Objective:To explore the optimal age cutoff for diagnosis and the prognosis of early-onset gastric cancer in young patients.Methods:Clinicopathological data of patients with gastric adenocarcinoma aged ≤45 years who had undergone radical gastrectomy in the Department of Gastric Surgery, Fudan University Shanghai Cancer Center from January 2013 to December 2018 were retrospectively collected. Patients with distant metastases, other malignant tumors, combined organ resection, gastric stump cancer, positive margin, and incomplete clinical or follow-up data were excluded. X-tile software analysis of the actual overall survival of the collected cases yielded an optimal cut-off of 32 years. Accordingly, the enrolled cases were divided into an early-onset young group (age ≤32 years) and young adult group (age >32 years). Clinicopathological characteristics, long-term survival, and postoperative recurrence were compared between the two groups. Univariate and multivariate analyses were performed using the Cox proportional hazards model to identify the factors affecting the prognosis of young patients with gastric cancer.Results:The study cohort comprised 462 patients, including 256 (55.4%) women, 419 (90.7%) with middle and lower gastric cancers, and 343 (74.2%) with poorly differentiated tumors. There were 101 patients in the early-onset young group and 361 in the young adult group. These groups did not differ significantly in terms of sex, body mass index, tumor location, tumor size, surgical procedure, neurovascular invasion, or tumor stage (all P>0.05). The proportion of patients with poorly differentiated tumors in the early-onset young group was significantly higher than that in the young adult group (89.1%[90/101] vs. 70.1%[253/361], χ 2=15.26, P<0.001). All study patients completed 5 years of follow-up, the median duration of which was 101 months (61-133 months). Death or tumor recurrence occurred in 151 patients (32.7%), in 118 of whom the sites of recurrence and metastasis could be identified, 38 in the early-onset young group and 80 in the young adult group. Fifty-five (46.6%) patients developed peritoneal metastases and 40 (33.9%) hematogenous metastases. In the early-onset young group, 20 patients developed peritoneal metastases, 11 hematogenous metastases, five distant lymph node metastases, and two local recurrence. In the young adult group, 35 patients developed peritoneal metastases, 29 hematogenous metastases, six local recurrences, and 10 distant lymph node metastases. The 5-year overall survival and disease-free survival rates were significantly higher in the young adult group than in the early-onset young group (73.7% vs. 57.4%, P=0.002 and 70.6% vs. 55.4%, P=0.004, respectively). Cox multivariate analysis showed that age >32 years (HR=0.63, 95%CI: 0.43-0.90, P=0.012) was an independent protective factor for overall survival, whereas later N stage (HR=1.67, 95%CI:1.09-2.57, P=0.018) was an independent risk factor for overall survival after surgery ( P<0.05). Age >32 years (HR=0.60, 95%CI: 0.41-0.86, P=0.006) was also an independent protective factor for disease-free survival, whereas later N stage was an independent risk factor (HR=1.69, 95%CI: 1.08-2.64, P=0.021). Conclusion:Young patients with early-onset gastric cancer aged ≤32 years have worse tumor differentiation and prognosis.

Objective:To explore the optimal age cutoff for diagnosis and the prognosis of early-onset gastric cancer in young patients.Methods:Clinicopathological data of patients with gastric adenocarcinoma aged ≤45 years who had undergone radical gastrectomy in the Department of Gastric Surgery, Fudan University Shanghai Cancer Center from January 2013 to December 2018 were retrospectively collected. Patients with distant metastases, other malignant tumors, combined organ resection, gastric stump cancer, positive margin, and incomplete clinical or follow-up data were excluded. X-tile software analysis of the actual overall survival of the collected cases yielded an optimal cut-off of 32 years. Accordingly, the enrolled cases were divided into an early-onset young group (age ≤32 years) and young adult group (age >32 years). Clinicopathological characteristics, long-term survival, and postoperative recurrence were compared between the two groups. Univariate and multivariate analyses were performed using the Cox proportional hazards model to identify the factors affecting the prognosis of young patients with gastric cancer.Results:The study cohort comprised 462 patients, including 256 (55.4%) women, 419 (90.7%) with middle and lower gastric cancers, and 343 (74.2%) with poorly differentiated tumors. There were 101 patients in the early-onset young group and 361 in the young adult group. These groups did not differ significantly in terms of sex, body mass index, tumor location, tumor size, surgical procedure, neurovascular invasion, or tumor stage (all P>0.05). The proportion of patients with poorly differentiated tumors in the early-onset young group was significantly higher than that in the young adult group (89.1%[90/101] vs. 70.1%[253/361], χ 2=15.26, P<0.001). All study patients completed 5 years of follow-up, the median duration of which was 101 months (61-133 months). Death or tumor recurrence occurred in 151 patients (32.7%), in 118 of whom the sites of recurrence and metastasis could be identified, 38 in the early-onset young group and 80 in the young adult group. Fifty-five (46.6%) patients developed peritoneal metastases and 40 (33.9%) hematogenous metastases. In the early-onset young group, 20 patients developed peritoneal metastases, 11 hematogenous metastases, five distant lymph node metastases, and two local recurrence. In the young adult group, 35 patients developed peritoneal metastases, 29 hematogenous metastases, six local recurrences, and 10 distant lymph node metastases. The 5-year overall survival and disease-free survival rates were significantly higher in the young adult group than in the early-onset young group (73.7% vs. 57.4%, P=0.002 and 70.6% vs. 55.4%, P=0.004, respectively). Cox multivariate analysis showed that age >32 years (HR=0.63, 95%CI: 0.43-0.90, P=0.012) was an independent protective factor for overall survival, whereas later N stage (HR=1.67, 95%CI:1.09-2.57, P=0.018) was an independent risk factor for overall survival after surgery ( P<0.05). Age >32 years (HR=0.60, 95%CI: 0.41-0.86, P=0.006) was also an independent protective factor for disease-free survival, whereas later N stage was an independent risk factor (HR=1.69, 95%CI: 1.08-2.64, P=0.021). Conclusion:Young patients with early-onset gastric cancer aged ≤32 years have worse tumor differentiation and prognosis.

