OBJECTIVE:To optimize the clarification and purification technology of Perillae folium extract. METHODS:The effects of 3 clarification and purification methods as chitosan flocculation clarification,ZTC 1+1-Ⅱflocculation clarification,water precipitation on retention rate of total flavonoids and removal rate of solid of Perillae folium extract were compared to screen suit-able clarification and purification technology. With the retention rate of total flavonoids and removal rate of solid as comprehensive evaluation index,single factor and orthogonal test were designed to investigate the optimal value of concentration proportion,the amount of the flocculant,flocculation temperature and whisking speed in optimal clarification and purification method. RESULTS:Among 3 methods,the chitosan flocculation clarification was the best with concentration proportion of 1∶4,chitosan of 1.0 g/L, flocculation temperature at 60 ℃,whisking speed of 100 r/min,whisking time of 4 min,standing time of 12 h. Under the condi-tion of optimal processing,the retention rate of total flavonoids was (85.1 ± 0.75)%,and the removal rate of solid was (24.6 ± 1.33)%(n=5). CONCLUSIONS:Chitosan flocculation can be used to effectively remove the impurity of Perillae folium extract, and optimized clarification and purification technology is stable and feasible.

ObjectiveTo analyze the perioperative curative effect of pancreaticoduodenectomy (PD) in a single center over two decades.MethodsClinical data of 523 patients who had complete medical record and underwent PD in Sun Yat-sen Memorial Hospital, Sun Yat-sen University between January 1994 and December 2013 were retrospectively analyzed. The patients were divided into the latter decade group and the former decade group according to the year when surgery was performed. Among the 396 patients in the latter decade group, 246 were males and 150 were females with the age ranging from 19 to 97 years old and the median of 58 years old. Among the 127 patients in the former decade group, 69 were males and 58 were females with the age ranging from 6 to 79 years old and the median of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. The perioperative conditions of two groups were compared and analyzed using rank sum test and the comparison of rate was conducted using Chi-squaretest.ResultsThe median length of surgery in the latter decade group was 340(187-920) min, significantly longer than 310(180-730) min in the former decade group (Z=3.12, P<0.05). The intraoperative blood loss in the latter decade group was 300(50-4 500) ml, significantly less than 600(200-18 000) ml in the former decade group (Z=-7.62,P<0.05). The postoperative length of stay in the latter decade group was 23(5-148) d, signiifcantly shorter than 25(11-309) d in the former decade group (Z=-2.82,P<0.05). The perioperative mortality in the latter decade group was 6% (24/396), significantly lower than 12%(15/127) in the former decade group (χ2=4.61,P<0.05). The incidence of postoperative complications and the reoperation rate of the patients with postoperative complications in the latter decade group were respectively 39% (156/396) and 29%(45/156), while those in the former decade group were respectively 46% (58/127) and 16% (9/58). The reoperation rate in the latter decade group was signiifcantly higher than that in the former decade group (χ2=3.98,P<0.05). The most common reason for reoperation was intra-abdominal hemorrhage.ConclusionsPD has become a safe and effective operation as the intraoperative blood loss, the postoperative length of stay and the perioperative mortality decrease. Timely reoperation may has an important signiifcance in reducing the perioperative mortality when severe postoperative complications happen.

Objective To explore the risk factors of hepatic failure after major hepatectomy. Methods Clinical data of 293 patients receiving major hepatectomy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2008 and February 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to whether there was postoperative hepatic failure, the patients were divided into the hepatic failure group and non-hepatic failure group. There were 23 cases in the hepatic failure group, including 22 males and 1 female with the mean age of (53±12) years. There were 270 cases in non-hepatic failure group, including 224 males and 46 females with the age of (49±12) years. Single factor analysis and Logistic regression analysis were used to analyze the risk factors of postoperative hepatic failure. Results The incidence of hepatic failure after major hepatectomy was 7.8% (23/293). Multi-factor Logistic regression analysis showed that preoperative Plt, Child-Pugh classification of liver function, tumor diameter and vascular tumor thrombus were the independent influence factors of postoperative hepatic failure (OR=0.983, 0.020, 0.726, 0.225;P<0.05). Conclusion Preoperative Plt, Child-Pugh classification of liver function, tumor diameter and vascular tumor thrombus are the independent influence factors of hepatic failure after major hepatectomy.

