By introducing an electro-withdrawing antipyrine group, N-(p-toluenesulfonyl)-N-(4-antipyrine)-10-methylacridinium-9-carboxamide triflate was prepared. The UV, FL and CL properties of the target compound and of its precursor were investigated by comparing with those of the model compound N-(p-toluenesulfonyl)-N-phenyl-10-methylacridinium-9-carboxamide triflate and the corresponding precursor respectively. The results show that acridine sulfonamide with a heterocyclic antipyrine group exhibits blue shift of both UV absorption and of maximum excitation wavelength(λex) and emission wavelength(λem) in FL spectra, comparing with the corresponding model compound. The λex of the final target and its precursor are 268 and 274 nm, respectively; and the λem are 321 and 327 nm, respectively, while λex of the model compound and its unmethylated precursor are 365 and 359 nm, respectively; and the λem are 504 and 440 nm, respectively. Moreover, the chemiluminescence of the final target compound triggered by H2O2 could finish within 1.1 s; and the quantum yield is similar to that of the model compound, being 5.6 times high as that of luminol.

Objective To investigate the effect and the potential mechanism of splenic artery coarctation on the expression of iNOS and Th1/Th2 cytokines in spleen of cirrhotic rats with portal hypertension (PHT). Methods Cirrhotic rats were randomized into 3 groups (n= 10):sham operation group (SOG), splenic artery coarctation group (SAC) and splenic artery ligation group (SAL). Ten normal rats treated with sham operation were employed to serve as normal control group (NCG). Immunohistochemial staining was used to observe iNOS. RT-PCR was used to detect IFN-γ and IL-4mRNA. The Pearson's correlation analysis was used to investigate the relationship between iNOS and IFN-γ or IL-4. Results The expression of iNOS was increased significantly in spleen of cirrhotic rats as compared with NCG(P＜0. 01). It was decreased after SAC and SAL compared with SOG (P＜0. 01). The expression of IFN-γmRNA and IFN-γ/IL-4 of SOG were decreased but IL-4mRNA increased significantly than that of NCG(P＜0.01). IFN-γmRNA was increased after SAC compared with SOG (P＜0.05). IL-4mRNA was decreased and IFN-γ/IL-4 increased after SAC and SAL compared with SOG (P＜0. 05). The expression of iNOS was negatively correlated with the expression of IFN-γmRNA(r=-0.672, P＜ 0.01 ) and positively correlated with the expression of IL-4 mRNA (r=0.634,P＜0. 01). Conclusion The expression of iNOS is decreased and IFN-γ/IL-4 increased after SAC in spleen of cirrhotic rats with PHT and it may improve Th1/Th2 polarization by reducing the expression of iNOS.

Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients over 80 years old with biliary-pancreatic diseases. Methods One hundred and twenty patients over 80 years old who underwent ERCP between January 2004 and April 2008 were retrospectively analyzed. The clinical efficacy, safety and complication were observed and followed up. Results One hundred and seventeen patients successfully underwent therapeutic ERCP and the success rate was 97.5%. All diseases of the patients included cholangiocarcinoma in 22 cases, duodenal papilla carcinoma in 3 cases, pancreatic carcinoma in 8 cases, acute pancreatitis in 15 cases, chronic pancreatitis in 5 cases, acute suppurative cholangitis in 9 cases and choledocholithiasis in 58 cases. During the procedure of ERCP, 3 cases failed to insert the duodenoscope, 3 cases were found hemobilia and 2 cases were found acute pancreatitis. Conclusions Therapeutic ERCP is effective and safe in elderly patients over 80 years. Age is not the contraindication of therapeutic ERCP.

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 analyze the clinical efficacy of neoadjuvant chemotherapy in patients with stageⅢA non-small cell lung cancer (NSCLC). Methods From March 2008 to October 2015, there were 92 cases of stageⅢA NSCLC patients received 2 cycles of neoadjuvant chemotherapy and underwent radical surgery for lung cancer 3-4 weeks late ( observation group) , and another group of 65 cases of stage ⅢA NSCLC patients ( control group) underwent surgery for lung cancer without preoperative chemotherapy. The clinical data as well as early and meddle term surgical outcome of both groups were analyzed retrospectively. Results The neoadjuvant chemotherapy effective rate was 73. 9％ in the observation group. All surgeries for lung cancer patients were undertaken either with video-assisted thoracotomy or traditional thoracotomy. No operative mortality and the postoperative pathology findings were in accordance with NSCLC. The bleed-ing amount and operation time of two groups were similar; the resection rate of the observation group was greater than that of the control group. All patients were followed up at least 3 years, and the 2 years and 3 years survival rate of the observation group was slightly higher than that of the control group. Conclusions Preoperative neoadjuvant chemotherapy in patients with NSCLC can improve the resection rate and prolong the survival time, which is worthy of clinical application.

