Objective To investigate curative efficacy of RevoLix 2 μm laser in combined with pirarubicine in the treatment of non-muscular invasive bladder cancer and its effects on level of serum vascular endothelial growth factor (VEGF).Methods 115 cases with non-muscular invasive bladder cancer who received therapy in our hospital from January 2012 to April 2013 were selected as research objects to retrospectively analyze their materials.According to therapeutic schemes,patients were divided into group A ( n=52 ) and group B ( n =63 ).Group A was given electrocision of bladder tumor and perfusion of pirarubicine 30 mg in 5% glucose injection 30 mL,one times per week,for eight weeks,and then one times per month,a total of one year; while group B was given RevoLix 2μm laser resection of bladder tumor and perfusion of pirarubicine 30 mg in 5% glucose injection 30 mL,one times per week, for eight week, and then one times per month, a total of one year.Then, operation status, incidence of complications after operation,level of VEGF and recurrence rate between the two groups were observed and compared.Results Compared with group A, group B had statistically less bleeding volume,shorter retention time of urinary tube and hospitalization time (P<0.05),while operation time in the two groups was statistically same.After operation,incidence of complications in group B was 3.2%,which was statistically lower than that of 15.4% in group A ( P<0.05).On admission and 1 week after operation,levels of VEGF of two groups had no significant differences.8 weeks and 6 months after operation,level of VEGF in group B was statistically lower than that in group A respectively (P<0.05).After the two-year follow-up,recurrence rate in group B was 4.8%,which was statistically lower than that of 17.3% in group A (P<0.05).Conclusion RevoLix 2μm laser combined with pirarubicine is effective for patients with non-muscular invasive bladder cancer with less bleeding volume,quicker postoperative recovery,lower incidence of complications and recurrence rate after operation.This may be related to the decrease of serum VEGF level in patients,it is necessary to further study.

OBJECTIVE: To study whether TGF-α possesses similar EGF effect of enforcing neuroendocrine differentiation (NED) in prostate cancer cell line DU145 and determine the influence of NED induced by TGF-α on chemoresistance. METHODS: DU145 cells were divided into 3 groups: a group with 2% FBS, a group with 2%FBS+TGF-α 5 ng/mL and a group with 2%FBS+TGF-α 10 ng/mL. Morphological change in DU145 cells was observed after TGF-α treatment. Expression levels of NSE mRNA were detected with real time RT-PCR. Western blot was used to detect the expression levels of protein NSE, P-gp, MRP1 and Bcl-2. Cell cycles of DU145 cells in the 3 groups were examined with flow cytometry. MTT assay was used to evaluate the influence of TGF-α in chemoresistance. RESULTS: Compared with DU145 cells cultured with 2% FBS, cells treated with 2% FBS+TGF-α were pleomorphic and pseudopodia extended. The expression level of NSE mRNA upregulated to (3.6±0.5) folds (P<0.05) and (10.1±0.1) folds (P<0.01). Western blot showed that the expression levels of protein NSE, Bcl-2, and MRP1 increased after treatment with different concentrations of TGF-α; P-gp was not detected. The proportion of DU145 cells in phase G1 decreased; proportions of cells in phase S and phase G2/M were increased after TGF-α treatment (5 μg/mL). At the same time, chemoresistance of DU145 cells to cisplatin increased. CONCLUSION TGF-α can increase NED in DU145 cells and enforce the chemoresistance to cisplatin.
Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Drug Resistance, Neoplasm ; drug effects ; Endosomal Sorting Complexes Required for Transport ; pharmacology ; Humans ; Male ; Prostatic Neoplasms ; metabolism ; pathology ; Transforming Growth Factor alpha ; pharmacology

OBJECTIVE:To observe the efficacy and safety of mecobalamin combined with folic acid in the treatment of dia-betic peripheral neuropathy(DPN)with hyperhomocysteinemia. METHODS:Data of 40 DPN patients with high hyperhomocystein-emia were enrolled into high Hcy group and 30 DPN patients with normal Hcy were enrolled into normal Hcy group. Normal Hcy group was given diet control,hypoglycemic drugs or insulin for controlling glucose and other conventional treatment to make the fasting plasma glucose was lower than 7.0 mmol/L and 2 h postprandial glucose lower than 11.0 mmol/L;based on it,high Hcy group was given Mecobalamin injection 500 μg by intramuscular injection,once a day+Folic acid tablet 5 mg,once a day. 14 d was a treatment course and it lasted 2 courses. Clinical efficacy,Hcy level,the motor nerve conduction velocity(MNCV)and sen-sory nerve conduction velocity (SNCV) of tibial and peroneal nerve and total symptom scale (TSS) score before and after treat-ment in high Hcy group were observed and compared with normal Hcy group,and the incidence of adverse reactions in high Hcy group was recorded. RESULTS:After treatment,the total effective rate in high Hcy group was 75.0%;Hcy and TSS score in high Hcy group were significantly lower than before and higher than normal Hcy group,MNCV and SNCV of tibial and peroneal nerve were significantly higher than before and lower than normal Hcy group,the differences were statistically significant(P<0.05). Th incidence of adverse reactions of high Hcy group was 5.0%. CONCLUSIONS:Based on the conventional treatment,Mecobalamin combined with folic acid has good efficacy in the treatmen of DPN with hyperhomocysteinemia,it can significantly reduce plasma Hcy levels and improve nerve conduction velocity in patients with DPN,with good safety.

