Objective To examine the protein expression levels of ERCC1 and RRM1 in non-small cell lung cancer(NSCLC)and its adjacent tissues in order to identify the the relationship between these expression profiles ,the pathological features and survival time of NSCLC undergoing platinum-containing chemotherapy .Methods The levels of ERCC1 and RRM1 protein expression in 121 NSCLC and adjacent cancer tissue were measured by immunohistochemistry .The relationship between survival time and the expres-sion of these two proteins was used by follow-up study .Results ERCC1 and RRM1 exhibited higher expression in NSCLC cancer compared with normal cancer tissues (P<0 .05) .After receiving platinum-containing chemotherapy postoperatively ,patients with ERCC1 or RRM1 negative expression showed prolonged median overall survival and median time to progression compared with those with positive expression (P<0 .05) .Conclusion The expression of ERCC1 ,RRM1 may have important correlation with the development of lung cancer .ERCC1 or RRM1 of negative protein expression has positive sensitive with platinum .

OBJECTIVE:To investigate the effects of salvianolate combined with bezafibrate on clinical efficacy,inflamma-tory factors and ventricular function of patients with ischemic cardiomyopathy,and the safety. METHODS:A total of 138 pa-tients with ischemic cardiomyopathy selected from our hospital during Mar. 2015-Mar. 2016 were randomly divided into observa-tion group and control group according to random number table,with 69 cases in each group. Control group was given Bezafi-brate dispersible tablets 0.2 g,po,tid. Observation group was additionally given Salvianolate for injection 200 mg added into 0.9% Sodium chloride injection 250 mL,ivgtt,qd,on the basis of control group. A treatment course lasted for 14 d,and both groups received 2 courses of treatment. Clinical efficacies,the levels of serum inflammatory factors (CRP,TNF-α,IL-6, MMP-9,MCP-1),ventricular function parameters(LVESD,LVEDD,LVEF)were compared between 2 group. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group(97.10%)was significantly higher than that of con-trol group(86.96%),with statistical significance(P<0.05). Before treatment,there was no statistical significance in serum lev-els of CRP,TNF-α,IL-6,MMP-9,MCP-1,LVESD,LVEDD and LVEF between 2 groups(P>0.05). After treatment,the lev-els of CRP,TNF-α,IL-6,MMP-9,MCP-1,LVESD and LVEDD in 2 groups were decreased significantly,while LVEF level was decreased significantly;the improvement of observation group was more significant than that of control group,with statisti-cal significance (P<0.05). No serious ADR was found in 2 groups during treatment. CONCLUSIONS:Salvianolate combined with bezafibrate have significant therapeutic efficacy for ischemic cardiomyopathy,reduce serum inflammatory factor level and improve ventricular function with good safety.

Objective To investigate natural killer(NK) and NKT cells in acute pancreatitis(AP).Methods Changes of NK and NKT cells in peripheral blood of 86 AP cases were detected using muhiparameter flow cytometry.Results Compared with control group,the NKT cells decreased in AP patients (t =5.23,P =0.00),but NK cells didn't (t =-1.15,P =0.25).NKT cells in severe SAP and mnoderate MAP were lower than that in the control group (t =-3.92,P =0.00;t =4.84,P =0.00).There was no statistically significant difference of NK cells between MAP and the controls (t =-0.54,P =0.59),but NK cells in SAP group was obviously higher than that in control group (t =3.12,P =0.00).After one week treatment,NK cells significantly decreased (t =8.43,P =0.00).NKT cells were higher than control group (t =-4.44,P =0.00).Dynamic monitoring in AP patients found continuous declination in NK cells,and NKT cells experienced an increase before a falling.Conclusion Monitoring of NK and NKT cells can be used as an important index for the severity and response to treatment in acute pancreatitis.

