Objective To investigate the effect of Matrine on the expression of X-linked inhibitor of apoptosis protein (XIAP) in human rhabdomyosarcoma RD cells in vitro.Methods Cultured human rbabdomyosarcoma RD cells were divided into Matrine intervention groups (0.5 g/L,1.0 g/L and 1.5 g/L) and a control group.The proliferation-inhibition rates in RD cells treated with different concentrations of matrine were detected by methylthiazolyl blue colorimetric assay.Flow cytometry analysis was performed for the apoptosis rates of RD cells.Reverse transcription-polymerase chain reaction analysis was used to measure the XIAP mRNA expression.Results There was a significant difference in the proliferation-inhibition rates [0.5 g/L Matrine group:(15.84 ± 2.58)％,1.0 g/L Matrine group:(23.13 ±4.19)％,1.5 g/L Matrine group:(30.32 ±3.02)％,and the control group:(8.92 ± 1.23)％];apoptotic rates [0.5 g/L Matrine group:(12.33 ± 1.15)％,1.0 g/L Matrine group:(16.67 ± 0.99)％,1.5 g/L Matrine group:(25.33 ± 1.91)％,and the control group:(9.47 ± 0.96)％];XIAP mRNA expression(0.5 g/L Matrine group:0.633 ± 0.046,1.0 g/L Matrine group:0.441 ± 0.055,1.5 g/L Matrine group:0.326 ± 0.065,control group:0.794 ±0.029)in RD cells among 0.5 g/L,1.0 g/L,1.5 g/L Matrine groups and the control group (F =14.15,83.37,50.57,all P ＜ 0.05).The proliferation-inhibition and apoptotic rates in RD cells were gradually increased with the increasing Matrine concentration.The expression of XIAP mRNA was significantly decreased in different Matrine groups compared with the control group,exhibiting a dose-dependent manner.Conclusions Matrine can inhibit the proliferation of RD cells and induce the apoptosis in a dose-dependent manner,which may be related to the down-regulated XIAP mRNA.

Objective To observe the clinical efficacy of electroacupuncture in treating herpes zoster.Method Ninety patients with herpes zoster were randomized into treatment group 1, treatment group 2, and a control group, 30 cases in each group. Treatment group 1 was intervened by surround needling at Ashi points (deep needling, by 33 mm) plus electroacupuncture; treatment group 2 was by surround needling at Ashi points (superficial needling by 16 mm) plus electroacupuncture; the control group was by oral administration of Valacyclovir Hydrochloride tablets plus Vitamin B1. After 10-day treatment, the blister-breaking time, crust-forming time, and the time of falling-off of the crust, and Visual Analogue Scale (VAS) were observed, and the clinical efficacies were compared.Result The recovery rate and total effective rate were respectively 73.3% and 93.3% in treatment group 1, versus 46.7% and 86.7% in treatment group 2, and 33.3% and 63.3% in the control group. The recovery rate of treatment group 1 was significantly different from that of treatment group 2 and the control group (P<0.01,P<0.05). The total effective rates of treatment group 1 and 2 were both significantly different from that of the control group (P<0.01,P<0.05). The blister-breaking time, crust-forming time, and crust falling-off time of treatment group 1 were significantly different from that of treatment group 2 and the control group (P<0.01,P<0.05). The crust-forming time and falling-off time of treatment group 2 were significantly different from that of the control group (P<0.05). The VAS scores were markedly changed after the intervention in the three groups (P<0.01). After the treatment, the VAS scores of treatment group 1 and 2 were significantly different from that of the control group (P<0.01). The VAS score of treatment group 1 was markedly different from that of treatment group 2 after the treatment (P<0.05).Conclusion Electroacupuncture is an effective method in treating herpes zoster, while deep surround needling at Ashi points plus electroacupuncture can effectively inhibit the development of blisters, promote crust-forming, release the neural pain, and reduce the incidence of postherpetic neuralgia.

