Primary site surgery for elderly patients with distant metastatic pancreatic neuroendocrine tumor: to do or not to do?

OBJECTIVE: To investigate the effect of primary site surgery (PSS) on elderly patients (≥65 years) with pancreatic neuroendocrine tumor (pNET) distant metastasis. PATIENTS AND METHODS: We reviewed Surveillance Epidemiology and the End Results database for elderly patients with distant pNET from 1973 to 2015. The variables and survival outcomes of patients with PSS were compared with that of patients with no PSS. After propensity score matching, the survival outcome was compared again between the two groups. Multivariable Cox proportional hazard model was used to identify variables associated with cancer-specific and overall survival. Four sub-groups were divided according to the age and differentiation: 1) age 65-74 years+ well or moderately differentiated; 2) age ≥75 years+ well or moderately differentiated; 3) age 65-74 years+ poorly differentiated or undifferentiated; and 4) age ≥75 years+ poorly differentiated or undifferentiated. Cancer-specific survival was compared between the patients with and without PSS in the above each group. RESULTS: A total of 210 elderly patients with distant pNET were finally confirmed. Of which, 148 patients did not undergo PSS, while 62 patients underwent PSS. Being female (p=0.049), locating on body/tail of pancreas (p=0.006), and well or moderately differentiated (p=0.032) were more likely received PSS. The patients underwent PSS had better survival outcomes both before and after propensity score matching. Multivariable Cox proportional hazard analysis proves PSS and higher histological grade to be protective and risk factors. PSS may improve cancer specific survival in patients of group 1), and no improvement was observed in patients of the other three sub-groups. CONCLUSION: Not all elderly patients with pNET distant metastasis could benefit from PSS. Patients aged 65-74 years with well or moderately differentiated may benefit from primary lesion surgery, but should be evaluated carefully. Prospective randomized controlled trials are worth performing.

Features of continuous glycemic profile and glycemic variability in patients with obstructive sleep apnea syndrome.

AIMS: To investigate glycemic variability (GV) in Obstructive Sleep Apnea Syndrome (OSAS) patients by monitoring continuous blood glucose profile. METHODS: OSAS group (n=86) and normal control group (n=40) were included. Continuous blood glucose was monitored. The relationship of GV, insulin resistance index (IRI) and the respiratory disturbance index (AHI) were analyzed. RESULTS: The daily average blood glucose level was significantly higher in the OSAS patients than in the control group (6.31±0.61vs. 4.94±0.78; P<0.01). The postprandial glycemic peaks in the OSAS patients were significantly higher and prolonged. The indicators of GV were all significantly higher in the OSAS patients, including blood glucose fluctuation coefficient (BGFC, 1.93±0.71vs. 1.21±0.38, P<0.05), mean amplitude of glycemic excursions (MAGE, 4.18±0.65vs. 2.18±0.48; P<0.05) and night mean amplitude of glycemic excursions (NMAGE, 2.00±0.53vs. 1.11±0.43; P<0.05). Pearson correlation analysis showed that among the OSAS patients, the severity of OSAS (AHI) was positively correlated with the IRI (r=0.310); and the GV indicators (MAGE and NMAGE) were positively correlated with IRI and AHI (r=0.318 and 0.349, respectively) (P<0.01 or 0.001). CONCLUSIONS: Continuous glycemic spectrum and GV provide comprehensive glycemic profiles and may reveal important aspects of glucose metabolism abnormality beyond regular examinations, and are therefore of particular significance for glycemic management in OSAS patients.

Platycodin D exerts anti-tumor efficacy in H22 tumor-bearing mice via improving immune function and inducing apoptosis.

Platycodin D (PD), a major saponin derived and isolated from the roots of Platycodon grandiflorum, exerts potent growth inhibition and strong cytotoxicity against various cancer cell lines. However, the anti-tumor efficacy of PD on H22 hepatocellular carcinoma remains unknown. In the present study, we aimed to explore the anti-hepatoma activity in vivo and the underlying mechanism of PD in H22 tumor-bearing mice. The results revealed that PD could considerably suppress tumor growth with no significant side effects on immune organs and body weight. Further investigations showed that the levels of serum cytokines, including interferon gamma (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-2 (IL-2), were enhanced by PD administration. On the other hand, PD inhibited the production of vascular endothelial growth factor (VEGF) in serum of H22 tumor mice. Additionally, the observations from H&E and Hoechst 33258 staining results demonstrated that PD noticeably induced apoptosis in H22 hepatocellular carcinoma cells. Importantly, immunohistochemical analysis showed that PD treatment increased Bax expression and decreased Bcl-2 and VEGF expression of H22 tumor tissues in a dose-dependent manner. Taken together, the findings in the present investigation clearly demonstrated that the PD markedly suppressed the tumor growth of H22 transplanted tumor in vivo at least partly via improving the immune functions, inducing apoptosis, and inhibiting angiogenesis.

[Study on Microwave Co-Pyrolysis of Low Rank Coal and Circulating Coal Gas].

