The expression of lncRNA CTA-796E4.4 is decreased in bladder cancer and cell lines. High expression of CTA-796E4.4 inhibites the proliferation and invasion of UM-UC-3 cells. The molecular mechanism may be that up-regulation of CTA-796E4.4 can promote the expression of FOXO1.
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@#Objective To investigate the changes in pulmonary function after video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) segmentectomy. Methods A total of 59 patients (30 males and 29 females) who underwent segmentectomy in the Affiliated Hospital of Qingdao University from July to October 2017 were included. There were 33 patients (18 males and 15 females) in the VATS group and 26 patients (12 males and 14 females) in the RATS group. Lung function tests were performed before surgery, 1 month, 6 months, and 12 months after surgery. Intra- and inter-group comparisons of lung function retention values were performed between the two groups of patients to analyze differences in lung function retention after VATS and RATS segmentectomy. Results The forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in the VATS group and the RATS group were significantly lower than those before surgery (P<0.05), and they increased significantly within 6 months after surgery (P<0.05). The recovery was not obvious after 6 months (P>0.05), and they were still lower than those before surgery. In addition, the retentions of FEV1 and FVC in the VATS group and the RATS group were similar in 1 month, 6 months, and 12 months after operation with no statistical difference(P>0.05). Conclusion Pulmonary function decreases significantly in 1 month after minimally invasive segmentectomy, and the recovery is obvious in 6 months after the operation, then the pulmonary function recovery gradually stabilizes 12 months after surgery. FEV1 of the patients in the two groups recovers to 93% and 94%, respectively. There is no statistical difference in pulmonary function retention after VATS and RATS segmentectomy.
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Pichia pastoris is one of the most convenient and widely used heterologous protein expression systems. To further improve its ability to express heterologous proteins, we developed a high-throughput P. pastoris screening method based on droplet microfluidic and demonstrated the method by screening and obtaining mutants with enhanced xylanase expression and secretion abilities. We used PCR (Polymerase Chain Reaction) amplification to obtain a fusion fragment of xylanase xyn5 gene and green fluorescent protein gfp gene, and cloned this fragment into pPIC9K, the expression vector of Pichia pastoris, to construct the plasmid pPIC9K-xyn5-gfp that recombined the DNA fragments of xylanase and green fluorescent protein. After this plasmid entered P. pastoris GS115 by electroporation, the P. pastoris SG strain that could express xylanase and green fluorescent protein was obtained. The above-said strains were then mutagenized by atmospheric room temperature plasma and subsequently encapsulated to form single-cell droplets. After 24-hour cultivation of the droplets, microfluidic screening was carried out to obtain the mutant strain with high xylanase expression for further construction and screening of the next mutagenesis library. After five rounds of droplet microfluidic screening, a highly productive strain P. pastoris SG-m5 was obtained. The activity of the expressed xylanase was 149.17 U/mg, 300% higher than that of those expressed by the original strain SG. This strain's ability to secrete heterologous protein was 160% higher than that of the original strain. With a screening throughput of 100 000 strains per hour, the high-throughput P. pastoris screening system based on single-cell droplet microfluidic developed by the present study screens a library with million strains in only 10 hours and consumes only 100 μL of fluorescent reagent, thus reducing the reagent cost by millions of times compared with the traditional microplate screening and more importantly, providing a novel method to obtain P. pastoris with high abilities to express and secret heterologous proteins by efficient and low-cost screening.
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Microfluidics , Mutagenesis , Pichia , Plasmids , Polymerase Chain Reaction , Recombinant ProteinsABSTRACT
Lung cancer is the most common cancer and the leading cause of cancer death. Non-small cell lung cancer (NSCLC) represents over 85% of all lung cancers, and up to 50% of Asian NSCLC patients harboring epidermal growth factor receptor (EGFR) gene mutations. A number of studies have consistently demonstrated that uncommon EGFR-mutated NSCLC patients treated with EGFR-tyrosine kinase inhibitors (EGFR-TKIs) can achieve better survival outcomes. However, because uncommon EGFR mutations are generally associated with reduced sensitivity to EGFR-TKIs, which will bring a negative impact on the result of the study, the majority of clinical trials investigating the efficacy of EGFR-TKIs have included only patients with common EGFR mutations. In addition, uncommon EGFR mutations are rare in themselves, leading to the small number of such patients enrolled in these trials. Due to the small number and highly heterogeneous sensitivity of uncommon EGFR mutations, the efficacy of EGFR-TKIs in patients harboring uncommon EGFR mutations remains elusive. This article reviews the efficacy of EGFR-TKIs in patients with uncommon EGFR mutations, and give some reasonable advice about the selection of treatments for patients with NSCLC who harbor uncommon EGFR mutations.
