Failure mode and long-term survival after neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma / 中华放射肿瘤学杂志

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.

Increased EZH2 Levels in Anterior Cingulate Cortex Microglia Aggravate Neuropathic Pain by Inhibiting Autophagy Following Brachial Plexus Avulsion in Rats / 神经科学通报·英文版

After brachial plexus avulsion (BPA), microglia induce inflammation, initiating and maintaining neuropathic pain. EZH2 (enhancer of zeste homolog 2) has been implicated in inflammation and neuropathic pain, but the mechanisms by which it regulates neuropathic pain remain unclear. Here, we found that EZH2 levels were markedly upregulated during BPA-induced neuropathic pain in vivo and in vitro, stimulating pro-inflammatory cytokines (IL-1β, TNF-α, and IL-6) secretion in vivo. In rats with BPA-induced neuropathic pain, mechanical and cold hypersensitivities were induced by EZH2 upregulation and inhibited by EZH2 downregulation in the anterior cingulate cortex. Microglial autophagy was also significantly inhibited, with EZH2 inhibition activating autophagy and reducing neuroinflammation in vivo. However, this effect was impaired by inhibiting autophagy with 3-methyladenine, suggesting that the MTOR signaling pathway is a functional target of EZH2. These data suggest that EZH2 regulates neuroinflammation and neuropathic pain via a novel MTOR-mediated autophagy signaling pathway, providing a promising approach for managing neuropathic pain.

Screening and identification of polypeptides targeting hepatitis B virus HBP-TP protein / 中华微生物学和免疫学杂志

Objective To identify specific peptides binding to hepatitis B virus ( HBV) DNA pol-ymerase TP region ( HBP-TP) and to study their effects on HBV replication. -ethods The phage polypep-tide display library was screened using the HBP-TP recombinant protein expressed in Escherichia coli as a substrate to obtain the specific phage, the polypeptide region of which was then sequenced. Polypeptide se-quences with a repetition rate greater than 10％ were counted and commercially synthesized. Changes in HBV replication were detected after treatment of HBV-expressing cells with synthetic peptides as drugs. Re-sults Eight peptides targeting HBP-TP recombinant protein were screened out from the phage display librar-y. One of the peptides was found to have a significant inhibitory effect on HBV replication at cellular level. Conclusions A HBP-TP protein-targeting polypeptide with an inhibitory effect on HBV replication was ob-tained.

Related factors of N2 lymph node metastasis in non-small cell lung cancer and selection of lymph node dissection / 中国医师杂志

Objective To analyze the related factors of lymph node metastasis in N2 group of patients with non-small cell lung cancer,and found its meaning for lymph node dissection.Methods A retrospective analysis was made on 110 patients with non-small cell lung cancer from July 2014 to May 2016 in our thoracic surgery department.Potential related factors were collected,single factor analysis and variate analysis were carried out to find the relationship between N2 lymph node metastasis and potential related factors.Results Univariate analysis showed that the longest diameter of the tumor ＞ 2 cm (P =0.016),lymph node imaging (P =0.021),pleural involvement (P =0.002) were related factors of lymph node metastasis in N2 group,and these three factors were independent related factors of lymph node metastasis in N2 group.Conclusions The longest diameter of the tumor,lymph node imaging and pleural involvement are related factors of N2 lymph node metastasis.Systematic lymph node dissection is strongly recommended for patients with three related factors at the same time.

Analysis of the impacts of drug price markup reform on hospitalization expenses of tertiary public hospitals in Sichuan province / 中华医院管理杂志

