Effect of neoadjuvant chemotherapy on the safety of laparoscopic D 2 radical resection and prognosis of patients with locally advanced gastric cancer / 中华消化外科杂志

Objective:To investigate the effect of neoadjuvant chemotherapy on the safety of laparoscopic D 2 radical resection and prognosis of patients with locally advanced gastric cancer. Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 351 patients with locally advanced gastric cancer who underwent laparos-copic D 2 radical resection in the Second Affiliated Hospital of Air Force Medical University from December 2016 to December 2021 were collected. There were 256 males and 95 females, aged (58±9)years. Of the 351 patients, 124 cases undergoing neoadjuvant chemotherapy were divided into the neoadjuvant chemotherapy group, 227 patients undergoing postoperative adjuvant chemotherapy were divided into the adjuvant chemotherapy group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) effect evaluation of neoadjuvant chemotherapy; (3) intraoperative and postoperative situations; (4) postoperative histopathological examinations; (5) follow-up. Propensity score matching was done by the 1∶1 nearest neighbor matching method. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measure-ment data with skewed distribution were represented as M(range) or M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to draw survival curves, and the Log-Rank test was used for survival analysis. Results:(1) Propensity score matching conditions and comparison of general data of patients between the two groups of patients after matching. Of 351 patients, 154 cases were successfully matched, including 77 cases in the neoadjuvant chemotherapy group and 77 cases in the adjuvant chemotherapy group. The elimination of gender, age, preoperative body mass index, clinical T staging and clinical N staging confounding bias ensured comparability between the two groups after propensity score matching. (2) Effect evaluation of neoadjuvant chemotherapy. Of the 77 patients receiving neoadjuvant chemotherapy, none of patient achieved complete response, 26 patients achieved partial response, 46 patients showed stable disease, 5 patients had progression of disease, showing the objective response rate as 33.8%(26/77) and the disease control rate as 93.5%(72/77). There were 15 males and 11 females sensitive to neoadjuvant chemotherapy, while 46 males and 5 females not sensitive, showing a significant difference between them ( χ2=11.05, P<0.05). (3) Intra-operative and postoperative situations. The operation time, volume of intraoperative blood loss, cases with intraoperative blood transfusion, time to postoperative first flatus, time to postoperative first liquid food intake, duration of postoperative hospital stay, cases with postoperative immediate complications, cost of hospital stay were (308±71)minutes, 100(range, 20?600)mL, 5, 3.0(range, 2.0?10.0)days, 4.0(range, 2.0?12.0)days, 9.0(range, 4.0?31.0)days, 7, 7.96(7.37,8.58) ten thousand yuan in patients of the neoadjuvant chemotherapy group, versus (296±67)minutes, 100(range, 20?500)mL, 4, 3.5(range, 1.0?14.0)days, 4.0(range, 2.0?15.0)days, 8.0(range, 5.0?45.0)days, 11, 8.18(7.52,9.19) ten thousand yuan in patients of the adjuvant chemotherapy group, showing no signifi-cant difference in the above indicators between the two groups ( t=1.13, Z=?0.37, χ2=0.12, Z=?1.26, ?0.33, ?0.70, χ2=1.01, Z=?1.04, P>0.05). (4) Postoperative histopathological examinations. Results of postoperative histopatho-logical examinations showed that all 154 patients achieving R 0 resection. Cases with pathological T staging as stage T1, stage T2, stage T3, stage T4, cases with pathological N staging as stage N0, stage N1, stage N2, stage N3, number of positive lymph nodes, cases with human epidermal growth factor receptor 2 (negative, positive) were 3, 7, 5, 62, 27, 19, 19, 12, 1(range, 0?28), 59, 18 in patients of the neoadjuvant chemotherapy group, versus 0, 0, 2, 75, 17, 15, 21, 24, 3(range, 0?31), 44, 33 in patients of the adjuvant chemotherapy group, showing significant differences in the above indicators between the two groups ( Z=?3.39, ?2.55, ?3.12, χ2=6.60, P<0.05). (5) Follow-up. Of the 154 patients, 143 patients were followed up for 37(range, 5?69)months. The 3-year overall survival rate and 3-year disease-free survival rate was 72.1% and 70.0%, respectively, in patients of the neoadjuvant chemotherapy group, versus 74.8% and 76.6% in patients of the adjuvant chemo-therapy group, showing no significant difference in the above indicators between the two groups ( χ2=0.14, 0.60, P>0.05). Conclusions:Compared to postoperative adjuvant chemotherapy, neoadjuvant chemotherapy does not bring additional surgical risks, but can reduce the tumor stage of patients who underwent laparoscopic D 2 radical resection for locally advanced gastric cancer. However, it does not show any advantage in improving survival of patients.