Objective:To discuss effect of nicorandil on unstable angina patients With persistent Weakly positive for troponin I (TnI).Methods:A total of 111 unstable angina patients With persistent Weakly positive for TnI Were randomly divided into control group (received routine treatment,55 cases) and intervention group (received nic-orandil 5mg,3 times/d based on routine treatment,56 cases).The relief of chest pain in one Week,the recurrent hospitalization for chest pain aggravation in 3 months and the cardiac mortality rate in one year betWeen tWo groups Were observed in tWo groups. Results:Compared With control group,the relief of angina pectoris in one Week (63.6% vs. 91.1%,χ2=11.97,P=0.0005)significantly increased,re-hospitalization for chest pain aggravation in three months (56.4% vs.19.6%,χ2=15.91,P=0.0001)significantly decreased in intervention group;but cardiac mortality rate during one year betWeen tWo groups Was no significant difference (5.5% vs. 8.9%,χ2=0.50,P=0.4792).Conclusion:Nicorandil can significantly reduce the unstable angina and re-hospitalization for chest pain aggravation in patients With persistent Weakly positive for TnI,but there Was no significant difference in reducing mortality Within one year betWeen tWo groups.

Objective To explore the effect of neutrophil to lymphocyte ratio(NLR)and other related in-dicators on the prognosis of advanced non-small cell lung cancer patients treated with programmed death 1(PD-1)inhibitor and construct a nomogram prediction model.Methods A total of 198 patients with advanced non-small cell lung cancer who received PD-1 inhibitor treatment in the hospital from February 2020 to April 2022 were selected and followed up to August 2022.According to the clinical outcome,they were divided into the death group(46 cases)and the survival group(152 cases).The clinical data of the death group and the survival group were recorded,and the prognostic factors of advanced non-small cell lung cancer patients trea-ted with PD-1 inhibitor were analyzed.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of NLR,platelet to lymphocyte ratio(PLR)and lymphocyte to monocyte ratio(LMR)for the prognosis of patients.Multivariate Logistic regression model was used to analyze the independent risk factors affecting the prognosis of patients.A prediction nomogram model for the prognosis of patients was construc-ted using R software 4.0"rms"package,and the calibration curve was used to internally validate the nomo-gram prediction model.Results Compared with the survival group,the proportion of smoking,TNM stageⅣ,ECOG score 2,and NLR,PLR,LMR were higher(P<0.05).The area under the curve of NLR,PLR and LMR were 0.707,0.793 and 0.819,respectively,and the optimal cut-off value were 4.72%,179.21%and 3.44%,respectively.Smoking,TNM stage,ECOG score,NLR,PLR,and LMR were independent risk factors for the prognosis of advanced non-small cell lung cancer patients treated with PD-1 inhibitor(P<0.05).The internal validation results show that the nomogram inhibitor treatment of PD-1 model prediction the prognosis of patients with advanced non-small cell lung cancer C-index was 0.847(95%CI 0.769-0.902),the calibra-tion curve tends to be the ideal curve.The threshold value of the nomogram model for predicting the prognosis of patients with advanced non-small cell lung cancer treated with PD-1 inhibitor was>0.22.The nomogram prediction model provided a net clinical benefit,and the net clinical benefit was higher than that of smoking,TNM stage,ECOG score,NLR,PLR and LMR.Conclusion Based on smoking,TNM stage,ECOG score,NLR,PLR,and LMR,a nomogram prediction model for the prognosis of advanced non-small cell lung cancer patients treated with PD-1 inhibitor is constructed,which has important clinical application value.

