Analysis of risk factors of perioperative complications in locally progressive gastric cancer patients / 国际外科学杂志

Objective:To investigate the risk factors affecting the occurrence of perioperative complications in patients with locally progressive gastric cancer undergoing radical gastric cancer treatment.Methods:The clinical data of 129 patients with locally progressive gastric cancer from January 2017 to December 2019 in Shaanxi Provincial People′s Hospital were retrospectively analyzed, including 98 males and 31 females, with an age ranged from 27 to 79 years and a mean age of (60.61±10.00) years. The postoperative complications of 129 patients with gastric cancer were firstly counted, and then the relationship between clinical data such as patients′ general condition, intraoperative status and pathological indexes and the occurrence of perioperative complications was analyzed by using univariate analysis, and significant factors were included in the logistic regression model for multifactor analysis to study the independent risk factors for the occurrence of perioperative complications.Results:Of the 129 patients, 25 cases (19.38%) had postoperative complications, including 10 cases (7.75%) with Clavien-Dindo classification combined with grade Ⅲ or higher complications. The results of univariate analysis suggested ACCI score >4 (30.76% vs 68.00%, χ2=11.86, P=0.001), body mass index ≥25 kg/m 2 (24.03% vs 60.00%, χ2=12.18, P=0.001), and preoperative hypoproteinemia (17.30% vs 36.00%, χ2=4.25, P=0.039), vascular cancer embolism (14.42% vs 40.00%, χ2=7.70, P=0.006), operative time ≥ 400 min (26.92% vs 52.00%, χ2=5.84, P=0.016), intraoperative bleeding ≥ 400 mL (13.46% vs 44.00%, χ2=12.03, P=0.001) were risk factors for the development of perioperative complications in patients with locally progressive gastric cancer. Multifactorial analysis showed that ACCI score >4, body mass index ≥25 kg/m 2, preoperative hypoproteinemia, vascular cancer embolism, and intraoperative bleeding ≥400 mL were independent risk factors for the occurrence of perioperative complications in patients with locally progressive gastric cancer ( P<0.05). Conclusions:The occurrence of perioperative complications in locally progressive gastric cancer hands was closely associated with ACCI score, body mass index, preoperative hypoproteinemia, vascular cancer embolism and intraoperative bleeding. ACCI score is expected to be a predictor of the occurrence of perioperative complications in patients with locally progressive gastric cancer.

A study on the difference of abdominal visceral fat area in postoperative complications in patients undergoing laparoscopic gastric stromal tumor surgery / 国际外科学杂志

Objective:To compare surgery-related indicators, patient recovery status, perioperative complications and risk factors affecting the occurrence of postoperative grade Ⅲ or higher complications in patients undergoing laparoscopic gastric mesenchymal tumor surgery with different visceral fat areas.Methods:Clinical data of 116 patients with gastric interstitial tumor in Shaanxi Provincial People′s Hospital from April 2014 to June 2020 were retrospectively analyzed, including 44 male patients and 72 female patients, with patient aged from 25 to 88 years old and the mean age was (61.8±10.7) years, including 54 patients in the high VFA group and 62 patients in the low VFA group. SPSS 23.0 was used for statistical analysis, and t-test and χ2 test were applied to compare and analyze the patients′ surgery-related indexes, postoperative recovery status, complications within 30 d after surgery and differences in Clavien-Dindo classification of complications, while univariate and multifactorial analyses were used to study the factors affecting the occurrence of postoperative grade Ⅲ or higher complications. Results:Patients in the high VFA group had a higher body mass index than in the low VFA group, and the difference was statistically significant ( t=4.48, P<0.001); patients in the high VFA group had longer operative time ( t=2.88, P=0.005), more intraoperative bleeding ( t=2.17, P=0.032), longer period of fasting ( t=2.73, P=0.008), longer time for defecation ( t=4.46, P<0.001) and bowel movement ( t=4.62, P<0.001), and longer postoperative hospital stay ( t=3.43) compared with those in the low VFA group ( t=2.73, P=0.001), prolonged defecation ( t=4.46), prolonged bowel movement ( t=4.62), and prolonged postoperative hospitalization ( t=3.43), with statistically significant differences ( P<0.05); the incidence of postoperative complications was significantly higher in the high VFA group (31.4%) compared with the low VFA group (14.5%) ( χ2=4.78, P=0.029); among them, the incidence of postoperative pulmonary infection was significantly higher in patients in the high VFA group (12.9%) compared with those in the low VFA group (1.6%), and the difference between them was statistically significant ( χ2=4.16, P<0.05); while the differences in postoperative incision-related complications, anastomotic fistula, lower limb venous thrombosis, and intestinal obstruction were not statistically significant ( P>0.05). The incidence of postoperative complications above grade Ⅲ of the Clavien-Dindo complication classification was significantly higher in patients in the high VFA group (16.7%) compared with those in the low VFA group (4.8%), and the difference between the two was statistically significant ( χ2=4.35, P<0.05); univariate analysis revealed that operative time ≥300 min and increased VFA were the risk factors for postoperative grade Ⅲ or higher complications, while VFA was not an independent risk factor. Conclusion:Larger visceral fat area increases the difficulty of laparoscopic gastric mesenchymal tumor surgery operation, and also affects patients′ postoperative recovery, leading to increased postoperative complications, but VFA is not an independent risk factor affecting the occurrence of postoperative grade Ⅲ or higher complications in patients with gastric mesenchymal tumor.

