Objective To explore the expression and significance intergrin alphavbeta3(art33)in the kidney of patients with IgA nephropathy(IgAN).Methods lmmunohistochemistry wag applied to detect the expression of avl33。fibronectin(Fn)and Connective tissue growth factor(CTGF)in the kidney of patients with IgAN.and correlation analysis was done with pathology and clinic index.Result With the development of the disease,the expression of etvl33 was gradually increased in the glomemlar capillary endothelial cell.and mesansial cell as well as glomerular crescent.The positive area ratio of αvβ33 in renal glomerulus was(16.18±o.98,19.58±0.99,28.35±1.99,17.72±2.17)％respectively in grade I～Ⅳ pathological changes.Among all the groups,the expression of αvβ33 was the strongest in grade Ⅲ,while decreased in grade Ⅳ(P

Objective To evaluate the anti-tumor activity and toxicity of FOLFIRI regimen in the treatment of patients with advanced colorectal cancer. Methods 22 patients with advanced colorectal cancer used Irinotecan combined with 5-Fu/CF regimen to chemotherapy. Regimen: CPT-11 150 mg/m2 iv drip d1, CF 200 mg/m2 iv drip 2 h d1, 2; 5-Fu 400 mg/m2 iv drip d1, 2; 5-Fu 600 mg/m2 iv drip 22 h d1, 2. It is repeated every 2 weeks, two times a course. Efficiency and toxicity was evaluated after 4-6 cycles. Results Forty four patients were evaluated the efficiency. Two patients achieved CR, 16 PR, response rate was 40.9 %; MST was 11.3 months. TTP was 6.5 months. The main toxicity was cholinergic syndrome and delayed diarrhea,myelosuppression. There were no deaths during treatment. Conclusion The effectiveness of FOLFIRI regimen was higher and side effects was minor in advanced colorectal cancer. It should be further used and studied.

Purpose: The clinical effects of scalp acupuncture in treating infantile cerebral palsy were observed. Methods: Forty-five patients were treated by scalp acupuncture, functional exercise, intravenous drip,and parents' instructive training. Results: Basic recovery occurred in 4 cases, marked effectiveness in 21 cases and effectiveness in 15 cases. The total effective rate was 88.9%. The shorter duration and the longer course were,the better curative effects got. Conclusion: A combined treatment of scalp acupuncture, physiotherapy and intravenous drip can markedly improve clinical symptoms, signs, and intelligence in children with cerebral palsy.

OBJECTIVETo compare the expression patterns of cytokeratin 7 (CK7) and CK20 in the Barrett's esophagus and gastric cardia intestinal metaplasia.

METHODSEndoscopic biopsy specimens from 19 patients with long segment Barrett's esophagus, 36 with short segment Barrett's esophagus, and 20 with histological evidence of gastric cardia intestinal metaplasia were immunostained for CK7 and CK20. The immunohistochemical data were analyzed in relation with the clinicopathological data of the patients including age, hiatal hernia, and Helicobacter pylori status.

RESULTSThe Barrett's pattern of CK7/20 expressions was found in all the 19 patients with long segment Barrett's esophagus, in 31 of the 36 (82%) patients with short segment Barrett's esophagus, and in 2 of the 20 (10%) patients with gastric cardia intestinal metaplasia. Patients with short segment Barrett's esophagus who had a Barrett's CK7/20 pattern showed similar clinicopathological findings to those with long segment Barrett's esophagus, while in cases of short segment Barrett's esophagus where no Barrett's CK7/20 pattern was found, the clinicopathological features were similar to those of gastric cardia intestinal metaplasia cases.

CONCLUSIONA Barrett's CK7/20 expression pattern is an objective marker of Barrett's mucosa. CK7 and CK20 reactivity patterns in routine endoscopic biopsy samples can reliably identify the location of intestinal metaplasia in the esophagus and stomach.

