FARSB stratifies prognosis and cold tumor microenvironment across different cancer types: an integrated single cell and bulk RNA sequencing analysis / 南方医科大学学报

OBJECTIVE@#Immunotherapy has brought significant clinical benefits to a subset of patients, but has thus far been disappointing in the treatment of immunologically "cold" tumors. Existing biomarkers that can precisely identify these populations are insufficient. In this context, a potential cold tumor microenvironment (TME) marker FARSB was investigated to reveal its impact on TME and patients' response to immunotherapy across pan-cancer.@*METHODS@#The expression levels and mutational landscape of FARSB in pan-cancer were investigated. Kaplan-Meier and univariate Cox regression analyses were applied to analyze the prognostic significance of FARSB. Pathways affected by FARSB were investigated by gene set enrichment and variation analysis. The relationship between FARSB expression and immune infiltration was examined using the TIMER2 and R packages. Single-cell RNA sequencing (scRNA-seq) data of several cancer types from GSE72056, GSE131907, GSE132465, GSE125449 and PMID32561858 were analyzed to validate the impact of FARSB on the TME. The predictive effect of FARSB on immunotherapy efficacy was explored in 3 immune checkpoint inhibitors (ICIs)- treated cohorts (PMID32472114, GSE176307, and Riaz2017).@*RESULTS@#FARSB expression was significantly higher in 25 tumor tissues than in normal tissues and was associated with poor prognosis in almost all tumor types. FARSB expression exhibited a strong association with several DNA damage repair pathways and was significantly associated with TP53 mutation in lung adenocarcinoma (P < 0.0001, OR=2.25). FARSB characterized a typical immune desert TME and correlated with impaired expression of chemokines and chemokines receptors. Large-scale scRNA-seq analysis confirmed the immunosuppressive role of FARSB and revealed that FARSB potentially shapes the cold TME by impeding intercellular interactions. In 3 ICI-treated cohorts, FARSB demonstrated predictive value for immunotherapy.@*CONCLUSION@#This study provides a pan-cancer landscape of the FARSB gene by integrated single-cell and bulk DNA sequencing analysis and elucidates its biological function to promote DNA damage repair and construct the immune desert TME, suggesting the potential value of FARSB as a novel marker for stratifying patients with poor immunotherapeutic benefits and "cold" TME.

A single-center, retrospective analysis of relapse and progression patterns of primary central nervous system lymphoma: can whole brain radiotherapy be replaced? / 南方医科大学学报

OBJECTIVE@#To analyze recurrence and progression patterns of primary central nervous system lymphoma (PCNSL) in patients without whole brain radiotherapy (WBRT) and assess the value of WBRT in PCNSL treatment.@*METHODS@#This retrospective single-center study included 27 patients with PCNSL, who experienced recurrence/progression after achieving complete remission (CR), partial remission, or stable disease following initial treatments with chemotherapy but without WBRT. The patients were followed up regularly after the treatment for treatment efficacy assessment. By comparing the anatomical location of the lesions on magnetic resonance images (MRI) at the initial diagnosis and at recurrence/progression, we analyzed the patterns of relapse/progression in patients with different treatment responses and different initial status of the lesions.@*RESULTS@#MRI data showed that in 16 (59.26%) of the 27 patients, recurrence/progression occurred in out-field area (outside the simulated clinical target volume [CTV]) but within the simulated WBRT target area in 16 (59.26%) patients, and within the CTV (in-field) in 11 (40.74%) patients. None of the patients had extracranial recurrence of the tumor. Of the 11 patients who achieved CR after the initial treatments, 9 (81.82%) had PCNSL recurrences in the out-field area but within WBRT target area; of the 13 patients with a single lesion at the initial treatment, 11 (84.62%) experienced PCNSL recurrence in the out-field area but within WBRT target area.@*CONCLUSIONS@#Systemic therapy combined with WBRT still remains the standard treatment for PCNSL patients, especially those who achieve CR after treatment or have a single initial lesion. Future prospective studies with larger sample sizes are needed to further explore the role of low-dose WBRT in PCNSL treatment.

