Analysis of risk factors for bleeding in patients with malignant obstructive jaundice after endoscopic retrograde cholangiopancreatography / 国际外科学杂志

Objective:To investigate the risk factor analysis and model prediction of bleeding after endoscopic retrograde cholangiopancreatography in patients with malignant obstructive jaundice (MOJ).Methods:A retrospective analysis was performed on 302 patients with MOJ treated with ERCP who were treated in the No. 363 Hospital Affiliated to Southwest Medical University from January 2015 to June 2021. The general clinical data of the patients were collected, and the biochemical indicators of the pancreatic and bile ducts were detected. The patients were followed up after discharge, and the patients were divided into a bleeding group ( n=47) and a control group ( n=255) according to whether the follow-up patients were bleeding after ERCP. Compared the general and clinical data of the two groups of patients, including age, gender, platelet count, presence of bile duct stones, acute cholangitis, acute pancreatitis, number of stones, intraoperative bleeding, pancreatic cancer, cholangiocarcinoma, large stone diameter, stone incarceration, duodenal papillary diverticulum, and pre-surgical incision. The measurement data that obey the normal distribution were represented by the mean±standard deviation ( ± s), and the two independent sample t test was used for the comparison between groups; the data that do not conform to the normal distribution were represented by M ( Q1, Q3), and the comparison between groups was used Mann-Whitney U test. The comparison of enumeration data between groups adopted chi-square test. Logistic multivariate regression was used to analyze the independent risk factors of postoperative bleeding after ERCP, and a nomogram prediction model was established and verified according to the independent risk factors of postoperative bleeding. Results:The two groups of patients were compared in age, gender, platelet count, bile duct stones, acute cholangitis, acute pancreatitis, the number of stones, intraoperative bleeding and other aspects, the difference was not statistically significant ( P>0.05). The percentages of pancreatic cancer, cholangiocarcinoma, large stone diameter, stone incarceration, duodenal papillary diverticulum, and surgical pre-incision in the bleeding group were 12.77%, 17.02%, 19.15%, 51.06%, 59.57%, and 14.89%, respectively. , the percentages of the control group were 3.92%, 5.10%, 9.02%, 19.22%, 17.65%, and 5.88%, and the difference was statistically significant between the two groups ( P<0.05). Taking postoperative bleeding as the dependent variable, and using the indicators with statistical differences in univariate analysis as independent variables, multivariate Logistic regression analysis showed that the patient had pancreatic cancer ( OR=1.838, 95% CI: 1.524-4.613, P=0.041), cholangiocarcinoma ( OR=2.548, 95% CI: 1.870-5.116, P=0.015), stone incarceration ( OR=3.078, 95% CI: 2.374-6.012, P<0.001), duodenum Intestinal papillary diverticula ( OR=1.140, 95% CI: 1.045-1.628, P<0.001), surgical pre-incision ( OR=1.640, 95% CI: 1.321-1.928, P<0.001) were associated with postoperative bleeding in MOJ patients after ERCP independent risk factors. The predictive ability of duodenal papillary diverticulum was the highest; the predictive ability of stone incarceration and cholangiocarcinoma was the second, and there was no significant difference between them; the predictive ability of pancreatic cancer, stone diameter, and pre-incision on bleeding after ERCP in MOJ patients smaller. Pancreatic cancer, cholangiocarcinoma, large stone diameter, stone incarceration, duodenal papillary diverticulum, and pre-incision scores were 42, 63, 28, 65, 76, and 34 points respectively, and the total score was 308 points corresponding to the nomogram model. The predictive power of the nomogram was 61.6%, and overall, the nomogram had good predictive performance. Harrell concordance index analysis and ROC curve were used to evaluate the model discrimination, the C-index calculation result was 0.826 (95% CI: 0.771-0.847), the ROC curve AUC was 0.843 (95% CI: 0.801-0.884), and the ROC prediction The value and the calculation result of C-index are relatively close. The model discrimination is applied in this study and has a certain prediction effect. The nomogram model in the Calibration curve predicted the probability of postoperative bleeding after ERCP in MOJ patients with high consistency with the actual probability. Conclusion:ERCP is safe and feasible for most patients with MOJ, but for patients with pancreatic cancer, bile duct cancer, large stone diameter, stone incarceration, and duodenal papillary diverticulum, it should be performed with caution, and preoperative incision should be avoided, to reduce the risk of postoperative bleeding. In addition, the nomogram model has a strong predictive ability in predicting bleeding after ERCP in patients with MOJ, which is worthy of reference in clinical research.

