Objective:To explore the clinicopathological features of serum alpha-fetoprotein-producing gastric cancer (AFPGC) and its subtype hepatoid adenocarcinoma of the stomach (HAS), and to analyze the related factors affecting the prognosis of AFPGC and HAS patients.Methods:The clinical data of 91 patients with AFPGC who were admitted to the Second Affiliated Hospital of Dalian Medical University from February, 2010 to February, 2021 were retrospectively collected. According to the results of hepatoid differentiation, the patients were divided into HAS group (26 cases) and non-HAS group (65 cases). Meanwhile, 130 patients with alpha-fetoprotein (AFP) negative gastric cancer at the Second Affiliated Hospital of Dalian Medical University were selected by stratified sampling method as common gastric cancer group. The clinicopathological data of patients in the HAS group, non-HAS group and common gastric cancer group were compared and all the patients were followed up for 3 years. Kaplan-Meier survival curves were plotted, and log-rank test was used to analyze the median survival time. Multivariate Cox regression was performed to analyze the independent risk factors affecting the prognosis of patients. Chi-square test was used for statistical comparison.Results:The proportion of patients with poorly differentiated tumor in the HAS group was higher than that in the non-HAS group (84.6%(22/26) vs. 55.4%(36/65)), and the difference was statistically significant ( χ2=7.02, P=0.030). The proportions of patients with age < 60 years old, abnormal level of carcinoembryonic antigen (CEA), vascular tumor thrombus, liver metastasis, poor differentiated tumor, and postoperative chemotherapy in the HAS group were higher than those in the common gastric cancer group (34.6% (9/26) vs. 13.8% (18/130), 26.9% (7/26) vs. 7.7% (10/130), 73.1% (19/26) vs. 51.5% (67/130), 30.8% (8/26) vs. 11.5% (15/130), 84.6% (22/26) vs. 37.7% (49/130), and 69.2% (18/26) vs. 27.7% (36/130), respectively), and the differences were all statistically significant ( χ2=5.16, 6.39, 4.06, 4.94, 18.73, and 16.52; all P<0.05). The proportion of male patients in the non-HAS group was lower than that in the common gastric cancer group (58.5%(38/65) vs. 73.1%(95/130)), while the proportions of patients with age < 60 years old, abnormal levels of carbohydrate antigen (CA)15-3, CA19-9, CA242, and CEA in the non-HAS group were higher than those in the common gastric cancer group (40.0% (26/65) vs. 13.8%(18/130), 7.7%(5/65) vs. 0, 23.1%(15/65) vs. 10.0%(13/130), 18.5%(12/65) vs. 7.7%(10/130), and 23.1%(15/65) vs. 7.7%(10/130), respectively), and the differences were all statistically significant ( χ2=4.27, 16.69, 11.25, 6.03, 5.02, and 9.18; all P<0.05). The proportion of patients with maximum diameter of tumor ≥ 5 cm, clinical stage Ⅲ or Ⅳ, lymph node metastasis, extrahepatic metastasis, and postoperative chemotherapy in the non-HAS group were all higher than those in the common gastric cancer group (58.5% (38/65) vs. 42.3% (55/130), 64.6% (42/65) vs. 46.2% (60/130), 83.1% (54/65) vs. 54.6% (71/130), 47.7% (31/65) vs. 15.4% (20/130), and 75.4% (49/65) vs. 27.7% (36/130), respectively), and the differences were all statistically significant ( χ2=4.53, 10.80, 15.26, 23.41, and 40.08; all P<0.05). The incidence of liver metastasis in patients with AFP >100 μg/L was higher than that in patients with AFP ≤100 μg/L (47.6%(10/21) vs. 17.1%(12/70)), and the difference was statistically significant ( χ2=8.18, P=0.004). The results of Kaplan-Meier survival analysis showed that the median survival time of patients in the HAS group, non-HAS group and common gastric cancer group was 13, 28, and 54 months, respectively, and the difference was statistically significant (log-rank test, χ2=20.33, P<0.001). The results of multivariate Cox regression analysis revealed that CA19-9 ( HR=5.803, 95% confidence interval (95% CI): 1.545 to 21.794, P<0.001) and extrahepatic metastasis ( HR=2.747, 95% CI: 1.243 to 6.068, P=0.012) were independent risk factors affecting the prognosis of patients in the non-HAS group. CA15-3 ( HR=84.163, 95% CI: 5.085 to 1 392.920, P=0.002), CA125 ( HR=0.038, 95% CI: 0.006 to 0.257, P=0.001), and the degree of tumor differentiation ( HR=2.284, 95% CI: 1.101 to 36.677, P=0.039) were independent risk factors affecting the prognosis of patients in the HAS group. Conclusions:Compared to common gastric cancer, AFPGC is characterized by advanced clinical stages, with higher propensity for lymph node metastasis, liver metastasis, extrahepatic metastasis and poor prognosis. The higher the AFP level before surgery, the more possibility of liver metastasis after surgery. Serum CA15-3 and CA125 might be tumor markers in predicting the prognosis of HAS patients.