Recent advances in the treatment of persistent Müllerian duct syndrome / 中华泌尿外科杂志

Male sex differentiation is driven by 2 hormones produced by the fetal testis, testosterone and anti-Müllerian hormone(AMH), responsible for the regression of müllerian ducts in male fetuses. Mutations inactivating AMH or its receptor AMHR2 lead to the persistent müllerian duct syndrome(PMDS) in otherwise normally virilized 46, XY males. Further assessment was carried out when suspicion of PMDS arose from physical examination which revealed that the testis crossed to the contralateral side of the body. Further examination include ultrasound, AMH concentration, karyotype, and gene sequencing. Once PMDS is considered, there is no need to perform the gonads biopsy. The optical surgery methods include one-stage cryptorchidism and hernia curation, and at the same time.Stripping/destroying the mucosa of the retained müllerian remnants to reduce the risk of malignancy and, simultaneously, to prevent the damage to vas deference.

Effect analysis of BOPPPS model in online teaching activities of radiobiology / 中华放射医学与防护杂志

Objective:To explore the effect of a new teaching mode, which includes bridge-in, outcome, pre-test, participation, post-test and summary (BOPPPS), on the online teaching of radiobiology related knowledge for cancer radiotherapy practitioners.Methods:Taking the cell survival curve, cell cycle and radiosensitivity as examples, the radiotherapy practitioners in multiple university-affiliated hospitals were organized to carry out a multicenter prospective randomized control study. All practitioners were randomly divided into BOPPPS group and control group. The courses for BOPPPS group were designed as an online classroom, consisting of pre-class preparation, online teaching and post-class stages. The online teaching stage included video viewing, basic knowledge learning, literature discussion, group discussion and others. The control group employed the traditional teaching mode. The χ2 test was used to compare the consistency of general conditions between the two groups, and nonparametric test was used to compare the differences in scores between two or more groups. Results:The score of the pre-class test was 58.56 ± 0.99. Post-class average score for BOPPPS group was 85.48±0.85 and for control group 77.79±1.10, with the former being higher 7.69 ( Z=5.31, P<0.001) than the latter. The average answer time was (296.62±15.40) s for BOPPPS group and (386.41±21.27) s for control group, with the former being shorter 89.79 s ( Z=3.34, P=0.001) than latter. Subgroup analysis shown that the scores of BOPPPS group were significantly rising, regardless of whether or not the students had studied radiobiology courses. Among the students who have not studied these courses, the scores were rising greatly. Moreover, From the analysis of different positions, it was found that both the scores of BOPPPS group and control group have risen, especially for doctors, deputy chief doctors, physicists and technicians. There were also statistically differences between different degrees, with significantly rise in scores for undergraduate and doctoral students ( Z=3.64, 4.18, P<0.001). Conclusions:The flexible application of BOPPPS teaching mode to the online education of such boring disciplines, like radiobiology, is of great significance to raise the theoretical basis of radiotherapy practitioners.

Prognostic values of immune efficacy biomarkers in the treatment of nasopharyngeal carcinoma / 国际肿瘤学杂志

Immunotherapy has achieved objective response rates of 20%-30% in patients with recurrent or metastatic nasopharyngeal carcinoma, but fewer people are benefiting. Studies have shown that patients with nasopharyngeal carcinoma carrying high expression of programmed death-1/programmed death-ligand 1 and/or high tumor mutation burden have a significant response to immunotherapy. Biomarkers of the tumor microenvironment, especially tumor infiltrating lymphocyte, are abundant in nasopharyngeal carcinoma, varying from different Epstein-Barr virus states, which can also play a predictive role of immunotherapy efficacy. Other biomarkers, such as mismatch repair-deficient, have a low incidence in nasopharyngeal carcinoma and limited predictive power. Combined detection of different types of immunotherapeutic biomarkers is more helpful to identify suitable populations for immunotherapy.