Monoclonal antibodies for the S2 subunit of spike of SARS-CoV cross-react with the newly-emerged SARS-CoV-2

The emergence of a novel coronavirus, SARS-CoV-2, at the end of 2019 has resulted in widespread human infections across the globe. While genetically distinct from SARS-CoV, the etiological agent that caused an outbreak of severe acute respiratory syndrome (SARS) in 2003, both coronaviruses exhibit receptor binding domain (RBD) conservation and utilize the same host cell receptor, angiotensin-converting enzyme 2 (ACE2), for virus entry. Therefore, it will be important to test the cross-reactivity of antibodies that have been previously generated against the surface spike (S) glycoprotein of SARS-CoV in order to aid research on the newly emerged SARS-CoV-2. Here, we show that an immunogenic domain in the S2 subunit of SARS-CoV S is highly conserved in multiple strains of SARS-CoV-2. Consistently, four murine monoclonal antibodies (mAbs) raised against this immunogenic SARS-CoV fragment were able to recognise the S protein of SARS-CoV-2 expressed in a mammalian cell line. Importantly, one of them (mAb 1A9) was demonstrated to detect S in SARS-CoV-2-infected cells. To our knowledge, this is the first study showing that mAbs targeting the S2 domain of SARS-CoV can cross-react with SARS-CoV-2 and this observation is consistent with the high sequence conservation in the S2 subunit. These cross-reactive mAbs may serve as tools useful for SARS-CoV-2 research as well as for the development of diagnostic assays for its associated coronavirus disease COVID-19.

Combined fibrinogen concentration and neutrophil-lymphocyte ratio as a prognosis indicator for gastrointestinal stromal tumors / 中华普通外科杂志

Objective To evaluate FIB-NLR,a combined neutrophil-lymphocyte ratio (NLR) and fibrinogen concentration (FIB) in predicting the prognosis of gastrointestinal stromal tumors (GIST).Methods Data of 79 GIST patients who underwent surgery from Jun 2010 to Dec 2014 were retrospectively analyzed.Patients were divided into 3 groups:NLR ＜ 2.30 and FIB ＜ 3.85 g/L were defined as group 0,NLR≥2.30 and FIB ＜3.85 g/L or NLR ＜2.30 and FIB≥3.85 g/L as group 1,NLR≥2.30 and FIB≥3.85 g/L as group 2.The clinicopathological features of the three groups and the 5-year recurrence-free survival rate after surgery were compared.Results FIB concentration and NLR were significantly correlated with NIH risk grade and tumor size in GIST patients (x2 =9.517,12.41 1,6.081,20.067,all P ＜ 0.05).FIB-NLR was closely related to tumor size,tumor risk and tumor mitosis (x2 =14.406,12.514,28.225,all P ＜ 0.05).Survival analysis showed that high FIB predicts lower 5-year recurrence-free survival rate,it was 87.4％ for group 0,60.8％ for group 1,21.1％ for group2,x2 =29.617,P＜0.000).Conclusion FIB-NLR independently predicts the prognosis of gastrointestinal stromal tumors.

Isolation, purification and antioxidant activity of polysaccharides from the leaves of maca (Lepidium Meyenii).