Objective:To explore the clinicopathological features of serum alpha-fetoprotein-producing gastric cancer (AFPGC) and its subtype hepatoid adenocarcinoma of the stomach (HAS), and to analyze the related factors affecting the prognosis of AFPGC and HAS patients.Methods:The clinical data of 91 patients with AFPGC who were admitted to the Second Affiliated Hospital of Dalian Medical University from February, 2010 to February, 2021 were retrospectively collected. According to the results of hepatoid differentiation, the patients were divided into HAS group (26 cases) and non-HAS group (65 cases). Meanwhile, 130 patients with alpha-fetoprotein (AFP) negative gastric cancer at the Second Affiliated Hospital of Dalian Medical University were selected by stratified sampling method as common gastric cancer group. The clinicopathological data of patients in the HAS group, non-HAS group and common gastric cancer group were compared and all the patients were followed up for 3 years. Kaplan-Meier survival curves were plotted, and log-rank test was used to analyze the median survival time. Multivariate Cox regression was performed to analyze the independent risk factors affecting the prognosis of patients. Chi-square test was used for statistical comparison.Results:The proportion of patients with poorly differentiated tumor in the HAS group was higher than that in the non-HAS group (84.6%(22/26) vs. 55.4%(36/65)), and the difference was statistically significant ( χ2=7.02, P=0.030). The proportions of patients with age < 60 years old, abnormal level of carcinoembryonic antigen (CEA), vascular tumor thrombus, liver metastasis, poor differentiated tumor, and postoperative chemotherapy in the HAS group were higher than those in the common gastric cancer group (34.6% (9/26) vs. 13.8% (18/130), 26.9% (7/26) vs. 7.7% (10/130), 73.1% (19/26) vs. 51.5% (67/130), 30.8% (8/26) vs. 11.5% (15/130), 84.6% (22/26) vs. 37.7% (49/130), and 69.2% (18/26) vs. 27.7% (36/130), respectively), and the differences were all statistically significant ( χ2=5.16, 6.39, 4.06, 4.94, 18.73, and 16.52; all P<0.05). The proportion of male patients in the non-HAS group was lower than that in the common gastric cancer group (58.5%(38/65) vs. 73.1%(95/130)), while the proportions of patients with age < 60 years old, abnormal levels of carbohydrate antigen (CA)15-3, CA19-9, CA242, and CEA in the non-HAS group were higher than those in the common gastric cancer group (40.0% (26/65) vs. 13.8%(18/130), 7.7%(5/65) vs. 0, 23.1%(15/65) vs. 10.0%(13/130), 18.5%(12/65) vs. 7.7%(10/130), and 23.1%(15/65) vs. 7.7%(10/130), respectively), and the differences were all statistically significant ( χ2=4.27, 16.69, 11.25, 6.03, 5.02, and 9.18; all P<0.05). The proportion of patients with maximum diameter of tumor ≥ 5 cm, clinical stage Ⅲ or Ⅳ, lymph node metastasis, extrahepatic metastasis, and postoperative chemotherapy in the non-HAS group were all higher than those in the common gastric cancer group (58.5% (38/65) vs. 42.3% (55/130), 64.6% (42/65) vs. 46.2% (60/130), 83.1% (54/65) vs. 54.6% (71/130), 47.7% (31/65) vs. 15.4% (20/130), and 75.4% (49/65) vs. 27.7% (36/130), respectively), and the differences were all statistically significant ( χ2=4.53, 10.80, 15.26, 23.41, and 40.08; all P<0.05). The incidence of liver metastasis in patients with AFP >100 μg/L was higher than that in patients with AFP ≤100 μg/L (47.6%(10/21) vs. 17.1%(12/70)), and the difference was statistically significant ( χ2=8.18, P=0.004). The results of Kaplan-Meier survival analysis showed that the median survival time of patients in the HAS group, non-HAS group and common gastric cancer group was 13, 28, and 54 months, respectively, and the difference was statistically significant (log-rank test, χ2=20.33, P<0.001). The results of multivariate Cox regression analysis revealed that CA19-9 ( HR=5.803, 95% confidence interval (95% CI): 1.545 to 21.794, P<0.001) and extrahepatic metastasis ( HR=2.747, 95% CI: 1.243 to 6.068, P=0.012) were independent risk factors affecting the prognosis of patients in the non-HAS group. CA15-3 ( HR=84.163, 95% CI: 5.085 to 1 392.920, P=0.002), CA125 ( HR=0.038, 95% CI: 0.006 to 0.257, P=0.001), and the degree of tumor differentiation ( HR=2.284, 95% CI: 1.101 to 36.677, P=0.039) were independent risk factors affecting the prognosis of patients in the HAS group. Conclusions:Compared to common gastric cancer, AFPGC is characterized by advanced clinical stages, with higher propensity for lymph node metastasis, liver metastasis, extrahepatic metastasis and poor prognosis. The higher the AFP level before surgery, the more possibility of liver metastasis after surgery. Serum CA15-3 and CA125 might be tumor markers in predicting the prognosis of HAS patients.