The pyrolysis of low rank coal to produce bluecoke, coal tar and gas is considered to be the optimal method to realize its clean and efficient utilization. However, the current mainstream pyrolysis production technology generally has a certain particle size requirements for raw coal, resulting in lower yield and poorer quality of coal tar, lower content of effective components in coal gas such as H2, CH4, CO, etc. To further improve the yield of coal tar obtained from the pyrolysis of low rank coal and explore systematically the effect of microwave power, pyrolysis time and particle size of coal samples on the yield and composition of microwave pyrolysis products of low rank coal through the analysis and characterization of products with FTIR and GC-MS, introducing microwave pyrolysis of low rank coal into the microwave pyrolysis reactor circularly was suggested to carry out the co-pyrolysis experiment of the low rank coal and coal gas generated by the pyrolysis of low rank coal. The results indicated that the yield of the bluecoke and liquid products were up to 62.2% and 26.8% respectively when the optimal pyrolysis process conditions with the microwave power of 800W, pyrolysis time of 40 min, coal samples particle size of 5-10 mm and circulating coal gas flow rate of 0.4 L · min⁻¹ were selected. The infrared spectrogram of the bluecoke under different microwave power and pyrolysis time overlapped roughly. The content of functional groups with -OH, C==O, C==C and C−O from the bluecoke through the pyrolysis of particle size coal samples had a larger difference. To improve microwave power, prolonging pyrolysis time and reducing particle size of coal samples were conducive to converting heavy component to light one into coal tar.

Platycodin D isolated from the aerial parts of Platycodon grandiflorum protects alcohol-induced liver injury in mice.

Platycodin D (PD) is the main active saponin of Platycodon grandiflorum (PG) and is reported to exhibit multiple biological effects, including anti-tumor, anti-inflammation, and anti-obesity properties. Although recently there have been many research reports on the chemical constituents of the plant's roots, only few works have been reported on the aerial parts of PG. In the present study, we report the first isolation of PD from the aerial parts of PG and its protective effect against acute alcohol-induced liver oxidative injury and inflammatory response in mice. In brief, the protective effect was evaluated by tracking biochemical markers, enzymatic antioxidants and proinflammatory cytokines in serum and liver tissue. The results indicated that PD pretreatment significantly decreased the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (L-DLC) in serum and malondialdehyde (MDA) in liver. PD was also found to increase the activities of catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in the liver (p < 0.05). In addition, PD markedly decreased the levels of proinflammatory cytokines, including tumor necrosis factor-α (TNF-α), interleukin (IL)-1ß, and IL-6, which was caused by alcohol exposure (p < 0.05). In contrast, histopathological examinations revealed that PD pretreatment noticeably prevented alcohol-induced hepatocyte apoptosis and steatosis. Collectively, the present study clearly suggests that the protective effect exhibited by PD on alcohol-induced liver oxidative injury may occur via the alleviation of oxidative stress and inflammatory response.

Predictive analysis of beer quality by correlating sensory evaluation with higher alcohol and ester production using multivariate statistics methods.

Sensory evaluation is regarded as a necessary procedure to ensure a reproducible quality of beer. Meanwhile, high-throughput analytical methods provide a powerful tool to analyse various flavour compounds, such as higher alcohol and ester. In this study, the relationship between flavour compounds and sensory evaluation was established by non-linear models such as partial least squares (PLS), genetic algorithm back-propagation neural network (GA-BP), support vector machine (SVM). It was shown that SVM with a Radial Basis Function (RBF) had a better performance of prediction accuracy for both calibration set (94.3%) and validation set (96.2%) than other models. Relatively lower prediction abilities were observed for GA-BP (52.1%) and PLS (31.7%). In addition, the kernel function of SVM played an essential role of model training when the prediction accuracy of SVM with polynomial kernel function was 32.9%. As a powerful multivariate statistics method, SVM holds great potential to assess beer quality.

[Determination of 16 elements in the different pine pollen by TXRF].

After microwave digestion, 16 elements in pine pollen were simultaneously determined by TXRF. The results show that all the 16 elements were found in all pine pollens. There was a significant difference in the average content of the element such as Ca, Ti, Mn, Zn and Rb between different groups of pine pollen (P < or = 0.01). There was a difference in the average content of the element such as K, V, Fe, Co, Cu and Sr between them (P < or = 0.05). And there was no difference in the average content of the element such as Cr, Ni, As, Pb and Se between them. The results also show that pine pollen has the spectral characteristics of warm property or cold property drug. They were closely related to the tree species and the growth environment or the growth area.

[Sensory integration function in children with primary nocturnal enuresis].

OBJECTIVE: To assess the sensory integration function of children with primary nocturnal enuresis (PNE) and explore the role of sensory integration dysfunction in the pathogenesis of PNE. METHODS: Sensory integration function was assessed by the Childhood Sensory Integration Ability Development Checklist in 46 children with PNE and 46 normal children (control). RESULTS: The incidence of sensory integration dysfunction in the PNE group (82.6%) was significantly higher than that in the control group (43.5%)(P<0.01). Seventeen patients (36.9%) presented with severe sensory integration dysfunction in the PNE group but only 1 (2.1%) in the control group (P<0.01). The scores of all nine sensory integration indexes revealed by sensory integration function testing in the PNE group were significantly lower than those in the control group (P<0.01). CONCLUSIONS: Children with PNE have sensory integration dysfunction. Sensory integration dysfunction may be associated with the pathogenesis of PNE.