[Differences in efficacy between drug-eluting beads transbronchial arterial chemoembolization combined with systemic chemotherapy and systemic chemotherapy alone for unresectable lung squamous cell carcinoma]

Objective: To investigate the differences in efficacy between drug-eluting beads transbronchial arterial chemoembolization (DEB-BACE) combined with systemic chemotherapy and systemic chemotherapy alone for unresectable lung squamous cell carcinoma. Methods: Totally 60 cases of unresectable lung squamous cell carcinoma undergoing systemic chemotherapy in Yancheng Third People Hospital were retrospectively selected as the research object. According to patients' wishes, they were divided into chemotherapy-only group (group A) and combined treatment group (group B). Group A received gemcitabine combined with cisplatin chemotherapy. DEB-BACE was applied in the first half, and systemic chemotherapy was administered in the second half (starting 3 d after BACE). The first half and the second half of the chemotherapy dose were 1/2 of the drug dose in the chemotherapy alone group. The short-term efficacy, incidence of toxic side effects, peripheral blood T lymphocyte subsets, serum vascular endothelial growth factor (VEGF) levels, and survival time were compared between the two groups. Results: After 2 cycles of treatment, the total effective rates of group A and group B were 50.0% (15/30) and 76.7% (23/30) (P<0.05), the incidence of nausea and vomiting (63.3% vs 20.0%), decreased appetite (76.7% vs 43.3%), hair loss (86.7% vs 40.0%), and bone marrow suppression (40.0% vs 10.0%) in group A were higher than in group B (all P<0.05). After 2 cycles of treatment, the levels of CD3(+), CD4(+)and CD4(+)/CD8(+)in the two groups were higher than before treatment (group A: 47.7%±6.6% vs 52.3%±7.7%, 31.5%±4.9% vs 34.7%±5.8%, 1.05±0.24 vs 1.18±0.32; group B: 49.2%±7.0% vs 62.0%±14.0%,29.2%±5.5% vs 42.2%±7.3%, 1.07±0.26 vs 1.39±0.42; all P<0.05), while the level of CD8(+)was lower than before treatment (group A: 30.4%±5.4% vs 24.5%±4.8%; group B: 29.5%±4.1% vs 21.1%±4.5%; all P<0.05). The CD3(+), CD4(+), and CD4(+)/CD8(+) levels in group A were lower than those in group B (P<0.05), while CD8(+)level was higher than in group B (P<0.05). After 2 cycles of treatment, the VEGF levels in the two groups were lower than before treatment (group A: (423±85) vs (352±64) ng/L; group B: (404±114) vs (296±66) ng/L; P<0.05), and the VEGF level in group A was higher than that in group B (P<0.05). The 1-year survival rates of groups A and B were 54.9% and 77.9%, and the 2-year survival rates were 17.2% and 41.7% (Log rank χ(2)=4.750, P=0.029). Conclusion: DEB-BACE combined with systemic chemotherapy is superior to systemic chemotherapy in the treatment of unresectable lung squamous cell carcinoma. It can reduce toxic and side effects, improve immune function and prolong survival time, which is worthy of clinical application.

[Impact of water body environments on the microbial community of Oncomelania hupensis snails in marshlands around the eastern Dongting Lake]

OBJECTIVE

To evaluate the effects of water body environments on the microbial community of Oncomelania hupensis snails in marshlands of the eastern Dongting Lake where natural extinction of O. hupensis snails are found, so as to explore the correlation between the natural extinction of O. hupensis snails and the microbial community in snails.

METHODS

Snails were caged water bodies in the Qianliang Lake marshland (Qianliang Lake regions) where natural extinction of snails was found and in the Junshan Park marshland (Junshan Park regions) in the eastern Dongting Lake for 30 days, and then all snails were collected and identified for survival or death. DNA sequencing of the fungi and bacteria was performed in snails before and after immersion in waters, and the biodiversity and abundance were analyzed.

RESULTS

The survival rates of O. hupensis snails were 28.0% (70/250) and 64.8% (162/250) in Qianliang Lake regions and Junshan Park regions 30 days after immersion in waters, respectively (χ² = 81.365, P < 0.01). The number of the fungal community and the biodiversity of the bacterial community were both greater in snails caged in Qianliang Lake regions post-immersion than pre-immersion, and there was a significant difference in the structure of the fungal and bacterial communities. The microbial community with a significant difference included Flavobacteriaceae,which was harmful to O. hupensis snails.

CONCLUSIONS

The water body environment affects the composition of the microbial community in O. hupensis snails in marshlands with natural snail distinction around the eastern Dongting Lake; however, further studies are required to investigate whether the natural distinction of snails is caused by water body environments-induced changes of the microbial spectrum in O. hupensis snails.

Negative magnetization, complex magnetic ordering and applications of Cr-doped Co2TiO4

Polycrystalline Co2Ti1-xCrxO4 (0 ≤ x ≤ 0.2) inverse spinel ceramics have been synthesized via a sol-gel technique. The dc magnetization measurement in the field-cooled mode shows that negative magnetization could be observed until x reaches 0.2. The exchange constants are calculated using the ferrimagnetic Curie-Weiss fitting and the mean-field theory. This reveals that the strength of the inter sublattice magnetic interaction presents a non-monotonic trend with the increase in Cr content and reaches the minimum at x = 0.1, giving rise to the highest compensation temperature in the x = 0.1 sample. The applicability of the x = 0.1 sample is investigated in light of two prominent magnetic effects: (i) the stable magnetic switching effect indicates the potential applications in magnetic switching and data storage and (ii) the coexistence of normal and inverse magnetocaloric effects suggests a potential application in a constant temperature bath at 54 K.

