Objective To explore the effect of traditional Chinese massage on upper limbs spasticity in stroke patients who accepted Botulinum toxin type A (BTX-A) injection. Methods 74 stroke patients with upper limbs spasticity were divided into treatment group (n=36)and control group (n=38). The control group received BTX-A injection, and the treatment group received massage after injection. Both groups received rehabilitation training after injection and were assessed with modified Ashworth scale, Fugl-Meyer assessment and modified Barthel index before and 2 weeks, 4 weeks, 8 weeks and 12 weeks after treatment. Results All the scores of assessments improved in both groups after treatment (P<0.001), and there was no significant difference between them (P>0.05). Conclusion Addition of traditional Chinese massage doesn't work more on spasticity of upper limbs after stroke when accepted BTX-A injection.

Objective To systemic evaluate postoperative pulmonary function between segmentectomy and lobectomy in patients with early stage non-small cell lung cancer.Methods Computer searched was performed up to September 2016 at the Cochrane Library,PubMed,EMBASE,CBM,CNKI,VIP and Wanfang database,collected postoperative pulmonary function between segmentectomy and lobectomy in Patients with early stage Non-Small Cell Lung Cancer.Study selection,data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.Results Eight studies included 308 segmentectomy and 386 lobectomy were identified for inclusion.FVC％ (MD =9.91,95％ CI:3.53-16.30,P =0.002),postoperation / preoperation FVC％ (MD =6.74,95％ CI:5.52-7.79,P ＜0.05),FEV1％ (MD =13.25,95％ CI:10.25-16.26,P ＜ 0.05),postoperation / preoperation FEV1％ (MD =7.18,95 ％ CI:5.88-8.48,P ＜ 0.05) showed significant difference.Conclusion Pulmonary function index was superior to lobectomy after segmentectomy in patients with early stage lung cancer,and segmentectomy resection was more beneficial to preserve lung function.

AIM:To investigate the expression of CUE domain-containing 2 (CUEDC2) in hepatocellular car-cinoma ( HCC) and to analyze its clinical prognostic significance .METHODS:Total 186 formalin-fixed paraffin-embed-ded tissues obtained from surgical HCC with detailed clinicopathological and follow -up data were used .The expression of CUEDC2 was detected by immunohistochemistry .The relationships between the expression of CUEDC 2 and clinicopatholog-ical characteristics and prognosis were analyzed .RESULTS: The positive rate of CUEDC 2 in HCC was 85.5% ( 159/186), among which, the low expression was 52.2%(97/186) and the high expression was 47.8%(89/186).CUEDC2 expression was correlated with serum alpha-fetal protein (AFP) level, tumor size, tumor number, tumor differentiation and TNM stage (P<0.05).Kaplan-Meier survival curves showed that the patients with high expression of CUEDC 2 were asso-ciated with significantly shorter overall survival and recurrence-free survival than those with low CUEDC 2 expression ( P<0.05).Multivariate Cox regression analysis revealed 3 independent prognostic factors including CUEDC 2 expression, ser-um AFP and tumor number .CONCLUSION:CUEDC2 was expressed in most HCC tissues , which was relevant to tumor growth, tumor differentiation and prognosis .CUEDC2 could be a novel valuable molecular marker to predict the HCC prog-nosis.

