Objective The aim of this study is to assess the value of serum vascular endothelial growth factor-C (VEGF-C) for predicting recurrence and prognosis in patients with esophageal cancer.Methods A total of 65 patients with esophageal cancer,40 healthy controls were recruited in this study.Serum levels of VEGF-C were measured by ELISA methods.Results Serum level of VEGF-C in esophageal cancer group was higher significantly than those in controls [7.2 (1.2 ～ 35.5) μ g/L vs.4.2 (0.2 ～ 12.6)μ g/L,P ＜ 0.01].Receiver operating characteristic (ROC) curve of serum VEGF-C for predicting recurrence was 0.781 (P＜ 0.01); sensitivity and specificity were 73.1％ and 61.5％,respectively.The survival rate in patients with high VEGF-C level was lower than those with low VEGF-C level (P ＜ 0.01).Conclusions VEGF-C may be closely associated with the development and metastasis of esophageal cancer.Serum VEGF-C is a useful marker for predicting recurrence and prognosis in esophageal cancer.

Objective To investigate the effect of metformin used during early pregnancy on pregnancy outcome of pregnant women with polycystic ovary syndrome (PCOS).Methods Two hundred and fifteen pregnant women with PCOS history were selected into our investigation from March 2007 to February 2010,among which,58 patients were taken as metformin group as they had taken metformin during early pregnancy,or with impaired glucose tolerance complicated by marked hyperinsulinemia and history of recurrent miscarriage.All patients in the study group received metformin (1.0～1.5 g/d) during early pregnancy.The rest 157 gravidas with PCOS history did not receive metformin as control group.The outcomes of pregnancy in the two groups were compared with x2 or t test.Results The early spontaneous miscarriage rate of metformin group was significantly lower than that of control group (5.2 ％ vs 28.7 ％,x2 =13.476,P＜0.01).There was no statistical difference in the rate of late abortion (6.90％ vs 6.4 ％ ),hypertension during pregnancy (3.9％ vs 4.9％),preeclampsia (3.9％ vs 3.9％),preterm birth (13.7％ vs 20.6％) and oligohydramnios (5.9％ vs 3.0％) between control group and metformin group (P ＞ 0.05 respectively).And there was no significant difference in neonatal birth weights [(2925±530) g vs (2910± 659) g],the rate of asphyxia (3.7％ vs 6.8％),malformation (0.0％ vs 0.9％),hypoglycaemia ( 5.6％ vs 6.8％),fetal macrosomia ( 1.9％ vs 3.4％),fetal growth restriction (5.6％ vs 6.0％) and rate of neonatal intensive care unit admission (18.0％ vs 27.4％) between the two groups (P＞0.05,respectively).The infants were followed up for 3 years and all are physically and mentally normal.Conclusions Metformin administration during early pregnancy might reduce the early spontaneous miscarriage rate of PCOS patients,and the adverse effects of metformin have not been identified on fetals and infants.

Objective To evaluate the clinical effect of retrievable esophageal covered metal internal stent in treating patients with achalasia.Methods Under DSA guidance,peroral"Z-type"double horn covered metal internal stent implantation was performed in 16 patients with achalasia.Esophagography was carried out about 28 days after the procedure and the stent was retrieved.Results Of 16 cases,the stent fell off into the stomach two weeks after the operation in one.And the stent was successfully replaced after it was taken out.The placed stent was successfully retrieved in all cases 28 days after the treatment.No serious complications occurred.All the patients were followed up for 3 months to 3 years.During the follow-up period restenosis of the esophagus developed in two cases(at one and 1.5 years respectively),and the restenosis degree was relived after balloon dilation.Clinically,no esophageal symptoms,such as dysphagia,occurred in all patients.Conclusion As a simple and safe technique,the retrievable esophageal covered metal internal stent implantation is very effective with fewer complications for the treatment of achalasia.Moreover,the technique carries lower restenosis occurrence.

