Ultrasound-guided stellate ganglion block accelerates postoperative gastrointestinal function recovery following laparoscopic radical gastrectomy for gastric cancer / 南方医科大学学报

OBJECTIVE@#To explore the effects of ultrasound-guided stellate ganglion block (SGB) on perioperative stress response, gastrointestinal hormones and postoperative gastrointestinal function recovery in patients undergoing laparoscopic radical gastrectomy for gastric cancer.@*METHODS@#This study was conducted among 60 American Society of Anesthesiologists (ASA) class II-III patients with gastric cancer (regardless of gender, aged 35-75 years with BMI of 18.5-26 kg/m2) undergoing elective laparoscopic radical gastrectomy. The patients were randomized into experimental group (S group, n=30) and control group (NS group, n=30). In S group, SGB at the C6 level of the right cervical spine was performed under ultrasound guidance 15 min before induction of anesthesia by injection of 7 mL 0.5% ropivacaine; the patients in NS group received injections of normal saline in the same manner. Peripheral venous blood samples were collected before SGB (T1), after surgery (T2), and on the 2nd and 6th days after surgery (T3 and T4) for determination of the levels of motitin (MOT), vasoactive intestinal peptide (VIP), cortisol (COR), and blood glucose (GLU). Intraoperative usage of sufentanil, recovery rate of intestinal sounds at 36, 48, 60, 72, 84 and 96 h after operation and the time of first passage of flatus were recorded and compared between the two groups.@*RESULTS@#There was no significant difference in the total amount of sufentanil consumption between the two groups. Compared with those in NS group, the patients in S group had significant lower COR and VIP levels (P < 0.05) and higher MOT level (P < 0.05) at T2, T3 and T4. Glu level at T2 and T3 was also significantly lower in S group (P < 0.05). The recovery rates of intestinal sounds at 36, 48, 60, 72 and 84 h after surgery were significantly higher (P < 0.05) and the time of the first passage of flatus was earlier in S group than in NS group (P < 0.05).@*CONCLUSION@#In patients with gastric cancer undergoing laparoscopic radical gastrectomy, ultrasound-guided SGB can reduce postoperative stress level, promote the recovery of gastrointestinal hormone secretion, and accelerate postoperative recovery of gastrointestinal functions.

A prospective cohort study on the clinical value of pelvic peritoneal reconstruction in laparoscopic anterior resection for middle and low rectal cancer / 中华胃肠外科杂志

Objective: To investigate the safety and efficacy of pelvic peritoneal reconstruction and its effect on anal function in laparoscopy-assisted anterior resection of low and middle rectal cancer. Methods: A prospective cohort study was conducted. Consecutive patients with low and middle rectal cancer who underwent laparoscopy-assisted transabdominal anterior resection at Naval Military Medical University Changhai Hospital from February 2020 to February 2021 were enrolled. Inclusion criteria: (1) the distance from tumor to the anal verge ≤10 cm; (2) laparoscopy-assisted transabdominal anterior resection of rectal cancer; (3) complete clinical data; (4) rectal adenocarcinoma diagnosed by postoperative pathology. Exclusion criteria: (1) emergency surgery; (2) patients with a history of anal dysfunction or anal surgery; (3) preoperative diagnosis of distant (liver, lung) metastasis; (4) intestinal obstruction; (5) conversion to open surgery for various reasons. The pelvic floor was reconstructed using SXMD1B405 (Stratafix helical PGA-PCL, Ethicon). The first needle was sutured from the left anterior wall of the neorectum to the right. Insertion of the needle was continued to suture the root of the sigmoid mesentery while the Hemo-lok was used to fix the suture. The second needle was started from the beginning of the first needle, after 3-4 needles, a drainage tube was inserted through the left lower abdominal trocar to the presacral space. Then, the left peritoneal incision of the descending colon was sutured, after which Hemo-lok fixation was performed. The operative time, perioperative complications, postoperative Wexner anal function score and low anterior resection syndrome (LARS) score were compared between the study group and the control group. Three to six months after the operation, pelvic MRI was performed to observe and compare the pelvic floor anatomical structure of the two groups. Results: A total of 230 patients were enrolled, including 58 who underwent pelvic floor peritoneum reconstruction as the study group and 172 who did not undergo pelvic floor peritoneum reconstruction as the control group. There were no significant differences in general data between the two groups (all P>0.05). The operation time of the study group was longer than that of control group [(177.5±33.0) minutes vs. (148.7±45.5) minutes, P<0.001]. There was no significant difference in the incidence of perioperative complications (including anastomotic leakage, anastomotic bleeding, postoperative pneumonia, urinary tract infection, deep vein thrombosis, and intestinal obstruction) between the two groups (all P>0.05). Eight cases had anastomotic leakage, of whom 2 cases (3.4%) in the study group were discharged after conservative treatment, 5 cases (2.9%) of other 6 cases (3.5%) in the control group were discharged after the secondary surgical treatment. The Wexner score and LARS score were 3.1±2.8 and 23.0 (16.0-28.0) in the study group, which were lower than those in the control group [4.7±3.4 and 27.0 (18.0-32.0)], and the differences were statistically significant (t=-3.018, P=0.003 and Z=-2.257, P=0.024). Severe LARS was 16.5% (7/45) in study group and 35.5% (50/141) in control group, and the difference was no significant differences (Z=4.373, P=0.373). Pelvic MRI examination 3 to 6 months after surgery showed that the incidence of intestinal accumulation in the pelvic floor was 9.1% (3/33) in study group and 46.4% (64/138) in control group (χ(2)=15.537, P<0.001). Conclusion: Pelvic peritoneal reconstruction using stratafix in laparoscopic anterior resection of middle and low rectal cancer is safe and feasible, which may reduce the probability of the secondary operation in patients with anastomotic leakage and significantly improve postoperative anal function.

