Application Value of Abbreviated Comprehensive Geriatric Assessment in Elderly Female Breast Cancer Patients / 中国医学科学院学报

Objective To evaluate the application value of abbreviated comprehensive geriatric assessment(aCGA)in elderly female breast cancer patients. Methods Eight aspects of the traditional CGA were simplified to form the aCGA assessment table,based on which the patients were classified into three grades of A,B and C according to the total scores.This study enrolled the elderly female patients with breast cancer aged 70 years and above who were treated in PUMC Hospital from June 2018 to January 2020.Eastern Cooperative Oncology Group(ECOG)scoring and aCGA grading were performed respectively,and the results of the two methods were compared. Results Of the 162 patients,111(68.5%)were classified by the aGGA method as grade A,43(26.5%)as grade B,and 8(5.0%)as grade C;131(80.9%)cases have concurrent diseases,and the most common complications were hypertension(

Fingerprint of Epimedium wushanense Based on Principal Component，Factor and Cluster Analysis / 中国实验方剂学杂志

Objective: To establish the fingerprint of Epimedium wushanense by HPLC,and study the comprehensive quality of E. wushanense by combining principal components,factors and cluster analysis,so as to provide theoretical basis for its quality evaluation. Method: The chromatographic column was Agilent infinitylab poroshell 120 SB-C18 (3.0 mm×100 mm,2.7 μm),the flow phase was acetonitrile (A)-water (B) with a gradient of 0-5 min,25%-26%A;5-6 min,26%-34%A;6-11 min,34%-38.5%A;11-17 min,38.5%-100%A;17-20 min,100%A,the flow rate was 0.8 mL·min- 1,the detection wavelength was 270 nm,and the column temperature was 30℃. Result: The cluster analysis better classified E. wushanense from different producing areas. E. wushanense from Guizhou province and E. wushanense from Chongqing were classified as class Ⅱ. E. wushanense from Guizhou province and Chongqing were far apart, indicating that the quality of E. wushanense varies from place to place affected by environment and climate. The results of principal component analysis showed that the quality of E. wushanense produced in Chongqing was better than that of E. wushanense produced in Guizhou. Among them,CQWS-02 (Yaque village,Guanyang town,Wushan county,Chongqing) and CQWS-10 (Hewan, Guanyang town,Wushan county,Chongqing) can be considered in the selection of high-quality varieties. In addition,No.1 common peak (epimedin A),No.2 common peak (epimedin B),No.4 common peak (icariin) and No.5 common peak (unknown component) in the fingerprint of the test samples could be used as the evaluation index components of E. wushanense quality. Conclusion: Principal components,factors and cluster analysis are used to achieve the rapid analysis, and their respective advantages are brought into full play for mutual verification and supplement. And the quality of E. wushanense in different origins can be comprehensively evaluated in all-round ways.

Challenges in the diagnosis and management of acute bowel obstruction: Focus on the standard of practice / 中国实用外科杂志

Acute bowel obstruction(ABO)is one of the most common acute abdomen with complicated etiology and critical conditions.Insufficient recognition of the clinicopathologic features for different types and the urgency for special types of ABO,over-reliance on imaging diagnosis,and less standard for practice are the major limitations in the management of ABO. Basically,a qualified clinical training program,including history collection, physical examination and thorough comprehension of the pathological mechanisms,is needed to be established. Furthermore,application and interpretation of imaging examinations should be standardized,in order to achieve precise qualitative,topical and etiological diagnosis. Specifically,strangulated and closed loop ABO should be identified and treated very soon due to critical outcome. Finally,the strategy of surgery should be made based on the strict indications and damage control principle.

lmpact of combined surgery on the MUC5 AC levels in patients with glaucoma and cataract / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AlM:To investigate the effects of the MUC5AC levels and ocular function of the patients with glaucoma and cataract with combined surgery.? METHODS: Twenty - eight patients treated with glaucoma and cataract combined surgery were chosen as the observation group from December 2011 to June 2014 in our hospital, and other 28 cases of glaucoma and cataract did not undergo surgical treatment were selected as the control group, 30 healthy subjects were as healthy control group. the MUC5AC level and ocular surface score of the three subjects before surgery 1d, after 3 and 6mo were compared.?RESULTS: The NUC5AC of the two groups of patients was significantly lower than that of the healthy control group before surgery (P<0. 05), the ocular function score was significantly higher than the healthy control group ( P<0. 05). After 1mo, the MUC5AC of the observation group were significantly lower than that of before surgery ( P<0. 05), after 3mo MUC5AC content gradually increased to preoperative levels, after 6mo the MUC5AC were significantly higher than before surgery (P<0. 05). After 1mo, ocular function scores were significantly higher than the preoperative ( P< 0. 05 ), while after 3mo, ocular function scores decreased after 6mo of ocular surface function scores were significantly lower than the preoperative (P<0. 05). While the control group after 6mo, with the passage of time, the MUC5AC content gradually reduce, ocular function score increased gradually. ?CONCLUSlON:To treat the patients with glaucoma and cataract with combined surgery, the level of MUC5AC can temporary decrease. Ocular function score can temporary increase in, but after 3mo, it can be gradually improved.

