Objective To investigate the therapeutic efficacy and safety of endoscopic resection of giant gastric stromal tumors without explicit evidence of metastases.Methods A total of 12 giant gastric stromal tumors with no evidence of metastases diagnosed by endoscopic ultrasound (EUS) and computed tomography (CT) scan were managed by endoscopic resection.Operation time,blood loss and the incidence rate of perforation were recorded respectively.The diagnoses of tissue specimens were made by pathological examination and immunohistochemistry.In order to assess local recurrence and distant metastases,endoscopy and endoscopic ultrasound follow-up examinations were performed routinely at 2,6 and 12 months,and the whole abdominal CT scan was also performed at 12 months after operation.Results Endoscopic resections were successfully performed in 10 of 12 cases (83.3％),among which,6 underwent endoscopic submucosal excavation (ESE) without unexpected perforation and 4 endoscopic full-thickness resection (EFR)with intentional perforation.The rate of intentional perforation was 33.3％ (4/12),and all the perforations could be sealed by endoscopic methods.The blood losses were all more than 100 ml,which could be controlled by argon plasma coagulation,electrocoagulation or hemostatic clips.In the 10 encapsulated tumors,8 could be smoothly removed from esophagus,whose long diameter of the minimum cross section was less than 3.5 cm,however,2 tumors whose diameters were larger than 3.5 cm were taken out after segmentation.In the 10 tissue samples,9 were confirmed as low risk GIST,1 larger than 5 cm was pathologically confirmed as high risk GIST.During 1-year follow-up,no local recurrence or peritoneal metastasis was found.2 tumors,larger than 5.0 cm,could not be removed by endoscopic methods due to uncontrolled bleeding.The rate of uncontrolled bleeding was 16.7％ (2/12).The patients were transferred to surgery,and pathologically confirmed as having high risk GIST.Conclusion For low-risk giant gastric stromal tumors whose diameters were less than 5cm without evidence of metastases,endoscopic resection is considered as a safe and effective procedure.Tumors with long diameter of the minimum cross section less than 3.5 cm are more suitable for endoscopic resection,which can be smoothly taken out through cardia.However,for high-risk GIST larger than 5.0 cm,the rate of uncontrolled bleeding is high,so endoscopic resection should be adopted with discretion.

OBJECTIVETo explore the clinical value of Chinese medical intervention and treatment of high-risk human papilloma virus (HR-HPV) infection in patients of cervical cancer (CC) during radiotherapy (RT).

METHODSEighty CC patients of the Ia-IIb stage receiving primary RT were assigned to two groups. RT and local intervention by Xunxi No. 1 was given to patients in the test group for 20 days, while patients in the control group were treated with RT alone. Expression of high-risk HPV (HR-HPV, HPV16/18 infection) was detected by in-situ hybridization (ISH) before and after treatment. The 5-year disease free survival rate and pelvic lymph node metastasis rate (with the lymph node diameter >0.9 cm shown by CT) in patients were observed.

RESULTSAfter treatment, the HR-HPV positive rate was lowered from 67.5% (27/40) to 37.5% (15/40) in the test group (P<0.05), while it was lowered from 72.5% (29/40) to 65.0% (26/40) in the control group (P>0.05). By follow-ups, the 3-year disease free survival rate in the test group was better than that in the control group (33/40 vs 27/40), showing insignificant difference between the two groups (P>0.05). Significant difference was shown in the 5-year disease free survival rate and the pelvic lymph node metastasis rate (65.0% vs 42.5%, 7.5% vs 25.0%) between the two groups (both P<0.05).

CONCLUSIONSIn early RT of CC, combined application of Xunxi No. 1 could obviously lower the HPV positive rate. The 5-year disease free survival rate was superior to that in the control group, with lower pelvic lymph node metastasis rate. Xunxi No. 1 had better clinical value in clinical application.

Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; diagnostic imaging ; therapy ; Phytotherapy ; Radiography ; Survival Rate ; Uterine Cervical Neoplasms ; diagnostic imaging ; therapy ; virology ; Young Adult

Tumor immune checkpoint therapy is a clinical treatment strategy developed based on the new principle of the inhibition of negative immune regulation. In this article, the tumor immune checkpoint therapy and the drug delivery strategies were reviewed, mainly including immunity and tumor therapy, tumor immune checkpoint therapy and its mechanism of action, clinical application of tumor immune checkpoint therapy and therapeutic drugs, immune resistance of programmed cell death protein 1 (PD1)/programmed cell death ligand 1 (PDL1) treatment and countermeasures, drug delivery strategies for tumor immune checkpoint therapeutic agents, etc. As a revolutionary new immunotherapy strategy, tumor immune checkpoint therapy has shown obvious superior therapeutic efficacy in a variety types of tumor. However, tumor immune checkpoint therapy is also faced with a big challenge, namely, immunotherapy resistance. With the discovery of new mechanism, the continuous development of new therapeutic drugs and delivery strategies, tumor immune checkpoint therapy is expected to further improve the clinical efficacy of tumor.