Two fractions of polysaccharides (MLP-1 and MLP-2) were extracted from the leaves of maca (Lepidium Meyenii Walp.) by water, and purified using DEAE-52 ion exchange resin and sephadex G-200 clumns chromatography. An investigation was carried out for their structural characterization and antioxidant activity in vitro. The results indicated that MLP-1 was mainly composed of ribose, rhamnose, arabinose, xylose, mannose, glucose and galactose, with the molar ratio of 0.12:0.32:1.50:0.32:1.03:1.00:0.93; the MLP-2 was a homopolysaccharide composed of glucose. The molecular weight (Mw) of MLP-1 was 42756Da, and the Mw of MLP-2 was 93541Da. The FT-IR spectra showed the general characteristic absorption peak of maca leaf polysaccharides (MLPs). The evaluation of antioxidant activity revealed that MLP-1 had strong scavenging effects in vitro on hydroxyl, superoxide anion and DPPH radicals, whose EC50 (mg/mL) was 0.44, 0.21, and 0.82, respectively. Both MLP-1 and MLP-2 presented dose-dependently positive effects on the antioxidant-related parameters. The results suggested that the purified MLP-1 displayed better antioxidant capacities than that of MLP-1, which could be explored as potential antioxidant agents for the complementary medicine or functional foods.

The relation between the trochlear line and the clinical epicondylar axis in patients with knee-osteoarthritis / 中国医师进修杂志

Objective To determine the angles of trochlear line(TL), antero-posterior line (APL) and posterior condylar line (PCL) with clinical epicondylar axis (CEA), analyze the variability difference in 3 axes relative to CEA. Methods The right knees in 36 patients with knee osteoarthritis (gradeⅣ) and who had underwent total knee arthroplasty were enrolled in this study, 11 male patients aged 60-81 (69.1 ± 6.3) years and 25 female patients aged 33- 85(67.7 ± 12.2) years. All of right knees were scanned using computed tomography. The angles between the CEA and each of the 3 axes (TL, PCL, APL) were measured using software. Results The angles of TL-CEA, APL-CEA and PCL-CEA was (6.10 ± 3.22)°, (85.80 ± 2.86)°and (2.70 ± 1.80)°. The F tests showed that the angel invariability between the TL and CEA the APL axis (α=0.58) or the PCL (α=0.28) for referencing the CEA had no significant differences. Conclusions The TL can be a relatively reliable reference axis to determine rotational alignment of the femoral component similar to PCL and APL.

Prognostic value of preoperative neutrophil lymphocyte ratio in patients with gastrointestinal stromal tumors / 中华普通外科杂志

Objective To investigate the prognostic value of preoperative neutrophil lymphocyte ratio (NLR) in patients with gastrointestinal stromal tumors (GIST).Methods The clinical-pathological data from 85 GIST cases were collected from the Second Affiliated Hospital of Wenzhou Medical University and retrospectively analyzed from June 2009 to December 2013.According to the exclusion criteria,79 cases were enrolled.Preoperative neutrophil and lymphocyte count was collected and NLR was calculated.According to the receiver operating characteristic (ROC) curve of NLR,GIST patients were divided into low NLR group (NLR ＜ 2.30) and high NLR group (NLR ≥ 2.30).Clinic-pathological features and five year disease free survival (DFS) were compared between the two groups.Results There was a statistical significant difference in tumor size and tumor risk between high NLR group and low NLR group (respectively,x2 =9.517,12.411,all P ＜ 0.05).Univariate analysis showed that the five year disease free survival rate of low NLR and high NLR group were 78％ and 32％ (x2 =18.749,P =0.000).By multivariate analysis a high NLR was identified as an independent risk factor of poorer prognosis for patients with GISTs (RR:3.516,95％CI:1.453-8.506,P=0.005).Conclusion A high preoperative NLR is an independent risk factor for the prognosis of GISTs.

DRP1-mediated overactive mitophagy increases the sensitivity of gastric cancer cell MKN-45 to oxaliplatin / 中华普通外科杂志

