Objective To investigate the inhibitory effects of arsenic trioxide on salivary duct carcinoma cell colony and to explore a new approach to treat salivary duct carcinoma .Methods Human salivary duct carci-noma cancer cells were established .The effects of different concentrations (0.5、1、2、4μmol/L)and time(48,96 H) of arsenic trioxid on salivary duct carcinoma cell colony and the changes of the cell colony were observed with MTT assay and microscopic cell analysis .Results Human salivary duct carcinoma were significantly inhibited by Different concentrations of arsenic trioxide at different times points , and the relationship between the doses and time points are dependent ,cell atypia disappearing apoptosis appears apoptotic bodies .Conclusion Arsenic tri-oxide can significantly inhibit proliferation ,induce differentiation and promote apoptosis in the salivary duct carci-noma cells .

Objective To investigate the expression and clinical significance of microRNA‐7 (miRNA‐7) and focal adhesion kinase (FAK) in colorectal cancer (CRC) .Methods Sixty pairs of CRC and adjacent colorectal tissues were collected .The expression of FAK was detected by immunohistochemistry and the expression of miRNA‐7 was determined by quantitative real‐time polymerase chain reaction (PCR) . Chi square test was used for statistical analysis and Spearman rank was applied for correlation analysis . Results The positive rate of FAK expression in CRC was 75 .0% (45/60) and that in adjacent colorectal tissues was 26 .7% (16/60) ,the difference was statistically significant (χ2 = 28 .04 , P < 0 .01) . The positive rate of phospho‐FAK (p‐FAK ) expression in CRC was 65 .0% (39/60 ) and that in adjacent colorectal tissues was 21 .7% (13/60) ,and the difference was statistically significant (χ2 = 22 .94 , P <0 .01) .The expression of miRNA‐7 in CRC tissues was down‐regulated compared with that in adjacent colorectal tissues (P= 0 .044) .The correlation between miRNA‐7 expression and lymph nodes metastasis was negative in patients with CRC (Z= - 2 .290 ,P= 0 .022) .The miRNA‐7 expression was significantly negatively correlated with TNM stage in patients with CRC (Z= - 2 .698 , P= 0 .007) .However it was not correlated with age ,gender ,the location of tumor and tumor differentiation .The correlation between miRNA‐7 expression and FAK ,p‐FAK was negative (Z= - 0 .303 ,P= 0 .019 ;Z= - 0 .267 ,P= 0 .038) . Conclusion The miRNA‐7 may involved in the genesis and development of CRC through regulating the expression of FAK ,which provide a new target for the diagnosis and treatment of CRC .

Objective To compare the dosage characteristics between three-dimensional conformal radiotherapy (3DCRT)plan and simplified inverse dynamic intensity modulated radiotherapy (IMRT)in patients with early-stage breast cancer after breast-conserving surgery.Methods 3DCRT and IMRT treament plans were designed for 14 female patients with early-stage breast cancer after breast-conserving surgery,4 of whom were left breast cancer cases.A dose of 50 Gy in 25 fractions to the whole ipsilateral breast was delivered using 6 MV photons for 3DCRT or IMRT.For 3DCRT plans,tangential field irradiation was adopted.While for IMRT,reverse dynamic intensity modulated technology was done through two pairs of tangential-likely fields, and 10 Gy was boosted to the tumor bed concomitantly in 25 fractions.The conformity index (CI),heterogenei-ty index (HI),dose and volume of organs at risk were evaluated by dose volume histograms (DVH).Results Compared with 3DCRT plans for ipsilateral lung,the high dose volumes were reduced and the low dose volumes were increased in IMRT plans.The same phenomenon was also observed for the heart of the patient with left breast cancer.The crosspoint doses of 3DCRT DVH and IMRT DVH for lung or heart were (25.16 ±9.11) Gy,(28.63 ±10.41 )Gy respectively.There was no difference between the two plans in the V10 of contra-lateral breast [IMRT(4.13 ±5.17)%∶3DCRT(1.99 ±2.43)%,t=2.11,P>0.05],but the D30 and mean of IMRT plan were higher than that of 3DCRT [(2.23 ±1.77)Gy ∶(1.20 ±0.46)Gy,t=2.58,P<0.05;(2.35 ±1.59)Gy ∶(1.54 ±0.88)Gy,t=3.15,P<0.01].The difference in HI between the two plans was not observed [IMRT(1.25 ±0.10)∶3DCRT(1.23 ±0.11),t=1.25,P>0.05].While the CI of IMRT plans were improved compared with 3DCRT [(0.75 ±0.07)∶(0.62 ±0.09),t =5.68,P<0.000 1]. Conclusion Compared with 3DCRT plan in patients with early-stage breast cancer after breast-conserving surgery,the main advantages of four fields simplified inverse dynamic IMRT are concomitant tumor boosting, decreasing the high dose volumes of ipsilateral lung,and improving the CI of planning target volume at the same time,but the HI is not improved.The IMRT plan is a simple,rational and feasible design scheme.

