The occurrence of nanoparticle carriers has greatly changed the traditional remedies of gastric cancer and other malignant tumors which makes the chemotherapeutic drugs possess better distribution, better targeting, less side-effects, and the ability to withstand the drug-resistance of tumor cells. Utilization of nanoparticle carriers in lymph-targeted chemotherapy of gastric cancer can not only achieve a better curative effect,but also direct the operation and improve patients' quality of lives. It has an expansive application foreground.

Objective To evaluate the practical value of preventive jejunum stoma for enteral nutrition in abdominal operation.Method Retrospectively analyzed 43 cases (from July,1995 to July, 2001) of patients under went performed with abdominal operation and preventive jejunum stoma, and compared their practical value in different diseases.Results The frequency of practical usage of jejunum stoma in acute severe pancreatitis was the highest (87%,13/15),while it was less in the patients group of upper digestive tract tumor and biliary or portal venous hypertension(41.67% and 45.45% respectively,P0.05 when compared with pancreatitis group.Conclusions Preventive jejunum stoma for enteral nutrition in abdominal operation must take into account three factors (disease, patient, and surgeon).Viewing from the diseases,the acute severe pancreatitis should be considered,patients with combined wound must be considered conditionally, patients with upper digestive tract tumor or biliary operation together with bile exo-drainage may take into account according to different situation,patients with portal venous hypertension should not be advocated.

Objective To investigate the effect of impulse noise expose on the expression of growth associated protein 43(Gap-43) in inferior colliculus in rat.Methods SPF grade Male SD rats were randomly divided into 5 groups.The normal control group received noise exposure.The model groups received an averange impulse noise exposure of 156 dB SPL with a pulse duration of 0.23 ms, once for 6 s, for 50 times.Auditory brainstem responses (ABRs) were measured before and 3,7,14, and 28 d after noise exposure with tone pips of 2,4,8,16, and 32 kHz, from 20 to 110 dB SPL.Bilateral inferior colliculus of rats in the model groups was collected and treated by immunohistochemical staining.Gap-43 expression of rats in different groups was measured by determining the gray value of inferior immunohistochemical images.Results After noise exposure, ABRs threshold in the model groups were significantly higher than those of in the normal group (P<0.05 or P<0.01).ABRs threshold at 14 and 28 days after noise exposure were significantly lower than 3 days after impulse exposure (P<0.05).Expression of Gap-43 in inferior colliculus was significantly up-regulated in the noise exposed groups compared with the normal group (P<0.05 or P<0.01).Expression of Gap-43 was significantly down-regulated 28 days after noise expose compared with 3 days after noise expose(P<0.05).Conclusion Impulse noise exposure leads to significant elevation of ABR thresholds and up-regulation of Gap-43 expression in inferior colliculus.Impulse noise exposure may induce auditory cortex prominent remodeling.

This study evaluated the effects of adenovirus vector mediated human vascular endothelial growth factor-165 (hVEGF165) gene on prevention of restenosis after angioplasty. Rabbit models of bilateral carotid artery injury were established by balloon denudation. The recombinant adenoviruses containing hVEGF165 cDNA was directly injected into left side of the injured carotid arteries. On day 3 and week 3 after transfection the expression of VEGF was observed by RT-PCR and immunohistochemistry. The thrombokinesis, reendothelialization (rET) and intimal hyperplasia in carotid arteries were evaluated by computerized image analysis system 3 weeks after gene transfer. The changes in the VEGF gene-treated side were compared with the control side. Our results showed that 3 days and 3 weeks after hVEGF165 gene transfer the VEGF mRNA and antigen expression were detected in vivo. 3 weeks after the transfer, the carotid artery rET was markedly better in the VEGF gene-treated group compared with the control. The thrombokinesis, intima area/media area (I/M), maximal intimal and medial thicknesses (ITmax and MTmax) demonstrated a statistically significant decrease in arteries treated with VEGF gene as compared with the control group. It is concluded that VEGF gene transfer could be achieved by intra-arterial injection of recombinant adenoviruses. It might accelerate the restoration of endothelial integrity, inhibit thrombokinesis and attenuate intimal hyperplasia in the injured arteries after VEGF gene transfer. This procedure could be useful in preventing restenosis after angioplasty.
Adenoviridae ; genetics ; metabolism ; Angioplasty, Balloon ; adverse effects ; Animals ; Carotid Artery Injuries ; pathology ; Carotid Stenosis ; physiopathology ; prevention & control ; Cell Division ; drug effects ; Endothelium, Vascular ; injuries ; pathology ; Genetic Therapy ; Hyperplasia ; prevention & control ; Male ; Muscle, Smooth, Vascular ; cytology ; RNA, Messenger ; biosynthesis ; genetics ; Rabbits ; Recombination, Genetic ; Transfection ; methods ; Vascular Endothelial Growth Factor A ; biosynthesis ; genetics

