Lin28 is a highly conserved RNA-binding protein that has an important role in human body development, metabolism, and tumorigenesis. Previous studies have found that the activation of Lin28 can suppress the maturity of let-7 miRNA in stem cells and promote the proliferation of stem cells by upregulating cell-cycle related genes, such as cyclins A and B. Other mechanisms underlying the activation of Lin28 can selectively block the processes of pre-let-7 miRNA in embryonic stem cells and ultimately promote tumori-genesis. In addition, Lin28 affects the occurrence, development, and prognosis of cancer by inhibiting the differentiation and maturation of miRNA and by moderating the expression of some cell-cycle related genes. Lin28 has an important function in the tumor's tolerance of chemotherapy and radiotherapy. We review the physiological function of Lin28 in tumors and its function in tumor treatment.

Objective To analyze the correlation of characteristics of carotid artery structure and the incidence of residual stenosis after carotid artery stent (CAS) placement and its influencing factors using color Doppler flow imaging (CDFI).Methods Five hundred and ninety-six cases from January 2013 to December 2015 who underwent CAS (600 pieces of stent) were included in this study.All patients were examined by CDFI within 1 month before and 1 week after carotid artery stenting.The incidence of residual stenosis was analysed.The correlation of residual stenosis and the characteristics of carotid artery lesions and atherosclerotic plaque before stenting were analyzed respectively.Results There was positive correlation between the incidence rates of residual stenosis and irregularly shaped plaque (odd ratios,9.02;95% confidence interval,5.21-15.59,P<0.05),the plaques with calcification in the surface(odd ratios,2.55;95% confidence interval,1.45-4.49,P<0.05),the residual diameter of carotid stenosis less than 1.0 mm(odd ratios,1.61;95% confidence interval,1.06-2.45,P<0.05),which were the independent risk factors for influencing residual stenosis after CAS.Conclusions Choosing a more adaptable stent based on the characteristics of carotid artery lesions and atherosclerotic plaque by CDFI before stenting may be useful for the patients to get best result of revascularization.The rate of residual stenosis may be decreased.

Objective To investigate clinical manifestations and histopathological features of cutaneous metastasis of malignant visceral tumors,to improve diagnosis of cutaneous metastasis of malignant visceral tumors.Methods A total of 50 patients with cutaneous metastasis of malignant visceral tumors were enrolled from Shanghai Skin Disease Hospital between January 2012 and June 2018,and the features of the skin lesions,source of tumors,histological and immunohistochemical features were retrospectively analyzed.Results There were 24 males and 26 females among the 50 patients,with an average age of 67.0 years (range,28-93 years).The average duration from the notice of cutaneous metastasis of malignant visceral tumors to the first clinic visit was 4.4 months (range,2 weeks-13 months).Cutaneous metastasis of malignant visceral tumors mostly occurred on the chest (16 cases),followed by the lower limbs (7 cases),the head and neck (5 cases),the back (5 cases),the abdomen (4 cases),the external genitalia (4 cases) and the upper limbs (3 cases).Cutaneous metastasis of malignant visceral tumors simultaneously or successively occurred on multiple sites in 6 cases.The most common skin lesion was solitary lump (35 cases,70％),followed by multiple papules and nodules (13 cases,26％),infiltrative plaques (1 case,2％) and non-infiltrative erythema (1 case,2％).The most common types of primary cancers were breast cancer (11 cases,22％),lung cancer (9 cases,18％) and gastric cancer (6 cases,12％),and the most common histological types were adenocarcinoma (32 cases,64％) and squamous cell carcinoma (8 cases,16％).Conclusions Cutaneous metastasis of malignant visceral tumors mostly occur in the elderly and on the chest.The most common skin lesion was solitary lump.Breast carcinoma,lung cancer and gastric cancer are the most common primary tumors,and adenocarcinoma and squamous cell carcinoma are the most common histological types.

Patients with cyclic vomiting syndrome usually have comorbid psychological disorders,the trigger and aggravating factors of gastrointestinal symptoms.It may decrease the quality of life and the response to the conventional therapies,bring the patients to seek medical care frequently and perform unnecessary examinations,result in the waste of medical resources.We reported a 20-year-old woman with complaint of recurrent vomiting since infant,and less response to symptomatic and supportive treatment.Her vomiting relieved with antidepressant after consultation with gastroenterological specialist and psychologist.Physicians should pay more attention to recognize the comorbid psychological disorders in patients with functional gastrointestinal disorders (FGIDs),including cyclic vomiting syndrome.It is important to refer the patients with refractory symptoms to the psychologists for further professional evaluation and antidepressants.

Objective To investigate the effect of serum lipid level on carotid artery stenosis in patients with ischemic cerebrovascular disease.Methods Using a multi-center cross-sectional study,10 711 consecutive inpatients with transient ischemic attack (TIA) or ischemic stroke diagnosed clearly in 20 stroke screening and prevention project base hospitals from June 2015 to May 2016 were enrolled.According to the results of carotid ultrasonography,1 560 patients with extracranial carotid artery stenosis rate≥50% screened were enrolled in the study.They were divided into a severe stenosis group (70%-99%) and a mild-moderate stenosis group (<70%).The distribution of total cholesterol (TC),triacylglycerol (TG),low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels in both groups of carotid stenosis patients were analyzed,and the quantitative classification was based on the normal range of serum lipids.The distributions of serum lipid levels in different grades in patients of both groups were compared with the non-parameter test.Results The incidence of dyslipidemia in the severe stenosis group was higher than that in the mild and moderate stenosis group.There was no significant difference between the two groups (54.4%[319/586]vs.48.3%[470/974],P<0.05).Dyslipidemia was an independent risk factor for severe carotid artery stenosis (OR,1.27,95% CI 1.24-1.30,P<0.01).The TC and LDL-C levels in patients of the severe stenosis group were significantly higher than those in the mild-moderate stenosis group (TC:3.98[3.31,4.82]mmol/L vs.3.91[3.31,4.53]mmol/L,LDL-C:2.48[1.86,3.14]vs.2.30[1.79,2.80];all P<0.01).With the increase of TC and LDL-C levels,there was significant differences between the severe stenosis group and the mild-moderate stenosis group (all P<0.05),and the proportions of TC >5.80 mmol/L (7.3%[43/586]vs.0.4%[4/974]) and LDL-C>3.12 mmol/L (26.3%[154/586]vs.10.0%[97/974]) in patients of the severe stenosis group were higher than those in the mild-moderate stenosis group (26.3%[154/586]vs.10.0%[97/974]).Conclusion The high LDL-C and TC levels may increase the incidence of severe carotid artery stenosis or occlusion.

A young male patient with abdominal pain and fever was diagnosed as acute hyper-triglyceridemicpancreatitis is clear. During the recovery of pancreatitis, the patient developed acute acalculous cholecystitis, as well as carbapenem-resistant Enterobacter infection and Cytomegaloviremia, and had anaphylaxis for several times after the use of antibiotics, which cannot be completely explained by drug allergy. This paper analyzes the possible causes of multiple diseases in the same patient in detail.