Objective To evaluate the efficacy of standard large trauma craniectomy to treat the patients with severe bump brain injury. Methods Thirty-two bump brain injured patients with cerebral hernia were treated with inside and outside decompression of standard large trauma craniectomy compared with 24 cases of routine temporoparietal craniectomy between Oct 2001 and Aug 2004.Results In standard large trauma craniectomy group,21 cases got good recovery(65.6%) and 5 were dead(15.6%).In routine temporoparietal craniectomy group,9 cases got good recovery(37.5%) and 10 were dead(41.7%).There was significant difference between the two groups in good recovery and mortality(P

Objective The Nuss procedure is a minimally invasive pectus repair.The aim of this study was to explore the changes in quality of life in patients who underwent a Nuss procedure.Methods 96 patients,who underwent a Nuss procedure in our institution,were interviewed at preoperation,1 year after operation with the bar in place,and before the planned bar removal.The Nuss Questionnaire modified by George Krasopoulos et al,which evaluates psychosocial and physical well-being,was independently used by patients.Results Most of the scoring of the individual questions and the total score of individual patients revealed a significant improvement,both in preoperation vs.1 year after operation and 1 year after operation vs.before the planned bar removal.Conclusion The Nuss procedure has been shown to improve the quality of life in patients with pectus excavatum deformity in the short term.

Objective To explore the relationship between MTHFR gene polymorphism and lung cancer in Han population of Heilongjiang Province.Methods Two hundred and twenty-five lung cancer patients were selected as the experimental group and the healthy subjects in the outpatient physical examination as the control group,A case-control study was used to analyze the association of MTHFR gene 677C/T,1298A/C SNP and lung cancer,and the gene typing was detected by Sanger double deoxidization chain termination method.Results In the control group,the frequencies of wild-type CC,mutant heterozygote CT,and homozygous TT genotypes of the MTHFR gene C677T were 34.2％,55.1％,and 10.7％,respectively.The frequencies of the three genotypes in the experimental group were 26.7％,50.2％,23.1％,respectively.The difference in the distribution of C677T SNP genotype frequencies of the experimental group and the control group was statistically significant (P =0.002),in which the mutation homozygous TT carriers were 2.78 times more likely to develop lung cancer than wild-type CC (OR(95％CI):2.78 (1.54 ～ 5.02),P =0.001);AA,AC and CC genotype frequencies ofthe A1298C locus of the MTHFR gene were 34.2％,55.1％,and 10.7％,respectively,and the control group was 64.0％.32.0％,4.0％,there was no significant difference between the two groups (P =0.247).The frequencies of AA,AC and CC genotypes in the A1298C locus of the MTHFR gene were 34.2％,55.1％,and 10.7％,respectively,and 64.0.％,32.0％,and 4.0％ in the control group,respectively.There was no significant difference between the two groups (P).=0.247).The haploid analysis showed that the distribution frequency of TA haplotype in the experimental group was significantly higher than that in the control group (43.1％ vs.35.3％).There was a statistically significant difference between the two groups (OR(95％CI):1.39 (1.06-1.81),P=0.016);while the frequencies of CC haplotypes in the experimental group and the control group were 10.6％ and 17.1％,respectively.The difference was statistically significant (OR(95％CI):0.58 (0.39-0.85).P=0.005).There was a linkage disequilibrium between the two points of MTHFR gene 677 and 1298 (D'=0.48,P=0.003).The gene-environment interaction analysis of the MTHFR gene C677T polymorphism showed that based on the comparison between TT and CC genotype,age over 60 (OR(95％CI):4.0(1.78-9.32),P =0.001),male (OR (95％CI):5.55 (2.10-14.67),P=0.000),smoking (OR(95％CI):8.13 (2.29-28.85),P=0.000) and small cell lung cancer (OR (95％CI):1.28 (1.10-1.44),P=0.000) can increase the risk of lung cancer;based on the comparison between CT and CC genotype,women (OR(95％CI):2.09 (1.05-4.16),P=0.030),non-smoking population (OR(95％CI):2.43 (1.25-4.74),P=0.008) and small cell lung cancer (OR (95％ CI):0.31 (1.16-1.59),P =0.000) can increase the risk of lung cancer.Conclusion MTHFR gene C677T is a genetic susceptibility gene for lung cancer and is associated with the risk of lung cancer.