Objective:To investigate the clinical and laboratory characteristics of lupus nephritis(LN) patients by detecting the anti-nucleosome antibodies, anti-C1q antibodies and anti-double stranded antibodies(anti-ds DNA), and to clarify the risk factors of LN in the patients with systemic lupus erythematosus(SLE),and the significance of three kinds of antibodies in diagnosis of LN.Methods:A total of 120 SLE patients were selected and divided into LN group(n=60) and non-LN group(n=60).The ANAS data of 120 patients were retrospectively analyzed,the levels of anti-C1q antibodies were measured.The clinical symptoms and laboratory data of the patients with positive anti-dsDNA,-nucleosome and-C1q antibodies (3-pos group)and negative three kinds of antibodies(non 3-pos group) were analyzed in LN group.Results:The positive rate of anti-C1q antibody of the patients in LN group (40.00%) was higher than that in non-LN group (21.67%) (χ2=4.728, P=0.03).The positive rate of anti-dsDNA antibody in LN group was 66.67%, and it was 46.67% in non-LN group;the positive rates of the patients had significant difference between two groups (χ2=4.887, P=0.027).The positive rate of anti-nucleosome antibody in LN group was 58.33%, and it was 40.00% in non-LN group;the positive rates of the patients had significant difference between two groups (χ2=4.034, P=0.045).The positive rates of U1-snRNP, SmD1 and other antibodies Jo-1, SSA/Ro60kD, SSA/Ro52kD, SSB, ScL-70, CENP-B,and P0 had no significant differences between two groups(P>0.05).The levels of C3 and C4 and hemoglobinin of the patients in 3-pos group were higher than those innon 3-pos group (P<0.05);the age,the levels of immunoglobulin protein and C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), white blood cell (WBC) and platelet had no statistically significant differences between 3-pos and non 3-pos groups(P>0.05).The clinical symptoms were not statistically significant in 3-pos and non 3-pos groups (P>0.05).Conclusion:The anti-nucleosome, anti-C1q and anti-dsDNA antibodies are the risk factors of SLE complicated with LN;the positive antibodies can improve the diagnostic rate of LN.The 3-pos patients have more severe damage in complements and blood system with higher renal disease activities.

Objective To identify the risk factors for positive resection residues after endoscopic submucosal dissection ( ESD ) of early esophageal squamous carcinomas and precancerous lesions. Methods A retrospective analysis was performed in 315 patients with early esophageal squamous cancer and precancerous lesion who underwent ESD. The pathological features of all resection margins in the specimen and the follow?up outcome of the patients with positive resection margin were evaluated. Univariate and multi?variate analysis were used to determine the risk factors for resection margin residues after ESD. Results In 315 lesions,there were 290 lesions with negative resection margins and 25 with positive resection margins.The number of lesions with positive lateral, basal, or both resection margins was 13, 8, and 4, respectively. Multivariate analysis showed that the depth of invasion( submucosal layer invasion, P=0?048) was the only independent risk factor for positive basal resection margin. The proportion of circumferential extension (≥3/4,P=0?014) and the depth of invasion( exceeding muscularis mucosa, P=0?007) were independent risk factors for positive lateral resection margin. Conclusion The diameter of the lesions and the depth of tumor invasion are independent risk factors for esophageal ESD positive resection margins. Accurate evaluation of lesion extension and invasive depth is critical to avoid residual or recurrent tumor after esophageal ESD.

Objective To investigate the role of p38 mitogen-activated protein kinase (p38MAPK) signaling pathway in the expression of aquaporin 4 (AQP4) in brain tissue of rats with cardiopulmonary resuscitation (CPR) during mild hypothermia. Methods Forty-eight healthy male Sprague-Dawley (SD) rats were divided into sham operation group, normal temperature group and mild hypothermia group according to random number table method, with 16 in each group. The rat model of cardiac arrest-cardiopulmonary resuscitation (CPR) was established by asphyxia method. The sham operation group only experienced venous catheterization and tracheal intubation. The mild hypothermia group was treated with hypothermia 0.5 hours after restore of spontaneous circulation (ROSC, maintaining esophageal temperature at 32-34 ℃); the normal temperature group was treated at room temperature after ROSC (maintaining esophageal temperature at 36-38 ℃). Brain tissue was harvested at 6 hours after ROSC, and histopathological changes were observed by hematoxylin-eosin (HE) staining. The water content of brain tissue was determined by dry-wet specific gravity method. The protein expressions of phosphorylation of p38 mitogen-activated protein kinase (p-p38MAPK), p38MAPK and AQP4 in brain tissue were determined by Western Blot. Results Compared with the sham operation group, the nerve cells in the normal temperature group were reduced in size, cytoplasmic loosening, nuclear pyknosis, and in apoptotic body formation, water content of brain tissue was significantly increased [(83.64±2.53)% vs. (77.95±0.94)%, P < 0.05], the protein expressions of p-p38MAPK, p38MAPK, AQP4 were significantly increased (p38MAPK/β- actin: 1.010±0.217 vs. 0.427±0.090, p-p38MAPK/p38MAPK: 0.451±0.172 vs. 0.191±0.141, AQP4/β- actin: 3.129±0.754 vs. 1.598±0.464, all P < 0.05). Compared with the normal temperature group, the degree of necrosis of nerve cells in the mild hypothermia group was reduced, the water content of brain tissue was significantly decreased [(80.49±2.05)% vs. (83.64±2.53)%, P < 0.05], the protein expression of p38MAPK, p-p38MAPK and AQP4 in brain tissue were significantly decreased (p38MAPK/β- actin: 0.590±0.162 vs. 1.010±0.217, p-p38MAPK/p38MAPK: 0.298±0.076 vs. 0.451±0.172, AQP4/β- actin: 2.061±0.340 vs. 3.129±0.754, all P < 0.05). Conclusion Mild hypothermia may regulate the expression of AQP4 in brain tissue of CPR rats through p38MAPK signaling pathway, and reduce brain edema, thereby exerting brain protection.