Adult ; Aged ; Barrett Esophagus ; diagnosis ; metabolism ; pathology ; Biomarkers ; metabolism ; Cardia ; metabolism ; pathology ; Female ; Humans ; Keratin-20 ; metabolism ; Keratin-7 ; metabolism ; Male ; Middle Aged ; Reagent Kits, Diagnostic

Objective To develop the analytical method of dexmedetomidine in human plasma by solid phase extraction with gas chromatography-mass spectrometry(SPE-GC/ MS). Methods The human plasma were extracted with a solid phase extraction(SPE) and determined by GC/MS. Results The lowest detectable limit was 0.05μg/mL, the standard curve was linear over the range of 0.2μg/mL~5μg/mL. The absolute recovery was 86.1%~91.5%. The intra-and interday precision was within 7.86% at three concentrations. Conclusion Since the procedure proved to be simple, quick and sensitive, it could be used for the determination of dexmedetomidine in human plasma.

Objective:To investigate the efficacy of additional treatment (chemoradiotherapy or esophagectomy) after endoscopic submucosal dissection (ESD) for superficial esophageal squamous cell carcinoma.Methods:Clinicopathological data of 97 patients of esophageal squamous cell carcinoma with infiltration depth of M3-SM3 who underwent ESD in Zhongda Hospital from July 2014 to April 2019 were reviewed. There were 57 patients in the additional treatment group and 40 patients in the observation group. The rate of relapse-free survival (RFS) was evaluated by Kaplan-Meier method (used log-rank test).Results:In the additional treatment group, 15 underwent esophagectomy after ESD, and no tumor metastases were found, but 1 patient died of upper gastrointestinal bleeding after surgery; 42 underwent chemoradiotherapy, and all patients were alive, but 3 patients experienced distant metastases. In the observation group, 13 patients experienced local recurrence, 2 patients died of tumor recurrence and 1 patient died of cerebrovascular disorder. Kaplan-Meier analysis showed that the RFS rate of the additional treatment group was higher than that of the observation group ( P=0.001). Conclusion:ESD followed by additional chemoradiotherapy or esophagectomy has good clinical efficacy and can improve prognosis for superficial esophageal squamous cell carcinoma (M3-SM3) patients.

Objective To establish a neural network model based on enhanced CT for distinguishing ISUP grade of clear cell renal cell carcinoma (ccRCC). Methods We collected 131 cases of ccRCC, with 92 cases of low ISUP grade and 39 cases of high ISUP grade. Patients were divided into training set and validation set according to 5:5 stratified sampling. The enhanced CT images of each ccRCC patient were evaluated by the radiologist. Recursive feature elimination (RFE) was used to reduce the dimension of patients' general features and enhanced CT features, which was used for neural network modeling and validation. Results Patients' general features and enhanced CT features were verified by RFE method and then reduced to 14 features. The top 5 features were growth pattern, necrosis, enlargement of lymph nodes, tumor size and capsule. The AUC of the neural network model based on these 5 features in training set was 0.8844 (95%CI: 0.8062-0.9626), sensitivity was 89.47% and specificity was 82.61%; and those in validation set were 0.7924 (95%CI: 0.6567-0.9280), 75.00% and 86.96%, respectively. Conclusion The neural network model of ccRCC ISUP grade based on enhanced CT has relatively high diagnostic efficiency.

OBJECTIVETo investigate the association of the expressions of angiopoietin-2 (Ang-2), vascular endothelial growth factor (VEGF) in colorectal cancer tissues with Dukes' clinicopathological features.

METHODSAng-2 and Tie-2 mRNA expressions were detected in colorectal cancer tissues, adjacent tissues, and normal tissues by real time-PCR. Quantikine immunoassays were used to measure the protein expressions of Ang-2 and VEGF in the tissues and serum samples.

RESULTSAng-2 and Tie-2 levels were significantly higher in the serum of the patients than in the normal tissues (P<0.05), and their expressions were strongly correlated (r=0.879, P=0.000). Tumor tissue Ang-2 and VEGF levels were significantly higher than their levels in the adjacent and normal tissues (P<0.05). In colorectal cancer patients, the peripheral blood level of Ang-2 was significantly higher than that in healthy control subjects, and comparable with that in mesenteric blood (P>0.05). In Dukes' stage C and D patients, serum Ang-2 and VEGF levels were significantly higher than those in patients in Dukes' stage A and B (P<0.05).

