Objective To evaluate the prevalence of the DJ-1 mutation in early-onset Parkinson's disease (EOPD) patients,and analyzed the association between the certain polymorphic marker g.168_185del in intron1 and Parkinson' s disease (PD).Methods We screened all 7 exons and exon-intron boundary regions of DJ-1 by PCR and direct nucleotide sequencing in 90 Chinese patients with EOPD.We also compared the allele and genotype frequencies of the g.168_185del polymorphism between EOPD patients and controls.Results We found no causative DJ-1 mutations in our cohort of Chinese EOPD patients.But we did identified 4 known polymorphic variants,including the g.168_185del in intron 1,g.5027G ＞ A (rs17523802),g.5065T ＞ C (rs226249),and g.5094C ＞ T (rs11121064) within exon 1.Del/Ins frequencies of the g.168_185 del polymorphism were 11.1％ (10/90)and 13.3％ (14/105) in EOPD group and normal group,respectively.Ins/Ins frequencies were 88.9％ (80/90) and 86.7％ (91/105),thex2 and P value of genotype frequency were 0.222 and 0.669 between EOPD patients and controls,respectively.The insert frequencies were 94.4％ (170/180)and 93.3％ (196/210) in EOPD patients and controls,the deletion frequencies were 5.6％ (10/180) and 6.7％ (14/210),thex2 and P value of allele frequency were 0.207 and 0.679 between EOPD patients and normal,respectively.Furthermore,the P value of genotype and allele frequencies were 0.736 and 0.744 between familial EOPD patients and controls,respectively;P values of genotype and allele frequencies were 0.847 and 0.852 between sporadic EOPD patients and control group,respectively.There was no statistical difference between groups.Conclusion Mutations in DJ-1 are uncommon in Chinese EOPD patients,and no association is observed between the DJ-1 intron 1 g.168_185del polymorphism and risk of PD.

Objective: To systematically evaluate the effectiveness of Kushen Gel in the treatment of cervical high-risk human papillomavirus (HR-HPV) infection. Methods: The Cochrane Library, PubMed, Embase, Medline, Wanfang, VIP, CNKI, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on Kushen Gel in the treatment of the cervical high-risk HPV infection from their inception to December 2019. Two researchers screened the articles, extracted the data, assessed the risk of bias of the eligble studies independently, and performed Meta-analysis with RevMan 5.3. Results: A total of 583 cases were included in five RCTs. The Meta-analysis showed that HR-HPV negative rate [RR = 1.38, 95% CI(1.20, 1.58), P < 0.000 01], reduction of HPV-DNA virus load [MD = -0.70, 95% CI (-0.85, -0.56), P < 0.000 01], and the reduction of postoperative complication rate [RR = 0.45, 95% CI (0.32, 0.65), P < 0.000 1] of applying Kushen Gel alone or applying Kushen Gel combined with microwave/LEEP therapy in the treatment of cervical HR-HPV infection or combined with cervical intraepithelial neoplasia (CIN) were significantly higher than those in the follow-up group; The HR-HPV negative rate of Kushen Gel was higher than interferon group (P < 0.05); There was no significant difference in the one year recurrence rate after LEEP combined with Kushen Gel in the treatment of cervical HR-HPV infection combined with CIN2/CIN3 compared with the follow-up control group (P > 0.05). Conclusion: The therapeutic effect of applying Kushen Gel can increase the rate of clearance of HPV, reduce HPV-DNA load, and reduce postoperative complication. There is no evidence that the use of Kushen Gel after LEEP can reduce the recurrence rate of CIN2/CIN3. Due to the limitation of the quantity and quality of the included studies, the results need to be further verified and updated by more high-quality RCTs.

As a kind of commonly used traditional Chinese medicine, ginseng has a high reputation at home and abroad. The research of ginseng has been expanded to medicine, pharmacy, biology, food science and other fields, with great achievements in recent years. Ginseng contains ginsenosides, volatile oil, carbohydrates, amino acids, polypeptides, inorganic elements and othser chemical constituents. Each component has extensive physiological activity, and is the base of ginseng's effect. After processing, the complicated changes are taken place in the constituents of ginseng, and some new substances produced. This paper aims to review the studies on chemical constituents and their mechanisms during ginseng processing, and the ideas, methods and the direction of the development of traditional Chinese medicine processing in the future.
Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; Panax ; chemistry ; Plants, Medicinal ; chemistry

OBJECTIVETo investigate the feasibility and therapeutic results of multiple organ resection in patients with tumor of the body and tail of pancreas.

