Objective:To investigate the changes of the plasma matrix metalloproteinase (MMP)-2 and MMP-9 levels and their clinical significances during the course of concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) patients.Methods:From January 2018 to June 2019, 46 patients with nasopharyngeal carcinoma were treated in the department of oncology, Changsha Central Hospital Affiliated to Nanhua University. All patients were confirmed by pathology. They were divided into early NPC group ( n=32) and invasive NPC group ( n=16) according to the degree of invasion. The early NPC group was treated with concurrent chemoradiotherapy alone, and the invasive NPC group was treated with neoadjuvant chemotherapy combined with concurrent chemoradiotherapy. Blood samples were collected at four stages of the treatment, and the concentrations of MMP-2 and MMP-9 were detected by enzyme linked immunosorbent assay (ELISA). Results:The longer the treatment time, the lower the concentration of MMP-9 ( P=0.007) in early NPC group; There was no significant difference in MMP-9 level before treatment, after neoadjuvant chemotherapy, after concurrent chemoradiotherapy, at the end of treatment and the first follow-up ( P>0.05) in invasive NPC group. There was no significant difference in the content of MMP-2 between the two groups before and after treatment ( P>0.05). There was no correlation between serum MMP-2 and MMP-9 levels and tumor stage, lymph node metastasis, tumor invasion and response rate ( P>0.05) in invasive NPC patients, while the level of MMP-9 was positively correlated with white blood count (WBC) and neutrophil count ( r=0.85, P=0.004, r=0.82, P=0.003); The ratio of MMP-9/MMP-2 was positively correlated with WBC and neutrophil count ( r=0.86, P=0.003, r=0.83, P=0.001). Conclusions:Synchronous radiotherapy and chemotherapy can reduce the serum MMP-9 level in early stage NPC patients, but it has no effect on the serum MMP-9 level in patients with invasive NPC, which suggests that synchronous radiotherapy and chemotherapy can not prevent the proliferation and distant metastasis of cancer cells in patients with invasive NPC.

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To investigate the correlation between histone deacetylase 1(HDAC1) and vascular endothelial growth factor(VEGF) in the patients with lung adenocarcinoma.Methods Eighty cases of lung adenocarcinoma in our hospital from August 2014 to April 2016 served as the research subjects,and contemporaneous 80 individuals undergoing healthy physical examination were taken as the control group.The fasting venous blood sample was collected in all subjects.Then serum HDAC1 and VEGF levels were detected by ELISA.The differences of serum HDAC1 and VEGF expression levels were compared between the two groups.The HDAC1 and VEGF expression levels in the patients with different characteristics of lung adenocarcinoma and the relation between serum HDAC1 and VEGF concentrations were analyzed.Furthermore the possible influence factors of HDAC1 protein expression level in the patients with lung adenocarcinoma were analyzed.Results The HDAC1 levels in the control group and observation group were(329.56 ± 23.83) ng/L and(568.20 ± 35.40) ng/L,the difference was statistically significant(t=23.576,P=0.000).The VEGF levels in the control group and observation group were(40.26±9.82)ng/L and(296.56±19.80)ng/L respec tively,the difference was statistically significant(t=31.154,P=0.000).The HDAC1 protein level had statistical difference among different genders,ages,clinical stages and smoking history,the HDAC1 protein level in male,age ＞60 years old,clinical stage Ⅲ,V and patients with smoking history were higher(P＜0.05).The Pearson correlation analysis results showed that serum HDAC1 in the patients with lung adenocarcinoma was positively correlated with VEGF protein concentration(r=0.526,P =0.000).The Logistic regression analysis showed that influence factor of HDAC1 protein expression level in the patients with lung adenocarcinoma was clinical stage.Conclusion The high expression of HDAC1 protein in lung adenocarcinoma patients may also simultaneously regulate the VEGF expression,thus promotes the development of lung adenocarcinoma.

Objective:To explore influence of health education on quality of life and compliance in community pa‐tients with coronary heart disease (CHD) .Methods :A total of 83 community CHD patients were selected and ran‐domly divided into routine treatment group (n=38 ,received routine treatment of CHD ) and health education group (n=45 ,received CHD health education based on routine treatment ) .Score of Seattle angina questionnaire (SAQ) after intervention ,therapeutic compliance and incidence rate of major adverse cardiovascular events (MACE) with‐in six months were compared between two groups .Results:Compared with routine treatment group after interven‐tion ,there were significant rise in each item score and total score of SAQ [total score ,(54.3 ± 7.2) scores vs .(65.4 ± 7.5) scores] ,P<0.05 all;and therapeutic compliance also significantly rose (good rate ,52.6% vs .77.8% ) in health education group , P< 0.05. After six‐month follow‐up ,total incidence rate of MACE in health education group was significantly lower than that of routine treatment group (8.9% vs .26.3% ) , P< 0.05. Conclusion:Health education can significantly improve quality of life ,compliance and prognosis in community patients with cor‐onary heart disease ,which is worth clinical extending and use .

Objective To explore the extent of axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes.Methods In this series,95 patients underwent complete axillary lymph node dissection (CALND) following positive sentinel lymph nodes identified and 97 patients underwent partial axillary lymph node dissection (PALND) at the absence of positive sentinel lymph nodes.The influence of different extent of axillary lymph node dissection was evaluated.Results The positive rate of level(Ⅰ + Ⅱ) non-sentinel lymph nodes (NSLN) and level Ⅲ lymph nodes was 68.4％ and 29.5％,respectively,in CALND group.In PALND situation,57.9％ CALND cases would have changed pathologic stage from pN1 to pN2 or pN3.But with level Ⅲ lymph node dissection followed PALND,only 2.1％ cases had changed pathologic stage from pN2 to pN3.Multivariate logistic regression showed that the number of positive SLNs (OR =2.157) and positive rate of SLNs (OR =10.374) were risk factors for having positive level Ⅲ lymph nodes.CALND needed longer operation time and larger postoperative drainage volume.Conclusions In cases of breast cancer with ≥ 3 positive sentinel lymph nodes,complete axillary lymph node dissection should be considered.