Objective To analyze the impact of canceling drug price markup policy on hospitalization expenses of urban public hospitals in Sichuan province and provide decision-making basis. Methods Data of hospitalization expenses of the top 50 diseases among inpatients discharged in 2016 and 2017 were collected, totaling 2 732 022 inpatient cases. Based on hospitalization expenses, these disease were divided into seven categories ( A-G) using dynamic clustering analysis, which represent respectively dominant diseases of different expense makeups, to compare such indicators as hospitalization expenses and composition ratios of these diseases before (2016) and after the reform (2017). Results The study found drastic changes among the medical expenses of different categories of dominant diseases. For example, per-hospitalization cost of categories E ( featuring high drug and examination expenses ) and G ( featuring balanced expenses distribution) diseases decreased since the reform, while the other categories rose instead. The proportion of drugs of different disease categories decreased to various extents. For example, category A ( high drug ratio of 5.60% ) and category E (5.15% ) diseases of which were found with the sharpest drop. Proportion of service expenses, on the other hand, rose to different extents. For example, the proportion of service expenses of all disease categories increased to varying degrees, among which category E (3.46% ), category F (3.37% ) and category D (3.36% ) accounted for the largest share of increase.Conclusions The reform is moving the cost structure of dominant diseases in Sichuan towards a rational level, yet with significant differences among disease categories. The authorities should target various categories to adjust their reimbursement policies, minimize financial burden on patients, strengthen their supervision on drug use and medical behavior, prevent such misbehaviors as the inducing demands and transferring drug markups.

Advanced natural products chemistry research in China between 2015 and 2017 / 中国天然药物

In this review, we intensively focus on the advances in research of natural products (NPs) discovery carried out by domestic scholars in China from 2015 through 2017. In general, a total of 1811 publications (1479 in English and 332 in Chinese) were accumulated regarding newly isolated NPs from plants, microorganisms, and marine sources. As a result, 277 selected papers concerning naturally occurring compounds with extraordinary frameworks, origins, and promising activities were discussed in this review article, mainly organized according to their structural classes and novelties.

Advanced natural products chemistry research in China between 2015 and 2017 / 中国天然药物

In this review, we intensively focus on the advances in research of natural products (NPs) discovery carried out by domestic scholars in China from 2015 through 2017. In general, a total of 1811 publications (1479 in English and 332 in Chinese) were accumulated regarding newly isolated NPs from plants, microorganisms, and marine sources. As a result, 277 selected papers concerning naturally occurring compounds with extraordinary frameworks, origins, and promising activities were discussed in this review article, mainly organized according to their structural classes and novelties.

DRGs-based evaluation of medical service quality and performance at tertiary hospitals in Sichuan province / 中华医院管理杂志

Objective To evaluate the performance of medical services of 18 tertiary hospitals in Sichuan province in 2016 based on DRGs, to identify objective methods to evaluate service quality and performance of medical institutions.Methods Based on the homepage data of inpatient medical records from 18 tertiary hospitals in Sichuan in 2016, using diagnosis-related groups as a risk-adjustment tool, the study evaluated the medical service quality and performance from three dimensions:medical ability,service efficiency and medical Quality.Results In the evaluation of medical service capacity, hospital I had the highest number of discharged cases and total weight(83 405 cases and 126 522.22),and hospital G had the lowest discharge cases and total weight(2 350 cases,2 797.12).The highest number of DRGs group was from hospital B(661 groups),and the lowest from hospital G(43 groups).The highest value of CMI was from hospital F(2.091),and the lowest from hospital D(0.953).Hospitals B,I and P had wide disease type range,while hospitals F, B and I had higher overall technical level than the other hospitals.Of the service efficiency evaluation,hospital E had the lowest time consumption index(0.740),and hospital P had the lowest expenditure index(1.073).Of the service quality evaluation,hospitals F and G had the lowest risk of mortality and the lower risk of mortality(0.00%,0.00%).Hospital I had the highest total score (100.0 points), and hospital G had the lowest total score(51.1 points).Conclusions DRGs based evaluation on medical service quality and performance of medical institutions can ensure reliability and scientific adequacy of evaluation.It may contribute to the continuous improvement of medical quality, and provide data support and decision reference for medical service supervision.