Objective: To explore the prognostic value of the international prognostic index (IPI), the national comprehensive cancer network IPI(NCCN-IPI)and the age-adjusted IPI (aa-IPI) in diffuse large B cell lymphoma. Methods: A total of 311 patients with de novo diffuse large B-cell lymphoma (DLBCL) diagnosed from 2003 to 2012 in Nanfang hospital were included. All patients were divided into CHOP (cyclophosphamide, vincristine, doxorubicin, and prednisone) and R-CHOP (rituximab, CHOP) groups. Survival analysis was compared among IPI, NCCN-IPI and aa-IPI models. Discrimination of three different prognostic models was assessed using the Harrell’s C statistic. Results: A total of 311 patients were analyzed. Among them, 128 patients were treated with CHOP regimen and other 183 patients were treated with R-CHOP regimen. In CHOP groups, both NCCN-IPI (5-year OS: 59.7% vs 26.8%, P<0.001) and aa-IPI (5-year OS: 71.0% vs 25.0%, P<0.001) showed better risk stratification for low-intermediate and high-intermediate group than the IPI (5-year OS: 47.6% vs 36.6%, P=0.003). However, in the patients treated with R-CHOP, NCCN-IPI showed better risk stratification in low, low-intermediate, high-intermediate groups (5-year OS: 96.0% vs 83.0% vs 66.5%, P=0.009). According to the Harrell’s C statistic, C-index of IPI, NCCN-IPI and aa-IPI for overall survival (OS) were 0.546, 0.667, 0.698 in CHOP group and 0.611,0.654, 0.695 in R-CHOP group respectively. In patients younger than 60 years old, C-index of IPI, NCCN-IPI and aa-IPI for OS were 0.534, 0.675, 0.698 in CHOP group and 0.584, 0.648, 0.695 in R-CHOP respectively. Conclusion The NCCN-IPI is more powerful than IPI and aa-IPI in DLBCL patients receiving R-CHOP. aa-IPI is a preferable model in predicting prognosis than IPI and NCCN-IPI in anthracycline-based chemotherapy without rituximab.

Objective To investigate the tumor molecular mechanism of Hedgehog/Gli in promoting the epithelial-mesenchymal transition (EMT) in gastric cancer AZ521 cells. Methods After 24 h of treatment with GANT61,the mRNA expression of Gli1,Gli2, N-cadherin,and E-cadherin in the AZ521 cell line were detected by real-time fluorescence quantitative PCR. A Western blotting assay was conducted to determine the expression of the above cytokines,p-AKT and AKT. The effect of GANT61 on invasion was observed by transwell assay. N-Shh stimulation of the Hedgehog pathway was conducted to confirm the changes in these cytokines. Results GANT61 significantly downregulated the mRNA expression of Gli1,Gli2,and N-cadherin,but upregulated E-cadherin mRNA expression. The Western blotting assay revealed that GANT61 downregulated the protein expression of Gli1,Gli2,p-AKT,and N-cadherin,but upregulated E-cadherin expression. Furthermore,GANT61 inhibited the invasion. N-Shh proteins up-regulated Gli1,Gli2,and N-cadherin mRNA,protein expression and p-AKT protein expression,but downregulated E-cadherin mRNA and protein expressions. N-Shh promoted the invasion of tumor cells. Conclusion Downregulation of Gli1 and Gli2 can inhibit the invasion and metastasis in gastric cancer cells,which may be related to the promotion of EMT by Gli through the PI3K/AKT pathway.