Comparative study of stenting and ostium packing in Endoscopic Dacryocystorhinostomy for Primary Acquired Nasolacrimal Duct Obstruction

In this retrospective study, we compared the efficacy and safety of mechanical adjuvants in mucosal-sparing, mechanical endoscopic dacryocystorhinostomy (MMED) for primary acquired nasolacrimal duct obstruction (PANDO). 116 adult patients (90 female) aged 61 ± 11 received one of the following after MMED without topical mitomycin: no stenting or packing (group 1, n = 25), 1-week ostium packing by ribbon gauze (group 2, n = 29) or non-medicated absorbable gelatin sponge (group 3, n = 25), 8-week bicanalicular stenting (group 4, n = 28). 104 patients(92%) provided 12-month outcomes. Number of patients, age, gender, surgeon, and osteotomy size were comparable among groups (p = 0.4-0.9). Marginal significance was found in anatomical (group 1:80%, group 2:96.6%, group 3:96%, group 4:96.4%, p = 0.05) but not functional success (group 1:85%, group 2:85.7%, group 3:83.3%, group 4:88.9%, p = 0.75) at postoperative 12-month. Patients receiving any packing or stenting achieved better anatomical (96% versus 80%, p = 0.015) but not functional success (85% versus 86%, p = 0.90) compared to those receiving none. More patients receiving stenting developed postoperative granuloma than those who did not (87% versus 63%, p = 0.04). 1-week ostium packing was found to be as effective as 8-week bicanalicular intubation in improving anatomical outcome after MMED for PANDO. Functional outcome, however, did not differ among patients receiving mechanical adjuvant or not.

[Endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound]

Objective: To evaluate the clinical efficacy of endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound. Methods: The clinical data of 40 patients with non-thrombotic right iliac vein compression syndromereceiving intravascular ultrasound-assisted balloon dilatation combined with stent implantation from January 2012 to December 2018 were retrospectively analyzed. There were 32 males and 8 females, the average age of whom was 63 (46-81) years old. The patients were classified according to the CEAP (Clinical-Etiology- Anatomy-Pathophysiology) classification: 7 cases as C3, 18 as C4, 10 as C5 and 5 as C6. All patients underwent percutaneous right femoral vein puncture, intravascular ultrasound, and balloon dilatation combined with stentimplantation in the right iliac vein lesion location. Results: The success rate of clinical operations was 100%. There were no serious complications during the perioperative period. All patients were followed up for 4-58 months. During the follow-up period, the relief rate of limb edema was 88.6% (31/35), the pain relief rate was 86.7%(13/15), and the healing rate of ulcers was 100% (6/6). After the stent implantation, the endovascular area of the compression site was significantly enlarged (34.5mm(2)± 11.1mm(2)vs129.8 mm(2)±17.2 mm(2), P<0.001). The follow-up of color Doppler and/or anterograde angiography for deep veins of lower limb with digital subtraction angiography showed that the blood flow in the stentsweres mooth in all patients. Three cases were observed that the intimal hyperplasia led to mild in-stent restenosis, no obvious in stent restenosis (>50%). The abdominal X-ray plain film showed no obvious displacement and fracture of the stents. The venous clinical severity score (VCSS) was statistically significant (13.0±2.4 vs 6.2±2.0, P<0.001). The statistical results of short-form health surver SF-36 showed that the scores of life quality in all dimensions of the affected limb were significantly improved after operation (P=0.000). Conclusion: Intravascular ultrasound-assisted balloon dilatation combined with stent implantation is not only a safe and effective treatment for non-thrombotic right iliac vein compression syndrome, but also has a good mid-term patency rate.

The role of ultrasonography in the diagnosis of persistent sciatic artery

AIM

To investigate the accuracy of ultrasonography in the diagnosis of persistent sciatic artery (PSA) compared to computed tomography angiography (CTA).

MATERIALS AND METHODS

From May 2002 to Dec 2018, 61 consecutive patients seen at Shandong Medical Imaging Research Institute with a clinical suspicion of PSA were included. Ultrasonography was used to assess the abdominal and lower-limb arteries. The main sonographic criteria for a positive diagnosis were the visualisation of PSA, the enlarged internal iliac artery, and abnormality of common femoral artery and superficial femoral artery. These data were compared with CTA findings. Kappa statistics was applied to determine the level of agreement. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography as a diagnostic method were assessed.

RESULTS

Ultrasonography findings were positive in 16 of 61 patients with a clinical suspicion of PSA. The diagnosis was confirmed by CTA in 17 patients. There was one false-positive result and two false-negative results at ultrasonography. The kappa value was 0.875. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography were 88.2%, 97.7%, 93.8%, 95.6%, 95.1% and 0.859, respectively.

CONCLUSIONS

Ultrasonography could be a reliable, accurate, and non-invasive diagnostic imaging method in the diagnosis of patients with suspected PSA.

