OBJECTIVE:To investigate the effects of total paeony glycoside (TPG) on the expression of tumor suppressor gene in lung cancer model rats. METHODS:90 rats were randomly divided into normal group,model group,positive control group [cyclophosphamide,50 mg/(kg·d)] and TPG low-dose,medium-dose and high-dose groups [50,100,200 mg/(kg·d)] with 15 rates in each group. Except for normal group,other groups were given disposable infusion of carcinogenic iodized oil via left lobe bronchus to induce lung cancer model. After modeling,those groups were given relevant medicine intravenously from Monday to Friday,while normal group and model group were given constant volume of normal saline intravenously for consecutive 16 weeks. The expression of multidrug resistance associated protein(MRP),human multidrug resistance gene(MDR1),P21 and P16 mRNA in lung tissue of rats were determined by RT-PCR;the expression of P53 protein in lung cancer tissue was determined by IHC method.The rate of positive expression was calculated,and pathological change of lung tissue was observed. RESULTS:Com-pared with normal group,the expression of MRP,MDR1,P21,P16 mRNA and P53 protein(positive rate of 66.67%)in lung tis-sue was increased significantly in model group (P<0.05);compared with model group,the expression of MRP,MDR1,P21, P16 mRNA and P53 protein (positive rate of 46.67%,46.67%,40.00%,13.33%) decreased in positive control group,TPG low-dose,medium-dose and high-dose groups in dose-dependent manner,and the decrease of TPG medium-dose and high-dose groups were more significant than that of positive control group (P<0.05);there was statistical significance in above indexes among TPG groups(P<0.05). CONCLUSIONS:TPG could inhibit the expression of MRP,MDR1,P21,P16 gene and P53 pro-tein in lung cancer model rats significantly.

Objective:To analyze the differences in clinical and endoscopic ultrasonography (EUS) findings between diffuse and focal IgG4-related autoimmune pancreatitis (IgG4-AIP).Methods:Data of patients diagnosed as having IgG4-AIP who underwent EUS at Chinese PLA General Hospital from September 2011 to April 2022 were retrospectively collected. General clinical data, EUS features, and postoperative pathology were analyzed for characteristic differences.Results:A total of 40 patients were included in the study, 60.03±10.87 years old, a higher proportion of males (85.0%, 34/40). All patients underwent EUS, and 28 underwent EUS-guided fine-needle aspiration. Among the 40 patients, 29 (72.5%) had diffuse type and 11 (27.5%) had focal type. Abdominal pain [65.5% (19/29) VS 18.2% (2/11), χ2=5.393, P=0.020] and thickening of the bile duct wall [51.7% (15/29) VS 9.1% (1/11), χ2=4.394, P=0.036] were more common in the diffuse type, while main pancreatic duct dilation [45.5% (5/11) VS 10.3% (3/29), χ2=4.146, P=0.042] was more common in the focal type, with the lesion most commonly located in the pancreatic head (90.9%, 10/11). There was no significant difference in the presence of chronic pancreatitis parenchymal changes between the two groups [34.5% (10/29) VS 27.3% (3/11), χ2=0.003, P=0.955]. Conclusion:There are certain differences in abdominal pain and biliary and pancreatic duct lesions between diffuse and focal AIP. The high expression of chronic pancreatitis characteristics is not observed in either group, which provides clues for the classification of AIP in clinical practice.

Objective To assess the efficacy and safety of autologous skin-grafting surgery ( ASGS) in the prevention of esophageal stenosis after complete circular endoscopic submucosal tunnel dissection ( ESTD) for early esophageal cancer. Methods Between January 2018 and March 2018, five patients with early esophageal cancer underwent complete circular ESTD and ASGS in Chinese PLA General Hospital. The skin-graft survival situation, and occurrence of esophageal stenosis and complications were observed by endoscopy follow-up. Results Complete circular ESTD and ASGS were successfully performed in all 5 patients, and no complications including perforation, bleeding, wound infection or stent migration occurred. The mean skin-graft survival rate was 86. 0％. Four patients did not experience esophageal stenosis over the mean follow-up of 9. 5 months. One patient experienced esophageal stenosis after operation, and underwent endoscopic balloon dilatation. No stenosis occurred in 8 months of follow-up. Conclusion ASGS is a safe and effective method to prevent esophageal stenosis after complete circular ESTD.

Rotavirus (RV) is one of the main pathogens causing diarrhea in children under five years old, but the mechanism of RV-infected diarrhea is still unclear. The RV genome encodes six structural proteins (VP1-VP4, VP6 and VP7) and six non-structural proteins (NSP1-NSP6), among which NSP4 can interact with other non-structural proteins or structural proteins of RV to produce corresponding biological functions, and is a key factor in the formation of RV morphology, the process of infection and the pathogenesis of diarrhea. In this paper, the current domestic and foreign studies on the structure and function of NSP4 are reviewed.