Dose evaluation of adaptive radiotherapy using high-field MR-Linac systems for head and neck cancers / 中华放射医学与防护杂志

Objective:To investigate the feasibilityof the adaptive radiotherapy using high-field MR-Linac systems for head neck cancers and perform the evaluation of target coverage and dose criteria.Methods:This study investigated 128 treatment plans of six patients who were treated on 1.5T MR-Linacsystems in Sun Yat-sen University Cancer Center in 2019, compared the differences in target coverage and dose criteria between the dose accumulation in the adaptive radiotherapy using MR-Linac systems and the reference plans, and evaluated the target coverage and dose criteria of each fraction of adaptive plan based on daily MRI anatomy.Results:There was no significant change in the target coverage and dose criteria for each treatment fraction(<1%). However, the change of lens dose was significant (maximum 98%). In addition, the result showed that there was no significant difference in target coverage and dose criteria between the dose accumulation in adaptive radiotherapy using MR-Linac systems and reference plans.In contrast, the average dose to lens was increased by 31.7%.Conclusions:It is feasible to perform adaptive radiotherapy using 1.5T MR-Linacsystems for head neck cancers according tothe evaluation of target coverage and dose criteria. Additionally, since the actual dose tolens was quite different from the reference plan, the lens exposure should be considered in clinical practice.

Spindle assembly checkpoint complex-related genes TTK and MAD2L1 are over-expressed in lung adenocarcinoma: a big data and bioinformatics analysis / 南方医科大学学报

OBJECTIVE@#To screen the key genes related to the prognosis of lung adenocarcinoma through big data analysis and explore their clinical value and potential mechanism.@*METHODS@#We analyzed GSE18842, GSE27262, and GSE33532 gene expression profile data obtained from the Gene Expression Omnibus (GEO). Bioinformatics methods were used to screen the differentially expressed genes in lung adenocarcinoma tissues and KEGG and GO enrichment analysis was performed, followed by PPI interaction network analysis, module analysis, differential expression analysis, and prognosis analysis. The expressions of MAD2L1 and TTK by immunohistochemistry were verified in 35 non-small cell lung cancer specimens and paired adjacent tissues.@*RESULTS@#We identified a total of 256 genes that showed significant differential expressions in lung adenocarcinoma, including 66 up-regulated and 190 down-regulated genes. Thirty-two up-regulated core genes were screened by functional analysis, and among them 29 were shown to significantly correlate with a poor prognosis of patients with lung adenocarcinoma. All the 29 genes were highly expressed in lung adenocarcinoma tissues compared with normal lung tissues and were mainly enriched in cell cycle pathways. Seven of these key genes were closely related to the spindle assembly checkpoint (SAC) complex and responsible for regulating cell behavior in G2/M phase. We selected SAC-related proteins TTK and MAD2L1 to test their expressions in clinical tumor samples, and detected their overexpression in lung adenocarcinoma tissues as compared with the adjacent tissues.@*CONCLUSIONS@#Seven SAC complex-related genes, including TTK and MAD2L1, are overexpressed in lung adenocarcinoma tissues with close correlation with the prognosis of the patients.

Value of preoperative localization techniques for solitary pulmonary nodules in singleport thoracoscopic surgery / 南方医科大学学报

To evaluate the value and clinical effect of different preoperative localization techniques for solitary pulmonary nodules (SPN) before single-port thoracoscopic surgery.From January 2018 to June 2019, 54 patients diagnosed with solitary pulmonary nodules received single-port thoracoscopic surgery in Thoracic Department of General Hospital of Southern Theater Command of PLA. Based on the location methods of the nodules, the patients were divided into group A (34 cases) with preoperative CT-guided Hook-wire (a common positioning needle usually using in mammary gland) positioning and group B (20 cases) with preoperative CT-guided methylene blue location.The success rate of localization in group A was 94.18% (32/34), significantly higher than that in group B [85% (17/20), < 0.05). No intraoperative conversion to thoracotomy occurred in group A, while the conversion rate was 10% (2/20) in group B ( < 0.05). The average positioning cost was significantly higher in group A than in group B (1715±109 1021±86 RMB yuan, < 0.05), but the total hospitalization cost was similar between the two groups (50 114±3788 47871±5902 RMB yuan, >0.05). The length of hospital stay was significantly shorter in group A than in group B (6.71±1.23 8.19±2.61 days, < 0.05).Compared with the traditional methylene blue localization method, Hook-wire localization positioning can significantly increase the success rate of localization, and can be used as the standard preoperative localization method in patients undergoing single-port thoracoscopic pulmonary nodule resection, especially in those with deep nodule location from the visceral pleura.

