Adult ; Aged ; Carcinoma, Hepatocellular ; metabolism ; Cell Line, Tumor ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Liver Neoplasms ; metabolism ; Male ; Middle Aged ; Proto-Oncogene Proteins ; metabolism

Objective: To evaluate the safety and efficacy of dental floss traction-assisted endoscopic submucosal dissection (DFS-ESD) for rectal neuroendocrine neoplasm (NEN). Methods: A retrospective cohort study was performed. Clinical data of rectal NEN patients undergoing ESD at Endoscopy Center of Zhongshan Hospital, Fudan University from January 2016 to December 2017 were retrospectively analyzed. Inclusion criteria: 1) age of 18 to 80 years old; 2) maximal diameter of lesions <1.5 cm; 3) tumor locating in the submucosa without invasion into the muscularis propria; 4) no enlarged lymph nodes around bowel and in abdominal cavity; 5) ESD requested actively by patients. A total of 37 patients were enrolled, including 23 male and 14 female cases with mean age of (56.0±11.3) years. All the lesions were single tumor of stage T1, and the mean size was 0.8±0.2(0.5-1.2) cm. Postoperative pathology revealed all samples as neuroendocrine tumors (NET). Seventeen patients received DFS-ESD treatment (DFS-ESD group) and 20 patient received conventional ESD treatment (conventional ESD group). In DFS-ESD group, after the mucosa was partly incised along the marker dots, the endoscopy was extracted, and the dental floss was tied to one arm of the metallic clip. When the endoscope was reinserted, the hemoclip was attached onto the incised mucosa; another hemoclip was attached onto normal mucosa opposite to the lesion in the same way. The submucosa was clearly exposed with the traction of dental floss and the resection could proceed. The conventional ESD group received the traditional ESD operation procedure. The operation time, modified operation time (remaining time after excluding the assembly time of dental floss traction in DFS-ESD group), en bloc resection rate, R0 resection rate, morbidity of operative complication, recurrence and metastasis were compared between two groups. Results: The average tumor size was (0.8±0.2) cm in DFS-ESD group and (0.7±0.2) cm in conventional ESD group (t=0.425, P=0.673). According to postoperative pathological grading of rectal neuroendocrine neoplasm, 13 were G1 and 4 were G2 in DFS-ESD group, while 17 cases were G1 and 3 cases were G2 in conventional ESD group without significant difference (P=0.680). There were no significant differences in baseline data between in the two groups (all P>0.05). All the basal resection margins were negative, the en bloc resection rate was 100% and the R0 resection rate was 100%. Pathological results showed tumor tissue close to the burning margin in 5 cases of conventional ESD group and in 2 cases of DFS-ESD group (P=0.416). The operation time was (17.9±6.6) minutes in conventional ESD group and (14.7±3.3) minutes in DFS-ESD group (t=1.776, P=0.084). The modified operation time of DFS-ESD group was (11.9±2.8) minutes, which was significantly shorter than (17.9±6.6) minutes in conventional ESD group (t=3.425, P=0.002). The hospital stay was (2.3±0.6) days and (2.0±0.5) days in conventional ESD group and DFS-ESD group, respectively, without significant difference (t=1.436, P=0.160). No patient was transferred to surgery, and no delayed bleeding or perforation occurred in either group. There was no recurrence or primary tumor-related death, and all the patients recovered well during a follow-up period of 14(1-24) months. Conclusion Dental floss traction-assisted ESD for rectal neuroendocrine neoplasm can simplify operation and ensure negative basal margin.

OBJECTIVETo explore the relationship between genetic polymorphisms of 3 single nucleotide polymorphisms (SNPs) in the elastin microfibril interfacer 1 (EMILIN1) gene and essential hypertension.

METHODSA case-control study was conducted in which 201 hypertensive patients and 202 healthy controls in Mongolian population were enrolled, and the genotypes of rs3754734, rs2011616 and rs2304682 loci were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and direct sequencing techniques.

RESULTSThere were significant differences in the frequencies of alleles and genotypes for the rs2304682 between the hypertensives and normotensives in the population (P<0.05). The frequency of the G-G haplotype established by rs3754734 and rs2304682 was significantly higher in the hypertensive patients (P<0.05). The frequencies of alleles and genotypes for the rs2304682 also had significant differences between the group with high diastolic blood pressure and normal diasto lic blood pressure (P<0.05).There were no significant differences in the frequencies of alleles and genotypes for the 3 SNPs between the group with high systolic blood pressure and normal systolic blood pressure (P>0.05).

CONCLUSIONThe rs2304682 locus in the EMILIN1 gene, as well as the haplotypes G-G constructed using rs3754734 and rs2304682, may associate with the susceptibility of essential hypertension in the Mongolian population. Also, rs2304682 may associate with the level of the diastolic blood pressure.

Blood Pressure ; genetics ; Case-Control Studies ; Genetic Predisposition to Disease ; Humans ; Hypertension ; genetics ; Membrane Glycoproteins ; genetics ; Middle Aged ; Mongolia ; Polymorphism, Single Nucleotide

OBJECTIVETo explore the clinical factors affecting the sensitivity of EGFR-TKI treatment in advanced non-small cell lung cancer.