Clinicopathological features and prognosis of chronic gastric ulcer with early canceration / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinicopathological features and prognosis of chronic gastric ulcer with early canceration in order to provide useful information for diagnosis and treatment strategies.</p><p><b>METHODS</b>A retrospective review of clinical data and prognosis from 43 patients of chronic gastric ulcer with early canceration from 2003 to 2010 was conducted. These data were compared with those with primary intra-mucosa gastric cancer (type I and II 275 cases, type III 68 cases).</p><p><b>RESULTS</b>In 43 cases of chronic gastric ulcer with early canceration, 30 cases (69.8%) were male, 22 cases (51.2%) were younger than 60 years old. Lesions located in the body or antrum of the stomach in 39 cases (90.7%), were less than 2 cm in 26 cases (60.5%), were undifferentiated type in 23 cases (53.5%), and developed lymph node metastasis in 4 cases (9.3%). Lesions of 4 cases of chronic gastric ulcer with early canceration located in the upper third of the stomach, while those of type III primary intra-mucosal gastric cancer all located in the lower two thirds, and the difference was statistically significant (P<0.01). Compared to type III and type I and II primary intra-mucosal gastric cancer, chronic gastric ulcer with early canceration did not differ in clinicopathological characteristics such as histological type, vascular or lymphatic invasion, and lymph nodes metastasis (all P>0.05). The median follow-up time was 57 months (range 16 to 98 months). The 5-year overall survival was 95.3% in chronic gastric ulcer with early canceration group, similar to that of type I, II (97.4%) or type III (94.5%) primary intra-mucosal gastric cancer group (P>0.05).</p><p><b>CONCLUSIONS</b>The clinicopathological features of chronic gastric ulcer with early canceration are similar to those of primary intra-mucosal gastric cancer. The prognosis is promising for those patients undergoing surgical treatment.</p>

Analysis of prognostic factors related to triple-negative breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the prognostic factors related to triple-negative breast cancer (TNBC) by analyzing clinicopathologic characteristics, treatment and prognosis.</p><p><b>METHODS</b>Three hundred and five TNBC patients treated between January 2004 and December 2011 were enrolled and retrospectively reviewed with Kaplan-Meier and Cox proportional hazards models. All patients were females and the age onset were 24-82 years old (the median were 50 years old).</p><p><b>RESULTS</b>The follow-up period was 1 to 114 months, with median 38 months. The 5-year disease free survival (DFS) rate was 68% and overall survival (OS) rate 75%. The peak risk of recurrence occurs within the first 2-3 years after initial treatment of the disease, but distant relapse after this time is much less common. Survival analysis showed that surgery type (χ(2) = 4.030, P = 0.045), tumor grade (χ(2) = 8.000, P = 0.046), lymph-vascular invasion (χ(2) = 10.386, P = 0.001) and lymph node stage (χ(2) = 119.36, P = 0.000), TNM stage (χ(2) = 65.961, P = 0.000) and treatment plan (χ(2) = 28.371, 21.874, 32.163, all P = 0.000) were statistically related to DFS; while age (χ(2) = 10.226, P = 0.006), lymph-vascular invasion (χ(2) = 18.881, P = 0.000), lymph node stage (χ(2) = 98.958, P = 0.000), TNM stage (χ(2) = 65.342, P = 0.000) and type of treatment (χ(2) = 17.862, 18.708, 31.921, all P = 0.000) were related to OS. The lymph nodes stage was prognostic factor related to both DFS and OS.</p><p><b>CONCLUSIONS</b>TNBC was characterized by poor prognosis and rapid progression. The lymph nodes metastatic status was the most important prognostic factor of TNBC.</p>