Analysis of poor distance visual acuity after refractive rotationally asymmetric multifocal intraocular lens implantation in cataract patients / 中国医师杂志

Objective:To analyze the cause of poor distance visual acuity after refractive rotationally asymmetric multifocal intraocular lens (IOL) implantation in cataract patients.Methods:The data were collected from patients who underwent cataract phacoemulsification combined with intraocular lens (refractive rotationally asymmetric multifocal intraocular lens, SBL-3) implantation at Beijing Aier Intech Eye Hospital from December 2016 to December 2018, and followed up for six months after operation. Standard logarithmic visual acuity chart was used to record uncorrected distance visual acuity, best corrected distance visual acuity, intermediate visual acuity, and near visual acuity. Defocus curve was drawn. The corneal topography, postoperative visual quality and intraocular lens centered or not were checked by Itrace.Results:Total 95 eyes of 70 patients were implemented by cataract phacoemulsification combined with regional refractive intraocular lens operation. Among them, uncorrected distance visual acuity of 16 eyes of 16 patients, were less than or equal to 0.6. The distance power zone of the intraocular lens of 7 patients were placed in the area of high corneal refractive power. Because of measurement error, reserved error, etc, the power of IOL in 7 patients had deviations. Farsightedness and dizziness occurred in 2 patients. The visual discomfort symptoms disappeared and vision improved through intraocular lens positioning.Conclusions:The poor quality of distance visual acuity is mainly caused by the coincidence of the distance power zone with the corneal high-refractive region, the deviation of the power of the intraocular lens, and the intraocular lens center shift. If the cornea has a high refractive area, the distance power zone should avoid to be placed in the same area. The intraocular lens should be reserved between 0-+ 0.25 D. Two-step surgery is recommended. It′s also recommended to make sure the lens is centered during the operation by lens reflection method.

Mechanism of Shengmaisan in Atrial Fibrillation Based on Network Pharmacology / 中国实验方剂学杂志

Objective:To study the mechanism of Shengmaisan in treating atrial fibrillation by regulating relative genes and signaling pathways based on network pharmacology. Method:Target genes of Shengmaisan were obtained using Bioinformatics Analysis Tool for Molecular Mechanism of TCM（BATMAN-TCM） database，and target genes of atrial fibrillation were obtained through GeneCards，OMIM and DisGeNET databases. The target genes of Shengmaisan-atrial fibrillation intersection protein were obtained through the integration of the two groups of genes. STRING was used to build the protein-protein interaction network and visualize the results. The drug-disease intersection genes were introduced into the DAVID 6.8 database for gene ontology （GO） analysis and enrichment analysis based on the Kyoto Encyclopedia of Genes and Geomes （KEGG）. Result:A total of 159 active ingredients for Shengmai powder for atrial fibrillation were obtained. After the drug targets and the disease targets were intersected，206 common targets were obtained. PPI protein interaction network analysis showed that AKT1，TP53，PRKACA，IL-1B，TNF，INS，PPAR，RXR，F2，CACAN1C PKC might be the core targets of Shengmaisan in treating AF. GO enrichment analysis was used to identify 175 items （P<0.05），among which biological processes mainly included regulation of heart rate by cardiac conduction，membrane depolarization during action potential；cell components mainly included voltage-gated sodium/ potassium/calcium channel complex；molecular functions mainly included high-voltage-gated calcium channel activity，steroid hormone receptor activity. Through KEGG pathway enrichment analysis，100 signaling pathways were identified，mainly including cGMP/PKG signaling pathway，cAMP signaling pathway，serotonergic synapse，renin secretion，calcium signaling pathway. Conclusion:Based on the network pharmacology，Shengmaisan has multiple mechanisms in the prevention and treatment of atrial fibrillation. This study explores relevant signaling pathways，advantages and research directions of Shengmaisan in treatment of atrial fibrillation，so as to lay the foundation for further experimental verification.

