AIM: To observe clinical effect of Fuzheng Guben Granules on mid-terminal esophagus cancer in combination with radiotherapy. METHODS: 232 patients of mid-terminal esophagus cancer were divided randomly into radiotherapy group and Fuzheng Guben Granules associated with radiotherapy. 1.8-2.0 Gy per day, total 50-70 Gy/5-8 weeks. During the course of treatment with Fuzheng Guben Granules and radiotherapy, Fuzheng Guben Granules was administrated, 15 g once, 50-55 days as a treatment course. RESULTS: The survival rates of the radiotherapy group in 1,3,5 years were 41.4%, 14.7%,7.6%. The survival rates of Fuzheng Guben Granules associated with radiotherapy group were 63.8%,29.3%,19.03% in contrast, the survival rates of Fuzheng Guben Granules associated with radiotherapy group were obviously superior to the radiotherapy group in 1.3.5 years (P

Ischemia and hypoxia cause functional damage to brain tissues during stroke， and when blood supply is restored to brain tissues after ischemia， a large number of free radicals and calcium overload cause cerebral ischemia-reperfusion injury， which further aggravates the condition. Autophagy is a self-protection mechanism that maintains the homeostasis of the intracellular environment， but excessive autophagy causes brain tissue damage. MiRNA is a small endogenous non-coding RNA molecule that regulate various physiological activities at the gene level by binding to complementary sequences in the 3 '- UTR of its target gene mRNA， leading to translation inhibition or mRNA degradation. MiRNA not only directly acts on autophagy related proteins， but also participates in autophagy regulation induced by ischemia/reperfusion through various signaling pathways. However， there is still a lack of systematic induction and analysis of miRNA regulation of autophagy signaling pathways induced by cerebral ischemia/reperfusion. This article reviews the regulation of cellular autophagy during cerebral ischemia/ reperfusion by miRNA-124， miRNA-298， miRNA-202-5p， miRNA-142， miRNA-26b and so on through different signaling pathways， providing a systematic and theoretical approach for the study of autophagy in stroke.

Objective: To investigate the efficacy and safety of cuboid stereotactic aspiration of necrotic brain tissue for treating malignant middle cerebral artery infarction in the elderly patients. Methods: Sixteen elderly patients with malignant middle cerebral artery infarction were selected from June 2017 to January 2019 in our hospital. Patients were followed up for 6 months to evaluate the efficacy of stereotactic aspiration of necrotic brain tissue using the modified Rankin Scale (mRS). Results: The 30-day mortality was 18.75%. Among the 16 elderly patients, 6 (37.5%) had an mRS score of 3 (defined as moderate disability), 6 (37.5%) had an mRS score of 4 (defined as moderate to severe disability), 1 (6.25%) had an mRS score of 5 (defined as severe disability), and 3 (18.75%) had an mRS score of 6. The probability of 6-month favorable outcome, defined as an mRS score of ≤3, was 37.5%, and the 6-month mortality was 18.75%. Conclusions It is a simple, minimally invasive, effective and safe method to treat malignant middle cerebral artery infarction in the elderly patients with cuboid stereotactic aspiration of necrotic brain tissue, which needs to be confirmed by further randomized controlled studies.

Objective To evaluate the feasibility and safety of transumbilical laparoendoscopic sin-gle-site dismembered pyeloplasty ( U-LESS-P ) for the treatment of ureteropelvic junction obstruction (UPJO). Methods Between Mar.2011 and Mar.2012, U-LESS-P was performed in 8 consecutive pa-tients with UPJO by one experienced laparoscopic surgeon .The patients included 5 males and 3 females, with an average age of 28 (16-45) years.Of the 8 patients, six presented with flank pain , and two were a-symptomatic and discovered incidentally by health check .Of the 8 patients, seven had UPJO on the left side and one on the right side .The diagnosis was established by renal ultrasonography , diuretic renal scan , intra-venous urography (IVU) or/and computed tomography urography (CTU).Renal ultrasonography, IVU and ( or) CTU showed hydronephrosis and UPJO in the affected side , while diuretic renal scan demonstrated re-nal function deteriorated .No patients had undergone abdominal surgery previously .A 2-2.5 cm umbilical in-cision was made for single-port access .The procedures were performed using 30°5 mm or 10 mm laparoscope with a combination of conventional and bent laparoscopic instruments . Results All procedures were com-pleted successfully .None was converted to open surgery or traditional laparoscopic surgery .The mean opera-tive time was 153 (117-190) min, and the average estimated blood loss about 20 (10-40) ml.The mean time to resume oral diet was 1.5 days.The drainage remained 2-7 days.The mean hospital stay was 6 (4-8) days.With the follow-up of 3-6 months, symptom-free was investigated in all 8 cases.Ultrasonography , diuretic renal scan and IVU showed decreased or disappeared hydronephrosis .No operative complication , such as anastomotic stoma stenosis , was founded . Conclusions U-LESS-P is a safe and effective proce-dure for the treatment of UPJO , with the advantages of decreased operative morbidity , postoperative rapid re-covery and improved cosmetic result .

