Research Progress of Pharmacological Therapy and Nutritional Support for Cachexia in Lung Cancer Patients / 中国肺癌杂志

Cachexia is a common complication in patients with lung cancer. It aggravates the toxic and side effects of chemotherapy, hinders the treatment plan, weakens the responsiveness of chemotherapy, reduces the quality of life, increases complications and mortality, and seriously endangers the physical and mental health of patients with lung cancer. The causes and pathogenesis of tumor cachexia are extremely complex, which makes its treatment difficult and complex. Controlling cachexia in lung cancer patients requires many means such as anti-tumor therapy, inhibition of inflammatory response, nutritional support, physical exercise, and relief of symptoms to exert the synergistic effect of multimodal therapy against multiple mechanisms of tumor cachexia. To date, there has been a consensus within the discipline that no single therapy can control the development of cachexia. Some therapies have made some progress, but they need to be implemented in combination with multimodal therapy after fully assessing the individual characteristics of lung cancer patients. This article reviews the application of drug therapy and nutritional support in lung cancer patients, and looks forward to the research direction of cachexia control in lung cancer patients.
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Mechanism of DERL3 Affecting the Proliferation, Invasion and Metastasis of Lung Adenocarcinoma A549 Cells / 中国肺癌杂志

BACKGROUND@#Derlin 3 (DERL3) is downregulated in colorectal cancer (CRC) samples. Its level is closely linked to lymphatic metastasis or distant metastasis rate in CRC patients. However, its biological behavior in lung adenocarcinoma were rarely reported. The aim of this study is to investigate the ectopic expression of DERL3 in lung adenocarcinoma tissues and its effect on the invasion and metastasis of lung adenocarcinoma A549 cell line to reveal the possible mechanism of invasion and metastasis of lung adenocarcinoma.@*METHODS@#Lung adenocarcinoma microarray gene chip data included 3 cases of lymph node metastasis and 3 cases of lung adenocarcinoma tissue without lymph node metastasis. The GEDS and Kaplan-Meier plot queries the survival curve and expression level of DERL3. Western blot was used to detect the expression of DERL3 in lung adenocarcinoma cells. The efficiency of knockdown DERL3 gene was detected by Western blot assay. Transwell detected the number of cells passing through the basement membrane of the transwell. EDU assay detected cell proliferation ability. Western blot detected the expression of epithelial-mesenchymal transition related proteins E-cadherin and Vimentin.@*RESULTS@#The microarray gene chip results showed that compared with lung adenocarcinoma tissues without lymph node metastasis, 1,314 mRNAs in lung adenocarcinoma tissues with lymph node metastasis were up-regulated, 400 mRNAs were down (P<0.05). The expression of DERL3 increased in lung adenocarcinoma (P<0.05). The results of survival curve showed that the lung cancer patients with high expression of DERL3 with poor prognosis (P<0.05). Western blot results indicated that plasmid transfection was successful. Knockdown of DERL3 suppressed the ability of proliferation, invasion and migration in A549 cells (P<0.05). After knockdown of DERL3, the expression level of Vimentin was decreased, while E-cadherin expression increased (P<0.05).@*CONCLUSIONS@#Knockdown of DERL3 inhibited the proliferation, invasion and metastasis of A549 cells.

Advances of microfluidic technologies applied in diagnosis and treatment of sepsis / 中华危重病急救医学

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. It is characterized by rapid progression, high mortality, and frequent sequelae. Early diagnosis and timely treatment can improve patient survival and long-term prognosis. Biomarkers such as procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) have been widely used in the early diagnosis of sepsis, but there still exist limitations on their specificity and sensitivity. Microfluidic technology was applied for the detection of some biomarkers and pathogenic microorganisms, not only because it has a higher specificity and sensitivity for the early diagnosis of sepsis, but also has a certain evaluation value for the severity of sepsis and the prognosis of patients. These quick and accurate methods have the feasibility of clinical application. To demonstrate the value of microfluidic technology for early diagnosis of sepsis and to guide the improvement of future research, the application of microfluidic technology in the diagnosis and treatment of sepsis was reviewed in this article.

