Purpose: Due to the preservation of the entire stomach after endoscopic resection, the occurrence of metachronous gastric cancer (MGC) remains a possibility. In this study, we investigated the incidence and risk factors for MGC in patients with early gastric cancer who underwent endoscopic submucosal dissection (ESD) and successfully eradicatedHelicobacter pylori. Materials and Methods: A retrospective analysis was conducted of 1,191 patients who underwent ESD and successfully eradicated H. pylori at the Affiliated Drum Tower Hospital of Nanjing University. Endoscopic surveillance was performed at 3, 6, and 12 months post-resection, and annually thereafter. MGC was defined as the development of a new cancer at a site other than the primary gastric cancer site, at least 1 year after the initial endoscopic resection. Results: A total of 77 patients were diagnosed with MGC during a median follow-up of 41.5 months. Kaplan-Meier analysis showed a 5-year cumulative incidence of MGC of 9.4% after successful H. pylori eradication. Multivariate analysis of the training set using Cox proportional hazards models identified male sex, severe atrophic gastritis, multiple gastric cancers before H. pylori eradication, and smoking history as independent risk factors for MGC.The nomogram exhibited favorable discrimination, with area under the curves of 0.767 and 0.822 in the training set and 0.724 and 0.745 in the testing set at 3 and 5 years, respectively. Conclusions Patients with gastric cancer who undergo endoscopic resection, even after successful H. pylori eradication, should undergo annual and continuous endoscopic surveillance for MGC.

Objective To compare of the clinical using effect of implantable venous -access port(VAP) among different methods and the postoperative complication.Methods From 2011 to 2014,a total of 359 patients with VAP were included in this study.All patients were divided into two groups according to the surgery approaches methods,307 cases were implanted through internal jugular vein,and other 52 cases were through subclavian vein intubation.Statistics of postoperative flow conditions and complication between the two groups were gathered and com-pared.Results There were 3 cases of postoperative infected,and 13 cases were not free of transfusion,while 2 cases catheter were shed and shifted in the 307 cases of implantation through internal jugular vein,the complication rate was 5.86%;In other group,which in total of 52 cases of implantation through subclavian vein,including 2 cases were post-operative infected,6 cases were not free of transfusion,2 cases are of catheter fracture and5 cases were local hemato-ma,the complication rate was 28.85%.There was difference in rate of catheter leakage,catheter tip dystopy and cath-eter related infection between two groups[the proportion of through internal jugular vein vs that the group through sub-clavian vein:5.86%(18 /307)vs 28.85%(15 /52),χ2 =28.140,P =0.000].Conclusion The study suggests that the two ways of different operation methods of VAP are safe and reliable for long term intermittent venous access.The internal jugular vein implanted group has a slight advantage over the group of subclavian vein implanted,when it comes to develop the patients′living quality.

BACKGROUNDShort-term outcomes of the Wallis system in the treatment of lumbar degenerative disease (LDD) have been shown to be effective, whereas there is a paucity of studies on the mid-long-term effects of the treatment of the Wallis system. This study was to evaluate the mid-long-term effects of the Wallis dynamic stabilization system in the treatment of LDD.

METHODSA total of 26 patients who received the treatment of the Wallis system between February 2008 and January 2009 were included in the study, with 14 patients (Group 1) with L4/5 disc herniation and 12 patients (Group 2) with L5/S1 disc herniation and L4/5 intervertebral disc degeneration (IDD). Visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical outcomes and lumbar X-rays and MRI were obtained to observe imaging changes before and after operation.

RESULTSThe mean follow-up period was (63.50±2.12) months. The mean ODI and VAS scores decreased obviously three months and five years after operation (P < 0.05). In Groups 1 and 2, L4/5 Cobb angle and range of motion (ROM) decreased and L4/5 posterior disc height increased at the last follow-up (P < 0.05). There were no statistically significant changes in L4/5 anterior disc height and L3/4 University of California at Los Angeles grading before and after operation. There was no statistically significant change in Pfirrmann grading system of L4/5 IDD in Group 2 before and after operation. Adjacent segment degeneration at the last follow-up was found in two patients (2/26, 7.69%) and Modic changes in L4/5 endplates were detected in one patient (1/26, 3.85%).