Analysis of operator learning curve of prostatic artery embolization for prostatic hyperplasia / 中国介入影像与治疗学

Objective To: analyze the operator learning curve of prostatic artery embolization (PAE) in treatment of prostatic hyperplasia (PH). Methods: Data of the first to 60th PH patients treated with PAE by the same operator having more than 5 years' experiences of peripheral vascular interventional therapy were retrospectively analyzed. The patients were divided into groups A, B and C according to the treatment order (each n=20). PAE operation time, intraoperative X-ray exposure time and post-operation hospitalization were compared among groups. International prostate symptom score (IPSS) and quality of life score (QOL), prostate volume, maximum flow rate (Qmax) and post void residual (PVR) before and after operation were analyzed. Results: There was no statistical difference of prostate volume, IPSS score, QOL score, Qmax nor PVR among three groups before PAE (all P>0.05).There were significantly statistical differences of operation time and intraoperative X-ray exposure time (F=32.74, 13.57, both P<0.01) among 3 groups. Pairwise comparison showed the operation time and intraoperative X-ray exposure time in group A were significantly longer than those in group B (both P<0.01) and group C (both P<0.01), while the differences between group B and C were not statistical (P=0.22, 0.30). No statistical difference of post-operation hospitalization was found among 3 groups (F=0.17, P=0.84). Three months after PAE, IPSS score (t=14.66, 11.74, 29.02), QOL score (t=8.51, 8.19, 7.99), PVR (t=11.68, 12.71, 16.80) and prostate volume (t=14.75, 17.45, 27.42) decreased compared with those before operation in all 3 groups (all P<0.01), and Qmax (t=-11.72, -10.80, -7.74) also statistically increased (all P<0.01). Conclusion: PAE is effective for PH in short-term. After accumulating 20 cases of PAE operation experience, the operation time and X-ray exposure are significantly shortened, and the learning curve turn to the plateau stage.

Clinical application of interventional therapy for hemorrhage after pancreaticoduodenectomy / 介入放射学杂志

Objective To discuss the angiographic manifestations of hemorrhage after pancreaticoduo-denectomy (PD), and to evaluate the clinical curative effect of interventional therapy. Methods The angiographic findings and the therapeutic effect of interventional therapy for hemorrhage after PD in 19 PD patients, who were admitted to Fujian Provincial Hospital, China, during the period from January 2014 to February 2018 to receive DSA examination and interventional therapy, were retrospectively analyzed. Results Among the 19 PD patients, DSA examination showed that extravasation of contrast medium, pseudoaneurysm formation and irregular arterial lumen were observed in 16 patients, the rate of positive signs was 84.2％ (16/19) . All the 16 patients, who had positive DSA findings, received covered-stent implantation or embolization therapy for the responsible artery, except one patient who had hemorrhage from the branch of superior mesenteric artery and the super-selective catheterization for him failed. The technical success rate was 93.8％ (15/16) . Successful hemostasis was achieved in 13 patients (86.7％, 13/15) . Two patients developed recurrent bleeding and were transferred to surgical treatment. Two patients received twice angiography, the resultsshowed that pseudoaneurysm formation of gastroduodenal artery was detected in one patient, which was treated with embolization therapy, and in another patient angiography was normal and this patient was transferred to surgical treatment. Conclusion For postoperative hemorrhage of PD, DSA has diagnostic value, while interventional therapy has therapeutic value. The techniques are minimally-invasive and highlyeffective. Therefore, it is worthy of clinical popularization and application.