Objective:To explore the prognostic value of serum deoxyribonuclease 1 like 3 (Dnase1L3), C-reactive protein/albumin ratio (CAR) combined with monocyte to high-density lipoprotein cholesterol ratio (MHR) in decompensated hepatitis B cirrhosis patients.Methods:A prospective selection was conducted on 236 decompensated hepatitis B cirrhosis patients (liver disease group) admitted to the Third Hospital of Qinhuangdao from January 2020 to December 2021, and 185 healthy volunteers (control group) who underwent outpatient physical examinations. The serum levels of Dnase1L3, CAR, MHR, and liver function were detected, and Pearson analysis was conducted to investigate the correlation between Dnase1L3, CAR, MHR, and liver function. Tracking the survival status of patients after 30 days of hospitalization, the risk factors affecting 30 day mortality in decompensated hepatitis B cirrhosis patients were analyzed using a multivariate logistic regression equation. The receiver operating characteristic (ROC) curve analysis was used to assess the value of Dnase1L3, CAR, and MHR in predicting 30 day in-hospital mortality in decompensated hepatitis B cirrhosis patients.Results:The serum levels of Dnase1L3, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBiL), CAR, and MHR in the liver disease group were higher than those in the control group (all P<0.05). The serum levels of Dnase1L3, CAR, and MHR in the liver disease group were positively correlated with AST, ALT, and TBiL (all P<0.05). Among 236 patients, 32 died within 30 days. Model for end-stage liver disease (MELD) scores>18, high Dnase1L3, high CAR, and high MHR were risk factors for 30 day mortality in decompensated hepatitis B cirrhosis patients (all P<0.05). The combined prediction of Dnase1L3, CAR, MHR, and MELD scores for 30 day mortality in decompensated patients with hepatitis B cirrhosis showed an area under the curve of 0.904, which was higher than the predicted values of 0.719, 0.678, 0.763, and 0.742 for individual indicators. Conclusions:The serum Dnase1L3 levels, CAR, and MHR are elevated in patients with decompensated hepatitis B cirrhosis, and are associated with the degree of liver function damage and mortality within 30 days of hospitalization. They have high value in predicting the prognosis of decompensated hepatitis B cirrhosis.

OBJECTIVETo study the association between phthalate esters (PAEs) metabolites in maternal urine and 11beta-hydroxysteroid dehydrogenase type 2 (11β-HSD2 ) enzyme activity, explore the possible mechanism of PAEs effect on fetal development.

METHODSAll of 33 cases of intrauterine growth retardation (IUGR) newborn were selected by random sampling in 2012. And 33 cases of normal control newborn were enrolled, use high performance liquid chromatography-tandem mass spectrometry method was used to detect 4 kinds of phthalate esters (PAEs) metabolites in maternal urine: mono-n-butyl phthalate ester (MBP), mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) and three kinds of cortisol corticosterone metabolites, tetrahydrocortisol (THF), allo-tetrahydrocortisol (allo-THF), tetrahydrocortisone (THE), and analyze the association between phthalate esters (PAEs) metabolites in maternal urine and 11β-HSD2 enzyme activity.