Hepatic stellate cell (HSC) activation is closely associated with the progression of liver fibrosis.As an important component of the innate immune system,natural killer (NK) cells are enriched in the liver and play a key role in host defense against viral infection and tumor,and their anti-fibrotic effect has also been confirmed.NK cells can reduce liver fibrosis by killing early-activated or senescent HSCs or secreting interferon-γ.This article summarizes related research advances in recent years,and introduces the molecular immunological mechanism of NK cells in regulating HSCs and their potential anti-fibrotic effect based on the function and phenotype of NK cells and HSCs.

Objective:To observe the influence of multi-disciplinary cooperation and optimization management mode on the negative situation and rehabilitation effect of patients with affective disorder after coronary heart disease and cerebrovascular disease.Methods:A total of 188 patients with emotional disorders caused by coronary heart disease and cerebrovascular disease from January 2017 to December 2018 to our hospital were selected. According to the random number method, 94 cases in the control group adopted the conventional management model, and 94 cases in the experimental group adopted the multidisciplinary collaborative optimization management model. The negative emotions [evaluated by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale(SDS) ] scores before and after management, the coping style (Jalowies) scores, and quality of life [evaluated by World Health Organization Quality of Life-Brief (WHOQOL-BREF) ] scores were compared between the two groups. The clinical rehabilitation effect and satisfaction rate of related management between the two groups were compared.Results:There were no significant differences between the two groups before management of SAS scores, SDS scores, Jalowies scores, and WHOQOL-BREF quality of life scores ( P> 0.05). After management, the SAS scores and SDS scores of the two groups were significantly reduced, and the Jalowies scores and WHOQOL-BREF quality of life scores were significantly increased. After management, the SAS score and SDS score of the experimental group were 47.32±5.68, 49.93±6.49 and 54.95±6.59, 55.33±8.30 in the control group, the difference was significant between two groups ( t value was 8.503, 4.969, P<0.01). The Jalowies scores and WHOQOL-BREF scores of the experimental group were higher than those of the control group ( t value was -27.662--4.290, P<0.01). The total effective rate of rehabilitation in the experimental group was 98.94%(93/94), which was significantly higher than 90.43%(85/94) in the control group, the difference was statistically significant ( χ2 value was 6.760, P <0.05). The total satisfaction rate of the experimental group for management intervention was 100.00%(94/94), which was significantly higher than the total satisfaction rate of the control group, 91.49%(86/94), the difference was statistically significant ( χ2 value was 6.397, P <0.05). Conclusions:In the patients with affective disorder caused by coronary heart disease and cerebrovascular disease, multi-disciplinary cooperation and optimization management mode can significantly reduce the negative emotions of patients after management, improve the way of patients to deal with the disease, effectively improve the clinical rehabilitation effect and the quality of life of patients, improve the satisfaction rate of patients with management, shorten the distance between nurses and patients, and achieve ideal results.

Objective To investigate the effect of norcantharidin on growth inhibition and induction of apoptosis of human rectal cancer Colo 320 cells. Methods Norcantharidin (NCTD) in different concentrations were added to rectal cancer Colo 320 cells. Morphological characteristics of apoptosis were observed using the light microscope and transmission electron microscope. The expressions of Bag-1 and Bcl-2 proteins were tested by Western blotting. The growth inhibition of Colo 320 cells on the cell cycle was observed by flow cytometry. Results The apoptosis morphological changes of Colo 320 cells were observed by the light microscope and transmission electron microscopy. Flow cytometry analysis showed that the cell count of G2/M phase in experimental group was higher than that in control group ( <0.05) but the cell counts of G0/G1 and S phases have decreased in experimental group after treatment with NCTD at the concentrations of 5μg/mL, 10μg/mL and 20 μg/mL, and presented dosage dependence relations. The expressions of Bag-1 and Bcl-2 proteins have decreased. Conclusion Norcantharidin has inhibitory effect on rectal cancer Colo 320 cells, and the effect may be related to the cell cycle arrest and apoptosis.