Multicenter real-world study on safety and efficacy of neoadjuvant therapy in combination with immunotherapy for colorectal cancer / 中华胃肠外科杂志

Objective: To provide reference and evidence for clinical application of neoadjuvant immunotherapy in patients with colorectal cancer through multicenter large-scale analysis based on real-world data in China. Methods: This was a retrospective multicenter case series study. From January 2017 to October 2021, data of 94 patients with colorectal cancer who received neoadjuvant immunotherapy in Peking University Cancer Hospital (55 cases), Union Hospital of Tongji Medical College of Huazhong University of Science and Technology (19 cases), Sun Yat-sen University Cancer Center (13 cases) and Changhai Hospital of Navy Medical University (7 cases) were retrospectively collected, including 48 males and 46 females. The median age was 58 years. Eighty-one cases were rectal cancer and 13 cases were colon cancer (2 cases of double primary colon cancer). Twelve cases were TNM staging II and 82 cases were stage III. Forty-six cases were well differentiated, 37 cases were moderately differentiated and 11 cases were poorly differentiated. Twenty-six patients (27.7%) with mismatch repair defects (dMMR) and microsatellite instability (MSI-H) were treated with immunotherapy alone, mainly programmed cell death protein-1 (PD-1); sixty-eight cases (72.3%) with mismatch repair proficient (pMMR) and microsatellite stability (MSS) were treated with immune combined with neoadjuvant therapy, mainly CapeOx (capecitabine+oxaliplatin) combined with PD-1 antibody plus long- or short-course radiotherapy, or PD-1 antibody combined with cytotoxic T lymphocyte associated antigen 4 (CTLA-4) antibody. Analysis and evaluation of adverse events during neoadjuvant immunotherapy were performed according to the National Cancer Institute Common Toxicity Standard version 3.0; the surgical complications were evaluated according to the Clavien-Dindo grading standard; the efficacy evaluation of neoadjuvant immunotherapy included the following indicators: major pathological remission (MPR) was defined as tumor regression induced by neoadjuvant therapy in pathology residual tumor ≤10%; pathological complete response (pCR) was defined as tumor regression induced by neoadjuvant therapy without residual tumor in pathology; the tumor response rate was disease control rate (DCR), namely the proportion of complete response (CR), partial response (PR) and stable disease (SD) in the whole group; the objective response rate (ORR) was CR+PR. Results: The median cycle of neoadjuvant immunotherapy was 4 (1-10) in whole group, and the incidence of immune-related adverse reactions was 37.2% (35/94), including 35 cases (37.2%) of skin-related adverse reactions, 21 cases (22.3%) of thyroid dysfunction and 8 cases (8.5%) of immune enteritis, of which grade III or above accounted for 1.1%. The median interval between completion of neoadjuvant therapy and surgery was 30 (21-55) days. There were 81 cases of radical resection of rectal cancer, 11 cases of radical resection of colon cancer, and 2 cases of colon cancer combined with other organ resection. The primary tumor resection of all the patients reached R0. The incidence of surgical-related complications was 22.3% (21/94), mainly anastomotic leakage (4 cases), pelvic infection (4 cases), abdominal effusion (3 cases), anastomotic stenosis (3 cases ) and abdominal and pelvic hemorrhage (2 cases). Grade I-II complications developed in 13 cases (13.8%), grade III and above complications developed in 8 cases (8.5%), no grade IV or above complications were found. During a median follow-up of 32 (1-46 ) months, DCR was 98.9% (93/94), ORR was 88.3 % (83/94), pCR was 41.5% (39/94), MPR was 60.6% (57/94). The pCR rate of 26 patients with dMMR and MSI-H undergoing simple immunotherapy was 57.7% (15/26), and MPR rate was 65.4% (17/26). The pCR rate of 68 pMMR and MSS patients undergoing combined immunotherapy was 35.3%(24/68), and MPR rate was 58.8% (40/68). Conclusions: Neoadjuvant immunotherapy has favorable tumor control rate and pathological remission rate for patients with initial resectable colorectal cancer. The incidences of perioperative adverse reactions and surgical complications are acceptable.