Study on chemical constituents from Carpesium faberi / 中草药

Objective: To investigate the chemical constituents from the whole plant of Carpesium faberi. Methods: Compounds were isolated by various chromatographic techniques, including silica gel, ODS, sephadex LH-20, and semi-preparative HPLC, and their structures were identified by comparison of their experimental spectroscopic data with their reported data. Results: The phytochemistry investigation led to the isolation of 12 compounds, and their structures were elucidated as ent-kaurane-3β,16β,17-triol (1), 3-(hydroxy-acetyl)-1H-indole (2), 8,9,10-trihydroxythymol (3), 8-hydroxy-9,10-diisobutyryloxy-thymol (4), neryl-β-D- glucopyranoside (5), (3S)-linalyl-β-D-glucopyranoside (6), (1R,2S,4S,5R)-2,5-dihydroxy-p-menthane (7), luteolin (8), apigenin-7-O-β-D-glucopyranoside (9), medioresinol (10), pinoresinol (11), and a mixture of silybin and isosilybin (12). Conclusion: All compounds except compound 7 are not only isolated from this plant for the first time, but also from this genus for the first time.

Survival condition and predictive model in a large data of esophageal squamous cell carcinoma / 中华胸心血管外科杂志

Objective The survival and prognosis factors of thoracic esophageal squamous cell carcinoma patients after radical resection was investigated.Methods 1923 patients of thoracic esophageal squamous cell carcinoma after radical resection were included in our study from January 1th 2000 to January 1th 2010 in Zhejiang Cancer Hospital,1 670 male and 253 female.the age in the majority with 40 to 59 years old(1 076/1 923,56.0％).Eighteen prognosis factors were collected.A multivariate analysis of these selected variables was performed using Cox proportional model and prognosis index.We used life table for accumulated survival rate.Results The accumulated survival rate for all patients were 82％,48％ and 35％ in 1 year,3 years and 5 years,respectively.Median survival time was 35.42 months.The significant prognosis factors included body mass index,length of tumor,depth of invasion,differentiation degree,lymph node metastatic degree and region,complication of surgery.Conclusion The prognosis of thoracic esophageal squamous cell carcinoma was affected by multi-factors and prognosis index can predict survival condition.

Studies on sesquiterpene lactones from Carpesium faberi / 中国中药杂志

By using various chromatographic techniques,18 sesquiterpene lactones were isolated from the acetone extract of Carpesium faberi. Their structures were identified on the basis of comprehensive spectroscopic data, involving 2 carabrane sesquiterpenoids [carabrone(1), 4R-carabrol(2)], 3 eudesmane sesquiterpenoids [granilin(3), 3-epi-isotelekin(4), 1α-hydroxypinatifidin(5)], 8 guaiane sesquiterpenoids [4β,10α-dihydroxy-5α(H)-1,11(13)-guaidien-8α,12-olide(6), 8-epi-helenium lactone(7), 4-epi-isoinuviscolide(8), 9β,10β-epoxy-4α-hydroxy-1β-H,11α-H-guaian-8α,12-olide(9), 4α,10α-dihydroxy-1β(H),5β(H)-guaian-11-(13)-en-8α,12-olide(10), 4α-hydroxy-9β,10β-epoxy-11β-H,5α-H-guaian-11(13)-en-8α,12-olide(11), 4α-hydroxy-1β,5α,11α-H-guaian-9(10)-en-8α,12-olide(12), inuviscolide(13)], 1 pseudoguaiane sesquiterpenoid [(+)-confertin(14)], 3 germacrane sesquiterpenoids [madolin B(15), carabrolactone A(16),11(13)-dehydroivaxillin(17)], 1 xanthane sesquiterpenoid [tomentosin(18)]. Furthermore, the absolute configuration of 1 was confirmed by Cu-Kα X-ray crystallographic analysis,and the R-configuration of the chiral center at C-4 in 2 was established by the modified Mosher's method.The compounds 2-5, 7 and 9-15 were isolated from this plant for the first time, and compounds 4-5, 7, and 12-15 were isolated from this genus for the first time.In addition, the neurotrophic activity of compounds 1-3, 6 and 17 were evaluated by morphological observation and statistical analysis of cells differentiation, using rat pheochromocytoma(PC12)cells as a model system. However, all compounds were inactive.

