OBJECTIVE:To observe the efficacy and toxicity of compound glycyrrhizin(Stronger Neo-Minophagen C SNMC) plus chemoradiotherapy in treating advanced esophageal carcinoma.METHODS:A total of 88 patients with advanced esophageal carcinoma were randomly assigned to receive compound glycyrrhizin in combination with chemoradiotherapy(trial group) or chemoradiotherapy alone(control group) with 3 weeks as one course of treatment.The efficacy and toxicity of the two groups after 2 courses of treatment were evaluated.RESULTS:The response rate of the trial group vs.control group was 70.5% vs.59.1%(P

Objective To observe the feasibility and security of the embolization with medical adhesive on renal artery in rab‐bits by animal experiments ,and explore the effectiveness of different concentration of embolic agents on the process and the effect of embolization for vascular ,and provide guidance for clinical application of medical adhesive .Methods A mixture of different ratios of lipiodol and medical adhesive were used to embolize the renal artery in 18 rabbits ,the usage and effects of embolization were ob‐served .Results Embolic agents were seen under the fluoroscopy ,easy to control and inject transcatheter ,also repeated injected by one micro‐catheter safety and effectively .Angiography review showed a reliable embolization ,no vascular recanalization and no spill‐over of contrast agent .Optical microscope ,after HE staining in postoperative pathological examination ,showed irregular shaped embolic agents or branch like refractive index of transparent material in the embolized artery .In 5∶1 group and 4∶1 group ,arteri‐ole and small artery were mainly embolized ,there was no significant difference between the two groups(P>0 .05);Whereas medium sized artery was mainly embolized in 3∶1 group ,compared with the 5∶1 group and 4∶1 group ,the differences was statistically significant(P<0 .05) .After operation ,renal function was transient damage ,leukocyte was transient increasing ,one week later ,both of renal function and leukocyte were recovered ,and there was no significantly renal function anomaly .Conclusion It is feasible ,safe and effective for medical adhesive to embolize rabbits renal artery ,the different concentration of the embolic agents can embolize the different branches of rabbit renal artery .

Objective To evaluate the safety and effectiveness of different anesthesia methods in performing percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods The clinical data of 102 HCC patients, who were admitted to authors’ hospital during the period from January 2010 to October 2014 to receive percutaneous RFA, were retrospective analyzed. According to the anesthesia method used for RFA, the patients were divided into 3 groups. Group A: control of breathing and general intravenous anesthesia; group B: general intravenous anesthesia with spontaneous breathing; group C: local anesthesia with monitoring. The vital signs, perioperative adverse reactions and procedure-related complications were analyzed. Results The operation time of group A and B was longer than that of group C (P<0.02); the time of waking up after the operation in group A was longer than that in group B (P<0.03). During the performance of RFA the patient’s vital signs in group A and B were more stable than those in group C (P<0.01);during the performance of RFA the blood oxygen saturation in patients of both group A and B remained above 95%(from the placement of oxygen masks to the end of operation), although the blood oxygen saturation of group B was lower than that of group A (P<0.05), and the blood oxygen saturation of group C was lower than that of both group A and B (P<0.01). The incidences of adverse reactions such as involuntary limb activity, tears, need of anesthesia machine-assisted respiration, etc. in group A were significantly lower than those in group B and C (P<0.01). The postoperative complications such as subcutaneous emphysema, pneumothorax or need of thoracic drainage in group B and C were significantly higher than those in group A (P<0.05). Conclusion General intravenous anesthesia can reduce the operation time of RFA for HCC, which can create a safe and comfortable surgical environment for patients. The use of general intravenous anesthesia together with the control of breathing is the safest method with lower incidence of perioperative adverse reactions and procedure-related complications; it might be a relatively optimal anesthesia method for RFA of HCC.

