Clinical characteristics of 272 437 patients with different histopathological subtypes of primary esophageal malignant tumors / 中华内科杂志

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

KIF2C: a novel link between Wnt/β-catenin and mTORC1 signaling in the pathogenesis of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is the fourth-leading cause of cancer-related deaths worldwide. HCC is refractory to many standard cancer treatments and the prognosis is often poor, highlighting a pressing need to identify biomarkers of aggressiveness and potential targets for future treatments. Kinesin family member 2C (KIF2C) is reported to be highly expressed in several human tumors. Nevertheless, the molecular mechanisms underlying the role of KIF2C in tumor development and progression have not been investigated. In this study, we found that KIF2C expression was significantly upregulated in HCC, and that KIF2C up-regulation was associated with a poor prognosis. Utilizing both gain and loss of function assays, we showed that KIF2C promoted HCC cell proliferation, migration, invasion, and metastasis both in vitro and in vivo. Mechanistically, we identified TBC1D7 as a binding partner of KIF2C, and this interaction disrupts the formation of the TSC complex, resulting in the enhancement of mammalian target of rapamycin complex1 (mTORC1) signal transduction. Additionally, we found that KIF2C is a direct target of the Wnt/β-catenin pathway, and acts as a key factor in mediating the crosstalk between Wnt/β-catenin and mTORC1 signaling. Thus, the results of our study establish a link between Wnt/β-catenin and mTORC1 signaling, which highlights the potential of KIF2C as a therapeutic target for the treatment of HCC.

Efficacy of local infiltration of ropivacaine combined with multimodal analgesia with parecoxib for perioperative analgesia in patients undergoing pancreaticoduodenectomy / 南方医科大学学报

OBJECTIVE@#To explore the effect of local infiltration of ropivacaine combined with multimodal analgesia with parecoxib for perioperative pain management in patients undergoing pancreaticoduodenectomy.@*METHODS@#This randomized controlled trial was conducted among 98 patients undergoing pancreaticoduodenectomy in the Department of Biliary Surgery of West China Hospital between March, 2017 and August, 2018. The patients were randomized to receive perioperative analgesia with local infiltration anesthesia with ropivacaine combined with multimodal analgesia with parecoxib (experimental group, =50) or postoperative analgesia with dizosin (control group, =48). The regimens for intraoperative anesthesia and postoperative pain relief were identical in the two groups. The differences in NRS pain score, use of pain relief agents, the incidences of adverse reactions to analgesia and wound infection, and the time to first ambulation and first flatus passage after the operation were compared between the two groups.@*RESULTS@#At 12, 24 h, 48 h, 72 h and 7 days after the operation, the patients in the experimental group had significantly lower NRS scores ( < 0.05) than those in the control group. The rate of use of rescue analgesics was significantly lower in the experimental group than in the control group (32% 66.67%, < 0.05); the rate of tramadol hydrochloride use was also significantly lower in the experimental group ( < 0.05). Compared with those in the control group, the patients in the experimental group showed a significantly lower total incidence of adverse reactions (22% 54.17%, < 0.05) as well as a lower incidence of nausea and vomiting ( < 0.05), an earlier time of first ambulation and first flatus passage after the operation ( < 0.05), and a shorter postoperative hospital stay ( < 0.05).@*CONCLUSIONS@#In patients undergoing pancreaticoduodenectomy, local infiltration of ropivacaine combined with multimodal analgesia with ropivacaine can effectively relieve perioperative pain, reduce the use of relief analgesics, lower the incidence of adverse reactions, and promote the recovery after the surgery.

Anaiysis of Clinical Manifestations and Risk Factors of Mortality due to Acinetobacter Baumannii Positive Pulmonary Infection in ICU / 医学研究杂志

Objective To analyze the clinical manifestations,bacterial resistance to antibiotics and risk factors of mortality in pneumonia patients with Acinetobacter baumannii(AB) positive in respiratory secretions.Methods Clinical datas of pneumonia patients with AB positive in respiratory secretions in ICU from June 2012 to June 2017 were analyzed.According to the 28 day survival after diagnosis,the patients were divided into death group and survival group.Univariate and multivariate Logistic analysis were used to examine the risk factors of AB positive patients.Results This study included 98 patients.The 28 day mortality was 54.1％.The independent risk factors of mortality were:merge coronary heart disease(OR =38.3,95％ CI:1.81-720.10,P =0.019),high APACHE Ⅱ score (OR =3.47,95％ CI:1.30-12.81,P=0.043),prolonged APTT(OR =1.32,95％ CI:1.03-1.71,P=0.037),high levels of PCT(OR=2.78,95％ CI:1.30-7.02,P =0.023).APACHE Ⅱ scores and patients died from AB culture positive time was significantly negative correlation,r =-0.601,P =0.000.Whether the application of antibiotics for AB was not clearly affected by the prognosis.Conclusion Merge coronary heart disease,high APACHE Ⅱ score,prolonged APTT,high levels of PCT are independent risk factors for AB culture positive patients.In particular,merge coronary heart disease and the severity of the underlying disease determine the patient's prognosis.