Objective To investigate the effects of DRP1 gene silencing on the chemosensitivity of human gastric cancer MKN-45 cells to oxaliplatin.Methods A lentiviral vector containing short hairpin RNA (shRNA) targeting DRP1 was constructed and cotransfected to MKN-45 cells.Levels of DRP1mRNA was detected by quantitative RT-PCR,With a final concentration of 0.5,1.0,2.0,4.0,8.0,16.0 and 32.0 μg/ml of oxaliplatin processing Lv-shRNA-DRPI group (experimental group),negative control group (NC group),and blank control group (CON group) respectively.Cellular proliferation was determined by MTT assay and calculate half maximal inhibitory concentration (IC5o).Celluar apoptosis was analyzed by flowcytometry.Using Western blot to detect LC3-Ⅱ and p62 expression.Results DRP1mRNA levels in experimental group (0.087 ± 0.025) was significantly inhibited as compared with NC group (1.040 ± 0.020) and CON group (1.027 ± 0.021) (P ＜ 0.001).Cellular survival rate decreased in a oxaliplatin dose-dependent manner (all P ＜ 0.001).IC50 value in experimental group (14.1 ± 0.4) μg/ml dropped compared with NC group (20.0 ± 1.1) μg/ml and CON group (20.0 ± 1.8) pg/ml (both P ＜ 0.01).Celluar apoptosis rates in experimental group (9.4％ ± 1.1％) elevated in contrast with NC group (6.4％ ± 0.8％) and CON group (6.5％ ± 1.0％) (both P ＜ 0.05),expression of LC3 in experimental group(0.36 ± 0.03) dropped compared with NC group (0.62 ± 0.04) and CON group (0.59 ± 0.07) (both P ＜ 0.05),expression of P62 in experimental group (0.58 ±-0.04) increased in contrast with NC group (0.39±0.04) and CON group (0.36 ±0.04) (both P＜0.05).Conclusions DRP1-mediated overactive mitophagy plays a vital role in increasing the sensitivity of gastric cancer cell MKN-45 to oxaliplatin.

DRP1-mediated overactive mitophagy increases the sensitivity of gastric cancer cell MKN-45 to oxaliplatin / 中华普通外科杂志

Objective To investigate the effects of DRP1 gene silencing on the chemosensitivity of human gastric cancer MKN-45 cells to oxaliplatin.Methods A lentiviral vector containing short hairpin RNA (shRNA) targeting DRP1 was constructed and cotransfected to MKN-45 cells.Levels of DRP1mRNA was detected by quantitative RT-PCR,With a final concentration of 0.5,1.0,2.0,4.0,8.0,16.0 and 32.0 μg/ml of oxaliplatin processing Lv-shRNA-DRPI group (experimental group),negative control group (NC group),and blank control group (CON group) respectively.Cellular proliferation was determined by MTT assay and calculate half maximal inhibitory concentration (IC5o).Celluar apoptosis was analyzed by flowcytometry.Using Western blot to detect LC3-Ⅱ and p62 expression.Results DRP1mRNA levels in experimental group (0.087 ± 0.025) was significantly inhibited as compared with NC group (1.040 ± 0.020) and CON group (1.027 ± 0.021) (P ＜ 0.001).Cellular survival rate decreased in a oxaliplatin dose-dependent manner (all P ＜ 0.001).IC50 value in experimental group (14.1 ± 0.4) μg/ml dropped compared with NC group (20.0 ± 1.1) μg/ml and CON group (20.0 ± 1.8) pg/ml (both P ＜ 0.01).Celluar apoptosis rates in experimental group (9.4％ ± 1.1％) elevated in contrast with NC group (6.4％ ± 0.8％) and CON group (6.5％ ± 1.0％) (both P ＜ 0.05),expression of LC3 in experimental group(0.36 ± 0.03) dropped compared with NC group (0.62 ± 0.04) and CON group (0.59 ± 0.07) (both P ＜ 0.05),expression of P62 in experimental group (0.58 ±-0.04) increased in contrast with NC group (0.39±0.04) and CON group (0.36 ±0.04) (both P＜0.05).Conclusions DRP1-mediated overactive mitophagy plays a vital role in increasing the sensitivity of gastric cancer cell MKN-45 to oxaliplatin.