Two cases of acute chlorfenapyr poisoning and literature review / 中华劳动卫生职业病杂志

In recent years, chlorfenapyr poisoning has gradually increased in clinical practice, but the case fatality rate remains high. At present, the research on its poisoning mechanism and clinical characteristics is limited, and there is no effective treatment. In order to summarize the clinical characteristics of chlorfenapyr poisoning, in order to guide the clinical treatment, this article reported 2 cases of acute chlorfenayr poisoning and 21 cases of literature review, and summarized the clinical characteristics of chlorfenapyr poisoning.Most of the symptoms of gastrointestinal symptoms, profuse sweating, high fever, and changes in consciousness after chlorfenapyr poisoning, and delayed exacerbations are common, which can involve multiple organ systems such as the central nervous system, providing a basis for clinical diagnosis and treatment.

Effect of Three Microbial Fertilizers on Growth，Yield，Quality and Cadmium Accumulation of Chuanxiong Rhizoma / 中国实验方剂学杂志

ObjectiveTo explore the effects of three kinds of microbial fertilizers on the growth， yield， quality， and cadmium （Cd） accumulation of Chuanxiong Rhizoma （CX）. MethodTaking CX seeds as materials， field experiments were carried out in the main producing areas， Pengzhou and Meishan. The samples were collected during the harvesting period， and the agronomic characters and yield were determined. The contents of extract， volatile oil， and ferulic acid were analyzed by the collection method of Chinese Pharmacopoeia （2020 edition）. The content of Cd was determined by inductively coupled plasma-mass spectrometry （ICP-MS）. Data were processed by difference significance analysis， correlation analysis and cluster analysis. ResultThree kinds of microbial fertilizers with appropriate concentrations could promote the growth of CX. In terms of yield and quality， the treatment of Jinwuzong （1.50 ton/hm2， 1 ton=1 000 kg， the same below） and Cuijingyuan （1.5 L·hm-2） could increase the yield of medicinal materials by 0.92%-46.34%， while Cuijingyuan （1.8 L·hm-2） and Shenchu （15， 30 kg·hm-2） could increase the water-soluble extract of CX by 0.06%-18.79%， of which Cuijingyuan （1.8 L·hm-2） was significantly increased （P<0.01）. The alcohol-soluble extract of CX treated with Jinwuzong （0.75， 1.50， 2.25 ton/hm2）， Shenchu （15， 45 kg·hm-2）， and Cuijingyuan （1.2 L·hm-2） decreased significantly by 3.51%-22.94% （P<0.01）. The content of ferulic acid in CX treated with Jinwuzong （1.50 ton/hm2） and Shenchu （30 kg·hm-2） decreased by 2.14%-30.56%. Three kinds of microbial fertilizers had little effect on the content of volatile oil in CX. In the aspect of Cd enrichment， the concentration of Cd in rhizosphere soil of CX was increased by 11.33%-76.36% （P<0.01） after the treatment of Jinwuzong （0.75， 1.50， 2.25 ton/hm2）， Shenchu （15， 30， 45 kg·hm-2） and Cuijingyuan （1.2 L·hm-2）. However， the Cd enrichment coefficient of CX reduced by 2.58%-48.38%， the Cd content and Cd accumulation of CX decreased respectively by 9.54%-25.96% and 9.34%-18.88% via Jinwuzong （0.75 ton/hm2） and Cuijingyuan （1.8 L·hm-2）. ConclusionThree kinds of microbial fertilizers have a certain positive effect on the growth， substance accumulation， and reduction of Cd content in medicinal parts of CX， and the changes of each index are affected by the producing area and treatment method. Based on the comprehensive analysis of various indicators， Jinwuzong （0.75， 1.50 ton/hm2） can better adapt to the rhizosphere soil micro-ecological environment of CX， it can effectively reduce the content of Cd on the premise of guaranteeing the yield and quality of CX.

