Objective: To observe the inhibitory effects of biotic royal jelly on the ascitic hepatoma cell H22. Methods: Mice bearing H22 tumor were fed on different types of royal jelly: No.1, 2 and 3. Their anti-tumor effects were observed in vivo. The general royal jelly and normal saline were observed as control. Results: Among these biotic royal jelly, the biotic royal jelly No.1 showed obvious tumor-inhibiting and survival-prolonging effects. In addition, it increased the number of WBC and augmented the amount of IL-2 and IFN-γ; the pathological study also indicated the denaturing and necrosis of most tumor cells with nuclei constraining and cell membrane rupturing, and large amount of lymphocytes and plasmacytes infiltrating around the mass. Conclusion: The No.1 biotic royal jelly has obvious anti-tumor effect, and it may take effects by inhibiting or killing tumor cells and improving the immunity of the host.

Objective: To observe the inhibitory effects of biotic royal jelly on the ascitic hepatoma cell H 22 . Methods: Mice bearing H 22 tumor were fed on different types of royal jelly: No.1, 2 and 3. Their anti tumor effects were observed in vivo . The general royal jelly and normal saline were observed as control. Results: Among these biotic royal jelly, the biotic royal jelly No.1 showed obvious tumor inhibiting and survival prolonging effects. In addition, it increased the number of WBC and augmented the amount of IL 2 and IFN ?; the pathological study also indicated the denaturing and necrosis of most tumor cells with nuclei constraining and cell membrane rupturing, and large amount of lymphocytes and plasmacytes infiltrating around the mass. Conclusion: The No.1 biotic royal jelly has obvious anti tumor effect, and it may take effects by inhibiting or killing tumor cells and improving the immunity of the host. [

Objective: To investigate the biological significance of CerbB-2 expression in nasopharyn-geal carcinoma. Methods: The expression of CerbB-2 was detected in 90 nasopharyngeal carcinoma tissues and 22 nasopharyngitis tissues by SP immunohistochemical method. The relationship between CerbB-2 ex-pression and clinicopathological characteristics of nasopharyngeal carcinoma was investigated. Results: The positive expression rate of CerbB-2 protein was 65.56% in nasopharyngeal carcinoma tissues, and 31.82% in nasopharyngitis tissues, with a significant difference (P<0.05). The ratio of expression was 81.0% in patients of N_2 and N_3 lymth node stage, significantly different from that in patients of N_0 and N_1 lymph node stage (52.1%, P<0.05). The expression of CerbB-2 gene was not correlated with age, gender, clinical stage, T stage and distant metastasis of nasopharyngeal carcinoma (P>0.05). Conclusion: There is a high expression of CerbB-2 in nasopharyngeal carcinoma tissues, which might be an important event in the pathogenesis and progression of nasopharyngeal carcinoma.

BACKGROUNDTo evaluate the efficacy and toxicity of the combination of gemcitabine and carboplatin in the treatment of patients with advanced non-small cell lung cancer (NSCLC).

METHODSForty-one patients with locally advanced (stage IIIB) or metastatic (stage IV) NSCLC were enrolled into the study. The patients received gemcitabine 1 000 mg/m² on days l, 8 and 15, and carboplatin AUC 5 on day 1, with 28 days as a cycle. Each patient received at least two cycles.

RESULTSOf the 41 patients, 2 cases got complete response, 18 got partial response, 15 had stable disease, and 6 had progressive disease, with an overall response rate of 48.8%. The response rate was 55.6% (10/18) in the initial patients, and 43.5% (10/23) in the retreated patients (P > 0.05). The median survival duration was 11.8 months. The 1-year survival rate was 49%. There were 29 patients whose KPS score increased. The main toxicities were leukopenia (incidence of 34.1% for grade III+IV) and thrombocytopenia (incidence of 29.3% for grade III+IV).

CONCLUSIONSThe combination of gemcitabine and carboplatin is a feasible, well-tolerated and active scheme in either first-line or second-line treatment of advanced NSCLC.

BACKGROUNDTo explore the significance of lung biopsy through CT-guided percutaneous paracentesis in the diagnosis of space-occupying lesions of the lung.

METHODSThirty-five patients with space occupying lesions of the lung underwent lung biopsy through CT-guided percutaneous paracentesis and DLTRA-CUT 16G, 18G or 20G soft-tissue-cutting biopsy needles and PICKER IQ computerized tomograph were used.

RESULTSOf the 35 patients, 26 were confirmed by pathological examination to suffer from primary malignant tumor, 1 from metastatic carcinoma, 3 from tuberculosis and 3 from inflammatory pseudotumor. No definite diagnosis was made in two patients. The diagnostic rate was 94.3%. After operation, minor pneumothorax occurred in 5 cases and traces of blood in sputum in 2 cases, however, they didn't need any treatment.