Association of transcriptional repressor Snail with Lauren classification of gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the association of Snail expression and Lauren classification of gastric cancer.</p><p><b>METHODS</b>The protein levels of Snail and E-cadherin were detected by Western blot in N87 (intestinal-type gastric cancer cell line) and AGS(diffuse-type gastric cancer cell line) cell lines and those after transfection of GSK-3β plasmid. The study included a total of 77 patients with primary gastric cancer who underwent curative gastrectomy in the Zhongshan Hospital from February 2000 to December 2005 without any chemotherapy or radiation therapy before surgery. Tissues of gastric cancer specimens were stained using immunohistochemistry to determine Snail expression.</p><p><b>RESULTS</b>Snail expression was low in N78 and high in AGS. E-cadherin expression showed reverse expression pattern. After transfection with GSK-3β, the expression of Snail was significantly suppressed and that of E-cadherin elevated (P<0.01). Different concentrations of GSK-3β inhibitor lithion chloride were used to treat the cell lines and Snail expression was significantly up-regulated in a dose-dependent manner (P<0.01). Snail expression was elevated in 16 out of 21 N78 cell lines, and in 21 out of 56 AGS cell lines, and the difference was statistically significant (P<0.01).</p><p><b>CONCLUSION</b>The expression of Snail is closely associated with the Lauren classification of gastric cancer, and it may be a potential marker of the gastric cancer classification.</p>

Effect of Notch ligand Delta1-RNA interference by lentivirus on proliferation and differentiation of human dental pulp stem cells / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of specific RNA interference (RNAi) to Notch ligand Delta1 on proliferation and differentiation of human dental pulp stem cells (DPSC).</p><p><b>METHODS</b>DPSC were infected by lentivirus vectors carrying Delta1-RNAi. DPSC were divided into three groups, DPSC/Delta1-RNAi group, DPSC/wt group and DPSC/vector group as control. Cell counting kit-8 (CCK-8) assay and flow cytometry were used to evaluate the proliferation of DPSC. Expression of proliferating cell nuclear antigen (PCNA) was examined with immunohistochemical staining. All groups were cultured in an odonto-inductive medium and were observed under microscope. The number of mineralization nodules was counted after Alizarin red staining. Alkaline phosphatase (ALP) activity and the expression of dentin sialophosphoprotein (DSPP) were detected by ALP activity assay and Western blotting.</p><p><b>RESULTS</b>Compared with DPSC/wt or DPSC/vector separately, proliferating rate and S-cycle of DPSC/Delta1-RNAi was significantly lower. The S phase and proliferation index (PI) decreased markedly from 22.32 ± 2.35 and 33.68 ± 4.19 (DPSC/Delta1-RNAi) to 5.44 ± 0.91 and 16.00 ± 6.07 (DPSC/wt). The PCNA staining of DPSC/Delta1-RNAi was evidently weaker. DPSC/Delta1-RNAi group had more calcified cell nodules than the other two control groups, and ALP activity and DSPP expression of DPSC/Delta1-RNAi group increased markedly.</p><p><b>CONCLUSIONS</b>Delta1-RNAi induced by the lentivirus vectors may inhibit DPSC proliferation and differentiation. Notch-Delta signal pathway plays an important role in self-renewal and differentiation.</p>

Evaluation the value of number of metastatic perigastric lymph nodes on prognosis in patients with gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To find out a simple and reproductive prognostic index in gastric cancer patients,which can be used as a comparable parameter among different regions of China.</p><p><b>METHODS</b>The perigastric metastatic lymph nodes(PGMLN) with long-term survival data were retrospectively evaluated in 148 gastric cancer patients, undergone potentially curative resections.</p><p><b>RESULTS</b>The 3-year cumulative survival rate was 62.8% and the survival rate decreased significantly with the increase of PGMLN, especially when the PGMLN was more than 6. The PGMLN had a clear linear relationship with total positive lymph nodes(r=0.94, P<0.01), while it had little correlation with total resected lymph nodes(r=0.18,P=0.2).</p><p><b>CONCLUSIONS</b>PGMLN is a convenient and reliable prognostic factor in gastric cancer patients, which may be a good candidate of comparable parameters among different regions of China.</p>