Replacing a smaller-size catheter after tubularized incised plate urethroplasty may decrease postoperative urethral complications / 中华泌尿外科杂志

Objective To investigate the effect of replacing a smaller-size catheter after tubularized incised plate (TIP) urethroplasty on postoperative urethral complications.Methods The data of 116 hypospadias patients underwent TIP urethroplasty performed by the same urologist in our hospital from January 2014 to December 2017 were retrospectively analyzed.The age of patients ranged from 0.5-15.4 years,with the median age of 1.5 years.Meatal location was distal in 47 (39.5％),midshaft in 62 (52.1％) and proximal in 10(8.4％) patients.Unhealthy urethral plate occurred in 49 (42.2％) patients.F8 catheter was used for urethroplasty in 92 (79.3 ％) patients,F10 in 17 (14.7％),and F12 in 7 (6.0％).According to the pattern of urinary diversion,patients were divided into two groups.Conventional catheter group in 56 patients (group A):the catheter was chosen in as large size as possible for urethroplasty without tension.Replace a smaller-size catheter group in 60 patients (group B):replace a smaller-size catheter after urethroplasty on the basis of group A.There were no statistically significant differences in age,meatal location and catheter size between the two groups (P ＞ 0.05).Results The mean follow up was 23 months (range 6-66 months).There were 73(62.9％) cases of orifice overflow during indwelling catheterization.There were 5 (4.3％) patients needed further reoperation result from postoperative urethral complications,including 4 cases of fistula and 1 case of meatal stenosis.The process of replacing a smaller-size catheter after urethroplasty in group B was simple and without adverse reactions.There were 15 (26.8％) cases of orifice overflow in group A and 58 (96.7％) in group B.There were statistically significant differences in orifice overflow between the two groups (P ＜ 0.05).There were 5 (8.9％) cases of postoperative urethral complications in group A and 0 case in group B.There were statistically significant differences in postoperative urethral complications (P ＜ 0.05).Conclusions The process of replacing a smaller-size catheter after TIP urethroplasty in was simple and subsequently contributed to less postoperative urethral complications.The results of replacing a smaller-size catheter after TIP urethroplasty were superior to that of no replacing conventionally.

Preliminary investigation of gender assignment in 46,XY disorders of sex development with severe male undermasculinisation / 中华儿科杂志

Objective@#To explore the feasibility of gender assignment in 46,XY disorders of sex development (DSD) with severe undermasculinisation mainly based on molecular diagnosis.@*Methods@#A retrospective study of 45 patients of 46, XY DSD with severe undermasculinisation were admitted between November 2015 and October 2018 at Children′s Hospital, Zhejiang University School of Medicine. The initial social gender were all female, of whom the external genital manifestations were Prader 0 to 2; the degree of masculinity was scored using external masculinisation score (EMS); the position and development of the gonads were examined by ultrasound, cystoscopy and laparoscopy, also including assessing the development of the Wolffian tube and the Müllerian tube. The level and ratio of testosterone to dihydrotestosterone before and after hCG stimulation were evaluated for the function of Leydig cell and 5α-reductase-2. Gender role scales and sandbox games were used to assess gender role behavior. Genital sensitivity to androgen stimulation was assessed; A panel including 163 genes related to gender development were determined by second-generation sequencing in all 45 patients. Finally, a multidisciplinary team (MDT) makes a gender assignment after a comprehensive analysis mainly based on the molecular etiological diagnosis.@*Results@#Thirty-nine out of 45 patients (87%) had an identifiable genetic etiology, and the remaining 6 (13%) were negative for genetic testing. Forty-five patients had EMS less than or equal to 3 points. Sexual psychological assessment was performed in 39 patients, with male dominance in 24 (62%) and female dominance in 15 (38%). The gender assignment was 23 cases (51%) for male and 19 cases (42%) for female, and 3 cases (7%) were not completely determined.@*Conclusions@#Molecular diagnosis provides a strong basis for appropriate gender assignment of 46, XY DSD children with severe undermasculinisation. Based on molecular diagnosis, each DSD should be analyzed by professional MDT to analyze the clinical symptoms/signs, gonadal development, gonad tumor risk, external genital morphology, sexual psychological assessment, potential fertility opportunities, parental views, Social and cultural factors, etc. make appropriate gender assignment.