Objective To identify clinicopathologic features of early onset RCC in Asian population.Methods Surveillance,Epidemiology,End Results Registry (SEER) database were queried for cases diagnosed as RCC in Asia or pacific islander between 2010 and 2015.Patients diagnosed with RCC in Renji hospital during 2014-2018 were reviewed.All Patients was divided into two group,including early onset group (≤46 years) and control group (＞46 years).There were 3 023 patients with average age of 61 years old,ranging from 10-93 years old in SEER cohort and 2 702 patients with average age of 57 years old,ranging from 15-89 years old in Renji cohort.Early onset group took up 13.4％ (406/3 023) in SEER cohort and 20.2％ (546/2 702) in Renji cohort.Clinicopathologic characteristics were compared between groups in both cohorts.Results The histologic spectrum of early onset group was significantly different from control group comprising fewer clear cell renal cell carcinoma(76.8％ vs.84.8％ in SEER cohort;84.3％ vs.88.5％ in Renji cohort),more chromophobe renal cell carcinoma(12.1％ vs.6.2％ in SEER cohort;11.2％ vs.4.8％ in Renji cohort) (P ＜ 0.01 in both cohorts).21 cases of Xp 11 translocation RCCs were identified in Renji cohort taking up 3.8％ (21/546) of early onset group which was higher than that in control group (0.3 ％,7/2 156),Von Hippel-Lindau syndromes took up 2.0％ (11/546) of early onset group larger than control group (0.3％,7/2 156).In addition,early onset RCC was more likely to be classified into lower pathological T stage(85.5％ vs.78.1％ P =0.037 in SEER cohort;96.1％ vs.91.2％ P ＜ 0.01 in Renji cohort)containing more low-grade tumors (58.1％ vs.53.4％,P =0.043 in SEER cohort;85.2％ vs.79.4％,P ＜0.01 in Renji cohort).The overall follow-up rate of SEER cohort was 96.0％ (2 901/3 023),follow-up time ranges from 1 to 71 months with a median of 26 months.The 1-year,3-year and 5-year overall survival rate were 94.0％ 、92.1％ 、92.1％ in early onset group and 89.7％、81.1％ 、74.2％ in control group,the differences were significant in statistics (P ＜ 0.01).Conclusions Asians who developed early onset RCC present with more ChRCC and fewer ccRCC compared to the older patients.Xp 11 translocation RCCs and VHL disease frequently occurred in younger group rather than the old counterparts.Younger patients diagnosed with RCC usually manifest lower T stage and tumor grade with a favorable prognosis.

Objective The objective of this study was to investigate the abnormal expression of Notch signaling pathway members in pancreatic cancer and its important effect on the development of pancreatic carcinoma. Methods Affymetrix gene expres-sion microarray was used to screen the differentially expressed members of Notch signal pathway in 10 cases of pancreatic carcinoma and its adjacent tissues,and verified by real-time quantitative PCR and Western blotting. The lentivirus expression vector carrying the siRNA fragment of Jagged 2(JAG2)gene was transfected into the pancreatic cancer primary cells to construct the JAG2 gene re-pression-expressing pancreatic cancer cell line. MTT,flow cytometry and Transwell assays were used to analyze cell proliferation, changes of cell cycle and invasive transfer capabilities. Results A total of 512 differentially expressed genes were detected by Affy-metrix gene expression microarray,including 419 up-regulated genes and 93 down-regulated genes. JAG2( up-regulated expres-sion 8. 20 times),NOTCH1(up-regulated expression 3. 74 times),HES1(up-regulated expression 3. 27 times),and NOTCH2(up-regulated expression 3. 16 times)were differentially expressed in Notch signaling pathway. The results of PCR and Western blotting were consistent with those of gene chip. The growth curves of JAG2 gene repressed pancreatic cancer cells and pancreatic cancer pri-mary cells were drawn by the standard OD490 value of d1-d5 by MTT assay. JAG2 gene repressor expression vector could signifi-cantly inhibit the proliferation of pancreatic cancer cells. The cell cycle analysis showed that the apoptosis and the arrested cell cycle at the S phase were significantly increased in pancreatic cancer cells with JAG2 gene repressor expression. The invasive ability was significantly reduced in JAG2 gene repressor expression pancreatic cancer cells(P<0. 05). Conclusion Some members of the Notch signaling pathway are significantly differentially expressed in pancreatic cancer tissues,and repression of this member can affect the growth,cell cycle,invasion and metastasis of pancreatic cancer cells.

MicroRNAs (miRNAs) that exert function by posttranscriptional suppression have recently brought insight in our understanding of the role of non-protein-coding RNAs in carcinogenesis and metastasis. In this study, we described the function and molecular mechanism of miR-139-5p in colorectal cancer (CRC) and its potential clinical application in CRC. We found that miR-139-5p was significantly downregulated in 73.8% CRC samples compared with adjacent noncancerous tissues (NCTs), and decreased miR-139-5p was associated with poor prognosis. Functional analyses demonstrated that ectopic expression of miR-139-5p suppressed CRC cell migration and invasion in vitro and metastasis in vivo. Mechanistic investigations revealed that miR-139-5p suppress CRC cell invasion and metastasis by targeting AMFR and NOTCH1. Knockdown of the two genes phenocopied the inhibitory effect of miR-139-5p on CRC metastasis. Furthermore, the protein levels of the two genes were upregulated in CRC samples compared with NCTs, and inversely correlated with the miR-139-5p expression. Increased NOTCH1 protein expression was correlated with poor prognosis of CRC patients. Together, our data indicate that miR-139-5p is a potential tumor suppressor and prognostic factor for CRC, and targeting miR-139-5p may repress the metastasis of CRC and improve survival.
Animals ; Base Sequence ; Cell Line, Tumor ; Cell Movement ; genetics ; Colorectal Neoplasms ; genetics ; pathology ; therapy ; Down-Regulation ; Female ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; HCT116 Cells ; HEK293 Cells ; Humans ; Male ; Mice, Inbred BALB C ; Mice, Nude ; MicroRNAs ; genetics ; Middle Aged ; Neoplasm Invasiveness ; RNA Interference ; Receptor, Notch1 ; genetics ; metabolism ; Receptors, Autocrine Motility Factor ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Homology, Nucleic Acid ; Survival Analysis ; Xenograft Model Antitumor Assays

