Objective:The influences of detection of the preoperative level of serum CA19-9 were analyzed on the prognosis of gastric cancer patients. Methods:A total of 513 gastric patients with preoperative CA19-9 detection were enrolled and underwent radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital from January 2003 to October 2008. Clinico-pathological variables associated with the CA19-9 level were analyzed, and the prognostic value of CA19-9 was evaluated. Results:Eighty-six (16.8%) patients manifested an increased CA19-9 level, which was associated with ageing, Borrmann typesⅢandⅣ, undifferentiated type, and advanced T stage. The five-year survival rates were 45.7%and 25.6%for patients with normal (<39 U/mL) and significantly high CA 19-9 levels (≥39 U/mL), respectively. Differences in survival rates between the patient groups were statistically significant (P<0.001). Tumor-node-metastasis (TNM)-stratified analysis revealed a difference in overall survival for patients with stageⅢtumors. The significantly increased CA19-9 level was an independent prognostic factor for gastric cancer patients after radical surgery based on multivariate analysis. Conclusion:Detection of preoperative level of serum CA19-9 could provide important information for prognostic evaluation of gastric cancer patients. CA19-9 was a potential independent prognostic factor for gastric cancer patients after surgery.

ObjectiveTo observe the modified Xiaoqinglong decoction and its ingredient-reduced prescription on plasma levels of IL-5 and TNF-ct in rats,and to explore its mechanism of treating AR.To make clear the law of combination in modified Xiaoqinglong decoction.MethodsThe modified Xiaoqinglong decoction was divided into six groups,namely,reinforcing qi group,warming yang group,expelling retained morbid fluid group,reinforcing qi and warming yang group,reinforcing qi and expelling retained morbid fluid group,warming yang to expel retained morbid fluid group.90 rats were randomly divided into nine groups,namely,normal control group,model group,reinforcing qi group,warming yang group,expelling retained morbid fluid group,reinforcing qi and warming yang group,reinforcing qi and expelling retained morbid fluid group,warming yang to expel retained morbid fluid group,and the whole decoction group,with 10 rats in each group.Rat model of allergic rhinitis was made by the use of adjuvant systemic antigen sensitization and local attack,the normal control group and model group were fed with normal saline,the other groups were treated with appropriate drugs,once a day oral administration,continuous for 4 weeks.Detected plasma IL-5 and TNF-α levels of each group in rats.ResultsThe contents of plasma IL-5 (16.0±2.7)mg/L and TNF-α (57.5±8.0)mg/L in the model group was significantly increased,while it was significantly reduced in the reinforcing qi group,warming yang group,expelling retained morbid fluid group,refinorcing qi and warming yang group,reinforcing qi and expelling retained morbid fluid group,warming yang to expel retained morbid fluid group with plasma IL-5[each group was (12.9± 3.1) mg/L、(11.8 ±2.8) mg/L、(12.0±2.3) mg/L、(12.3±2.3) mg/L、(11.1±2.1)mg/L、(11.2±2.5)mg/L、(8.42.3)mg/L respectively]and TNF-α[each group was (27.7±5.7)mg/L、(29.5 ± 3.7) mg/L、(31.2 ± 4.9) mg/L、(28.1 ± 2.8) mg/L、(33.4 ± 5.6) mg/L、(26.3 ± 3.9) mg/L、(21.6 ±4.9) mg/L respectively],the whole decoction group effect was significant compared with the other treated groups (P＜0.05).ConclusionThe modified Xiaoqinglong decoction and its ingredient-reduced prescription can regulate plasma levels of IL-5 and TNF-α.The modified Xiaoqinglong decoction had best results in reinforcing qi,warming yang and expelling retained morbid fluid.

Objective To observe the effect of Yiqi Huexue Recipe on the expression of TGF-β1 and TNF-α on serum and lung of rots with radiation-induced lung injury in different radiation time,and discuss the preventative and curative effect and mechanisms of Yiqi Huoxue Recipe.Methods 66 Wistar rats were randomly allocated into irradiation with Yiqi Huoxue Recipe-treated group(A group)irradiation group(B group),and normal control group(C group).The first two groups were irradiated at right hemithorax with a dose of 30 Gy/6 fractions(in 6 weeks).The levels of TGF-β1,and TNF-α on rat serum and lung were measured by ELISA and immunohistochemistry at the end of the 4th,6th,8th,12th,and 26th week after the first irradiation.Results TGF-β1,and TNF-α level on rats serum and lung in irradiation group showed an increase from the 4th week after the first irradiation,peaking at the 12th week,and descending at the 26th week.In A group,the levels of TGF-β1 and TNF-α were significantly lower from the 4th week than those of B group.Conclusions Yiqi Huoxue Recipe could inhibit the excretion of TGF-β1,and TNF-α and might play an important role in the prevention and curation of radiation-induced lung injury,which might be related to inhibiting the expression of TGF-β1 and TNF-α.