Diagnosis and treatment of urethral mucosa prolapse in female children / 中华泌尿外科杂志

Objective To review the clinical characteristics of urethral prolapse in female children and summarize our experience of treatment.Methods A retrospective analysis of the clinical characteristics of 102 patients with urethral prolapse from January 2007 to December 2017 was conducted at The Children's Hospital of Zhejiang University School of Medicine.The age of the patients ranged from 8-156 months with an median of 80 months.The presenting symptoms in the 102 girls were:bleeding in 57 patients (55.9％),mass in 31 patients (30.4％),and dysuria/urinary frequency,urgent and pain in 14 patients (13.4％).In all,58 patients were managed conservatively with Sitz baths as their masses were small,39 underwent prolapse reduction under topical anesthesia and Sitz baths because their mass were large,and 5 patients were treated by excision of the prolapsed urethral mucosa with four-quadrant excisional technique because thrombosed urethral prolapse at first visit.Results A total of 89 patients were cured after conservative treatment (87.3％),8 patients were converted to surgical treatment because frequent recurrence with conservative treatment.No urethral stricture,active hemorrhage and recurrent were found in 13 patients after operation.Conclusions The most common clinical manifestations of urethral prolapse are urethral mass and bleeding.Most patients can be cured by conservative treatment.The patients whose symptoms were severe or suffered from frequent recurrence of urethral prolapse should be managed with surgical excision.

Clinical research of adenosine triphosphate and spermatic vein ligation combined treatment of children with primary varicocele disease / 中国生化药物杂志

Objective To study the clinical effect of adenosine triphosphate and spermatic vein ligation combined treatment of children with primary varicocele disease.Methods80 cases of children with primary varicocele disease who were treated in pediatric surgery department of Hangzhou City Yuhang District MCH from May 2014 to May 2016 were selected, these children were divided into adenosine triphosphate and spermatic vein ligation combined treatment group (combined treatment group, n= 40) and spermatic vein ligation treatment group (monotherapy group, n=40) two groups according to the random number table, the postoperative pain score, gastrointestinal recovery time, hospital stay, cost of hospitalization, incidence of complications and recurrence of the two groups were statistically analyzed.ResultsThe postoperative pain score and hospitalization cost of the combined treatment group were significantly lower (P<0.05), the gastrointestinal function recovery time and hospital stay were significantly shorter (P<0.05), the incidence of complications 2.5% (1/40) was significantly lower than the monotherapy group 17.5% (7/40) (P<0.05), the recurrence rate 2.5% (1/40) was significantly lower than the monotherapy group 10.0% (4/40) (P< 0.05).ConclusionThe clinical effect of adenosine triphosphate and spermatic vein ligation combined treatment of children with primary varicocele disease is better than spermatic vein ligation treatment alone, so is worthy of promotion in the clinical.

The significance of serum inhibin B levels in evaluating the Sertoli cell function of cryptorchidism / 中华泌尿外科杂志

