Matrix metallopmteinase 9(MMP-9) is one kind of matrix metalloproteinases and plays a role in the process of breast cancer metastasis. It can not only degrade the basement membrane and the extracellular matrix around tumor tissue but also promote angiogenesis, even create conditions for the growth of tumors, local invasion and distant metastasis. Current study shows that the over-expression of MMP-9 can significantly speed up the breast lymph node metastasis and the relevant research will provide guidance for clinical treatment and prognosis of breast cancer.

Excision repair cross complementing group 1 (ERCC1) gene is an enzyme of the speed limit of DNA repair protein in nucleotide excision repair (NER) pathways.Researches suggest that ERCC1 has been associated with cisplatin resistance in non-small cell lung cancer (NSCLC) patients.Thus,ERCC1 gene is a new target in malignant tumor gene therapy research,providing a new approach for the treatment of malignant,especially NSCLC.

Objective To detect the expression levels of serum alpha fetal protein (AFP),carbohydrate antigen 199(CA-199) and carcinoembryonic antigen(CEA) in a rat model of liver cancer and elderly liver cancer patients,and explore its clinical significance.Methods A rat model of liver cancer was successfully established by intraperitoneal injection of a low dose of diethylnitrosamine (DEN).The expression levels of serum AFP,CA-199 and CEA in rats were determined and compared during the development of liver cancer.Blood samples were collected from elderly subjects with normal liver and elderly liver cancer patients(n=80,each).The expressions of serum AFP,CA-199 and CEA were determined and compared between healthy elderly patients and elderly liver cancer patients.Results Serum levels of AFP,CA-199 and CEA were higher in liver cancer rats than in normal rats [(4.21±1.32) μg/Lvs.(1.05±0.33) μg/L,(3.78±1.04) kU/L vs.(1.00±0.28) kU/L,(3.54±0.92) μg/Lvs.(1.10±0.37) μg/L,t=9.493,8.609,7.675,respectively,all P=0.000].Serum AFP,CA-199 and CEA levels were higher in elderly patients with liver cancer than in elderly subjects with normal liver [(66.89±9.33) μg/L vs.(2.56±1.09) μg/L,(116.89±43.33) kU/L vs.(5.56±1.26) kU/L,(5.83 ± 1.56) μg/L vs.(1.17 ± 0.51) μg/L(t=14.379,17.470,10.677,respectively,all P=0.000).The positive rate of joint detection of AFP,CA-199 and CEA was higher in elderly patients with liver cancer than in elderly subjects with normal liver [77.50％ (62/80) vs.1.25％(1/80),x2 =17.260,P=0.000].Conclusions The joint detection of AFP,CA-199 and CEA can help increase the diagnostic rate of liver cancer in elderly patients.

Objectives To investigate the correlation between HIF-1α expression level and clinical pathological characteristics of ovarian carcinoma in the elderly.Methods The expression levels of HIF-1α in normal ovary tissue,benign ovarian tumor tissue,borderline ovarian tumor tissue and ovarian cancer tissue were detected in the elderly by immunohistochemical method.And the correlations between HIF-1α expression level and clinical pathological characteristics of ovarian carcinoma were analyzed in the elderly.Results The HIF-1α expression was almost nothing in normal ovarian and benign ovarian tumor tissues,low in the borderline ovarian tissues,and high in the ovarian cancer tissue(Z=11.324,P =0.002).The IOD value of tissues was higher in borderline ovarian tumor tissue[(2.58 ± 0.65) × 105] and ovarian cancer tissue [(5.95 ± 1.02) × 105] than in normal ovary tissue[(1.90±0.35) × 105]and benign ovarian tumor tissue[1.95±0.41) × 105] (F=15.711,P=0.001).The expression of HIF-1α in the tissues was lower in ovarian cancer with stage Ⅰ-Ⅱ,high or moderate differentiation and non-metastatic lymph node than in ovarian cancer with stage Ⅲ-Ⅳ,low differentiation and metastatic lymph node (x2 =4.714,6.121,6.364;P =0.030,0.013,0.012).Conclusions The expression of HIF-1α is up-regulated in ovarian cancer in the elderly compared with normal ovarian tissues,which may be related to occurrence,development and clinical prognosis of ovarian cancer.

Objective To summarize the etiology and surgical treatment of obstructive infantile cholestasis.Methods Clinical data of 108 cases of obstructive infantile cholestasis was studied retrospectively from April 2009 to April 2014.Results Correct diagnosis was established in all 108 patients by laparoscopic biliary tract exploration and cholangiography.Among those,there were noncorrectable biliary atresia in 81 cases (75.0％),correctable biliary atresia in 5 cases (4.6％),inspissated bile syndrome in 8 cases (7.4％),infantile hepatitis syndrome in 6 cases (5.6％),choledochal cyst in 4 cases (3.7％),biliary hypoplasia in 2 cases (1.9％),1 case (0.9％) suffered from spontaneous bile duct perforation,1 case (0.9％) suffered from oppression of lymph nodes in hepatic portal.Patients of nocorrectable biliary atresia were treated with open Kasai portoenterostomy or laparoscopic Kasai portoenterostomy,correctable biliary atresia and choledochal cyst underwent laparoscopic cyst excision and Roux-Y hepaticojejunostomy,inspissated bile syndrome,infantile hepatitis syndrome and biliary hypoplasia were treated by laparoscopic cholecystostomy and biliary tract irrigation.The patient of spontaneous bile duct perforation was treated with laparoscopic common bile duct exploration and T-tube drainage,the lymph node was excised in patient with oppression of lymph nodes in hepatic portal.All infants were followed-up for 3 months to 48 months,the clearance of jaundice rate varied in patients with Kasai portoenterostomy,patients with non-Kasai portoenterostomy were all in good condition and there were no symptom recurrence.Conclusion Biliary atresia,inspissated bile syndrome,infantile hepatitis syndrome,choledochal cyst and biliary hypoplasia are the most common cause of surgery-related infantile cholestasis.Kasai portoenterostomy,hepaticojejunostomy and cholecystostomy and biliary tract irrigation are the main surgical method for surgery-related infantile cholestasis.

