Objective To compare the operation effect of esophageal foreign body removal with transparent cap-assisted endoscopic technique and traditional method. Methods Ninety-six patients with foreign body incarcerated in esophageal were randomly divided into two groups, and they were underwent transparent cap-assisted endoscopic esophageal foreign body removal or traditional endoscopic esophageal foreign body removal respectively. The clinical data of the two groups were collected, and the success rate, the operation time, the endoscopic vision clarity and the complication rate of the two groups were all recorded and analyzed. Results The success rate in transparent cap-assisted endoscopic technique group was 100% compared with 95.83% in traditional method group, and two cases of failure were transferred to transparent cap-assisted endoscopic technique and finally succeed. The mean operation time were (8.58±3.21) min in transparent cap-assisted endoscopic technique group, and (10.64 ± 5.45) min in traditional method group, and there was no significant difference in two groups (P > 0.05). Forty-five cases got A level and three got B in transparent cap-assisted endoscopic technique group in endoscopic vision clarity, in contrast to 35 A, 11 B and two C in traditional method group. The difference between the two groups was statistically significant (P = 0.020). There was no case with serious complications such as bleeding, perforation or death in two groups. Conclusions Transparent cap-assisted endoscopic technique for body removal is safety and efficacy, and this technique can provide better endoscopic operation field of vision and help improve the success rate of esophageal foreign body removal.

Objective To detect the changes of visceral sensitivity in rats presenting intestinal dysbacteriosis and the expressions of tight junction protein (ZO-1)and Toll-like receptor 4 (TLR4)so as to explore the effect of intestinal dysbacteriosis on visceral sensitivity and the possible mechanisms.Methods We randomly divided 30 male SD rats of SPF grade into normal control group (n = 12 )and dysbacteriosis group (n = 18 ).Rats in dysbacteriosis group were administered with lincomycin hydrochloride (300 mg/mL),1 mL each time per rat once a day for 7 consecutive days;those in normal control group were fed with the same amount of saline.On the eighth day,six rats were randomly selected from normal control group and dysbacteriosis group respectively to detect whether the model was successful.After the model was successfully constructed,the remaining 12 dysbacteriosis rats were randomly divided into the negative control group and the probiotics intervention group with 6 in each.Rats in the intervention group were given probiotic bifidobacterium triple viable capsules (Bifico)orally,one capsule with 1/3 mL of saline,1 mL each time per rat once a day for 7 consecutive days;those in the negative control group received the same amount of saline.On the eighth day,fresh feces was cultured for flora to detect visceral sensitivity by abdominal withdrawal reflex (AWR),the mRNA and protein expressions of ZO-1 and TLR4 in the colon,and the expression of serum inflammatory cytokines IL-10 and TNFα.Results The expression of ZO-1 in the colon was significantly lower in the rats of dysbacteriosis group than those in the control group,and the expression of TLR4 was also significantly increased.Correspondingly,the expression of pro-inflammatory factor TNFα in the serum of the rats in dysbacteriosis group was significantly increased,while that of anti-inflammatory factor IL-10 was significantly lower than in the control group (P <0.05).Furthermore,compared with dysbacteriosis group,the expression of ZO-1 was increased significantly and TLR4 was decreased in probiotics group in varying degrees. Similarly,the expression of TNFα was obviously lower while that of IL-10 in the serum was higher (P < 0.05 ). Conclusion Inhibiting the expression of ZO-1 and increasing the expression of TLR4,thus leading to chronic low-grade inflammation, may be one mechanism of visceral hypersensitivity caused by intestinal dysbacteriosis. Probiotics may restore the dysbacteriosis and thus improve visceral hypersensitivity.

