OBJECTIVE:To establish a rapid and accurate method for the identification of Lycium barbarism.METHO-DS:The Lycium barbarism in different processing method was studied in respect of 1 000-seed weight,acidity and basicity,UV spectra and TLC etc.RESULTS:Striking differences were noted between Lycium barbarism and Sulfuring Lycium barbarism in 1000-seed weight and all the other indexes.CONCLUSION:UV and TLC were proved to be simple and reliable methods for the identification of Lycium barbarism,which thus can be considered as the quality control methods for Lycium barbarism and its Chinese patient drugs.

Objective To analyze the endoscopic and pathological characteristics of rectum neuroendocrine neoplasm (NEN).Methods From January 2005 to May 2012,the endoscopic and pathological data of 66 patients with rectum NEN were collected and graded according to historistic grade of gastroenteropancreatic-neuroendocrine neoplasm (GEP-NEN) by World Health Organization (WHO).The factors related with the metastasis of neuroendocrine tumor (NET) and neuroendocrine cancer (NEC) were analyzed by Chi square test and Fisher exact probability method.Results The locations of 66 NEN cases were between three and 15 cm from the anus.The diameters of 54 cases were less than 1 cm and under endoscopy the appearance of most tumors was submucosal hemispherical polypoid bulge.The diameters of nine cases were over 1 cm but less than 2 cm,of which the appearance of five cases was submucosal thickening or sessile polypoid bulge.The diameter of three cases was over 2 cm and the appearance was cauliflower-like or polypoid tumor which caused annular lumen stenosis.Sixty-one cases were NET (grade G1),three cases were NEC (grade G3) and two cases were mixed adenoendocrine carcinoma with both NEC and adenocarcinoma components.The metastasis of NET and NEC was not related with gender (x2 =0.158,P＞0.05) and age (Fisher exact probability method,P＞ 0.05),however was related with the diameter of tumor (Fisher exact probability method,P＜0.05).Conclusions NEN is a tumor with variety endoscopic characteristics and pathological features.The metastasis of NET and NEC seems not related with gender and age,but related with diameter.

Objective To compare diagnostic performance of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum.Methods Totally 46 children suspected with Meckel's diverticulum were enrolled.Ultrasound,radionuclide imaging data were analyzed and compared with pathology.Results In 46 children suspected with Meckel's diverticulum,38 cases were confirmed by operation.Thirty-three cases of 38 were diagnosed Meckel's diverticulum by ultrasound,5 cases of 38 were false negative,there was no false positive case.Radionuclide imaging was positive in 24 cases of 46,false positive in 4 eases and false negative in 18 cases.The ultrasound diagnostic accuracy rate was 89.13％ (41/46),sensitivity was 86.84％ (33/38),specificity was 100％ (8/8).Diagnostic accuracy rate of radionuclide imaging was 52.17％ (24/46),sensitivity was 52.63 ％ (20/38) and specificity was 50.00 ％ (4/8).The sensitivity of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum had significant difference (P＜0.01).Conclusion Ultrasound in diagnosis of Meckel's diverticulum has advantages of non-invasive,no radiation,acceptable price and high sensitivity.

Objective To explore the prognosis related genes of pancreatic ductal adenocarcinoma (PDAC)and investigate the molecular regulation mechanism.Methods Gene expression data of 102 PDAC patients with complete clinical survival data were selected from gene expression database of National Center for Biotechnology Information.The 106 transcription regulation gene collection was collected from Transfac database.The 715 microRNA (miRNA)target regulation gene collection was selected according to PicTar and TargetScanS method.Biological pathway data obtained from the Kyoto Encyclopedia of Genes and Genomes (KEGG).The known cancer genes were collected from the cancer gene census (CGC) database.Univariate Cox proportional hazards model was used to analyze the correlation between gene expression data and survival time,then obtained survival related candidate genes from the whole genome. Then the enriched genes were analyzed by hypergeometric distribution algorithm from three databases. Multiple correction testing was performed by BH-FDR method (FDR < 0.05 ).Kaplan-Meier was performed for survival curve analysis of PDAC.Results The results of data of 102 PDAC patients analyzed by univariate Cox proportional hazards model indicated that 273 genes were significantly related to the survival time of patients (P <0.000 1 ).After 273 survival genes were enrichment analyzed in 106 transcription factor regulation gene collection,12 survival genes enriched transcription factor target gene sets were found.After 273 survival genes were enrichment analyzed in 715 miRNA target regulation gene collection,11 survival genes enriched miRNAs target sets were discovered.After 273 survival genes were enrichment analyzed in pathway data of KEGG,15 survival genes enriched pathways were obtained. Period circadian clock 2 (PER2 )was regulated by CCAAT/enhancer binding protein (CEBPA)at transcription level and regulated by miRNA-32 after transcription.The prognosis of PDAC was affected by circadian rhythm pathway.The 102 patients with PDAC were ranked according to the expression of PER2 from high to low,the first 51 cases were included in PER2 higher expression group and the left were included in PER2 lower expression group.Kaplan-Meier survival analysis indicated that PER2 was significantly correlated with prognosis of PDAC (P <0.01 ).Conclusion CEBPA/miRNA-32/PER2 and its related circadian clock pathway may be the target pathway in interfering the development of PDAC,and is correlated with the prognosis of PDAC.