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Objective To observe the expression of long non-coding RNA (LncRNA-NEAT1) in renal cell carcinoma and cell lines,and to explore its influence on the malignant biological behavior of renal cell carcinoma and its possible molecular mechanism.Methods The expression of NEAT1 was detected by quantitative polymerase chain reaction (qPCR) in l0 cases of renal cell carcinoma and paracancerous tissues,and in 4 types of renal cell carcinoma cells and normal renal tubular epithelial cells.ACHN cells infected with negative control lentivirus (LV-NC) were used as control group,and ACHN cells infected with recombinant lentivirus carrying NEAT1 gene (LV-NEAT1) were used as experimental group.Bioinformatics predicts targeted miRNA and downstream genes of NEAT1.The effect of overexpression of NEAT1 on the mRNA expression of miR-342-3p and cell adhesion molecule 1 (CADM1) was detected by qPCR.The protein expression of CADM1 was detected by Western blot.The proliferation and invasion of ACHN cells were detected by methyl thiazolyl tetrazolium (MTT) method and Transwell invasion assay.Results The expression level of NEAT1 in renal cell carcinoma was lower than that in paracancerous tissue (P ＜ 0.01).The expression of NEAT1 in renal carcinoma cell lines was lower than that in renal tubular epithelial cells (P ＜0.01).After LV-NEAT1 infection,the expression of NEAT1 and CADM1 gene were significantly increased (P ＜0.01),while the expression of miR-342-3p decreased (P ＜0.01).Overexpression of NEAT1 significantly inhibited cell proliferation and invasion of ACHN cells (P ＜ 0.05).Conclusions LncRNA NEAT1 was down-regulated in renal cell carcinoma and cell lines.Overexpression of NEAT1 inhibited the proliferation and invasion of ACHN cells.The molecular mechanism may be that NEAT1 up-regulates the expression of CADM1 gene through complementary binding to miR-342-3p.
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Objective To investigate the efficacy and safety of gastric peroral endoscopic myotomy ( G-POEM) for postsurgical gastroparesis. Methods A retrospective analysis was performed on data of 47 patients with gastroparesis after subtotal gastrectomy, who underwent G-POEM at Zhongda Hospital Southeast University form August 2016 to June 2018. G-POEM procedure, complications related to G-POEM, and improvement of symptoms and gastric emptying function were observed. Results All patients underwent G-POEM successfully. No serious G-POEM-related complications were observed. During a follow-up period of 9. 8±5. 8 months (range 3-18 months), the scores of gastroparesis cardinal symptoms index (GCSI) were 1. 6±0. 5, 1. 2±0. 4, 1. 1±0. 6, 1. 4±0. 3 and 1. 7±0. 3 respectively at the 1st, 3rd, 6th, 12th, and 18th months after G-POEM, and all scores were lower than that before G-POEM (3. 8±1. 1, all P<0. 01). The results showed the symptoms of gastroparesis were improved significantly. Gastric emptying imaging showed the hemi-emptying time was 23. 8±8. 8 min, 21. 2±9. 5 min, 20. 9±8. 3 min and 26. 4±7. 8 min at the 1st, 6th, 12th and 18th months after G-POEM, respectively, significantly shorter than that before G-POEM (67. 8±12. 5 min, all P<0. 01). Three-dimensional ultrasonography results of gastric antrum volume showed that the hemi-emptying time was 26. 4 (21. 8, 40. 3) min, 22. 6 (13. 9, 32. 7) min, 24. 3 (18. 2, 36. 5) min and 26. 8 (16. 4, 38. 5) min at the 1st, 6th, 12th and 18th months after G-POEM, respectively, which were all significantly shorter than that before G-POEM [ 72. 5 ( 48. 3, 108. 6 ) min, all P<0. 01 ] . Conclusion G-POEM has a satisfactory long-term efficacy on the treatment of gastroparesis after subtotal gastrectomy with good safety.