[China statistics of extracorporeal life support in 2018]

Objective: To investigate China statistics of extracorporeal life support (ECLS) in 2018. Methods: The statistics data was collected by provincial coordinators assigned by Chinese Society of Extracorporeal Life Support (CSECLS) in 2019, including cases, centers, indications, and in-hospital survival rate. Results: Three thousand nine hundred and twenty-three cases were reported by 260 ECLS centers. There were an increase of 38.8% in extracorporeal membrane oxygenation (ECMO) cases and an increase of 11.6% in ECMO centers compared with that in 2017 (2 826 cases and 233 centers). Adult, pediatric, and neonatal patients accounted for 88.0%, 9.7%, and 2.3% of total cases, respectively. Centers with more than 20 ECMO cases per year had favorable in-hospital survival rate compared with those less than 20 cases (49.1% vs 44.0%, P=0.005). ECMO cases (r=0.71, P<0.001) and centers (r=0.81, P<0.001) were both associated with regional gross domestic product. Conclusions: There was a growth in ECLS cases, centers, and center scale in China within 2018. The majority of ECLS cases and centers were in developed regions. The ECLS indications, and in-hospital mortality in China were in accordance with that in the Extracorporeal Life Support Organization registry gradually. Large-scale ECLS centers had favorable patient outcomes. The development of ECLS still has tremendous potential in China, especially for pediatric and neonatal patients.

[Blood pressure changes in 18-59 years old adults in rural area of Shanxi province, China]

Objective: To analyze the blood pressure changes of adults aged 18-59 years in rural area of Shanxi province based on a cohort study, and provide reference for the study of the blood pressure level of rural residents and hypertension prevention and control in rural areas in China. Methods: Data were obtained from Shanxi Nutrition and Chronic Disease Family Cohort from 2002 to 2015. Subjects aged <18 years or ≥60 years and individuals with hypertension at baseline survey in 2002, and those who had taken antihypertensive drugs for nearly two weeks during the follow-up survey in 2015 were excluded from the study. A total of 1 629 subjects aged 18-59 years were included in the analyses of the blood pressure level and its change from the baseline survey in 2002 to follow-up survey in 2015. Results: The systolic blood pressure (SBP) of the subjects increased from (122.7±10.4) mmHg in 2002 to (132.8±17.6) mmHg in 2015 and the diastolic pressure (DBP) increased from (72.7±6.9) mmHg in 2002 to (78.8±10.3) mmHg in 2015. The SBP in men and women increased with growth rates of 6.7% and 9.5%. While DBP in men and women increased with growth rates of 9.3% and 7.8%. The SBP levels of those aged 18-, 30-, 40- and 50-59 years increased with growth rates of 5.0%, 6.7%, 9.4% and 11.8%. While the DBP of these age groups increased with growth rates of 12.2%, 8.2%, 8.2% and 6.5%. Conclusions: The blood pressure of adults aged 18-59 years old in rural area of Shanxi showed a substantially increasing trend. The mean increase level of SBP in women was higher than that in men, and increased with age. While the mean increase level of DBP in men is higher than that in women, and decreased with age.

[China statistics of extracorporeal life support in 2017]

Objective: To investigate China statistics of extracorporeal life support (ECLS) in 2017. Methods: The statistics data was collected by provincial coordinators assigned by Chinese Society of Extracorporeal Life Support in 2018, including cases, centers, and indications. Results: Two thousand eight hundred and twenty-six cases were reported by 233 ECLS centers. There was an increase of 129% in extracorporeal membrane oxygenation (ECMO) cases and an increase of 64% in ECMO centers compared with that in 2016 (1 234 cases and 142 centers). ECMO cases was associated with regional per capita gross domestic product (GDP) positively (r=0.619, P<0.001). ECMO centers was associated with regional GDP (r=0.416, P=0.020) and regional per capita GDP positively (r=0.666, P<0.001) as well. Adult patients accounted for 86.6% of total ECMO cases. Pediatric and neonatal patients only accounted for 10.5% and 2.9%, respectively. Conclusions: There was a growth in ECLS cases and ECLS centers in China in 2017. The majority of ECLS cases and centers were in developed regions. The proportion of ECLS indications in China was in accordance with that in Extracorporeal Life Support Organization registry gradually. The development of ECLS for critically ill patients still has a tremendous potential in China.

[Clinical analysis of 8 cases of the mixed epithelial and stromal tumour family of kidney]

Objective: To investigate the diagnosis and treatment of the mixed epithelial and stromal tumour family of kidney. Methods: Eight cases of the mixed epithelial and stromal tumour family of kidney were retrospectively analyzed. Before operation, radiologic evaluation was performed in all cases, including CT and MRI scan. Three cases were diagnosed as cystic renal cell carcinoma, 5 cases were diagnosed as renal complex cysts. Radical nephrectomy was performed in 4 cases and partial nephrectomy was performed in 4 cases. Results: The manifestation of the pathological specimens were multilocular cystic or cystic solid tumors grossly. Microscopically, the tumors were composed of two components, epithelial and stromal. Immunohistochemical staining showed that the epithelial components of the tumors were positive for AE1/AE3 (8/8), CK18 (3/3), and CK-7 (1/1). The stromal components were positive for PR (8/8), ER (6/8), Vim (6/6), Desmin (5/5), and SMA (5/5). HB-45 staining were negative (7/7) and Ki-67 staining were negative (7/8). All cases were diagnosed as the mixed epithelial and stromal tumour family of kidney. All patients were followed up for 3-124 months, with a median follow-up of 41 months. No tumour recurrence or metastasis were observed. Conclusion: The mixed epithelial and stromal tumour family of kidney mostly occurs in women, but have no specific clinical manifestations. They were often misdiagnosed as cystic renal cell carcinoma before operation. These following imaging features may be helpful for diagnosis. The definite diagnosis of the disease depends on the pathological examination, and immunohistochemistry plays an important role in differential diagnosis. Surgical treatment is the first choice, and partial nephrectomy is feasible. Most of the tumors are benign, and the patients can be cured after complete excision.