Objective To investigate whether the sodium arsenite inhibiting proliferation of hepatocellar carcinoma(HCC) cells and having a relation with the expression of promyelocytic leukemia (PML) protein .Methods The immunohistochemistry , Western blot analysis ,immunofluorescence assay and quantitative PCR were used to examine the PML gene and protein expression in HCC tissue and cells .Results The immunohis to chemical staining showed that the PML protein was expressed in nucleus of well‐differentiated ,moderately differentiated and poorly differentiated HCC tissues randomly selected from 15 cases of HCC under‐going hepatic resection .Western blot analysis showed that PML protein was expressed at varying levels in all 24 HCC tissue sam‐ples ,HuH7 ,HepG2 ,Hep3B ,SMMC‐7721 and L02 cells .The immunofluorescence assay demonstrated that PML protein grains were found in the nucleis of the HuH7 ,HepG2 ,Hep3B and SMCC‐7721 cells ,in which HuH7 and Hep3B expressed more PML proteins than HepG2 and SMMC‐7721 cells .24 HCC tissue samples ,Hep3B ,HepG2 ,SMCC‐7721 and HuH7 cells all expressed PML gene .Sodium arsenite not only down‐regulated the PML protein expressed in HuH7 and primary HCC cells ,but also inhibited the HCC cell growth of HepG2 ,Hep3B ,HuH7 and SMMC‐7721 ,with the exposure time extension ,the inhibiting effect of sodium arsenite on HCC cells was enhanced .Conclusion Both HCC cell lines and tissues generally express ther PML protein and gene , PML protein may serve as the molecular basis for the direct targeting effects of arsenical agents .

Objective To evaluate the effect of tripterine on hydrochloric acid-induced acute lung injury(ALI)in mice.Methods Eighteen pathogen-free healthy adult male ICR mice,aged 7-9 weeks,weighing 25-30 g,were divided into 3 groups(n=6 each)using a random number table:control group(group C),hydrochloric acid-induced ALI group(group ALI)and tripterine group(group T).ALI was induced by a single intratracheal instillation of hydrochloric acid 2 ml/kg(pH 1.5)via a 24-gauge angiocatheter inserted into the trachea in pentobarbital sodium-anesthetized mice.Tripterine 3 mg/kg was injected intraperitoneally once a day for 3 consecutive days,and then the model was established in group T.The mice were sacrificed at 6 h after instillation,and lung specimens were obtained for microscopic examination and for determination of the levels of tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),macrophage migration inhibitory factor(MIF)and myeloperoxidase(MPO)in lung tissues.Results Compared with group C,the levels of TNF-α,IL-6,MIF and MPO were significantly increased at 6 h after instillation in ALI and T groups(P<0.01).Compared with group ALI,the levels of TNF-α,IL-6,MIF and MPO were significantly decreased at 6 h after instillation in group T(P<0.01).The pathological changes of lung tissues were significantly attenuated in group T compared with group ALI.Conclusion Tripterine can attenuate hydrochloric acid-induced ALI in mice.