Comparison of tooth movement and biological response resulting from different force magnitudes combined with osteoperforation in rabbits

Abstract Objective To compare tooth movement rate and histological responses with three different force magnitude designs under osteoperforation in rabbit models. Methodology 48 rabbits were divided into three groups: Group A, Group B, and Group C, with traction force of 50 g, 100 g, 150 g, respectively. Osteoperforation was performed at the mesial of the right mandibular first premolar, the left side was not affected. One mini-screw was inserted into bones between two central incisors. Coil springs were fixed to the first premolars and the mini-screw. Tooth movement distance was calculated, and immunohistochemical staining of PCNA, OCN, VEGF, and TGF-β1 was analyzed. Results The tooth movement distance on the surgical side was larger than the control side in all groups (P<0.01). No significant intergroup difference was observed for the surgical side in tooth movement distance among the three groups (P>0.05). For the control side, tooth movement distance in Group A was significantly smaller than Groups B and C (P<0.001); no significant difference in tooth movement distance between Group B and Group C was observed (P>0.05). On the tension area of the moving premolar, labeling of PCNA, OCN, VEGF and TGF-β1 were confirmed in alveolar bone and periodontal ligament in all groups. PCNA, OCN, VEGF and TGF-β1 on the surgical side was larger than the control side in all groups (P<0.001). Conclusion Osteoperforation could accelerate orthodontic tooth movement rate in rabbits. Fast osteoperforation-assisted tooth movement in rabbits was achieve with light 50 g traction.

Construction and application of recombinant human UDP-glucuronosyltransferases expression systems / 药学学报

In the research and development of new drugs, it is very important to investigate the in vitro metabolism of candidate drugs. Traditional models such as liver microsomes have many limitations, while the in vitro model of recombinant human drug metabolizing enzymes is considered as an important and useful approach because of its convenient access, stable activity and low cost. In this study, six major human UDP-glucuronosyltransferases (UGTs) genes (UGT1A1, 1A3, 1A4, 1A6, 1A9 and 2B7) were cloned from human liver cDNA and heterologously expressed in Saccharomyces cerevisiae and baculovirus-infected insect cell. UGT1A1, 1A3, 1A6 and 1A9 were successfully expressed in yeast and showed glucuronidation activity against a variety of different structural types of substrates, but their activities were low. All six UGTs were successfully expressed and exhibited significantly improved glucuronidation activity when Trichopolusia ni cells BTI-TN5B1-4 (High Five) were used as the host. The recombinant human UGTs expressed in insect cells can catalyze the glucuronidation of their specific substrates, and the glucuronidation products were synthesized at milligram-scale with yields of 13%-66% for the first time, of which the structures were identified via MS, 1H NMR, and 13C NMR spectroscopic analysis. Above all, the recombinant human UGTs yeast and insect cell expression systems constructed in this study can be used for in vitro metabolism evaluation in the early stage of new drugs research and development, and also provide a new tool for the synthesis of glucuronide metabolites.

Soothing moisturizing repair cream in promoting wound repair of acne depressed scar after laser operation: a clinical analysis / 中华医学美学美容杂志

Objective:To investigate the effectiveness and safety of soothing moisturizing repair cream on acne depressed scar exfoliative fractional laser wound repair.Methods:From October 2018 to June 2020, the Department of Dermatology, Qingdao Haici Hospital Affiliated to Qingdao University took 33 patients with acne depressed scars as the research object, including 8 males and 25 females, aged from 20 to 36 years (29.6±8.6) years. The left and right face comparison method was adopted. After laser operation, the trial side was given a soothing moisturizing repair cream, and the control side was given a placebo. By collecting the patient's facial pictures and objective skin data before and after the laser operation, 1 h, 1 d, 3 d, 7 d, 21 d, and combined with the researcher's semi-subjective evaluation and patient's subjective evaluation the wound skin reaction and wound healing were observed.Results:At 1, 3, 7, 21 days after laser operation, the skin water content of the test side was higher than that of the control side ( P<0.05), and the skin water loss was lower than the control side ( P<0.05); at 3, 7, 21 days, the skin pigment of the test side was lower than the control side ( P<0.05); at 3, 7 d, the test side skin erythema index was lower than the control side ( P<0.05); at 1, 3, 7 d, the test side wound skin erythema, edema, dryness and tightness, etc. were better than the control side ( P<0.05). The duration of pain, crusting time, scab removal time, and complete healing time of the wound on the test side were shorter than those on the control side ( P<0.05). The patient's satisfaction with the moisturization and comfort of the nursing products on the trial side was better than that on the control side ( P<0.05). Conclusions:There is no adverse reaction to the soothing moisturizing repair cream after laser surgery, which can better inhibit skin inflammation, reduce post-inflammatory pigmentation, promote skin healing, and help repair the wound after laser surgery.

Research advancement of bone marrow and adipose-derived mesenchymal stem cells in the treatment of eye diseases / 国际眼科杂志(Guoji Yanke Zazhi)

@#Mesenchymal stem cells(MSCs)are multipotent cells with high proliferation ability that can differentiate into a variety of cell types. Thus great plasticity was provided for the regeneration of somatic cells in animal individual growth. Recently, MSCs have been applied to the treatment of traumatic and degenerative diseases on account of its distinct biologic peculiarity. The cells have tremendous potential in the clinical application. This article reviewed clinical treatment of ophthalmic diseases, administration route, methods of acquiring and security about two of MSCs derived from bone marrow and adipose tissue(BMSCs and ADSCs).