OBJECTIVETo compare the knee osteoarthritis (OA) models in rabbits by different concentrations of papain and provide data for exploring pathogenesis and treatments of this disease.

METHODSSixty New Zealand white rabbits were randomly divided into four groups of 15 each and given injections into the right knee on days 1, 3 and 5 including intra-articular injections of 2%, 5% or 10% (w/v) papain and 0.03 mol/L L-cysteine at the dose of 0.1 ml/kg (experimental groups). The 0.9% NaCl (w/v) with a dose of 0.1 ml/kg were injected intra-articularly into the right knees of rabbits in the control group. The rabbits were sacrificed at 2, 4, 6 weeks respectively after the initiation of papain injection and these OA models were evaluated through recording the width of knee joint, performing the morphological observation and histological evaluation of articular cartilage and synovium.

RESULTSThe degenerative changes were demonstrated in knee joints of rabbit in all experimental groups, such as thinner articular cartilage, fibrillation and destroyed cartilage matrix, and inflammation, proliferation, and degeneration of the synovial tissue. All these changes were much worse with increased concentration and prolonged observation time.

CONCLUSIONDifferent severity of OA are established through intra-articular injections of 2%, 5% or 10% papain and 0.03 mol/L L-cysteine at the dose of 0.1 ml/kg. These models are of the characters of short period and a good reproducibility.

Animals ; Disease Models, Animal ; Male ; Osteoarthritis, Knee ; chemically induced ; pathology ; Papain ; toxicity ; Rabbits

OBJECTIVETo verify the hypothesis that selected nestin positive cells derived from human fetal pancreas (according as medical ethnics) have surface markers similar to bone marrow mesenchymal stem cells (MSCs), and that these cells have multilineage potential.

METHODThe cell surface markers were determined by flow cytometry, and then the potential that these cells might be differentiated into adipocytes and osteoplasts were explored.

RESULTThese cells have similar surface markers as MSCs of bone marrow origin. These cells was induced to differentiate into adipocytes and osteoplasts.

CONCLUSIONSelected nestin positive cells derived from human fetal pancreas have certain characteristics of MSCs.

Adipocytes ; cytology ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cell Separation ; methods ; Cells, Cultured ; Fetal Stem Cells ; chemistry ; cytology ; metabolism ; Flow Cytometry ; Humans ; Intermediate Filament Proteins ; Mesenchymal Stromal Cells ; metabolism ; Nerve Tissue Proteins ; Nestin ; Pancreas ; cytology ; embryology

AIMTo investigate the effects of shivering on airway rewarming.

METHODSThe hypothermic dog model without shivering was established by immersing an anesthetized dog in cold water and administering atracurium to inhibit the dog shivering. The model dog respired warm fully humidified (40-45 degrees C, RH 99.9%) air and room temperature air(19 +/- 1 degrees C, RH 30% - 75%) to rewarm each for 2 hours, the priority of different temperature air respired was arranged randomly. After rewarming for 4 hours, the relaxed dog breathed warm humidified air by positive pressure ventilation in order to restore its spontaneous respiratory. Then the dog continued to respire warm humidified air spontaneously until the esophageal (Te) and rectal temperature (Tr) of the dog achieved the same degrees as the dog was immersed in the water. The metabolic heat production was detected by indirect calorimetry during the experiment.

RESULTS(1) When the shivering was inhibited, inhaling warm humidified air for 2 hours made the Tr and Te of the dogs increase 0.26-0.39 degrees C and 0.44-1.11 degrees C per hour respectively, inhaling air at room temperature for 2 hours made Tr and Te of the dogs decrease 0.24-0.51 degrees C and 0.58-0.67 degrees C per hour, respectively. And the changes in Tr and Te of the dogs were unrelated to the priority of inhaling air at different temperature. (2) When the dog with shivering respired spontaneously warm humidified air, the rewarming rates of Tr and Te were 2.26-2.33 degrees C/h and 1.96-2.38 degrees C/h respectively, quicker than those of the dogs whose shivering was inhibited. (3) Compared with metabolic heat production of the unshivering dog respiring warm humidified air by positive pressure ventilation, that of the shivering dog respiring warm humidified air spontaneously increased outstandingly, shivering thermogenesis made the rewarming rates increased obviously.