CONCLUSIONSThe mid-long-term effects of the Wallis system in the treatment of LDD were satisfied. The Wallis system, as a dynamic stabilization system, which can preserve some ROM of the fixed segment, sustain the lumbar stabilization, and prevent adjacent segment disease and fixed segment degeneration, is an effective instrument to treat LDD.

Adult ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; surgery ; Lumbosacral Region ; surgery ; Male ; Middle Aged ; Spinal Fusion

The transcriptional factor Oct-4 and Survivin are the key regulatory factors in cancer cell proliferation and mitosis. A dual cancer-specific shRNA adenovirus vector, Ad5-Dual-shRNA, targeting Oct-4 and Survivin genes was constructed by molecular cloning and recombination. After cells were infected with virus, hepatocellular carcinoma cell line EHBH-H1 was used for detecting the expression of Oct-4 and Survivin proteins by Western blotting. The viral cytotoxic effect on cancer cells was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) reduction assay in vitro, and the inhibition effect on tumor xenografts was observed in nude mice. The results showed that the expression of Oct-4 and Survivin in cancer cell line EHBH-H1 could be silenced markedly by Ad5-Dual-shRNA. In MTT and animal experiments, Ad5-Dual-shRNA also represented much stronger anti-tumor effect on tumor growth than Ad5-Surv-shRNA and Ad5-Oct4-shRNA. From this research we can draw a conclusion that the cancer-specific adenovirus vector expressing dual-shRNA targeting Oct-4 and Survivin genes may provide us a more effective, specific and convenient gene therapy method.
Adenoviridae ; genetics ; metabolism ; Animals ; Apoptosis ; genetics ; Carcinoma, Hepatocellular ; pathology ; therapy ; Cell Line, Tumor ; Genetic Therapy ; Genetic Vectors ; genetics ; HEK293 Cells ; Humans ; Inhibitor of Apoptosis Proteins ; biosynthesis ; genetics ; Liver Neoplasms ; pathology ; therapy ; Mice ; Mice, Nude ; Octamer Transcription Factor-3 ; biosynthesis ; genetics ; RNA, Small Interfering ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection

Objective To investigate the change of ATM phosphorylation in HepG2 cells following a condnuous low dose-rate irradiation.Methods Cells were pemistendy exposed to low dose-rate(8.28 cGy/h) irradiation.Indirect immunofluorescence and Western blot were used to detect the expression of ATM phosphorylated proteins.Colony forming assay Was used to observe the effect of a low dose-rate irradiation on HepG2 cell survival.Results After 30 min of low dose-rate irradiation.the phosphorylation of ATM occurred.After 6 h persistent irradiation,the expression of ATM phosphorylated protein reached the peak value,then gradually decreased.After ATM phosphorylation was inhibited with Wortmannin,the surviving fraction of HepG2 cells was lower than that of the irradiation alone group at each time point(P<0.05).Conclusions Continuous low dose-rate irradiation attenuated ATM phosphorylation.suggesting that continuous low dose-rate irradiation has a potential effect for increasing the radiosensitivity of HepG2 cells.

OBJECTIVE:To evaluate safety of drug-eluting stent versus bare stent in clinical application and observe application of drug-eluting stent and bare stent in treating coronary atherosclerotic heart disease.METHODS:A computer-based online search of CNKI(2004/2008) was performed to retrieve randomized controlled experiments of clinical and basic studies concerning drug-eluting stent and bare stent with the key words of "drug-eluting stent,bare stent".The data were extracted and analyzed.RESULTS:A total of 19 experiments involving 2 731 patients undergoing endovascular stenting were included.The vascular stenosis rate was significantly reduced after drug-eluting stent implantation compared with bare stent implantation.Follow-up results show that drug-eluting stent significantly reduced restenosis and affected vascular reconstruction compared with bare stent.However,the long-term effect on hemodynamics in vivo requires further investigation.CONCLUSION:Compared bare stent,drug-eluting stent is more effective in complex pathological changes of small vessels,and could significantly reduce restenosis and affected vascular reconstruction.However,the included studies are not sufficient,and the efficacy indexes and safety requires further exploration.