Application of rapid proto-typing technology in the treatment of Standford type a aortic dissection / 安徽医科大学学报

To explore the feasibility of rapid proto-typing ( RP) technology in the treatment of Standford type A aortic dissection. 5 patients with Standford type A aortic dissection received computed tomography angiography (CTA) of their aortas. The CTA images were then processed by 3D reconstruction with MIMICS16. 0 in order to create aortic dissection models through RP technology based on real patient aorta size with a ratio of 1 ∶ 1 . Accord-ing to these models, the surgeons were able to fully understand the aortic diseases of patients, thus establish indi-vidualized treatment strategies for each patient. Besides, the surgeons simulated operations on the models, which helped them achieve better results in real surgery. These patients experienced no post-operative complications and were discharged from hospital with recovery. In conclusion, RP technology can provide adequate preoperotive prep-arations for patients with Standford type A aortic dissection, improve operation efficiency and accuracy in aortic dis-section and guide precise proximal anchoring of stents during intracavitary therapy.

Final test analysis and teaching reflection of clinical diagnostics / 中华医学教育探索杂志

Objective To evaluate the quality of the examination paper of the theory of Clinical Diagnostics,to explore and reflect on the teaching methods,so as to improve the quality of teaching.Methods Finals results of Clinical Diagnostics including 40 clinical undergraduates of Capital Medical University were analyzed.SPSS 20.0 was used to make analysis of the frequency,means statistics and normality of the examination paper.Kuder Richardson/Cmnbacha formula,percentage unification methods and so on were used to calculate confidence,validity,difficulty and degrees of distinction.Acquisition of relevant knowledge was assessed according to score distribution,while test paper quality was evaluated based on indicators including confidence,validity,difficulty and degrees of distinction.Results Test scores of 40 students were between 61 to 96 (83.64 ± 8.07).The degree of confidence (γ) for choice questions and subjective questions was 0.65 and 0.59 respectively;The validity (V) was 0.27;The overall difficulty (P) of the examination was 0.84;The degrees of distinction (D) were between 0.16 to 0.30.And the total points losing rate was 16.36％.Conclusion The examination is of medium difficulty and good degree of distinction,but the teaching strategies still need further adjustment in order to improve the students' ability of flexible application of the basic knowledge.

MicroRNA-126 inhibits the proliferation of lung cancer cell line A549

OBJECTIVE@#To study the role of microRNA-126 in the development of lung cancer.@*METHODS@#The biological function of microRNA-126 was detected using EdU assay and CCK-8 assay; the target gene of microRNA-126 was analyzed using real time RT-PCR and Western blot assay.@*RESULTS@#In A549 cell line, overexpression of microRNA-126 inhibits the proliferation rate; VEGF is the target gene of microRNA-126; microRNA-126 exerts its function via regulating VEGF protein level.@*CONCLUSIONS@#microRNA-126 inhibits the proliferation in A549 cell line.

MicroRNA-126 inhibits the proliferation of lung cancer cell line A549

Objective:To study the role of microRNA-126 in the development of lung cancer.Methods:The biological function of microRNA-126 was detected using EdU assay and CCK-8 assay;the target gene of microRNA-126 was analyzed using real time RT-PCR and Western blot assay.Results: In A549 cell line, overexpression of microRNA-126 inhibits the proliferation rate; VEGF is the target gene of microRNA-126; microRNA-126 exerts its function via regulating VEGF protein level.Conclusions: microRNA-126 inhibits the proliferation in A549 cell line.

MicroRNA-126 inhibits the proliferation of lung cancer cell line A549

Objective: To study the role of microRNA-126 in the development of lung cancer. Methods: The biological function of microRNA-126 was detected using EdU assay and CCK-8 assay; the target gene of microRNA-126 was analyzed using real time RT-PCR and Western blot assay. Results: In A549 cell line, overexpression of microRNA-126 inhibits the proliferation rate; VEGF is the target gene of microRNA-126; microRNA-126 exerts its function via regulating VEGF protein level. Conclusions: microRNA-126 inhibits the proliferation in A549 cell line.