Objective:To understand the epidemic characteristics of epidemic Japanese encephalitis and the antibody level of healthy people in Longnan City, Gansu Province, analyze and evaluate its epidemic risk, and provide scientific basis for future prevention and control of Japanese encephalitis.Methods:By retrospective analysis, the data of Japanese encephalitis cases in Longnan City from 2015 to 2020 were collected from the "Japanese Encephalitis Monitoring Information Report Management System" of the "China Disease Prevention and Control Information System", and the distributions of the cases(time, region and population distribution) were statistically described and analyzed. In 2018, the cluster stratified sampling method was adopted to select Li County and Xihe County with higher incidence rate of Japanese encephalitis in Longnan City, and Wudu District and Hui County with lower incidence rate as monitoring sites, and 3 administrative villages (communities) were selected from each monitoring site to collect blood samples from healthy people to detect the level of Japanese encephalitis IgG antibodies.Results:From 2015 to 2020, a total of 261 cases of Japanese encephalitis were reported in Longnan City, with an average annual incidence of 1.66 per 100 000; among them, the number of reported cases in 2017 and 2018 accounted for 82.38% (215/261) of the total number of cases. The incidence of Japanese encephalitis was mainly concentrated in August, accounting for 72.03% (188/261); 9 counties (districts) in Longnan City had reported cases of Japanese encephalitis, and the top 5 counties (districts) with the number of cases were Li County (68 cases), Xihe County (64 cases), Wudu District (40 cases), Kang County (33 cases) and Cheng County (18 cases), accounting for 85.44% (223/261) of the total number of cases. The age of onset of Japanese encephalitis cases was mainly concentrated in the 40 - < 60 years old, accounting for 40.23% (105/261); male to female ratio was 1.00 ∶ 1.14 (122 ∶ 139); the occupation was mainly farmers, accounting for 75.86% (198/261). A total of 887 sera samples from healthy people were tested, and the antibody positive rate was 91.09% (808/887); the difference in antibody positive rate of different age groups was statistically significant (χ 2 = 5.77, P < 0.05); the differences of positive rate of antibodies between different genders and regions were not statistically significant (χ 2 = 0.45, 2.06, P > 0.05). Conclusions:The incidence of Japanese encephalitis in Longnan City is mainly middle-aged farmers, with a high incidence in August each year. After the outbreak of Japanese encephalitis in Longnan City in 2017 and 2018, it has showed a low epidemic trend, and the positive rate of Japanese encephalitis antibody in healthy people is high. It is recommended to carry out regular monitoring of Japanese encephalitis immunization level of healthy people and strengthen the immunization of key populations in time.

Objective:To study the value of myocardial perfusion imaging (MPI) and coronary flow reserve (CFR) combined with coronary artery calcium score (CACS) in the diagnosis of obstructive coronary artery disease (CAD).Methods:From January 2019 to December 2020, 96 confirmed or suspective CAD patients (65 males, 31 females; age: 30-81 years) who completed rest/stress MPI, CFR and CACS defection in Fuwai Central China Cardiovascular Hospital were retrospectively analyzed. Coronary angiography (CAG) was used as the diagnostic standard to calculate the sensitivity and accuracy of MPI, CFR and MPI/CFR combined with CACS in the diagnosis of CAD. The χ2 test was used to compare the diagnostic efficiency of different methods. Results:The diagnostic sensitivity of MPI was 76.06%(54/71), and the accuracy was 75.00%(72/96), while the sensitivity increased to 97.18%(69/71; χ2=13.67, P<0.001) and the accuracy increased to 87.50%(84/96; χ2=4.92, P=0.020) with significant differences after combined with CACS. The sensitivity and accuracy of CFR were 91.55%(65/71)and 87.50%(84/96), which increased to 97.18%(69/71; χ2=2.12, P=0.137) and 89.58%(86/96; χ2=0.21, P=0.411) with no significant differences after combined with CACS. The sensitivity of MPI in the diagnosis of three-vessel CAD was 70.00%(21/30), which increased to 100%(30/30; χ2=7.75, P=0.004) after combined with CACS; while the sensitivity of MPI combined with CACS in the diagnosis of single-vessel and double-vessel CAD were not significantly improved ( χ2 values: 3.29, 1.51, P values: 0.114, 0.416). Conclusion:The combination of MPI and CACS can significantly improve the diagnostic efficiency of CAD, contributed by the improvement of the diagnostic sensitivity in three-vessel disease; whereas the diagnostic efficiency of CFR for CAD is not significantly improved after combined with CACS.