Objective To investigate the value of serum inhibin B in evaluating the Sertoli cell function in cryptorchidism children by the study of the correlation between the serum inhibin B levels and cryptorchidism.Methods From August 2006 to August 2011,672 cryptorchidism aged from 6 to 72 months (mean age 27.7 months) were measured of serum inhibin B level by ELISA.Of those 672 boys,505 were unilateral,106 were bilateral and 61 were unilateral vanished testis.Three hundred and eighty-five cases aged 6 to 24 months,109 cases aged 25 to 36 months and 178 cases aged 37 to 72 months.The control group consisted of 335 boys selected from physical examination or circumcision with corresponded age,98 cases aged 6 to 24 months,101 cases aged 25 to 36 months and 136 cases aged 37 to 72 months.The blood samples for serum inhibin B were taken from everyone and,in part of cases,6 months,12 months,18 months postoperatively respectively.The comparision of serum inhibin B levels among the groups was done,and the correlation between serum inhibin B level and testicular volume was analyzed.Results Compared with the control group,the serum inhibin B levels of all groups with unilateral and bilateral cryptorchidism are lower significantly (P ＜ 0.05).No difference was found between the unilateral vanished testis and the control group (P ＞ 0.05),except those aged 6 to 24 months [38.54 pg/ml (25.98,50.24) pg/ml vs.68.04 pg/ml (44.95,115.64) pg/ml,P ＜0.05].For bilateral cases aged 6 to 24 months,the serum inhibin B level are significantly lower than that of unilateral cases [30.68 pg/ml(17.37,42.43)pg/ml vs.45.91 pg/ml (30.98,69.70) pg/ml,P ＜ 0.05].The serum inhibin B levels were significantly increased 6 months later in those who had undergone orchidopexy [37.34 pg/ml (22.79,64.25) pg/ml vs.30.48 pg/ml (16.56,50.08) pg/ ml,P ＜ 0.05].For boys with unilateral and bilateral cryptorchidism aged 6 to 24 months,inhibin B levels correlated positively with testicular volume (P ＜ 0.05).Conclusions The serum inhibin B level can be used as a reliable marker in evaluating the Sertoli cell function of cryptorchidism,and the orchidopexy had a positive impact on the serum levels of inhibin B.

Comparison of development of intraoperative atrial fibrillation in elderly patients undergoing thoracic surgery using different anesthetic methods: a large sample clinical trial / 中华麻醉学杂志

Objective To compare the development of intraoperative atrial fibrillation in elderly patients undergoing thoracic surgery using different anesthetic methods in a large sample clinical trial.Methods A total of 1 380 patients of both sexes,aged 60-80 yr,with body mass index of 16-33 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical operations for lung or esophageal cancer,were divided into 3 groups (n =460 each) using a random number table:general anesthesia group (group G),general anesthesia combined with paravertebral block group (group GP),and general anesthesia combined with epidural block group (group GE).After induction of anesthesia,an epidural catheter was placed at T4-7 interspace on the operated side,and 0.375％ ropivacaine 8 ml was administrated via the catheter in group GP.After induction of anesthesia,the patients were tracheally intubated and mechanically ventilated,and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg in the 3 groups.Maintenance of anesthesia was as follows:propofol was given by target-controlled infusion with the target plasma concentration of 2.5-4.0 μg/ml in the 3 groups;intermittent iv boluses of sufentanil 10 μg were given,and the total dosage was not expected to exceed 1.0 μg/kg in group G;sufentanil 10 μg was injected intravenously when necessary in group GP;0.25％ ropivacaine 5 ml was injected epidurally every 1.5 h in group GE;bispectral index value was maintained at 40-60;rocuronium was injected intravenously according to the condition in the 3 groups.The development of intraoperative atrial fibrillation was recorded.Results The incidence of intraoperative atrial fibrillation was 6.1％,3.7％ and 2.2％ in G,GP and GE groups,respectively.Compared with group G,the incidence of intraoperative atrial fibrillation was significantly decreased in group GE (P＜0.05),and no significant change was found in the incidence of intraoperative atrial fibrillation in group GP (P＞0.05).Conclusion Compared with general anesthesia,general anesthesia combined with epidural block can decrease the development of intraoperative atrial fibrillation,it is more suitable for this type of patients,however,general anesthesia combined with paravertebral block produces no improvement in the development of intraoperative atrial fibrillation in elderly patients undergoing thoracic surgery.