[Serum levels of periostin and their influencing factors in the beta-lactam antibiotic enterprise workers]

Objective: To observe serum levels of periostin, ECP, IgE in the antibiotic enterprise workers, and study the role of periostin, ECP, IgE in the development of allergic inflammation. Methods: 90 cases with asthma or rhinitis were enrolled as disease group, another 117 workers exposed to 7-ACA、6-APA dust without suffering from allergic illness, are chosen as group of dust exposed, and 192 healthy workers who didn't contact dust were chosen as control group. Questionnaires were used to learn their basic information.Lung function was determined with a portable spirometer.The expression levels of periostin、ECP and IgE in serum were measured by enzyme-linked immuno sorbent assay. Results: The exposure group and disease group had significantly lower forced vital capacity (FVC) , forced expiratory volume in 1 second (FEV(l.0)) , and FEV(l.0)/FVC ratio than the control group (P<0.05) . The disease group had significantly higher eosinophil than the control group (P<0.05) . Compared with the control group, the exposure group, the disease group, asthma subgroup, rhinitis subgroup of serum periostin and IgE increased, the differences are statistically significant (P<0.05) . Serum levels of ECP in the workers of asthma subgroup were significantly higher than that in control group (P<0.05) . Serum expression levels of periostin were positively correlated with IgE, ECP in workers (P<0.001) , serum levels of periostin were negatively correlated with FEV(1.0) in workers (P<0.05) . Multiple logistics regression analysis found that exposure to 7-ACA or 6-APA (OR=3.09, 95%CI: 1.83-5.21) , age>47years (OR=2.53, 95%CI: 1.22-5.26) , higher ECP (OR=1.04, 95%CI: 1.01-1.06) were risk factors for increased serum periostin level. Conclusion: Occupational exposure to 7-ACA or 6-APA can result in higher serum periostin level, exposure to 7-ACA or 6-APA, age>47 years, higher ECP are risk factors for increased serum periostin level.

[Clinical experience in diagnosis and treatment of primary retroperitoneal liposarcoma]

Objective: To summarize the experience in diagnosis and treatment of primary retroperitoneal liposarcoma. Methods: The clinic data of 73 cases of primary retroperitoneal liposarcoma were reviewed. The age of patients was 23 to 75 years old, with a median age of 53 years. Forty-five cases were treated for the first time, and 28 cases were re-treated after local recurrence. All patients underwent ultrasonography, CT or MRI before operation and were diagnosed of primary retroperitoneal liposarcoma. Results: No lymph node and distant metastasis were found in all patients. The maximum diameter of the tumor was 3-40 cm, with a median diameter of 18.9 cm. Of the 45 patients with primary treatment, 6 patients were in T2 stage and 39 in T3 stage. Of the 28 patients with retreatment after local recurrence, 4 patients were in T1, 8 in T2, and 16 in T3 stage. All the 73 patients received surgery, 7 were treated with adjuvant radiotherapy, and 3 received adjuvant chemotherapy. One hundred and ten operations were performed in 73 patients. Sixty-seven cases were diagnosed of well differentiated liposarcoma, with 60 cases of lipoma-like liposarcoma and 7 cases of sclerosing liposarcoma. Nine cases were diagnosed of dedifferentiated liposarcoma, 16 cases were myxoid liposarcoma, and 2 cases were pleomorphic liposarcoma. Sixteen cases were mixed types. A total of 69 cases were followed up for 6 months to 13 years, with an average of 4 years. Sixty-six cases obtained complete resection, 34 cases relapsed, and the recurrence rate was 51.5% (34/66). Distant metastasis occurred in 4 cases. Fourteen cases died of tumor recurrence or distant metastasis and the rest were all alive. Four cases lost follow-up after 3 months. No matter in the initial treatment group or the retreatment group, the recurrence rate of combined organ resection is lower than that of simple tumor resection, and the average recurrence time was longer. Results: Primary retroperitoneal liposarcoma was rare in clinical experience. CT is the most effective method in the diagnosis of retroperitoneal liposarcoma, however pathological examination was still the key to the diagnosis. The main treatment of retroperitoneal liposarcoma was surgical resection. Complete resection was the objective of the operation, and the combined viscera resection was performed for those with invasion of other organs. Retroperitoneal liposarcoma had the characteristics of local recurrence after operation and insensitivity to radiotherapy and chemotherapy, but the recurrent tumor can still be resected.