Objective:To compare the efficacy and safety of endoscopic mucosal resection (EMR), EMR with pre-cutting (EMR-P), endoscopic submucosal dissection (ESD) and ESD with snare (ESD-S) for the treatment of colorectal laterally spreading tumors (LSTs).Methods:Between January 2016 and March 2018, a total of 146 patients with 146 colorectal LSTs undergone endoscopic resection at the first medical center of PLA General Hospital. Data of demographics, treatment information, pathology and follow-up results were retrospectively analyzed.Results:Among the 146 patients, EMR, EMR-P, ESD, and ESD-S were performed in 23, 29, 50 and 44 tumors, respectively. Median tumor diameter was 2.5 cm (ranged 1.2-10.0 cm). The en bloc resection rate of EMR, EMR-P, ESD and ESD-S were 73.9% (17/23), 72.4% (21/29), 96.0% (48/50), and 65.9% (29/44), respectively, with statistical difference ( P<0.001). And the R0 resection rate were 65.2% (15/23), 69.0% (20/29), 94.0% (47/50), and 63.6% (28/44), respectively, with statistical difference ( P=0.002). The en bloc resection rate and R0 resection rate of the ESD group were significantly higher than those of the other three groups (all P<0.05). The difference was not statistically significant in terms of perforation rate [0, 0, 6.0% (3/50), and 9.1% (4/44), respectively, P=0.269] and delayed hemorrhage rate [4.3% (1/23), 0, 2.0% (1/50), and 2.3% (1/44), respectively, P=0.768] among the four groups. Follow-up endoscopy was performed in 117 cases (80.1%) with a median period of 10.0 months (ranged 3.0-26.0 months), and local recurrence was identified in 7 (6.0%) cases. Conclusion:ESD could be the optimal method for the resection of colorectal LSTs, while LSTs smaller than 20 mm can be resected by EMR. EMR-P and ESD-S as modified methods have their respective advantages for the treatment of LSTs.

Objective:To evaluate the clinical value of suspensory incision and suture technique in endoscopic full-thickness resection (EFTR) for muscularis propria tumor of gastric fundus.Methods:A retrospective analysis was performed on the data of 20 patients with muscularis propria tumor in gastric fundus and undergoing EFTR in the First Medical Center of PLA General Hospital from June 2017 to June 2019. Patients were divided into the observation group (9 cases) treated with suspensory incision and suture technique in EFTR and the control group (11 cases) treated with traditional EFTR method. The baseline data and perioperative data of the two groups were analyzed.Results:EFTR was successfully performed on all 20 patients. The tumor size of the observation group and the control group was 10.0 (7.5, 21.0) mm and 14.0 (10.0, 20.0) mm, respectively. The resection time of the two groups was 26.4±6.3 min and 35.5±11.4 min, respectively. The postoperative hospital stay was 6.4±1.0 d and 7.7±1.5 d, respectively. No postoperative delayed bleeding, perforation, or other complications occurred in the two groups.Conclusion:Using suspensory incision and suture technique is safe and effective during EFTR for muscularis propria tumor in gastric fundus, and can reduce operation time. This technique is worth applying in clinic.

Pathological dry skin is a disturbing and intractable healthcare burden,characterized by epithelial hy-perplasia and severe itch.Atopic dermatitis(AD)and psoriasis models with complications of dry skin have been studied using single-cell RNA sequencing(scRNA-seq).However,scRNA-seq analysis of the dry skin mouse model(acetone/ether/water(AEW)-treated model)is still lacking.Here,we used scRNA-seq and in situ hybridization to identify a novel proliferative basal cell(PBC)state that exclusively expresses transcription factor CUT-like homeobox 1(Cux1).Further in vitro study demonstrated that Cux1 is vital for keratinocyte proliferation by regulating a series of cyclin-dependent kinases(CDKs)and cyclins.Clinically,Cux1+PBCs were increased in patients with psoriasis,suggesting that Cux1+ PBCs play an important part in epidermal hyperplasia.This study presents a systematic knowledge of the tran-scriptomic changes in a chronic dry skin mouse model,as well as a potential therapeutic target against dry skin-related dermatoses.

