Objective: To investigate the value of decreased carbohydrate antigen 19-9(CA19-9) kinetics in predicting short-term outcomes and determining prognosis among advanced biliary or pancreatic cancer patients receiving first-or second-line therapy in the real world. Methods : Eighty-nine patients were retrospectively collected with advanced biliary or pancreatic cancer, especially on the CA19-9 dynamics and decline rates at different time points. This study evaluated the association of CA19-9 changes with clinicopathological features, short-term response to antitumor therapy, and survival outcomes. Results : The enrolled patients recorded baseline CA19-9 levels ranging from 1.20 to 65 706.40 U/ml, with a median of 303.11 U/ml. There was no statistical correlation between baseline CA19-9 levels and gender, age, body mass index, primary tumor site, hepatic metastases, pulmonary metastases, lymph node metastases, peritoneal metastases, performance status, treatment lines, and combinations of drug types. Baseline CA19-9 levels were not associated with systemic immunoinflammatory index, prognostic nutritional index, and total bilirubin. A 25% or 50% decrease in CA19-9 after 2-3 therapy courses indicated short-term efficacy in reaching tumor objective remission or disease control. Both combinations of multiple drug types and a 25% decline in CA19-9 after one course of treatment were independent prognostic factors that affected the longer progression-free survival of patients receiving first or second line of treatment. Conclusion Decreased CA19-9 kinetics has specific values in predicting the efficacy and prognosis of advanced biliary or pancreatic cancer.

Myelodysplastic syndrome (MDS) is a malignant hematologic tumor, which is currently difficult to cure. The theory of Xuanfu was proposed by Liu Wansu, which is unique in the clinical evidence of Chinese medicine and is less frequently applied to hematological diseases. The application of Xuanfu theory in myelodysplastic syndrome provides new ideas for the treatment of the disease. The abnormal flow of Qi, blood and fluids caused by the occlusion of the Xuanfu is the cause of toxic stasis obstruction, which is the pathogenesis of toxic stasis obstruction. Thus, the method of dispersion of Bone from Xuanfu, the external treatment of Xuanfu, and regulation of liver qi and Xuanfu help to return to normal of opening and closing function of Xuanfu, and release toxic stasis. In this paper, we analyzed the evidence of toxin-stasis obstruction in myelodysplastic syndrome from the theory of Xuanfu, aiming to provide a feasible theoretical basis for clinical treatment of the disease.

Objective:To explore the feasibility of contrast-enhanced ultrasound in assessing the degree of transplant renal artery stenosis(TRAS)and evaluate its diagnostic efficacy of severe TRAS.Methods:From February 2013 to February 2022, clinical and follow-up data are retrospectively reviewed for 23 TRAS recipients.A definite diagnosis is made by magnetic resonance angiography (MRA, 2 cases)or digital subtraction angiography(DSA, 21 cases). They are assigned into two groups of mild-moderate stenosis(5 cases)and severe stenosis(18 cases)according to the diameter reduction rate of transplanted renal artery detected by DSA/MRA.Another 32 recipients of stable renal function are selected as controls.All contrast-enhanced ultrasonic images are quantitatively processed with SonoLiver.The following quantitative parameters are obtained, including rising time of interlobular artery(RTi), rising time of cortex(RTc), rising time of medulla(RTm), time to peak of interlobular artery(TTPi), time to peak of cortex(TTPc)and time to peak of medulla(TTPm). The differences of contrast-enhanced ultrasonic quantitative parameters are compared among three groups.And their diagnostic efficacies are calculated in the diagnosis of severe TRAS.Results:As compared with those in normal group, RTi, RTc, TTPi and TTPc are significantly longer in mild-moderate stenosis group(all P<0.05); Meanwhile, RTi, RTc, RTm, TTPi, TTPc and TTPm are significantly longer in severe stenosis group than those in normal group(all P<0.05); Comparing mild-moderate stenosis and severe stenosis groups, only RTm is significantly different between two groups( P<0.05). Among all the above parameters, RTc has the highest diagnostic efficacy in the diagnosis of severe TRAS(AUC=0.848)with a sensitivity of 72.22%, a specificity of 86.49% and an accuracy of 81.82%. Conclusions:The quantitative parameters of contrast-enhanced ultrasound offer aid in assessing the degree of TRAS.And RTc is the most valuable in the diagnosis of severe TRAS.

Objective To inve stigate in vestigate the effects of splenectomy on the expression of the PTEN gene in liver fibrosis of rats induced by biliary tract obstruction.Methods The liver fibrosis model was induced by bile duct ligation.Rats were randomly divided into 3 groups.Group A had bile duct ligation + splenectomy (BDL + SPL,45 rats),group B had bile duct ligation + spleen sham operation (BDL + SSP,45 rats),and group C had sham bile duct ligation + spleen sham operation (SBDL + SSP,45 rats).Liver tissue samples from each group were taken in weeks 1,3,and 5.HE and Sirius staining displayed the degree of liver fibrosis.Western-blot,real-time PCR,and immunohistochemistry SP measured the expression of α-smooth muscle actin (α-SMA) together with the expression of PTEN mRNA and PTEN protein.The relevance was also tested in this study.Results As time increased,liver fibrosis gradually occurred in group A and B,and the degree of liver fibrosis was more serious in group B than in group A.The expression volume of PTEN mRNA and PTEN protein in group A was higher than that in group B (P ＜ 0.05),while the expression volume of α-SMA was the opposite (P ＜ 0.05).The expression volume of PTEN mRNA and PTEN protein were negatively correlated to α-SMA (r =-0.86,P ＜ 0.05).Conclusion In the rat liver fibrosis model,splenectomy up-regulated the expression of the PTEN gene and reduced the secretion of α-SMA,thereby delaying the progression of liver fibrosis.

AIM:To study the oral bioavailability of Silymarin-loaded Nanoparticles(SM-NP). METHODS: Beagle dogs were employed as experiment animals,Yiganling Tablet and Silymarin Extraction were used as the reference preparations.Three constituents were isolated on Ultimate~(TM) AQ-C_(18) column with mobile phase methanol:water(50∶50) at 0.8 mL/min flow rate using gradient elution and ESI ionic source and negative ion detection.Silybin plasma concentration in rat was determined by LC-M. RESULTS: The pharmacokinetics of the tested preparation and Yiganling Tablet met with one-compartment model.The relative bioavailability of three components of SMNP were higher than that of Yiganling Tablet. CONCLUSION: The results indicate that SM-NP has better bioavailability than the reference preparation,which confirms that nanoparticles is a good carrier for improving oral bioavailability of poorly-soluble drugs.