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Objective:To explore the regulation effect and possible mechanism of transcutaneous electrical acustimulation (TEA) on the improvement of gastrointestinal motility and inflammation in patients with acute pancreatitis (AP).Methods:A randomized, single-blinded, sham-controlled study was performed. A total of 62 AP patients were randomly divided into the TEA group ( n=31) and sham-TEA group ( n=31), on the basis of regular treatment, who received TEA treatment at Neiguan (PC6) and Zusanli (ST36) or sham-TEA treatment at corresponding pseudo stimulation acupoints for 2 days. Abdominal distension score, time to first defecation, gastric slow wave, heart rate variability (low frequency and high frequency, reflecting sympathetic and vagal activity, respectively), serum level of tumor tecrosis factor (TNF)-α, plasma levels of motilin, ghrelin and vasoactive intestinal peptide(VIP) tested by enzyme linked immunosorbent assay were compared before and after the treatment. Wilcoxon rank test, Mann-Whitney U test, t-test and two factor repeated measurement analysis of variance were used for statistical analysis. Results:After the treatment, abdominal distension score of TEA group was lower than that of sham-TEA group(1 (0 to 2) vs.5(3 to 6)) and time to first defecation was earlier than that of sham-TEA group((55.00±24.27) h vs.(67.95±23.84) h), the percentage of normal gastric slow wave was higher than that of sham-TEA group((57.42±11.16)% vs. (40.92±8.52)%), and the differences were statistically significant ( Z=-4.95、 t=-2.12、 F=61.53, all P<0.05). After the treatment, the serum level of TNF-α of TEA group was significantly lower than that of sham-TEA group((4.27±1.28) ng/L vs.(6.19±2.03) ng/L), and the difference was statistically significant ( F=28.65, P<0.05). The ratio of post/pre-treatment of low frequency heart rate variability of the TEA group was significantly lower than that of sham-TEA group, however, the result of high frequency was opposite (0.87±0.18 vs.1.14±0.16, 1.19±0.18 vs.0.96±0.13), and the differences were statistically significant ( t=-6.22 and 5.74, both P<0.05). After the treatment, the plasma level of ghrelin of TEA group was higher than that of sham-TEA group ((2.02±0.62) μg/L vs. (0.93±0.49) μg/L), the VIP level was lower than of sham-TEA group ((30.58±12.20) μg/L vs.(44.35±29.52) μg/L), and the differences were statistically significant ( F=59.22 and 5.50, both P<0.05). However, there was no significant difference in motilin levels between two groups ((24.57±9.58) ng/L vs. (22.75±9.58) ng/L, P>0.05). Conclusion:TEA treatment can improve gastrointestinal motility and inhibit the inflammation in early AP, which may be related with the regulation of autonomic function, gastrointestinal hormone ghrelin and VIP.
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Objective To investigate the influence of the concept of collaborative innovation on the construction of a scientific research system for regional liver pathology center from multiple perspectives, and to explore its application significance. Methods A total of 1246 liver biopsy specimens which were examined in Department of Pathology in Wuxi Second People's Hospital and Wuxi Fifth People's Hospital from January 2014 to September 2020 were collected, among which the specimens examined before the founding of the regional liver pathology center were collected as nI group, and those examined after the founding of the center were collected as nII group. According to the examination time of the first, second, or third year after founding, the nII group was further divided into nIIa group, nIIb group, and nIIc group. A multi-perspective analysis was performed based on five indices, i.e., number of liver biopsy specimens, growth rate of liver biopsy specimens, growth rate of internal collaborative departments, growth rate of external collaborative units, and evaluation of the collaborative and innovative scientific research system. Results The growth rate of liver biopsy specimens in the nI group was 15.51%; after the founding of the regional liver pathology center, the highest growth rate of 187.76% was observed in the nIIa group, and a relatively stable growth rate of 76.35% was observed in the nIIb group. There was a gradual increase in the number of specimens in internal collaborative departments, with a growth rate of 50% in the nIIa group and 83.33% in the nIIb group, while the number of external collaborative units increased steadily, with a growth rate of 100% in the nIIa group and 50% in the nIIb group. The nII group showed a diversified increasing trend in the evaluation indices of the scientific research system. Conclusion It is a new perspective for the construction of regional disciplinary scientific research system to grasp the opportunity of policy-supported development and innovate the effective cooperation mode between internal departments and external units under the concept of collaborative innovation.
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The incidence of pancreatic cancer is increasing year by year, but the clinical diagnosis and treatment progress is limited and the prognosis is poor. Tumor microenvironment (TME) is closely related to the invasion, metastasis and chemotherapy resistance of pancreatic cancer. Cancer-associated fibroblasts (CAFs) are fibroblasts in a state of continuous activation, which are the most prominent components in TME. CAFs can promote the malignant biological behavior of pancreatic cancer through a variety of molecule-mediated mechanisms. Moreover, several attempts targeting CAFs for the treatment of pancreatic cancer have been largely unsuccessful. It may be related to the heterogeneity of CAFs in pancreatic cancer. Therefore, in-depth study of its heterogeneity and accurate targeting of some specific phenotypes and functional CAFs subtypes in the matrix on this basis may be more promising in the clinical treatment of pancreatic cancer.