ObjectiveTo systematically evaluate the value of contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance imaging (CEMRI) in the diagnosis of residual or recurrent lesion after transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). MethodsPubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang Data were searched for studies on CECT and/or CEMRI in the diagnosis of residual or recurrent lesion after TACE published up to April 2019. After two reviewers independently performed literature screening, data extraction, and assessment of the risk of bias using the QUADAS-2 tool, Stata 12.0 and RevMan 5.3 were used to analyze pooled sensitivity, specificity, and area under the receiver operator characteristic curve (AUC). ResultsA total of 13 studies on CECT and 13 studies on CEMRI in the diagnosis of residual or recurrent HCC lesion after TACE were included, with 934 lesions from 748 patients and 847 lesions from 557 patients, respectively. High heterogeneity was observed in the 13 studies on CECT in the diagnosis of residual or recurrent HCC lesion after TACE (P=0.001, Q=12.56, I2=84.08%), while no significant heterogeneity was observed in the 13 studies on CEMRI (P=0.473, Q=0.11, I2=0). In the diagnosis of residual or recurrent HCC lesion after TACE, CECT had a sensitivity of 72% (95% confidence interval ［CI］: 66%-78%), a specificity of 99% (95% CI: 93%-100%), and an AUC of 0.87 (95% CI: 0.83-0.89), and CEMRI had a sensitivity of 88% (95% CI: 82%-93%), a specificity of 96% (95% CI: 91%-98%), and an AUC of 0.98 (95% CI: 0.96-0.99). CECT had a significantly lower sensitivity than CEMRI in the diagnosis of residual or recurrent HCC lesion after TACE (Z=2.12, P=0.03). ConclusionIn comparison with CECT, CEMRI has an extremely higher diagnostic efficiency in the diagnosis of residual or recurrent HCC lesion after TACE and is thus an effective method for diagnosis.

Objective To investigate the role of immunoglobulin superfamily containing leucine-rich repeat protein(ISLR)in the malignant progression of osteosarcoma cells and its potential regulatory mechanism.Methods ISLR mRNA levels in osteosarcoma tissues and cells were detected by quantitative real time polymerase chain reaction(qRT-PCR).U2OS cells were transfected with ISLR short hairpin RNA(shRNA)sequence or negative-control shRNA(NC shRNA)sequence,thus the cells were treated with phosphatidylinositol 3 kinase(PI3K)activator 740 Y-P.The cell viability,invasion ability and apoptosis rate were detected by CCK-8 assay,Transwell assay and flow cytometry,respectively.Western blot was used to detect the expressions of ISLR protein,epithelial-mesenchymal transition(EMT)-related proteins[Epitheia-cadherin(E-cadherin),Nerve cadherin(N-cadherin),Vimentin,Snail],PI3K/protein kinase B(AKT)pathline-related proteins,apoptotic proteins[Cysteinyl aspartate-specific proteinase-3(Caspase-3),B cell lymphoma/leukemia-2(Bcl-2),Bcl-2 associated X protein(Bax)]and proliferation marker Ki67 protein.Lentivirus was used to transfect U2OS cells,and the cells were injected into nude mice to construct a xenograft tumor model,and tumor growth was monitored.Results ISLR mRNA level in osteosarcoma tissue(5.14±1.63)was up-regulated compared with para-cancerous tissue(1.01±0.02),and the difference was significant(t=-14.332,P＜0.001).Compared with normal osteoblasts hFOB1.19(1.01±0.01),osteosarcoma cells MG63(3.05±0.57),U2OS(4.55±0.79),HOS(2.46±0.41),the relative expression of ISLR mRNA in Saos-2(2.62±0.44)and 143B(3.62±0.51)were increased,and differences were significant(t=4.883,8.473,3.471,3.854,6.247,all P＜0.05).Silencing ISLR inhibited the proliferation of U2OS cells(t=6.593,6.835)and invasion(t=8.621,8.448),but promoted cell apoptosis(t=25.505,25.574),and the differences were significant(all P＜0.05).Silencing ISLR promoted Caspase-3 activity in U2OS cells(t=13.489,13.366)and Bax protein(t=8.628,8.524),but inhibited Bcl-2 protein expression(t=10.948,10.775),with significant differences(all P＜0.05).Silencing ISLR promoted EMT-related protein E-cadherin(t=15.168,15.087),inhibited N-cadherin(t=10.220,10.058),Vimentin(t=8.303,8.164)and Snail(t=9.211,9.384),but reduced the phosphorylation levels of PI3K and AKT(t=17.441,14.452),with significant differences(all P＜0.05).Additionally,740 Y-P treatment reversed the effect of silencing ISLR on U2OS cells.Experimental results in vivo showed that knockdown of ISLR significantly inhibited tumor growth.Conclusion ISLR could promote EMT,proliferation and invasion,but inhibit apoptosis of osteosarcoma cells by activating the PI3K/AKT pathway,there by promoting osteosarcoma progression.

