Purpose: Lung cancer is frequently observed as a second primary malignancy following gastric cancer, yet the genetic causality between them remains uncertain. This study aims to evaluate the causal relationship between gastric and lung cancers using Mendelian randomization (MR) analysis. Materials and Methods: Single nucleotide polymorphisms associated with gastric and lung cancers were selected from genome-wide association study in East Asian and European populations as instrumental variables. The causal effects between gastric and lung cancers were evaluated using univariable and multivariable MR analysis, with the inverse variance weighted (IVW) method serving as the primary criterion. Heterogeneity and sensitivity analyses were performed to ensure the robustness of the findings. Results: Univariable MR analysis demonstrated that genetic susceptibility to gastric cancer in the European population was significantly associated with an increased risk of lung cancer (IVW: odds ratio [OR], 1.285; 95% confidence interval [CI], 1.072 to 1.541; p=6.83E-03), which was consistently validated in the East Asian population (IVW: OR, 1.356; 95% CI, 1.114 to 1.651; p=2.40E-03). Multivariable MR analysis further indicated that the significant positive causal relationship between gastric cancer and lung cancer persisted in both populations after adjusting for confounding factors (all p < 0.05). Conversely, no significant causal relationship was observed for the risk of developing gastric cancer following the diagnosis of lung cancer in either population (p > 0.05). Conclusion This study confirms that genetic susceptibility to gastric cancer increases the risk of lung cancer. This finding provides a theoretical basis for exploring the underlying biological mechanisms and suggests that enhancing lung cancer screening in patients with gastric cancer may be necessary to improve patient prognosis.

With the continuous progress of modern science and technology, the research of TCM inspection is gradually moving towards a new stage of objectification and intelligence. By systematically sorting out the key technologies involved in the objectification of inspection and diagnosis, and summarizing its clinical application progress in the three core areas of face diagnosis, tongue diagnosis and visual diagnosis, it is found that the inspection and diagnosis of TCM can not only significantly improve the efficiency and accuracy of clinical diagnosis with the help of modern technology, but also achieve more results in disease differentiation, constitution identification and efficacy evaluation. The key technologies include digital image processing, infrared thermal imaging, spectroscopy, photoelectric volume and artificial intelligence (AI) technology. In terms of clinical application, facial diagnosis focuses on image and infrared thermography feature analysis, tongue diagnosis involves image, spectral feature research and AI model construction, and eye diagnosis focuses on white eye collaterals extraction, fundus sign analysis and eye movement information research. However, there are still some problems, such as imperfect standardization system, bottleneck of multi-modal fusion and interpretation, insufficient clinical verification and practicability. In the future, the deep integration of TCM observation and modern science and technology should be promoted by means of technological integration and innovation and strengthening interdisciplinary cooperation, so as to help the modernization of TCM diagnosis.

Objective To analyze the clinical value of temperature-controlled ablation radio-frequency(TCAR)as a surgical option for the treatment of pediatric snoring.Method This study selected 120 children with snoring from January 2021 to December 2022 for observation.They were divided into the control group(n=60,receiving tonsil removal+nasal underopia gland scraping therapy)and the observation group(n=60,using TCAR to remove patients with gland samples and tonsils)using a random number table method.The clinical efficacy,surgery-related situation and sleep quality were compared.Results The effective rate of observation group was 93.33%,which was significantly higher than 76.67%of the control group.The intraoperative blood loss in the observation group was less than that in the control group,the operation time,symptom remission time and hospital stay were shorter,and the VAS was lower than those in the control group,with statistical significance(P<0.05).There was no statistically significant difference in the comparison of Quebec sleep questionnaire(QSQ)score,Epworth sleepiness scale(ESS),and disease specific quality of life for children with obstructive sleep apnea 18 items survey(OSA-18)between the two groups of patients before surgery(P>0.05);The postoperative ESS and OSA-18 of the observation group were lower than those of the control group,while the QSQ score was higher than that of the control group,with statistical significance(P<0.05).After surgery,the QSQ scores of the two groups were higher than before surgery,while the ESS and OSA-18 of the two groups were lower than before surgery,with statistical significance(P<0.05).The postoperative complications in the observation group(1.67%)was lower than that of the control group(11.67%),with statistical significance(P<0.05).Conclusion Compared with traditional surgery,TCAR for tonsillectomy and adenoidectomy in children with snoring can improve clinical efficacy,further improve ventilation capacity,reduce patient pain,shorten symptom relief time,improve sleep quality and living standards,and reduce the risk of postoperative complications.