Objective To study the risk factors for pathological upgrading after diagnosis of esophageal low?grade intra?epithelial neoplasia with ESD preoperative biopsy. Methods The endoscopic and pathological data of 85 lesions with ESD preoperative biopsy were analyzed, and grouped based on pathological upgrading after ESD. The risk factors for pathological upgrading after ESD was studied through single and multiple factor analysis. Results Pathological upgrading occurred in 45(52?94%) lesions after ESD, among whom 38 lesions developed up to high?grade intra?epithelial neoplasia and 7 lesions developed to esophageal early cancer. NBI?ME was performed on 37 patients and the accuracy of detecting the pathological invasion was 83?8%(31/37).Multi?factor analysis showed that reddish surface(OR=9?478, 95%CI:2?775?32?368, P = 0?000 3 ) and nodular lesion ( OR = 15?628, 95%CI:1?475?165?617, P =0?022 5) were independent factors for pathological upgrading after ESD. Conclusion Pathological upgrading of low?grade intra?epithelial neoplasia was common, especially esophageal mucosa with red surface and nodular lesion.Biopsy combined with NBI?ME is of significant importance to improve diagnostic accuracy.

Objective:To evaluate the safety and efficacy of circulating tumor cells(CTCs)measurement in patients with pancreatic cancer by endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA).Methods:This prospective, single-center clinical study recruited 5 patients with pancreatic cancer, who underwent EUS-FNA for portal vein blood collection to detect CTCs in portal vein blood and CTCs in peripheral blood as control. CTCs were determined using negative immunomagnetic beads combined with FISH and a folate receptor positive circulating tumor cells detection kit.Results:All 5 patients underwent EUS-FNA portal vein blood collection successfully. One sample developed blood agglutination and failed to perform CTCs test. Four others were tested, and CTCs in portal vein samples and peripheral blood samples were obtained from 3 patients. The mean CTCs in portal vein blood was 10.5±4.0 FU/3.7 mL, and the mean CTCs in peripheral blood was 11.4±4.2 FU/3.7 mL. There was no significant difference between the two groups ( P >0.05). There were no complications such as infection, abdominal bleeding or shock during operation. Conclusion:It is a safe and feasible method to collect and determine the CTCs in portal venous blood from patients with pancreatic cancer under EUS, which helps prediction and treatment of early metastasis of pancreatic cancer.

Objective To observe the application effects of expander between collarbone and first rib space in Peripherally Inserted Central Catheter (PICC ).Methods A total of 1 20 PICC patients with chemotherapy were recruited from April 201 4 to April 201 5 and were divided into control group (54 cases, routine tube)and observation group (66 cases,self-designed expander between collarbone and first rib space) according to the method of random number table.And then,we compared the success rate of tubing and puncturing at once,operation time,catheter misplacement,mechanical phlebitis,the incidence of infection between two groups.Results The success rates of tubing and puncturing at once,operation time in observation group were better than those in control group with significant differences (P <0.05).There were statistically significant differences in catheter misplacement,mechanical phlebitis,the incidence of infection of patients between two groups (P <0.05).Conclusions The expander between collarbone and first rib can effectively decrease the incidence of complications and improve the effects of PICC.

Objective To evaluate the safety and feasibility of endoscopic ultrasonography(EUS)-guided dehydrated ethanol lavage on treatment of pancreatic cystic neoplasms(PCN). Methods The data of 15 patients with PCN treated by EUS-guided dehydrated ethanol lavage in Nanjing Drum Tower Hospital from April 2014 to December 2016 were retrospectively analyzed. All the patients underwent EUS-guided fine needle aspiration, and then the cyst cavity was lavaged with dehydrated ethanol. The curative effects and complications were evaluated after the procedure. Results Each patient had one operation and all the operations were successful. No operation-related intraoperative or postoperative complications occurred. Patients were followed up for a median time of 15 months(range from 3-30 months).Twelve patients finished a long term follow-up,including 6 cases of complete remission and 6 cases of partly remission. None of the patients underwent surgical resection. Conclusion Dehydrated ethanol lavage is safe and feasible for treatment of PCN.