[Analysis of corneal and conjunctival sensitivities and its related factors of premature babies]

Objective: To analyse the corneal and conjunctival sensitivities of premature babies and to study the relevant influencing factors. Methods: Cross-sectional study. One hundred premature infants born at Women's Hospital School of Medicine Zhejiang University between May 2015 and September 2015 were enrolled, among which 51 were male (51%) and 49 were female (49%), the mean gestational age was (30.93±1.75)w, the mean corrected gestational age was (33.65±1.53)w, the mean birth weight was (1 592±336)g. The thresholds of cornea and conjunctiva of infants' left or right eyes were measured with Cochet-Bonnet aesthesiometer at 8-10 o'clock every morning when they naturally woke up, the minimum length of nylon wire that induced three successive times of eye-blink responses was recorded. Paired sample t test was used to compare the corneal and conjunctival sensitivities, the ocular surface sensitivities of preterm infants of different gender were compared using independent samples t-test, Pearson correlation and multiple linear regression analysis was conducted to analyze the correlation of corneal and conjuncitval sensitivities with gestational age, birth weight, age and corrected gestational age. Results: The mean corneal sensitivity was (44.85±5.53) mm and the mean conjunctival sensitivity was (23.50±5.48)mm in premature babies, corneal sensitivity was significantly higher than conjunctival sensitivity (t=25.620, P<0.001). No statistical significance was found between male and female preterm infants in corneal sensitivity [(44.80±5.83) mm vs. (44.90±5.25) mm, t=-0.085, P=0.933] and conjunctival sensitivity[(23.14±5.83) mm vs. (23.88±5.13) mm, t=-0.673, P=0.502]. Pearson correlation analysis showed that corneal sensitivity was significantly associated with conjunctival sensitivity in prematurity(r=0.676, P<0.001). There was significant correlation between corneal sensitivity and age, corrected gestational age (r=0.238, P=0.017; r=0.679, P<0.001), however no significant correlation was found between corneal sensitivity and gestational age, birth weight in preterm infants (r=0.067, P=0.510; r=-0.179, P=0.075). There was significant correlation between conjunctival sensitivity and corrected gestational age (r=0.490, P<0.001), however no significant correlation was found between conjunctival sensitivity and gestational age, birth weight and age in preterm infants (r=0.078, P=0.439; r=-0.096, P=0.344; r=0.151, P=0.133). Multiple linear regression revealed that corneal sensitivity(Y1) was positively correlated with corrected gestational age(X), the regression equation was Y1=2.45X-37.52, the conjunctical sensitivity(Y2) was also positively correlated with corrected gestational age(X), the regression equation was Y2=1.75X-35.41. Conclusions: The corneal sensitivity is higher than conjunctival sensitivity in premature babies.No statistical significance is found between male and female preterm infants in corneal sensitivity and conjunctival sensitivity. The corneal sensitivity and conjunctival sensitivity are correlated with corrected gestational age in preterm infants. The corneal and conjunctival sensitivities of premature babies tend to increase along with the increase of corrected gestational age. (Chin J Ophthalmol, 2018, 54: 115-119).

[Therapeutic effect of AngioJet mechanical thrombus aspiration system combined with catheter directed thrombolysis on acute deep vein thrombosis]

Objective: To analyze the curative effect of AngioJet mechanical thrombus aspiration combined with catheter directed thrombolysis (CDT) on acute lower extremity deep vein thrombosis (LEDVT). Methods: The clinical data of 20 cases of acute LEDVT treated by AngioJet combined with CDT were analyzed. The inferior vena cava filter was implanted preoperatively, and then the thrombolysis was performed by using AngioJet. The thrombolytic catheter was placed for CDT treatment, and the thrombolysis was evaluated by review angiography. Results: All cases were successfully punctured and catheterized. The suction time was (235±75) seconds. The usage of urokinase was (180±90)*10(4) U. The differences before and after thrombolysis of ipsilateral and contralateral thigh circumference were (8.3±1.5) cm and (2.5±1.0) cm, respectively. The differences before and after thrombolysis of the ipsilateral and contralateral calf circumference were (2.4±1.0)cm and (1.5±0.7) cm, respectively. All of which had statistical significant (P<0.01). Conclusion: AngioJet mechanical thrombus aspiration system is a novel and safe method for the treatment of acute LEDVT. When used in conjunction with CDT, its advantages was more significant.

[Endovascular implantation of iodine-125 seeds strand and portal vein stenting followed by transcatheter arterial chemoembolization combined therapy with sorafenib for hepatocellular carcinoma with main portal vein tumor thrombus]

OBJECTIVE

To compare the therapeutic effect of portal vein stenting and endovascular implantation of iodine-125 seeds strand followed by transcatheter arterial chemoembolization combined with or without sorafenib in patients for hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (MPVTT).

METHODS

A total of 53 patients with HCC complicated by MPVTT who received portal vein stenting and endovascular implantation of iodine-125 seeds strand followed by transcatheter arterial chemoembolization combined without (group A, n=38) or with (group B, n=15) sorafenib in Affiliated Yancheng Hospital of Southeast University Medical College during January 2010 and August 2015 were analyzed retropectively.Overal survival, progress free survival and procedure-related adverse event were compared between the two groups.

RESULTS

The technical success rate was 100% for placement of (125)I seeds strand and stent in the obstructed main portal vein.No serious procedure-related adverse events occurred. Median survival time of group A and B were 12.1 and 14.8 months, respectively (P=0.037). Additionally, Median progress free survival time of group A and B were 2.8 and 4.0 months, respectively (P=0.002).