ObjectiveTo observe the effects of Xibining （XBN） and adipose stem cell exosome （ADSC-Exos） in the cases of separate or joint application on cartilage degeneration and mitochondrial autophagy and explore its mechanism of action to improve knee osteoarthritis （KOA）. MethodSD rats were divided into a sham operation group （sham group）， a model group， an ADSC-Exos group （Exos group）， an XBN group， and an ADSC-Exos+XBN group （Exos+XBN group）. KOA model was established by using anterior cruciate ligament transection （ACLT）. The pain sensitivity status of rats was evaluated， and the degeneration degree of the knee joint and cartilage tissue was detected by Micro-CT and pathological staining. The expression of p62 and LC3B was observed by immunofluorescence， and the serum levels of TNF-α， IL-1β， IL-6， and IL-15 in rats were detected by ELISA. The Western blot was used to detect the protein expression levels of MMP-3， MMP-13， ADAMTS5， ColⅡ， TIMP， ACAN， PINK1， Parkin， p62， and LC3A/B. ResultCompared with the sham group， rats in the model group showed decreased cold-stimulated foot-shrinkage thresholds and mechanical pain sensitivity thresholds， varying degrees of abrasion and loss of cartilage tissue， degeneration of cartilage tissue， elevated serum IL-1β， IL-6， IL-15， and TNF-α levels （P<0.01）， and increased protein expression of MMP-3， MMP-13， and ADAMTS5 in cartilage tissue. In addition， the protein expression of ColⅡ， TIMP1， and ACAN was decreased （P<0.01）. Compared with the model group， rats in each treatment group showed higher cold-stimulated foot-shrinkage thresholds and mechanical pain sensitivity thresholds， reduced cartilage tissue degeneration， lower serum levels of IL-1β， IL-6， IL-15， and TNF-α （P<0.05，P<0.01）， decreased protein expression of MMP-3， MMP-13， and ADAMTS5， and higher protein expression of Cold， TIMP1， and ACAN in cartilage tissue （P<0.05，P<0.01）. Moreover， the changes were the most obvious in the Exos+XBN group. ConclusionBoth ADSCs-Exos and XBN can increase the level of mitochondrial autophagy in chondrocytes and delay cartilage tissue degeneration by promoting the expression of the PINK1/Parkin signaling pathway， and the combination of the two can enhance the therapeutic effect.

PURPOSE: The purpose of this study was to investigate the biological role and mechanism of miR-373 targeting of TFIIB-related factor 2 (BRF2) in the regulation of non-small cell lung cancer (NSCLC) cells. MATERIALS AND METHODS: miRNA microarray chip analysis of four paired NSCLC and adjacent non-tumor tissues was performed. Quantitative real-time polymerase chain reaction (qRT-PCR) andwestern blotting were used to detect the expression levels of miR-373 and BRF2 in NSCLC tissues and cell lines. The dual-luciferase reporter method was performed to determine if BRF2 is a target of miR-373. MTT, wound-healing, Transwell, and flow cytometric assays were conducted to examine the proliferation, migration, invasion, and cell cycle progression of NSCLC A549 cells, respectively; western blotting was used to detect the expression of epithelial-mesenchymal transition (EMT)–related proteins. RESULTS: The miRNA microarray chip analysis demonstrated that miR-373 was down-regulated in NSCLC tissues, and this result was confirmed by qRT-PCR. Additionally, miR-373 was confirmed to target BRF2. Moreover, miR-373 expression was inversely correlated with BRF2 expression in NSCLC tissues and cell lines; both miR-373 down-regulation and BRF2 up-regulation were strongly associated with the clinicopathological features and prognosis of NSCLC patients. In vitro, overexpression of miR-373 markedly inhibited cell proliferation, migration, and invasion; up-regulated the expression of E-cadherin; and down-regulated the expression of N-cadherin and Snail in A549 cell. Knockdown BRF2 by siRNA resulted in effects similar to those caused by overexpression of miR-373. CONCLUSION: MiR-373 is decreased in NSCLC, and overexpression of miR-373 can suppress cell EMT, and inhibit the proliferation, migration, and invasion of NSCLC A549 cells by targeting BRF2.
Blotting, Western ; Cadherins ; Carcinoma, Non-Small-Cell Lung* ; Cell Cycle ; Cell Line* ; Cell Migration Inhibition ; Cell Proliferation* ; Down-Regulation ; Epithelial-Mesenchymal Transition ; Humans* ; In Vitro Techniques ; Methods ; MicroRNAs ; Prognosis ; Real-Time Polymerase Chain Reaction ; RNA, Small Interfering ; Snails ; Up-Regulation