Human body meridian spatial decision support system for clinical treatment and teaching of acupuncture and moxibustion / 中国针灸

The spatial position and distribution of human body meridian are expressed limitedly in the decision support system (DSS) of acupuncture and moxibustion at present, which leads to the failure to give the effective quantitative analysis on the spatial range and the difficulty for the decision-maker to provide a realistic spatial decision environment. Focusing on the limit spatial expression in DSS of acupuncture and moxibustion, it was proposed that on the basis of the geographic information system, in association of DSS technology, the design idea was developed on the human body meridian spatial DSS. With the 4-layer service-oriented architecture adopted, the data center integrated development platform was taken as the system development environment. The hierarchical organization was done for the spatial data of human body meridian via the directory tree. The structured query language (SQL) server was used to achieve the unified management of spatial data and attribute data. The technologies of architecture, configuration and plug-in development model were integrated to achieve the data inquiry, buffer analysis and program evaluation of the human body meridian spatial DSS. The research results show that the human body meridian spatial DSS could reflect realistically the spatial characteristics of the spatial position and distribution of human body meridian and met the constantly changeable demand of users. It has the powerful spatial analysis function and assists with the scientific decision in clinical treatment and teaching of acupuncture and moxibustion. It is the new attempt to the informatization research of human body meridian.

Efficacy of strategy of optimizing anesthetic management in preventing occurrence of cardiac arrest during thoracic surgery / 中华麻醉学杂志

The strategy of optimizing anesthetic management was carried out in all the patients un?dergoing thoracic surgery in our hospital from January 1, 2012: the patients were monitored using routine electrocardiogram combined with invasive arterial blood pressure monitoring, double?lumen central venous catheter pathway was established, and when severe bradycardia ( heart rate0?05) , and the incidence of cardiac arrest was decreased by 45% after optimizing anesthetic management. In conclusion, the strategy of optimizing anesthetic management is helpful in decreasing the occurrence of cardiac arrest during thoracic surgery.

Effect of HMGB1 on proliferation of human nasopharyngeal carcinoma cell line C666-1 in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of high-mobility group box-1 protein (HMGB1) on the proliferation of human nasopharyngeal carcinoma cell line C666-1 and explore the possible underlying mechanisms.</p><p><b>METHODS</b>Cultured C666-1 cells were treated with a siRNA targeting HMGB1 gene. The changes in the cell proliferation were detected by CCK8 analysis, the cell cycle distribution was assayed with flow cytometry, and the expressions of cyclin D1, CDK6 and related pathway proteins were detected with Western blotting. The effect of a HMGB1 plasmid carrying the reporter gene GFP on the proliferation of C666-1 cells was tested with CCK8 and EDU analysis.</p><p><b>RESULTS</b>Compared with the control cells, the cells transfected with the siRNA targeting HMGB1 showed obviously suppressed cell proliferation (P<0.001), cell cycle arrest in G1 phase (P<0.001), and down-regulated expressions of cyclin D1, CDK6, STAT3 and P-STAT3. Overexpression of HMGB1 in cells transfected with the HMGB1 plasmid showed a significantly increased ratio of S phase cells (P<0.05) and obviously enhanced cell proliferation (P<0.001).</p><p><b>CONCLUSION</b>HMGB1 can promote the proliferation of human nasopharyngeal carcinoma cell line C666-1 by up- regulating cyclin D1 and CDK6 via the STAT3 signaling pathway.</p>

FAT10 promotes invasion and metastasis of hepatocellular carcino-ma through activating RhoA / 中国肿瘤临床