The application of 360-degree feedback in nursing performance management in China: a literature review / 中国实用护理杂志

360-degree feedback evaluates the performance of employers by using a variety of resources related to the employers and emphasizes the feedback after evaluating. It aims at improving the employers' work performance and personal development, which are the needs of nursing performance management. This paper reviewed the application of 360-degree feedback in nursing performance management in China by combining the implementation steps, found out the potential problems through the reviewed papers, and proposed more effective ways of application of 360-degree feedback in nursing performance management in China.

Study on application effect of cyclooxygenase-2 inhibitor in perioperative pain management in patients with laparoscopic cholecystectomy / 重庆医学

Objective To investigate the application effect of selective cyclooxygenase-2 (COX-2) inhibitor in perioperative preemptive on-demand analgesia of the patients with laparoscopic cholecystectomy under enhanced recovery after surgery(ERAS).Methods The clinical data in 206 cases of gallstones undergoing selective COX-2 inhibitor for preemptive analgesia (new type analgesic group) from June to December 2015 and 198 cases of gallstones undergoing tramadol postoperative analgesia (traditional analgesia group) in the biliary surgery department of West China Hospital of Sichuan University were retrospectively analyzed.The intraoperative anesthesia schemes in the two groups were consistent.The same pain resolution scheme was adopted after operation.Then the VAS pain score,pain relief drug use rate,adverse reactions,analgesic satisfaction and hospitalization time were compared between the two groups.Results The VAS scores at postoperative 2,6,12,24 h in the new type analgesia group were lower than those in the traditional analgesia group,the difference was statistically significant (P＜0.05);the analgesic drug use rate in the new type analgesia group was lower than that in the traditional analgesia group (14.56％ vs.44.95％,P＜0.05),and the use rate of tramadol hydrochloride and pethidine hydrochloride was lower than that in the traditional analgesia group (P＜0.05).The incidence rate of adverse reactions in the new type analgesia group was lower (2.43％ vs.36.36％,P＜0.05).The incidence rate of nausea and vomiting in the new type analgesia group was lower than that in the traditional analgesia group (P＜0.05),and the incidence rate of other complications had no statistically signifiwas higher than that in the traditional analgesia group (P＜0.05);the average hospital stay and postoperative hospital stay had no statistical difference between the two groups (P＞0.05).Conclusion COX-2 inhibitors can effectively reduce perioperative pain degree in the patients with laparoscopic cholecystectomy,reduces the use frequency of analgesic drugs,shortens the hospital stay time and increases the patient satisfaction.cant difference (P＞0.05).The perioperative patient analgesia satisfaction the in the new type analgesia group

Analysis of therapeutic effect and prognostic factors of non-small cell lung cancer leptomeningeal metastasis patients treated by epidermal growth factor receptor tyrosine kinase inhibitors / 中国医师进修杂志

Objective To investigate the efficacy and prognostic factors of non-small cell lung cancer (NSCLC) leptomeningeal metastasis (LM) patients undergoing treatment with epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs).Methods The clinical data of 30 patients with NSCLC- LM were retrospectively analyzed, including the basic situation, survival time, clinical characteristics,pathological type,differentiation degree and treatment method.The median survival time (MOS) was calculated by Kaplan-Meier method. The log-rank test was used to analyze the prognostic single factors.The Cox regression model was used to analyze the multivariate factors. Results The log-rank test result showed that sex,pathological type,differentiation degree and EGFR-TKIs treatment were the influencing factors of MOS(P<0.05).The multivariate analysis result showed that sex,pathological type, differentiation degree and EGFR-TKIs treatment were the independent influencing factors of prognosis in NSCLC-LM patients (P<0.05), and the female gender (RR = 0.090, 95% CI 0.048 -0.140),adenocarcinoma(RR=0.108,95% CI 0.073-0.134),well differentiation(RR=0.112,95% CI 0.076 - 0.141), using EGFR-TKIs treatment (RR = 0.042, 95% CI 0.012 - 0.074) were significant predictors of a good prognosis. Conclusions The female gender, well differentiation, adenocarcinoma and EGFR-TKIs treatments are significant predictors of a good prognosis. EGFR-TKIs can prolong the survival time of patients with NSCLC-LM,and it is recommended for a clinical treatment for patients with NSCLC-LM.