Objective Through detecting the genotypes of vascular endothelial growth factor (VEGF) to investigate the correlation between the different VEGF genotypes and survival rate of patients with hepatocellular carcinoma (HCC) after receiving transcatheter arterial chemoembolization (TACE). Methods A total of 156 patients with pathologically confirmed HCC, who were admitted to authors’ hospital during the period from January 2008 to January 2009 and received TACE within 2 months after the disease was confirmed by pathology, were included in this study. The genotypes of VEGF-2578C/A, -1154G/A, -634C/G, and-1498T/C were determined using a blood kit on a 384-well plat. The clinical data were collected, and the correlations between the genotypes and the patient’s prognosis were analyzed. Results In this study, a total of four genotypes were detected, including VEGF-2578C/A, VEGF-1154G/A, VEGF-634C/G and VEGF-1498T/C. The mean 5-year survival rate was 55.47%. Multivariate analysis revealed that only the tumor-node-metastasis(TNM) stage, metastasis, and the VEGF-2578 AA and VEGF-1154 AA genotypes were independent prognostic factors. HCC of TNM stage Ⅲ-Ⅳ would greatly increase the risk of death in HCC patients (HR=3.64, 95%CI=1.67-6.79; HR=2.91, 95%CI=1.30-6.27). Moreover, the death risk in patients with the VEGF-2578 AA and VEGF-1154 AA genotypes was much higher than that in patients with the wild-type genotype (HR=3.65, 95%CI=1.35-11.13; HR=7.13, 95%CI=1.46-65.8). Conclusion VEGF-2578C/A genotype and VEGF-1154G/A genotype are closely related to the prognosis of HCC patients after TACE treatment, which may be helpful for predicting the clinical outcome of HCC patients after interventional treatment.

Human gut microbiota contains around 1014 colonized intestinal microbes.Gut microbiome outnumbers the human gene pool by ten to one.Therefore,it's generally considered to be our "second gene pool".Several research have clarified that the cycle of "maternal intestinal microbes-placental microbes-fetal intestinal microbes" plays a critical role in the neurological and immune regulation and metabolism in infants,which may contribute to the furtherance of research on gut microbes.We summarized the factors affecting the colonization of maternal and fetal gut microorganisms during perinatal period from recent research.

Objective To discuss the effect of PI3K-AKT signaling pathway regulated by microRNA-155(miRNA-155)targeted protein tyrosine phosphatase non-receptor type 21(PTPN21)on the proliferation,migration and invasion of hepatocellular carcinoma(HCC)cells.Methods Lentivirus transfection was used to silence the expression of miRNA-155 in human Huh7 HCC cells,and real-time fluorescent quantitative polymerase chain reaction(RT-qPCR)was used to detect the silencing effect of miR-155.After obtaining stable cell lines,the cell lines were randomly divided into Blank group(normal Huh7 cells),shNC group(Huh7 cells+empty miR-155 vector),sh-miR-155(Huh7 cells+miR-155 silencing),sh-miR-155+Recilisib group(Huh7 cells+miR-155 silencing+PI3K-AKT agonist),shNC+Recilisib group(Huh7 cells+empty miR-155 vector+PI3K-AKT agonist).Dual luciferase assay was used to determine whether PTPN21 was the downstream of miR-155.The cell proliferation ability of cells in each group was detected by MTT assay.The apoptosis level of each group was tested by flow cytometry.The invasion and migration ability of cells was assessed by Transwell assay.Western blot analysis was used to observe the differences in protein expression of PTPN21,PI3K,P-PI3K,AKT,P-AKT,and apoptosis-related proteins including BAX,BCL-2 and caspase-3 in all groups.Results The expression level of miR-155 in sh-miR-155 group was lower than that in Blank group and shNC group(P＜0.000 1),and the difference in miR-155 expression level between Blank group and shNC group was not statistically significant(P＞0.05).MTT results showed that A values of Huh7 cells at 2,3,4 and 5 day in sh-miR-155 group were lower than those in Blank group and shNC group(P＜0.000 1),while these differences between Blank group and shNC group were not statistically significant(P＞0.05).In sh-miR-155 group the A values at 2,3,4 and 5 day were lower than those in sh-miR-155+Recilisib group and shNC+Recilisib group(P=0.0052 and P＜0.0001,respectively),while the A values at 2,3,4 and 5 day in sh-miR-155+Recilisib were lower than those in shNC+Recilisib group(P＜0.000 1).There was no significant differences in cell migration and number of invasion cells between the Blank group and shNC group(P＞0.05).After activation of PI3K-AKT signaling pathway,the migration and invasion capacity of HCC cells in the shNC+Recilisib group were significantly enhanced when compared with the Blank group(P＜0.000 1).In contrast,the number of migrated and invaded Huh7 cells after miR-155 silencing was significantly lower than that in the Blank group and shNC group(P＜0.000 1)and this phenomenon became reversed by PI3K agonist.Compared with the sh-miR-155 group,in the sh-miR-155+Recilisib group the migration and invasion ability of HCC cells was enhanced(P=0.000 2).Lentiviral transfection of Huh7 human HCC cells to silence miR-155 and downregulate miR-155 inhibiting PTPN21 regulation of the PI3K-AKT signaling pathway,thus inhibiting the invasion,migration and proliferation ability of HCC cells and promoting the apoptosis of HCC cells.Conclusion miR-155 inhibits the migration,invasion and proliferation of HCC cells through targeting PTPN21 regulation of PI3K-AKT signaling pathway.The miR-155 may be a potential therapeutic target for HCC in the future.(J Intervent Radiol,2024,32:44-51)