Prevalence and Prognostic Role of PIK3CA/AKT1 Mutations in Chinese Breast Cancer Patients / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The prevalence of PIK3CA in Chinese breast cancer patients may be underestimated. Therefore, we investigated the distribution of somatic PIK3CA/AKT1 mutations in Chinese breast cancer patients and explored their roles in tumor phenotypes and disease prognosis. MATERIALS AND METHODS: Tumors from 507 breast cancer patients were prospectively collected from the West China Hospital between 2008 and 2013. Whole exons of AKT1 and PIK3CA were detected in fresh-frozen tumors using next-generation sequencing, and correlations between PIK3CA/AKT1 mutations and clinicopathological features were analyzed. RESULTS: The AKT1 mutation was found in 3.6% (18/507) of patients. Tumors from patients that carried the AKT1 mutation were estrogen receptor (ER)+/progesterone receptor (PR)+/human epidermal growth factor receptor 2 (HER2)‒ and were more likely to have high expression levels of Ki67. The prevalence of the PIK3CA mutation was 46.5% (236/507), and 35 patients carried two or three variants of the PIK3CA gene. PIK3CA mutations were associated with ER+/PR+/HER2‒ status. The prognosis of patients with one mutation in PIK3CA (or PIK3CA/AKT1) was not significantly different than that of patients with wild-type PIK3CA (or PIK3CA/AKT1), while patients with two or three variants in PIK3CA (or PIK3CA/AKT1) exhibited poorer outcomes in the entire group and in all three subgroups (ER+, HER2‒, Ki67 high), particularly with respect to overall survival. CONCLUSION: A high frequency of somatic PIK3CA mutations was detected in Chinese breast cancer patients. In addition to the mutation frequency, the tumor mutational burden of the PIK3CA and AKT1 genes should also be of concern, as they may be associated with poor prognosis.

A study on common bile duct primary suture after laparoscopic choledocholithotomy with bile duct decompression tube / 中华普通外科杂志

Objective To evaluate intraoperative placement of bile duct decompression drainage tube in CBD primary suture after laparoscopic choledocholithotomy.Methods 152 patients undergoing laparoscopic choledocholithotomy were divided into group A (placement of bile duct decompression drainage tube during operation,82 cases) and group B (no decompression drainage tube placement,70 casas).Results There was no significant difference in operative time and intraoperative bleeding between the two groups (P ＞ 0.05).In group B patients the abdominal drainage tube indwelling time,abdominal drainage volume,peritoneal drainage fluid bilirubin value,postoperative hospitalization time were significantly longer than group A,the difference was statistically significant (P ＜ 0.05).No recurrence of choledocholithiasis and biliary stricture were found in either groups.Conclusions Placement of bile duct decompression drainage tube in laparoscopic choledocholithotomy and CBD primary suture after laparoscopic choledochotomy can significantly reduce the incidence of biliary leakage and shorten the postoperative hospital stay.

Study progress of treatment for children with tuberous sclerosis complex / 中华实用儿科临床杂志

The tuberous sclerosis complex (TSC) in children is also named Bourneville disease,the 3 main symptoms namely epilepsy,mental retardation and facial angiofibromas.It is an autosomal dominant disease.It is an important cause of epilepsy,skin disease,and renal and pulmonary disease in children and adults.The appropriate therapy and prognosis for TSC patients are often different than that for individuals with epilepsy,renal tumors,or interstitial lung disease from other causes.In recent years,certain progress has been made in management of tuberous sclerosis,inhibitors of the mammalian target of rapamycin (mTOR) have demonstrated regression of astrocytomas,angiofibromas,and angiomyoliomas,as well as improved pulmonary function in persons with TSC.This article reviews the current therapeutic recommendations for medical and surgical management of neurologic,renal,and pulmonary manifestations of TSC.

Characteristics and risk factors of lymphatic metastasis in early gastric cancer / 中华内科杂志

Objective To summarize the characteristics of regional lymph node metastasis in patients with early gastric cancer and analyze the risk factors for lymphatic metastasis. Methods 103 cases surgically treated for early gastric cancer in the Third Hospital of Peking University between March, 1988 and March, 2009 were analyzed retrospectively. Several clinicalpathologic variables including patients' age, gender, size of tumor, tumor location, macroscopic type, histological type, invasion depth were investigated by using chi-square test and logistic regression analysis for the possible relationship to lymphatic metastasis. Results The rate of lymph node metastasis in early gastric cancer was 17.5% (18/103), which in mucosal cancer was 4. 1% (2/49). Submucosal cancer had a lymph node metastatic rate of 29. 6% (16/54). Logistic regression indicated that invasion to submucosa and tumor size > 2 em were independent risk factors for lymph node metastasis of early gastric cancer. Metastatic cases of mucosal cancer were all signet ring cell cancer with diameters more than 2 cm. Lymph node metastatic rate in submueosal cancers within 2 cm was 16. 1% (5/31), that in > 2 cm submucosal cancers was 47. 8% (11/23) (P = 0. 012). Rate of lymph node metastasis in well-differentiated cancers was 0 (0/13), that in moderately-differentiated, poorly differentiated and signet ring cell cancers were 18. 2% (4/22), 16. 7% (5/30) and 23.7% (9/38) respectively (P = 0. 294). Patients' age, gender, tumor location and macroscopic type showed no relationship with lymph node state. Conclusion The tumor size and invasion depth are related with lymph node metastasis in early gastric cancer, considering these factors and assessing lymph node state is essential to appropriate therapeutic options for early gastric cancer.