Objective To study the effect of reducing no-reflow after PCI treatment by early using Tirofiban and suction catheter in AMI patients .Methods 76 cases of patients were divided into group A (38 cases) and group B(38 cases) .The group A began to use Tirofiban with suction catheter to aspiration after coronary guidewire entering ,the suction were used in group B when the thrombus burden became exacerbation after balloon dilation .In addition ,chosen 38 cases of AMI patients treated with Tirofiban af-ter balloon dilation as group C .The influence of different treatment options to no-reflow and slow blood flow ,cardiovascular adverse events and the incidence of bleeding were observed .Results Group A compared with other two groups ,the no-reflow and slow flow rate had statistically significant differences (P< 0 .05) ,but there was no statistically significant differencebetween group B and group C(P>0 .05) .After three different surgical treatments ,the incidence of bleeding complications had no significant difference (P>0 .05 .The occurrence of adverse cardiovascular events had statistically significant between A group and C (P<0 .05) ,but there was no statistically significant difference between group B and group C (P<0 .05) .Conclusion Three kinds of treatment all have certain effect to reduce no-reflow in emergency PCI of AMI ,but early use of tirofiban with suction catheter in treatment of emergen-cy treatment has great clinical significance to reduce no-reflow .This study provides an effective treatment plan to reduce no-reflow in PCI for AMI .

Objective To investigate the HPV infection influence on the disease evolution of cervical intraepithelial neoplasia (CIN) .Methods 120 CIN grade Ⅰ patients diagnosed by under colposcopic biopsy pathology in 324th Hospital of PLA obstetrics and gynecology clinic from January to December 2010 were selected as the research objects ,concentrations of cervical secretions'HPV DNA were detected by hybrid capture two generations(HC-Ⅱ) of quantitative method .According to HPV infection ,patients were divided into CIN Ⅰ + HPV(-) and CIN Ⅰ + HPV(+ ) group and followed up for 3 years to obseve the disease evolution of CIN by means of TCT test and HR-HPV test .Results 13 .33% patients appeared disease progression in the CIN Ⅰ + HPV (-) group ,while 21 .67% in the CIN Ⅰ + HPV(+ ) group ,the difference between the two groups had significantly statistical difference (P<0 .05) .Conclusion HPV infection has an important role in the disease progression of CIN ,suggesting that the prevention and treatment of the HPV infection could slow down the progression of CIN .

ObjectiveTo study the characteristic of apoptosis and the expression of inducible nitric oxide synthase(iNOS),as well as relation between them after spinal cord injury (SCI) in rats.Methods84 adult SD rats were randomly divided into three groups,and made into mild,moderate and severe acute SCI models.The rats were killed at 4h,8h,1d,3d,7d,14d and 21d after surgery.The histopathology changes in spinal cord tissue were observed with HE staining microscopic examination.The expression of iNOS was determined by immunohistochemistry and the apoptosis was labeled by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling(TUNEL).ResultsThe histopathology changes in spinal cord tissue deteriorated with increasing in injury degree.A little iNOS immunoreactivity (iNOS-IR) was detected in nerve cells,gliocytes,ependymocytes and blood vessel endotheliocytes of normal and vertebra shelf operated controls,increasing at 8 h, and in flood tide in 7 d. The expression of Bax and the rates of TUNEL positive cells were similar with that of iNOS after SCI. There was positive correlation between expression of iNOS and degree of primary SCI ,apoptosis index(r=0.414,P<0.01;r=0.854,P<0.01).Conclusions Expression of iNOS and Bax increase and a large number of TUNEL positive cells present after SCI in rats. There is positive correlation between expression of iNOS and degree of primary SCI,apoptosis index.

Objective:To screen the antagonist of C5a anaphylatoxin,and further to study the dinetic characteristics of interaction between C5a and its anti-sense peptides.Methods:The anti-sense peptides were screened that can interact with C5a selectively by means of dinetic analysis,via biosensor technique.Results:There is one piece of anti-sense peptide(R4) being screened from these four synthesized peptides.The dissociation equilibrium constant(K D) between R4 and the immobilized hC5a is 6.62?10 -6 mol/L and the K D between R4 and L2 is 7.02?10 -7 . Conclusion:Based on the results obtained,it was concluded that the optic biosensor is a ideal and powerful tool to facilitate the kinetic analysis of interaction between sense peptide and its anti-sense peptide and to screen antagonist of biologic activity molecule.

Objective:To discover some high hydrophilic profiles of the human C5a anaphylatoxin based on relationship between the structure and function of the protein and the protein molecular design principles.Methods:The peptides were synthesized by 431A automatic peptide synthesizer,purified by PHLC and confirmed by caplilliary electrophoresis.Results:The N terminus No.9 30 profile of the C5aR(P22) could interacte with anti C5aR McAb(S5/1,from Serotic Co.),as determined by ELISA.Furthermore,it could be inhibited OD490 values remarkably by 10.0 ?g/L rhC5a(P