Significance of circulating tumor cell monitoring in targeted therapy for gastrointestinal stromal tumors / 中华胃肠外科杂志

Objective: To explore the significance of circulating tumor cell (CTC) monitoring in evaluating the efficacy of targeted therapy for gastrointestinal stromal tumor (GIST). Methods: A prospective cohort study was performed. The data of patients with locally advanced GIST or liver metastasis who were admitted to The Affiliated Hospital of Nantong University from August 2013 to December 2018 were collected. Inclusion criteria: (1) patients aged older than 18 years; (2) patients who were diagnosed with GIST based on pathology; (3) patients without surgery, whose preoperative imaging evaluation of GIST found the violations of the surrounding organs or partial transfer of an estimated difficulty to achieve R0 resection, or the maximum diameter of the tumor > 10 cm, or the liver metastasis, or the expectation of higher risk of surgical complications; (4) patients who were treated with the imatinib 400 mg/d for the first time; (5) Eastern Cooperative Oncology Group (ECOG) score of 0-2. Exclusion criteria: (1) genetic testing revealed a D842V mutation in exon 18 of the PDGFRA gene; (2) alanine aminotransferase and/or aspartate aminotransferase > 2.5 times the normal upper limit; (3) serum total bilirubin >1.5 times of normal upper limit; (4) neutrophil count < 1.5×10(9)/L, or platelet count < 75×10(9)/L, or hemoglobin < 60 g/L; (5) creatinine > normal upper limit; (6) patients had serious cardiovascular and cerebrovascular diseases within 12 months before enrollment; (7) female patients were pregnant or lactating; (8) patients suffered from other serious acute and chronic physical or mental problems, and were not suitable for participating in this study judged by researchers. The patients who could not tolerate treatment regimen, or developed serious adverse reactions and did not follow the medication scheme after enrollment were excluded. Before imatinib treatment and 1-month and 2-month after treatment, quantitative PCR was used to detect the DOG-1 expression of monocytes in peripheral blood, and the ratio of DOG-1/β-actin > 3×10(-5) was used as the CTC positive threshold of GIST. The positive rate of CTC, the efficacy of imatinib treatment (complete response, partial response, stable disease, progressive disease, and occurrence of adverse reactions), and the relationship between CTC positive rate and clinicopathological characteristics of patients were analyzed. Furthermore, the ratio of DOG-1 decrease/baseline DOG-1 after 1-month of treatment was used as an indicator to evaluate whether targeted therapy was effective. The receiver operating characteristic (ROC) curve was rendered, and the area under the curve (AUC) was calculated. Results: A total of 68 GIST patients were enrolled in this study, including 39 cases of locally advanced GIST and 29 cases with liver metastases, 32 males and 36 females with the mean age of (51.2±11.8) (range 31 to 74) years. After 2-month of imatinib treatment, 43 cases were evaluated as partial response, 11 cases as stable disease, and 14 cases as progressive disease, with an effective rate of 79.4% (54/68). During the treatment of imatinib, the incidence of grade 3 or higher adverse reactions was 22.1% (15/68), including 12 cases of grade 3 neutropenia and 3 of grade 4 drug eruption, which were all relieved after conservative treatment. The positive rates of CTC in 68 patients before treatment, 1-month and 2-month after treatment were 66.2% (45/68), 41.2% (28/68) and 23.5% (16/68), respectively. The positive rate of CTC was associated with tumor size, liver metastasis, mitotic count and risk level (all P<0.05). By analyzing the effective group and the ineffective group of targeted therapy, it was found that the positive rate of CTC in the effective group showed a decreasing trend, while the positive rate of CTC in the ineffective group showed an increasing trend. The AUC of predicting the efficacy of targeted therapy for GIST was 0.823 by detecting the change trend of CTC 1-month after treatment (P<0.001). When the DOG-1 content decreased by more than 57.5% 1-month after treatment, it can be used as an indicator to judge the effectiveness of the treatment, whose sensitivity was 72.2% and specificity was 100%. Conclusion: The detection of peripheral blood CTC can evaluate the efficacy of targeted therapy in GIST patients and can provide decision-making basis for further clinical treatment.

Relationship between obstructive sleep apnea hypopnea syndrome and inflammation in children / 解放军医学杂志