METHODSClinical data were retrospective analyzed to determine the clinical factors affecting the outcome of 166 patients with advanced non-small cell lung cancer who received EGFR-TKI treatment in our hospttal from January of 2005 to December of 2006.

RESULTSOne hundred and nineteen patients benefited from EGFR-TKI treatment in the total of 166 patients and the disease control rate was 71.7%. Among the factors analyzed, sex, age, smoking, pathological type, brain and bone metastasis or not when EGFR-TKI was used, the time using EGFR-TKI and the level of LDH at the time of diagnosis had no significant effect on the clinical benefit rate. Among the 126 patients with serum CEA assayed at diagnosis, 84 cases had a higher serum CEA level. Compared with the patients with normal serum CEA level, the patients with a higher serum CEA level benefited more easily from EGFR-TKI therapy, with a disease control rate of 79.8% and 59.5%, respectively (P = 0.016). Among the patients who got benefits from EGFR-TKI treatment, smoking and the CEA level at diagnosis had effects on the duration of progression-free survival. The progression free survivals were 9.57 ± 6.75 months in non-smokers, 4.86 ± 3.44 months in light-smokers and 5.25 ± 4.34 months in heavy-smokers (P = 0.007). The progression free survival was 9.45 ± 7.48 months in the group with a higher serum CEA level and 6.52 ± 4.46 months in the group with normal serum CEA level (P = 0.036).

CONCLUSIONSIn patients with advanced non-small cell lung cancer, EGFR-TKIs treatment is safe and effective. The patients with high CEA level are prone to benefit from it.

Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Bone Neoplasms ; drug therapy ; secondary ; Brain Neoplasms ; drug therapy ; secondary ; Carcinoembryonic Antigen ; blood ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; pathology ; secondary ; Disease-Free Survival ; Erlotinib Hydrochloride ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; blood ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Protein Kinase Inhibitors ; therapeutic use ; Quinazolines ; therapeutic use ; Receptor, Epidermal Growth Factor ; antagonists & inhibitors ; Retrospective Studies ; Smoking

AIM: To study the Amaryllidaceae alkaloids of the bulbs of Lycoris radiata. METHODS: The chemical constituents were isolated and purified by various chromatographic techniques, and the chemical structures were elucidated on the basis of spectroscopic methods. In addition, the antiviral activities of alkaloids 1-10 were evaluated using flu virus A. RESULTS: One new homolycorine-type alkaloid 2α-methoxy-6-O-ethyloduline (1), together with nine known alkaloids 2α-methoxy-6-O-methyloduline (2), trispherine (3), 8-O-demethylhomolycorine (4), homolycorine (5), 9-O-demethylhomolycorine (6), oduline (7), lycorenine (8), 6α-O-methyllycorenine (9) and O-ethyllycorenine (10) were obtained. CONCLUSION Alkaloid 1 is a new compound, and 1-3 were major alkaloids in this plant. Alkaloids 1-3 showed weak antiviral activities against flu virus A with IC50 values of 2.06, 0.69, and 2.71 μg·mL-1 and CC50 values of 14.37, 4.79, and 80.12 μg·mL-1, respectively.
Alkaloids ; chemistry ; isolation & purification ; pharmacology ; Antiviral Agents ; chemistry ; isolation & purification ; pharmacology ; Flowers ; chemistry ; Influenza A virus ; drug effects ; Lycoris ; chemistry ; Molecular Structure ; Plant Extracts ; chemistry ; isolation & purification ; pharmacology

Objective To evaluate the safety and efficacy of therapeutic ERCP for patients above 90 years of age.Methods The data of 37 patients of above 90 years who underwent 42 ERCP procedures from January 2001 to December 2009 were studied retrospectively and compared with those of 152 matched patients ( 168 procedures) below 65 years old at a 1∶4 ratio for success rate and complications.Results The rate of complete success,partial success,and failure in observation group was 73.81％ (31/42),19.05％(8/42) and 2.38％ (1/42),respectively,which were similar (P ＞0.05) with those in control group,with complete success rate at 85.12％ ( 143/168),partial success rate at 12.50％ (21/168) and failure rate at 2.38％ (4/168).The rate of terminated operation in observation group (4.76％,2/42) was significantly higher than that of the control group (0.00％,0,P =0.039).The overall rate of complication in observation group was 7.14％ ( 3/42 ),slightly higher than that of the control group ( 6.55％,11/168,P ＞0.05 ).There was no significant difference between the two groups regarding the rates and severity of such complications as pancreatitis,hemorrhage and infection ( P ＞ 0.05 ).No perforation or death was observed.Conclusion Therapeutic ERCP for patients of 90 years or older is safe and effective.Adverse events related to chronic concomitant diseases need early detection and proper management.

