Objective To observe the effects of statins, angiotensin-converting enzyme inhibitor/adrenergic receptor binder ( ACEI/ARB ) treatment on Heme Oxidase-1 ( HO-1 ) expression in patients with coronary artery disease. Methods HO-1 expression in periphery white blood cells was detected using Western blot before and after 3 months treatment of the above antioxidants in 60 patients who were diagnosed as coronary artery disease by coronary angiography. Results HO-1 expression measured by gray scale peak by western blot was significantly higher after 3 months antioxidant treatment than that before antioxidant treatment( 168. 9 t6. 8vs 112.7 ± 6.3, P = 0.008 ). Conclusion Effects of statins and ACEI/ARB in treating coronary artery disease may be due to its promoting expression of HO-1.

Objective To study the clinical features of aged patients with sudden cardiac death(SCD) for improving the resuscitation rate. Methods Hie usual etiology of SCD,electrocardiogram(ECG),echocardiography, dynamic electrocardiography(DCG), X-ray and electrolytes were analyzed. Results Most sudden death had inducement. Electrolytes disorder,ventricular ectopic beats,high grade atrioventricular block, auxocardia, left ventricular hypertrophy, cardiac insufficiency and myocardial ischemia could cause serious arrhythmias (.all P <0.05). Conclusion It could be related to heart functional class,left ventricular enlargement,myocardial ischemia,hypokalemia in aged patients with SCD.

Objective To investigate the effects of over-expression of homo sapiens eukaryotic translation elongation factor 1 alpha 2 (EEF1A2) on in vitro invasion and lung metastasis of human pancreatic cancer SW1990 cells.Methods Letivirus-mediated delivery of EEF1A2 was used to enhance the expression of EEF1A2 gene in human pancreatic cancer SW1990 cells,the SW1990 cells stably over-expressing EEF1A2 protein (SW1990/EEF1A2 cells) were obtained,and the parent SW1990 cells and SW1990/GFP cells were used as the control,and the expressions of EEF1 A2 mRNA and protein were determined by Real-time PCR and Western blotting.The invasion ability of cells was determined by Transwell assay.The lung metastasis model was established by injection of SW1990 cells into the tail vein.Whole lung tissues were harvested,and visible nodules on tung surface were counted macroscopically 8 weeks later.Results The EEF1 A2 mRNA expression of SW1990/EEF1A2 was 3.252 ± 0.344,which was significantly higher than those in SW1990/GFP cells (1.000 ±0.060) and SW1990 cells (0.944 ±0.041,t =2.255,2.305,P＜0.01) ; the EEF1A2 protein expression was 0.833 ± 0.050,which was significantly higher than those in SW1990/GFP cells (0.247 ± 0.035) and SW1990 cells (0.273± 0.041,t=0.572,0.559,P＜0.01).The ability of invasion of SW1990/EEF1A2 cells was (60 ±4) cells,which was sigmificantly higher than (33 ±4) cells in SW1990/GFP group and (26 ± 3) cells in SW1990 group (t =31.33,34.78,P ＜ 0.01).Furthernore,SW1990/EEF1 A2 cells had a much higher incidence of lung metastasis in nude mice than SW1990/GFP cells and SW1990 cells in vivo (100％ vs.20％,20％,P ＜ 0.05).Conclusions EEF1 A2 over-expression can obviously increase the in vitro invasion and lung metastasis of pancreatic cancer SW1990 cells.

Objective To analyze the clinical characteristics and prognosis of patients with rectal gastrointestinal stromal tumor ( GIST) . Methods We collected the data of 31 rectal GIST patients definitely demonstrated by pathology and immunohistochemistry in the First Affiliated Hospital of Soochow University, the Second Affiliated Hospital of Soochow University, and Suzhou Wuzhong People′s Hospital from January 2008 to December 2016. The clinical characteristics, therapeutic modalities, and prognoses were retrospectively analyzed. Results Among the 31 rectal GIST patients, 16 underwent local resection and 15 underwent radical surgery. There was no significant difference on the three-year survival rate between the two groups [ 93. 8％ ( 15/16 ) VS 73. 3％ ( 11/15 ) , P=0. 135 ] . There was no significant difference on the survival rate between the oral imatinib patients and non-oral imatinib patients in the local resection group [ 75. 0％ ( 3/4) VS 100. 0％ ( 12/12) , P=0. 083] and the radical surgery group[ 77. 8％ ( 7/9) VS 66. 7％(4/6), P=0. 579]. The postoperative recurrence and metastasis rate of the two groups was no significantly different[31. 3％ (5/16) VS 53. 3％ (8/15), P=0. 213]. Conclusion The choice of surgical procedure has no significant effects on the survival rate and postoperative recurrence for rectal GIST patients, and whether oral imatinib or not has no significant effects on the survival of patients.

To evaluate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for portal vein tumor thrombus, data of patients with digestive system malignant tumors combined with portal vein tumor thrombus diagnosed by CT or magnetic resonance imaging who underwent EUS-FNA from April 2015 to July 2020 in the Second Affiliated Hospital of Soochow University were collected. A total of 7 patients were included, with 2 cases of primary hepatocellular carcinoma, 3 cases of primary pancreatic carcinoma and 2 cases of primary gastric cancer. EUS-FNA was successfully performed in 7 patients with portal vein embolus. Pathological examination of portal vein embolus showed 5 cases of malignant tumor. No tumor cell was found in 2 cases. There were no complications such as local hematoma, abdominal hemorrhage or infection in all patients. EUS-FNA is safe and effective for patients diagnosed as having malignant tumors with portal vein embolus.

