AIM: To investigate the expression and effects of sialyl Lewis X (SLeX) on the invasion and migration of human hepatocellular carcinoma HepG2 cells.METHODS: The expression of α1,3-fucosyltransferase VII (FUT7) in HepG2 cells and L-02 cells was detected by RT-qPCR and Western blot.The SLeX expression in HepG2 cells and L-02 cells was determined by Western blot and immunocytochemical staining.The invasion and migration abilities of the treated cells were evaluated by Transwell assay.RESULTS: The expression of FUT7 and SLeX in the HepG2 cells, but not in the L-02 cells, was observed.The invasion rates of the HepG2 cells treated with SLeX monoclonal antibody at 0.05, 0.5 and 5 mg/L were significantly decreased as compared with control group (P<0.05).The migration ability of the HepG2 cells treated with SLeX monoclonal antibody at 0.05, 0.5 and 5 mg/L was also significantly reduced as compared with control group (P<0.05).The invasion rate and migratory cell number were significantly different between any 2 groups in the HepG2 cells treated with SLeX monoclonal antibody at 0.05, 0.5 and 5 mg/L (P<0.05).CONCLUSION: HepG2 cells express SLeX.SLeX is closely related to the migration and invasion abilities of the HepG2 cells.

Objective To evaluate the feasibility of increasing the perfraction dose in treatment of neoplasms by 3DCRT (three- dimention confornial radiation therapy). Methods From May 1998 to June 2002, the radiation therapy plans of 300 out- cranial neoplasms patients were analysed retrospectively, including 143 patients with chest neoplasms and 157 patients with abdomen neoplasms. The PTV was 7.0 ~ 1 478 cm3, major PTV was encircled by 90 % isodose curve, minor 95 % PTV were encircled by 80 % isodose curve. Prescription dose was 90 % reference point dose, perfraction dose was 5 ~ 10 Gy, a majority of dose was 6 ~ 8 Gy, period of treatment was 5 ~ 15 days with an interval of 0 ~ 1 day. The general dose was given to radical cure dose or appeasement dose. The biological effect increased 10 % ~ 30 %. Results All treatment plans were accomplished and there were not complication which reduced patients' QOL. Conclusions 1.Owing to the f factor, increasing dose of perfraction, shortening general period of treatment and improving radiative biological effect were possible during the 3DCRT. 2. It was suggested that the larger out- cranial neoplasms should be treated by 3DCRT firstly, but precise plan, precise design and precise treatment can not intensely be pursued because of the limit of knowledge. 3. During the 3DCRT for out- cranial neoplasms, 2 ~ 3 times routine radiation therapy dose was secure, credible and effective according to different purpose.

Objective To study the clinical efficacies of different surgical palliative treatments for patients with advanced pancreatic carcinoma.Methods A retrospective analysis was conducted on the clinical data of 119 patients with advanced pancreatic carcinoma who were treated in the department of General Surgery of Linyi's Central Hospital from January 2010 to January 2016.According to the different surgical methods the patients received,they were divided into the seed group (n =38),the radiofrequency ablation (RF) group (n =52) and the control group (n =29).Patients' general data,operation data,postoperative complications and follow-up profiles were analyzed.Results There was no significant difference in the patients'general data among the three groups of patients (P ＞ 0.05).The incidences of postoperative complication in the seed group,the RF group and the control group were 55.3％,38.5％ and 20.7％,respectively.There was significant differences between the incidences of postoperative complications between the seed group and the control group (P ＜ 0.05).There was no perioperative death.The postoperative follow-up rate was 91.6％.Pain in the seed group and the RF group significantly improved,while it was not significantly improved in the control group.There were significant differences in the postoperative pain scores (P ＜0.05).The 6 months,1-year and 2-year overall survival rates were 61.3％,25.9％,8.6％ respectively.The median survival was 8 months.In the seed group,the 6 months,1-year and 2-year survival rates were 75.2％,37.8％,18.9％ respectively.The median survival was 9 months.In the RF group,the 6 months,1-year and 2-year survival rates were 60.4％,25％,6.3％ respectively.The median survival was 8 months.In the control group,the 6 months,1-year and 2-year survival rates were 53.4％,15.3％,3.8％ respectively.The median survival was 6.5 months.On log-rank test,there was no significant difference in survival rates among the three groups (P =0.145).Conclusions Patients with advanced pancreatic carcinoma had poor prognosis.I125 radioactive particles implantation and radiofrequency ablation were useful to improve patients'quality of life and prolonged their survival.