Objective To study on the value and safety of early endoscopic retrograde cholangiopan-creatography (ERCP)and endoscopic sphincterotomy (EST) in acute biliary pancreatitis. Methods Ninety-two patients with acute biliary pancreatitis underwent early ERCP (within 72 hours) and received endoscopic therapy (ERCP group). Another 40 patients with acute biliary pancreatitis were treated conservatively without ERCP (control group). The disappearance of abdominal pain, decrease of serum amylase level, the mean days and costs of hospitalization and complications were observed in all patients. Results In ERCP group, all patients were performed EST, stones in 72 choledocholithiasis patients had been removed with net-basket or air pocket. Ten cases of severe acute biliary pancreatitis received endoscopic pancreatic duct stents drainage. Ninety two cases of acute biliary pancreatitis received endoscopic nasal catheter bile drainage. The days of the disappearance of abdominal pain, the decrease of serum amylase levels, the cost of the hospitalization and the days of the hospitalization were significantly shorter in the early ERCP group than in the control group. The mortalities in ERCP and control group were 8. 3% and 33. 3% respectively. Conclusion Early ERCP endoscopic therapy is a safe procedure has the superiorities in lowering the mortality, hospital days and expense.

Objective To evaluate the safety and efficacy of an endoscopic dilation in association with the intramuscular injection of either mitomycin C for benign esophageal strictures. Methods A total of 89 patients with benign esophageal strictures were retrospectively divided into 3 groups, including 30 cases of dilation combined with mitomycin C injection (mitomycin C group) , 29 of dilation combined with dexamethasone injection (dexamethasone group) and 30 of dilation with saline injection (dilation group). The successful rate, complications and the clinical effect in the 3 groups were compared. Results The 89 patients all successfully received the procedure, with the endoscopic and clinical release. No massive hemorrhage occurred. In mitomycin C group, 1 case with major complication (perforation) and 7 minor complication occurred;9 and 7 cases with minor complication occurred in dexamethasone group and dilation group, respectively. There were no significant difference of the complications in the 3 groups (P<0. 05). The mean dysphagia-free period was 5. 25±1. 18 months in the mitomycin C group, 4. 46±1. 53 months in the dexamethasone group, and 3. 03±1. 62 months in the dilation group (P<0. 05). Conclusion Endo-scopic dilation with or without the intramuscular injection of either mitomycin C or dexamethasone are safe and effective. Dilation combined with drug injection may prolong the esophageal dysphagia-free period. Furthermore, mitomycin C injection may have the dominant effect.

Objective:To evaluate the objective imaging markers of cognitive impairment in patients with end-stage renal disease by MRI intravoxel incoherent motion.Methods:A total of 40 patients with ESRD were enrolled in the Department of Nephrology, Changzhou Second Hospital Affiliated to Nanjing Medical University from January 2019 to August 2020, and 24 healthy controls were prospectively enrolled at the same time.All subjects performed with MRI scan were collected, and the slow apparent diffusion coefficient (ADC slow) of the corresponding brain regions were obtained .The cognitive function was evaluated by the Montreal cognitive assessment scale (MoCA). Two-sample t test was used to analyze the difference of ADC slow and cognitive score between the two groups.Pearson correlation analysis was performed among the cognitive function score of end-stage renal disease and ADC slow value. Results:(1) The score of the intelligence test scale in the ESRD group (23.30±1.76) was significantly lower than that of the healthy control group (27.92±1.00) ( P<0.01). The ADC slow values of bilateral frontal lobe, hippocampus, and insula brain areas (respectively(0.648±0.035), (0.633±0.043), (0.762±0.043), (0.756±0.042), (0.792±0.048), (0.776±0.054))in the ESRD group were significantly higher than those in the healthy control group ((0.600±0.039), 0.610±0.037, (0.725±0.059), (0.711±0.054), (0.740±0.063), (0.716±0.051)) ( P<0.01). (2) Pearson correlation analysis showed that the ADC slow values of bilateral insula and right hippocampus in the ESRD group were negatively correlated with MoCA scales ( r=-0.38, -0.38, -0.66, all P<0.05). Conclusion:ADC slow value in IVIM can better reflect the changes of cognitive function impairment in ESRD patients.