Objective:To investigate the safety of minimally invasive liver resection for resectable hepatocellular carcinoma (HCC) complicated with portal hypertension.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 807 patients with resectable HCC who underwent minimally invasive liver resection in 8 medical centers, including Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine et al, from June 2011 to November 2022 were collected. There were 670 males and 137 females, aged 58(50,66)years. Of the 807 patients, 173 cases with portal hypertension were divided into the portal hypertension group, and 634 cases without portal hypertension were divided into the non-portal hypertension group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and post-operative situations; (3) subgroup analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method, with the caliper setting as 0.001. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was constructed using the non-parameter rank sun test. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 807 patients, 268 cases were successfully matched, including 134 cases in the portal hypertension group and 134 cases in the non-portal hypertension group. The elimination of the tumor diameter and robot-assisted surgery confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative and postoperative situations. The occlusion time of porta hepatis, cases with intraoperative blood transfusion, cases with postoperative complication, cases with complication >Ⅱ grade of Clavien-Dindo classification, cases of Clavien-Dindo classification as Ⅰ grade, Ⅱ grade, Ⅲ grade, Ⅳ grade, cases with liver related complication were 27.0(15.0,43.0)minutes, 33, 55, 15, 13, 29, 14, 1, 37 in the portal hypertension group, versus 35.0(22.0,60.0)minutes, 17, 25, 5, 14, 9, 4, 1, 13 in the non-portal hypertension group, showing significant differences in the above indicators between the two groups ( Z=-2.15, χ2=6.30, 16.39, 4.38, 20.72, 14.16, P<0.05). (3) Subgroup analysis. Results of subgroups analysis showed that in cases with major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 243.5(174.6,296.3)minutes, 200.0(150.0,600.0)mL, 7.5(6.0,13.0)days in the portal hypertension group, versus 270.0(180.0,314.5)minutes, 200.0 (75.0,450.0)mL, 7.0(5.5,10.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.54, -1.73, -0.92, P>0.05). In cases with non-major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 8.0(5.0,10.0)days in the portal hypertension group, versus 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.5,9.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-1.39, -0.10, 1.05, P>0.05). In cases with anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 210.0(150.0,285.0)minutes, 150.0(50.0,200.0)mL, 8.0(6.0,9.3)days in the portal hypertension group, versus 225.5(146.3,306.8)minutes, 100.0(50.0,250.0)mL, 7.0(6.0,9.0)days in the non-portal hypertension group, showing no significant difference in the above indica-tors between the two groups ( Z=-0.75, -0.26, -0.91, P>0.05). In cases with non-anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 173.5(120.0,231.5)minutes, 175.0(50.0,300.0)mL, 7.0(5.0,11.0)days in the portal hyper-tension group, versus 186.0(123.0,262.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.0,9.5)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.97, -1.12, -0.98, P>0.05). Conclusion:Minimally invasive liver resection or even major liver resection is safe and feasible for screened HCC patients complicated with portal hyper-tension, but attention should be paid to the prevention and treatment of postoperative complications.

The incidence of gastrointestinal malignancies is high in the population, and 40%?80% of gastrointestinal tumor patients suffer from malnutrition. The metabolic mechanism of tumor disease itself, and the perioperative stress reaction caused by surgical treatment can further aggravate malnutrition. Therefore, nutritional support should be routinely provided during the perioperative period in tumor patients with nutritional risk or malnutrition. For a long time, immunonutrients such as glutamine, ω-3 fatty acids, arginine and nucleotides have attracted much attention in the treatment of perioperative tumor patients. Most studies have shown that perioperative immunonutrition therapy not only improve nutritional deficiency and correct malnutrition, but also maintain immune function, reduce inflammation and maintain intestinal barrier integrity, to reduce postopera-tive complications and short postoperative duration of hospital stay. However, with the extensive clinical application and in-depth study of immunonutrition in recent years, there are still many doubts and controversies about its application in the perioperative gastrointestinal malignancies. The authors review the pharmacological mechanism and clinical application of perioperative immunonutrients, perioperative combined application of immunonutrients, and application timing and approach of immunonutrition in patients with gastrointestinal malignancies, so as to provide some clues for its subsequent clinical application.