CONCLUSIONAng-2 and VEGF over expressions may play an important role in the occurrence and progression of colorectal cancer.

Adult ; Aged ; Angiopoietin-2 ; blood ; metabolism ; Case-Control Studies ; Colorectal Neoplasms ; blood supply ; metabolism ; pathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Middle Aged ; Neovascularization, Pathologic ; Vascular Endothelial Growth Factor A ; blood ; metabolism

Objective To investigate the effect of rebamipide on chronic non-atrophic gastritis (NAG) with erosion and its protection of gastric mucosa from Helicobacter priori(Hp) associated lesions.Methods Patients(n=452)with endoscopically confirmed NAG with erosion from 11 hospitals in China were enrolled and randomly assigned at a ratio of 3:1 to receive either rebamipide(100 mg t.i.d.)or sucralfate(1.0 t.i.d.)for 8 weeks.Hp infected patients received eradication treatment before randomization.Symptoms,endoscopic scores and histological changes were recorded before and after therapy.Concentrations of serum prostaglandin E(PGE:)and oxygen free radical(MDA)were measured in patients from 2 centers.Results Per-protocol analysis(n=415)showed that the dyspeptic symptom score in rebamipide group decreased significantly after eight weeks of treatment. The endoscopic inflammation score in rebamipide group also decreased from 2.65 ±0.09 to 0.60±0.10(P<0.001),which was,significantly better than that of sucralfate group(P<0.001).Histological findings were consistent with the endoscopic findings.There Was a significant elevation(P=0.002)in PGE2 concentration in mucesa from rebamipide-treated subjects [(225.4±18.3) pg/g vs.(266.7±14.7)Pg/g] compared with that in sucralfate group.The concentration of MDA significantly decreased from(325.9±65.6)mmoL/g to(216.5±61.5)mmol/g,which is markedly different from that of sucralfate group(P=0.046).No statistical difference was found between Hp eradication group,Hp infection group and Hp negative group,regarding the effect of Rebamipide.Conclusion Compared to sucralfate,Rebamipide demonstrates a superior effect on improvement of dyspepsia symptom and endoscopic findings in erosive NAG,which is not influenced by Hp infection.

Objective:To investigate the medium- and long-term efficacy of peroral endoscopic myotomy (POEM) for esophageal diverticulum and the risk factors for postoperative recurrence.Methods:A retrospective study was conducted on 31 cases of esophageal diverticulum who were treated by POEM in Zhongda Hospital, Southeast University from May 1st 2016 to August 1st 2019. The Eckardt score, the operative success rate, and the recurrence rate after the operation were observed and recorded. Multivariate logistic regression analysis was performed to explore the risk factors for postoperative recurrence.Results:POEM was successfully completed in all 31 patients, who were followed up for 30.6±11.1 months (20-63 months). The Eckardt score before the operation was 8.2±2.4, and was 1.4±0.7, 1.4±1.1, 1.3±1.1, and 1.3±0.9 at 1, 6, 12 and 24 months, respectively after the operation, which significantly decreased at all follow-up time points ( P<0.001). The success rates at 1, 6, 12, and 24 months after the operation were 96.8% (30/31), 90.3% (28/31), 90.3% (28/31) and 90.3% (28/31), respectively. Three patients suffered symptom relapse, with an overall recurrence rate of 9.7% (3/31). Logistic regression analysis showed that the disease duration ( P=0.038, OR=1.041, 95% CI: 1.002-1.080) and preoperative Eckardt score ( P=0.024, OR=2.299, 95% CI: 1.117-4.728) were risk factors for postoperative recurrence of POEM. Conclusion:POEM is safe and effective for esophageal diverticulum. Patients with long disease duration and high preoperative Eckardt score are associated with recurrence.