Objective To explore the role of growth factor receptor-bound 2 (GRB2) in homo sapiens eukaryotic translation elongation factor 1 alpha 2 (EEF1A2) promoting the carcinogenesis and development of pancreatic cancer.Methods The human pancreatic cancer cell line SW1990 with low expression of EEF1A2,was transfected by Ad5/F35-EEF1A2 plasmid.The expression of EEF1A2 in human pancreatic cancer cell lines BxPC-3 cells with high expression of EEF1A2,was down-regulated by small interfering RNA (siRNA) interference.The expressions of GRB2 in SW1990 and BxPC-3 cells were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot before and after interference.The pancreatic cancer BxPC-3 cells were interfered by specific and efficient chemical synthesized siRNA fragment.The changes of BxPC-3 cell proliferation and migration were observed by methyl thiazoly tetrazolium (MTT) and Transwell assay before and after interference.The data were analyzed by one-way analysis of variance.Results After human pancreatic cancer cell line SW1990 was transfected with Ad5/F35-EEF1A2 plasmid,the expression of GRB2 at mRNA and protein level both increased significantly (F=5.67,6.39,both P＜0.05).After the expression of EEF1A2 was inhibited by EEF1A2-siRNA,the expression of GRB2 at mRNA and protein level both decreased significantly (F=6.59,4.69,both P＜0.05).After BxPC-3 cells was transfected with siRNA-GRB2 for 72 hours,the results of MTT assay indicated that the absorbance value was 1.22±0.14,compared with negative control group (1.42±0.15) and blank control group (1.39 ± 0.15) the difference was statistically significant (F =6.63,P＜ 0.05).The results of transwell assay showed that the migration ability of cells in siRNA-GRB2 group decreased.After 24 hours,the number of migrated cells was 24.10±4.25,compared with negative control group (54.72±5.24) and blank control group (51.26 ± 6.23) the difference was statistically significant (F=55.00,P＜ 0.05).Conclusion GRB2 is key molecule in EEF1A2 promoting the progenesis and development of pancreatic cancer.

Objective To observe the effects of statins, angiotensin-converting enzyme inhibitor/adrenergic receptor binder ( ACEI/ARB ) treatment on Heme Oxidase-1 ( HO-1 ) expression in patients with coronary artery disease. Methods HO-1 expression in periphery white blood cells was detected using Western blot before and after 3 months treatment of the above antioxidants in 60 patients who were diagnosed as coronary artery disease by coronary angiography. Results HO-1 expression measured by gray scale peak by western blot was significantly higher after 3 months antioxidant treatment than that before antioxidant treatment( 168. 9 t6. 8vs 112.7 ± 6.3, P = 0.008 ). Conclusion Effects of statins and ACEI/ARB in treating coronary artery disease may be due to its promoting expression of HO-1.

Objective To investigate the effects of over-expression of homo sapiens eukaryotic translation elongation factor 1 alpha 2 (EEF1A2) on in vitro invasion and lung metastasis of human pancreatic cancer SW1990 cells.Methods Letivirus-mediated delivery of EEF1A2 was used to enhance the expression of EEF1A2 gene in human pancreatic cancer SW1990 cells,the SW1990 cells stably over-expressing EEF1A2 protein (SW1990/EEF1A2 cells) were obtained,and the parent SW1990 cells and SW1990/GFP cells were used as the control,and the expressions of EEF1 A2 mRNA and protein were determined by Real-time PCR and Western blotting.The invasion ability of cells was determined by Transwell assay.The lung metastasis model was established by injection of SW1990 cells into the tail vein.Whole lung tissues were harvested,and visible nodules on tung surface were counted macroscopically 8 weeks later.Results The EEF1 A2 mRNA expression of SW1990/EEF1A2 was 3.252 ± 0.344,which was significantly higher than those in SW1990/GFP cells (1.000 ±0.060) and SW1990 cells (0.944 ±0.041,t =2.255,2.305,P＜0.01) ; the EEF1A2 protein expression was 0.833 ± 0.050,which was significantly higher than those in SW1990/GFP cells (0.247 ± 0.035) and SW1990 cells (0.273± 0.041,t=0.572,0.559,P＜0.01).The ability of invasion of SW1990/EEF1A2 cells was (60 ±4) cells,which was sigmificantly higher than (33 ±4) cells in SW1990/GFP group and (26 ± 3) cells in SW1990 group (t =31.33,34.78,P ＜ 0.01).Furthernore,SW1990/EEF1 A2 cells had a much higher incidence of lung metastasis in nude mice than SW1990/GFP cells and SW1990 cells in vivo (100％ vs.20％,20％,P ＜ 0.05).Conclusions EEF1 A2 over-expression can obviously increase the in vitro invasion and lung metastasis of pancreatic cancer SW1990 cells.