Efficacy observation of chiropractic plus foot bath with Chinese medicine for transient synovitis of the hip in children / 针灸推拿医学（英文版）

Objective: To compare the efficacy of different treatment protocols in treating transient synovitis of the hip (TSH) in children and to optimize the clinical treatment strategy for this condition. Methods: Ninety kids with TSH were divided into a control group, a chiropractic group and a chiropractic plus foot bath group using the random number table method, with 30 cases in each group. The control group was treated with conventional traction; the chiropractic group was given chiropractic treatment based on the control group; the chiropractic plus foot bath group was given Chinese medicine foot bath based on the chiropractic group. Traction and foot bath were conducted once daily while chiropractic was done once every other day, all with 14 d as a treatment course for a total of two courses. Changes in the visual analog scale (VAS) score and range of motion (ROM) of the hip joint in the three groups were observed, and the efficacy was compared. Results: The total effective rate was 93.3％ in the chiropractic plus foot bath group, versus 76.7％ in the chiropractic group and 66.7％ in the control group, and the total effective rate was notably higher in the chiropractic plus foot bath group than in the other two groups (both P<0.05). Respectively after the first and second treatment course, the VAS score decreased significantly in each of the three groups compared with that before treatment (all P<0.01), and the ROM of the hip joint in flexion increased significantly (all P<0.01). After two treatment courses, the VAS score was lower in the chiropractic plus foot bath group than in the other two groups (both P<0.05), and its ROM of the hip joint in flexion was larger than that in the other two groups (both P<0.05). Conclusion: Based on traction, chiropractic plus Chinese medicine foot bath can effectively reduce pain and improve motor function of the hip joint in treating TSH.

Self-assembled aggregations in Coptidis Rhizoma decoction dynamically regulate intestinal tissue permeability through Peyer's patch-associated immunity / 中草药·英文版

Objective: To investigate the dynamic regulation of self-assembled aggregations (SAA) in Coptidis Rhizoma decoction on the permeability of intestinal tissue and the mechanism underlying. Methods: The effects of SAA on berberine (Ber) absorption were respectively analyzed in an in situ intestinal perfusion model and in an Ussing Chamber jejunum model with or without Peyer's patches (PPs). The expression levels of ZO-1, Occludin and Claudin-1 were detected by immunofluorescence to evaluate the tight junction (TJ) between intestinal epithelium cells. The expression levels of T-box-containing protein expressed in T cells, signal transducers and activators of tranion-6, retinoic acid receptor-related orphan receptor γt and forkhead box P3 in PPs were detected by the reverse transcription-polymerase chain reaction and the secretions of interferon-γ (IFN-γ), interleukin-4 (IL-4), interleukin-17 (IL-17) and transforming growth factor-β (TGF-β) in PPs were evaluated by immunohistochemistry, to reflect the differentiation of T lymphocyte in PPs to helper T (Th) cell 1, Th2, Th17 and regulatory T (Treg) cell. To confirm the correlation between SAA in Coptidis Rhizoma decoction, PPs-associated immunity and intestinal epithelium permeability, SAA were administrated on an Ussing Chamber jejunum model with immunosuppressed PPs and evaluated its influences on intestinal tissue permeability and TJ proteins expression. Results: SAA in Coptidis Rhizoma decoction could dose-dependently promote Ber absorption in jejunum segment, with the participation of PPs. The dose-dependent and dynamical regulations of SAA on permeability of intestinal tissue and TJ proteins expression level between intestinal epithelium cells occurred along with the dynamically changed T lymphocyte differentiation and immune effectors secretion in PPs. The administration of SAA on immunosuppressed PPs exhibited dose-dependent PPs activation, inducing dynamic promotion on intestinal tissue permeability and inhibition on TJ proteins expression. Conclusion: SAA can improve the Ber absorption in small intestine, through the PPs-associated immunity induced dynamic regulation on intestinal tissue permeability and TJ proteins expression. These findings might enlighten the research of traditional Chinese medicine decoction.