Endoscopic data of 108 upper gastrointestinal elevated lesions caused by vascular or hemangioma compression by endoscopic ultrasonography (EUS) at the Second Affiliated Hospital of Soochow University, Changshu No.1 People's Hospital, Kushan Hospital of Chinese Medicine and Traditional Chinese Medicine Hospital of Changshu from December 2010 to June 2019 were retrospectively summarized. The results showed that lesions were mainly located in the esophagus [50.9% (55/108)] and stomach [47.2% (51/108)], especially in the middle [40.0% (22/55)] and upper esophagus [36.4% (20/55)], body [66.7% (34/51)] and fundus of stomach [31.4% (16/51)], respectively. The major etiology included splenic artery and aneurysm compression [29.6% (32/108)], aortic compression [23.1% (25/108)], isolated esophageal venous aneurysm compression [13.9% (15/108)] and gastric submucosal vein and venous aneurysm compression [12.0% (13/108)], with diverse endoscopic presentation. The above results suggest that elevated lesions of upper gastrointestinal tract caused by blood vessels and hemangiomas are mostly due to external vascular pressure outside the lumen, but ectopic submucosal arteries and isolated phlebangioma are not uncommon. The lesions are widely distributed with different gastroscopic manifestations. EUS is important for definite diagnosis, and can be combined with color Doppler technique, CT plain scan and angiographic reconstruction if necessary.

Objective:To investigate the features of endoscopic ultrasonography in the diagnosis of malignant mediastinal and abdominal lymphadenopathy and to provide more evidence for endoscopic ultrasound-guided fine-needle aspiraiton (EUS-FNA).Methods:A case-control study was performed on 83 consecutive patients who underwent EUS in the Second Affiliated Hospital of Soochow University from September 2016 to February 2021. Lymph node properties were identified by pathological results of EUS-FNA and (or) surgery and follow-up for at least 6 months. According to the final diagnosis, patients were divided into malignant lymph node group ( n=56) and benign lymph node group ( n=27). Univariate analysis and multivariate logistic analysis were performed to identify independent risk factors for malignant lymphadenopathy in terms of EUS features. Results:Univariate analysis showed that the length of short axis, short-long axis ratio, shape, border, presence or absence of hilum, heterogeneous echo, and the growth pattern of lymph node were risk factors for malignant lymph nodes ( P<0.10). Multivariate logistic regression analysis showed that short axis>10 mm ( P=0.021, OR=9.751, 95% CI: 1.407-57.573), clear border ( P=0.009, OR=20.587, 95% CI: 2.149-197.251), absence of hilum ( P=0.019, OR=28.502, 95% CI: 1.725-470.864), nodal matting ( P=0.004, OR=45.539, 95% CI: 3.429-604.822), partial nodal fusion ( P=0.004, OR=50.012, 95% CI: 3.497-715.266) were independent risk factors for malignant mediastinal and abdominal lymph nodes. Conclusion:EUS is useful to differentiate the lymph node properties in the mediastinal or abdominal cavity. Short axis>10 mm, clear border, absence of hilum, nodal matting and partial nodal fusion are high-risk EUS features of malignant mediastinal or abdominal lymphadenopathy, where priority should be given to EUS-FNA.

Objective:To explore the related factors of thrombocytopenia (TCP) occurrence in patients with cirrhosis.Methods:A cross-sectional study was conducted. Inpatients with an initial diagnosis of cirrhosis at Peking University First Hospital from January 1, 2010 to December 31, 2020 were included. Clinical data such as demographic characteristics, etiology of cirrhosis, complications of cirrhosis, laboratory indicators, Child-Pugh grade, invasive procedures, and mortality during hospitalization were collected. A logistic regression model was used to explore the related factors of TCP occurrence in patients with cirrhosis. Categorical variables were compared by the χ2 test. The inter-group comparison was performed using continuous variables, a t-test, one-way analysis of variance (ANOVA), or a nonparametric test. Results:There were a total of 2 592 cases of cirrhosis. 75 cases with incomplete clinical data were excluded. 2 517 cases were included for analysis. The median age was 58 (50, 67) years. Males accounted for 64%. 1 435 cases (57.0%) developed TCP, and 434 cases (17.2%) had grade 3-4 TCP. Gender, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and concomitant esophagogastric varices (EGV) were the major factors associated with TCP. Females were more prone to combine with TCP ( OR=1.32, 95% CI: 1.12-1.56, P=0.001). Patients combined with EGV ( OR=3.09, 95% CI: 2.63-3.65, P<0.001) were more prone to develop TCP, which was associated with the increased incidence of hypersplenism ( P<0.001). Patients with PBC ( OR=0.64, 95% CI: 0.50-0.82, P<0.001) and PSC ( OR=0.23, 95% CI: 0.06-0.65, P=0.010) were less prone to develop TCP, which was due to the shorter prothrombin time and better coagulation function of PBC patients ( P<0.001), and the lower proportion of hypersplenism in combined PSC patients ( P=0.004). Patients with TCP and grade 3-4 TCP had a higher rate of hemostatic procedures ( P<0.05), but a lower rate of liver biopsy ( P<0.05). Patients with grade 3-4 TCP had a higher nosocomial mortality rate compared to those without ( P=0.004). Conclusion:TCP is common in patients with cirrhosis. However, TCP occurrence is higher in female patients with EGV and lower in patients combined with PBC and PSC. TCP affects invasive procedures and is associated with adverse outcomes.