RESULTSMBP, MEHP, MEHHP, MEOHP metabolites can be detected in 98% (65 cases) , 89% (59 cases), 91% (60 cases), 91% (60 cases) of all 66 maternal urine samples, respectively. The median concentrations of test material in case group were 31.20 ng/ml for MBP, 24.61 ng/ml for MEHHP, 11.72 ng/ml for MEOHP and 48.67 ng/ml for SumDEHP which were significantly higher than those of the control group (were 17.32, 12.03, 5.68 and 28.64 ng/ml); 11β-HSD2 activity in case group ((THF+allo-THF)/THE = (0.79 ± 0.09) ng/ml) was significantly lower than that of the control group((THF+allo-THF)/THE = (0.58 ± 0.04) ng/ml); PAEs metabolites MBP (β' = 1.12), MEHHP(β' = 1.14), MEOHP(β' = 1.10), SumDEHP(β' = 1.08) in baby boy mother's urine was reversely correlated to 11β-HSD2 activity.

CONCLUSIONSPAEs could affect fetal development by inhibit 11β-HSD2 activity.

11-beta-Hydroxysteroid Dehydrogenase Type 2 ; Chromatography, Liquid ; Diethylhexyl Phthalate ; analogs & derivatives ; Fetal Development ; Humans ; Infant, Newborn ; Male ; Mass Spectrometry ; Phthalic Acids ; Tetrahydrocortisol ; analogs & derivatives ; Tetrahydrocortisone

Objective To investigate the efficacy and safety of 308-nm excimer laser compared to high-intensity ultraviolet radiation for the treatment of active localized vitiligo,and to observe changes in skin lesions before and after the treatment by confocal laser scanning microscopy.Methods Sixty patients with 203 skin lesions of active localized vitiligo and were enrolled into this study,and the vitiligo disease activity (VIDA) score of these patients ranged from 2 to 3.We selected more than 3 skin lesions from a same anatomical site of each patient,one of lesions served as a control and the other skin lesions (≥ 2) were randomly treated with 308-nm excimer laser (laser group) or high-intensity ultraviolet radiation (ultraviolet group).The treatment was conducted twice a week for 25 sessions,and a 3-month follow-up was performed.Results A total of 48 patients with 169 skin lesions completed the trial.The marked response rate was significantly higher in the laser group [66.15％ (43/65)] than in the ultraviolet group [44.64％ (25/56),x2 =8.28,P ＜ 0.01].The patients with a VIDA score of 2 showed a significantly higher marked response rate [67.69％(44/65)] compared with those with a VIDA score of 3 [44.64％(25/56),x2 =6.80,P ＜ 0.01].During the 3-month follow-up,no relapse was observed.Confocal laser scanning microscopy showed that the number of inflammatory cells increased at the dermal-epidermal junction of the intra-and extra-marginal lesional skin.After treatment,the number of inflammatory cells markedly decreased and returned to normal level in lesions.Conclusion Both 308-nm excimer laser and high-intensity ultraviolet radiation are effective in the treatment of active localized vitiligo,but the 308-nm excimer laser shows a more rapid onset of action and a better therapeutic effect.

Ginsenoside compound K (GCK), the main metabolite of protopanaxadiol constituents of Panax ginseng, easily produces alkali metal adduct ions during mass spectrometry particularly with lithium. Accordingly, we have developed a rapid and sensitive liquid chromatography-tandem mass spectrometric method for analysis of GCK in human plasma based on formation of a lithium adduct. The analyte and paclitaxel (internal standard) were extracted from 50 µL human plasma using methyl tert-butyl ether. Chromatographic separation was performed on a Phenomenex Gemini C18 column (50 mm×2.0 mm; 5 μm) using stepwise gradient elution with acetonitrile-water and 0.2 mmol/L lithium carbonate at a flow rate of 0.5 mL/min. Detection was performed in the positive ion mode using multiple reaction monitoring of the transitions at m/z 629→449 for the GCK-lithium adduct and m/z 860→292 for the adduct of paclitaxel. The assay was linear in the concentration range 1.00-1000 ng/mL (r (2)>0.9988) with intra- and inter-day precision of ±8.4% and accuracy in the range of -4.8% to 6.5%. Recovery, stability and matrix effects were all satisfactory. The method was successfully applied to a pharmacokinetic study involving administration of a single GCK 50 mg tablet to healthy Chinese volunteers.