Objective To evaluate the efficacy and safety of biphasic insulin aspart 30 (BIAsp30)plus metformin in type 2 diabetes subjects switching from basal insulin plus oral antidiabetic drugs (OAD)Methods During 16 weeks, multiple-center, open-label, and single-arm study including 2 weeks of screening period,4 weeks of run-in period,and 16 weeks of treatment period were carried out. Subjects with type 2 diabetes mellitus inadequately controlled on basal insulin therapy with or without oral antidiabetic drugs were switched to twice-daily BIAsp30 plus metformin with dose titration to achieve fasting plasma glucose target. Results Of the 293 Chinese subjects exposed to trial drugs [age: ( 54.0±9.6 ) years, diabetes duration: ( 8.54±5.49 ) years, body mass index: (24.89±3.28)kg/m2, baseline HbA1c: 8.16% ±0.89%], 122 were previously treated with basal insulin analogues and 169 with human basal insulin. At end of the trial ,the mean reduction of HbA1 c was 1.30% ±0.96% (P＜0. 01 ). The proportion of patients achieved HbA1c＜7.0% and HbA1c ≤6.5% was 60.4% and 38.9% respectively. 8-point plasma glucose measurements showed significant improvements at all the time points examined ( all P＜0. 01 ) ,and the average value of all 8 points measured decreased from ( 10.53±2.58 ) mmol/L atbaseline to (7.79± 1.58 ) mmol/L at the end of treatment ( P＜0. 01 ), reduced by 2.76 mmol/L. Postprandial glucose increments were significantly reduced after breakfast ( -1.73 mmol/L,P＜0.01 )and dinner ( -1.28 mmol/L,P＜0.01 ), while no significant reduction was observed after lunch ( -0.09 mmol/L, P = 0. 734 5 ). No severe adverse effect and no major hypoglycemia were reported. The overall hypoglycaemia rate was 2.68 events/subject year. The average weight gain was (0. 76 ±0. 14 )kg (P＜0. 0l ). Conclusion Twice-daily BIAsp30 plus metformin is effective and safe to type 2 diabetic subjects inadequately controlled on basal insulin treatment.BIAsp30 treatment should be considered for type 2 diabetic subjects who have unsatisfactory response to previous basal insulin treatment.

OBJECTIVE: To investigate the clinical application of retroperitoneoscopic dismembered pyeloplasty for pediatric ureteropelvic junction obstruction (UPJO). METHODS: Of the 85 pediatric patients with UPJO, 56 were boys and 29 were girls. The age of the patients ranged from 2.5 to 11 years (mean = 4.6 years).B-ultrasonography showed hydronephrosis <15 mm (mild) in 15 patients,15-30 mm (moderate) in 59, <30 mm (severe) in the other 6. Intravenous urography (IVU) showed good imaging in 55 patients within 30 min, light imaging in 27 at 30-120 min, and no imaging in 3 after 120 min. The 85 patients underwent retroperitoneoscopic dismembered pyeloplasty. Conventional antegrade or modified antegrade double-J stenting was inserted in the 85 patients intraoperatively. RESULTS: The operation was successful in all, with no conversion to open surgery during the operation. The mean operation time was 146 min (125-240 min).The mean blood loss was 68 mL (55-112 mL).The mean postoperative hospitalization was 7 d (6-8 d ).Urine leakage occurred in 1 patient and with a good drainage, urine leakage disappeared in 1 week. Follow-up ranged 3-24 months (mean = 11 months).IVU showed on UPJ stricture, and good imaging in 75 patients within 30 min, light imaging in 10 at 30-120 min. Hydronephrosis was remitted:hydronephrosis resolution in 51 patients, mild in 6 and moderate in 3. CONCLUSION Retroperitoneoscopic dismembered pyeloplasty is a safe, effective and mini-invasive procedure for pediatric ureteropelvic junction obstruction, with a rapid postoperative recovery. It will be the ideal treatment for UPJO in pediatric patients.
Child ; Child, Preschool ; Female ; Humans ; Kidney Pelvis ; surgery ; Laparoscopy ; methods ; Male ; Retroperitoneal Space ; Ureteral Obstruction ; diagnosis ; etiology ; surgery ; Urologic Surgical Procedures ; methods

MicroRNAs (miRNAs) are small noncoding RNAs that have a pivotal role in the post-transcriptional regulation of gene expression by sequence-specifically targeting multiple mRNAs. Although miR-33a was recently reported to play an important role in lipid homeostasis, atherosclerosis, and hepatic fibrosis, the functions of miR-33a in tumor progression and metastasis are largely unknown. Here, we found that downregulated miR-33a in breast cancer tissues correlates with lymph node metastasis. MiR-33a expression is significantly lower in the highly metastatic breast cancer cell lines than the noncancerous breast epithelial cells and non-metastatic breast cancer cells. Moreover, the overexpression of miR-33a in metastatic breast cancer cells remarkably decreases cell proliferation and invasion in vitro and significantly inhibits tumor growth and lung metastasis in vivo, whereas its knockdown in non-metastatic breast cancer cells significantly enhances cell proliferation and invasion in vitro and promotes tumor growth and lung metastasis in vivo. Combining bioinformatics prediction and biochemical analyses, we showed that ADAM9 and ROS1 are direct downstream targets of miR-33a. These findings identified miR-33a as a negative regulator of breast cancer cell proliferation and metastasis.
ADAM Proteins ; deficiency ; genetics ; Animals ; Breast Neoplasms ; genetics ; pathology ; Cell Line, Tumor ; Cell Movement ; genetics ; Cell Proliferation ; genetics ; Female ; Humans ; Lung Neoplasms ; secondary ; Membrane Proteins ; deficiency ; genetics ; Mice ; MicroRNAs ; genetics ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; deficiency ; genetics ; Proto-Oncogene Proteins ; deficiency ; genetics