CONCLUSIONAirway rewarming is a method conducive to rewarming of hypothermia. When the body is shivering, the metabolic heat production increases obviously, that makes the rewarming rate increase markedly. So the shivering must be inhibited in order to eliminate the interference of shivering thermogenesis when the effects of airway rewarming are detected.

Animals ; Body Temperature Regulation ; Cold Temperature ; Dogs ; Hypothermia ; physiopathology ; therapy ; Hypothermia, Induced ; Male ; Respiratory Physiological Phenomena ; Shivering

OBJECTIVETo investigate the effects of oxidized low-density lipoprotein receptor 1 (LOX-1) on secretion of adhesive molecules mediated by ox-LDL in human umbilical endothelial cells (HUVECs).

METHODSHUVECs with different concentration of ox-LDL (0, 10, 20, 50, 100 microg/ml) were incubated for 24 h, or HUVECs were pretreated with 250 microg/ml poly (I) or 250 microg/ml carrageenan for 2 h and then incubated with 50 microg/ml ox-LDL for another 24 h. Expression of LOX-1 was determined by realtime RT-PCR and Western blot. mRNA and protein of ICAM-1, VCAM-1 and E-selectin were examined by RT-PCR and Western blot respectively.

RESULTSIncubation of HUVECs with ox-LDL (10-100 microg/ml) enhanced the expressions of LOX-1, ICAM-1 and E-selectin in a concentration-dependent manner (P < 0.01). On the contrary, ox-LDL did not affect the expression of VCAM-1 by HUVECs. The expression of LOX-1, ICAM-1 and E-selectin induced by ox-LDL were reduced in HUVECs pretreated with 250 microg/ml poly (I) or 250 microg/ml carrageenan for 2 h and then incubated with 50 microg/ml ox-LDL for 24 h. This showed that both poly (I) and carrageenan obviously decreased the expression of LOX-1, ICAM-1 and E-selectin induced by ox-LDL.

CONCLUSIONox-LDL may upregulate the expression of LOX-1, ICAM-1 and E-selectin, and LOX-1 blocker may partly inhibit this upregulation. The results suggest that the expression of inflammatory molecules induced by ox-LDL in HUVECs is mediated by LOX-1.

Cell Adhesion ; Cell Adhesion Molecules ; Cells, Cultured ; E-Selectin ; metabolism ; Endothelial Cells ; metabolism ; Endothelium, Vascular ; metabolism ; Humans ; Intercellular Adhesion Molecule-1 ; metabolism ; Lipoproteins, LDL ; biosynthesis ; RNA, Messenger ; metabolism ; Receptors, Oxidized LDL ; metabolism ; Scavenger Receptors, Class E ; metabolism ; Umbilical Veins ; cytology ; Vascular Cell Adhesion Molecule-1 ; metabolism

AIMTo investigate the role of ICAM-1 on the surface of vascular endothelial cell (VEC) in freezing/thawing injury of VEC, in order to elucidate the pathogenesis of freezing/thawing injury.

METHODSVEC separated and cultured from rat aorta and PMN separated from rat peripheral blood were selected as experiment materials. The frozen/thawed VEC model was founded by freezing VEC with the type WKL-V rate cooling instrument and then rewarming them in a water bath. ICAM-1 expression on the surface of frozen/thawed VEC was detected at 4, 12 and 24 h after freezing/thawing with immunohistochemical method. After coincubating frozen/thawed VEC with normal PMN, the adhesion of VEC to PMN was monitored with rose bengal staining assay and the injury level of VEC was indicated by measuring LDH activity in nutrient solution.

RESULTSThe ICAM-1 expression on the surface of VEC increased from 13.2% +/- 3.6% before freezing/thawing of VEC to 22.3% +/- 4.4% at 4 hour after freezing/thawing, and reached the peak (37.9% +/- 2.5%) at 12 hour after freezing/thawing of VEC. After coincubation of frozen/thawed VEC with normal PMN, the adherence of frozen/thawed VEC to PMN increased from group control 0.204 +/- 0.025 to 0.363 +/- 0.022 (P < 0.01), LDH activity in nutrient solution increased from group control 104.64 +/- 20.14 U/L to 162.33 +/- 27.88 U/L (P < 0.01), monoclonal antibody against ICAM-1 (ICAM-1 Mab) could partially block the adherence of frozen/thawed VEC to PMN (0.270 +/- 0.021, P < 0.01), and diminish LDH activity in nutrient solution (125.39 +/- 22.26 U/L, P < 0.05).