Effect of bendamustine plus rituximab on relapsed extragastric mucosa-associated lymphoid tissue lymphoma / 白血病·淋巴瘤

Objective To investigate the rituximab plus bendamustine (R-Benda) therapeutic effect for relapsed extragastric mucosa-associated lymphoid tissue (MALT) lymphoma.Methods Ten patients (three females and seven males) with relapsed extragastric MALT lymphoma undergoing therapy with R-Benda were defined.Bendamustine was given at a dose of 90 mg/m2 on days 2 and 3 in nine patients and at 70 mg/m2 in one patient, while all received 375 mg/m2 rituximab on day 1.Results Nine patients received six courses of therapy,while one patient discontinued therapy after five courses for personal reasons, while one elderly patient had progressive disease after three courses.Tolerance of therapy was excellent, and all except one patient responded.Eight patients achieved the complete remission, one achieved the partial remission, and one patient progressed.Toxicities were mild and mainly hematological.After a median follow-up of 24 months (range, 5-43 months), 9 patients were alive.Conclusion R-Benda regime has high activity and good tolerance for patients with relapsed extragastric MALT lymphoma.

Effect of different radiation doses on intestinal mitochondria in Tibet minipigs / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the injuries of intestinal mitochondria induced by different doses of whole-body radiation in Tibet minipigs.</p><p><b>METHODS</b>Eighteen Tibet minipigs were randomized into 5 radiation groups (n=3) and a control group (n=3). The minipigs in the radiation groups were subject to a total body X-ray radiation at 2, 5, 8, 11, or 14 Gy, and 72 h after the exposure, the mRNA expressions of the intestinal mitochondrial genes were examined using RT-PCR. The changes in the respiratory chain complexes I-IV and the respiratory functions of succinate and NADH were assayed, and the intestinal ultrastructures were observed using transmission electron microscopy (TEM) following the exposures.</p><p><b>RESULTS</b>Compared with those in the control group, the expression levels of the related mitochondrial genes, the activities of the respiratory chain complexes and the function of the respiratory chain were significantly lowered in the radiation groups. At the doses below 8 Gy, the exposures caused significant reduction in the measurements as the radiation doses increased, but at higher doses, these measurements showed no further reductions. Ultrastructurally, exposures at 2 and 5 Gy caused mitochondrial expansion and mild reduction of the density, whereas radiation at 8 Gy or greater resulted in vacuolar changes and obvious expansion of the mitochondria with damages of the mitochondrial cristae and membranes.</p><p><b>CONCLUSION</b>Below the doses of 8 Gy, intestinal mitochondrial damages in the minipigs increase with the radiation dose, but at higher doses, the damages do not further increase with the radiation dose.</p>

Distribution and antimicrobial activity of marine actinomycetes in Jiaozhou Bay / 中国海洋药物

Objective To study the distribution and antimicrobial activity of marine actinomycetes from Jiaozhou Bay and to estimate its application potentials.Methods The strains were isolated using gradient dilution and streak plate techniques and the activity was determined by Oxford cup method and paper disk method.Results 516 strains of marine actinomycetes were isolated from various places along Jiaozhou Bay;The rates of active strains determined by both methods were 22.3% and 50.0%,respectively.Conclusion The estuary was rich in marine actinomycetes resources; paper disk method was a better method in screening active strains of marine actinomycetes.The results from both determination methods showed a good exploitability of the marine actinomycets from Jiaozhou Bay.