OBJECTIVE：To study the effects of Cu rcumin solid lipid n anoparticels （Cur-SLN） on cardiac ，renal and pulmonary functions ，the expression of autophagy related factors in cardiorenal syndrome model rats. METHODS ：The rats were divided into sham operation group ，model group ，rapamycin group （positive control ，2 mg/kg），Cur-SLN low-dose and high-dose groups（5，10 mg/kg），except for 13 rats in the model group （3 of which are used to judge whether modeling is successful ），10 rats in the other groups. Except for sham operation group ，cardiorenal syndrome of other groups were induced by abdominal aortic coarctation combined with acute renal ischemia-reperfusion injury. After successful modeling ，rats in each administration group were injected with corresponding drugs through caudal vein ，and rats in sham operation group and model group were injected with equal volume normal saline ，once a day for 4 weeks. Twenty-four hours after the last administration ，the contents of angiotensin converting enzyme （ACE），free triiodothyronine （FT3） and arginine vasopressin （AVP） in rat serum were detected. The pathological morphology of rat heart ，kidney and lung were observed. The distribution and expression of LC 3 and Beclin- 1 protein in rat heart ，kidney and lung were detected. RESULTS ：Compared with sham operation group ，the contents of ACE and FT 3 in serum，the indexes of heart and kidney ，the expression of LC 3（except in renal tissue ）and Beclin- 1 protein in heart ，kidney and lung were significantly increased （P＜0.01），and the contents of AVP and lung index were decreased significantly （P＜0.01）； myocardial cells in the non-infarcted area of the heart were obviously hypertrophic ，the arrangement of myocardial fibers was disordered ； the structure of renal tubules in the non-infarcted area of the kidney was disordered ；and there was cystic expansion and obvious inflammatory cell infiltration llittls- in the alveoli ；positive expression of LC 3 and Beclin- 1 protein nows@126.com in heart ，kidney and lung increased ，mainly distributed in the cytoplasm of cardiomyocytes ，distal renal tubular epithelial cells ，alveolar macrophages and epithelial cells. Compared with model group，the above indexes of rats in each dose group of Cur-SLN were mostly significantly reversed ；the pathological changes of heart，kidney and lung tissues were reduced ，the infiltration of inflammatory cells was reduced ；and the positive expression of LC 3 and Beclin- 1 protein were reduced ，which were mainly distributed in the cytoplasm of cardiomyocytes and proximal renal tubular epithelial cells ，and a few in distal renal tubular epithelial cells ，alveolar macrophages and epithelial cells. CONCLUSIONS ： Cur-SLN can improve the heart ，kidney and lung functions of rats with cardiorenal syndrome ，and its mechanism may be related to regulating the distribution or expression of LC 3 and Beclin- 1 protein in heart ，kidney and lung.

Objective To analyze the burden and changing trend of testicular cancer in China from 1990 to 2019.Methods Based on the 2019 Global Burden of Disease Database(GBD 2019),analyze the incidence,mortality,disability-adjusted life years(DALYs),years of life lost(YLLs),years lived with disability(YLDs)and their variation trend of testicular cancer in Chinese population from 1990 to 2019.Evaluating changes in age standardized rate(ASR)by calculating annual estimated percentage change(EAPC).According to the age grouping,analyze the age distribution characteristics of testicular cancer disease burden by age group.Results In 2019,the incident cases,deaths,age-standardized incidence rate,and age-standardized mortality rate of testicular cancer in China were 17.17×103,1.21×103,2.39/105,and 0.16/105,respectively.Compared to 1990,incident cases,deaths,and age-standardized incidence rate increased obviously in China,which was consistent with the global change trend,while the increase was higher than the global level.However,both Chinese and global age-standardized mortality rate showed a downward trend.From 1990 to 2019,DALYs,YLLs and YLDs of testicular cancer increased by 29.66%,9.83%and 720.91%respectively in China.The two age groups,0-15 years group and 30-35 years group,were with highest incidence of testicular cancer,while the highest disease burden of testicular cancer was 30-35 years.Conclusion From 1990 to 2019,the disease burden of testicular cancer in China showed an upward trend.Adolescents and young adults should be the priority population for screening and prevention due to their higher incidence and disease burden.

OBJECTIVEThis study aims to study the effect of the improved partial denture treatment in the rehabilitation of patients with temporomandibular joint disorders (TMD).

METHODSTwenty middle-aged and old patients suffering from osteoarthrosis were treated with the improved partial denture treatment. These patients were followed up during the partial denture treatment and after the rehabilitation. Both the clinical symptoms and Fricton's craniomandibular index were used to evaluate the clinical effects. Data were analyzed using SPSS17.0.

RESULTSThe effective rate reached 100% when the patients wore partial dentures for 1 month. All of the 20 patients were comfortable with temporomandibular joint, and they expressed ultimate satisfaction with the denture. The Fricton indexes of 20 patients decreased significantly after the treatment (P<0.05).

CONCLUSIONSPartial denture treatment is an ideal method in rehabilitation for patients with TMD (osteoarthrosis) and dentition defect.

Humans ; Renal Artery ; Constriction, Pathologic ; Hypertension, Renovascular/therapy* ; Vascular Diseases ; Renal Artery Obstruction/therapy* ; Embolization, Therapeutic