Objective To study the clinical features of aged patients with sudden cardiac death(SCD) for improving the resuscitation rate. Methods Hie usual etiology of SCD,electrocardiogram(ECG),echocardiography, dynamic electrocardiography(DCG), X-ray and electrolytes were analyzed. Results Most sudden death had inducement. Electrolytes disorder,ventricular ectopic beats,high grade atrioventricular block, auxocardia, left ventricular hypertrophy, cardiac insufficiency and myocardial ischemia could cause serious arrhythmias (.all P <0.05). Conclusion It could be related to heart functional class,left ventricular enlargement,myocardial ischemia,hypokalemia in aged patients with SCD.

Background:Conventional gastrointestinal endoscopy is incapable of determining the deriving layers,size and nature of submucosal lesions,however,mini probe ultrasonography(MPS)is effective for mural stratification and determining the deriving layers and nature of lesions within gastrointestinal wall,and is considered to be an optimal examination for suspected submucosal tumors before endoscopic or surgical operation. Aims:To assess the diagnostic value of MPS for gastrointestinal submucosal lesions and the significance of MPS-assisted endoscopic therapy. Methods:A total of 69 patients with presumed gastrointestinal submucosal protruded lesions were retrospectively enrolled. All of them underwent MPS and then endoscopic therapy,such as cyst incision,high frequency electric snare resection,endoscopic mucosal resection and endoscopic submucosal dissection were performed according to the deriving layers,size and nature determined by MPS. The ultimate diagnosis was confirmed by histopathological examination. Results:In the 69 cases of lesions,MPS showed that 15 were derived from muscularis mucosa,40 from submucosa,and 14 from muscularis propria;10 of them were considered as cyst,18 were stromal tumor,8 were leiomyoma,6 were ectopic pancreas,15 were neuroendocrine tumor,and 12 were lipoma. Compared with pathological diagnosis,an overall coincidence rate of 91. 3%(63 / 69)was achieved by MPS. Conclusions:The accuracy rate of MPS is high for determining the deriving layers and nature of gastrointestinal submucosal protruded lesions prior to the attempting of endoscopic removal. It might be helpful for selecting treatment modalities for this kind of lesions.

Substantial development in equipment such as miniprobe endosonography and enteroscopy has made it possible to use endoscopic ultrasonography (EUS) to detect any part of the digestive tract. EUS plays a vital role in evaluating a lower intestinal malignancy, particularly rectal cancer, to determine whether the disease is localized (T1-2, N0) and appropriate for surgery or locally advanced (T any, N1-2) and would benefit from preoperative neoadjuvant chemoradiation. Moreover, follow-up by EUS may contribute to early recognition of focal tumor recurrence, particularly for lesions that cannot be detected by other imaging modalities. EUS is also an invaluable modality for diagnosing intestinal submucosal tumors, such as gastrointestinal stromal tumors, lipomas, lymphangiomas, leiomyomas, carcinoids, and others such as intestinal endometriosis. Although a definite diagnosis of a submucosal tumor is generally confirmed by cytology or histology results, EUS-guided fine needle aspiration or core biopsy is a fairly helpful practice. EUS is also useful for discriminating between Crohn's disease and ulcerative colitis as well as assessing disease severity. Moreover, it has emerged as a powerful imaging tool to manage perianorectal diseases. EUS also has the potential to be useful for intra-small intestinal ultrasonography for the diagnosis of small bowel diseases in the future.
Biopsy ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Colitis, Ulcerative ; Crohn Disease ; Endometriosis ; Endosonography ; Female ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Intestinal Diseases ; Leiomyoma ; Lipoma ; Lymphangioma ; Rectal Neoplasms ; Recurrence

To evaluate the diagnostic value and safety of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in patients with biopsy-negative malignant gastrointestinal stricture, a retrospective analysis was performed on data of patients whose computed tomography scan showed gastrointestinal malignant tumor with complete lumen stricture and endoscopic biopsy results showed negative, who underwent EUS-FNA in the Second Affiliated Hospital of Soochow University from July 2016 to January 2020. Perioperative complications, technical success rate and accuracy of EUS-FNA were analyzed. Eleven cases included in the study, including 7 males and 4 females, with mean age of 60.3 years. There were 8 esophageal strictures and 3 rectal strictures. All patients successfully underwent EUS-FNA, and malignant tumor was found in 10 cases and no tumor cell was found in 1 case. No complications were reported. EUS-FNA is a safe and valuable approach to diagnosing biopsy-negative malignant gastrointestinal strictures.