METHODSThe clinical and pathological data were analysed in 16 consecutive patients with neoplasm of the body and tail of pancreas from 1999 to 2004 retrospectively.

RESULTSMultiple organ resection was performed in 6 cases of primary pancreatic adenocarcinoma of the body and tail (3 cases of pancreatic cancer, 2 cases of malignant glucagonoma, and 1 case of well-differentiated pancreatic stromal sarcoma) and 10 cases of extrapancreatic malignancy (4 cases of gastric cancer, 2 cases of gastric leiomyosarcoma, 1 case of duodenal cancer, and 3 cases of colon cancer of hepatic flexure). Distal pancreatectomy with splenectomy was performed in all cases. In addition, 10 patients received splenic flexure colectomy, 6 patients received distal gastrectomy, 3 patients received left nephrectomy, left colectomy, total gastrectomy, liver lobe resection, left adrenalectomy, and local diaphragma resection, and 2 patients received transverse colectomy, subtotal colectomy, proximal proctectomy, proximal gastrectomy, and duodenectomy. No perioperative death and severe complications were observed. Patients with primary pancreatic cancer or pancreatic stromal sarcoma died within 1 year. Two patients with malignant glucagonoma died 51 and 39 months later. The 3-year survival rate was 70% in 10 patients with extrapancreatic malignancy, among which 2 patients with enteric cancer have survived 37 and 48 months.

CONCLUSIONRadical combined multiple organ resection may be performed actively in appropriately selected patients.

Adenocarcinoma ; mortality ; pathology ; surgery ; Adult ; Aged ; Colectomy ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; mortality ; pathology ; surgery ; Pancreaticoduodenectomy ; Retrospective Studies ; Splenectomy ; Survival Rate ; Treatment Outcome

Objective To analyze the correlation between foveal avascular zone (FAZ) size and foveal morphology in patients with idiopathic macular epiretinal membrane (IMEM) using OCT angiography (OCTA).Methods A retrospective case series study contained of 54 eyes of 54 patients affected with IMEM (IEM group) and 50 eyes of 50 normal persons as the control group.The BCVA was measured using the international standard visual acuity chart,and the results were converted to the logMAR visual acuity.The FAZ areas were evaluated with OCTA in both the superficial and deep capillary plexus layers by using 3 mm × 3 mm images of the macular.The central macular thickness (CMT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),subfoveal choroidal thickness (SFCT),and the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography.The differences of FAZ areas between the two groups were analyzed.The correlative analysis was performed to investigate the relationship between areas and foveal morphology.Results Compared with control group,the FAZ area in superficial and deep capillary plexus in the IMEM group were significantly smaller (t=-29.095,-28.743;P＜0.001,＜0.001);the mean CMT,IRT,ORT and SFCT were significantly thickening in the IMEM group (Z=-8.784,-8.524,-7.709,-7.535;P＜0.001,＜0.001,＜0.001,＜0.001).In the IMEM group,the FAZ area in superficial capillary plexus correlated inversely with the CMT,IRT,and the integrity of EZ (r=-0.464,-0.536,-0.293;P＜ 0.001,＜ 0.001,0.039),no significant correlation of superficial plexus FAZ areas with ORT and SFCT (r=-0.218,-0.165;P=0.172,0.157).The FAZ area in deep capillary plexus correlated inversely with the CMT,IRT,and the integrity of EZ (r=-0.306,-0.694,-0.468;P=0.037,＜0.001,＜0.001),no significant correlation with ORT and SFCT (r=-0.242,-0.227;P=-0.079,0.094).Conclusions The FAZ areas is significantly decreased in IMEM eyes compared with normal eyes.Both superficial and deep FAZ area are correlated with the CMT,IRT,and the integrity of EZ.