Objective To evaluate the clinical effects of the totally laparoscopic and laparoscopic-assisted radical gastrectomy for gastric cancer,and evaluate the feasibility and safety of the two methods.Methods Eighty patients with gastric cancer undergoing radical D2 gastrectomy from Mar 2016 to Jul 2017 were enrolled.Patients were divided into totally laparoscopically hand-sewn escophagojejunostomy group (35 cases) and control group of hand-assisted laparoscopic esophagojejunostomy (45 cases).Results Compared with the control group,the operation time,blood loss,lymph node dissection in the control group were not significantly different [(256 ± 53) min vs.(248 ± 62) min,t =2.40,P ＞ 0.05;(123 ±78)ml vs.(162±56)ml,t=-1.94,P＞0.05;(28±6) vs.(30±7),t=-3.18,P＞0.05].The postoperative ambulation time,first exhaust time,postoperative hospital stay,incision complications were all in favor of the totally laparoscopic group [(1.5 ± 0.7) d vs.(2.6 ± 0.6) d,t =-2.41,P ＜ 0.05;(2.7 ±0.8)d vs.(4.0 ±1.2)d,t =-4.63,P＜0.01;(6.8 ±0.8)d vs.(9.2 ± 1.6)d,t =-7.32,P＜0.05].Conclusions Totally laparoscopic radical gastrectomy and hand-sewn esophagojejunostomy for gastric cancer is safe and reliable and has advantages such as less pain and fast recovery.

Objective To investigate the imaging features and pathogenesis of lethal iatrogenic hemobilia(LIH)and the value of transarterial intervention in the treatment of LIH.Methods A total of 269 patients with upper gastrointestinal bleeding who were admitted to The First Affiliated Hospital of Nanjing Medical University from August 2009 to July 2023 were enrolled,among whom 24 had a confirmed diagnosis of LIH and received treatment,and a retrospective analysis was performed for the clinical data of these 24 patients,including the iatrogenic causes,angiographic findings,and arterial interventions of LIH.Among the 24 patients,23 received transarterial embolization(TAE)with gelatin sponge particles and coils,and 1 received a covered stent for isolation.The main criteria for assessing treatment outcome included the technical success rate of surgery,procedure-related complications,and long-term clinical follow-up.Results Among the 24 patients with LIH,12 had LIH caused by interventional procedures,and 12 had LIH caused by hepatobiliary and pancreatic surgery.The main clinical manifestations included a significant reduction in blood pressure or a persistent reduction in hemoglobin in 13 patients and upper gastrointestinal bleeding in 18 patients.Among the 24 patients,2 developed symptoms during surgery,4 developed symptoms within 24 hours,and 18 developed symptoms after 24 hours.Angiography showed a positive bleeding rate of 100%(24/24),and imaging findings included pseudoaneurysms in 15 patients,hepatic artery truncation in 3 patients,extravasation of contrast medium in 5 patients,and hepatic arteriobiliary fistula in 3 patients.Among the 24 patients,23 received TAE and 1 received stent implantation.Successful hemostasis was achieved for 23 patients,with a technical success rate of 95.8%(23/24).Four patients developed hepatic necrosis and abscess after TAE,and there was no rebleeding or recurrence after hemostatic treatment.Conclusion Various iatrogenic injuries may result in LIH with diverse clinical and imaging findings,and integrated diagnostic imaging combined with transarterial intervention is the best effective life-saving measure for LIH.