Endoscopic data of 108 upper gastrointestinal elevated lesions caused by vascular or hemangioma compression by endoscopic ultrasonography (EUS) at the Second Affiliated Hospital of Soochow University, Changshu No.1 People's Hospital, Kushan Hospital of Chinese Medicine and Traditional Chinese Medicine Hospital of Changshu from December 2010 to June 2019 were retrospectively summarized. The results showed that lesions were mainly located in the esophagus [50.9% (55/108)] and stomach [47.2% (51/108)], especially in the middle [40.0% (22/55)] and upper esophagus [36.4% (20/55)], body [66.7% (34/51)] and fundus of stomach [31.4% (16/51)], respectively. The major etiology included splenic artery and aneurysm compression [29.6% (32/108)], aortic compression [23.1% (25/108)], isolated esophageal venous aneurysm compression [13.9% (15/108)] and gastric submucosal vein and venous aneurysm compression [12.0% (13/108)], with diverse endoscopic presentation. The above results suggest that elevated lesions of upper gastrointestinal tract caused by blood vessels and hemangiomas are mostly due to external vascular pressure outside the lumen, but ectopic submucosal arteries and isolated phlebangioma are not uncommon. The lesions are widely distributed with different gastroscopic manifestations. EUS is important for definite diagnosis, and can be combined with color Doppler technique, CT plain scan and angiographic reconstruction if necessary.

Objective:To investigate the features of endoscopic ultrasonography in the diagnosis of malignant mediastinal and abdominal lymphadenopathy and to provide more evidence for endoscopic ultrasound-guided fine-needle aspiraiton (EUS-FNA).Methods:A case-control study was performed on 83 consecutive patients who underwent EUS in the Second Affiliated Hospital of Soochow University from September 2016 to February 2021. Lymph node properties were identified by pathological results of EUS-FNA and (or) surgery and follow-up for at least 6 months. According to the final diagnosis, patients were divided into malignant lymph node group ( n=56) and benign lymph node group ( n=27). Univariate analysis and multivariate logistic analysis were performed to identify independent risk factors for malignant lymphadenopathy in terms of EUS features. Results:Univariate analysis showed that the length of short axis, short-long axis ratio, shape, border, presence or absence of hilum, heterogeneous echo, and the growth pattern of lymph node were risk factors for malignant lymph nodes ( P<0.10). Multivariate logistic regression analysis showed that short axis>10 mm ( P=0.021, OR=9.751, 95% CI: 1.407-57.573), clear border ( P=0.009, OR=20.587, 95% CI: 2.149-197.251), absence of hilum ( P=0.019, OR=28.502, 95% CI: 1.725-470.864), nodal matting ( P=0.004, OR=45.539, 95% CI: 3.429-604.822), partial nodal fusion ( P=0.004, OR=50.012, 95% CI: 3.497-715.266) were independent risk factors for malignant mediastinal and abdominal lymph nodes. Conclusion:EUS is useful to differentiate the lymph node properties in the mediastinal or abdominal cavity. Short axis>10 mm, clear border, absence of hilum, nodal matting and partial nodal fusion are high-risk EUS features of malignant mediastinal or abdominal lymphadenopathy, where priority should be given to EUS-FNA.

Objective:To explore the related factors of thrombocytopenia (TCP) occurrence in patients with cirrhosis.Methods:A cross-sectional study was conducted. Inpatients with an initial diagnosis of cirrhosis at Peking University First Hospital from January 1, 2010 to December 31, 2020 were included. Clinical data such as demographic characteristics, etiology of cirrhosis, complications of cirrhosis, laboratory indicators, Child-Pugh grade, invasive procedures, and mortality during hospitalization were collected. A logistic regression model was used to explore the related factors of TCP occurrence in patients with cirrhosis. Categorical variables were compared by the χ2 test. The inter-group comparison was performed using continuous variables, a t-test, one-way analysis of variance (ANOVA), or a nonparametric test. Results:There were a total of 2 592 cases of cirrhosis. 75 cases with incomplete clinical data were excluded. 2 517 cases were included for analysis. The median age was 58 (50, 67) years. Males accounted for 64%. 1 435 cases (57.0%) developed TCP, and 434 cases (17.2%) had grade 3-4 TCP. Gender, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and concomitant esophagogastric varices (EGV) were the major factors associated with TCP. Females were more prone to combine with TCP ( OR=1.32, 95% CI: 1.12-1.56, P=0.001). Patients combined with EGV ( OR=3.09, 95% CI: 2.63-3.65, P<0.001) were more prone to develop TCP, which was associated with the increased incidence of hypersplenism ( P<0.001). Patients with PBC ( OR=0.64, 95% CI: 0.50-0.82, P<0.001) and PSC ( OR=0.23, 95% CI: 0.06-0.65, P=0.010) were less prone to develop TCP, which was due to the shorter prothrombin time and better coagulation function of PBC patients ( P<0.001), and the lower proportion of hypersplenism in combined PSC patients ( P=0.004). Patients with TCP and grade 3-4 TCP had a higher rate of hemostatic procedures ( P<0.05), but a lower rate of liver biopsy ( P<0.05). Patients with grade 3-4 TCP had a higher nosocomial mortality rate compared to those without ( P=0.004). Conclusion:TCP is common in patients with cirrhosis. However, TCP occurrence is higher in female patients with EGV and lower in patients combined with PBC and PSC. TCP affects invasive procedures and is associated with adverse outcomes.