Objective: To evaluate the potential effect of zinc, copper, and selenium on placental cadmium transport. Methods: Pregnant women were selected from Daye,Hubei Province. Whole blood, cord blood and placenta were collected, and Cd levels were determined by inductively coupled plasma emission mass spectroscopy. Zn, Cu, and Se levels in whole blood were also determined. The potential association between essential elements and placental Cd transport was evaluated. Results: Whole blood Cd (0.8–25.2?g/L) in 47 pregnant women aged 20 to 34 years was significantly higher than that in cord blood(0.020–1.48?g/L). Placental Cd ranged from 0.082 to 3.97 ?g/g dry weight. Multiple linear regression indicated that lower maternal blood Cu was significantly associated with higher cord blood Cd. Placental Cd in pregnant women with lower maternal Zn was significantly higher than that in those with normal Zn level. Placental Cd in pregnant women with lower maternal Se was significantly lower than that in those with normal Se level. Conclusion: Essential elements, such as Cu, Se, and Zn might affect placental Cd transport.

Objective To study the expression of p27kip1 and Ki67 proteins in various types of gastric polyp and the relationship be-tween gastric polyp and gastric carcinoma (CA:). Methods The expression of p27kip1 and Ki67 proteins were detected in normal gastric mu-cosa, hyperplasie polyp, adenomatons polyp, and carcinoma by S-P immunohistochemical staining. Results In the normal gastric mucosa,hyperplasie polyp, adenomatous polyp and gastric carcinoma, the expression rate of the p27kip1 protein was 90. 00% ,70. 00% ,65.00% and 30. 43%, respectively. The positive rate of p27kip1 protein in gastric cancer was significantly lower than that in other tissues. The rate of Ki67 protein expression in those tissues was 10. 00%, 15.00%, 45.00%, and 73.33%, respectively. The positive rate of Ki67 protein in gastric cancer was significantly higher than that in other tissues. And the positive rate of Ki67 in adenomatous polyp was significantly higher than that in the normal gnstric mucosa and hyperplasic polyp. There were significant differences among them(P <0.05). There was no correlation between the expression of p27kip1 and Ki67 proteins in gastric polyp(rs=-0. 093, P >0. 05). Conclusion Detection of p27kip1 and Ki67 proteins in gastric polyp was very helpful in early diagnosis and prognosis of GC.

Objective To evaluate a new prenatal diagnosis model of chromosomal abnormalities and nine microdeletion syndromes by using both traditional karyotyping and a newly-developed rapid prenatal diagnosis technology, BACs-on-Beads (BoBs) technique. Methods From June 2012 to December 2014, 807 pregnant women with high risk after screening or with other indicators, were performed amniocentesis. Traditional karyotyping and BoBs were employed simultaneously for prenatal diagnosis. Results Thirty-two cases with chromosome aneupoidies were successfully detected both by BoBs and karyotyping, including 18 cases of trisomy 21, 6 cases of trisomy 18, 1 case of trisomy 13, and 7 cases with sex chromosome abnormality. All 8 fetuses with chromosome structural abnormalities detected by karyotyping were missed by BoBs;while BoBs contributed more in detection of five microdeletion syndrome cases, including 3 cases of DiGeorge syndromes (two with microduplication and one with microdeletion), one case of Miller-Dieker syndrome, and one case of Wolf-Hirschhorn syndrome. Conclusion Combined use of traditional karyotyping and BoBs, is a rapid and effective prenatal diagnosis model that may enlarge our horizon on chromosomal diseases and should be widely used in future clinical service.

Clinical data of 62 patients with gastrointestinal submucosal tumors (diameter ≥1 cm) who were treated with kissing suture by single-channel endoscope after endoscopic full-thickness resection (EFR) in the First Affiliated Hospital of Zhengzhou University from February 2017 to May 2019 were analyzed retrospectively to evaluate the clinical value of kissing suture technique by single-channel endoscope in defect closure after EFR. All the post-EFR defects were successfully closed (100%). No postoperative anastomotic leakage or other serious complications occurred. The mean maximum diameter of lesions was 3 cm (ranged 1-7 cm), and 13 (21%) of them were greater than or equal to 5 cm.The mean number of clips used was 25.7 (ranged 7-78). The mean procedure time was 168 min (ranged 44-300 min), and the mean suture time was 63 min (ranged 13-211 min). The mean postoperative hospital stay was 7 days (ranged 4-12 days). Endoscopic reexamination 3-6 months after operation showed that all wounds healed well. Kissing suture method by single-channel endoscope is a safe, effective, easy and feasible for closing gastrointestinal defect after EFR.

Objective:To investigate the efficacy and safety of BeEAM (bendamustine+cytarabine+etoposide+melphalan) regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma.Methods:The clinical data of 15 patients with lymphoma who underwent autologous hematopoietic stem cell transplantation after pretreatment with BeEAM regimen from January 2020 to February 2021 in Gansu Provincial Hospital were retrospectively analyzed. The transplant-related adverse reactions and hematopoietic reconstitution were evaluated.Results:During the pretreatment process of 15 patients, 13 patients had gastrointestinal adverse reactions such as nausea, vomiting and diarrhea, 2 patients had hypokalemia, and 1 patient had abnormal liver function, but all of them were grade 1-2, and no grade 3-4 adverse reactions occurred. One patient had poor platelet implantation, and the remaining 14 patients all achieved hematopoietic reconstruction. After transplantation, the median time of peripheral blood neutrophils and platelets good implantation in patients was 10 d (9-14 d) and 11 d (9-17 d), respectively. Until March 2021, all patients were alive during follow-up.Conclusions:The efficacy of BeEAM regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma is good, and the adverse reactions are tolerable.