Effects of Arsenic Disulfide Combined with Itraconazole on Proli- feration and Apoptosis and Hedgehog Pathway of Diffuse Large B-Cell Lymphoma Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of arsenic disulfide (AS@*METHODS@#The human DLBCL cell OCI-LY3 was treated with different concentrations of AS@*RESULTS@#The DLBCL cell viability was decreased significantly at 24, 48 or 72 h as cultured with itraconazole. Along with the increasing of itraconazole concentration, the DLBCL cell viability was significantly reduced as compared with that in control group, and the results showed statistically significant(r=-0.690，r=-0.639, r=-0.833, r=-0.808, r=-0.578). The inhibitory and apoptosis rates of the cells were significantly increased as compared with those of the single drug-treated group after treated by the combination of itraconazole and AS@*CONCLUSION@#Itraconazole can inhibit proliferation of DLBCL cells in a concentration-and time-dependent manner. In addition, the combination of AS

The Effect of Novel Phosphodiesterase 4 Inhibitor ZL-n-91 to the Proliferation of Leukemia Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the inhibitory effects of novel phosphodiesterase 4 inhibitor ZL-n-91 to the proliferation of leukemia cells L1210 and K562.@*METHODS@#CCK-8 method was used to detect the effect of ZL-n-91 to the proliferation of L1210 and K562 cells, and the proliferation rate, IC@*RESULTS@#ZL-n-91 showed a significant inhibitory effect to the proliferation of leukemia cells L1210 and K562 in a dose-dependent manner (P<0.001). After treated by ZL-n-91, the leukemia cells L1210 and K562 in the S-phase in cell cycle decreased significantly compared with those in control group (P<0.01). The apoptosis of leukemia cells L1210 and K562 could be induced by ZL-n-91 (P<0.001), and the expression level of apoptosis related protein BAX significantly increased. In the animal experiment, the result showed that ZL-n-91 could significantly inhibit the growth of subcutaneously transplantation tumor (P<0.05).@*CONCLUSION@#The novel phosphodiesterase 4 inhibitor ZL-n-91 can effectively inhibit the proliferation of leukemia cells L1210 and K562, which has the potential of anti-leukemia drug development.

The function and mechanism of long non-coding RNA RP11-159K7.2 in sinonasal squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the role and mechanism of long non-coding RNA RP11-159K7.2 in the progression of sinonasal squamous cell carcinoma (SNSCC). Methods: Sixty-five cases of SNSCC tissues and adjacent tissues were selected from the Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Harbin Medical University from 2009 to 2014. The expression of RP11-159K7.2 in SNSCC and adjacent tissues was detected by RNAscope in situ hybridization to observe its association with prognosis. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR associated proteins 9 (CRISPR/Cas9) was used to knockout the expression of RP11-159K7.2 in RPMI-2650 cells (SNSCC cell line). Cell counting kit-8 (CCK-8), wound healing and Transwell were performed to observe the changes of proliferation, migration and invasion of SNSCC cells in vitro after down-regulation of RP11-159K7.2. Moreover, the growth of xenograft in nude mice after down-regulation of RP11-159K7.2 was examined in vivo. Mechanically, the protein chip, Western blot and RNA immunoprecipitation were performed to identify the proteins bound by RP11-159K7.2. SPSS 17.0 was used for statistical analysis. Results: The expression of RP11-159K7.2 in SNSCC tissue was significantly higher than that in adjacent tissues. RP11-159K7.2 expression was closely related with T grade, nodal metastasis and differentiation of SNSCC (χ2 value was 4.697, 4.235 and 10.753, respectively, all P<0.05). The five-year survival rate of RP11-159K7.2 high expression patients was significantly lower than that of RP11-159K7.2 low expression ones (P=0.013 7). After the down-regulation of RP11-159K7.2, the proliferation, migration and invasion ability of SNSCC cells decreased significantly, and the growth of SNSCC xenograft was significantly inhibited. There were 31 candidate proteins that may bind to RP11-159K7.2. RP11-159K7.2 directly bound to nuclear factor-κB (NF-κB) in SNSCC cells, and the regulation of RP11-159K7.2 on the proliferation and invasion of SNSCC cells depended on NF-κB. Conclusion: The increased expression of RP11-159K7.2 in SNSCC may serve as a potential molecular marker for SNSCC prognosis assessment. It is currently considered that the carcinogenic mechanism of RP11-159K7.2 in SNSCC is related to the regulation of NF-κB protein.