Diagnostic value of X-ray stereotactic vacuum-assisted biopsy for breast micro-calcification / 肿瘤研究与临床

Objective To compare the accuracy and clinical effect between X-ray stereotactic vacuum-assisted biopsy (SVAB) and metal wire guided lumpectony.Methods From January 2010 to June 2014,681 cases of breast micro-calcification biopsy were performed.Among them,78 cases were performed with SVAB and 603 eases were performed with the method of stereotaetic metal wire guided lumpectomy.All cases were non-palpable breast lesions (NPBLs) and breast imaging-reporting and data system (BI-RADS) assessment categories 4.The diagnostic accuracy and clinical effect were compared.Results The sensitivity of both methods was 100 ％ with no misdiagnosis.The underestimation rate of SVAB was 12.5 ％.Compared with the method of metal wire guided lumpectomy,SVAB had many advantages,such as easy to use,quickly performed,low rate of local deformation and lower rate of operative complications.77.5 ％ patients benefited from SVAB by avoiding open surgery of benign disease.Conclusions SVAB is an accurate,safe and convenient method of biopsy.It can be recommended as the preferred method of micro-calcification (BI-RADS 4).Additional operation should be performed on patients with the pathological diagnosis of middle and high grade of dysplasia and any kind of carcinoma.

Clinical implication of urinary protein markers in diabetic nephropathy and interventional effects of Chinese herbal medicine / 中国中药杂志

In clinic, some urinary protein makers can dynamically and noninvasively reflect the degree of renal tubular injury in patients with diabetic nephropathy (DN). These urinary biomarkers of tubular damage are broadly divided into two categories. One is newfound, including kidney injury molecule-1 (Kim-1), neutrophil getatinase-associated lipocalin (NGAL), liver-type fatty acid-binding protein (L-FABP) and cystatin C (CysC); the other one is classical, including beta2 microglobulin (beta2-MG), retinal binding protein (RBP) and N-acetyl-beta-D-glucosaminidase (NAG). It is reported that, the increases in urinary protein markers are not only closely related to the damage of tubular epithelial cells in DN patients, but also can be ameliorated by the treatment with Chinese herbal compound preparations or Chinese herbal medicine. Recently, although urinary proteomics are used in the protein separation and identification, the traditional associated detection of urinary protein markers is more practical in clinic. At present, it is possible that the associated detection of urinary biomarkers of glomerular and tubular damages may be a feasible measure to reveal the clinical significance of urinary protein markers in DN patients and the interventional effects of Chinese herbal medicine.

Sterols from roots of Clerodendrum trichotomum and their anti-inflammatory activity / 中草药

Objective: To investigate the anti-inflammatory chemical constituents from the roots of Clerodendrum trichotomum. Methods: The compounds were isolated and purified by silica gel, Sephadex LH-20 column chromatographies, as well as prep-HPLC; Their structures were characterized on the basis of physicochemical properties and their spectral analysis; An in vitro anti-inflammatory method was applied to determine their activities against interleukin-8 (IL-8) production. Results: Four 24-ethylcholestane derivatives have been identified as 24-ethyl-7-oxocholesta-5, 22(E), 25-trien-3β-ol (1), decortinone (2), 22-dehydroclerosterol (3), and clerosterol (4). Conclusion: Coumpounds 1-3 are isolated from the roots of C. trichotomum for the first time. The absolute configuration of C-24 of compound 1 is determined to be S. In an in vitro anti-inflammatory assay, compound 1 is found to show a remarkable inhibition on IL-8 production induced by interleukin-1β (IL-1β) in HT-29 cells.

Serratene triterpenoids in Lycopodium japonicum from Hubei province / 中草药

Objective: To investigate the chemical constituents in the whole plant of Lycopodium japonicum, native to Suizhou city, Hubei province for the first time. Methods: The compounds were isolated and purified by a combination of silica gel, ODS, and Sephadex LH-20 column chromatography and prep-HPLC. Their chemical structures were established by their physicochemical properties and spectral data. Results: Eight pentacyclic triterpenoids have been isolated and characterized from the methanol extract of the whole plant, they are 21-episerratenediol (1), serratenediol (2), α-onocerin (3), serrat-14-en-3β, 21β, 24-triol (4), 3β, 21α- dihydroxyserrat-14-en-16-one (5), lycoclavanol (6), lyclaninol (7), and 3α, 21β, 24-trihydroxyserrat-14-en-16-one (8). Conclusion: Compounds 1-8 are all serretene triterpenoids, the characteristic chemical constituents in the plants of genus Lycopodium L. Compound 5 is isolated from this plant for the first time.