miR-4739 mediates pleural fibrosis by targeting bone morphogenetic protein 7.

BACKGROUND: Pleural fibrosis is defined as excessive depositions of matrix components that result in pleural tissue architecture destruction and dysfunction. In severe cases, the progression of pleural fibrosis leads to lung entrapment, resulting in dyspnea and respiratory failure. However, the mechanism of pleural fibrosis is poorly understood. METHODS: miR-4739 levels were detected by miRNA array and real-time PCR. Real-time PCR, western blotting and immunofluorescence were used to identify the expression profile of indicators related to fibrosis. Target gene of miR-4739 and promoter activity assay was measured by using dual-luciferase reporter assay system. In vivo, pleural fibrosis was evaluated by Masson staining and miR-4739 level was detected by In situ hybridization histochemistry. FINDINGS: We found that bleomycin induced up-regulation of miR-4739 in pleural mesothelial cells (PMCs). Over-regulated miR-4739 mediated mesothelial-mesenchymal transition and increased collagen-I synthesis in PMCs. Investigation on the clinical specimens revealed that high levels of miR-4739 and low levels of bone morphogenetic protein 7 (BMP-7) associated with pleural fibrosis in patients. Then we next identified that miR-4739 targeted and down-regulated BMP-7 which further resulted in unbalance between Smad1/5/9 and Smad2/3 signaling. Lastly, in vivo studies revealed that miR-4739 over-expression induced pleural fibrosis, and exogenous BMP-7 prevented pleural fibrosis in mice. INTERPRETATION: Our data indicated that miR-4739 targets BMP-7 which mediates pleural fibrosis. The miR-4739/BMP-7 axis is a promising therapeutic target for the disease. FUND: The National Natural Science Foundation of China.

Cigarette smoking aggravates bleomycin-induced experimental pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease that typically leads to respiratory failure and death. The cause of IPF is poorly understood. Although several environmental and occupational factors are considered as risk factors in IPF, cigarette smoking seems to be the most strongly associated risk factor. Here firstly, we treated mice with cigarette (16 mg tar, 1.0 mg nicotine in each cigarette) smoking and tried to explore the role of cigarette smoking in pulmonary fibrosis. Mice were continuously subjected to smoke for about 1 h each day (12 cigarettes per day, 5 days per week) during 40 days. Bleomycin was administrated by intraperitoneal injection at a dose of 40 mg/kg on days 1, 5, 8, 11 and 15. We found bleomycin induced pulmonary fibrosis in mice, and cigarette smoking augmented bleomycin-induced fibrosis reflected by both in fibrotic area and percentages of collagen in the lungs. Then we prepared and employed cigarette smoke extract (CSE) in cell models and found that CSE could induce the activation of p-Smad2/3 and p-Akt, as well as collagen-I synthesis and cell proliferation in lung fibroblasts and pleural mesothelial cells (PMCs). TGF-ß1 signaling mediated CSE-induced PMCs migration. Moreover, in vitro studies revealed that CSE had superimposed effect on bleomycin-induced activation of TGF-ß-Smad2/3 and -Akt signaling. TGF-ß-Smad2/3 and -Akt signaling were further augmented by cigarette smoking in the lung of bleomycin-treated mice. Taken together, these findings represent the first evidence that cigarette smoking aggravated bleomycin-induced pulmonary fibrosis via TGF-ß1 signaling.