Effect of autoflation on the prognosis of otitis media with effusion in children / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the effect of autoinflation on the prognosis of OME in children. Methods: Total of 325 pediatric patients, age ranged from 3 to 8 years, with OME(486 ears)diagnosed in our department from January 2019 to January 2020 were collected. Among them, 177 were males, 148 were females. Disease course ranged from 25 to 86 days. According to watchful waiting and autoinflation application during follow-up, these children were divided into two groups including 183 cases(271 ears) and 142 cases(215 ears), respectively. The average auditory threshold and tympanogram curve type in two groups were analyzed in the period of 3 months follow-up, and the recovery of OME was evaluated. Results: At the end of 1- and 2- month follow-up, the auditory threshold of patients in autoinflation group was significantly lower than that in watchful waiting group (t=2.139 5 and 2.680 6, P<0.05). However, at the end of 3- month follow-up, there was no significant difference between two groups (t=1.158 5, P>0.05). At the end of 1-, 2- and 3- month follow-up, 89 (33%, 89/271), 200 (74%, 200/271), 220 (81%, 220/271) and 176 (82%, 176/215), 178 (83%, 178/215), 183 (85%, 183/215) ears in watchful waiting group and autoinflation group had a hearing threshold <20 dB HL, respectively, in which ears with auditory threshold<20 dB HL in watchful waiting group were significantly less than those in autoinflation group at the end of 1 and 2 month follow-up (P<0.05), However, ears with auditory threshold<20 dB HL in watchful waiting group were not significantly different from that in the autoflation group at the end of 3- month follow-up (P>0.05). The proportion of ears with type A tympanogram curve was 74%(159/215), 79%(170/215), and 85%(183/215) at the end of 1-, 2- and 3- month follow-up in autoinflation group and 36%(98/271), 71%(192/271) and 76%(206/271) in watchful waiting group, respectively. Proportion of ears with type A tympanogram curve in autoflation group was significantly higher than that in watchful waiting group (P<0.05). Conclusion: Autoinflation can improve the hearing of children with OME in early stage, restore normal middle ear pressure, increase recovery rate, and reduce the choice of surgical treatment of OME.

Several suggestion of operation for colorectal cancer under the outbreak of Corona Virus Disease 19 in China / 中华胃肠外科杂志

Pneumonia caused by SARS-Cov-2 infection has been reported in Wuhan since December 2019, and spread rapidly across the country. The radical operation of colorectal cancer is confine operation. Patients with colorectal cancer should receive operation as soon as possible after elective operation is resumed in each hospital. SARS-Cov-2 virus can be transmitted by asymptomatic infectors, and it has been confirmed to be transmitted by droplets and contact. However, fecal-oral transmission and aerosol transmission have not been excluded. Based onLaparoscopic colorectal operation experiences, the author suggests that the surgery strategy for colorectal cancer patients under the COVID-19 situation. Recommending laparoscopy-assisted radical surgery for colorectal cancer patients. The aerosols need to be strictly managed during operation. NOSES and TaTME should be carried out with cautious during the epidemic period. Protective stoma should be carried out scientifically and reasonably, and the protection of operating room personnel should be strengthened.

Clinical value of plasma presepsin level in early severity evaluation for acute pancreatitis patients / 中华胰腺病杂志

Objective:To investigate the clinical value of plasma presepsin level in early severity evaluation for acute pancreatitis (AP) patients.Methods:The clinical data of 67 patients with AP admitted in Second Affiliated Hospital of Wenzhou Medical University from December 2016 to January 2019 were prospectively selected. The patients were divided into mild AP group (MAP, n=36) and moderately severe and severe AP group (MSAP+ SAP, n=31) according to CTSI and with or without organ dysfunction and local or systemic complications on admission. Another 20 healthy normal subjects were selected as the control group. Plasma presepsin, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), serum amylase and calcium levels were measured within 2 hours, and the APACHEⅡ score was calculated within 24 hours of admission. Receiver operating characteristic curves(ROC) were plotted and the area under the curve (AUC) was calculated to assess the clinical value of presepsin, CRP, PCT, WBC, serum amylase and calcium for predicting the severity of AP patients, respectively. Results:The plasma presepsin level in MAP, MSAP+ SAP and control group was (439.59±74.23)ng/L, (1097.82±93.15)ng/L and (97.31±21.57)ng/L, respectively. Plasma presepsin level in MAP and MSAP+ SAP patients with biliary pancreatitis were obviously higher than those patients with other etiological factors, and plasma presepsin level in MSAP+ SAP patients with hyperlipidemia-associated pancreatitis was significantly higher than those in the MAP group, and the difference was statistically significant ( P<0.05). The AUC of plasma presepsin in the diagnosis of MSAP+ SAP was 0.873(95% CI 0.734-0.922), which was greater than the AUC values of CRP, PCT, WBC and serum calcium; the optimal cut-off value was 951.94 ng/L; the diagnostic sensitivity was 85.6%, which was superior to CRP, PCT, WBC and serum calcium; and the specificity was 76.2%, which was second to 78.9% of serum calcium. Conclusions:Plasma presepsin level can be used as a sensitive indicator for early severity evaluation of AP patients, with a specificity only second to serum calcium.