AIM:To observe the expression of angiogenesis factors in the myocardial tissue of streptozotocin-induced diabetic rats .METHODS:The diabetic rat model was induced by intraperitoneal injection of streptozotocin .After 12 weeks, the cardiac function was measured by MPA cardiac function analysis system .The myocardial collagen volume fraction ( CVF) was assessed by Masson staining .The capillary vessels was quantified as the ratio of capillary to myocyte (C/M) using CD31 immunostaining.The expression levels of vascular endothelial growth factor (VEGF), angiopoietin ( Ang)-1, endostatin and Ang-2 were observed by Western blotting .RESULTS:Compared with normal control group , the left ventricular end-diastolic pressure (LVEDP) was evidently increased (P<0.01), but left ventricular pressure rise maximum rate (+dp/dtmax), left ventricular pressure decrease maximum rate (-dp/dtmax) and the ratio of capillary/myo-cyte (C/M) were significantly decreased (P<0.05).The CVF and the expression level of endostatin were significantly increased, whereas the expression levels of VEGF and Ang-1 evidently decreased (both P<0.05) in diabetic rats.Howev-er, no marked difference in the expression of Ang-2 between the 2 groups was observed (P>0.05).CONCLUSION:Im-balances between the angiogenic factors (VEGF and Ang-1) and anti-angiogenic factors (endostatin) may play an impor-tant role in the pathogenesis of diabetic cardiomyopathy .

Forty-two patients with type 2 diabetes (DM group),23 type 2 diabetic patients with unstable angina pectoris (DM + UAP group),and 36 healthy subjects (control group) were enrolled in this study.Serum samples were collected for determining serum concentrations of vascular endothelial growth factor (VEGF),Angiopoietin (Ang)-1,Ang-2,angiogenin,angiostatin,basic fibroblast growth factor,and platelet-derived growth factor-BB using protein array technology.The results showed that there were no significant differences in serum concentrations of all 7 angiogenic factors between control group and DM group.Whereas,serum concentrations of V EGF and Ang-2 were significantly increased in DM + UAP group compared with control group [(3 532.10 ± 1 813.72vs 2 444.50 ± 1 152.21) pg/ml,(286.90-± 217.01 vs 171.92 ± 106.63) pg/ml,both P＜0.01].Pearson's correlation analysis revealed that serum concentrations of all 7 angiogenic factors were not related to HbA1C,fasting and 2 h postprandial plasma glucose,triglycerides,high density lipoprotein cholesterol,as well as low density lipoprotein cholesterol.

Objective To detect the changes in serum concentrations of angiogenic factors in patients with unstable angina pectoris.Methods A total of 57 patients with unstable angina pectoris were eligible for study and divided into diabetes group (n =23) and non-diabetes group (n =34).Exclusion criteria included complicated diseases,symptomatic peripheral vascular diseases,renal or liver diseases,cerebral embolism and evidence of ongoing infection.Another 36 age-matched healthy subjects from medical examination center were enrolled as control group.Serum samples were collected,and serum concentrations of vascular endothelial growth factor (VEGF),angiopoietin-1,angiopoietin-2,angiogenin,angiostatin,basic fibroblast growth factor (bFGF) and platelet-derived growth factor-BB (PDGF-BB) were measured by using cytokine array technology.The data were analyzed by independent-samples t test with the SPSS 13.0statistic software package.Results Compared with the control group,the serum concentrations of VEGF and angiopoietin-2 were significantly increased in patients with unstable angina pectoris (both P ＜ 0.01).Whereas,no significant differences in serum concentrations of angiogenin,angiopoietin-1,angiostatin,bFGF,and PDGF-BB were detected between control group and patient groups.There were no significant differences in serum concentrations of above all 7 biomarkers between diabetes group and non-diabetes group.Conclusions Serum concentrations of VEGF and angiopoietin-2 were increased in patients with unstable angina pectoris,and diabetes didn' t affect the increases in serum concentrations of VEGF and angiopoietin2 caused by unstable angina pectoris.

Objective To evaluate the angiographic findings and the therapeutic effect of thrombolysis in AMI (acute myocardial infarction) patients. Method A retrospective study were carried out in consecutive eighty-four inpatients with AMI treated with intravenous thrombolysis and coronary angiography was taken within a week after illness onset from January 2000 to August 2007. The patients were divided into successful recanalization group and non-recanalization group. Single factor χ2 test and multi-factor logistic regression analysis were applied to observe the relationship among the angiographic features of IRA (infarct-related artery including the number of stnosis, the location of stenosis, the severity of stenosis and the morphological changes) and treatment effect of intravenous urokinase thrombolysis. Results (1) Single factor χ2 test showed that location and the extent of lesion of IRA were eligible to enter the logistic regression formula (P ＜ 0.05),whereas the number of lesions and the severity of IRA's stenosis were not eligible to enter the logistic regression formula (P ＞ 0. 05). (2) Multi-factor logistic regression analysis showed that the extent of lesion of IRA was the only factor that had a negative impact on the therapeutic effect of intravenous thrombolysis.Conclusions The study shows that the extent of lesion of IRA is the only factor that has a negative impact on the therapeutic effect of intravenous thrombolysis; The number, the location of lesion and the severity of stenosis of IRA have no impact on the therapeutic effect of intravenous thrombolysis in AMI.