Objective:To investigate the correlation of FAT10 expression with the malignant characteristics of hepatocellular car-cinoma (HCC), and to explore the effect of FAT10 on RhoA and cytoskeleton of HCC. Methods: Immunohistochemistry (IHC) was used to detect the FAT10 expression level of 108 HCC patients, and the correlation between the expression of FAT10 and the malignant characteristics of HCC patients was analyzed. We transiently transfected plasmids with overexpressed FAT10 using 7721 and HepG2 cells or interfered with FAT10 expression using siRNA in Huh7 and LM3 cells. Active-RhoA, total-RhoA, and ROCK protein expres-sion levels were detected by Western blot analysis after overexpression or interference. We also used immunofluorescence to detect changes in the cytoskeleton protein F-actin after FAT10 overexpression in 7721 cells. Results:Correlation analysis showed that both ac-tive-RhoA and FAT10 expression levels were significantly correlated with clinical malignant characteristics by using IHC (RhoA:me-tastasis, P=0.036 and recurrence, P=0.026;FAT10:metastasis, P=0.031 and recurrence P=0.004). In addition, active-RhoA expression level was correlated with FAT10 (P=0.000). Survival analysis showed that the prognoses of low-expression active RhoA (P=0.019) or FAT10 (P=0.026) groups were significantly better than those of the high-expression groups. Western blot analysis showed that FAT10 increased the expression of active-RhoA and ROCK. However, the expression of active-RhoA and ROCK decreased after FAT10 inter-ference. F-actin expression increased in the 7721 cells with overexpressed FAT10 (all P<0.01). Moreover, FAT10 facilitated F-actin ag-gregation on cell membrane and changes in F-actin. Conclusion:FAT10 is correlated with the malignant characteristics of HCC and may promote changes in HCC cytoskeleton induced by active-RhoA.

A restrospective analysis of adverse events during peri-anesthesia period in patients scheduled for thoracic surgery / 中华麻醉学杂志

From August 2006 to June 2011 among consecutive 18 294 patients underwent thoracic surgery from Shanghai Chest Hospital,41 developed adverse events during peri-anesthesia period and the incidence was 0.224％,and the constituent ratios of the predictable and unpredictable events were 15％ and 85％,respectively.Cardiac arrest and massive hemorrhage were the main clinical manifestation of the adverse events and the constituent ratios were 37％ and 24％,respectively.Among the inducements for adverse events,patient's factor,surgical factor,anesthesia factor,patient-surgery factor,patient-anesthesia factor and patient-surgery-anesthesia factor accounted for 12.2％,48.8％,12.2％,7.3％,7.3％ and 12.2％,respectively.The ratio of death from adverse events was 17％ (7 cases),and among the inducements for adverse events causing death,surgical factor,patient-surgery factor and patient-surgery-anesthesia factor accounted for 43％,43％ and 14％,respectively.The incidence of adverse events was 1.093％ in the patients underwent operation on trachea,which was significantly higher than that in the patients underwent operation on lung (0.223％),mediastinum (0.236％) and esophagus (0.194％).In conclusion,although the adverse events which occurred during peri-anesthesia period in the patients underwent thoracic surgery were rare,they threatened the safety of patients.Surgical factor was not only the main inducement,but also the risk factor for death,and cardiac arrest and massive hemorrhage were the main clinical manifestation of the surgery-related adverse events.For cardiac arrest,as long as it was found in time and treated appropriately,the serious consequences could be avoided.For massive hemorrhage,more attention should be paid due to be the main reason of death,and the prevention depended on the surgeon's improvement of diagnosis and surgery.It was difficult to predict patient-related the adverse events and careful monitoring was required.For the anesthesia-related adverse events,they were mostly due to the poor airway management,so preoperative airway assessment should be strengthened.

miR-128a is up-regulated in hepatocellular carcinoma and promotes tumor cell proliferation by targeting RND3 / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expression of microRNA-128a (miR-128a) and its role in hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Nineteen pairs of fresh surgical specimens of HCC and adjacent tissues were examined for miR-128a expression using qRT-PCR. A miR-128a mimics or inhibitor was transfected into HCC cells, and the cell viability was analyzed by MTT assay. RND3, one of the potential targets of miR-128a, was predicted by bioinformatics software and demonstrated by dual luciferase reporter assay. The expression of RND3 after transfection was detected using qRT-PCR and Western blotting, and the cell cycle-related proteins were determined with Western blotting.</p><p><b>RESULTS</b>The expression of miR-128a were significantly up-regulated in HCC tissues as compared to the adjacent tissues (P<0.05). In cultured HCC cells, miR-128a promoted the cell proliferation and resulted in down-regulated RND3 mRNA and protein expressions by targeting RND3' 3'UTR (P<0.05) and also in the down-regulation of cyclin B1, cyclin D1 and CDK4 protein expressions.</p><p><b>CONCLUSION</b>miR-128a is up-regulated in HCC and promotes HCC cell proliferation by targeting RND3.</p>