CONCLUSIONS

Endovascular implantation of iodine-125 seeds strand and portal vein stenting followed by transcatheter arterial chemoembolization combined with sorafenib could improve the survival time, the progress free survival time of patients with HCC complicated by MPVTT.

[The effects of exposure to ozone on sperm quality in Wuhan]

Objective: To evaluate the effects of exposure to ozone (O(3)) on sperm quality during different stages of spermatogenesis. Methods: All 1 780 subjects attending to the Reproductive Medicine Center in Renmin Hospital of Wuhan University were recruited from April, 4, 2013 to June, 30, 2015. The subjects were living in Wuhan more than 3 months before attending to the program, aged 20 to 40 years. Semen quality (sperm concentration and sperm count) were measured according to standardized protocols. Corresponding daily 8 hours average concentration of O(3), other polluted concentration, average temperature and relative humidity were collected in different time, including lag 0, 10, 70 and 90 d, and lag 0-9 d, lag 10-14 d, lag 70-90 d and lag 0-90 d. After controlling the age, BMI, education level and other confounders, generalized linear Model was used to investigate the association between O(3) and sperm quality during different stages of spermatogenesis. Results: Average daily concentration of O(3) during the study period was (114.20±74.88) μg/m(3) and the mean values of sperm concentration and count were (76.32±50.17) millions/ml and (164.77 ± 133.05) millions/sample, respectively. Exposure to O(3) was associated with decreasing sperm concentration and count. For every 1 μg/m(3) increase of O(3), the decrease of sperm concentration during lag 10, lag 0-9 and lag 10-14 days exposure windows were 0.040 (95%CI: 0.004-0.077) millions/ml, 0.081 (95% CI: 0.003-0.158) millions/ml and 0.059 (95% CI: 0.001-0.116) millions/ml, respectively. And the decrease of sperm count during lag 10, lag 0-9 days exposure windows were 0.105 (95%CI: 0.008-0.202) millions/sample and 0.221 (95% CI: 0.016-0.426) millions/sample. After stratification, in the ozone concentration <P(50) and ≥P(50) groups, and the number of subjects in each exposure windows (lag 0-9, lag 10-14, lag 70-90, lag 0-90 days) were 887 and 893, 890 and 890, 895 and 885, 889 and 891, respectively. Compared with the high ozone concentration group, the effects of low group were more obvious. Furthermore, the effects of low concentration group was the most obvious during lag 10-14 days, for every 1 μg/m(3) increase of O(3), the decrease of sperm concentration was 0.249 (95% CI: 0.028-0.470) millions/ml. After sensitivity analysis, the effects of exposure to ozone on sperm concentration and sperm count remained relatively unchanged. Conclusion: Our study suggested that exposure to O(3) was significantly associated with decreasing semen quality in Wuhan. Moreover, the effects were more obvious during lag 0-9 and lag 10-14 days.

[High glucose reduced the repair function of kidney stem cells conditional medium to the hypoxia-injured renal tubular epithelium cells]

OBJECTIVE

To evaluate the impacts of high glucose on the repair function of kidney stem cells (KSC) conditional medium to the hypoxia-injured renal tubular epithelium cells (RTEC).

METHODS

KSC were isolated from the renal papilla in 4-week-Sprague-Dawley rats. The KSC were pretreated in media with high glucose (30 mmol/L) or with normal glucose (5.6 mmol/L), respectively. The supernatants of the pre-treated KSC were collected as the conditional media. The hypoxia/reoxygenation (H/R) model of rat RTEC was established using the NRK-52E cell line. The effects of KSC conditional media on the H/R RTEC were investigated.

RESULTS

(1) The best H/R model of RTEC was established using hypoxia for 4 h and reoxygenation 2 h. (2) After hypoxia, the early and late cell apoptosis rates of the H/R RTEC were increased. The H/R RTEC were co-cultured with KSC conditional media for 12 h and 24 h, respectively. The H/R RTEC were co-cultured with DMEM/F12 as a control group. The cell apoptosis rate of H/R RTEC was lower after co-cultured with KSC conditional media (P<0.01), and the cell apoptosis rate of H/R RTEC in high glucose group was much higher than that in normal glucose group after co-cultured 24 h (P=0.02). (3) After hypoxia, the lactic dehydrogenase (LDH) and malondialdehyde (MDA) levels of the H/R RTEC supernatant were increased, and the superoxide dismutase (SOD) level decreased. The LDH and MDA levels were lower and the SOD level was higher after co-cultured with KSC conditional media for 12 h and 24 h, respectively (P<0.01). The LDH and MDA levels of H/R RTEC supernatant were much higher in the high glucose group than in the normal glucose group (P<0.05), and the SOD level of H/R RTEC supernatant was much lower in the high glucose group than in the normal glucose group (P<0.01).

CONCLUSION

KSC conditional media could repair the H/R injury of RTEC. The effects were mainly by inhibiting cell apoptosis, and reducing oxidative stress; the anti-cell apoptosis ability and the anti-oxidative stress capacity of the conditional medium were reduced after KSC were pre-treated with high glucose.