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Objective: To investigate the diet of lactating mothers, breast milk components and the growth of infants in Changchun City, Jilin Province and explore the relationships between the nutritional status of breast milk and the growth of infants, and to provide the theoretical basis for the development of the infant health.Methods: A total of 138 healthy nursing mothers were selected. Within 40-45 d after the delivery, face-to-face investigations were conducted to obtain the basic information of the subjects and the growth and development information of the infants. The 24-hour dietary review method was adopted to investigate the dietary status of the lactating mothers, the standard food pictures were provided to estimate the dietary variety and the quantities of the subjects. Golden key maternal nutrition expert system software was applied to analyze the energy and nutrients of dietary intake, and they were compared with Dietary Guidelines of Pregnant, Lactating Women and 0-6 Years Old Children in China (2007) and Chinese Dietary Reference Intake of Nutrients (2013);the diet intake level of the lactating mothers was evaluated. The breast milk was collected and the infant growth and development indicators were measured. The compositions of breast milk were analyzed by milk composition analyzer. The relationships between the lactating mother's diet, the breast milk composition and the infant growth and development were analyzed.Results: The average energy intake of the lactating mothers was (1 698.7±406.23) kcal·d-1, and the energy proportions of proteins, lipids, and carbohydrates were 14.06%, 33.83%, and 52.09%, respectively. The average energy content of breast milk was (61.18±13.04) kcal·100g-1, the average protein content was (0.94±0.19) g·100g-1, the average lipid content was (3.55±1.27) g·100g-1, and the average lactose content was (6.38±0.82) g·100g-1. The dietary protein intake was associated with the protein content of breast milk (r=0.203,P=0.017).When the influence of feeding patterns, energy of breast milk, infant gender, and age were controlled, the partial correlation analysis result showed that the breast milk composition had no correlations with the increases in body lengths and weights of the infants (P>0.05).Conclusion: There are insufficience and imbalance in the general dietary intakes in the lactating mothers. The dietary protein intake of lactating mothers may influence the protein content of breast milk. The lipid and carbohydrate contents in milk have no significant correlations with the dietary nutrients of the lactating mothers. The breast milk compositions of lactating mothers have no effects on the growth and development of infants.
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An analytical method was developed for determination of low-level uranium isotopes in vegetation samples. Dry ashing method was employed to decompose organic matters of vegetation. The sample ash was further digested using multiple acids. Uranium in the prepared sample solution was separated and purified by an extraction chromatography using UTEVA resin. The chemical recovery of uranium in the separation procedure was more than 94% , and more than 99% of Na, K, Ca and other matrix elements and interfering elements were removed. Three natural uranium isotopes were finally measured with high sensitivity ICP-MS/MS. The detection limits of the method for 238U, 235U, 234U were 3. 05, 0. 34 and 0. 04 pg/g, respectively. The detection limits for 238U and 235U were 10 times better than the reported values. Analysis result of U in GBW-10046 standard reference material was in good agreement with reference value, indicating that this method was reliable. The method was successfully applied to determination of uranium isotopes in the vegetation samples collected in Xi′an region, and it was found that the uranium concentrations and isotopic ratios in these vegetation samples fall well into natural level, and there was no significant artificial uranium contamination. This was the first survey of the three natural uranium isotopes in vegetation samples in this region.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the intervention effect of Shugan Jianpi Formula (, SGJPF) on a breast cancer mouse model with depression and investigate the underlying mechanism of SGJPF in preventing the development of breast cancer.</p><p><b>METHODS</b>The breast cancer model was induced by inoculation of breast cancer cells, the depression model was induced by chronic stress stimuli, and the depression cancer model was established by combining the two factors. The mice were divided into 7 groups: normal control, depression model, tumor model, depression tumor model, SGJPF, chemotherapy, and SGJPF+chemotherapy groups. The last 3 groups were depression breast cancer mice and treated respectively with SGJPF, chemotherapy drug gemcitabine (GEM), and SGJPF alongside GEM. The condition of the mice was evaluated by the expression of 5-hydroxytryptamine in hippocampus after the sucrose water test and open field test, weight change, and survival time. Tumor growth was monitored with in vivo imaging. Flow cytometry was used to analyze the level of myeloid-derived suppression cell (MDSC) in the mouse spleen, T cell subsets, and the early apoptosis of CD8T cells.</p><p><b>RESULTS</b>The SGJPF+GEM group had the highest inhibition rate and the longest survival time (P<0.01). The MDSC level and the apoptosis rate of CD8T cells was the highest in the SGJPF+GEM group (P<0.05).</p><p><b>CONCLUSIONS</b>Depressive disorders and tumor growth could suppress the immune function of mice to different degrees, and the microenvironment in late 4T1 inflammatory breast cancer may play an important role in the pathological process. SGJYF could regulate the immune microenvironment by reducing CD8T lymphocyte apoptosis and tumor cell activity, increasing immune surveillance capability, and inhibiting MDSC proliferation, thus prolonging the survival time of tumor-bearing mice.</p>