Comparison of double contrast-enhanced ultrasonography and endoscopic ultrasonography in evaluating regional lymph node metastasis of gastric cancer / 中华医学超声杂志（电子版）

Objective To evaluate the accuracy of double contrast-enhanced ultrasonography (DCUS) and endoscopic ultrasonography (EUS) in the preoperative N staging of gastric cancer.Methods Between June 2015 and September 2016,a total of 65 consecutive patients who were diagnosed with histologically confirmed gastric carcinoma and underwent surgery in the 2nd Affiliated Hospital of Wenzhou Medical University were enrolled into this study.DCUS and EUS were performed in all patients to estimate lymph node metastasis (N stage) within 5 days before surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.The sensitivity,specificity and Youden index of DCUS and EUS were calculated.The difference of diagnostic performance between DCUS and EUS was assessed by chi-square test.Results There were 25 N-patients and 40 N + patients confirmed by pathology.Of all 25 N-cases,18 cases were diagnosed correctly by DCUS and 20 cases were diagnosed correctly by EUS;Of all 40 N + cases,32 cases were diagnosed correctly by DCUS and 31 cases were diagnosed correctly by EUS.The sensitivity,specificity and Youden index of DCUS were 80.0％,72.0％ and 0.52 respectively.The sensitivity,specificity and Youden index of EUS were 77.5％,80.0％ and 0.58 respectively.The overall accuracy of DCUS and EUS in N-staging were 76.9％ (50/65) and 78.5％ (51/65).There was no significant difference between two methods (x2=0.044,P=0.833).Conclusions There was no significant difference between DCUS and EUS in overall N-staging of gastric cancers.Either of these two methods had its advantages and disadvantages.When the two methods were combined,the accuracy of preoperative N-staging of gastric cancers could be improved and this improvement may influence treatment algorithms.

A preliminary study of the maximum volume of oral cavity / 实用口腔医学杂志

Objective:To study the maximum volume of oral cavity (MVOC) of the young adults with normal occlusion and to explore the correlation of MOVC with the height,weight,mouth opening degree and masticatory efficiency.Methods:100 volunteers with normal occlusion(50 for each sex) were enrolled.MVOC was measured by the maximum water capacity method,the height,weight,degree of mouth opening and masticatory efficiency value of the subjects were measured.Results:The average values of MVOC of the male and female were (117.63±15.31) ml and (92.08±14.06) ml respectively(P<0.01).MVOC was positively correlation with the height(r=0.67,P<0.01),weight(r=0.63,P<0.01),degree of mouth opening(r=0.47,P<0.01) and masticatory efficiency(r=0.45,P<0.01).Conclusion:MVOC is moderate-positively correlated and low-positively correlated with mouth opening degree and masticatory efficiency.

Lxn inhibits the proliferation of PANC-1 CD133 positive cells by regulating bcl-2 and bax expression / 中华普通外科杂志

Objective To study the effects of Lxn on CD133 + PANC-1 pancreatic cancer cells.Methods CD133 + PANC-1 cell were isolated by magnetic activated cell sorting (MACS).The properties of the CD133 + PANC-1 cells and Lxn effects on CD133 + PANC-1 cell proliferation in transplanted tumor in nude mice were determined by floating spheres test and tumor xenograft assays.Cell proliferation was assayed by Cell Counting Kit-8 (CCK-8).The Bcl-2,Bax protein and mRNA expression of CD133 + PANC-1 cells treated by Lxn were analyzed by Western blot and Quantitative real-time PCR (qRT-PCR).Results We successfully isolated the CD133 + PANC-1 cells and cultured in serum free medium,CD133 + PANC-1 cells formed sphere,while CD133-PANC-1 cells grew with adherence slowly and then underwent apoptotic process.CD133 + PANC-1 cells showed high tumorigenic in athymic BALB/c mice.Lxn suppressed the growth of transplanted tumor obviously.Compared with control group [(225.52 ± 34.09) mm3],tumor volume decreased significantly (P ＜ 0.05).Significant reduction in cell proliferation was observed in response to Lxn in PANC-1 CD133 + cells by CCK-8 assay with concentration and time dependent manners (P ＜ 0.05).Treated by Lxn,Bcl-2 expression decreased,Bax expression increased.Conclusions Lxn inhibits the proliferation of CD133 + PANC-1 cells probably through a mechanism down-regualting Bcl-2 and up-regulating Bax.

