Objective To study whether Clonorchis sinensis eggs were involved in the pathogen esis of gallbladder stones.Method From March to August 2011,the gallbladder stones from 183 patients were studied using microscopic examination and FTIR spectroscopy.Twenty egg-positive and 20egg-negative gallbladder stones found under microscopic examination were chosen randomly and analyzed through real-time fluorescent PCR and scanning electron microscopy.Results Eggs were detected in 118 of 183 gallbladder stones.The eggs were preliminarily diagnosed as Clonorchis sinensis eggs using the morphologic characteristics under light microscope.The results of real-time fluorescent PCR showed eggs in the gallbladder stones were Clonorchis sinensis eggs.The 118 egg-positive gallbladder stones were composed of 97 pigment stones,21 mixed stones and no cholesterol stones.The detection rate of Clonorchis sinensis eggs in pigment stones were the highest among the three types of gallbladder stones (P＜0.001).The 20 egg-positive stones were observed by scanning electronic microscopy:dozens or even hundreds of Clonorchis sinensis eggs were visible under 400 times magnification; and a dozen or even dozens of Clonorchis sinensis eggs and the surrounding particles were adherent to or parceled with each other under 1000 times magnification.While under 3000 times magnification,uneven texture was seen on the surface of eggs with pieces being shed from some eggs.Some eggs were hollow or without cover.Most of them were adherent to or wrapped with amorphous particles or mucoid matter.Conclusions A large amount of Clonorchis sinensis eggs were detected in gallbladder stones.Clonorchis sinensis eggs were associated with the formation of gallbladder stones,especially with pig ment stones.

OBJECTIVE:To evaluate the stability of tinidazole and cefotaxime sodium mixed in infusion fluid at 4℃,25℃ and 37℃ for 24 hours.METHODS:Tinidazole and cefotaxime sodium were determined by RP-HPLC method and the pH of solution was determined with a pH meter.RESULTS:There were no significant changes in pH of the solution at 4℃,25℃ and 37℃ for 24 hours; Along with the duration, there were significant changes in the appearance of solution and the concentrations of tinidazole and cefotaxime sodium.UV absorption curve of tinidazole and cefotaxime mixed solution revealed small changes at 4℃ for 6 hours, 25℃ for 2 hours and 37℃ for 1 hour, showing a new peak.CONCLUSION: Tinidazole and cefotaxime sodium mixed in infusion fluid were stable at 4℃ for 6 hours,25℃ for 2 hours and 37℃ for 1 hour.

Objective To develop a classification of gallbladder stones,to analyze the clinical characteristics of each type of stone and to provide a theoretical basis for the formation of different types of gallbladder stones.Method 925 consecutive patients with gallbladder stones were enrolled and their gallstones were studied.The material composition of the gallbladder stones was analyzed using fourier transform infrared spectroscopy and the distribution and microstructure of the material components were observed using scanning electron microscopy.The composition and distribution of the elements were analyzed by an X-ray energy spectrometer.Gallbladder stones were classified accordingly.Results The gallbladder stones were classified into 8 types and more than ten subtypes,including cholesterol stones (n =334),pigment stones (n =246),calcium carbonate stones (n =167),phosphate stones (n =14),calcium stearate stones (n =11),protein stones (n =3),cystine stones (n =1) and mixed stones (n =149).Mixed stones were those stones with two or more than two kinds of material components and the content of each component was similar.A total of 11 subtypes of mixed stones were found in this study.Conclusion The systematic classification of gallbladder stones indicated that different types of stones had different characteristics in terms of infrared spectrogram,microstructure,elemental composition and distribution,thus providing an important basis for the mechanistic study of gallbladder stones.

Objective To study the relationship between Clonorchis sinensis infestation and different types of gallbladder stones.Methods From May 2011 to September 2014, 1 052 cases of gallbladder stones were collected from the Department of General Surgery at The Sixth People's Hospital of Nansha, Guangzhou.These stones were first grinded for microscopic examination and divided into two groups based on the results of detection of Clonorchis sinensis eggs.They were then analyzed by FTIR spectroscopy to identify the type of gallbladder stones.Some stones were also chosen randomly for observation under scanning electron microscope (SEM).Results Clonorchis sinensis eggs were found in 300 stones and among these, the number and proportion of cholesterol, bile pigment, calcium carbonate, mixed and other types of stones were 28 (9.3％), 102 (34.0％), 102 (34.0％), 50 (16.7％), and 18 (6.0％), respectively.In the 752 egg-negative stones, the number and proportion of the above five types of stones were 414 (55.1％), 132 (17.6％), 66 (8.8％), 94 (12.5％), and 46 (6.1％), respectively.Observation under SEM showed a lot of tiny particles were absorbed on the mesh of the superficial texture of the Clonorchis sinensis eggs, which were also adherent to the bilirubin particles, calcium stearate crystals, phosphate, calcium stearate and protein particles.Conclusions The main types of egg-positive stones were bile pigment and calcium carbonate stones, while cholesterol stone was the main type of egg-negative stones.Clonorchis sinensis infestation was associated mainly with bile pigment and calcium carbonate stones.