Objective To investigate the prevalence and risk factor of Ofloxacin resistance among the tuberculosis patients in Shanghai.Methods Totally 447 isolates resistant to anyone of first-line drug (Isoniazid,Rifampicin,Streptomycin and Ethambutol) and 151 randomly selected isolates susceptible to all above drugs were collected from district tuberculosis(TB) hospitals in Shanghai during 2009 to 2010.All 598 isolates were subject to Ofloxacin sensitive test.Logistic regression analysis was conducted to determine risk factors of Ofloxacin resistance.DNA sequencing was applied to study the mutation characteristics in gyrA and gyrB among Ofloxacin resistant isolates.Results Seventy-two(16.1%) of the 447 drug-resistant isolates were found resistant to Ofloxacin,and the Ofloxacin resistant rate among multiple drug-resistant (MDR) isolates was 39.6%(44/111).Ofloxacin resistance was also found in 4(2.6%) of the 151 drug sensitive isolates.Logistic regression analysis showed that first-line drug-resistance MDR(resistant to at least rifampin and isoniazid) and poly-drug resistance(resistance to two or more first-line drugs but not MDR) had significant effect on Ofloxacin resistance(OR = 19.5、5.6,95% CI:6.4 - 59.4、1.7 - 18.1,all P＜ 0.05);re-treatment(OR = 2.3,95 % CI:1.2 -4.0,P＜ 0.05),and a higher age(OR = 1.03,95 % CI:1.0 1 - 1.05,P＜ 0.05)were also significantly associated with Ofloxacin resistance.Resistance mutations in the gyrA and gyrB genes were detected in 62 of 76(81.6%) isolates with phenotypic Ofloxacin-resistance. Conclusions The Ofloxacin resistance rate in Shanghai MDR-TB patients is significantly higher than the pan-susceptible TB patients.Risk factors of ofloxacin resistance are MDR,poly-resistant,retreated patients,age.Among them,MDR has the highest strength of association.

Objective:To discuss the efficacy of pelvic lymph node dissection (PLND) on the patients undergoing radical cystectomy (RC).Methods:The clinicopathological data of bladder cancer patients who did not receive neoadjuvant chemotherapy and underwent RC in our center from November 2013 to December 2019 were collected. The average age of the patients was (67.4±10.9) years, including 284 males and 55 females. Postoperative pathology showed that 171 cases of MIBC and 168 cases of NMIBC. In the MIBC group, 124 patients received PLND. In the NMIBC group, 118 patients received PLND. There was no statistical difference of the PLND ratio between the two groups(72.5% vs. 65.5%, P=0.643). The average number of lymph nodes(LNs)in patients receiving PLND was(13.7±7.1). Explore the prognostic factors in NMIBC and MIBC respectively. The Kaplan-Meier method was used to analyze the effect of PLND on the prognosis of patients in MIBC and NMIBC group. Results:In MIBC group, 26 patients showed positive LNs, while 98 had negative LNs. 144 cases were high-grade urothelial carcinoma, and 47 cases received adjuvant treatment. In NMIBC group, 4 patients exhibited positive LNs, while 114 had negative LNs. 99 cases were high-grade urothelial carcinoma, and 15 cases received adjuvant treatment. After a median follow-up of 24(13, 43)months, Kaplan-Meier survival analysis showed that the 5-year overall survival(OS)of 395 patients was 63.6%. MIBC had a 5-year OS rate of 47.5%, while NMIBC had a rate of 79.1%. Univariate Cox regression showed that age≥65 years( HR=2.07, 95% CI 1.21-3.54, P=0.009), high tumor grade( HR=9.76, 95% CI 2.39-39.90, P<0.01), and positive lymph nodes( HR=2.47, 95% CI 1.27-4.78, P=0.008)were risk factors for the prognosis of MIBC.PLND ( HR=0.37, 95% CI 0.23-0.60, P<0.01) and adjuvant therapy ( HR=0.21, 95% CI 0.10-0.46, P<0.01) were protective factors of MIBC. However, the only risk factor of NMIBC was high tumor grade ( HR=6.66, 95% CI1.51-29.50, P=0.012). PLND had no effect on the prognosis of NMIBC patients following RC( HR=1.32, 95% CI 0.37-4.75, P=0.667). Multivariate COX regression analysis revealed that high tumor grade( HR=6.38, 95% CI 1.54-26.50, P=0.011) was independent risk factor of MIBC, PLND( HR=0.59, 95% CI 0.35-0.99, P=0.047), as well as adjuvant therapy ( HR=0.30, 95% CI 0.13-0.68, P=0.004) were independent protective factors of MIBC. Further analysis discovered that MIBC patients with negative LNs had a better prognosis than those with no PLND (62.4% vs. 16.1%, P<0.01)and positive LNs(62.4% vs.32.3%, P=0.005). However, there was no difference in prognosis between the negative LNs and no PLND group in NMIBC patients (81.3% vs. 66.6%, P=0.764). Conclusions:This study found that PLND was an independent predictive factor for MIBC patients receiving radical cystectomy.