Intraductal papillary mucinous neoplasm (IPMN) is one of the precancerous lesions of the pancreas. Currently there is controversial over the management and follow-up strategy of IPMN, including the timing of surgery. The core problem lies in the accurate preoperative assessment of the nature of the lesions and the risk of malignant transformation. Cumulation of high-quality evidence and development of efficient evaluation methods are vital for the establishment of standardized decision-making system and the improvement of clinical benefits to patients. This review aims to summarize the consensus and controversies on surgical evaluation standards in the latest guidelines and representative literatures, and to look forward to the development direction of IPMN diagnosis and treatment decisions in combination with the progress of related evaluation techniques.

As an important course in medical laboratory science, clinical immunology is composed of advanced immunological knowledge and advanced testing technology, which are closely related to many disciplines, such as basic medicine, clinical medicine and so on. Medical educators introduced case-based teaching into clinical immunology, selected the typical, enlightening and interesting clinical cases, designed some reasonable questions for students majoring in medical laboratory science and improved students' participation via pre-class discussion and answering their questions during class, so as to help them study actively. Case-based teaching has been proved through practice as one of the important ways to improve the learning efficiency of medical students and promote their overall development, and it is a successful method for teaching reform.

Objective:To study the differences in preoperative examination indexes between pancreatic head cancer and distal bile duct cancer, and to establish a preliminary prediction model to provide reference for clinical decision-making.Methods:Retrospective analysis was conducted on 243 consecutive patients who underwent open radical pancreaticoduodenectomy from January 1, 2015 to December 31, 2019 at the Chinese PLA General Hospital. There were 177 males and 66 females, aged (58.9±8.9) years old. Based on postoperative pathological results, these 243 patients were divided into the pancreatic head cancer group ( n=113) and the distal bile duct cancer group ( n=130). The clinical data of the two groups were collected. Minimum absolute value convergence and selection operator regression were used to screen the best predictors of pancreatic head cancer. The rms package was used to construct the nomogram model, and k-fold cross was used for internal validation. Results:Seven best predictive indexes are selected: age, rate of weight loss, main pancreatic duct diameter, neutrophil/lymphocyte, DTR (DBil/TBil), carcinoembryonic antigen and CA125. Based on these indexes, a nomogram prediction model was constructed with the C-index of 0.868 after k-fold cross-validation, indicating that discrimination of the model to be acceptable. Validation using calibration curve exhibited good concordance between the predicted probability with the ideal probability ( P=0.728). Conclusion:The nomogram prediction model established in this study effectively predicted patients with pancreatic head cancer, and helped preoperatively to differentiate pancreatic head cancer from distal cholangiocarcinoma.