Level and clinical significance of RNA oxidative damage in human gastric cancer and para-carcinoma tissues / 中国病理生理杂志

AIM:To investigate the RNA oxidative damage in human gastric cancer tissue and para-carcinoma tissue for exploring the role of RNA oxidation in the occurrence of gastric cancer .METHODS:Immunohistochemical ob-servation and LC-MS/MS analysis were performed in 61 cases of gastric carcinoma .The position and concentration of 8-oxoguanosine ( 8-oxoGsn ) were detected , respectively . RESULTS: The results of immunohistochemical observation showed that 8-oxoGsn was obviously up-regulated in the gastric cancer .The positive staining mainly accumulated in the cy-toplasm of the tumor cells .The results of mass spectrometry showed that the level of 8-oxoGsn in the gastric cancer tissues was higher than that in the para-carcinoma tissues (P<0.05).CONCLUSION:8-oxoGsn is up-regulated in gastric canc-er.RNA oxidative damage may play important roles in the occurrence of gastric cancer .

Analysis on risk factors for deep vein thrombosis in patients with traumatic fractures / 中华骨科杂志

Objective To explore the incidence rate and the risk factors of deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT.Methods All of 534 Patients with fresh four extremities or pelvic fracture between January 2010 and December 2013 were involved in this study.The incidence of DVT under 5 risk factors including general state, injury type, fracture condition, operation and laboratory examination were analyzed.Each patient underwent three Doppler ultrasound exams in actions as the epidemiology diagnostic criterion for DVT.Results The total incidence rate of DVT in 534 patients was 11.99％.The univariate analysis showed that male patients with age≥60 years, BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension and coronary artery disease had higher incidence rate of DVT.In different injury types, the fall injury caused the highest incidence rate of DVT (45.71％).There were different DVT rates for different fracture sites, with the highest incidence rate of DVT for femur shaft fracture (20.69％).The incidence rate of DVT was 50.00％ for fractures of more than three parts, 15.29％ for fractures of two parts and only 3.98％ for sole part.The incidence rate of DVT for comminuted fractures was higher than others.The operation duration, massive transfusion during operation and general anesthesia were related with the increase of incidence of DVT.Positive ACA and enhancement of D-dimer, Fib and CRP were related with the increase of incidence of DVT.Conclusion The incidence of DVT in patients with traumatic fractures approaches a considerable level.It has relationships with age≥60 years, BMI≥25 kg/m2, history of smoking, fall injury, fracture of femoral shaft and hip, more than three parts of fractures, comminuted fractures, operation duration≥2 hours, largely blood transfused, massive transfusion during operation, general anesthesia, positive ACA, enhancement of D-dimer, Fib and CRP.The surgeons should recognize the importance to prevent DVT and PE in the traumatic patients.

Diagnostic value of contrast-enhanced ultrasonography in preoperative Borrmann classification of gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic value of contrast-enhanced ultrasonography (CEUS) in preoperative Borrmann classification of gastric cancer.</p><p><b>METHODS</b>Asulfur hexafluonde-filled microbubble ultrasound contrast agent and continuous real-time imaging technique of contrast pulse sequencing were used. Two hundred and eighty-five patients with gastric cancer confirmed by biopsies who received preoperative CEUS examination were involved in this study. CEUS results were compared with postoperative pathological findings.</p><p><b>RESULTS</b>The accuracy rate of CEUS in determining the Borrmann classification of gastric cancer was 92.3%(263/285). The accuracy rates of BorrmannI(, II(, III(, IIII(, and IIIII( were 100%(12/12), 90.6%(77/85), 92.6%(126/136), 95.7%(45/47), and 60.0%(3/5) respectively.</p><p><b>CONCLUSION</b>CEUS is a useful diagnostic method for preoperative Borrmann classification of gastric cancer.</p>

Intravenous chemotherapy in combination with TACE for the treatment of hepatic metastasis of gastric cancer / 中华普通外科杂志

Objective To evaluate efficacy and safety of intravenous chemotherapy combined with TACE in the treatment of gastric cancer with hepatic metastasis.Methods In this study 60 gastric cancer patients with hepatic metastasis were divided into two groups randomly,the trial group (30 cases) took intravenous chemotherapy consisted of docetaxel 60 mg/m2 intravenous drip d1,oxaliplatin 80 mg/m2 intravenous drip d1 followed by 5-fiuorouracil 500 mg/m2 intravenous drip d1-5 after TACE.The control group (30 cases) took the same chemotherapy protocol and one treatment cycle covering 4 weeks.Results The overall response rate in trial group was 53％ and the increase rate of Karnofsky was 70％ while that was 37％ and 40％ respectively in the control group (P ＜ 0.05).The median overall survival of trial group was 13 months and which was 8 months in the control group (P ＜ 0.05),meanwhile the toxicities and side reactions of trial group didn't increase notably.Conclusions Intravenous chemotherapy combined with TACE is safe and more effective in the treatment of gastric cancer with hepatic metastasis.