Objective To investigate the inhibitory effect and mechanism of arsenic trioxide on hepatocellular carcinoma (HCC) cells migration induced by low dose of sorafenib. Methods Human HCC cells MHCC97H in logarithmic phase were treated with 2μmol/L arsenic trioxide (arsenic trioxide group), 3μmol/L sorafenib (sorafenib group), 2μmol/L arsenic trioxide+3μmol/L sorafenib (combination group), 50 μmol/L LY294002(LY group) and 3 μmol/L sorafenib + 50 μmol/L LY294002 (LY+ sorafenib group) respectively. Dimethyl sulfoxide (DMSO) was used in the control group. Wound healing assay and Transwell migration assay were used to detect the ability of horizontal and vertical cell migration. The expression of p-Akt, E-cadherin, Vimentin and Snail proteins was measured by Western blot. The experiment data were compared using one-way ANOVA and Bonferroni test. Results Wound healing assay revealed that the horizontal migration speed in the sorafenib, arsenic trioxide and combination groups was (1.59±0.14), (0.39±0.08) and (0.58±0.12) times of that in the control group (t=7.20,-12.58,-6.62;P<0.05). Transwell migration assay revealed that the number of cells in the sorafenib, arsenic trioxide, combination and control groups was 285±26, 169±18, 194±19 and 228±9 respectively. Compared with the control group, the number of cells was signiifcantly increased in the sorafenib group (t=3.48, P<0.05), whereas signiifcantly decreased in the arsenic trioxide group (t=-3.80, P<0.05). The number of cells in the combination group was signiifcantly decreased than that in the sorafenib group (t=-5.67, P<0.05). Western blot revealed that the expression of p-Akt, Snail and Vimentin proteins was up-regulated, whereas the expression of E-cadherin protein was down-regulated in the sorafenib group compared with those in the control group. Compared with the control group, the expression of p-Akt, Snail and Vimentin proteins was down-regulated whereas the expression of E-cadherin protein was up-regulated in the arsenic trioxide, combination, LY and LY+sorafenib groups. Conclusion Arsenic trioxide can inhibit the epithelial-mesenchymal transition and reverse the promoting effect of low-dose sorafenib upon MHCC97H cell migration through suppressing the activation of PI3K/Akt/Snail signaling pathway.

Since the first case of corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the end of 2019, the virus has spread rapidly around the world and has become a global public health problem. In the process of this virus epidemic, compared with the general population, cancer patients are considered to be highly susceptible people, especially the lung cancer patients. Some studies have shown that angiotensin converting enzyme 2 (ACE2) may be the pathway for SARS-CoV-2 to infect the host. At the same time, ACE2 is often abnormally expressed in non-small cell lung cancer. Therefore, understanding the respective mechanisms of ACE2 in COVID-19 and non-small cell lung cancer has extremely important reference value for the study of vaccines and therapeutic drugs, and also provides meaningful guidance for the protection of patients with lung cancer during the epidemic. This article reviews the possible invasive mechanism of ACE2 in SARS-CoV-2 and its abnormal expression in non-small cell lung cancer.

Objective    To systematically evaluate the efficacy and safety of jejunostomy tube versus nasojejunal tube for enteral nutrition after radical resection of esophageal cancer. Methods    PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP and CBM databases were searched to collect the clinical effects of jejunostomy tube versus nasojejunal nutrition tube after radical resection of esophageal cancer from inception to October 2021. Meta-analysis was performed using RevMan 5.4 software. Results    Twenty-six articles were included, including 17 randomized controlled studies and 9 cohort studies, with a total of 35 808 patients. Meta-analysis results showed that: in the jejunostomy tube group, the postoperative exhaust time (MD=–4.27, 95%CI –5.87 to –2.66, P=0.001), the incidence of pulmonary infection (OR=1.39, 95%CI 1.06 to 1.82, P=0.02), incidence of tube removal (OR=0.11, 95%CI 0.04 to 0.30, P=0.001), incidence of tube blockage (OR=0.47, 95%CI 0.23 to 0.97, P=0.04), incidence of nasopharyngeal discomfort (OR=0.04, 95%CI 0.01 to 0.13, P=0.001), the incidence of nasopharyngeal mucosal damage (OR=0.13, 95%CI 0.04 to 0.42, P=0.008), the incidence of nausea and vomiting (OR=0.20, 95%CI 0.08 to 0.47, P=0.003) were significantly shorter or lower than those of the nasojejunal tube group. The postoperative serum albumin level (MD=5.75, 95%CI 5.34 to 6.16, P=0.001) was significantly better than that of the nasojejunal tube group. However, the intraoperative operation time of the jejunostomy tube group (MD=13.65, 95%CI 2.32 to 24.98, P=0.02) and the indent time of the postoperative nutrition tube (MD=17.81, 95%CI 12.71 to 22.91, P=0.001) were longer than those of the nasojejunal nutrition tube. At the same time, the incidence of postoperative intestinal obstruction (OR=6.08, 95%CI 2.55 to 14.50, P=0.001) was significantly higher than that of the nasojejunal tube group. There were no statistical differences in the length of postoperative hospital stay or the occurrence of anastomotic fistula between the two groups (P>0.05). Conclusion    In the process of enteral nutrition after radical resection of esophageal cancer, jejunostomy tube has better clinical treatment effect and is more comfortable during catheterization, but the incidence of intestinal obstruction is higher than that of traditional nasojejunal tube.