Objective:To investigate the expression and clinical application value of exosomal circRPS6 in serum of colorectal cancer (CRC) patients.Methods:Peripheral serum samples were collected from 115 CRC patients admitted to Henan Provincial People′s Hospital from January 2019 to December 2020. There were 68 males and 47 females, aged (63.0±9.5) years. Meanwhile, one hundred and twenty healthy subjects from the same period wereenrolled, with 70 males and 50 females, aged (61.0±10.7) years. In addition, sixty pairs of tumor and adjacent tissue specimens from CRC patients undergoing surgical treatment were collected. The circRPS6 expression in serum exosome and tissue of CRC patients were detected via real-time fluorescence quantitative PCR (RT-qPCR), and its relationship with clinicopathological features and prognosis of CRC patients were also investigated. The levels of CEA and CA19-9 in serum were detected by electrochemiluminescence assay. The ROC curve and AUC were used to estimate the diagnostic capacity. Univariate and multivariate regression analysis was performed using Cox proportional hazard analysis.Results:The expression level of circRPS6 in CRC tissue was significantly higher than that in adjacent tissue( Z=5.38, P<0.001). Compared with healthy control, the expression of serum exosomal circRPS6 was significantly upregulated in the CRC group( t=14.52, P<0.001). ROC curve analysis results showed that the AUC of exosomal circRPS6 was 0.882, which had a higher diagnostic efficacy in CRC patients than CEA and CA19-9 detection. There was a positive correlation between the expression level of exosomal circRPS6 with TNM stage and lymph node metastasis and distant metastasis( P<0.05). Kaplan-Meier survival analysis revealed that CRC patients with low exosomal circRPS6 levels had a much longer average survival time compared with those in high group. Moreover,multivariate analysis results indicated that exosomal circRPS6 was an independent prognostic factor in colorectal cancer. Conclusion:Exosomal circRPS6 is highly expressed in the serum of CRC patients and correlated with malignant progression and poor prognosis, which is expected to be a potential marker for the diagnosis and prognosis evaluation of CRC patients.

Objective To investigate the diagnostic value of Bcl-2, miR-451 and Th17 cells in esophageal cancer and their relation with recurrence. Methods We selected 101 patients with esophageal cancer as the experimental group and 95 healthy patients as the control group. The correlation between the clinicopathological characteristics and the level of each peripheral blood index was analyzed. The ROC curve was used to analyze the diagnostic value of each peripheral blood index. Multiple linear regression analysis was used to analyze the relation between each index and tumor recurrence. Results Peripheral blood Bcl-2, miR-451 and Th17 cells in the experimental group were higher than those in the control group (all P < 0.05); differentiation degree, clinical stage, tumor diameter and lymph node metastasis were positively correlated with the levels of Bcl-2, miR-451, and Th17 cells (all P < 0.05). Bcl-2, miR-451 and Th17 cells in relapsed patients were higher than those in non-relapsed patients (all P < 0.05); after controlling other factors such as differentiation degree, clinical stage, tumor size and lymph node metastasis, the levels of Bcl-2, miR-451 and Th17 cells were significantly correlated with recurrence (all P < 0.05). Conclusion Bcl-2, miR-451 and Th17 cells in peripheral blood of esophageal cancer patients are abnormally expressed and their expression are closely related to differentiation degree, clinical stage and recurrence. The combined detection could provide an objective basis for clinical diagnosis and prognosis assessment.