To summarise Professor WANG Xixing's experience in treating brain tumour from emotions and minds. Professor WANG regarded abnormal emotions and minds as the key to the treatment of brain tumor. Emotions and minds internal damage lead to malfunction of the five zang organs， resulting in phlegm， stasis， dampness， toxicity and other pathogenic qi gathering in the brain and developing into brain tumour. The treatment advocated regulating qi of the five zang organs and dispelling phlegm， blood stasis， dampness and toxins at the same time. The brain tumour is classified into four syndromes： heart-spleen deficiency， liver depression and spleen deficiency， failure of the heart and kidney to interact， and liver-kidney yin deficiency， with Guipi Yangshen Decoction （归脾养神汤） to fortify the spleen and nourish the heart， Guishao Shunzhi Decoction （归芍顺志汤） to soothe the liver and fortify the spleen， Liangui Tongshen Decoction （连桂通神汤） to restore interaction between the heart and the kidney， and Zishui Qingmu Huashen Decoction （滋水清木化神汤） to nourish the kidney and clear liver. At the same time， it was emphasised that the patient's emotional changes should be paid attention to， and psychological guidance should be given at the right time， so as to overcome the disease with emotions and mind.

Objective:To evaluate the endometrial implantation window in patients with recurrent implantation failure using endometrial receptive array(ERA)sequencing or endometrial histological detection methods,and to explore the effectiveness and cost-effectiveness analysis of two technologies for improving clinical outcomes in such patients.Methods:A retrospective cohort study was conducted on clinical data of 125 patients diagnosed with repeated implantation failure in Gansu Maternal and Child Health Hospital from January 2018 to December 2022.According to whether endometrial receptivity testing was accepted and different detection techniques were used,they were divided into a control group(n=36),a genomic group(n=35),and a histological group(n=54).The clinical data and pregnancy outcomes of the three groups were compared.Results:①The results of one-way ANOVA showed that the embryo implantation rate in the genomic group and histological group was significantly higher than that in the control group,and the difference was statistically significant(P＜0.05).There was no sta-tistically significant difference in embryo implantation rate between genomic and histological groups(P=0.48).②There was no statistically significant difference in clinical pregnancy rate and live birth rate among the three groups(P＞0.05).③Log rank test showed:The time for 50％of patients to reach live labor was significantly shorter than that of the control group,and the difference was statistically significant(P＜0.05);There was no sta-tistically significant difference in the time to live birth in 50％of patients between the genomic and histological groups of 50％of patients(P＞0.05).④The average number of embryos transferred in the control group was significantly higher than that in the genomic and histological groups,with statistical significance(P＜0.05).The cost of genomic patients was significantly higher than that of histology group,and the difference was statistically significant(P＜0.05).Conclusions:①Endometrial implantation window detection is feasible for patients with re-peated implantation failure,which can effectively shorten the time to live birth and reduce the number of transplan-ted embryos;②Both ERA sequencing and endometrial histology detection have limitations as methods to evaluate endometrial implantation window,and it is not clear which detection method has more advantages in accuracy and practicability.