BACKGROUND:Cytotoxicity of graphene oxide to normal cel s is relatively low, but whether graphene oxide loaded with doxorubicin has some effects on malignant cel s is rarely reported. OBJECTIVE:To explore the cytotoxicity of graphene oxide loaded with doxorubicin on multiple myeloma cel s. METHODS:Multiple myeloma cel line RPMI8226 in logarithmic phase was selected, cultured and divided into four groups, including graphene oxide loaded with doxorubicin, doxorubicin and graphene oxide groups as wel as control group with no intervention. After 24 hours of culture, the cel activity was detected by cel counting kit-8 method, and the cel cycle and apoptosis were detected using flow cytometry. RESULTS AND CONCLUSION:Plump-shaped cel s with translucent and clear cytoplasm were found in the control group;cel s with relatively translucent cytoplasm, and even a few shrunken cel s appeared in the graphene oxide group;cel ular morphology was in a heterogeneity, apoptotic bodies appeared in the doxorubicin group;the cel s was significantly reduced in size, presenting more obvious shrinkage and apoptotic bodies in the group of graphene oxide loaded with doxorubicin. The cel survival rate in the graphene oxide loaded with doxorubicin, doxorubicin and graphene oxide groups was significantly lower than that in the control group (P<0.05), and this indicator was significantly lower in the group of graphene oxide loaded with doxorubicin than the graphene oxide group (P<0.05). The apoptotic rate in the group of graphene oxide loaded with doxorubicin and doxorubicin group was significantly higher than those in the graphene oxide and control groups (P<0.05), respectively. Additional y, there were no significant differences in the cel cycle among groups. These results show that graphene oxide loaded with doxorubicin has a stronger cytotoxicity, and can induce apoptosis in human multiple myeloma cel s.

Objective To study the effect of baicalin on the apoptosis and cell cycle of colorectal cancer cells in orthotopic transplantation mice model with mismatch repair gene hMLH1 deficient.Methods Sixty orthotopic transplantation mice models of human colorectal cancer cell line HCT1 16 expressing green fluorescent protein (GFP) were established,and were randomly divided into the control group and the 50,100,200 mg/kg baicalin groups according to the random number table.Mice in the 50,100,200 mg/kg baicalin groups received intragastric infusion of baicalin at the corresponding dosages twice a day,while mice in the control group received intragastric infusion of 5％ NaHCO3.Cell cycles and apoptotic rates of the HCT116-GFP cells were detected by flow cytometry and TUNEL method respectively.Differences between the 2 groups were analyzed using the analysis of variance or chi-square test,and differences within each group were analyzed using the LSD-t test.Results The orthotopic transplantation mice models of human colorecta] cancer were successfully constructed,and there was no significant difference in the body weight of the mice and tumor size among the 4 groups (F =0.343,0.107,P ＞0.05).The proportion of HCT116-GFP cells in the G2/M phase in the 50,100,200 mg/kg baicalin groups were 22％±6％,18％±7％ and 19％±6％,which were significantly higher than 7％ ±5％ of the control group (t =5.421,3.483,3.575,P ＜0.05).There were no significant differences in the proportion of HCT116-GFP cells in the G2/M phase among the 50,100,200 mg/kg baicalin groups (F =1.291,P ＞ 0.05).The apoptotic rates of HCT116-GFP cells in the 50,100,200 mg/kg baicalin groups were significantly higher than the control group (t =7.163,3.703,2.688,P ＜0.05).The apoptotic rate of the 50 mg/kg baicalin group was significantly higher than that of the 200 mg/kg baicalin group (t =2.259,P ＜ 0.05).Conclusions Baicalin significantly inhibits tumor growth in the orthotopic transplantation mice model with mismatch repair gene hMLH1 deficient.After treated with baicalin,the cell cycle is arrested at the G2/M phase,thus the tumor growth is inhibited.

OBJECTIVE:To prepare transferrin modified paclitaxel-loaded liposome(TF-PTX-LP),and to study the tumor in-hibition effect. METHODS:TF-PTX-LP was prepared by thin-film method,and morphology of TF-PTX-LP was observed. Qualita-tive and quantitative investigation were used to value the uptake efficiency of TF-LP and LP by HepG2 cells. The proliferation inhi-bition rate of HepG2 cells was investigated after treated with PTX,PTX-LP and TF-PTX-LP for 24,48 and 72 h. Tumor spheres were prepared by using HepG2 cells. Effects of normal saline,PTX,PTX-LP and TF-PTX-LP on the volume of tumor spheres were investigated after 0,1,2,4,5,6 and 7 d treatment. HepG2 tumor-bearing nude mice model was induced. Inhibitory effects of normal saline,PTX,PTX-LP and TF-PTX-LP(8.5 mg/kg by PTX)on transplantable tumor of tumor-bearing nude mice were in-vestigated. RESULTS:TF-PTX-LP showed uniform spherical shape,with particle size of 100-120 nm. The fluorescence intensity of HepG2 cells treated with TF-LP was stronger than that treated with LP(P<0.01). Compared with PTX and PTX-LP,TF-PTX-LP showed higher proliferation inhibition rate(P<0.01). Compared with normal saline,PTX and PTX-LP,tumor spheres were small-er in volume after treated with TF-PTX-LP,and inhibition rate of tumor was higher in tumor-bearing nude mice;there were statisti-cal significance after treated for 6,7 d(P<0.01). The proliferation inhibition rate and tumor spheres volume changed in time-de-pendent manner. CONCLUSIONS:TF-PTX-LP which owns good tumor inhibition effect is prepared successfully.