A unique case report of endobronchial cryptococcosis and review of the literature.

Cryptococcosis is an infection caused by the yeast-like fungus Cryptococcus neoformans. Pulmonary cryptococcosis is typically identified as a single mass or as multiple nodules, while endobronchial lesions are quite rare. Here we report an uncommon case of pulmonary cryptococcosis presenting as endobronchial lesion in an immunocompetent patient. A 49-year-old male patient complained of intermittent cough with hemoptysis for two years. Computerized tomography of the chest showed a filling defect in the basal segment of the right lower lobe bronchus. A flexible bronchoscopic examination revealed a white smooth-surfaced polypoid lesion completely occluding the medial basal segment of the right lower lobe bronchus. The diagnosis was confirmed by bronchial biopsy under bronchoscopy, and the histopathologic findings showed the organisms were Cryptococcal neoformans. The patient was treated with fluconazole at a dose of 400 mg daily. The endobronchial lesion was found rapidly diminished after 18 days of therapy, and disappeared after 6.5 months of therapy by repeated fiberoptic bronchoscopy. Then the patient continued fluconazole for another 2.5 months. During the total 16 months' follow-up visits, the patient repeated CT scanning for five times, the results of which were all normal. The patient's symptoms disappeared as well, and now he is still under follow-up. This case highlights the fact that pulmonary cryptococcosis can present as endobronchial lesions even in immunocompetent subjects, mimicking lung tumor. Pathological confirmation is important to establish the definite diagnosis.

Medical thoracoscopy in China-the present status and the future.

Medical thoracoscopy (MT) refers to a minimally invasive procedure to inspect and perform a biopsy of the pleural space, as well as to perform therapeutic interventions, in a nonintubated patient under local anesthesia. This procedure provides the physician a window into the pleural space. Over the past two decades, MT has been developed very rapidly in China. We performed a review of the published data on MT in China, and estimated the present status, the challenges, and future perspectives of MT. From the data we conduct that MT is widely used well in China, not only in the diagnosis of exudative pleural effusions, but also in the management of pleural diseases, such as tuberculous pleural effusion, malignant pleural effusion and spontaneous pneumothorax. Meanwhile, it is noteworthy that few prospective clinical trials, lack of routine follow-up of MT are current domestic problems for diagnosis and management in pleural effusion. Consequently, more prospective, randomized clinical trials are needed to assess the diagnostic value and treatment superiorities of MT compared with traditional methods or other subjects in China in the future.

Expression and Clinicopathological Significance of LAMP2a in Colorectal Cancer / 中国医科大学学报

Objective To investigate the clinicopathological and prognostic significance of lysosome-associated membrane protein-2a (LAMP2a) expression in the development of colorectal cancer.Methods Immunohistochemistry was performed to detect the LAMP2a expression in colorectal cancer,normal mucosa,and adenoma tissues.Results LAMP2a expression in colorectal cancer and adenoma was higher than that in normal mucosa (P ＜ 0.05).Further,LAMP2a expression in colorectal cancer was negatively correlated with TNM staging and lymph node metastasis (P ＜ 0.05);however,the invasion and liver metastasis,depth of invasion and differentiation had no correlation with the lymph node (P ＞ 0.05).Kaplan-Meier analysis showed that LAMP2a expression in colorectal cancer is not significantly correlated with good prognosis (P ＞ 0.05).Univariate survival analysis showed that lymphatic invasion,vascular invasion,lymph node metastasis,TNM stage,liver metastasis,distant metastasis,and differentiation were correlated with poor prognosis of colorectal cancer (P ＜ 0.05).The Cox proportional hazards regression model showed that the depth of invasion and distant metastasis were important factors affecting the survival period of patients with colorectal cancer (P ＜ 0.05).Conclusion LAMP2a may play a role in the carcinogenesis and progression of colorectal cancer,and may be used as a molecular marker for the biological behavior of colorectal cancer.