Objective:To investigate the impact of malnutrition diagnosed with Global Leadership Initiative on Malnutrition (GLIM) criteria on the outcomes of patients with primary gastrointestinal lymphoma (PGIL).Methods:Patients with PGIL admitted into Gansu Provincial People's Hospital from January 2014 to July 2022 were retrospectively enrolled. Nutritional risk screening was conducted using Nutritional Risk Screening 2002 (NRS 2002) scale, and malnutrition was diagnosed as per GLIM criteria. Kaplan-Meier survival analysis and multivariate Cox regression analysis were performed to investigate the effect of malnutrition as per GLIM criteria on the outcomes of PGIL patients.Results:A total of 82 patients were included. The phenotypic parameters, including body mass index (BMI), arm circumference, leg circumference and grip strength, were at significantly lower levels in the 28 malnourished patients, compared with the other non-malnourished patients. The median overall survival of patients with malnutrition as per GLIM criteria was 10 months, while that of patients without malnutrition was 41 months, showing significant differences between groups. The univariate analysis revealed that age, loss of muscle mass, tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the impacting factors for survival in patients with PGIL. The multivariate analysis further demonstrated that tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the independent impacting factors for survival in patients with PGIL.Conclusion:Malnutrition based on GLIM criteria is an independent risk factor for unfavorable outcomes in patients with PGIL and could be utilized as a prognostic indicator.

Objective:To investigate the early efficacy and safety of pomalidomide-based regimen in relapsed/refractory multiple myeloma (MM) in the real world.Methods:The clinical data of 15 patients with relapsed/refractory MM treated with pomalidomide-based regimen who were admitted to Gansu Provincial Hospital from January 2021 to July 2021 were retrospectively analyzed, and the early efficacy and safety were also evaluated.Results:There were 8 males and 7 females, and the median age of onset of 15 patients was 60 years (43-83 years); the median time for the diagnosis of relapse and refractory was 15 months (4-84 months). All 15 patients previously received bortezomib-based treatment regimens, 9 patients previously received lenalidomide treatment, and 7 cases received autologous hematopoietic stem cell transplantation. All patients received pomalidomide-based regimen combined with two-drug or three-drug regimen (pomalidomide combined with bortezomib,daratumumab,bendamustine, dexamethasone, cyclophosphamide or lenalidomide). The median treatment cycle was 2 cycles (2-4 cycles). After 2 cycles of treatment, the therapeutic efficacy was evaluated; the overall response rate was 73% (11/15), including 3 cases of complete remission, 3 cases of very good partial remission, and 5 cases of partial remission. Hematological toxicity occurred in 9 patients, of which 5 cases had grade 3-4 hematological toxicity, 4 cases had grade 1-2 hematological toxicity, and other adverse reactions were mild and tolerable.Conclusion:Pomalidomide-based regimen is effective and safe for relapsed/refractory MM patients.

From June 2017 to September 2019, 5 patients who were diagnosed as having benign severe pyloric stenosis underwent fully covered stent placement using a new stenting method at the First Affiliated Hospital of Zhengzhou University. Five patients were performed successfully without serious complications. Postoperative barium meal radiograph revealed that the stents were in good location and the acontrast agent passed smoothly. The liquid diet was commenced 1-3 days after surgery. No vomiting, abdominal pain and diarrhea occurred. During the follow-up, all the patients had improved weight and nutritional status. Four patients underwent stent removal 3-4 months postoperatively. One patient was found that the stent had migrated to stomach 3 months after discharge. After removing the stent, balloon dilation and mucosal resection was performed for the mild pyloric stenosis. All 5 patients had an additional follow-up of 3 months, and no symptoms and restenosis occured. These preliminary results showed that the new stenting method of fully covered stent placement is feasible, safe and effective in the treatment of benign pyloric stenosis.

Objective:To study the safety and effectiveness of endoscopic full-thickness resection(EFR) in the treatment of large gastric stromal tumors with diameter of 5-7 cm.Methods:Data of 36 patients with large gastric stromal tumors (5-7 cm) who received EFR or surgery (including laparoscopic and open surgery) in the First Affiliated Hospital of Zhengzhou University and confirmed by postoperative histopathology from January 2017 to October 2018 were retrospectively analyzed. Patients were divided into endoscopic group (9 cases) and surgical group (27 cases) according to different resection methods. The perioperative indicators and the total incidence of complications in the two groups were compared.Results:In terms of perioperative indicators, the median operation time of the endoscopic group was significantly longer than that of the surgical group (4.0 hours VS 2.0 hours, P<0.01), and the postoperative fasting time (4.55±0.88 days VS 6.22±2.24 days, t=-2.15, P=0.03) and hospital stay (6.88±1.26 days VS 10.03±2.90 days, t=-3.13, P<0.01) were significantly shorter than those of the surgical group. The median visual analogue scores (VAS) of abdominal pain of the endoscopic group on the first postoperative day (3 VS 6, P<0.01)and the third postoperative day (1 VS 3, P<0.01) were significantly lower than those of the surgical group. The hospitalization cost was significantly less than that of the surgical group (55±14.7 thousand yuan VS 73±24.3 thousand yuan, t=-2.11, P=0.04). In term of the total incidence of complications, the endoscopic group was 11.1% (1/9), which was higher than that of the surgical group [7.4% (2/27)], but there was no statistically significant difference( P=1.00). Conclusion:EFR is safe and effective in the treatment of large gastric stromal tumors (5-7 cm), and has the advantages of less invasiveness, rapid postoperative recovery, and lower hospitalization cost. But how to shorten the operation time is an urgent problem to be solved.