Objective:To investigate the association of peripheral axial lengths and retinal curvatures with refractive status.Methods:A cross-sectional study was conducted out.Two hundred and eighty-seven eyes of 287 consecutive children aged 6-15 years old who recieved eye examinations at Beijing Tongren Hospital from July to October 2021 were enrolled, including 154 males and 133 females.Uncorrected and best corrected visual acuity were tested with a standard logarithmic visual acuity chart.Spherical equivalent (SE) was measured via an auto refractometer after cycloplegia with tropicamide.The hyperopic, emmetropic and myopic groups were defined with a SE >+ 0.5 D, SE >-0.5 D to ≤+ 0.5 D and SE≤-0.5 D, respectively.Central and 30° peripheral eye lengths (nasal, temporal, superior, inferior) were obtained using the Lenstar LS900.Retinal coordinates were derived from partial coherence interferometry modeling and converted to retinal curvatures.According to the median horizontal peripheral eye length differences (absolute difference between nasal and temporal), participants were assigned to H1 group (absolute difference <0.35 mm) or H2 group (absolute difference ≥0.35 mm). According to the median vertical peripheral eye length differences (absolute difference between superior and inferior), participants were assigned to V1 group (absolute difference <0.32 mm) or V2 group (absolute difference ≥0.32 mm). Four groups of V1H1, V1H2, V2H1 and V2H2 were constructed according to the grouping methods in both directions above.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2021-162). Written informed consent was obtained from guardians of each subject prior to any medical examination.Results:The central axial length was 23.53(22.93, 24.10)mm.Peripheral eye lengths of temporal, nasal, superior and inferior were 22.75(22.11, 23.22)mm, 22.99(22.32, 23.45)mm, 23.24(22.58, 23.75)mm and 23.12(22.52, 23.56)mm, respectively.Temporal eye length was shorter than nasal, showing a statistically significant difference ( Z=-3.58, P<0.01). Compared with H2 group, H1 group had shorter central, nasal, superior and inferior eye lengths, showing statistically significant differences (all at P<0.05). Compared with V2 group, V1 group had shorter central, nasal and superior eye lengths, showing statistically significant differences (all at P<0.05). SE of H1 group was + 0.06 (-1.06, + 0.75) D, which was significantly greater than -0.32 (-1.64, + 0.56) D of H2 group ( Z=-2.10, P=0.04). SE of V1 group was + 0.13 (-0.81, + 0.80) D, which was significantly greater than -0.56 (-1.83, + 0.48) D of H2 group ( Z=-3.39, P<0.01). The myopia ratio of V1 group was 33.5% (58/173), which was significantly lower than 50.5% (53/105) of V2 group ( χ2=7.83, P<0.01). There was a significant overall difference in SE among VIH1, V1H2, V2H1 and V2H2 groups ( H=24.79, P<0.01). SE was greater in V1H1 group than V1H2, V2H1 and V2H2 groups (all at P<0.01). There was a significant difference in both horizontal and vertical retinal curvatures among different refractive groups ( H=22.34, 19.30; both at P<0.01). The retical curvature in both directions of hyperopic and emmetropic groups were significantly larger than those of myopic group (both at P<0.01). Conclusions:Peripheral eye lengths are asymmetric in school-aged children.Higher asymmetry is associated with myopic shifts.Myopic children have a steeper retina than the hyperopic and emmetropic children.

Objective To analyze the serum levels of apurinic/apyrimidinic endonuclease 1 au-toantibodies(APE1-AAbs)and growth differentiation factor 15(GDF-15)and their predictive value for postoperative recurrence and metastasis in patients with colorectal cancer.Methods Fifty-two pa-tients with colorectal cancer were selected as observation group,and were divided into postoperative re-currence and metastasis group(n=15)and non-recurrence and metastasis group(n=37)according to prognosis.Fifty-two healthy individuals undergoing routine physical examination during the same pe-riod were selected as the control group.The levels of APE1-AAbs and GDF-15 were measured.Pear-son correlation analysis was used to analyze the correlations of APE1-AAbs,GDF-15 with post-surgical recurrence and metastasis of colorectal cancer.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of APE1-AAbs and GDF-15 for post-surgical recurrence and metastasis of colorectal cancer.Results The levels of APE1-AAbs and GDF-15 in the observation group were significantly higher than those in the control group(P＜0.05).The levels of APE1-AAbs and GDF-15 in the postoperative recurrence and metastasis group were significantly higher than those in the non-recurrence and metastasis group(P＜0.05).There was a positive correlation between the levels of APE1-AAbs,GDF-15 and post-surgical recurrence and metastasis of colorectal cancer(P＜0.05).The combined use of APE1-AAbs and GDF-15 had higher predictive value for post-surgical recurrence and metastasis of colorectal cancer than either single prediction(P＜0.05).Conclusion APE1-AAbs and GDF-15 are highly expressed in the serum of colorectal cancer patients.APE1-AAbs and GDF-15 may serve as markers for post-surgical recurrence and metastasis of colorectal cancer.