Objective To evaluate the efficacy of single intravitreal injection of C3F8 in treating vitremacular traction (VMT) syndrome.Methods A retrospective case series of 38 eyes of 36 patients affected with VMT syndrome in Department of Ophthalmology,Central Theater Command General Hospital from March 2016 to June 2017 were enrolled in this study.There were 16 males (16 eyes) and 20 females (22 eyes),with the mean age of 64.1 1 ± 9.49 years and the mean courses of 151.55 ± 127.87 days.All the patients received an intravitreal injection of 0.3 ml of 100％ C3F8 within one week.The BCVA examination was performed using the international standard visual acuity chart,which was converted into logMAR visual acuity.The severity of metamorphopsia was detected using M-charts.The extent of vitreomacular adhesion (VMA),central macular thickness (CMT) and the status of ellipsoid zone (EZ) were assessed with spectral-domain OCT at baseline and each month after treatment.The average BCVA was 0.58± 0.22.The mean horizontal metamorphopsia (MH)and vertical metamorphopsia (MV) were 0.34±0.30 and 0.50±0.42,respectively.The mean CMT was 415.15 ± 89.59 μm.The mean horizontal VMA was 1168.68± 400.61 μm (30 eyes with VMA ≤ 1500 μtm and 8 eyes with VMA＞ 1500 μm).The mean vertical VMA was 976.89±295.92 μtm.There were 22 eyes with integrity EZ and 16 eyes without integrity EZ,33 eyes with crystalline lens and 5 eyes with IOL.The mean follow-up time was 10.7 months.The differences in BCVA,MH,MV,CMT,the integrity of EZ before and after treatment were analyzed.The VMT release rates were assessed.The Spearman rank correlation analysis was performed to investigate the relationship of VMT release rates with the data at baseline.Results Vitreomacular traction release occurred in 29 of 38 eyes by the final follow-up visit,the VMT release rate was 76.3％.VMT release occurred and the average time of VMT release occurred was 2.2 weeks.VMT persisted in 7 eyes,in the rest two eyes,one eye developed a retinal detachment and another eye formed macular hole,both eyes responded to vitrectomy.At 6 months after treatment,the average logMAR BCVA was 0.43±0.23,the mean MH and MV were 0.25± 0.23 and 0.24± 0.23,the mean CMT was 310.61 ± 63.10 pm.Among 16 eyes without integrity EZ before treatment,there were 9 eyes with integrity EZ at 6 months after treatment.There were 16 eyes with integrity EZ and 9 Compared with baseline,the mean BCVA at 6 months after treatment was significantly increased (F=3.779,P=0.037),but the MV (F=4.958,P =0.003) and CMT (F=13.419,P＜0.001) were significantly decreased,the integrity of EZ was improved significantly (22=5.050,P=0.025).The VMT release correlated inversely with the extent of horizontal VMA,BCVA,and CMT at baseline (r=-0.514,-0.348,-0.429;P=0.009,0.001,0.038).Conclusion Intravitreal injection of C3F8 can induce a posterior vitreous detachment and release vitreomacular traction,it is an efficient and safe treatment for VMT syndrome.It can improve the visual acuity,metamorphopsia and foveal morphology in patients with VMT syndrome.