OBJECTIVES: It is an important reform for medical education in China to combine professional postgraduate training with standardized resident training. This study aims to evaluate the depression and perceived stress in postgraduate students of clinical medicine and residents from society and to determine the relation between depression and perceived stress in medical residents. METHODS: Chinese Perceived Stress Scale (CPSS) and Self-Rating Depression Scale (SDS) were applied to 330 residents (including 235 postgraduate students of clinical medicine and 95 residents from society) from a Class-A Grade-3 genernal hospital in Hunan Province to evaluate and compare the depression and perceived stress in postgraduate students of clinical medicine and residents from society. Pearson correlation analysis was performed to assess the association between depression and perceived stress. Stress resources between 2 groups of residents were observed and compared. RESULTS: Of the 235 postgraduate students of clinical medicine, 148 (63.0%) showed depression and 162 (68.9%) showed elevated perceived stress. Main stress resources were academic pressure, scientific research pressure, and employment pressure. Of the 95 residents from society, 52 (54.7%) showed depression and 58 (61.1%) showed elevated perceived stress. Main stress resources were economic stress, employment pressure, and academic pressure. The scores of CPSS and SDS were significantly higher in postgraduate students of clinical medicine than those in residents from society ( CONCLUSIONS Residents (including postgraduate students of clinical medicine and residents from society) possess depression and elevated perceived stress with positive correlation. The postgraduate students of clinical medicine show higher level of depression and perceived stress than the residents from society under the "unified double-track" training system.
China/epidemiology* ; Depression/epidemiology* ; Humans ; Internship and Residency ; Students, Medical

[摘 要] 目的：探讨程序性死亡受体-1（PD-1）单抗联合顺铂或吉西他滨在KRAS基因突变非小细胞肺癌（NSCLC）A549细胞移植瘤小鼠模型治疗中的作用。方法：构建免疫系统-肿瘤双人源化A549细胞小鼠移植瘤模型，将60只小鼠按随机数字表法分成6组（10只/组），分别为对照组（200 μL/kg PBS）、PD-1单抗组（20 mg/kg PD-1单抗）、顺铂组（3 mg/kg顺铂）、PD-1单抗+顺铂组（20 mg/kg PD-1单抗+3 mg/kg顺铂）、吉西他滨组（30 mg/kg吉西他滨）和PD-1单抗+吉西他滨组（20 mg/kg PD-1单抗+30 mg/kg吉西他滨）。TUNEL和DAPI双染色法检测移植瘤组织中细胞凋亡水平，测量移植瘤体积和质量并计算肿瘤生长抑制率，免疫组化法检测移植瘤微血管密度（MVD）。结果：成功构建免疫系统-肿瘤双人源化NSCLC A549细胞小鼠移植瘤模型，PD-1单抗+顺铂组移植瘤的细胞凋亡率、肿瘤生长抑制率均最高，移植瘤体积、质量和MVD均最小，与其他5组小鼠比较差异均有统计学意义（均P<0.05）。结论：顺铂与PD-1单抗具有协同活性，而吉西他滨拮抗PD-1单抗的治疗作用。提示PD-1单抗联合顺铂对KRAS突变NSCLC A549细胞移植瘤小鼠的疗效更好。

Objective To study the relationship between cancer-related fatigue (CRF) and clinicopathological features and quality of life in patients with advanced gastric cancer. Methods The clinical and pathological data of 182 patients with advanced gastric cancer were collected, The CRF level and quality of life were assessed by the brief fatigue inventory (BFI), European Organization for Research on Treatment of Cancer (EORTC) life quality scale QLQ-C30 (V3.0). The correlations between CRF and clinicopathological features and quality of life were analyzed. Results One hundred twenty-two patients with advanced gastric cancer were associated with different degrees of fatigue. The CEF BFI score had correlation with the age(F=6.637,P=0.001),PS score(F=15.559,P=0.000),the World Health Organization(WHO) pathologic type (F=7.352, P=0.000). The CRF index of the 50-59 age group was higher than that of other age groups; the CRF BFI scores of PS score 1 and 2 were higher than that of 0 group; CRF BFI score of gastric signet ring cell carcinoma was significantly higher than that of gastric squamous cell carcinoma. The Pearson correlation analysis showed that the CRF BFI score was positively correlated with mood (r=0.423, P=0.008). There were significant differences in body function and mood (F=-16.254, F=-13.256, both P<0.05)and fatigue,pain and loss of appetite among 3 CRF groups(F=12.075,F=14.361,F=13.837, all P<0.05). There was a significant difference in the mean CRF BFI score between the three groups before and after chemotherapy(tSD=6.981,tPR=6.903,tPD=7.437,all P<0.05). Compared with pre-chemotherapy, the mean CRF BFI score of SD and PR group decreased after 3 months follow-up, score of PD group increased, the differences were statistically significant(t=2.371,t=6.912,t=18.237,all P<0.05).Conclusions The incidence of CRF in patients with advanced gastric cancer is very high,the degree of CRF has correlation with age, PS score and pathological type. Relieve symptoms such as fatigue, pain and loss of appetite and control adverse reactions could help to reduce the degree of CRF.