Objective To explore the changes of serum interleukin-6 (IL-6),and interleukin-8 (IL-8) in patients with gastric cancers and the clinical relationships with Helicobacter pylori (Hp) infection.Methods Totally 62 cases of patients who were diagnosed gastric cancer in our hospital from January 2013 to September 2015 were selected as the study group,who did not accept anti-tumor therapy.The patients were divided into the Hp positive group (with 53 cases) and Hp negative group (with 9 cases) according to whether the merger of Hp infection.Another 60 normal healthy volunteers of the same age in our hospital for health examination during the same period were selected as the control group.The serum IL-6 and IL-8 levels were detected,and the changes of the factors in the study group and control group were compared and analyzed,as well as the U values of Hp infection.The clinical relationships between the expression levels of the two in patients with gastric cancer and the U values of Hp infection were confirmed.Results The serum IL-6 and IL-8 levels and the U values of Hp infection of the study group were significantly higher than those of the control group (P ＜ 0.05),which in the Hp positive group were significantly higher than those in the Hp negative group (P ＜ 0.05).The levels of serum IL-6 and IL-8 in patients with gastric cancer showed positive correlations with the U value of Hp infection (r =0.457,0.531,P ＜ 0.05).Conclusions The serum IL-6 and IL-8 levels in patients with gastric cancer are much higher than those in normal healthy people,and there are significant positive relationship with Hp infection.It can improve the curative effect of gastric cancer patients by improving the eradication rate of Hp.

Objective To explore the diagnostic value of four tumor markers analyzed with Logistic regression and receiver operator characteristic (ROC) curve in patients with lung cancer.Methods The serum levels of carcinoembryonic antigen (CEA) 、carbohydrate antigen 125 (CA125),cytokeratin 19 fragment (CYFRA21-1) and neuron specific enolase (NSE) were determined by radioimmunoassay in 112 patients with lung cancer and 74 patients with benign pulmonary disease.Four tumor markers were analyzed by Logistic regression and ROC curve.Results The serum levels of CEA,CA125,CYFRA21-1 and NSE in lung cancer patients were [4.53(2.22-11.53)ng/ml,28.97 (11.39-62.10) U/ml,4.05(2.29-8.18)ng/ml,14.11 (11.35-24.12) ng/ml],respectively,which were significantly higher than those in health adults[2.08 (1.45-2.52) ng/ml,12.90 (9.80-19.44) U/ml,1.53 (1.21-2.17) ng/ml,11.38 (9.07-12.80) ng/ml] (all P ＜ 0.01).According to regression equation Y =1/[1 + EXP (4.902-0.394X1-0.627X2-0.165X3)],the area under the ROC curve (AUC),sensitivity,specificity,and accuracy of new variable Y were 0.915 ± 0.020,79.46％,93.24％,and 84.95％,respectively.Conclusions Application of logistic regression and ROC curve increases diagnostic accuracy in lung cancer.

Objective To summary and analysis the clinical experiences on the three hole method of VATS surgery in treatment of primary spontaneous pneumothorax.Methods The clinical data of 276 cases of primary spontaneous pneumothorax undergoing VATS surgery from July 2005 to July 2011 were analyzed retrospectively.Results The operating times were 25 to 76 minutes,averaging (41.7 ± 2.1) minutes ; all with traces of bleeding; transiting assisted small incision operation in 5 cases;postoperative thoracic closed drainage extubation time of 4-13 days,average (6.7 ± 0.2) days,mild postoperative air leakage in 27 cases,moderate in 9 cases without severe leakage,leakage,postoperative pulmonary atelectasis in 7 cases,pulmonary infection in 2 cases,reexpansion pulmonary edema in 1 cases,postoperative follow-up for 6-17 months,averaging(10.2 ± 1.7) months,recurrence occurred in 7 cases,1 case of operation again.Conclusion Three hole method of VATS technique has short operating time,less trauma,fewer complications,faster recovery,shorter hospitalization time and other advantages,and the recurrence rate is low,which is the ideal mode of operation for the treatment of primary spontaneous pneumothorax.