OBJECTIVETo study the chemical constituents in the active portion from the flowers of Polygonum oriental.

METHODChromatographic techniques were employed for isolation and purification of the constituents and their structures were determined by spectral analysis and chemical evidence.

RESULTNine compounds were obtained and identified as alphitonin (1), methyl 3, 4-dihydroxybenzoate (2), apocynin (3), kaempferol-3-O-beta-D-glucoside (4), 1,3,5-trihydroxybenzene (5), 3,3'-dimethoxyellagic-acid-4-O-beta-D-glucoside (6), kaempferol-3-O-alpha-L-rhamnoside (7), quercetin-3-O-alpha-L-rhamnoside (8), kaempferol (9).

CONCLUSIONCompounds 2, 4, 5 were isolated from P. oriental for the first time and compounds 1, 3 were firstly obtained from the genus Polygonum.

Objective:To investigate the efficacy and safety of targeted therapy with Crizotinib for children with ALK gene mutation positive inflammatory myofibroblastic tumor (IMT). Methods:A retrospective analysis was performed on 4 children with ALK gene mutation positive IMT admitted to Shanghai Children′s Hospital from January 2019 to June 2021.Among them, 3 cases were given the targeted drug Crizotinib[280 mg/(m 2· time), q12h] orally, and 1 case was observed after complete tumor resection to analyze the efficacy and adverse drug reactions. Results:All 4 cases were male, aged from 2 years and 3 months to 11 years and 3 months.The tumors originated from the abdominal cavity in 2 cases, the right orbit in 1 case, and the right lung in 1 case.Pathological immunohistochemistry and fluorescence in situ hybridization were both positive for ALK gene mutation, and complete remission was achieved after comprehensive treatment.Among them, 3 patients were treated with oral Crizotinib, and 2 patients were tried to stop taking the drug for 1 year, relapsed 1 month later, and still achieved complete remission after the second treatment.The 4 cases were followed up for 8-30 months, and all survived.All the cases showed no abnormalities in blood image, liver and kidney function, myocardial enzyme profile, cardiac function, hearing and vision, and 2 cases showed prolonged Q-T interval in the course of Crizotinib treatment, which could be recovered by temporary withdrawal of drug, and no abnormality in electrocardiogram was found in continued drug use. Conclusions:Crizotinib was used to treat ALK mutation positive IMT, shrink tumor and consolidate postoperative treatment, which is a good choice for IMT in children with difficult surgical resection and refractory recurrence.

On the basis of the qualitative preparation quality markers of Zhibao Sanbian Wan (ZBSBW), we screened out the quantitative markers and evaluated the content consistency of ZBSBW. A method capable of simultaneously determining 34 compounds in ZBSBW was established based on HPLC-MS/MS, and 16 batches of ZBSBW were simultaneously analyzed by this method. Furthermore, we explored a general strategy for analyzing the component migration in preparation, plasma, brain tissue and cerebrospinal fluid. The methodological investigation was confirmed by linear range, recovery (85.10%-105.07%), precision (RSD: 1.37%-4.58%), stability, and repeatability (3.00%-12.45%), the established method was suitable for the detection and quantification of the compounds in ZBSBW. The contents of compounds in ZBSBW were all lower than 1 mg·g^-1, and the contents and daily dose of nystose were the highest, followed by echinacoside, paeoniflorin, osthole and paeonol. The results of systematic clustering showed that the contents were consistent for ordinary preparations of ZBSBW. The principal component analysis showed that the components of berberine, ginsenoside Re, ginsenoside Rg1, pinoresinol diglucoside and tenuifolin had large variation, which contributed significantly to the grouping. The contents of echinacoside, verbascoside, polygalaxanthone Ⅲ, β-ecdysterone, osthole, alisol B 23-acetate, liquiritin and glycyrrhizic acid were stable from batch to batch. The animal experiment results showed that osthole, paeonol and liquiritin in ZBSBW could be absorbed into the blood and enter the brain tissue by passing through the blood-brain barrier. All animal studies were reviewed and approved by the Institutional Animal Care and Use Committee at Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences (No. 2020B071). The above compounds contributed the quantitative preparation quality markers of ZBSBW. In conclusion, the HPLC-MS/MS method established in this study was sensitive, accurate and rapid, and could be used for simultaneous quantification of 34 compounds and content consistency evaluation of multiple batches of preparations in ZBSBW. The result provided a methodological basis for the screening of quantitative preparation quality markers and material basis research of ZBSBW.