Objective:To investigate the influencing factors for celiac lymph node metastasis in thoracic esophageal squamous cell carcinoma (TE-SCC), construct a prediction model of celiac lymph node metastasis in TE-SCC, and stratify the probability of celiac lymph node metastasis.Methods:The retrospective case-control study was conducted. The clinicopathological data of 443 patients with TE-SCC who underwent thoracoscopic and laparoscopic esophagectomy with systematic lymph node dissection in the First Affiliated Hospital of Zhengzhou University between March 2015 and April 2019 were collected. There were 259 males and 184 females, aged from 41 to 81 years, with a median age of 64 years. The nomogram prediction model was constructed based on the results of multivariate analysis of influencing factors for celiac lymph node metastasis in TE-SCC, of which calibration curve and decision curve were drawed. The predictive performance was evaluated using the concordance index. The score for celiac lymph node metastasis in TE-SCC predicted by nomogram model was used for further recursive partitioning analysis, and patients were stratified into risk subgroups using the decision-making tree model. Observation indicators: (1) celiac lymph node metastasis in TE-SCC; (2) analysis of influencing factors for celiac lymph node metastasis in TE-SCC; (3) construction of nomogram prediction model of celiac lymph node metastasis in TE-SCC; (4) construction of decision-making tree model of celiac lymph node metastasis in TE-SCC and risk subgroup analysis of celiac lymph node metastasis probability. Measurement data with skewed distribution were represented as M (range). Count data were represented as absolute numbers and percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data between groups was analyzed using the nonparametric rank sum test. Multivariate analysis was performed using the Logistic regression model. Based on Logistic regression model multivariate analysis, a new nomogram model was constructed using the RStudio 3.4 software. Results:(1) Celiac lymph node metastasis in TE-SCC: celiac lymph node metastasis was found in 89 of the 443 patients, with a celiac lymph node metastasis rate of 20.09%(89/443). (2) Analysis of influencing factors for celiac lymph node metastasis in TE-SCC. Results of univariate analysis showed that tumor location, tumor length, tumor differentiation degree, pathological T staging, nerve invasion, vessel invasion, and thoracic lymph node metastasis were related factors for celiac lymph node metastasis in TE-SCC ( χ2=12.177, Z=-2.754, -4.218, -4.254, χ2=3.908, 33.025, 30.387, P<0.05). Results of multivariate analysis showed that tumor location, vessel invasion, and thoracic lymph node metastasis were independent influencing factors for celiac lymph node metastasis in TE-SCC ( odds ratio=2.165, 3.442, 2.876, 95% confidence interval: 1.380-3.396, 1.787-6.633, 1.631-5.071, P<0.05). (3) Construction of nomogram prediction model of celiac lymph node metastasis in TE-SCC: based on the factors screened by multivariate analysis, including tumor location, vessel invasion, and thoracic lymph node metastasis, the nomogram prediction model of celiac lymph node metastasis in TE-SCC was established, with the concordance index of 0.846. The calibration curve showed a high consistency between the celiac lymph node metastasis probability estimated by the prediction model and the actual rate of celiac lymph node metastasis. The decision curve showed that the nomogram prediction model of celiac lymph node metastasis in TE-SCC had a good prediction value when the probability threshold was 0.001-0.819.(4) Construction of decision-making tree model of celiac lymph node metastasis in TE-SCC and risk subgroup analysis of celiac lymph node metastasis probability: patients were stratified into six risk subgroups using the decision-making tree model based on the celiac lymph node metastasis probability. The group A included patients with no vessel invasion+negative thoracic lymph node, group B included patients with no vessel invasion+the number of positive thoracic lymph nodes of 1-3, group C included patients with no vessel invasion+the number of positive thoracic lymph nodes of ≥4, group D included patients with vessel invasion+the number of positive thoracic lymph nodes of 0-2+upper or middle thoracic esophageal carcinoma, group E included patients with vessel invasion+the number of positive thoracic lymph nodes of 0-2+lower thoracic esophageal carcinoma, group F included patients with vessel invasion+the number of positive thoracic lymph nodes of ≥3. The group A was low-risk group with the celiac lymph node metastasis probability of 11%, group B and D were intermediate low-risk groups with the celiac lymph node metastasis probability of 27% and 21%, group C and E were the intermediate high-risk groups with the celiac lymph node metastasis probability of 56% and 55%, and group F was high-risk group with the celiac lymph node metastasis probability of 80%. Conclusions:The tumor location, vessel invasion, and thoracic lymph node metastasis are independent influencing factors for celiac lymph node metastasis in TE-SCC. Vessel invasion has the dominant influence on celiac lymph node metastasis, followed by the number of positive thoracic lymph nodes, and then the tumor location. Patients can be stratified into six risk subgroups based on the nomogram prediction model and decision-making tree model of celiac lymph node metastasis in TE-SCC.