Detection and clinical significance of plasma vascular endothelial growth factor level in gastrointestinal stromal tumor patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical significance of plasma vascular endothelial growth factor (p-VEGF) levels in gastrointestinal stromal tumor (GIST) patients.</p><p><b>METHODS</b>The p-VEGF levels in 61 primary GIST patients, 18 patients with recurrence or metastasis, and 28 healthy blood donators (as control) were measured by enzyme-linked immunosorbent assay. Paired p-VEGF levels of pre- and post-treatment were obtained from 44 patients. One patient received 22 consecutive detections during the follow up.</p><p><b>RESULTS</b>Primary and recurrent GIST patients had higher p-VEGF levels than healthy controls [(145.31+/-45.58) ng/L, (145.72+/-52.73) ng/L vs (89.86+/-18.30) ng/L] (P<0.01). And there were no significant differences between primary patients and patients with recurrence or metastasis (P>0.05). Significant difference were found in the p-VEGF levels between pre- and post-treatment patients (P<0.01). Post-treatment p-VEGF levels decreased markedly both in 26 primary and 11 recurrent patients [(101.81+/-27.63) ng/L and (112.45+/-38.58) ng/L]. As for the patient with 22 consecutive detections during the follow up, p-VEGF levels the period of were higher before surgery and after recurrence, and lower two months after surgery and during Glivec therapy.</p><p><b>CONCLUSIONS</b>The p-VEGF level of GIST patients is significantly higher than that of healthy people, which will decrease markedly after effective management. Monitoring the p-VEGF level in GIST patients will be helpful to evaluate the therapeutic efficacy and predict the recurrence or metastasis.</p>

Clinical characteristics and surgical treatment of 18 cases of duodenal gastrointestinal stromal tumors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics, surgical procedures and prognosis of duodenal gastrointestinal stromal tumors (GISTs).</p><p><b>METHODS</b>The clinical data of 18 GIST patients, collected from 1995 to 2004, were retrospectively analyzed.</p><p><b>RESULTS</b>The lesions of duodenal GISTs mainly located in the descending duodenum (13/18), unusually in the horizontal part (2/18), ascending part (1/18), and the bulb (2/18). Pathological examination revealed 1 case of benign tumor, 2 cases of borderline tumors and 15 cases of malignant tumors, Microscopically, the tumors were composed of spindle cells (14 cases), epithelial cell (1 case), and mixed cell types (3 cases). The clinical manifestations were non-specific, mostly was melena (7/18), as well as abdominal pain (6/18), fullness (5/18), and anemia (3/18). The diagnoses were performed by upper gastrointestinal radiography, gastroscopy, endoscopic ultrasonography and CT scan. All of the 18 patients received surgical treatment, including 9 pancreaticoduodenectomies, 5 local resections, 3 segmental resections of duodenum, and 1 distal subtotal gastrectomy. 1 and 3 year survival rates were 100% and 86.7% respectively.</p><p><b>CONCLUSION</b>Most duodenal GISTs are malignant, and the choices of surgical procedures are mainly determined by the location and size of the tumors.</p>

Clinical values of extended lymph node dissection for gastric cancer:a meta-analysis for D1 versus D2 gastrectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the survival, complication and postoperative mortality after D(1) or D(2) lymph node dissection for gastric cancer.</p><p><b>METHODS</b>All the randomized clinical trials about nodal dissection for gastric cancer published within the last 20 years were collected. Quality assessment was done on each trial and relevant data were extracted from qualified trials. Meta-analysis was performed with the use of RevMan 4.2 (Cochrane) for statistic analysis.</p><p><b>RESULTS</b>Three hundred and ninety-four trials were yielded at the initial search. Four trials, recruited 1316 cases of gastric cancer in total, were included after quality assessment. Results of Meta-analysis showed that standard D(2) dissection could effectively improve patients' long-term survival [RR 1.35, 95%CI(1.12-1.62), NNT=9] as compared with D(1) dissection. If splenectomy (or pancreatico-splenectomy) was involved, D(2) dissection only improved the clinical outcome of T(3)-staged cases [RR 1.80,95%CI(1.03-3.15), NNT=13]. D(2) dissection produced higher rates of postoperative complication [RR 1.72,95%CI(1.46-2.03), NNT=6] and mortality [RR 2.12,95%CI(1.39-3.25), NNT=21] than D(1) dissection.</p><p><b>CONCLUSIONS</b>Standard D(2) dissection can increase the overall survival rate when compared with D(1) dissection. If splenectomy (or pancreatico-splenectomy) cases are involved,D(2) dissection can only improve the survival rate of T(3)-staged patients. D(2) dissection yields higher postoperative morbidity and mortality than D(1) dissection.</p>