[Combined multiple artery-first approach to pancreatoduodenectomy]

Objective: To investigate the clinical application of combined multiple artery-first approach to pancreatoduodenectomy. Methods: The clinical data of 53 patients who were diagnosed with peripancreatic head tumor at Department of Biliary-Pancreatic Surgery of Second Affiliated Hospital of Harbin Medical University between June 2013 and June 2015 was retrospectively analyzed.Pancreatic enhanced CT scan, magnetic resonance cholangiopancreatography, ultrasonography and tumor marker detection were applied for all the patients preoperatively.The 53 patients were operated by combined multiple artery-first approach(superior+ posterior approach, superior+ inferior approach, posterior+ inferior approach, superior+ posterior+ inferior approach) according to individualized therapeutic concept.And 42 patients underwent pancreatoduodenectomy, 9 patients underwent palliative operation and 2 patients just received exploratory operation. Results: Forty-two peripancreatic head tumor patients underwent pancreatoduodenectomy by applying combined multiple artery-first approach.The median operation time and intraoperative blood loss were (5.4±3.1)hours and (366±297)ml and the harvested lymph node and duration of hospital stay were 19±5 and (14.0±5.6)days.Nine patients underwent "total mesopancreas excision" and the rate of postoperative pancreatic fistula and R0 resection were 38.1% and 88.1%. Anomalous origin hepatic right artery was detected in one patients during the operation and no death occurred within 30 days postoperatively. Conclusion: According to the tumor location and patient's condition, individualistically applying combined multiple artery-first approach can reduce intraoperative blood loss, terminate unnecessary surgery, detect anomalous origin artery, make the tumor resection more radical and pancreatoduodenectomy more safety.

Phylogenetic analysis of the Mongolian gerbil (Meriones unguiculatus) from China based on mitochondrial genome

Meriones unguiculatus (Gerbillinae, Rodentia) is widely used as an animal model of human disease. Here, we provide the first report of the complete mitochondrial genome sequence of M. unguiculatus (GenBank accession Nos. KF425526 and NC_023263). The sequence contained the conserved vertebrate pattern of 13 protein-coding genes, 2 ribosomal RNAs, 22 transfer RNAs, and 1 major noncoding region. We identified one extended termination-associated sequence and one conserved sequence block in the non-coding region. The putative origin of replication for the light strand (O_L) was 35 bp long. The O_L stem and adjacent sequences were highly conserved, but the loop region differed from those of other rodent species. Base composition and codon usage of the 13 protein-coding genes in M. unguiculatus were compared with those of 23 rodent species with previously sequenced mitochondrial genomes. An A+T content of 63.0% was present in M. unguiculatus; this is similar to the Murinae average (62.4 ± 0.8%) and falls between the average for Mus musculus (63.1 ± 0.1%) and Rattus sp (61.7 ± 0.4%). The AT and GC skew values of M. unguiculatus were 0.035 and -0.28, respectively, similar to those of Cricetinae species (0.057 ± 0.05 and -0.31 ± 0.05). The codon families exhibited similar abundance in all 24 species. Analysis of phylogenetic relationships with 23 other rodent species using neighbor-joining and maximum likelihood protocols and the 12 protein-coding regions on the H strand showed that M. unguiculatus should be classified as genus Meriones, sub-family Gerbillinae, family Muridae.

[A survey of correlation between serum 25-hydroxyvitamin D levels and dyslipidemia rlsk among middle-aged individuals in Beijing]

OBJECTIVE

To evaluate vitamin D status in middle-aged subjects in Beijing and explore the correlation between serum 25-hydroxyvitamin D[25(OH)D] levels and dyslipidemia.

METHODS

A total of 448 individuals over 40 years old were enrolled in the cross-sectional survey. The general information, blood biochemical and lipid profiles and serum 25(OH)D levels were collected. The subjects were either divided into two groups (the dyslipidemia group and the non-dyslipidemia group) based on the lipid levels, or four groups according to quartiles of 25(OH)D levels. The association between 25(OH)D levels and dyslipidemia risk was analyzed by a logistic regression analysis.

RESULTS

A total of 234 cases were in dyslipidemia group, which accounted for 52.23% of the subjects. The serum 25(OH)D levels were significantly lower in the dyslipidemia group than in the non-dyslipidemia group both in men and in women (all P<0.05). The median serum 25(OH)D level in the total subjects was 15.7 (12.2, 20.1)μg/L with 91.1% subjects of serum 25(OH)D level<30 μg/L. The proportion of subjects with dyslipidemia (high TC, high TG, high LDL-C, or low HDL-C) increased with the decrease of 25(OH)D level quartiles (P<0.05). After adjustment of confounding factors, the logistic regression analysis showed that subjects in the lowest 25(OH) D quartile group had 143% higher risks for dyslipidemia than those in the highest quartile group.

CONCLUSION

These findings indicate that 25(OH)D insufficiency is highly prevalent among middle-aged individuals and it may be associated with the risk of dyslipidemia.

[Analysis on the total allergens of phoenix roebelenii pollen with two dimensional electrophoresis followed by immunoblotting]

Objective:To investigate allergen extract and to seek the main allergens of phoenix roebelenii pollen by the technology of two dimensional electrophoresis(2-DE)in protein analysis and immunoblotting.Method:Phoenix roebelenii pollen allergen extract was prepared with routine method, 2-DE combined with immunoblotting assay(Western Blotting),laser imagescanning, 2-DE gel analysis software were used to analyzing its protein components.Result:About 601 soluble proteins spots were revealed in coomassie stained gels.Most of the proteins had a molecular weight (Mr) of 20 to 130 kD, and an isoelectric point(pI) value of 4.0 to 8.0. Immunoblotting of 2-DE were showed and there were 19 specific antigen spots, compared with the controls.Conclusion:2-DE is a good method in protein analysis of ephemeroptera allergen extract, and it is useful in seeking main allergens and further research for allergic components.