With the development of molecular biology research, targeted therapy has become the fourth effective method for the treatment of malignant tumors after surgery, radiotherapy, and chemotherapy. Unlike the traditional chemotherapeutic drugs, molecular targeted drugs possess the advantages of high specificity, definite curative effects, and less adverse effects. CLDN18.2 protein is a transmembrane protein that is highly selective and stably overexpressed during the development of various malignant tumors, especially gastrointestinal tumors, and metastases. A specific antibody against this protein, claudiximab (zolbetuximab/IMAB362), has achieved great success in recent clinical trials. Thus, CLDN18.2 protein is expected to be a safe and effective molecular target for targeted therapy in some malignancies.

Objective To introduce the detailed surgical procedure of parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD),and to study its clinical results.Methods A retrospective study was conducted on 31 patients who underwent parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy between January 2016 and June 2018 in our department.Results Of 31 patients who underwent total laparoscopic pancreaticoduodenectomy,5 patients underwent two-dimensional (2D) LPD and 26 underwent three-dimensional (3D) LPD.Total mesopancreas excision (TMpE) was performed in 12 patients,including 2 patients combined with PV-SMV segmental resection and reconstruction.The mean operative duration,and mean estimated blood loss,post-operative hospital stay were 412.8 ± 102.4 min,462.8 ± 396.7 ml,14.7 ± 8.9 d,respectively.The operating time of parachute-like-suture double-pouch pancreaticojejunostomy was 29.7 ± 6.8 min (20 ～45 min).Post-operative complications occurred in 8 patients (25.8％),3 of whom suffered from more than two types of complications.There were 2 patients (6.5％) with postoperative B/C grade pancreatic fistula,4 patients with postoperative biliary leakage (12.9％),3 patients with delayed gastric emptying (9.7％),1 patient with portal vein thrombosis (3.2％) and 1 patient with peritoneal effusion (3.2％).One patient died during perioperative period due to gastrointestinal hemorrhage.Conclusions Parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy was a simple,convenient,reliable method.It is worthy of clinical promotion and further studied.