Clinical value of plasma presepsin level in early severity evaluation for acute pancreatitis patients / 中华胰腺病杂志

Objective@#To investigate the clinical value of plasma presepsin level in early severity evaluation for acute pancreatitis (AP) patients.@*Methods@#The clinical data of 67 patients with AP admitted in Second Affiliated Hospital of Wenzhou Medical University from December 2016 to January 2019 were prospectively selected. The patients were divided into mild AP group (MAP, n=36) and moderately severe and severe AP group (MSAP+ SAP, n=31) according to CTSI and with or without organ dysfunction and local or systemic complications on admission. Another 20 healthy normal subjects were selected as the control group. Plasma presepsin, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), serum amylase and calcium levels were measured within 2 hours, and the APACHEⅡ score was calculated within 24 hours of admission. Receiver operating characteristic curves(ROC) were plotted and the area under the curve (AUC) was calculated to assess the clinical value of presepsin, CRP, PCT, WBC, serum amylase and calcium for predicting the severity of AP patients, respectively.@*Results@#The plasma presepsin level in MAP, MSAP+ SAP and control group was (439.59±74.23)ng/L, (1097.82±93.15)ng/L and (97.31±21.57)ng/L, respectively. Plasma presepsin level in MAP and MSAP+ SAP patients with biliary pancreatitis were obviously higher than those patients with other etiological factors, and plasma presepsin level in MSAP+ SAP patients with hyperlipidemia-associated pancreatitis was significantly higher than those in the MAP group, and the difference was statistically significant (P<0.05). The AUC of plasma presepsin in the diagnosis of MSAP+ SAP was 0.873(95% CI 0.734-0.922), which was greater than the AUC values of CRP, PCT, WBC and serum calcium; the optimal cut-off value was 951.94 ng/L; the diagnostic sensitivity was 85.6%, which was superior to CRP, PCT, WBC and serum calcium; and the specificity was 76.2%, which was second to 78.9% of serum calcium.@*Conclusions@#Plasma presepsin level can be used as a sensitive indicator for early severity evaluation of AP patients, with a specificity only second to serum calcium.

Research progress of the resistance mechanism and reversal strategies of ALK inhibitors in NSCLC / 中国药科大学学报

@#Anaplastic lymphoma kinase (ALK) inhibitors are regarded as effective drugs for the treatment of ALK-positive NSCLC. However,the emergence of drug resistance has limited its further clinical application. This article briefly introduces the resistance mechanism of ALK inhibitors including acquired secondary mutations,gene amplification,bypass signaling pathway activation and reviews the recent advances on the reversal strategies such as drug combination,developing novel PROTACs to overcome drug resistance,so as to provide some reference for the development of ALK inhibitors.

Enhanced recovery after surgery in total laparoscopic radical gastrectomy / 中华普通外科杂志

Objective To investigate the effect of enhanced recovery after surgery (ERAS) on immune function and postoperative recovery in gastric cancer patients undergoing total laparoscopic radical gastrectomy.Methods Patients were randomly divided into ERAS group and control group.Blood CD4 +,CD8+,CD4 + CD25 +,C-reactive protein,postoperative recovery and complications were compared between the two groups.Results On day1,CD4 +,CD8 +,CD4 + CD25 + in the two groups were significantly lower than those before surgery (t =9.070,7.297,5.830,12.870,3.529,10.547,all P＜0.05).The ERAS group had higher CD8 +,CD4 + CD25 + levels than the control group (t =2.163,2.203,P ＜ 0.05).On day3,CD4 + CD25 + in ERAS group was not different from that before surgery (t =1.062,P ＞ 0.05) while the other indexes in the two groups raised but still were lower than preoperative level (t =3.322,5.015,3.418,9.912,all P ＜0.05);CD4 +,CDs +,CD4 + CD25 + in ERAS group were higher than control group (t =2.804,2.040,2.210,all P＜0.05).On day5,CD4+,CD4 + CD25+ in the two groups and CDs+ in ERAS group returned to the preoperative level,while CDs + of the control group was still lower than the preoperative level (t =6.862,P ＜0.05).On day1,3 and 5,the C-reactive protein levels of the two groups were higher than those before surgery(t=-13.338,-13.715,-11.319,-12.286,-13.182,-15.076,all P ＜ 0.05),and ERAS group were lower than the control group (t =-3.246,-2.100,-2.211,all P＜0.05).There was no mortality in neither groups.The time of passage gas by anus,defecation,getting out of bed,oral feeding,and postoperative hospital stay in the ERAS group were less than thoseinthecontrolgroup[(2.8±1.0)dvs.(3.9±0.9)d,t=-5.974;(3.8± 0.9)d vs.(4.3±1.0)d,t=-2.700;(19.1 ±4.0)hvs.(35.9±6.6)h,t=-16.045;(9.9 ±1.6)d vs.(11.5±2.0) d,t =-4.479,all P ＜ 0.05].Conclusions ERAS in the perioperative period of patients with total laparoscopic radical gastrectomy mitigates the stress on the cellular immune system,reduces inflammatory response,and help fast recover the postoperative gastrointestinal function.