Objective:To evaluate the application value of small IT knife pre-cut in assistance to duodenal papillary cannulation compared with conventional guidewire cannulation.Methods:A retrospective analysis was performed on the data of 90 patients with choledocholithiasis including 52 patients with small IT knife pre-cut assisted intubation (small IT knife group) and 38 patients with conventional guidewire intubation (conventional group) in endoscopic retrograde cholangiopancreatography (ERCP) from May 2016 to July 2019 in the digestive endoscopy center of Nanjing Drum Tower Hospital. The basic data, curative effect and complications of the two groups were collected and compared.Results:There was statistically significant difference in gender composition between the small IT knife group and the conventional group ( χ2=5.679, P=0.017), but no significant difference in other baseline data between the two groups (all P>0.05). The median intubation time of the small IT knife group was significantly shorter than that of the conventional group (141.5 s VS 270.0 s, Z=1 268.0, P=0.022). There were no significant differences in the success rate of intubation [98.1% (51/52) VS 94.7% (36/38), χ2=0.760, P=0.571], the incidence of intraoperative bleeding [15.4% (8/52) VS 7.9% (3/38), χ2=1.148, P=0.345], postoperative pancreatitis [5.8% (3/52) VS 7.9% (3/38), χ2=0.159, P=0.694], and postoperative cholangitis [1.9% (1/52) VS 5.3% (2/38), χ2=0.760, P=0.571] between the two groups. No perforation occurred in the two groups. After stratifying according to the operator′s proficiency, the median intubation time was significantly different between the small IT knife expert group and the conventional expert group (116.0 s VS 258.0 s, Z=276.0, P=0.038), while there was no significant difference in the intubation time among other groups (all P>0.05). Conclusion:The small IT knife is safe and effective to pre-cut and assist intubation in ERCP, and it may shorten the intubation time.

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer with a very poor prognosis.In order to guide better clinical management of ICC patients,the American Joint Committee on Cancer (AJCC) cancer staging manual (7th edition) have established a unique TNM staging scheme for separating ICC from hepatocellular carcinoma (HCC) for the first time,and reflected a difference between risk factor of ICC and HCC.This TNM staging system for ICC has been most recently updated by the AJCC cancer staging manual (8th edition),in which T staging has been redefined without gross features,and lymph node metastasis (N1) in N staging has been grouped as stage Ⅲ B,but not stage Ⅳ as required by the 7th edition of AJCC cancer staging manual.In addition,region lymphatic and distant metastases have been clearly redefined by the AJCC cancer staging manual (8th edition) that also requires recovering at least 6 lymph nodes for the N staging scheme.The apparent advantages of the AJCC cancer staging manual (8th edition) for ICC pathologic staging may better stratify the prognosis of ICC patients and provide an improved guidance in clinical practice.

OBJECTIVETo introduce a new spinal internal fixation system, Texas Scottish Rite Hospital (TSRH), and to investigate its early clinical outcomes.

METHODSThe preliminary clinical outcomes of 15 patients with thoracolumbar or lumbar scoliosis treated by anterior spinal fusion with TSRH instrumentation were studied retrospectively. Fourteen patients were diagnosed as idiopathic scoliosis and 1 as neuromuscular scoliosis.

RESULTSPreoperatively, the Cobb's angle on the coronal plane was 55.8 degrees (range 35 degrees to approximately 78 degrees), and 14 degrees postoperatively, with an average correction of 74.8%. The average unfused thoracical curve was 35.9 degrees preoperatively (range 26 degrees to approximately 51 degrees) and 21.8 degrees (10 degrees to approximately 42 degrees) postoperatively, with 40% correction. The sagittal curve of lumbar was kept physiologically, preoperative 27.9 degrees and postoperative 25.7 degrees respectively. The trunk shift was 13.4 mm (5 to approximately 28 mm) preoperatively and 3.5 mm (0 to approximately 7 mm) postoperatively. The averaged apic vertebra derivation was 47.8 mm (21 to approximately 69 mm) before operation and 10.8 mm (3 to approximately 20 mm) after operation. The distance of C7 to center sacrum vertical line (CSVL) was 19.5 mm (16 to approximately 42) preoperatively and 11.3 mm (0 to approximately 32 mm) postoperatively. The apical vertebra rotation was 3 degree in 15 patients preoperatively, and were improved to normal in 10 patients, 1 degree in 4 patients, and 2 degree in 1 patients postoperatively. None had neurological injury and infection. Only 1 patient complained a cool feeling in the low extremity of concave side, and the symptom vanished at 3-month followed up.