Background and objective With further understanding and research into non-small cell lung cancer with tumours ≤2 cm in maximum diameter,segmental lung resection is able to achieve the same long-term prognosis as lobec-tomy.However,there are few studies on the prognostic effect of wedge resection on small volume invasive lung adenocarci-noma with an invasion depth of 0.5 to 1.0 cm.Therefore,this study focuses on the clinical efficacy and prognosis of wedge re-section in patients with small-volume invasive lung adenocarcinoma.Methods A retrospective analysis of the medical records of 208 patients who underwent surgery in the Department of Thoracic Surgery of the Affiliated Provincial Hospital of Anhui Medical University from February 2016 to December 2017 was made,and the postoperative pathological results confirmed small volume invasive lung adenocarcinoma.According to their surgical methods,they were divided into lobectomy group(n=115),segmentectomy group(n=48)and wedge resection group(n=45).Kaplan-Meier survival curve estimation and Cox proportional risk regression model were used to explore the influence of different surgical methods on the prognosis of patients with small volume invasive lung adenocarcinoma.Results The wedge resection group had better perioperative outcomes compared with the segmentectomy group and lobectomy group,with statistically significant differences in intraoperative bleed-ing(P=0.036),postoperative drainage(P＜0.001),operative time(P=0.018),postoperative time with tubes(P=0.001),and postoperative complication rate(P=0.006).There were no significant differences when comparing the three groups in terms of survival rate(lobectomy group vs segmentectomy group,P=0.303;lobectomy group vs wedge resection group,P=0.742;and segmentectomy group vs wedge resection group,P=0.278)and recurrence-free survival rate(lobectomy group vs segmentec-tomy group,P=0.495;lobectomy group vs wedge resection group,P=0.362;segmentectomy group vs wedge resection group,P=0.775).Univariate and multivariate survival analyses showed that consolidation tumor ratio(CTR)was the prognostic factor of overall survival and revurrence-free survival for patients with small-volume invasive lung adenocarcinoma(P＜0.05).Conclusion Wedge resection in patients with small volume invasive lung adenocarcinoma can achieve long-term outcomes similar to segmentectomy and lobectomy.When the CTR≤0.5,wedge resection is preferred in such patients.

OBJECTIVETo evaluate the efficacy of endoscopic purse-string suture (EPSS) with metallic clips and endoloop for the gastric wall defect after postoperative perforation.

METHODSClinical data of 25 patients with gastric tumors(1 of gastric adenocarcinoma, 24 of gastric gastrointestinal stromal tumor, GIST) undergoing EPSS in Jiangsu Province People's Hospital and The Second Affiliated Hospital of Nanjing Medical University from January 2013 to May 2014 were retrospectively analyzed. During the procedure, EPSS was performed in 8 cases with perforation after endoscopic submucosal dissection(ESD), and in 17 cases with active perforation after endoscopic full-thickness resection.

RESULTSTwenty-five patients underwent EPSS successfully. The procedure time was 35.0-75.0(49.8±10.1) min. No severe operational and postoperative complications occurred. Tumor resection margin were all negative. Time to withdraw gastrointestinal decompression drainage tube was 1-3(1.3±0.8) d. Postoperative hospital stay was 2-10(4.8±2.1) d and total cost was 10-31(19±0.5) thousand Yuan. One month after the procedure, all the patients received follow-up with no complaint of discomfort, and endoscopy confirmed that all the lesions healed.

CONCLUSIONEPSS with metallic clips and endoloop is effective and safe to close the gastric wall defect after full-thickness resection.