Objective To evaluate the clinical curative effect and prognosis of hand-assisted laparoscopic (HALS) and laparoscopic assisted surgery for Siewert Ⅱ,Ⅲ gastroesophageal junction adenocarcinoma (AEG).Methods A retrospective analysis of 105 patients with advanced Siewert type Ⅱ and Ⅲ AEG between Jan 2012 and Jan 2013 was made on the operation time,amount of blood loss,number of lymph nodes dissected,postoperative complications,postoperative hospital stay and postoperative 5-year survival rate.Results HALS resulted in significantly shorter operation time and the average postoperative hospital stay [(203±54) min比(283±72) min,t=-4.902,P=0;(10±4) d 比(13±3)d,t=-0.939,P =0.002] for advanced Siewert type Ⅱ and Ⅲ AEG.There was no conversion to open surgery in HALS group,while there was 3 cases in laparoscopy assisted surgery group (x2 =4.118,P =0.042).5 year overall survival (OS) in HALS group was 46.7％ (95％ CI39.98-53.88),and it was 60.9％ for stage Ⅱ patients 37.8％ for stage Ⅲ.5 years OS rate was not significantly different between the two groups.Conclusion HALS compared with laparoscopy assisted surgery in the treatment of advanced Siewert type Ⅱ and type Ⅲ AEG has shorter operation time,higher safety operation,shorter postoperative recovery time.The number of patients with postoperative complications and the 5-year survival rate after surgery are not significantly different between the two groups.

Objective:To investigate expressions and clinical significance of plasma exosomal hsa_circ_0022417 in gastric cancer (GC).Methods:Sixty gastric cancer patients, 30 chronic gastritis patients (disease control group) and 30 healthy volunteers (healthy control group) were enrolled in this study. The expression levels of plasma exosomal hsa_circ_0022417 and serum CEA and CA19-9 were detected. The ROC curve and AUC were used to estimate the diagnostic capacity.Results:Compared with chronic gastritis patients and healthy control, the expression of plasma exosomal hsa_circ_0022417 was significantly upregulated in the gastric cancer group ( F=9.96, P<0.05). The expression level of hsa_circ_0022417 in GC tissue was significantly higher than that in adjacent tissue ( t=6.08, P<0.05). The AUC of hsa_circ_0022417, serum CEA and CA 19-9 was 0.79, 0.68 and 0.66, respectively. The combined detection of three indicators had the highest AUC (0.86) ( P<0.05). The expression level of exosomal hsa_circ_0022417 was significantly correlated with tumor size ( χ2=6.42, P<0.01), differentiation degree ( χ2=5.83, P=0.05), TNM stage ( χ2=7.14, P<0.05) and lymph node metastasis ( χ2=5.17, P<0.05). Conclusion:Exosome hsa_circ_0022417 is highly expressed in the plasma of GC patients, which is of great significance for clinical auxiliary diagnosis and early screening of GC.

Objective:This study aimed to investigate the expression of plasma exosomal hsa_circ_0064910 in gastric cancer (GC) patients, explore its correlation with the clinical pathological characteristics and evaluate its diagnostic efficacy in GC.Methods:Sixty patients with GC and 30 patients with Chronic Gastritis (disease control group) admitted to The First Affiliated Hospital of Henan University from October 2019 to December 2020 were selected. Meanwhile, 30 healthy subjects (healthy control group) who underwent physical examination were also enrolled. General data of GC patients were collected, including tumor size, degree of differentiation, TNM stage, lymph node metastasis, etc. Blood samples were collected before treatment and the expression levels of plasma exosomal hsa_circ_0064910 were detected via quantitative reverse transcription PCR (qRT-PCR). The serum concentrations of traditional biomarker (CEA and CA19-9) were measured via a chemiluminescent detection system. The receiver operating characteristic (ROC) curve and area under curve (AUC) were used to estimate the diagnostic capacity of different index in GC. Then, the expression difference of plasma exosomal hsa_circ_0064910 in GC patients before and after operation was analyzed, and its relationship with clinicopathological features of GC patients was also investigated.Results:RT-PCR results revealed that compared with Chronic gastritis patients and healthy control, the expression of plasma exosomal hsa_circ_0064910 was upregulated in the gastric cancer group(0.47±0.06, 0.43±0.05, 0.97±0.12, all P<0.001). The area under the ROC curve was 0.778, and AUC of the combination of CEA and CA19-9 for the diagnosis of gastric cancer was 0.841. which was higher than the diagnostic accuracies of CEA (AUC=0.673)and CA 19-9(AUC=0.653). The expression level of exosomal hsa_circ_0064910 was also significantly correlated with tumor size( χ2=7.545, P<0.01), TNM stage( χ2=4.571, P<0.05)and lymph node metastasis( χ2=6.907, P<0.01). The postoperative expression levels of exosomal hsa_circ_0064910 were lower compared with those of preoperative levels(1.21±0.21 vs 0.62±0.11, P<0.01). Conclusion:Our data demonstrated that exosomal hsa_circ_0064910 is highly expressed in GC patients and might be a potential noninvasive biomarker for the auxiliary diagnosis of GC.