CONCLUSIONThe freezing/thawing of VEC can elicit an increase in ICAM-1 expression on the surface of VEC, and then proceed to VEC-PMN adherence and lead to VEC injury.

Animals ; Cells, Cultured ; Endothelial Cells ; metabolism ; Endothelium, Vascular ; cytology ; Freezing ; Intercellular Adhesion Molecule-1 ; metabolism ; Neutrophils ; cytology ; Rats

Ticks are obligate ectoparasites and vectors of arboviruses, vickettsiate, spirochetes and parasitil protozoa of humans and domestic animals. Immunological protection of mammalian hosts against tick infestation has been proposed as the most sustainable alternative tick control method to the current use of acaricides. The success of this method is dependent on the identification of key molecules for use as tick vaccine antigens. Proteolytic enzymes are involved in a wide range of cellular processes, thus they can be considered as good target antigens for a tick vaccine. In the present study, we used rapid amplification of cDNA ends protocol and primers that were designed based on the consensus amino acid motifs flanking present in all papain-like cysteine proteinases, to amplify, sequence and characterize two Rhipicephalus haemaphysaloides haemaphysaloides cathepsin L-like cysteine proteinases, named as cysA and cysB. The full length of cysA is 1168bp, encoding a 332 amino acid residue polypeptide with 36.33kD predicted molecular mass; the full length of cysB is 1153bp, encoding a 335 amino acid residue polypeptide with 37.56kD predicted molecular mass. The consensus amino acid motifs flanking presence in both deduced amino acid sequences. And both genes show high sequence homology to other tick cathepsin L-like cysteine proteinase, so they were identified as members of the cysteine proteinase gene family. Expression analysis by RT-PCR revealed that cysA and cysB were expressed differently in different periods of tick development.
Amino Acid Sequence ; Animals ; Cathepsin L ; Cathepsins ; genetics ; Cloning, Molecular ; Cysteine Endopeptidases ; genetics ; Female ; Molecular Sequence Data ; Reverse Transcriptase Polymerase Chain Reaction ; Rhipicephalus ; enzymology ; Sequence Analysis

OBJECTIVETo investigate the correlation of serum sex hormones and parathyroid hormone (PTH) with the biochemical markers of bone turnover in aged men.

METHODSWe collected the laboratory data of 465 men aged 60- 93 (73. 1 +/- 8. 3) years old, who came for routine physical examinations in our hospital. We obtained the levels of serum follicle- stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), sex hormone binding globulin (SHBG), PTH, 25-hydroxy-vitamin D3 (25(OH) D3), and bone turnover markers C-terminal telopeptide of type I collagen (CTX), osteocalcin (OC) and amino-terminal propeptide of type I procollagen (PINP). We also determined free testosterone (FT) , bioactive testosterone (BT) , testosterone secretion index (TSI) and FT index (FTI), and analyzed the correlation of each index with the biochemical markers of bone turnover.

RESULTSThe concentrations of serum FSH, LH, and SHBG increased, while the levels of FT, BT, TSI, FTI, PTH, CTX, OC and PINP decreased with age, especially in those over 80 years old (P <0.05). PTH was positively correlated with CTX, OC and PINP (r =0. 227, 0. 269 and 0. 162, P <0. 01), even after the adjustment for age, while SHBG negatively correlated with OC (r = -0. 100, P <0.05). The bone turnover markers increased with the elevation of the PTH quartiles, with significant differences between the first and the fourth quartile (P <0. 01). Multiple stepwise regression analysis showed that age was correlated inversely with CTX, OC and PINP ( beta = -0. 126, -0. 141 and -0. 122, P <0.05) , PTH positively with the three markers (beta = 0. 196, 0.279 and 0.189; P <0. 001), and SHBG negatively with OC ( beta = -0. 100, P <0.05) .

CONCLUSIONAging is the fundamental cause of reduced bone turnover in aged men. The levels serum PTH and SHBG are significantly associated with the biochemical markers of bone turnover.

Aged ; Aged, 80 and over ; Aging ; Bone Density ; Bone Remodeling ; physiology ; Bone and Bones ; metabolism ; Estradiol ; blood ; Follicle Stimulating Hormone ; blood ; Gonadal Steroid Hormones ; blood ; Humans ; Male ; Middle Aged ; Parathyroid Hormone ; blood ; Testosterone ; blood