Modified FOLFOX4 vs docetaxel-oxaliplatin program neoadjuvant chemotherapy in postoperative stage Ⅲ gastric cancer / 中华普通外科杂志

Objective To compare the efficacy and safety of modified FOLFOX4 program with docetaxel-oxaliplatin-5-fluorouracil (DOF) program as neoadjuvant chemotherapy in stage Ⅲ gastric cancer patients.Methods In 86 cases of stage Ⅲ gastric cancer patients,42 received modified FOLFOX4 chemotherapy,44 cases were treated by DOF program.After two cycles of chemotherapy,the treatment effect and adverse reactions were evaluated.Results The total effectiveness in modified FOLFOX4 group and DOF group was 60％ (25/42) and 68％ (30/44) respectively (P ＞ 0.05).Tumor control rate was 83％ (35/42) and 89％ (39/44) respectively (P ＞ 0.05).The incidence of nausea,vomiting and leukopenia was higher in DOF group than modified FOLFOX4 group (P ＜ 0.05).The D2 lymph node dissection rate between modified FOLFOX4 group and DOF group was 80％ (20/25) and 87％ (26/30) respectively (P ＞ 0.05),the R0 resection rate was 72％ (18/25) and 83％ (25/30) respectively (P ＞ 0.05).In 43 R0 resection patients using FOLFOX4 the median survival time was 38.7 months,1-,3-year survival rate was 90％,and 60％ ; while that in DOF group the median survival time was 39.6 months,1-,3-year survival rate was 95％,and 75％.Multivariate analysis showed that postoperative TNM stage only was an independent risk factor for prognosis.Conclusions TNM stage was the independent risk factor for prognosis of gastric carcinoma patients after radical gastrectomy.

The impact of neoadjuvant chemotherapy on lymph node micrometastasis and dendritic cells in patients with stage Ⅲ gastric carcinoma / 中华普通外科杂志

Objective To evaluate the effect of neoadjuvant chemotherapy on lymph node micrometastasis and DC cell number in stage Ⅲ gastric cancer patients.Methods Lymph node micrometastases in pathologically negative lymph nodes from 76 stage Ⅲ gastric cancer patients [56 cases with neoadjavant chemotherapy (NCT) and 20 cases without],were assessed by cytokeratin-20 antibody.Dendritic cells (DC) in HE positive lymph nodes,HE negatives near tumor foci and HE negatives far foci were assessed by CD83 antibody respectively.Patients were divided into four groups:group 0 (20 cases without NCT),group 2 (two courses of NCT in 29 patients),group 3 (three courses of NCT in 16 patients),group 4 (four courses of NCT in 11 patients).Results In NCT group there were two patients with micrometastases (2/56).All the patients were with micrometastases in control group (20/20).Difference was statistically significant (P =0.000).In HE-positive lymph node group:the number of CD83-positive DC in 2 times group,3 times group,and 4 times group when compared with no chemotherapy group were statistically significant (P20 =0.001,P30 =0.000,P40 =0.000).In HE-negative lymph node near foci group:the number of CD83-positive DC in 3 times group,and 4 times group compared with 0 group were statistically significant increased (P30 =0.001,P40 =0.001).In HE-negative lymph node far foci group:the number of 4 times group was significantly higher than 0,2 and 3 group (P40 =0.000,P42 =0.000,P43 =0.001).Conclusions Neoadjuvant chemotherapy is effective in the prevention of lymph node micrometastases in stage Ⅲ gastric carcinoma and it increases the number of mature dendritic cells in lymph nodes.