Objective To investigate the inhibitory effect of the lentiviral vector (LV)-mediated RNA interference (RNAi) targeting HIF-1α on the expression of HIF-1α and Glut-1 in human pancreatic cancer Patu8988 cells.Methods The RNAi targeting HIF-1α was combined to LV,and transfected into Patu8988 cells.The Patu8988 cells transfected with the empty vector and exposed to 0.5％ O2 for 4 h served as hypoxia negative control,the Patu8988 cells not transfected with vector and exposed to 0.5％ O2 for 4 h as hypoxia blank control,and the Patu8988 cells transfected with LV-RNAi-HIF-1α and exposed to 0.5％O2 for 4 h as experimental group.The expression of HIF-1α was measured by RT-PCR and Western blot respectively.The expression of Glut-1 was measured by RT-PCR.Each group was compared according to oneway analysis of variance and two-sample t test.Results After transfection with LV-RNAi-HIF-1α,HIF-1α mRNA expression decreased by 65.1％ (0.209/0.321) and 80.6％ (0.791/0.982) (t=10.52,15.24,both P＜0.05) under normoxia and hypoxia conditions,meanwhile with the empty vector,HIF-1α mRNA expression decreased by 0.6％ (0.002/0.321) and 7.2％ (0.071/0.982) (t =5.26,7.38,both P＜0.05).Under hypoxia conditions,the protein of HIF-1α in experimental group cells (0.159±0.010) was down-regulated obviously compared to the negative control group (0.745± 0.012) and the blank control group (0.711 ± 0.023)(F=35.52,t =6.72,10.56,all P＜0.05).The expression of Glut-1 mRNA in experimental group cells (0.040±0.003) decreased obviously compared to the negative control group (0.054±0.003) and blank control group (0.062±0.004) (F=35.28,t=5.94,8.55,all P＜0.01).Conclusion Gene silencing of HIF-1α using LV-mediated RNAi can inhibit the expression of HIF-1α and decrease the expression of Glut-1mRNA in Patu8988 cells.

[摘 要] 目的：评价活化自体淋巴细胞过继性免疫治疗（adoptive immunotherapy，AIT）是否有助于改善原发性肝细胞癌的临床疗效。方法：选取2016年8月至2018年12月在中国人民解放军总医院第五医学中心确诊的64例原发性肝细胞癌患者，通过分层随机法分为免疫治疗组（n=29）和对照组（n=35）。免疫治疗组患者取60 ml外周血分离制备单个核细胞并在含OKT-3和IL-2的培养基中活化培养，回输前进行质控检测。免疫治疗组中的Ⅰ~Ⅲ期患者（n=14）于一线治疗后接受自体淋巴细胞输注（3个月内输注6次），Ⅳ期患者（n=15）仅接受自体淋巴细胞输注；对照组患者接受肝细胞癌相关的其他治疗。疗效评估的主要终点是2年无复发生存（relapse-free survival，RFS）率，次要终点为无进展生存期（progression-free survival，PFS）和总生存期（overall survival，OS）。结果：入组患者中位随访时间为2.8年（0.2~4.2年）。免疫治疗组29名患者共接受了167次（计划174次，完成率96%）预定淋巴细胞输注（平均每人次回输9.30×109个细胞，其中CD3+HLA-DR细胞约占63%），治疗期间未观察到3级或4级不良反应发生。与对照组相比，免疫治疗组患者2年RFS率显著升高（62.1% vs 22.9%，OR=0.181，95%CI：0.06~0.54，P=0.002），中位PFS（28 vs 8个月，P=0.004）和中位OS（38 vs 34个月，P=0.915）均显著延长。在Ⅰ~Ⅲ期患者中，免疫治疗组（n=14）2年RFS率较对照组（n=18）显著升高（92.9% vs 33.3%，OR=0.38，95%CI：0.004~0.368，P=0.005），中位PFS明显延长（38 vs 14.5个月，P=0.005），而两组OS间无显著差异；Ⅳ期患者两组间PFS（P=0.077）及OS（P=0.994）均未见显著差异。结论：活化自体淋巴细胞AIT为安全可行的肝细胞癌辅助性治疗方法，可提高Ⅰ~Ⅲ期肝细胞癌一线治疗后RFS率、延长患者RFS时间，而对进展期肝细胞癌患者的PFS和OS无明显影响。