CONCLUSIONIf used appropriately, TSRH anterior spinal system is a good teatment for low thoracic or thoracic lumbar scoliosis.

Adolescent ; Adult ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Lumbar Vertebrae ; diagnostic imaging ; surgery ; Male ; Radiography ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; surgery ; Spinal Fusion ; instrumentation ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Treatment Outcome

Objective To evaluate the effects of exendin-4 on glial brillary acidic protein (GFAP ) and interleukin-1β(IL-1β) expression in hippocampi of aged rats .Methods Forty-eight healthy male Sprague-Dawley rats ,aged 22-24 weeks ,weighing 500-700 g ,were randomly divided into 4 groups (n=12 each) using a random number table:control group (group C ) ,exendin-4 group (group E ) ,operation group (group O ) and exendin-4 plus operation group (group OE) .The rats were anesthetized with intraperitoneal fentanyl and droperidol .Groups C and E did not receive anesthesia or splenectomy .In O and OE groups ,splenectomy was carried out .In E and OE groups , exendin-4 5 μg/kg was injected intraperitoneally at 30 min before skin incision and 12 h after operation .C and O groups received the equal volume of normal saline instead of exendin-4 .Learning and memory function was assessed using Morris water maze test (escape latency (EL) and total swimming distance (TSD) at 1 day before operation (T0 ) .The fasting blood glucose was measured after anesthesia (T1 ) ,at the end of operation (T2 ) and on postoperative day 1 (T3 ) .The rats were sacrificed after assessment of the cognitive function at T 3 and the hippocampi were removed for determination of the expression of GFAP (by immuno-histochemistry ) and IL-1β(by Western blot ) .Results There was no significant difference in the EL and TSD at T0 between the four groups ( P>0.05) .Compared with group C ,the EL and TSD were significantly prolonged at T3 and fasting blood glucose was increased at T2 ,3 ,and the expression of IL-1βand GFAP was up-regulated at T3 in O and OE groups ( P<0.05) .Compared with group O ,the EL and TSD were significantly prolonged at T3 and fasting blood glucose was decreased at T2 ,3 ,and the expression of IL-1βand GFAP was down-regulated at T3 in group OE ( P<0.05) . Conclusion Exendin-4 can improve the postoperative cognitive function of aged rats by inhibiting inflammatory responses in hippocampi and maintaining stable perioperative blood glucose .

Objective To investigate the effects of microRNA-134 (miR-134) on the proliferation and apoptosis of non-small cell lung cancer (NSCLC) and its potential molecular mechanism.Methods Quantitative real-time fluorescent polymerase chain reaction (qRT-PCR) was used to detect the differences of miR-134 expression between 10 cases of lung cancer tissues and normal lung tissues,and between normal human lung epithelial cell line BEAS-2B and lung adenocarcinoma cell line A549.miR-NC and miR-134 mimic were transfected into A549 cells.The effect of miR-134 on proliferation of A549 cells was detected by methyl thiazolyl tetrazolium (MTT) and colony form experiment.Flow cytometry was used to determine the effect of miR-134 on A549 cells apoptosis.The effect of miR-134 on the expression of P53 protein was detected by Western blotting.Results The relative expressions of miR-134 in NSCLC tumor tissues and adjacent tissues were 0.429 ± 0.126 and 0.971 ±0.183 respectively,and the difference was statistically significant (t =7.742,P ＜0.001).The relative expressions of miR-134 in BEAS-2B cells and A549 cells were 1.013 ± 0.095 and 0.371 ± 0.068 respectively,and the difference was statistically significant (t =17.377,P ＜ 0.001).The absorbance (A) values of A549 cells transfected with miR-mimic were 0.451 ±0.051 and 0.518 ±0.074 on the third and forth day respectively,and those of A549 cells transfected with miR-NC were 0.683 ± 0.041 and 0.815 ± 0.065 respectively.The proliferation ability of miR-mimic group was significantly lower than that of miR-NC group (t =12.965,P ＜ 0.001;t =9.535,P ＜ 0.001).The colony forming rates of A549 cells transfected with miR-NC and miR-134 mimic were 91.2％ ± 8.3％ and 38.6％ ±4.5％ respectively,and the colony forming rate of A549 cells in miR-134 mimic group was significantly decreased (t =17.617,P ＜0.001).The apoptosis rates of miR-134 mimic group and miR-NC group were 93.5％ ± 3.7％ and 85.4％ ± 2.0％ respectively,and the difference was significant difference (t =6.119,P ＜ 0.001).The relative expressions of P53 protein in miR-134 mimic group and miR-NC group were 1.816 ±0.173 and 0.992 ± 0.096 respectively,and the difference was statistically significant (t =19.308,P ＜ 0.001).Conclusion miR-134 can be an effective target for the treatment of NSCLC by increasing the protein expression of P53,inhibiting the viability and proliferation of tumor cells,and promoting the apoptosis of tumor cells.