Objective:To investigate the application value of TRIANGLE operation in radical resection of pancreatic cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 30 patients with pancreatic cancer who underwent TRIANGLE operation in the First Affiliated Hospital of Nanjing Medical University from March 2020 to July 2020 were collected. There were 18 females and 12 males, aged from 41 to 79 years, with a median age of 65 years. After assessment of the resectability and dissection of the hepatoduodenal ligament, the superior mesenteric artery, celiac axis, common hepatic artery, portal vein and superior mesenteric vein of patients were exposed. According to the location of tumor, patients were performed pancreaticoduodenectomy, distal pancreatectomy or total pancreatectomy combined with dissection of putatively tumor-infiltrated lymphatic and neural tissue from the triangular space. During the TRIANGLE operation, it required to at least finish the skeletonization of right semi-circumference of the superior mesenteric artery and celiac axis in cases of pancreatico-duodenectomy, whereas the left semi-circumference in cases of distal pancreatectomy. In principle, both of the superior mesenteric artery and celiac axis were circumferentially skeletonized for cases of total pancreatectomy. Lymphatic, neural and fibrous tissues between the superior mesenteric artery and the celiac artery were completely dissected in all patients. Observation indicators: (1) surgical conditions and postoperative histopathological examination; (2) postoperative recovery situations; (3) follow-up. Regular follow-up was conducted by telephone interview or outpatient examinations to understand tumor recurrence and metastasis of patients up to January 2021. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages, Fisher exact probability method was used for comparison between groups. Results:(1) Surgical conditions and postoperative histopathological examination: all patients underwent open operation, including 21 cases of pancreaticoduodenec-tomy, 6 cases of distal pancreatectomy, 2 cases of total pancreatectomy, 1 case of mid-segment preserving pancreatectomy. There were 16 cases combined with portal vein-superior mesenteric vein resection and 3 cases combined with left adrenal resection. For the dissection area of superior mesenteric artery-celiac axis, one cycle was conducted in 5 of 30 patients, one and a quarter cycle in 8 patients, one and a half cycle in 8 patients, one and three quarters?two cycles in 9 patients. There were 16 cases with left gastric vein dissection and 14 cases with left gastric vein preservation. The operative time of 30 patients was 287 minutes (range, 165?495 minutes) and the volume of intraoperative blood loss was 275 mL(range, 50?800 mL). Nine patients received intraoperative transfusion of red blood cells or frozen plasma. Postoperative histopathological examination showed that the tumor diameter was 3.4 cm (range, 1.2?7.3 cm), the number of harvested lymph nodes was 20 (range, 9?35), the number of positive lymph nodes was 2 (0?19). Of the 30 patients,20 cases had moderately differentiated tumor and 10 cases had poorly differentiated tumor. R 0 resection was achieved in 9 patients, 1 mm R 1 resection in 17 patients, and R 1 resection in 4 patients. Postoperative pathological T stages: 3 of 30 patents were in stage T1, 18 cases were in stage T2, 5 cases were in stage T3, and 4 cases were in stage T4. Postoperative pathological N stages: 9 of 30 patents were in stage N0, 13 cases were in stage N1, and 8 cases were in stage N2. Postoperative pathological TNM stages: 2 of 30 patents were in stage Ⅰa, 2 cases were in stage Ⅰb, 3 case were in stage Ⅱa, 11 cases were in stage Ⅱb, 12 cases were in stage Ⅲ. (2) Postoperative recovery situations: 20 of 30 patients had postoperative complications, including 6 cases of Clavien-Dindo grade I complications, 9 cases of grade Ⅱ complications, 3 cases of grade Ⅲa complications, 2 cases of grade V complications. The incidence of postoperative diarrhea was 0 in cases with one cycle dissection of tissues around superior mesenteric artery-celiac axis, 1/8 in cases with one and a quarter cycle dissection, 4/8 in cases with one and a half cycle dissection, 9/9 in cases in with one and three quarters-two cycles dissection, showing a significant difference between the four groups ( P<0.05). The incidence of delayed gastric emptying was 5/16 in patients with left gastric vein dissection, versus 1/14 in patients with left gastric vein preservation, showing no significant difference between the two groups ( P>0.05). Nineteen of 30 patients received adjuvant chemotherapy.Twenty-eight of 30 patients were successfully discharged from hospital, with the duration of postoperative hospital stay of 15 days(range, 8?68 days) and the rest of 2 patients died. Three patients had unplanned readmission within postoperative 90 days. (3) Follow-up: all the 28 patients discharged from hospital were followed up for 1.0?9.0 months, with the median follow-up time of 6.5 months. During the follow-up, one patient with locally advanced pancreatic cancer had local recurrence, 9 patients had liver metastasis (including 4 cases with resectable pancreatic cancer, 4 cases with borderline resectable pancreatic cancer, 1 case with borderline resectable pancreatic cancer), and 1 patient with borderline resectable pancreatic cancer had peritoneal metastasis. The rest of 17 patients survived without tumor recurrence. Conclusions:TRIANGLE operation in the radical resection of pancreatic cancer has high radicality and low postoperative local recurrence, but a slightly high morbidity and mortality rate. Its long-term efficacy needs to be further evaluated. It is recommend that this procedure should be performed for selected patients after neoadjuvant chemotherapy in high-volume pancreatic surgery centers.

Objective:To retrospectively analyze the magnetic resonance imaging (MRI) signal differences between prostate cancer,benign prostatic hyperplasia,and normal prostate,and to explore the value of apparent diffusion coefficient (ADC) in prostate cancer grading.Methods:Forty cases of prostate cancer and eleven cases of benign prostatic hyperplasia in Zhongshan Hospital Affiliated to Fudan University between January 2013 to March 2014 were enrolled,which were all confirmed by surgery or biopsy.At the same time,20 normal cases were arranged as the control group,which were healthy volunteers.All the patients and volunteers were obtained informed consent.The T2WI signal intensity,T1 WI signal intensity (including unenhanced,arterial and venous phase) and ADC value of the three groups were compared after MRI and magnetic resonance diffusion weighted imaging (DWI).Then the correlation between ADC value of prostate cancer and Gleason score was analyzed to determine the critical value of ADC in the identification of high-risk and low-risk prostate cancer.Results:In terms of T2WI signal intensity and ADC values,there were significant differences among the three groups (P＜0.05).In terms of T1 WI signal intensity,only the difference of dynamic and venous phase in central gland of normal prostate was significantly different from that in prostate cancer and benign prostatic hyperplasia (P＜0.05),with the former higher than the latter two.The ADC value of prostate cancer was negatively correlated with Gleason score (r=-0.401,P=0.010).The higher the Gleason score,the smaller the ADC value.When the critical value of ADC was 0.70 × 10-3 rm2/s,the sensitivity of identifying low/intermediate-risk group and high-risk group for prostate cancer was 96.4％,and the specificity was 58.3％.Conclusions:T2WI signal intensity and ADC value can be used to identify prostate cancer,benign prostatic hyperplasia,and normal prostate.T2WI signal differences of dynamic and venous phase also have a certain reference value.The ADC value of prostate cancer is related to Gleason score,suggesting that it may be used for grading the clinical risk of prostate cancer.