Effects of ING5 gene on the malignant phenotype of breast cancer Bcap-37 cells / 解放军医学杂志

Objective To investigate the effects of inhibitor of growth 5 (ING5) gene on the proliferation, apoptosis, migration and cell cycle of human breast cancer Bcap-37 cells.Methods The eukaryotic ING5-expressing plasmid and GFP-empty plasmid were steadily transfected in Bcap-37 cells, the expression of green fluorescent protein was measured with fluorescence microscopy, and the high expression of ING5 was measured by real time-PCR. Bcap-37-ING5 cells served as the experimental group, Bcap-37-GFP cells as the mock group and Bcap-37 as the control group. The effects of ING5 on the proliferation were detected by MTT, the cell cycle and apoptosis were detected by Flow cytometry, and the cell migration was detected by cell wound scratch assay and Transwell experiment.Results Bcap-37 cell lines steadily expressing ING5 protein with GFP-tag were acquired by stable transfection. ING5 over-expression inhibited the proliferation and led to G2 arrest of Bcap-37 cells, increased cells apoptosis and decreased the cell migration ability (P<0.05).Conclusion ING5 over-expression may have reverse effect for malignant phenotype of breast cancer cells, and may be employed to indicate the biomarker of prognosis of breast cancer patients and regarded as a target of gene therapy.

The expression of CREB in the Glioma / 中国神经精神疾病杂志

Objective To investigate the clinical significance and abnormal expression of the CREB in different grade gliomas. Methods The expression of CREB was examined by using immunohistochemistry in brain tissues from the brain injury (5 cases) and different grade gliomas (55 cases).The mRNA and protein levels of CREB were further as?sessed using Western blot and RT-PCR in brain tissues from the patients with brain injury (10 cases) and those with dif?ferent grade gliomas (30 cases). Results The positive rates of CREB immunohistochemistry were 2/5 in control, 10/15 inⅠ-,Ⅱ11/12 in Ⅲ, 28/28 in Ⅳ. The positive rates of CREB were significantly different among different groups (H=28.183,P<0.05).The mRNA levels of CREB were 1.00 ± 0.000 in control, 1.35 ± 0.068 inⅠ-Ⅱ, 2.88 ± 0.111 in Ⅲand 3.75 ± 0.196 in Ⅳ. The expression of CREB was higher in the glioma than in control group, and the mRNA levels of CREB were significantly different among different groups(F=1.208,P<0.05). The protein levels of CREB were 0.311 ± 0.014 in control, 0.469±0.026 inⅠ-Ⅱ, 0.641±0.028 inⅢand 0.896±0.024 inⅣ. The protein levels of CREB were sig?nificantly different among different groups(F=1.123,P<0.05). Conclusion The expression of CREB is elevated in glio?mas with different differentiation degrees. The expression of CREB was positively correlated with the degree of differentia?tion, indicating that CREB may have an important regulatory role in the progress of gliomas.

Clinicopathological Significance and Relevant Molecular Mechanisms of Beclin 1 in Gastric Cancer / 中国医科大学学报

Objective to explore the role of Beclin 1 in gastric carcinogenesis and subsequent progression. Methods MkN28 cells were trans-fected with Beclin 1-expressing plasmid,and then the proliferation and cell cycle was measured by CCk-8 and PI staining. Beclin 1 expression was examined by immunohistochemistry and in situ hybridization on tissue microarrays containing gastric cancers,adjacent non-neoplastic mucosa,and metastatic lymph node. the correlation with the tumorgenesis,clinicopathological and prognostic parameters was analyzed. Results Beclin 1 overex-pression resulted in G2 arrest of MkN28 cells and reduced the proliferation. Beclin 1 mRNA was highly expressed in gastric cancer than matched mu-cosa by ISH(P < 0.05). Beclin 1 was highly expressed in male than female patients with gastric cancer(P < 0.05). the elder patients with gastric cancer had higher Beclin 1 expression than younger ones(P < 0.05). the diffuse-type carcinomas showed less Beclin 1 expression than intestinal and mixed type ones(P < 0.05). kaplan-Meier analysis indicated that Beclin 1 expression was positively correlated to favorable prognosis of the can-cer patients(P < 0.05). Conclusion Beclin 1 expression is closely linked to pathogenesis,metastasis and differentiation of gastric cancer. Beclin 1 might be employed to indicate the favorable prognosis of gastric cancer patients and regarded as a target of gene therapy.

[Effects of fuel properties on the performance of a typical Euro IV diesel engine].