OBJECTIVE： To investigate the protective effect of total flavonoids from the leaves of Choerospondias axillaris （TFLC） on myocardial ischemia reperfusion injury （MIRI） model rats. METHODS： Male SD rats were randomly divided into sham operation group， model group， positive control group （verapamil， 0.02 g/kg）， TFLC low-dose and high-dose groups （0.1， 0.4 g/kg）， with 10 rats in each group. Administration groups were intragastrically given relevant medicine （2 mL/100 g）； sham operation group and model group were given constant volume of normal saline intragastrically， once a day， for consecutive 7 d. After last medication， MIRI model was induced by modified ligation method. The times and duration of ventricular tachycardia （VT） and ventricular fibrillation （VF） in rats were recorded with biological function experiment system during reperfusion period.The activity of CK and contents of TNF-α， IL-6， NF-κB and NO in serum were determined by ELISA double antibody clip art assay. The morphological characteristics of myocardial tissue was observed by HE staining. The myocardial infarction scope （i.e. the ratio of myocardial tissue mass to ventricular mass） was measured by TTC method. RESULTS： Compared with sham operation group， the times and duration of VT and VF were increased or prolonged significantly in model group； CK activity， serum contents of TNF-α， IL-6 and NF-κB were enhanced or increased significantly， while NO content was decreased significantly （P＜0.05 or P＜0.01）. Obvious myocardial infarction focus， serious cell structure damage， disorderly muscle fibers arrangement， cell nucleus pyknosis and accompanied inflammatory cell infiltration were all observed in cardiac tissue； the mass of infarcted myocardial tissue and ventricular as well as the scope of myocardial infarction increased significantly （P＜0.01）. Compared with model group， the times and duration of VT and VF were decreased or shortened significantly in administration groups； CK activity， serum contents of TNF-α， IL-6， NF-κB were decreased significantly， while NO content was increased significantly （P＜0.05 or P＜0.01）. The above symptoms of myocardial injury were improved；the mass of infarcted myocardial tissue and ventricular as well as the scope of myocardial infarction was significantly reduced （P＜0.05 or P＜0.01）. CONCLUSIONS： TFLC can relieve MIRI-induced ischemic arrhythmia and myocardial damage， reduce the release of inflammatory factors， promote the recovery of myocardial and endothelial cell function， reduce the scope of myocardial infarction and has a certain protective effect.

MicroRNAs (miRNAs) are a type of small non-coding RNAs that are often play important roles in carcinogenesis, but the carcinogenic mechanism of miRNAs is still unclear. This study will investigate the function and the mechanism of miR-638 in carcinoma (GC). The expression of miR-638 in GC and the DNA copy number of miR-638 were detected by real-time PCR. The effect of miR-638 on cell proliferation was measured by counting kit-8 assay. Different assays, including bioinformatics algorithms (TargetScan and miRanda), luciferase report assay and Western blotting, were used to identify the target gene of miR-638 in GC. The expression of miR-638 target gene in clinical CRC tissues was also validated by immunohistochemical assay. From this research, we found that miR-638 was downregulated in GC tissues compared with corresponding noncancerous tissues (NCTs), and the DNA copy number of miR-638 was lower in GC than NCTs, which may induce the corresponding downregulation of miR-638 in GC. Ectopic expression of miR-638 inhibited GC cell growth in vitro. Subsequently, we identified that PLD1 is the target gene of miR-638 in GC, and silencing PLD1 expression phenocopied the inhibitory effect of miR-638 on GC cell proliferation. Furthermore, we observed that PLD1 was overexpressed in GC tissues, and high expression of PLD1 in GC predicted poor overall survival. In summary, we revealed that miR-638 functions as a tumor suppressor in GC through inhibiting PLD1.
3' Untranslated Regions ; genetics ; Apoptosis ; genetics ; Base Sequence ; Cell Line, Tumor ; Cell Proliferation ; genetics ; Down-Regulation ; genetics ; Humans ; MicroRNAs ; genetics ; Phospholipase D ; genetics ; Prognosis ; Stomach Neoplasms ; diagnosis ; enzymology ; genetics ; pathology