Objective:To investigate the value of the vesical imaging reporting and data system score (VI-RADS) in the prognostic assessment of patients with bladder cancer.Methods:The data of 294 patients with pathologically confirmed bladder cancer in our department from February 2012 to September 2019 were retrospectively analyzed. Divide the patients into two groups based on the surgical method. In the transurethral resection of bladder tumor (TURBT) group, there were 121 cases, 102 males and 19 females; The average age of the patients was (66.7±12.3) years old, 52 cases <65 years old, 69 cases ≥65 years old, with VI-RADS <3 in 84 cases, VI-RADS ≥3 in 37 cases. In the radical cystectomy (RC) group, there were 173 cases, including 154 males and 19 females; The average age of the patients was (65.7±10.8) years, 77 cases <65 years old, 96 cases ≥65 years old, with VI-RADS <3 in 51 cases and VI-RADS ≥3 in 122 cases. The prognostic factors of TURBT group and RC group were analyzed, and the predictive value of VI-RADS score on overall survival (OS) and progression free survival (PFS) of bladder cancer patients after surgery was analyzed.Results:In this study, there were 294 cases with postoperative pathological diagnosis of urothelial carcinoma. The pathological staging was Ta stage in 104 cases (35.4%), T 1stage in 82 cases (27.9%), T 2 stage in 58 cases (19.7%), T 3 stage in 34 cases (11.6%), and T 4stage in 16 cases (5.4%). Pathological grading: 11 cases (3.7%) were low malignant potential, 77 cases (26.2%) were low grade, and 206 cases (70.1%) were high grade. There were 186 cases (63.3%) in the NMIBC group and 108 cases (36.7%) in the MIBC group. In the TURBT group, there were 114 cases (94.2%) in the NMIBC group and 7 cases (5.8%) in the MIBC group; In the RC group, there were 72 cases (41.6%) in the NMIBC group and 101 cases (58.4%) in the MIBC group. In the NMIBC group, the VI-RADS<3 and ≥3 were 128 cases (68.8%) and 58 cases (31.2%), respectively ( P<0.01); In the MIBC group, 101 cases (93.5%) had a VI-RADS <3 and 7 cases (6.5%) had a VI-RADS ≥ 3, respectively ( P<0.01). In the high grade of postoperative pathological group, 62 cases (30.1%) had a VI-RADS <3 and 144 cases (69.9%) had a VI-RADS ≥ 3, respectively ( P<0.01); In the non-high grade of postoperative pathological group, the VI-RADS <3 and ≥ 3 were 73 cases (83.0%) and 15 cases (17.0%), respectively ( P<0.01). The median OS survival for all patients in this study was 27.4 (16.6, 38.1)months and the median PFS survival was 24.7(14.0, 36.8) months. The results of univariate analysis showed that age ≥ 65 years old (OS: HR=6.09, P=0.001; PFS: HR=1.71, P=0.035), postoperative pathological diagnosis of tumor muscle infiltration (OS: HR=4.66, P<0.01; PFS: HR=2.24, P=0.001), postoperative high-grade tumor (OS: HR=4.26, P=0.008; PFS: HR=1.92, P=0.023), and VI-RADS score ≥ 3 (OS: HR=4.24, P=0.001; PFS: HR=2.21, P=0.002) were associated with poorer OS and PFS in patients. Multifactorial Cox model analysis revealed that a score of VI-RADS ≥3 was an independent risk factor for OS ( HR=3.41, P=0.012) and PFS ( HR=2.23, P=0.016). In the TURBT group, univariate analysis found that VI-RADS ≥3 ( HR=2.05, P=0.053) and high grade of postoperative pathology ( HR=2.77, P=0.005) were associated with poor PFS in patients, multifactorial Cox model analysis found only high grade of postoperative pathology ( HR=2.54, P=0.013) to be an independent risk factor for PFS. In the RC group, VI-RADS ≥3 ( HR=3.29, P=0.032) and age ≥65 years ( HR=5.37, P=0.001) were found to be independent risk factors for OS. The survival curve showed that the 5-year OS rates for groups with a VI-RADS ≥ 3 and <3 were 93.9% and 73.1%, respectively ( P<0.01), and the 5-year PFS rates for groups with a VI-RADS ≥ 3 and <3 were 76.5% and 53.0%, respectively ( P<0.01), with statistically significant differences. Conclusions:This study showed that VI-RADS ≥3 was an independent risk factor for prognosis in patients with bladder cancer and was more significant in patients receiving RC, but was not a significant predictor of prognosis in patients receiving TURBT.

