A prediction model of pathological complete response in patients with locally advanced rectal cancer after PD-1 antibody combined with total neoadjuvant chemoradiotherapy based on MRI radiomics / 中华胃肠外科杂志

Objective: To construct a prediction model of pathologic complete response (pCR) in locally advanced rectal cancer patients who received programmed cell death protein-1 (PD-1) antibody and total neoadjuvant chemoradiotherapy by using radiomics based on MR imaging data and to investigate its predictive value. Methods: A clinical diagnostic test study was carried out. Clinicopathalogical and radiological data of 38 patients with middle-low rectal cancer who received PD-1 antibody combined with total neoadjuvant chemoradiotherapy and underwent TME surgery from January 2019 to September 2021 in our hospital were retrospectively collected. Among 38 patients, 23 were males and 15 were females with a median age of 68 (47-79) years and 13 (34.2%) a chieved pCR. These 38 patients were stratified and randomly divided into the training group (n=26) and test group (n=12) for modeling. All the patients underwent rectal MRI before treatment. The clinical, imaging and radiomics features of all the patients were collected, and the clinical feature model and radiomics model were constructed. The receiver operating characteristic (ROC) curves of each model were drawn, and the constructed model was evaluated through the area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value and negative predictive value. Results: There were no significant differences in age, gender, primary location of tumor and postoperative pathology between the two groups (all P>0.05). Forty-one features were extracted from region of interest in each modality, including 9 first-order features, 24 gray level co-occurrence matrix features and 8 shape features. From 38 patients, 41 features were extracted from each imaging modality of baseline and preoperative DWI and T2WI images, totally 164 features. Only 4 features were preserved after correlation analysis between each pair of features and t-test between pCR and non-pCR subjects. After LASSO cross validation, only the first-order skewness of the baseline DWI image before treatment and the volume in the baseline T2WI image before treatment were retained. The area under the curve, sensitivity, specificity, positive and negative predictive values of the prediction model established by applying these two features in the training group and the test group were 0.856 and 0.844, 77.8% and 100.0%, 88.2% and 75.0%, 77.8% and 66.7%, 88.2% and 100.0%, respectively. The decision curve analysis of the radiomics model showed that the strategy of this model in predicting pCR was better than that in treating all the patients as pCR and that in treating all the patients as non-pCR. Conclusion: The pCR prediction model for rectal cancer patients receiving PD-1 antibody combined with total neoadjuvant radiochemotherapy based on MRI radiomics has the potential to be used in clinical screening or rectal cancer patients who can be spared from radical surgery.

Digoxin and Tamoxifen synergistically suppress proliferation, migration and invasion in breast cancer MCF-7 cells / 中国药理学通报

Aim To investigate the effect of digoxin combined with tamoxifen on proliferation, migration, invasion of breast cancer MCF-7 cells and the possible underlying mechanism. Methods MTT, colony formation and flow cytometry were used to detect the effect of the combination therapy of tamoxifen and digoxin on proliferation and apoptosis in MCF-7 cells. Wound healing assay and transwell assay were used to detect the effect of the combination therapy of tamoxifen and digoxin on migration and invasion of MCF-7 cells. Western blot was used to detect the effect of the combination therapy of tamoxifen and digoxin on the expression of related proteins in MCF-7 cells. Results MTT, colony formation assay and flow cytometry results showed that digoxin and tamoxifen synergistically inhibited the proliferation and promoted the apoptosis of MCF-7 cells. Wound healing and transwell assay results showed that digoxin and tamoxifen synergistically inhibited the migration and invasion of MCF-7 cells. Western blot results showed that digoxin and tamoxifen synergistically inhibited the expression of PI3K, p-PI3K, p-AKT, Bcl-2, N-cadherin, Vimentin and promoted the expression of Bax, cleaved-caspase-3, cleaved-caspase-9, E-cadherin of MCF-7 cells. Conclusions Digoxin combined with tamoxifen can synergistically inhibit the proliferation, migration, invasion and induce apoptosis of MCF-7 cells, the possible mechanism of which may involve the suppression of PI3K-Akt signaling pathway and epithelial-mesenchy-mal transition (EMT).

