Objective To evaluate the effects of inhaled iloprost on pulmonary hypertension after cardiopulmonary bypass in patients with congenital heart disease undergoing surgical correction of anomaly. Methods Fifty-eight patients with congenital heart disease aged 14-60 yr undergoing surgical correction of anomaly under cardiopulmonary bypass (CPB) were enrolled in this study. Radial artery was cannulated before induction of anesthesia. A 6-lumen pulmonary catheter was placed via right internal jugular vein after tracheal intubation. Their mean pulmonary arterial pressure was still > 25 mm Hg after operation. ECG, HR, BP, CO, PAP and SpO_2 were continuously monitored. Aerosolized iloprost 10 fig was inhaled via nebulizer after CPB. Hemodynamics were measured before iloprost inhalation (baseline) and at 0, 5, 15, 30 and 60 min after the end of iloprost inhalation. Results There were 28 patients with pulmonary hypertension after CPB among the 58 patients with congenital heart disease. Inhalation of iloprost 10μg significantly decreased mPAP, pulmonary vascular resistance and intrapulmonary shunt as compared with the baseline. Iloprost inhalation could also improve significantly CO and the mixed venous oxygen saturation (SvO_2 ). Conclusion Iloprost inhaled after CPB can effectively reduce pulmonary arterial pressure and pulmonary vascular resistance in patients with congenital heart disease undergoing surgical correction of anomaly and help them wean from CPB.

Objective:The characteristics of lymph node metastasis were investigated to guide the range of lymph node dissection during the radical operation of distal gastric cancer. Methods:The clinical data of 773 patients with distal gastric cancer who under-went radical distal subtotal gastrectomy at the Tianjin Medical University Cancer Institute and Hospital between February 2010 and September 2014 were reviewed and analyzed to infer the potential clinical mechanisms of lymph node metastasis. Results:Among the included patients, 423 (54.72%) had lymph node metastasis. The proportion of metastasis in the patients from the highest to the lowest rate was observed in group NO. 6, 3, 4sb, and 5 lymph nodes. The metastasis rates of the N1 lymph nodes from the highest to the low-est were observed in group NO. 3, 6, 5, and 4d lymph nodes, whereas those of the N2 lymph nodes occurred in group NO. 8a, 7, and 1 lymph nodes. Group NO. 8a lymph node with skipped metastasis was observed in 50.68%of the patients. Conclusion:During radical distal gastric cancer surgery, attention should be given to the possibility of metastasis in group NO. 8a lymph node. Appropriate exten-sion of the lymph node dissection should be conducted when necessary.

Objective To analyze copy number variance (CNV) in whole genome by using gene chip technology, and to screen the radiosensitivity associated genes on esophageal squamous cell carcinoma (ESCC). Methods The patients with ESCC who received radiotherapy alone in Anyang Tumor Hospital from December 2013 to August 2016 were selected, and biopsy paraffin samples were preserved in the center of pathology. The patients were divided into radiosensitivity group (group S) and radio-resistance group (group R). DNA was extracted from these paraffin samples in both groups. Whole human genome CNV was detected by using genechip from OncoScan Array platform designed by Affymetrix company, and the differences of gene segments were screened in the two groups. Results Nineteen samples of ESCC patients were collected to extract DNA in this study. To balance pair analysis in the two groups, 10 samples were selected from the qualified patients, including 5 cases in group S and 5 cases in group R respectively. There were no statistical differences in gender, age, lesion site, lesion length, radiation dose of the two groups (all P> 0.05). Loss of heterozygosity (LOH) was the main type of CNV. The analysis results showed that LOH in q24.32-q24.33 of chromosome 10 and LOH in q21.2-q21.31 of chromosome 18 had high frequencies (100 ％) in group R, however, none were detected in group S. LOH in q27-q28.1 of chromosome 4 had a high frequency (80％) in group S , however, none were detected in group R. Conclusion LOH in 10q/18q is related to radio-resistance in ESCC, and LOH in 4p is associated with radiosensitivity in ESCC.

OBJECTIVETo investigate the role of apoptosis stimulating protein 2 of p53 (ASPP2) phosphorylation status in the regulation of ASPP2-p53 apoptotic pathway activity.

METHODSCells were individually transfected with green fluorescent protein (GFP)-encoding vector, constitutively non-phosphorylatable ASPP2 mutant-ASPP2 (Am)-encoding vector, and wild type ASPP2 (Aw)-encoding vector) plasmids, respectively, to make them overexpressing phosphorylated and non-phosphorylated ASPP2 proteins, respectively. Cell apoptosis was induced by oxaliplatin. The apoptosis rate of cells was determined by flow cytometry after staining with FITC-conjugated annexin V and PI. ASPP2 protein level and its phosphorylation status were observed by Western blot. The interaction between ASPP2 and p53 was observed by immunoprecipitation assay.