Objective:To evaluate the long-term efficacy and safety of a novel self-help inflatable balloon to prevent esophageal stenosis after extensive endoscopic submucosal dissection (ESD).Methods:Patients with early esophageal cancer or precancerous lesions, undergoing ESD in the First Medical Center of Chinese PLA General Hospital from January 2018 to December 2019 were included in the prospective study, who had post-ESD mucosal defect greater than 5/6 of the esophageal circumference and 30-100 mm in length. The self-help inflatable balloon was used to prevent esophageal stenosis after ESD. Mucosal defect of ESD was divided into grade 1 (≥5/6 and less than the whole circumference) and grade 2 (the whole circumference). The incidence of stricture, the time from ESD to the occurrence of stricture, the total number of endoscopic balloon dilations (EBD) or radial incision and cuttings (RIC), and other adverse events were observed.Results:A total of 27 patients met the including criteria with follow-up time of 14-38 months, including 3 patients of grade 1 and 24 of grade 2. The ulcer longitudinal length was 73.7±18.4 mm. The time of wearing balloons was 92.0±20.0 days. The overall frequency of stricture was 18.5% (5/27), and the stricture incidence of patients of grade 2 resection was only 16.7% (4/27). The median time from balloon removal to stricture was 17 days. To treat the stricture, two patients received 3 EBD sessions, and three other patients received 2, 1 and 2 RIC sessions, respectively. No balloon was removed in advance, and none had a perforation or delayed bleeding.Conclusion:The self-help inflatable balloon shows high efficacy and safety in preventing esophageal stenosis in patients with mucosal defect greater than 5/6 of the esophageal circumference and less than 100 mm in length after extensive esophageal ESD.

Objective: To evaluate optical coherence tomography(OCT)for predicting invasion depth of early esophageal cancer(EEC) and to compare OCT and magnifying endoscopy-narrow band imaging (ME-NBI)in clinical performance. Methods: Twenty-eight patients who were diagnosed with EEC and accepted OCT and ME-NBI before endoscopic submucosal dissection(ESD)were enrolled in this prospective study. On the basis of OCT and ME-NBI images, real-time prediction of EEC invasion depth was conducted. Postoperative pathological results were taken as golden standard to compare the accuracy of OCT and ME-NBI in evaluation of EEC invasion depth. The procedure time and incidence of complications during evaluation process were also analyzed. Results: The overall accuracy of OCT and ME-NBI in predicting invasion depth of 28 EEC patients were 67.9% (19/28) and 75.0% (21/28) respectively, with no significant difference(P>0.05). The accuracy of OCT and ME-NBI in distinguishing lesions located in epithelium/lamina propria mucosa (EP/LPM) lesions were 78.9%(15/19) and 68.4% (13/19), with no significant difference(P>0.05). The procedure time of OCT was significantly shorter than that of ME-NBI (6.0±2.9 min VS 16.3±5.4 min, P<0.001). Conclusion The ability of OCT to predict invasion depth of EEC and distinguish lesions located in the EP/LPM is comparable with that of ME-NBI. Besides, OCT requires shorter procedure time for evaluation.

AIM: To reveal the ameliorative effect of salvianolic acid A on palmitie acid-induced lipotoxicity in H9C2 cells and to explore its potential molecular mechanisms preliminarily. METHODS: H9C2 cell were induced by palmitie acid to establish a lipotoxicity model, while salvianolic acid A was added prior to palmitie acid treatment. Lactate dehydrogenase (LDH) was employed to detect cell damage. Cell counting Kit-8 was used to detect cell viability. The changes of mitochondrial membrane potential in cardiomyocyte were observed by rhodamine 123 staining. The molecular mechanisms of the ameliorative effect of salvianolic acid A was analyzed by Western Blotting. RESULTS: Palmitie acid at a concentration of 400 μmol/L significantly caused lipotoxicity damage to H9C2 cells (P<0.05). There was no cytotoxic effect of different concentrations of salvianolic acid A (10, 20, 40, 80 μmol/L) treatment on H9C2 cells (P>0.05). Salvianolic acid A intervention significantly improved lipotoxicity-induced cell death and reduction of cell mitochondrial membrane potential (P<0.05). The activation of toll-like receptor 4 (TLR4) significantly enhanced lipotoxicity-induced cell damage (P<0.05), while inhibition of TLR4 significantly reduced palmitie acid-induced lipotoxicity (P<0.05). In addition, salvianolic acid A effectively inhibited the upregulation of TLR4 and the downstream c-Jun N-terminal kinase (JNK MAPK) of TLR4 by palmitie acid treatment (P<0.05). CONCLUSION: Salvianolic acid A effectively improves lipotoxicity-induced cardiomyocyte damage. The inhibition of p38 signaling pathway is potentially involved in its protective effect. The protective effect may be related to the inhibition of TLR4/JNK MAPK signaling pathway, providing a potential molecular target for the prevention and treatment of lipotoxic cardiomyopathy.