CONCLUSIONSLung biopsy through CT-guided percutaneous paracentesis is a safe and practical technique and may be widely used in hospitals if conditions permit.

Objective:To investigate the surgical situations and perioperative outcome of pancreaticoduodenectomy in Jiangsu Province and the influencing factors for postoperative 90-day mortality.Methods:The retrospective case-control study was conducted. The clinicopathological data of 2 886 patients who underwent pancreaticoduodenectomy in 21 large tertiary hospitals of Jiangsu Quality Control Center for Pancreatic Diseases, including The First Affiliated Hospital of Nanjing Medical University, from March 2021 to December 2022 were collected. There were 1 732 males and 1 154 females, aged 65(57,71)years. Under the framework of the Jiangsu Provincial Pancreatic Disease Quality Control Project, the Jiangsu Quality Control Center for Pancreatic Diseases adopted a multi-center registration research method to establish a provincial electronic database for pancrea-ticoduodenectomy. Observation indicators: (1) clinical characteristics; (2) intraoperative and post-operative conditions; (3) influencing factors for 90-day mortality after pancreaticoduodenectomy. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(IQR), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers or constituent ratio, and comparison between groups was conducted using the chi-square test, continuity correction chi-square test and Fisher exact probability. Maximal Youden index method was used to determine the cutoff value of continuous variables. Univariate analysis was performed using the corresponding statistical methods based on data types. Multivariate analysis was performed using the Logistic multiple regression model. Results:(1) Clinical characteristics. Of the 2 886 patients who underwent pancreaticoduodenectomy, there were 1 175 and 1 711 cases in 2021 and 2022, respectively. Of the 21 hospitals, 8 hospitals had an average annual surgical volume of <36 cases for pancreaticoduodenectomy, 10 hospitals had an average annual surgical volume of 36-119 cases, and 3 hospitals had an average annual surgical volume of ≥120 cases. There were 2 584 cases performed pancreaticoduodenectomy in thirteen hospitals with an average annual surgical volume of ≥36 cases, accounting for 89.536%(2 584/2 886)of the total cases. There were 1 357 cases performed pancrea-ticoduodenectomy in three hospitals with an average annual surgical volume of ≥120 cases, accounting for 47.020%(1 357/2 886) of the total cases. (2) Intraoperative and postoperative conditions. Of the 2 886 patients, the surgical approach was open surgery in 2 397 cases, minimally invasive surgery in 488 cases, and it is unknown in 1 case. The pylorus was preserved in 871 cases, not preserved in 1 952 cases, and it is unknown in 63 cases. Combined organ resection was performed in 305 cases (including vascular resection in 209 cases), not combined organ resection in 2 579 cases, and it is unknown in 2 cases. The operation time of 2 885 patients was 290(115)minutes, the volume of intra-operative blood loss of 2 882 patients was 240(250)mL, and the intraoperative blood transfusion rate of 2 880 patients was 27.153%(782/2 880). Of the 2 886 patients, the invasive treatment rate was 11.342%(327/2 883), the unplanned Intensive Care Unit (ICU) treatment rate was 3.087%(89/2 883), the reoperation rate was 1.590%(45/2 830), the duration of postoperative hospital stay was 17(11)days, the hospitalization mortality rate was 0.798%(23/2 882), and the failure rate of rescue data in 2 083 cases with severe complications was 6.529%(19/291). There were 2 477 patients receiving postoperative 90-day follow-up, with the 90-day mortality of 2.705%(67/2477). The total incidence rate of complication in 2 886 patients was 58.997%(1 423/2 412). The incidence rate of severe complication was 13.970%(291/2 083). The comprehensive complication index was 8.7(22.6) in 2 078 patients. (3) Influencing factors for 90-day mortality after pancreaticoduodenectomy. Results of multivariate analysis showed that age ≥ 70 years, postoperative invasive treatment, and unplanned ICU treatment were independent risk factors for 90-day mortality after pancreaticoduodenectomy ( odds ratio=2.403, 2.609, 16.141, 95% confidence interval as 1.281-4.510, 1.298-5.244, 7.119-36.596, P<0.05). Average annual surgical volume ≥36 cases in the hospital was an independent protective factor for 90-day mortality after pancreaticoduodenectomy ( odds ratio=0.368, 95% confidence interval as 0.168-0.808, P<0.05). Conclusions:Pancreaticoduodenectomy in Jiangsu Province is highly con-centrated in some hospitals, with a high incidence of postoperative complications, and the risk of postoperative 90-day mortality is significant higher than that of hospitallization mortality. Age ≥ 70 years, postoperative invasive treatment, and unplanned ICU treatment are independent risk factors for 90-day motality after pancreaticoduodenectomy, and average annual surgical volume ≥36 cases in the hospital is an independent protective factor.