Objective To evaluate the efficacy,safety of rigid gas permeable contact lens (RGPCL) wearing for over 5 years in different degrees of keratoconus eyes.Methods A retrospective case study was performed.The clinical data of 217 eyes with different degree of keratoconus from 126 keratoconus patients who fitted with RGPCL in Beijing Tongren Hospital from 2000-2010 over 5 years were analyzed.The eyes were divided into mild keratoconus group (Ks≤45.0 D),moderate keratoconus group (45.0 D＜ Ks ＜ 52.0 D) and severe keratoconus group (Ks ≥52.0 D) according to the severity.Uncorrected visual acuity (UCVA,LogMAR),spectacle corrected visual acuity (SCVA) and RGP corrected visual acuity (RGPVA) was examined before RGPCL wearing and the end of followingup after RGPCL wearing.The refraction,corneal curvature,corneal astigmatism were measured with auto-refractomer/keratometer and keratoconus screening analysis system of computer-assisted corneal topography.Comparisons of the changes of corrected visual acuity and corneal parameters were assessed.Results The RGPVA was 0.09±0.17,0.05±0.07 and 0.07 ±0.07 in the mild,moderate and severe keratoconus group,respectively,showing a significant difference among the three groups (F=0.522,P=0.594);The △Ks was (2.25±5.42),(0.26±3.44) and (-4.52±3.44)D,and △Kf was (2.06±4.98),(1.02±3.41) and (-2.03±5.05)D,and the change value of corneal astigmatism was (0.19±2.87),(-0.78±2.84) and (-2.44±3.77)D in the mild,moderate and severe keratoconus group(all at P＜ 0.05),respectively,with the minimum amount of change in the severe keratoconus group.The variation of differential sector index (△DSI) was-0.33 ± 1.64,0.14±3.01 and-2.11 ±4.28;the variation of center/ surround index (△CSI) was-0.41 ± 1.07,0.03±2.22 and-2.49±4.15;the variation of standard deviation of power (△SDP) was-0.43 ±0.64,-0.02 ±0.89 and-1.67 ± 1.68;the variation of keratoconus prediction index (△KPI)was 0.00±0.07,0.03±0.09 and-0.05±0.11 in the mild,moderate and severe keratoconus group,respectively,and the reduced amount in above parameters was much more in the severe keratoconus group than that in the mild and moderate keratoconus group (all at P＜0.01).Mild conjunctivitis and corneal affection occurred in 12 eyes (5.5％)during the follow-up.Conclusions Long-term wearing RGPCL can improve the visual acuity and slow the tendency of corneal curvature increase in keratoconus eyes,and this procedure is safe and effective for the correction of different degree of keratoconus.