The influence of different method of mediastinal lymph node excision on perioperative immune function of lung cancer patients / 肿瘤研究与临床

Objective To explore the influence of different method of mediastinal lymph node excision on the immune function of non-small cell lung cancer patients.Metbods Clinical data was collected continuously from 415 cases of inhospital patients with non-small cell lung cancer from March 2009 to March 2012,who were divided into system lymph node dissection group (SLND,216 cases) and lymph node sampling group (LNS,199 cases).The total lymphocytes,NK cells,CD4+ T cells and CD8+ T cells in blood samples taken preoperatively and at 3rd and 7th day postoperation were analyzed.Results Total lymphocytes,NK cells and CD8+ T cells were reduced significantly in the SLND group compared with those in LNS group at 3rd day and 7th day postoperation (3rd day:LC (0.95±0.57) × 109/L vs (1.10±0.65) × 109/L,CD8+ T cells (19.53± 6.48) ％ vs (20.93±6.70) ％,NK (17.36±6.06) ％ vs (18.57±5.97) ％,P ＜ 0.05; 7th day:LC (0.86±0.53) × 109/L vs (1.00±0.60) × 109/L,CD8+ T cells (17.27±5.64) ％ vs (18.40±5.26) ％,NK (13.11±4.84) ％ vs (14.20± 5.30) ％; P ＜ 0.05).CD4+ T cells in the SLND group were reduced significantly at 3rd day postoperation compared with LNS group ((29.59±6.53) ％ vs (31.19±6.32) ％,P ＜ 0.05).Conclusion LNS can reduce immunosuppression compared with SLND for postoperative patients.

A pilot study on Lauren classification of advanced gastric carcinoma using virtual touch tissue quantification / 中华超声影像学杂志

ObjectiveTo explore the value of virtual touch tissue quantification (VTQ) in evaluating Lauren classification of advanced gastric carcinoma.MethodsForty-one patients with gastric cancer proved by endoscopic biopsy performed preoperative VTQ examination,and the findings were compared with postoperative pathologic results via hematoxylin -eosin and Alcian Blue-Periodic Acid Schiff (AB-PAS) staining.ResultsIn 41 patients,26 cases were diagnosed as diffuse type and 15 cases as intestinal type by pathology after operation.The shear wave velocity(SWV) of diffuse type was higher than that of intestinal type [(1.72± 0.83)m/s vs (1.05± 0.66)m/s,t =2.819,P=0.008] measured by virtual touch tissue quantification (VTQ).According to the area under the ROC curve,the cut- off value of SWV in gastric cancer tissues for assessing the diffuse type was 1.045 m/s with a sensitivity of 80.8％ and specificity of 73.3 ％ respectively.ConclusionsVTQ could be considered as a promising method to distinguish the Lauren classification in patients with advanced gastric carcinoma.

The significance of peripheral blood CK19 mRNA expression in breast cancer patients / 中华普通外科杂志

ObjectiveTo evaluate the significance of CK19 mRNA monitoring in peripheral blood of breast cancer patients.MethodsPeripheral blood samples were collected from 137 breast cancer patients preoperatively,one day post-operation,7 days,1,3,6,12,18,and 24 months after operation.RTPCR was used to detect CK19 mRNA expression.The relationships were analyzed between CK19 mRNA expression and treatment result, between CK19 mRNA expression and clinicopathological parameters.ResultsThere was no significant difference between the level of CK19 mRNA as tested preoperatively,and 1,7 days postoperatively(P ＞ 0.05 ).From one month and thereafter,CK 19 mRNA decreased significantly when compared with that immediate perioperatives ( P ＜ 0.05 ). Postoperative peripheral CK19 mRNA expression increased in those found with recurrent or metastasized tumors ( P ＜ 0.01 ). CK19 mRNA expression does not correlate with patient's menstrual status,estrogen receptor expression,progesterone receptor expression,HER-2 expression and Ki67 proliferation expression (P ＞ 0.05 ). But there was statistically significant correlation between CK19 mRNA expression and tumour size,histology grading,pathological type,lymph node metastasis ( P ＜ 0.01 ).ConclusionsIn breast cancer patients peripheral blood CK19 mRNA expression is correlated with risk clinicopathological parameters, and increases in patients with postoperative recurrence and tumor metastasis.