Objective To evaluate the effects of pyruvate Ringer' s solution on erythrocyte deformation function in the patients undergoing cardiopulmonary bypass (CPB) in vitro.Methods Thirteen patients of both sexes,aged 25-64 yr,of ASA physical status Ⅱ or Ⅲ (NAHY Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement under CPB were enrolled in the study.At 10 and 60 min of CPB (T1,2) and 60 min after termination of CPB (T3),blood samples 18 ml were drawn from the radial artery and each patient's blood sample was equally divided into 6 parts (3 ml per part).The blood samples were divided into 3 groups (n =13 each):control group (group C),lactated Ringer's solution group (group R),and pyruvate Ringer's solution group (group P).In C,R and P groups,normal saline 1 ml,lactated Ringer's solution 1 ml,and pyruvate Ringer's solution 1 ml were added,respectively,and then the erythrocytes were incubated for 60 min at 37 ℃.At 30 and 60 min of incubation,the erythrocyte rigidity index (ERI) and erythrocyte deformation index (EDI) were detected.Results Compared with C and R groups,the ERI was significantly decreased at 30 and 60 min of incubation at T1,the EDI was decreased at 30 min of incubation at T1,2,and no significant change was found in ERI at T2,3 or in EDI at T3 in group P.There was no significant difference in ERI and EDI at different time points of incubation within groups.Conclusion Pyruvate Ringer's solution can enhance erythrocyte deformation function in the patients undergoing CPB.

Objective To investigate the clinical and pathological features of patients with esophageal neuroendocrine carcinoma (ENEC).Methods From January 2011 to November 2018,107 patients with pathologically confirmed ENEC were enrolled at the First Affiliated Hospital of Zhengzhou University.The clinical manifestation,tumor location,tumor size,clinical pathological classification and immunohistochemical markers were analyzed.Statistical description was used for measurement data analysis,and chi-square test was performed for classification data analysis.Results Among 107 patients with ENEC,feeling obstruction during eating was the most common initial symptom,accounting for 63.6％ (68/107);followed by chest and back pain,accounting for 13.1％ (14/107).About 60.7％ (65/107) patients were diagnosed by biopsy under endoscopy and 39.3％ (42/107) patients were confirmed by pathological diagnosis after surgery.The proportion of tumor located in the upper thoracic esophagus and middle and lower thoracic segments was 13.1％ (14/107),45.8％ (49/107) and 41.1％ (44/107),respectively.The length of tumor was 0.7 cm to 9.0 cm,and the median was 2.5 cm.Among them,57.0％ (61/107) were less than 2.5 cm and 43.0％ (46/107) were over 2.5 cm.Among 107 patients,50 (46.7％) patients were ulcerative type,32 (29.9％) patients were medullary type,16 (15.0％) patients were mushroom type and nine (8.4％) patients were protrude type.Among 107 patients,96 (89.7％) patients were pure neuroendocrine carcinoma (P-NEC;including 95 small cell types,one large cell type);11 (10.3％) patients were mixed neuroendocrine carcinoma (M-NEC;including nine small cell carcinoma mixed with squamous cell carcinoma,two small cell carcinoma mixed with adenocarcinoma).The positive rates of synaptophysin,CD56 and chromogranin A were 99.0％ (104/105),98.0％ (100/102) and 31.5％ (17/54),respectively.Ki-67 proliferation index of 47.7％ tumors (51/107) was between 90％ and 100％.P-NEC with the maximum diameter over 2.5 cm accounting for 42.1％ (45/107),and M-NEC accounting for 0.9％ (1/107).The maximum diameter of P-NEC group was larger than that of M-NEC group,and the difference was statistically significant (x2 =4.311,P =0.038).Conclusions ENEC is a kind of highly aggressive malignant tumor with nonspecific manifestations.The diagnosis mainly depends on histopathology and immunohistochemistry.

Tryptophan 2,3-dioxygnease 2 (TDO2) is specific for metabolizing tryptophan to kynurenine (KYN), which plays a critical role in mediating immune escape of cancer. Although accumulating evidence demonstrates that TDO2 overexpression is implicated in the development and progression of multiple cancers, its tumor-promoting role in esophageal squamous cell carcinoma (ESCC) remains unclear. Here, we observed that TDO2 was overexpressed in ESCC tissues and correlated significantly with lymph node metastasis, advanced clinical stage, and unfavorable prognosis. Functional experiments showed that TDO2 promoted tumor cell proliferation, migration, and colony formation, which could be prevented by inhibition of TDO2 and aryl hydrocarbon receptor (AHR). Further experimentation demonstrated that TDO2 could promote the tumor growth of KYSE150 tumor-bearing model, tumor burden of C57BL/6 mice with ESCC induced by 4-NQO, enhance the expression of phosphorylated AKT, with subsequent phosphorylation of GSK3