OBJECTIVE: To investigate the relationship of group B (GBS) colonization in late pregnancy with perinatal outcome. METHODS: Pregnant women who underwent antenatal check-up at General Hospital of PLA Eastern Theater Command and the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2018 were enrolled in the study. The vaginal and rectal swab samples were collected for GBS culture at 35-37 weeks of pregnancy. The perinatal outcomes of positive and negative GBS groups were compared. The GBS-positive group samples were tested for antibiotic susceptibility. In GBS positive group the maternal and child perinatal outcomes were compared between pregnant women with antibiotics treatment and those without antibiotics. RESULTS: A total of 13 000 pregnant women were enrolled, and the overall colonization rate of GBS was 3.65%(475/13 000). The colonization rate of GBS in the vagina was 2.33%(303/13 000), and the colonization rate in the rectum was 1.75%(227/13 000). Through the collection and detection of rectal specimens, the positive rate of GBS increased by 56.77%(172/303). The monthly colonization rate of GBS showed significant fluctuations with the highest in March and October (all < 0.05). The sensitivity of 475 GBS-positive specimens to ceftriaxone, vancomycin and linezolid were 100%, and the sensitivity to ampicillin and penicillin were 97.26%and 93.47%, respectively. The resistance rates of the strains to levofloxacin, clindamycin, erythromycin and tetracycline were 30.11%, 48.00%, 52.21%and 88.63%. The incidence of premature rupture of membranes, postpartum hemorrhage, puerperal infection, neonatal pneumonia and sepsis in GBS positive group were significantly higher than those in GBS negative group (all < 0.01). In pregnant women with positive GBS, the incidence of puerperal infection, neonatal infection and admission to the NICU in the antibiotic group were significantly lower than those in the non-antibiotic group ( < 0.05 or < 0.01). CONCLUSIONS The total colonization rate of GBS is low. The detection of GBS can be significantly improved by supplementing rectal examination. Ceftriaxone, ampicillin and penicillin are currently the drugs of choice for the prevention and treatment of GBS-related diseases. GBS infection can increase the incidence of maternal and child complications. The use of antibiotics during labor can improve the outcome of mothers and infants.
Anti-Bacterial Agents ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications, Infectious ; Pregnancy Outcome ; Streptococcal Infections ; Streptococcus agalactiae ; Vagina

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for early hypopharyngeal carcinoma and precancerous lesions.Methods:Clinical data of 41 patients who received ESD for early hypopharyngeal carcinoma and precancerous lesions from August 2013 to August 2019 in the Department of Endoscopy of Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were retrospectively analyzed. Main outcome measurements included operation completion rate, operation time, en bloc resection rate, R0 resection rate, complication rate and recurrence.Results:ESD was successfully completed in all 41 cases, with a success rate of 100.0% and a mean time of 49.1 min (ranged 10-110 min). Fifty-four lesions underwent en bloc resection, with an en bloc resection rate of 98.2% (54/55), of which 41 had negative horizontal and vertical margins, and the R0 resection rate was 74.5% (41/55). During the operation of 55 lesions, there was a small amount of blood oozing on the wound surface, and electrocoagulation with thermal biopsy forceps could successfully stop the bleeding. No perforation occurred, and 2 cases (4.3%) had delayed bleeding after ESD, and hemostasis was successful under emergency endoscopy. Postoperative endoscopy showed that 1 case (2.2%) had esophageal entrance stenosis, and the obstruction was relieved after repeated water balloon dilatation. The follow-up period ranged from 3 to 72 months, and the median time was 18 months. One case was found to have mucosal lesions in the same part of the hypopharynx and received ESD treatment again. Follow-up to October 2020, no residual lesions and recurrence were found.Conclusion:ESD is a safe and effective option for the treatment of early hypopharyngeal carcinoma and precancerous lesions, which is worthy of clinical application.