OBJECTIVESTo increase the number and quality of adverse events reported in medical devices, dealing with adverse events that have occurred in time, preventing the occurrence of adverse events, and ensuring the safety of device use.

METHODSBased on risk management methods, through a comprehensive analysis of risk of adverse events, scientifically assessing the risk level and completing the classification of adverse events. Administrative supervision departments take corresponding supervision measures according to the classification results.

RESULTSBuilding a classification monitoring model of medical device adverse events based on risk management.

CONCLUSIONSThe classification of adverse events will help the administrative supervision department to focus on the work, reduce the workload, and improve the efficiency of supervision.

Equipment and Supplies ; adverse effects ; classification ; Risk Management

OBJECTIVETo compare the difference between the acupoint embedding therapy and polyene phosphatidylcholine capsules in the clinical efficacy on non-alcoholic fatty liver disease (NAFLD) of liver stagnation and spleen deficiency pattern.

METHODSThe multi-center clinical trial was adopted and 180 cases of NAFLD of liver stagnation and spleen deficiency pattern were randomized into an embedding therapy group and a western medication group, 90 cases in each one. On the basis of general treatment such as diet control and proper physical exercise, in the embedding therapy group, the acupoint embedding therapy was applied to Ganshu (BL 18), Tai-chong (LR 3), Fenglong (ST 40), Zusanli (ST 36) and Sanyinjiao (SP 6), once every 7 days; in the western medication group, polyene phosphatidylcholine capsules (essentiale) were prescribed, 228 mg/capsule, 2 capsules each time, three times a day. In 6 months of treatment, TCM syndrome score, liver enzymology, blood lipid and abdomen B-ultrasound examination were observed and compared before and after treatment between the two groups.

RESULTS(1) For TCM syndrome score, the total score in the embedding therapy group was lower significantly than that in the western medication group (P<0. 05); (2) For liver enzymology and blood lipid, the levels of serum alanine transarninase (ALT), serum glutamic oxalacetic transaminase (AST), total cholesterol (TC) and triacylglycerol (TG) in the embedding therapy group were reduced significantly as compared with those in the western medication group (all P<0. 05); (3) For abdomen B-ultrasound examination, the fatty liver degree in the embedding therapy group was relieved significantly as compared with that in the western medication group (P< 0. 05); (4) For clinical efficacy, the total effective rate was 89. 8%o (79/88) in the embedding therapy group, higher significantly than 76. 7% (69/90) in the western medication group(P<0. 05).