MTUS1 (microtubule-associated tumor suppressor 1) has been identified that can function as a tumor suppressor gene in many malignant tumors. However, the function and mechanisms underlying the regulation of MTUS1 are unclear. In the present study, we reported that miR-19a and miR-19b (miR-19a/b) promote proliferation and migration of lung cancer cells by targeting MTUS1. First, MTUS1 was proved to function as a tumor suppressor in lung cancer and was linked to cell proliferation and migration promotion. Second, an inverse correlation between miR-19a/b expression and MTUS1 mRNA/protein expression was noted in human lung cancer tissues. Third, MTUS1 was appraised as a direct target of miR-19a/b by bioinformatics analysis. Fourth, direct MTUS1 regulation by miR-19a/b in lung cancer cells was experimentally affirmed by cell transfection assay and luciferase reporter assay. Finally, miR-19a/b were shown to cooperatively repress MTUS1 expression and synergistically regulate MTUS1 expression to promote lung cancer cell proliferation and migration. In conclusion, our findings have provided the first clues regarding the roles of miR-19a/b, which appear to function as oncomirs in lung cancer by downregulating MTUS1.
A549 Cells ; Cell Movement ; Cell Proliferation ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Male ; MicroRNAs ; genetics ; metabolism ; RNA, Neoplasm ; genetics ; metabolism ; Tumor Suppressor Proteins ; biosynthesis ; genetics

Objective To observe the analgesia effect of oxycodone hydrochloride injection successive subtraction method background infusion on postoperative analgesia in patients of lobectomy under thoracoscope.Methods Ninety lobectomy under thoracoscope patients, using the random number table method patients were randomly divided into three groups:sufentanil group (group S), the constant speed oxycodone infusion group (Q1) and the decreasing background infusion oxycodone group (Q2), 30 cases in each group. On the time of 10 minutes before the end of surgery, S group was given sufentanil 0.10 μg/kg, Q1 and Q2 group was given oxycodone 0.10 mg/kg, each patient was given intravenous patient-controlled analgesia (PCIA), the group of S set electronic pump sufentanil 2.00 μg/kg (100 ml), background infusion was 0.03 μg/(kg·h), PCA dose was 0.015 μg/kg; The group of Q1 was oxycodone 1.00 mg/kg (100 ml), background dose of 15.00 μg/(kg·h), PCA dose of 15.0 μg/kg; The group of Q2 also was oxycodone 1.00 mg/kg (100 ml), on the first 12 h after operation, the background infusion was 15.00 μg/(kg·h), every 12 h later, the background infusion decreased by 20%, PCA dose was 15.00 μg/kg, all of the pump locking time was 10 minutes, lock 4 times per hour. Recorded the number of hemodynamic on the end of operation, immediate extubation and extubation after 5 minutes. On the time of postoperative 2 h, 8 h, 12 h, 24 h, 48 h, recorded the scores of NRS?, NRS (M), Ramsay. Recorded the times of PCA compression,times of medicaments remedies,the amount of drug use, adverse reactions such as respiratory depression, nausea, vomiting, itching and satisfaction of patients to postoperative analgesia.Results The MAP and HR of three groups of patients were increased in the time of tube drawing (P < 0.05), there was no significantly difference in MAP and HR among the three groups at the end of operation, immediate extubation and after 5 minutes of extubation (P > 0.05). The score of NRS ? in the groups of Q1 and Q2 was lower than group S at the time of (T3~5) (P < 0.05), the score of NRS (M) in the groups of Q1 and Q2 was lower than group S at the time of (T3~6) also. The Ramsay score of Q1 and Q2 group was higher than the group S in the point (T3~7). Which the times of PCA and remedial drug use, sleep disturbed times in the first day and second day of group Q1 and Q2 was lower than the group S (P < 0.05). The volume of drug use at 48 h in the group of Q2 was lower than the group Q1 and S (P < 0.05). Postoperative nausea and vomiting of group Q2 was lowered than group S (P < 0.05). The satisfaction of Patients to postoperative analgesia in the group Q2 and Q1 was higher than group S (P < 0.05).Conclusion Lobectomy under thoracoscope patients with postoperative application of successive subtraction method background infusion oxycodone can obtain satisfactory analgesia effect with a smooth anesthesia recovery period, satisfied analgesic effect, reduce the dosage of drugs and reduce the adverse reaction.