Adenocarcinoma ; Digestive System Surgical Procedures ; Gastrointestinal Stromal Tumors ; Gastroscopy ; Humans ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; Sutures

Objective To evaluate the learning curve of video-assisted thoracoscopic sleeve lobectomy in patients with central lung cancer.Methods A total of 86 consecutive patients with resected central lung cancer in the second department of thoracic surgery of Hunan Cancer Hospital between Apirl 2016 and July 2018 were retrospectively enrolled.Video-assisted tho-racoscopic tracheoplasty with sleeve resection and lobectomy were performed in 56 patients, video-assisted thoracoscopic tra-cheoplasty with wedge resection and lobectomy were performed in 20 patients, and 10 patients transit to thoracotomy.Surgical parameter of patients who underwent video-assisted thoracoscopic sleeve lobectomy were investigated to assess the learning curve, including operation duration, bleeding volume, amount of lymph nodes examined(medianstinal and intrapulmonary). Lowess smoothing method was performed to fit curve to evaluate the variation tendency of surgical parameters .Cut-off point, as well as the confidence interval, were identified using piecewise regression analysis.Results Surgical duration tend to be stable (almost 200 min) when the cumulative case amount of video-assisted thoracoscopic sleeve lobectomy reach 40.Surgical bleed-ing tend to be stable( almost 200 ml) when the cumulative case amount of video-assisted thoracoscopic sleeve lobectomy reach 20.There is no significant correlation between the amount of lymph node harvest and surgical volume .Conclusion The cut-off point for video-assisted thoracoscopic sleeve lobectomy is approximately 40 cases.

Objective To investigate the expression and mechanism of long non-coding RNA(ln-cRNA)GHRLOS2 in colorectal cancer tissues and cells.Methods Real-time quantitative reverse transcription polymerase chain reaction(qRT-PCR)was used to detect the expression levels of GHR-LOS2 and microRNA-33b-5p(miR-33b-5p)in colorectal cancer tissues or cells.Overexpressing of GHRLOS2 in HCT116 and SW480 colorectal cancer cell lines were constructed,and the effects of overexpression of GHRLOS2 on the migration and invasion abilities in HCT116 and SW480 cell lines were detected by wound healing assay and Transwell assay.Glucose content in cells of overexpressing GHRLOS2 and control cells was detected using a glucose detection kit.Western blot was used to detect the expression level of PCK1 protein in cells.The targeted binding relationship between miR-33b-5p and PCK1 was predicted based on bioinformatics methods.Results The qRT-PCR results showed that the expression level of GHRLOS2 in colorectal cancer tissue samples was lower than that in adjacent non-cancerous tissues,and was lower in colorectal cancer cells than that in normal colon epithelial cells(P＜0.05).The expression of GHRLOS2 was correlated with grade classification,staging,and lymph node metastasis(P＜0.05).The expression level of miR-33b-5p in colorectal cancer tissues was higher than that in corresponding adjacent non-cancerous tissues(P＜0.001).The results of wound healing assay,Transwell assay,and glucose content detection showed that overexpression of GHRLOS2 significantly inhibited the invasion,migration,and glucose metabolism of colorectal cancer cells.Overexpression of GHRLOS2 inhibited the expression level of miR-33b-5p;GHRLOS2 functioned as a molecular sponge for miR-33b-5p,and PCK1 was a target of miR-33b-5p;overex-pression of GHRLOS2 competitively bound to miR-33b-5p,thereby promoting increased expression of PCK1.Conclusion The expression of GHRLOS2 is downregulated in colorectal cancer tissues and cells,and it may regulate the invasion,migration,and glucose metabolism of colorectal cancer cells through the miR-33b-5p/PCK1 pathway,making it a potential biological target for targeted therapy of colorectal cancer.

Objective To evaluate the efficacy of endoscopic purse-string suture (EPSS) with metallic clips and endoloop for the gastric wall defect after postoperative perforation. Methods Clinical data of 25 patients with gastric tumors(1 of gastric adenocarcinoma, 24 of gastric gastrointestinal stromal tumor, GIST) undergoing EPSS in Jiangsu Province People′s Hospital and The Second Affiliated Hospital of Nanjing Medical University from January 2013 to May 2014 were retrospectively analyzed. During the procedure, EPSS was performed in 8 cases with perforation after endoscopic submucosal dissection (ESD), and in 17 cases with active perforation after endoscopic full-thickness resection. Results Twenty-five patients underwent EPSS successfully. The procedure time was 35.0-75.0 (49.8± 10.1) min. No severe operational and postoperative complications occurred. Tumor resection margin were all negative. Time to withdraw gastrointestinal decompression drainage tube was 1-3 (1.3 ±0.8) d. Postoperative hospital stay was 2-10(4.8±2.1) d and total cost was 10-31(19±0.5) thousand Yuan. One month after the procedure, all the patients received follow-up with no complaint of discomfort, and endoscopy confirmed that all the lesions healed. Conclusion EPSS with metallic clips and endoloop is effective and safe to close the gastric wall defect after full-thickness resection.