Progression of immunotherapy in gastric cancer / 中华胃肠外科杂志

Gastric cancer is a malignant disease with high incidence and mortality. The therapeutic methods for advanced gastric cancer, including chemotherapy and targeted therapy are very limited. Immunotherapy is a new method for cancer treatment. The immune checkpoint inhibitors developed for cancer treatment mainly target the CTLA-4 and PD-1/PD-L pathways. There have already been several inhibitors approved for the treatment of melanoma and non-small cell lung cancer by the FDA, including Ipilimumab (fully human antibody against CTLA-4), Pembrolizumab (fully human antibody against PD-1) and Nivolumab (fully human antibody against PD-1). There are also many on-going clinical trials investigating the value of immune checkpoint inhibitors in treating various malignancies, including advanced gastric cancer. In KEYNOTE-012 trial, for advanced gastric and esophagogastric junction cancer anti-PD-1 therapy seemed to be safe and effective for advanced gastric cancer with PD-L1 positivity. Moreover, studies of adoptive cell therapy and tumor vaccine in gastric cancer are underway. Here the latest developments in immunotherapy for gastric cancer will be illustrated.

The effect of constraint-induced movement therapy combined with motor imagery on unilateral spatial neglect in stroke patients / 中华物理医学与康复杂志

Objective To observe the effect of constraint-induced movement therapy combined with motor imagery on unilateral spatial neglect (USN) in stroke patients. Methods Fifty stroke patients with USN were randomly divided into a treatment group ( n = 27 ) and a control group ( n = 23 ). Both groups received routine physical therapy training, including with the Bobath technique and low frequency electrotherapy, while the treatment group received constraint-induced movement therapy and motor imagery in addition. All the patients were assessed with 4 scales of the regular USN assessment ( cancellation tests, line bisection tests, clock drawing tests,copying drawing tests) and with the Barthel index (BI) before and after 8 weeks of treatment. Results After 8 weeks of treatment, both groups' average USN assessments and Barthel indices improved significantly. Furthermore, both the USN results and the Barthel index scores in the treatment group were, on average, significantly better than those in the control group. Conclusion For USN stroke patients, constraint-induced movement therapy combined with motor imagery improves the symptoms of USN and ADL ability significantly better than routine physical therapy treatment alone.

Efficacy and safety evaluation for 28 Chinese non-Hodgkin lymphoma patients treated with Hyper-CVAD/MA regimen / 肿瘤研究与临床

Objective To evaluate the efficacy and safety of the hyper-CVAD/MA regimen as an intensified treatment option for 28 T cell and aggressive/highly aggressive B cell NHL in Chinese patients. Methods Clinical data of 28 NHL patients treated with hyper-CVAD/MA regimen from Jan 2005 to Sep 2008 were retrospectively analyzed. Results 27 NHL patients were available for the efficacy analysis, with a response rate of 70.4 %. For the 13 B cell lymphoma cases, the response rate was 84.6 %. The main toxicity was Grade Ⅲ or Grade Ⅳ myelosuppression in all cases and 2 treatment related deaths. Conclusion Hyper-CVAD/MA regimen had a high response rate in T cell and aggressive /highly aggressive B cell NHL lymphoma, companied by significant toxicity when treating Chinese patients. Further clinical practices are needed to pick up a suitable dose which can balance efficacy and safety.

Phase Ⅱ clinical study of intratumoral H101,an E1B deleted adenovirus,in patients with cancer / 中国癌症杂志

Purpose:To evaluate the efficacy and toxicity o f intratumoral H101, an E1B deleted oncolytic adenovires. Methods :A total of 53 patients with malignant tumors from multiple centers were treated with H101, 5?10 11 viral particle (VP) per day for 5 consecutive days ever y three weeks. The efficacy and toxicity were evaluated. Results :Among 49 evaluable cases, complete response 2, partial response 9, minimal respo nse 8, stable disease 19, progressive disease 11, overall response rate was 22.4 %. In the 56 ITT population the response rate was 19.6%, including 2 CR and 9 PR . The rate of clinical benefit response (CR+PR+MR+SD) was 77.6% (38/49). Main si de effects were injection site pain (57.4%) and fever (35.2%). No serious advers e events developed. Conclusions:The study showed that genetical ly E1B-deleted adenovirus (H101) showed some efficacy in some refractory malign ant tumors, and was well tolerated.