Objective To observe the clinical effects and safety of scalp-body acupuncture and spine-manipulation therapy on preventively treating cervical cancer patients with postoperative urinary retention. Methods A total of 160 cases of cervical cancer patients with postoperative urinary retention were randomized into treatment group and control group, 80 cases in each group. Both groups were given conventional western medical treatment including preoperative indwelling of urethral catheter, clamping of urethral catheter 5 d after operation and release of the urine every 2-3 h, and trying to remove the urethral catheter 10-12 d after operation. Additionally, the treatment group received scalp acupuncture in the foot motor sensory area, body acupuncture of bilateral Shenshu (BL23) , Pangguangshu (BL28) , Ciliao (BL32) acupoints, and spine-manipulation therapy 5 d after operation. The clinical outcomes covered the incidence of urinary retention, residual urine volume, reset rate of catheter, and the clinical effect and safety in the two groups were evaluated. Results ( 1) The therapeutic effect of the treatment group was superior to that of the control group, and then the difference was significant (P<0.05). (2) After treatment, the incidence of urinary retention, residual urine volume, reset rate of catheter and average hospitalization days were less in the treatment group than those in the control group, the differences being significant ( P<0.05). ( 3) There was no adverse reaction during the treatment course. Conclusion Scalp acupuncture in the foot motor sensory area combined with body acupuncture and spine-manipulation therapy can promote the recovery of micturation function, and have satisfactory clinical effect and high safety in preventively treating cervical cancer with postoperative urinary retention.

ObjectiveTo probe the indication,treatment algorithm,anesthesia method,safety and efficacy ofextracorporealshockwavelithotripsy(ESWL)incombinationwithendoscopicretrograde cholangiopancreatography (ERCP) for pancreatic duct stones.MethodsThe patients with chronic pancreatitis and large pancreatic duct stones ( ＞ 5 mm diameter) and receiving ESWL and ERCP between March and July 2011 in Changhai Hospital were prospective studied.The third generation of extracorporeal shockwave lithotripsy was applied in ESWL,and the localization of stone was determined by X-ray.No more than 5000 shocks were given per session,and ESWL was performed continuously till the calculi were fragmented,and then was cleared by ERCP.ResultsA total of 100 patients underwent ESWL during the 5 months,among whom 84 patients received ERCP treatment and 41 cases failed to deep cannulation (41/84,48.8％ ).Multiple stones were seen in 83 patients.Ninety five patients had radio-opaque stones,two patients had radiolucent calculi,while three patients had both radio-opaque and radiolucent stones.Seventy five percent,14％ and 11％ stones were located in pancreatic head,pancreatic head and body,pancreatic body and tail,respectively.A total of 175 ESWL procedures were performed,43 patients needed 2 or more sessions for successful fragmentation.Anesthesia method was mainly intravenous sedation,accounting for 96％ (168/175).ERCP was successful in 96 patients after ESWL,only 4 patients failed after ESWL. Forty one cases which failed ERCP procedures before ESWL underwent ERCP,and 37 patients (90.2％) achieved successful cannulation.Successful fragmentation ratewas 100％.Complete clearance was achieved in 78 patients,and complication rate of post-ERCP pancreatitis,fever was 1.71％ (n =3 ),0.57％ (n =1 ),and the overall complication rate was 2.28％.Conclusions ESWL is an effective,safe and necessary modality for fragmentation of large PD stones in the management of minimal invasive treatment of chronic pancreatitis.

Objective To evaluate the safety and efficacy of therapeutic ERCP for patients above 90 years of age.Methods The data of 37 patients of above 90 years who underwent 42 ERCP procedures from January 2001 to December 2009 were studied retrospectively and compared with those of 152 matched patients ( 168 procedures) below 65 years old at a 1∶4 ratio for success rate and complications.Results The rate of complete success,partial success,and failure in observation group was 73.81％ (31/42),19.05％(8/42) and 2.38％ (1/42),respectively,which were similar (P ＞0.05) with those in control group,with complete success rate at 85.12％ ( 143/168),partial success rate at 12.50％ (21/168) and failure rate at 2.38％ (4/168).The rate of terminated operation in observation group (4.76％,2/42) was significantly higher than that of the control group (0.00％,0,P =0.039).The overall rate of complication in observation group was 7.14％ ( 3/42 ),slightly higher than that of the control group ( 6.55％,11/168,P ＞0.05 ).There was no significant difference between the two groups regarding the rates and severity of such complications as pancreatitis,hemorrhage and infection ( P ＞ 0.05 ).No perforation or death was observed.Conclusion Therapeutic ERCP for patients of 90 years or older is safe and effective.Adverse events related to chronic concomitant diseases need early detection and proper management.