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Objective:To investigate the indication of pre-cut-endoscopic mucosal resection (pre-cut-EMR) on the treatment of colorectal laterally spreading tumors (LSTs).Methods:A retrospective study was performed on data of colorectal LSTs patients, who underwent pre-cut-EMR in Wuxi Second People’s Hospital and Zhongshan Hospital from January 2014 to June 2019. The relationships between the clinical characteristics of the lesions and the success rate and complications of pre-cut-EMR were analyzed.Results:Data of 132 colorectal LSTs cases were included in the study. Morphology of 29 (22.0%) LSTs were homogeneous granular type, 43 (32.6%) LSTs were mixed non-granular type, 58 (43.9%) LSTs were flat elevated type, and 2 (1.5%) LSTs were pseudo-depressed type. The diameter of lesions was 2.3±1.5 cm (ranged from 2.0 cm to 5.0 cm). Among the 132 LSTs, 36 (27.3%) tumors were located in rectum, 15 (11.4%) in sigmoid colon, 10 (7.6%) in descending colon, 17 (12.9%) in splenic flexure of colon, 21 (15.9%) in transverse colon, 24 (18.2%) in hepatic flexure of colon, 6 (4.5%) in ascending colon, and 3 (2.3%) in cecum. The histopathological diagnoses of the 132 LSTs included low grade intraepithelial neoplasia in 58 cases (43.9%), high grade intraepithelial neoplasia in 69 cases (52.3%), intramucosal carcinoma in 2 cases (1.5%), and canceration in 3 cases (2.3%). Pre-cut-EMR was achieved in all 132 patients, and the operation time was 25.3±13.6 min (ranged 20-65 min). The rate of en bloc resection and complete resection were 95.5% (126/132) and 100.0% (132/132), respectively. Two cases (1.5%) had intraoperative perforation, and were both located in the sigmoid colon with the diameter of 4.0 cm and 4.5 cm, respectively. Twelve cases (9.0%) had immediate bleeding during operation, and 2 cases (1.5%) had delayed bleeding after operation. Patients had been followed up for 6-24 months, the wound healed well after operation, and no local recurrence was found.Conclusion:Pre-cut-EMR is an effective and safe therapy for colorectal LSTs with diameter less than 4.0 cm.
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Objective To explore the level of the oxidative stress and the DNA oxidative damage of peripheral blood mononuclear cells (PBMCs) in pulmonary embolism (PE) patients after remission and in acute exacerbation.Methods The PBMCs DNA damage in 35 PE patients (test group) after remission and in acute exacerbation respectively and in 33 healthy persons (control group) was detected by single-cell gel electrophoresissingle (Comet assay).The total antioxidative capacity (TAC) in blood plasma was measured by phenanthroline colorimetric analysis.The contents of malondialdehyde (MDA) in blood plasma was measured by thiobarbituricacid colorimetric analysis.The capacity of glutathion peroxidase (GSH-PX) in blood plasma was measured by the method of improved Hafeman direct determination method (DNTB).Results The level of TAC,GSH-PX in test group after remission were significantly higher than those in acute exacerbation[(6.86 ± 1.21) kU/L vs.(5.18 ± 1.13) kU/L,(165.25 ± 41.96) kU/L vs.(137.23 ± 38.52) kU/L] (P ＜0.01),and they were all significantly lower than those in control group [(7.85 ± 1.44),(189.92 ± 51.32) kU/L] (P ＜ 0.01).The level of MDA in test group after remission was significantly lower than that in acute exacerbation [(5.58 ± 1.89) μmol/L vs.(7.26 ± 2.25) μmol/L] (P ＜ 0.01),and they were significantly higher than that in control group [(3.71 ± 1.52) μmol/L] (P ＜ 0.01).The arbitrary units (AU) of PBMCs DNA damage in PE patients after remission (29.01 ± 6.75) was significantly lower than that in acute exacerbation (42.13 ± 8.01),and they were all significantly higher than that in control group (15.12 ± 4.36),there were significant differences (P＜ 0.01).There were negative correlations between the PBMCs DNA damage and the level of TAC in PE patients after remission and in acute exacerbation (r =-0.695,P ＜ 0.01 ;r =-0.536,P ＜ 0.01).There were positive correlations between the PBMCs DNA damage and the contents of MDA in PE patients after remission and in acute exacerbation (r =0.513,P ＜ 0.01 ;r =0.628,P ＜ 0.01).There were negative correlations between the level of TAC and the contents of MDA in PE after remission and in acute exacerbation respectively (r =-0.534,P ＜ 0.01 ;r =-0.486,P ＜ 0.05).There were positive correlation between the level of TAC and GSH-PX in PE patients after remission and in acute exacerbation (r =0.512,P ＜ 0.01 ;r =0.497,P ＜ 0.01).Conclusions There are oxidation/antioxidation imbalance,oxidative stress and the PBMCs DNA damage in PE patients.There is positive correlation between the PBMCs DNA damage and the oxidative stress.After remission,the level of the oxidative stress and the PBMCs DNA oxidative damage in the same PE patients is improved respectively.
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ObjectivesTo study the expression of lipoxygenase-12 (12-LOX) in human pancreatic adenocarcinoma and its relationship with the clinicopathological parameters.MethodsExpression of 12-LOX in pancreatic carcinoma tissue,pancreatic cancer cell lines SW1990 and PANC1,and adjacent normal pancreatic tissue was detected by using immunohistochemistry,RT-PCR,and Western blot,respectively.The relationship between 12-LOX expression and clinicopathological parameters was analyzed.ResultsExpression of 12-LOX was negative in 8 cases,weak positive in 7 cases and strong positive in 15 cases of pancreatic carcinoma.The overall positive rate in pancreatic carcinoma was 73.3％.The expressions of 12-LOX mRNA and protein were positive in pancreatic cancer cell lines SW1990 and PANC1,and negative in adjacent normal pancreatic tissue.The strong positive expression of 12-LOX in pancreatic cancer was associated with TNM stage,pathological grade,lymph node metastasis (P ＜ 0.05 ).ConclusionsThe expression of 12-LOX was up-regulated in pancreatic cancer and is correlated well to malignant behaviors of tumor.