Expression of vascular intercellular adhesion molecule-1 and its significance in children with bronchiolitis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the expression of intercellular adhesion molecule-1 (ICAM-1) in serum and induced sputum supernatant in children with bronchiolitis, as well as its role in the pathogenesis of bronchiolitis in children.</p><p><b>METHODS</b>A total of 67 children with bronchiolitis who were diagnosed and hospitalized between July 2015 and January 2017 were enrolled. According to the diagnostic criteria, these children were divided into mild group with 22 children, moderate group with 24 children, and severe group with 21 children. A total of 20 children who underwent physical examination were enrolled as healthy control group. ELISA was used to measure the level of ICAM-1 in serum and induced sputum supernatant in the children with bronchiolitis in the acute stage and recovery stage and the children in the healthy control group.</p><p><b>RESULTS</b>Compared with the healthy control group, the mild, moderate, and severe bronchiolitis groups had a significant increase in the level of ICAM-1 in serum and sputum (P<0.01). Compared with the mild group, the moderate and severe groups had a significant increase in the level of ICAM-1 in serum and sputum (P<0.01). Compared with the moderate group, the severe group had a significant increase in the level of ICAM-1 in serum and sputum (P<0.01). Compared with the children with bronchiolitis in the acute stage, the children in the recovery stage had a significant reduction in the level of ICAM-1 in serum and sputum (P<0.01). The correlation analysis showed that in the acute stage, the level of ICAM-1 in serum was positively correlated with that in sputum in children with bronchiolitis (r=0.875, P<0.001).</p><p><b>CONCLUSIONS</b>ICAM-1 is involved in the pathogenesis of bronchiolitis and is associated with disease severity.</p>

Treatment of complex fracture--dislocation of elbow with external fixator with joint and limited internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the method and the effect of external fixator and limited internal fixation with joint applied for complex fracture-dislocation of elbow.</p><p><b>METHODS</b>From Mar. 2005 to Mar. 2008, 17 patients with complex fracture-dislocation of elbow were treated with external fixator with joint and limited internal fixation. Nine of them were on the left side and 8 on the right side. There were 11 males and 6 females. The age was from 21 to 57 years with an average of 37 years. The clinical effects were evaluated according to Mayo scoring of elbow joint function (including pain, rang of motion, joint stability and so on).</p><p><b>RESULTS</b>All patients were followed up from 5 to 10 months with an average of 8 months. The mean mayo score was 82 +/- 10 (62-96). The results were excellent in 7 cases, good in 7, fair in 3.</p><p><b>CONCLUSION</b>The technique of external fixator with joint and limited internal fixation for complex fracture-dislocation of elbow can restore anatomical articular surface with advantage of early functional training which can decrease the occurrence of elbow stiff and soft tissue contracture. It is a satisfactory method in treating complex fracture-dislocation of elbow.</p>

Relationship between serosal invasion types and lymph node metastasis after total gastrectomy in gastric cancer and its significance in selection of rational dissection / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between serosal invasion types and lymph node metastasis after total gastrectomy in gastric cancer patients, and explore its significance in planning practice rational dissection based on the serosa types of gastric cancer during surgery.</p><p><b>METHODS</b>A total of 73 gastric cancer patients, who underwent total gastrectomy and lymph node dissection, were included in this study, and their clinicopathological data were analyzed. The serosa of gastric cancer was divided into five types: normal, reactive, nodular, tendonoid, and color-diffused, then they were combined into 3 groups: group 1: normal and reactive, group 2: nodular (including protruding nodular and flat nodular), and group 3: tendonoid and color-diffused. The lymph node metastasis ratios in the 3 groups were compared. The lymph nodes in each of the 3 groups were divided into 16 subgroups and the lymph node metastasis ratios of each subgroup in the 3 groups were compared and analyzed.</p><p><b>RESULTS</b>The lymph node metastasis ratio of the gastric cancer with normal and reactive type serosa was 5.3% (26/492), the nodular was 37.1% (250/673), the tendonoid and color-diffused was 50.0% (486/972). The lymph node metastasis ratio of normal and reactive type groups was the lowest, that of the tendonoid and color-diffused groups was the highest, and the nodular type in between, showing a statistically significant difference (P<0.01). The results of comparing the lymph node metastasis ratios from the 1st to 16th subgroup in the 3 groups showed the same trend (P<0.05).</p><p><b>CONCLUSION</b>Among all serosa types of gastric cancer, the lymph node metastasis ratio of the tendonoid and color-diffused is the highest, the normal and reactive type is the lowest, and the nodular in between. The extent of rational dissection should be carried out on the basis of serosa types of gastric cancer during surgery. An extended dissection including D2 and D3 lymphadenectomy should be performed for the patients with tendonoid and color-diffused serosa, a rational decreased operation including D1-D1+ lymphadenectomy should be performed for those with a normal and reactive type serosa, and for the patients with nodular type serosa, we suggest performing standard D2 dissection.</p>