With the purpose of establishing diesel fuel standard for China National 4th Emission Standard, as one part of Beijing "Auto-Oil" programme, engine performance test has been done on a typical Euro IV diesel engine using eight diesel fuels with different fuel properties. Test results show that, fuel properties has little effect on power, fuel consumption, and in-cylinder combustion process of tested Euro IV diesel engine; sulfate in PM and gaseous SO2 emissions increase linearly with diesel sulfur content increase; cetane number increase cause BSFC and PM reduce and NOx increase; T90 decrease cause NOx reduce while PM shows trend of reduce. Prediction equations of tested Euro IV diesel engine's ESC cycle NOx and PM emissions before SCR response to diesel fuel sulfur content, cetane number, T90 and aromatics have been obtained using linear regression method on the base of test results.

Studies on the infection status of seven species Mycoplasma, three species of Chlamydia, Neisseria gonorrhoeae and Garderella vaginalis in 76 patients with sexual transmitted diseases / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the infectious status of seven species of Mycoplasma, three species of Chlamydia, Neisseria gonorrhoeae and Garderella vaginalis in the 76 male sexual transmitted disease (STD) patients in Yangzhou city.</p><p><b>METHODS</b>Twelve species of pathogens including Ureaplasma urealyticum (Uu), Mycoplasma hominis (Mh), Mycoplasma pneumoniae (Mpn), Mycoplasma genitalium (Mg), Mycoplasma fermentans (Mf), Mycoplasma penetrans (Mpe), Mycoplasma prium (Mpi), Chlamydia trachomatis (Ct), Chlamydia pneumoniae (Cpn), Chlamydia psittaci (Cps), Neisseria gonorrhoeae (Ng) and Garderella vaginalis (GV) were detected by nested polymerase chain reaction including PPNG.</p><p><b>RESULTS</b>The positive rates of Uu, Mh, Mpn, Mg, Mf, Mpe, Ct, Ng were 64.5%, 27.6%, 26.3%, 18.4%, 2.6%, 2.6%, 31.6%, 36.8%, in which Penicillinase-producing neisseria gonorrhoeae (PPNG) accounted for 14.3%, GV 15.8%. No Mpi, Cpn or Cps were found. There was more significant therapeutic effects on the detectable rate of Mycoplasma nucleic acid between positive gonococcus and negative gonococcus in male STDs patients (chi(2) = 3.848, P < 0.05).</p><p><b>CONCLUSION</b>The infection rates of Mycoplasma, Chlamydia, Ng and GV were high among male STD patients in Yangzhou city. In clinical practice, more attention should be paid on correct diagnosis and treatment for patients, with Gonococcus, Chlamydia, Mycoplasma and GV.</p>

Study on the disabilities in aged 0-7 years children in Shenzhen, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the prevalence of vision, mental, audibility, language, psychiatry, extremity, and influence factors in the 0 - 7 year olds.</p><p><b>METHODS</b>A total number of 77,727 0 - 7 year old children living in Shenzhen city were tested with tree phase screening under the Chinese standard of evaluation in disabilities.</p><p><b>RESULTS</b>The prevalence of all disabilities was 5.59 per thousand (adjusted rate was 8.49 per thousand with a false negative of 3.1 per thousand ). The prevalence of mental disease was the highest (1.88 per thousand, with adjusted rate 3.43 per thousand ), the prevalence of language disability was 1.88 per thousand (including retarded language development, with adjusted rate 3.43 per thousand ). The prevalence rates of psychiatry, extremity and audibility disability were 1.59 per thousand, 1.56 per thousand, 1.11 per thousand respectively with of vision the lowest (0.37 per thousand ). The prevalence of all disabilities, audibility, language and mental was on the increase with age. The difference was statistically significant. Among all different age groups regarding psychiatric disease, the highest fell in the 2 - 4 year olds. The prevalence of extremity was not statistically different among age groups. The suspected agents of disease which occurred before or during pregnancy took up 45.7%.</p><p><b>CONCLUSION</b>The prevalence of six kinds disabilities in Shenzhen was about 10 per thousand lower than that of the samples of the nation in 1989, but two times higher than that of similar studies in Japan. The prevalence rates of language and psychiatric disease were higher than that of the nation in 1989. The causation should be further studied.</p>