Objective To investigate the molecule mechanism of microRNA (miR)-138 in inhibiting invasion and migration of breast cancer by regulating epithelial mesenchymal transformation (EMT). Methods Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect expression of miR-138 after transfecting miR negative control simulacrum (miR-NC) and miR-138 simulacrum in human normal mammary epithelial cell (MCF-10A) and breast cancer cells (MCF-7 and MDA-MB-231) from July 2017 to June 2018. MTT method was used to detect the breast cancer cell activity. Cell scratch test and Transwell test were used to detect the breast cancer cell migration distance and invasion rate. RT-PCR was used to detect the expression of the EMT key molecules Vimentin, N-cadherin and E-cadherin after transfecting miR-138 simulacrum. Results The expression level of miR-138 in MCF-10A was significantly higher than that in MCF-7 and MDA-MB-231 (1.006 ± 0.009 vs. 0.324 ± 0.027 and 0.512 ± 0.068), and there was statistical difference (P<0.05);there was no statistical difference in the expression level of miR-138 between MCF-7 and MDA-MB-231 (P>0.05). The breast cancer cell viabilities of MCF-7 and MDA-MB-231 at third and fourth day after transfecting miR-138 simulacrum were significantly lower than those of transfecting miR-NC (MCF-7: 0.514 ± 0.052 vs. 0.593 ± 0.061 and 0.643 ± 0.074 vs. 0.784 ± 0.081;MDA-MB-231:0.552 ± 0.043 vs. 0.614 ± 0.063 and 0.673 ± 0.074 vs. 0.792 ± 0.077), and there were statistical differences (P<0.05). The breast cancer cell migration distances and invasion rates of MCF-7 and MDA-MB-231 after transfecting miR-138 simulacrum were significantly lower than those of transfecting miR-NC (MCF-7: 0.572 ± 0.051 vs. 1.003 ± 0.012 and 0.624 ± 0.043 vs. 1.002 ± 0.007, MDA-MB-231:0.472 ± 0.051 vs. 1.003 ± 0.095 and 0.573 ± 0.044 vs. 1.004 ± 0.091), and there were statistical differences (P<0.05). The expressions of Vimentin and N-cadherin mRNA in MCF-7 and MDA-MB-231 after transfecting miR-138 simulacrum were significantly lower than those of transfecting miR-NC, but the expression of E-cadherin mRNA was significantly increased, and there were statistical differences (P<0.05). Conclusions The expressions of miR-138 in both breast cancer cells decreased. Overexpression of miR-138 in breast cancer cell can inhibit proliferation, migration and invasion via regulating EMT.

Objective To discuss the clinical application of CT-guided localization of small pulmonary nodules (SPNs) by using double-hook-wire before the performance of video-assisted thoracoscopic (VATS) resection.Methods Before the performance of VATS resection,CT-guided localization by using doublehook-wire was carried out in 54 patients with SPNs (67 small pulmonary nodules in total) and CT-guided localization by using single-hook-wire was employed in 63 patients with SPNs(81 small pulmonary nodules in total).The location success rate and complication rate of the double-hook-wire technique and the singlehook-wire technique were calculated.Results The location success rate of CT-guided localization for SPNs by using double-hook-wire performed before VATS resection in 54 patients was 100％.The incidences of pneumothorax and hemorrhage were 29.6％ (16/54) and 48.1％ (26/54) respectively.In 63 patients receiving single-hook-wire technique,the location success rate for SPNs was 98.4％ (62/63).The incidences of pneumothorax and hemorrhage were 28.5％ (18/63) and 25.4％ (16/63) respectively.Conclusion CT-guided localization for SPNs by using double-hook-wire before VATS resection can reduce the risk of failure in positioning the hook-wire,and this technique is an important supplement for other localization techniques.