Objective To investigate the clinical efficacy of anti-inflammatory therapy (intranasal corticosteroids combined with oral leukotriene receptor antagonist) in pediatric mild to moderate obstructive sleep apnea hypopnea syndrome (OSAHS),and analyze the relationship between OSAHS and inflammation factors.Methods Fifty patients with mild to moderate OSAHS,diagnosed by polysomnography (PSG) during Jan.to Nov.2016,were enrolled in present study.The patients' medical history,data of special physical examination,paryngorhinoscopy,PSG and OSA-18 questionnaire were collected.Patients received the therapy of intranasal corticosteroids combined with oral leukotriene receptor antagonist for 12 weeks.Special physical examination,paryngorhinoscopy,PSG and OSA-18 questionnaire were reviewed and the data before and after treatment were compared.Results Of the 50 subjects,37 were with mild OSAHS and 13 with moderate OSAHS.A total of 19 cases (38％) were cured including 17 mild OSAHS and 2 moderate cases.Other 19 cases (38％) got therapeutic effect but not be cured.Twelve cases (24％) were invalid or aggravated.There were 10 patients (20％) who received surgical treatment after drug treatment.The average values of obstructive apnea index (OAI) and mixed apnea index (MAI) decreased significantly in mild group and only OAI decreased in moderate group.After treatment,the average volumes of adenoids and tonsils were significantly reduced in mild OSAHS children but not in moderate OSAHS children.The OSA-18 questionnaire score declined only in mild group.No obvious correlation existed between the change of tonsil volume and the parameters of PSG.Conclusion Anti-inflammatory therapy of intranasal corticosteroids combined with oral leukotriene receptor antagonist may obviously reduce the volumes of adenoids and tonsils,improve the PSG indexes and the life quality of OSAHS patients,especially for those children with mild OSAHS.

Studies on the chemical constituents of Cirsium japonicum DC / 药学学报

<p><b>AIM</b>In order to look for new bioactive compounds, investigation on the chemical constituents, especially on the typical polyacetylenes from the rhizomes of Cirsium japonicum DC. was carried out.</p><p><b>METHODS</b>Chromatographic techniques including silica column chromatography and preparative silica thin-layer chromatography were used to separate and purify the constituents. Their structures were elucidated by physicochemical properties and spectral analyses including UV, IR, 1HNMR, 13CNMR, HMQC, HMBC and HREIMS.</p><p><b>RESULTS</b>Twelve compounds were isolated from the rhizomes of Cirsium japonicum DC., and their structures were identified as cis-8, 9-epoxy-heptadeca-1-ene-11, 13-diyne-10-ol (1), ciryneol A (2), 8,9,10-triacetoxyheptadeca-1-ene-11,13-diyne (3), ciryneone F (4), cireneol G (5), ciryneol H (6), ciryneol C (7), p-coumaric acid (8), syringin (9), linarin (10), beta-sitosterol (11) and daucosterol (12).</p><p><b>CONCLUSION</b>Compounds 4, 5 and 6 are new compounds, compound 3 is a new natural product and compound 8 was isolated from this plant for the first time.</p>

Effect of electroacupuncture on vascular dementia and AVP in brain of rats / 中国康复理论与实践

@#ObjectiveTo probe the effect of the electroacupuncture on vascular dementia(VD) and content of arginine vasopressin(AVP) in brain of rats. Methods30 Sprague Dawley rats were made renal hypertension(RHR) by the kidney arteries pinched with silver clip.After 42 days, their bilateral common carotid arteries were blocked repeatedly to cause cerebral ischemia.The Hypertension Vascular Dementia model was made. Then they were divided into model group,electroacupuncture group and medicine group(Dihydroergotoxine,DHET) with 10 in each group. The course was 28 days. The ability of learning and memorizing was observed by water maze, and the content of AVP in brain was detected after treatment. ResultsThe latent period of the electroacupuncture group and medicine group was shorter than that of the model group(P<0.05-0.005), and that of the electroacupuncture group was shorter than medicine group(P<0.05-0.005). In frontal lobe, the contents of AVP in the electroacupuncture and medicine groups were higher than that of model group( P<0.01,P<0.05), and the electroacupuncture group was higher than medicine group in striatum (P<0.05). Conclusions It indicated that electroacupuncture therapy can promote the ability of learning and memorizing and enhance the content of AVP in the brain of VD rats. It's therapeutic effect is better than that of DHET.

RELATIONSHIP BETWEEN GALLBLADDER STONE AND LIPOROGLUCOSE METABOLISM XU / 中国普外基础与临床杂志

Objective　To study the effects of glucose and lipid metabolism on gallstone formation. Methods　Twenty five patients with gallstones and 25 normal volunteer controls were studied from January to April in 1998. The patients were well matched the control with sex and age (1∶1). In the study, Body Mass Index (BMI) and Waist-to-Hip circumference ratio (W/H) were measured. Blood glucose, glucosylated hemoglobin (HbA1C), insulin, C peptide and all parameters of lipids were detected at fasting state. The glucose,insulin, C peptide were detected again at 2-hour after taking 75g glucose orally. Results　The result showed there was no difference on BMI and W/H between the patients and controls. HbA1C、mean fasting and 2-hour glucose concentration were not in significantly different between the two groups (P>0.05, P>0.2, P>0.1 respectively). There were 10 patients with abnormal glucose metabolism (7 with NIDDM, 3 with IGT), but only 4 controls were abnoumal (one with NIDDM, three with IGT). The difference was significant (P<0.05). Furthermore, the mean fasting and 2-hour insulin concentration of gallstone group was higher than that of the control (P<0.02, P<0.05). And the gallstone group had a higher fasting C peptide concentration than control (P<0.05). There was no statistical difference on the parameters of plasma lipid between the tow groups. Conclusion　The study suggests that diabetes mellious and hyperinsulinemia acted as an important role on gallstone formation.