RESULTSOxaliplatin induced cell apoptosis and caused phosphorylation of ASPP2 at ser92/ser361 in the HCT116 cells. The apoptosis rate of Aw and Am plasmids-transfected cells were (3.8 ± 1.0)% and (3.9 ± 1.2)% respectively, statistically with a non-significant difference (P > 0.05) in comparison with that of the GFP plasmid-transfected cells [(4.0 ± 0.8)%]. After oxaliplatin treatment, the apoptosis rate of Aw plasmid-transfected cells was (46.7 ± 3.9)%, significantly higher than that of the Am and GFP plasmid-transfected cells [(40.1 ± 10.2)% and (37.1 ± 6.9)%, respectively, P < 0.05], however, there was no statistically significant difference (P > 0.05) between Am and GFP plasmid-transfected cells. These results indicate that phosphorylated ASPP2 promoted the oxaliplatin-induced apoptosis of HCT116 cells through a p53-dependent pathway. Phosphorylation status of ASPP2 influenced its binding activity to p53.

CONCLUSIONPhosphorylation status of ASPP2 modulates p53 apoptotic function in oxaliplatin-induced apoptosis of colorectal cancer HCT116 cells.

Apoptosis ; Apoptosis Regulatory Proteins ; metabolism ; Colorectal Neoplasms ; metabolism ; HCT116 Cells ; Humans ; Organoplatinum Compounds ; Phosphorylation ; Tumor Suppressor Protein p53 ; genetics ; metabolism

Objective:To evaluate the predictive value of stair climbing test combined with arterial blood gas analysis on postoperative complications in lung cancer patients with limited pulmonary function.Methods:A total of 1 231 hospitalized lung cancer patients with limited pulmonary function dating from August 2012 to August 2020 were retrospectively reviewed. Included in the cohort were 766 of patients who underwent stair climbing test(SCT) preoperatively and completed data collection. Patients were grouped according to their general condition, past medical history, surgical approach, pulmonary function test(PFT) and SCT results. Comparison of the postoperative cardiopulmonary complication rates were made between different groups, and independent risk factors were identified.Results:A total of 182 cardiopulmonary-related complications occurred in 144 cases, accounting for 18.8% of the entire cohort. Perioperative mortality rate was 0.9%(7/766). The rate of postoperative cardiopulmonary complications was significantly different between the groups stratified by gender, age, smoking index, PFT index(FEV1%, DLCO%), SCT results(height achieved, speed, changes in heart rate and oxygen saturation of the arteries before and after the test), ASA score, surgical approach(VATS/Open), resection range(Lobectomy/Sublobectomy), anesthetic duration, blood loss volume, etc. Logistic regression analysis showed that only height achieved( P<0.001), changes in heart rate( P<0.001), changes in oxygen saturation of the arteries( P=0.001), resection range( P=0.006) and anesthetic duration( P=0.025) were independent risk factors for cardiopulmonary-related complications in lung cancer patients with limited pulmonary function. Conclusion:The stair climbing test combined with arterial blood gas analysis could be used as a preoperative screening method for lung cancer patients with limited lung function and may have a predictive value for postoperative cardiopulmonary-related complications.

OBJECTIVETo evaluate the value of D2+ lymph node dissection for patients with distal advanced gastric cancer.

METHODSClinicopathological data of 305 cases with distal advanced gastric cancer receiving D2+(n=68) or D2(n=237) lymph node dissection in the Tianjin Cancer Hospital from January 2003 to December 2007 were analyzed retrospectively. The overall 5-year survival rate between the 2 groups.

RESULTSThe median survival was 36 months and the 5-year overall survival rate was 40.3% in all patients. The 5-year overall survival rates in the D2+ and D2 groups were 50.4% and 37.4% respectively, and the difference was statistically significant(P=0.049). In multivariate prognostic analysis however, the extent of lymph node dissection was not identified as an independent prognostic factor(P=0.174). Subgroup analysis showed that 5-year survival rate of D2+ group was significantly higher as compared to D2 group for the following subgroups: maximum diameter of tumor larger than 4 cm(43.9% vs. 27.0%), Borrmann type III(-IIII((55.5% vs. 30.1%), poorly differentiated and undifferentiated tumor (49.8% vs. 37.0%), T4 stage (47.8% vs. 31.0%), N2 stage (53.3% vs. 13.9%), N3 stage (20.0% vs. 9.6%) and positive No.6 lymph nodes (33.1% vs. 16.0%).

CONCLUSIONCompared with D2 lymph node dissection, D2+ lymph node dissection may benefit some patients with large, poorly differentiated, or late-stage tumor.

Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

Objective To evaluate the performance of large language models in answering ques-tions about childhood asthma,comprehensively understand the quality of their provision of information on children's health,and identify their limitations to facilitate model improvement.Methods Sixty common questions related to childhood asthma were formulated and put to two large language models known as Wenxin Yiyan and Zhipu Qingyan,which were publicly available in China.Three pediatric asthma specialists assessed the quality of the large language models'responses by using a blind meth-od.Results Wenxin Yiyan scored higher in terms of accuracy,understanding,reliability,and logi-cality;Zhipu Qingyan scored higher in term of safety.Comparing the scores of the five different di-mensions,it was found that large language models scored higher in terms of understanding,reliability and logicality,but relatively insufficient in terms of accuracy and safety.Conclusion Application of large language models in the education of children with asthma can provide useful references for asth-ma children and their parents.However,the current large language model technology still has certain limitations in terms of accuracy and safety,which requires further improvement and optimization.

Objective To evaluate the value of D2+ lymph node dissection for patients with distal advanced gastric cancer. Methods Clinicopathological data of 305 cases with distal advanced gastric cancer receiving D2+(n=68) or D2 (n=237) lymph node dissection in the Tianjin Cancer Hospital from January 2003 to December 2007 were analyzed retrospectively. The overall 5-year survival rate between the 2 groups. Results The median survival was 36 months and the 5-year overall survival rate was 40.3% in all patients. The 5-year overall survival rates in the D2+ and D2 groups were 50.4% and 37.4% respectively, and the difference was statistically significant (P =0.049). In multivariate prognostic analysis however, the extent of lymph node dissection was not identified as an independent prognostic factor(P=0.174). Subgroup analysis showed that 5-year survival rate of D2+group was significantly higher as compared to D2 group for the following subgroups: maximum diameter of tumor larger than 4 cm (43.9% vs. 27.0%), Borrmann type Ⅲ-Ⅳ (55.5% vs. 30.1%), poorly differentiated and undifferentiated tumor (49.8% vs. 37.0%), T4 stage (47.8% vs. 31.0%), N2 stage (53.3% vs. 13.9%), N3 stage (20.0% vs. 9.6%) and positive No.6 lymph nodes (33.1% vs. 16.0%). Conclusion Compared with D2 lymph node dissection, D2+ lymph node dissection may benefit some patients with large, poorly differentiated, or late-stage tumor.

Objective To evaluate the performance of large language models in answering ques-tions about childhood asthma,comprehensively understand the quality of their provision of information on children's health,and identify their limitations to facilitate model improvement.Methods Sixty common questions related to childhood asthma were formulated and put to two large language models known as Wenxin Yiyan and Zhipu Qingyan,which were publicly available in China.Three pediatric asthma specialists assessed the quality of the large language models'responses by using a blind meth-od.Results Wenxin Yiyan scored higher in terms of accuracy,understanding,reliability,and logi-cality;Zhipu Qingyan scored higher in term of safety.Comparing the scores of the five different di-mensions,it was found that large language models scored higher in terms of understanding,reliability and logicality,but relatively insufficient in terms of accuracy and safety.Conclusion Application of large language models in the education of children with asthma can provide useful references for asth-ma children and their parents.However,the current large language model technology still has certain limitations in terms of accuracy and safety,which requires further improvement and optimization.

Objective To evaluate the value of D2+ lymph node dissection for patients with distal advanced gastric cancer. Methods Clinicopathological data of 305 cases with distal advanced gastric cancer receiving D2+(n=68) or D2 (n=237) lymph node dissection in the Tianjin Cancer Hospital from January 2003 to December 2007 were analyzed retrospectively. The overall 5-year survival rate between the 2 groups. Results The median survival was 36 months and the 5-year overall survival rate was 40.3% in all patients. The 5-year overall survival rates in the D2+ and D2 groups were 50.4% and 37.4% respectively, and the difference was statistically significant (P =0.049). In multivariate prognostic analysis however, the extent of lymph node dissection was not identified as an independent prognostic factor(P=0.174). Subgroup analysis showed that 5-year survival rate of D2+group was significantly higher as compared to D2 group for the following subgroups: maximum diameter of tumor larger than 4 cm (43.9% vs. 27.0%), Borrmann type Ⅲ-Ⅳ (55.5% vs. 30.1%), poorly differentiated and undifferentiated tumor (49.8% vs. 37.0%), T4 stage (47.8% vs. 31.0%), N2 stage (53.3% vs. 13.9%), N3 stage (20.0% vs. 9.6%) and positive No.6 lymph nodes (33.1% vs. 16.0%). Conclusion Compared with D2 lymph node dissection, D2+ lymph node dissection may benefit some patients with large, poorly differentiated, or late-stage tumor.