CONCLUSIONThe acupoint embedding therapy achieves the definite efficacy on NAFLD of liver stagnation and spleen deficiency pattern, better than polyene phosphatidylcholine capsules.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Catgut ; utilization ; Female ; Humans ; Liver ; physiopathology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; physiopathology ; therapy ; Spleen ; physiopathology ; Treatment Outcome ; Young Adult

Objective:To evaluate the therapeutic effects of orthodontic therapy with mandibular first molar extraction.Methods:77 cases of malocclusion were divided into 3 groups:Bilateral mandibular first premolar extraction group(A,30 cases),unilateral man-dibular first molar extraction group(B,27cases)and bilateral mandibular first molar extraction group(C,20 cases).The OGS indexes were measured before and after orthodontic treatment and statistically analysed.Results:Remarkable occlusal improvement was seen in all three groups after treatment(P<0.01 ),but the variation of OGS indexes had no significant difference among the 3 groups(P>0.05).OGS indexes among the three groups after treatment were significantly different(P<0.05).The improvement in group A was more significant than that in group C(P<0.01)and the improvement in group C was more significant than that in group B(P<0.01). Conclusion:Orthodontic therapy with bilateral mandibular first molar extraction is effective in orthodontic treatment of malocclusion, but is not as effective as that with bilateral mandibular first premolar extraction.

Gliomas are extremely aggressive brain tumors with a very poor prognosis. One of the more promising strategies for the treatment of human gliomas is targeted immunotherapy where antigens that are unique to the tumors are exploited to generate vaccines. The approach, however, is complicated by the fact that human gliomas escape immune surveillance by creating an immune suppressed microenvironment. In order to oppose the glioma imposed immune suppression, molecules and pathways involved in immune cell maturation, expansion, and migration are under intensive clinical investigation as adjuvant therapy. Toll-like receptors (TLRs) mediate many of these functions in immune cell types, and TLR agonists, thus, are currently primary candidate molecules to be used as important adjuvants in a variety of cancers. In animal models for glioma, TLR agonists have exhibited antitumor properties by facilitating antigen presentation and stimulating innate and adaptive immunity. In clinical trials, several TLR agonists have achieved survival benefit, and many more trials are recruiting or ongoing. However, a second complicating factor is that TLRs are also expressed on cancer cells where they can participate instead in a variety of tumor promoting activities including cell growth, proliferation, invasion, migration, and even stem cell maintenance. TLR agonists can, therefore, possibly play dual roles in tumor biology. Here, how TLRs and TLR agonists function in glioma biology and in anti-glioma therapies is summarized in an effort to provide a current picture of the sophisticated relationship of glioma with the immune system and the implications for immunotherapy.
Animals ; Antigens, Neoplasm ; chemistry ; immunology ; Antineoplastic Agents ; chemistry ; immunology ; therapeutic use ; Brain Neoplasms ; genetics ; immunology ; pathology ; therapy ; Chemotherapy, Adjuvant ; Clinical Trials as Topic ; Disease Models, Animal ; Gene Expression Regulation, Neoplastic ; drug effects ; immunology ; Glioma ; genetics ; immunology ; pathology ; therapy ; Humans ; Immunotherapy ; methods ; Signal Transduction ; Toll-Like Receptors ; agonists ; genetics ; immunology

Objective To assess the relationship between position of incisor and soft tissues changes in class Ⅲ malocclusion cases after orthodontic treatment.Methods All 26 patients in this study were diagnosed as skeletal class Ⅲ malocclusion.The lateral X-ray cephalometric films taken at the beginning and the end of the treatment were analyzed for position of incisor and soft tissues changes.Statistical analysis Waft performed using SAS v8.0 software.Resuits There was correlation between the labial inelination of upper and lower incisors and the soft tissue profile.Conclusion Soft tissue will be harmonious by the labial inclination increase of the upper incisor teeth and reduction of the lower incisor teeth.

Objective: To determine the relation between root resorption and different types of malocclusion. Methods: 108 Chinese patients with orthodonctic treatment by fixed Edgewise appliance were divided into three groups according to Angle's types of malocclusion. Paired measurements of root degrees of all visual root shape on panoramic radiographs were taken before and after orthodonctic treatment. Then root resorption and its distribution were analized. Results: Root resorption occurred during orthodontic treatment in each group(P