Features of metastasis in different lymph node groups and their significance in lymph node dissection in total gastrectomy for gastric cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To summarize the features of metastasis in different lymph node groups (from 1 to 16 groups) in gastric cancer patients treated by total gastrectomy, and evaluate their clinical significance in lymph node dissection.</p><p><b>METHODS</b>The data of 73 gastric cancer patients with total gastrectomy and lymph node dissection from January 2004 to April 2006 were analyzed retrospectively. The lymph nodes were divided into 16 groups according to the 13(th) edition of gastric cancer treatment guideline of JGCA (The Japan Gastric Cancer Association). The metastatic rate and degree of dissected lymph nodes in these patients were compared.</p><p><b>RESULTS</b>The metastatic rates of lymph node groups in these patients from lower to higher were as follows: group 15, 13/16, 14v, 12, 10, 9, 11, 8, 2, 6/7, 5, 1, 4, 3. The lowest was the 15(th) group lymph nodes (1.4%), the highest was the 3rd group (65.8%), with a statistically significant difference between those two groups (P < 0.01). The metastatic degrees of the lymph node groups from lower to higher were as follows: 13, 16, 1, 7, 6, 5, 12, 4, 11, 8, 2, 15, 9, 3, 10, 14v. There was a statistically significant difference between the lowest group of lymph node (13(th) group, 10.7%) and the highest (14v(th), 56.3%, P < 0.01).</p><p><b>CONCLUSION</b>In the radical total gastrectomy for patients with gastric cancer, it is suggested that the regional lymph nodes with higher metastatic rate should be resected necessarily, and the group with a higher metastatic degree should be dissected completely. If the result of sentinel lymph node biopsy in the 3(rd) or 14v(th) group is negative, the operation extent can be reduced. If positive, it should be extended. When the biopsy result in the 13(th) or 16(th) is positive, palliative operation may be indicated. However, if the biopsy result is negative in the 13(th) or 16(th), but positive in the 14v(th) group, extended operation is indicated.</p>

Nuclear factor-kappaB expression in peripheral blood polymorphonuclear leukocytes of patients with acute pancreatitis and the preventive effectiveness of pyrrolidine dithiocarbamate on NF-kappaB in vitro / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of NF-kappaB in peripheral blood polymorphonuclear leukocyte (PMN) of acute pancreatitis (AP) and to assess the preventive effectiveness of pyrrolidine dithiocarbamate (PDTC) on NF-kappaB in vitro.</p><p><b>METHODS</b>Nineteen patients and 16 healthy individuals as control were enrolled in this study. The expression of NF-kappaB in PMNs was determined by gel electrophoretic mobility shift assay (EMSA). Routine clinical examination results and computed tomography findings of AP were recorded in all patients.</p><p><b>RESULTS</b>The PMNs from the patients with AP showed higher levels of NF-kappaB activities than those from control subjects (P < 0.01), severe acute pancreatitis (SAP) group showed much higher than mild acute pancreatitis (MAP) group (P < 0.05). In vitro, PDTC could reduce the NF-kappaB activity in PMNs of patients with AP, and its effectiveness at 2 mmol/L was stronger than at 1 mmol/L (P < 0.05). The PMNs from control subjects pretreated with 2 mmol/L PDTC before stimulation with the plasma from patients with SAP showed lower levels of NF-kappaB activities than did those untreated (P < 0.05).</p><p><b>CONCLUSION</b>The NF-kappaB activation in peripheral blood PMNs participate in the course of acute pancreatitis and can be inhibited by PDTC in vitro.</p>