The extent of lymph node dissection has been a relevant issue in gastric cancer surgery. Although D2 lymphadenectomy has been increasingly regarded as the standard surgical procedure for advanced gastric cancer, the dispute exists in whether extended lymphadenectomy can bring more survival benefit. The metastatic rate of No.14v lymph nodes is relatively high in advanced distal gas-tric cancer. D2 plus No.14v lymph node dissection may contribute to improved survival for gastric cancer patients with obvious No.6 lymph node metastasis. Although gastric cancer with para-aortic lymph node metastasis is considered as M1 disease beyond surgical cure, several studies revealed that these patients may benefit from D2 plus No.16a2/b1 lymph node dissection. D2 plus No.13 lymph-adenectomy may be an option in a potentially curative gastrectomy for tumors invading the duodenum. The purpose of this article is to explore the value of extended lymph node dissection in gastric cancer and to provide the basis for extended lymph node dissection. The progress of extended lymph node dissection in advanced distal gastric cancer is reviewed in this article.

Leukemia is a critical disease with a high incidence and extremely high fatality rate.Immune escape by leukemia stem cells(LSC)is the main factor for recurrence and progression after remission.Clinical diagnosis and treatment by Traditional Chinese Medicine(TCM)have distinct advantages of syndrome differentiation and treatment.Based on the purpose of diagnosis and treatment,leukemia treatment by TCM emphasizes the harmony of yin and yang to restore human functions,which is conducive to improve autoimmunity and conforms to the mechanism of intervention for tumor cell immune escape.This article discusses the mechanism and research progress of TCM interventions in LSC immune escape based on literature and TCM theory.

Objective To develop clinical practice guidelines for breastfeeding in neonates in hospital conforming to the situation in China by adaptation of existing guidelines.Methods According to ADAPTE methodology and current status of breastfeeding in neonates in hospital,we searched existing guidelines and systematic reviews of breastfeeding,used AGREE Ⅱ to evaluate the guidelines,content analysis method was used to select and integrate the content of the evidence,and feasibility investigation and expert external review were performed for the established guidelines.Results A total of 10 guidelines,3 evidence summaries and 4 systematic reviews were included,and the "Evidence-Based Guideline:Breastfeeding of Neonates in the Hospital" were established,involving 8 aspects:breastfeeding promotion,screening,expression,storage,transport,reception,procedures and quality management,and a total of 83 evidences were recommended,which were practical and recommended by all experts.Conclusion High quality evidence resources provided by the established clinical practice guideline can provide reliable evidence support for clinical practice.

Objective To investigate the efficacy and safety of tigecycline therapy in children with ventilator-associated pneumonia infected by gram-negative bacteria. Methods We conducted a restrospective chart review of children with ventilator-associated pneumonia in a tertiary hospital from May 1,2012 to April 30,2017. Inclusion criteria:positive sputum culture result;receiving tigecycline administration of at least 2 days (4 doses). Clinical data and laboratory results were recorded before and after the therapy. Results Twenty-seven children were enrolled,with the in-hospital mortality of 37. 0％(10/27). Twenty-seven bacteri-a strains were recorded,all of which were gram-negative,with Acinetobacter baumanmii took up the most. Most bacteria were susceptible to tigecycline. Median duration of tigecycline was 10 days ( 3-27 days ) , 40. 7％ patients(11/27) got clinically improvement and 44. 4％(12/27) got pathogen eradication. Sulpera-zone was the most concomitantly used antibiotics. Totally 3 dosage models were observed and model 1(load-ing dose 2 mg/kg,maintain dose 1 mg/kg) and model 2 ( loading dose 1. 5 mg/kg,maintain dose 1 mg/kg) were the primary. Rate of clinical improvement and microbiology eradication in model 1 group was higher than other groups. No serious adverse effect was detected. Conclusion Tigecycline combined with other a-gents could be used as salvage therapy in gram-negative bacteria infected ventilator-associated pneumonia children and it is tolerated.