Elevated serum complement C3 levels are related to the development of prediabetes in an adult population: the Tianjin Chronic Low-Grade Systematic Inflammation and Health Cohort Study

AIMS

To investigate whether serum complement C3 is related to the prevalence and incidence of prediabetes in an adult population.

METHODS

A cross-sectional (n = 10 206) and prospective cohort study (n = 3333), with a mean (range; 95% CI) follow-up of 2.63 (1-6; 2.58-2.68) years, was conducted in people recruited from the Health Management Centre of Tianjin Medical University General Hospital in Tianjin, China. Measurement of serum C3 concentration, blood fasting glucose, oral glucose tolerance, HbA1c and other potential confounding factors was performed at baseline and each year during the follow-up. Prediabetes was defined according to the criteria of the American Diabetes Association. Adjusted logistic and Cox proportional hazards regression models were used to assess the relationships between C3 quintiles and prediabetes.

RESULTS

The prevalence and incidence of prediabetes were 38.5% and 119 per 1000 person-years, respectively. In cross-sectional analysis, after adjustment for potential confounders, the odds ratios of prediabetes for increasing quintiles of C3 were 1.00 (reference), 1.32 (95% CI 1.14-1.53), 1.37 (95% CI 1.18-1.59), 1.75 (95% CI 1.51-2.03), 2.25 (95% CI 1.93-2.62; P for trend < 0.0001). In the cohort analysis, the multiple-adjusted hazard ratio of prediabetes in the highest quintile of baseline C3 was 1.43 (95% CI 1.15, 1.78; P for trend < 0.001), when compared with the lowest quintile.

CONCLUSIONS

These findings indicate that elevated serum C3 levels are significantly related to an increased risk of developing prediabetes in an adult population, suggesting that C3 can be used as a biomarker in high-risk individuals to improve primary prevention of prediabetes and diabetes.

[RNPC1 induces sensitivity of HER-2-positive breast cancer BT474 cells to trastuzumab through upregulation of HER2]

OBJECTIVE

To explore the sensitivity of HER-2-positive BT474 breast cancer cells to trastuzumab after knockdown or overexpression of RNA binding protein 38 (RNPC1).

METHODS

The expressions of RNPC1 and HER-2 mRNA were detected by qRT-PCR, and the expressions of RNPC1, HER-2 and PI3K/AKT proteins were detected by Western blot after transfected with RNPC1 lentiviral vector, respectively. The experimental groups were treated with different concentration of trastuzumab, and cell apoptosis rate was analyzed by 7-AAD/APC double staining flow cytometry, and cell growth inhibition rate was tested by cell counting kit 8 (CCK-8). The expression of apoptosis-related proteins was detected by Western blot assay.

RESULTS

The results of qRT-PCR showed that overexpression of RNPC1 increased the expressions of RNPC1 and HER-2 mRNA, and the expressions of RNPC1 and HER-2 were decreased after RNPC1 knockdown. The knockdown of RNPC1 decreased the expressions of RNPC1 and HER-2. Moreover, overexpression of RNPC1 decreased and knockdown of RNPC1 increased the levels of p-PI3K and p-AKT while the total protein expressions of both were marginally changed.The results of analysis using a cell counting CCK-8 kit showed that the RNPC1 overexpressed group had a higher growth inhibition rate [(20.33±1.25)%, (35.38±2.05)%, (50.43±2.12)%, (65.35±2.08)% and(76.00±2.16)%, respectively] than that of the control group [(13.67±1.24)%, (27.86±2.05)%, (39.72±1.69)%, (53.33±1.70)% and(62.68±2.07)% ] when treated with different concentrations of trastuzumab (5, 10, 15, 20 and 25 μg/ml). The cell apoptosis rates in the RNPC1-overexpressed group [(19.46±1.06)%, (30.87±0.98)%, (50.45±1.13)%, respectively] were also increased compared with that in the control group [(14.38±0.64)%, (21.65±1.24)%, (38.03±0.85)%] when treated with different concentrations of trastuzumab (0, 10, 20 and 30 μg/ml)(P<0.05 for all). Reverse results were observed in the RNPC1 knockdown experiments [experimental groups: (9.67±1.18)%, (21.67±1.23)%, (30.33±1.25)%, (40.33±1.69)%, and (53.00±1.63)%] compared with those of control groups: [(14.00±0.82)%, (27.67±1.25)%, (39.67±1.79)%, (53.67±1.50)%, and (63.33±1.52)%]; and experimental groups: [(11.64±0.68)%, (16.60±1.01)%, and (25.14±3.12)%] compared with those of the control groups: [(14.71±0.61)%, (22.65±0.96)%, and (39.03±0.85)%]. The overexpression of RNPC1 increased the expression levels of Bim and Bad and decreased the level of Bcl-xl, and reverse result was observed after knockdown of RNPC1.

CONCLUSION

RNPC1 may promote the sensitivity of breast cancer cells to trastuzumab through the increased expression of HER-2 in the BT474 breast cancer cells.