OBJECTIVESTo establish a gemcitabine-resistant pancreatic cancer cell line SW1990/GZ, and to explore the relationship between drug-resistant cell line SW1990/GZ and pancreatic cancer stem cell.

METHODSGemcitabine-resistant pancreatic cancer cell line SW1990/GZ was obtained by treating parental cell line SW1990 in vitro with increasing dosage of gemcitabine in culture medium intermittently for 24 weeks. Stable cultures were obtained which were 77.2-fold increased in resistance relative to parental cells. Gene expressions of ABCB1/MDR1, ABCC1/MRP and ABCG2/BCRP were determined by real-time PCR. Tumorigenic potential was performed by nude mice xenograft transplant experiments. Side population analysis and CD24CD44 positive cells explore were determined by flow cytometry to examine cancer stem cell proportion.

RESULTSGemcitabine-resistant cell line SW1990/GZ underwent obvious morphological and functional changes. Compared with the parental cell line, SW1990/GZ cell was small and turned into round shape. SW1990/GZ had a higher gene expression level of ABCB1/MDR1, ABCC1/MRP and ABCG2/BCRP than SW1990 (P < 0.01). Nude mice xenograft transplant experiments showed that only 1 × 10(5) SW1990/GZ cells were sufficient for tumor formation, whereas an injection of 1 × 10(5) SW1990 cells did not initiate tumors. Flow cytometry analysis showed that SP proportion in SW1990/GZ was (11.0 ± 1.0)%, whereas in parental SW1990 it was (4.6 ± 0.9)%, CD44CD24 positive cells was (8.73 ± 0.81)% in SW1990/GZ, whereas (1.1 ± 0.4)% in SW1990.

CONCLUSIONSGemcitabine-resistant cell line SW1990/GZ has a higher proportion of pancreatic cancer stem cells compared to its parental cell line SW1990. CD44 is mainly responsible for acquired drug resistance, which can be a potential target to overcome acquired drug resistance in pancreatic cancer.

Animals ; Antimetabolites, Antineoplastic ; pharmacology ; Cell Line, Tumor ; Deoxycytidine ; analogs & derivatives ; pharmacology ; Drug Resistance, Neoplasm ; Female ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplastic Stem Cells ; drug effects ; pathology ; Pancreatic Neoplasms ; drug therapy ; metabolism ; pathology ; Xenograft Model Antitumor Assays

The aim of this study was to investigate the correlation of NK and NKT cells in peripheral blood of patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) with chronic graft-versus-host disease (cGVHD). 64 patients undergoing allo-HSCT in Guangdong Provincial People Hospital were studied retrospectively. Among 64 cases, 21 cases were did not develop with cGVHD, 43 cases (mild 15, moderate 18, severe 10) were recorded with cGVHD. The frequency of NK and NKT cells in peripheral blood of patients were measured by flow cytometry. The counts of NK and NKT cells were measured by automatic five sort hematology cyto-analyser (LH-750). The frequency and counts of NK and NKT cells between patients with non-cGVHD and patients with different status of cGVHD were analysed. The results indicated that as compared with the non-cGVHD patients, the frequency and counts of NK cells in patients with cGVHD obviously reduced (P < 0.05), the frequency and count of NKT cells were did not changed significantly. The frequency and counts of NK cells gradually decreased within the different status of cGVHD, the frequency and counts of NK cells in severe-cGVHD were significantly lower than that in mild-cGVHD. It is concluded that NK cells may play an important role in the incidence and development of cGVHD. The detection of frequency and counts of NK cells should be helpful to early diagnose cGVHD and provide valuable clues for assessing the severity of illnesses. NKT cells may have little effect on the incidence and development of cGVHD.
Adolescent ; Adult ; Female ; Graft vs Host Disease ; blood ; Hematopoietic Stem Cell Transplantation ; Humans ; Killer Cells, Natural ; Male ; Middle Aged ; Natural Killer T-Cells ; Retrospective Studies ; Transplantation, Homologous ; Young Adult