Objective:To study the risk factors for early recurrence of patients undergoing radical pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) and construct a normogram model.Methods:Patients undergoing open radical PD for PDAC at Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital from January 2014 to December 2021 were retrospectively screened. A total of 213 patients were enrolled, including 145 males and 68 females, aged (58.4±9.8) years. Patients were divided into the early recurrence group ( n=59, recurrence within 6 months after surgery) and a control group ( n=154, no recurrence within 6 months after surgery). Using minimum absolute value convergence and selection operator regression (LASSO) and multi-factor logistic regression analysis, we screened out the best predictor of early recurrence after PD for PDAC, and then established a nomogram model. The effectiveness of the model was validated by receiver operating characteristic (ROC) curve, calibration curves, and decision analysis curves. Results:Multivariate logistic regression analysis showed that patients with obstructive jaundice, vascular invasion, massive intraoperative bleeding, high-risk tumors (poorly differentiated or undifferentiated), high carbohydrate antigen 19-9 to total bilirubin ratio, and high fibrinogen and neutrophil to lymphocyte ratio scores had a higher risk of early postoperative recurrence. Based on the indexes above, a nomogram prediction model was constructed. The area under the ROC curve was 0.797 (95% CI: 0.726-0.854). Validation of the calibration curve exhibited good concordance between the predicted probability and ideal probability, decision curve analysis showed that the net benefits of the groupings established according to the model were all greater than 0 within the high risk threshold of 0.08 to 1.00. Conclusion:The nomogram for predicting early recurrence after PD for PDAC has a good efficiency, which could be helpful to screen out the high-risk patients for adjuvant or neoadjuvant therapy.

Objective:This study aims to determine the efficacy of chemotherapy and to identify potential chemotherapy agents for advanced primary duodenal carcinoma (PDC). Methods:Fifty-six patients with advanced PDC, who did and did not receive chemo-therapy, were involved in this study. Response rates (RR), disease control rates (DCR), progression-free survival (PFS), and overall sur-vival (OS) were analyzed. Results:The overall RR and DCR of 43 patients were 19.04%and 71.42%, respectively. The patients who re-ceived chemotherapy agents fluorourzcil and oxaliplatin exhibited higher RR compared with patients who received other chemotherapy combinations (35.29%vs. 7.69%, P=0.010 9). Palliative chemotherapy improved the OS of patients with advanced PDC compared with patients who did not receive chemotherapy (13.35 months vs. 5.65 months, HR=0.203, 95%CI:0.083 to 0.497, P=0.000 5). Compared with the use of other chemotherapy regimens, treatment with a fluorourzcil-based chemotherapy agent resulted in a longer PFS (5.08 months vs. 1.08 months, HR=0.004, 95%CI:0.000 to 0.315, P=0.013 2). Multivariate analysis indicated mucinous histology and lymph mode metastasis as factors predictive of poor prognosis in patients with advanced PDC. Conclusion:Palliative chemotherapy may im-prove the OS of patients with advanced PDC.

Objective:This retrospective study aims to determine the efficacy of chemotherapy and improve a salvage chemother-apy agent for metastatic colorectal cancer (MCRC) after failure of treatment with irinotecan and oxaliplatin. Methods:Between Janu-ary 2002 and March 2013, 37 patients with metastatic MCRC who had progressed after treatment with irinotecan and oxaliplatin were analyzed for their response rate (RR) and progression-free survival (PFS). Results:The overall RR of the 37 patients was 13.51%, with 5 cases of partial response (PR), 12 cases of disease stabilization (SD), and 20 cases of progression (PD). Compared with other chemo-therapy regimens, treatment with a pemetrexed-based chemotherapy agent had a higher RR (17.64%vs. 10.00%, P=0.64) without a lon-ger PFS (2.00 months vs. 1.63 months, HR=0.79, 95%, CI:0.35 to 1.78, P=0.58). Compared with other chemotherapy regimens, treat-ment with a raltirexed-based chemotherapy agent had a higher RR (16.67%vs. 12.00%, P=0.34) without a longer PFS (1.58 months vs. 1.90 months, HR=2.24, 95%, CI:0.98 to 5.12, P=0.06).Conclusion:In patients with MCRC after failure of treatment with irinotecan and oxaliplatin, a pemetrexed-based or raltirexed-based chemotherapy agent may beneficial during salvage treatment and is therefore worthy of further study.

Desmoplastic stroma of pancreatic ductal adenocarcinoma plays an important role in tumor progression and treatment resistance. Stroma-targeted therapies are therefore promising for clinical application and extensive related researches are undergoing. In this article, recent advances in stromal targeting strategies were reviewed from three perspectives: cancer-associated fibroblasts, extracellular matrix and angiogenesis, and an outlook for the future of this strategy was also provided.