Objective:To compare the prognosis and complications of muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC) patients undergoing radical cystectomy (RC) followed by ileal neobladder.Methods:The clinical data of 103 patients who underwent orthotopic ileal neobladder in Jiangsu Province Hospital from April 2010 to October 2021 were retrospectively analyzed. There were 51 MIBC patients and 52 NMIBC patients. In the MIBC group, there were 49 males and 2 females, aged (58.1 ± 8.9) years, with American Society of Anesthesiologists (ASA) score of 1-2 in 48 cases and 3 in 3 cases. Open radical cystectomy (ORC) was performed in 2 cases, laparoscopic (LRC) in 34 cases and robot-assisted radical cystectomy (RARC) in 15 cases. In the NMIBC group, there were 49 males and 3 females, aged (55.7 ± 9.9) years, ASA score of 1-2 in 51 cases and ASA score of 3 in 1 case. LRC was performed in 41 cases, and RARC in 11 cases. There were no statistically differences between the two groups in above indicators ( P>0.05). The Clavien-Dindo grading system (CCS) was used to assess the complications, defining CCS Ⅰ-Ⅱ as mild complications and CCS Ⅲ-Ⅴ as severe complications. According to their relationship to the neobladder, complications were be classified as neobladder-related and non-neobladder-related complications. The occurrence of complications and the prognosis of neobladder between MIBC and NMIBC were compared. Results:The average operation time of the MIBC group and NMIBC group were (421.2 ± 119.7) min vs. (439.8 ± 106.2) min. The blood loss were 400 (300, 700) ml vs. 400 (300, 625) ml. The frequency of lymph nodes removed were (14.9 ± 8.3) vs. (14.8 ± 8.5). The postoperative defecation time were 5 (4, 6) d vs. 5 (3, 6) d. And the postoperative hospital stay were 20 (15, 28) d vs. 22 (19, 28) d. There were no statistically differences between the two groups in above indicators ( P>0.05). The MIBC group had a significantly lower rate of pelvic lymph node metastasis [17.6% (9/51) vs. 0(0/52), P=0.001] and tumor thrombosis [23.5% (12/51) vs. 5.8% (3/51), P=0.011] than the MIBC group. Moreover, the NMIBC group had a considerably superior 5-year overall survival (OS) (97.6% vs. 70.2%, P=0.035). The proportion of pads needed in the daytime of the MIBC group and NMIBC group were 14.6% (7/46) vs. 6.7% (3/45). The frequency of urination were (2.0 ± 0.7) h vs. (2.4 ± 0.7) h. Furthermore, The proportion of pads needed at night were 47.9% (23/48) vs. 53.3% (24/45). The frequency of nocturnal urination were 3.1±1.5 vs. 2.3 ± 1.7. And the number of pads needed at night were all 1 (0, 1) pad. The daytime and nighttime incontinence rate were 25.0% (12/48) and 62.5% (30/48) respectively in MIBC, compared to 11.1% (5/45) and 62.2% (28/45) respectively in NMIBC. And the proportion of erectile function retention were 15.8% (6/38) vs. 25.0% (10/40). There were no statistically significant differences in the prognosis of neobladder function between the two groups ( P>0.05). Furthermore, the proportions of mild complications in the MIBC group and NMIBC group were [41.2% (21/51) vs. 51.9 (27/52)]. The proportions of severe complications were [21.6% (11/51) vs. 19.2% (27/52)]. The proportions of neobladder-related complications were [27.5% (14/51) vs. 25.0% (13/52)]. And the proportions of non-neobladder-related complications were [39.2% (20/51) vs. 25.0% (13/52)]. There were no statistically significant differences in the complications between the two groups ( P>0.05). Conclusions:There was no statistically significant difference in functional prognosis and complications of neobladder between MIBC group and NMIBC group, and NMIBC had a better oncologic prognosis.