Objective To investigate the effects of whole breast combined with regional nodal hypofractionated radiotherapy compared with conventional fractionated radiotherapy on peripheral lymphocyte count (PLC) and neutrophil-to-lymphocyte ratio (NLR) in patients with breast cancer after breast-conserving surgery. Methods This retrospective study enrolled 94 patients with breast cancer who underwent breast-conserving surgery in Tangshan People’s Hospital between April 2022 and April 2024. All patients received whole breast combined with regional nodal radiotherapy. These patients were divided into hypofractionated radiotherapy group (n = 42) and conventional fractionated radiotherapy group (n = 52) according to radiotherapy regimen. Differences in PLC and NLR before and after radiotherapy between the two groups were compared using the t-test. Results Before radiotherapy, the baseline PLC and NLR were comparable between the two groups (P > 0.05). After radiotherapy, PLC decreased and NLR increased in both groups (P < 0.05). The PLC in the hypofractionated radiotherapy group was significantly higher than that in the conventional fractionated radiotherapy group (0.95 ± 0.30 vs. 0.77 ± 0.26, P = 0.002), and the NLR was significantly lower in the hypofractionated radiotherapy group than in the conventional fractionated radiotherapy group (2.86 ± 1.27 vs. 3.67 ± 1.59, P = 0.010). Conclusion Compared with conventional fractionated radiotherapy, whole breast combined with regional nodal hypofractionated radiotherapy has less impact on PLC and NLR in patients with breast cancer after breast-conserving surgery.

Objective To compare the efficacy and tolerability of the novel bowel-cleansing agent TCIC-001 and the traditional polyethylene glycol (PEG) regimen for bowel preparation prior to colonoscopy. Methods Prospective inclusion of 62 patients who were scheduled to undergo colonoscopy at Zhongshan Hospital, Fudan University from July 2021 to July 2022. They were randomly divided into TCIC-001 group (n=31) and PEG group (n=31) using a random number table method. The TCIC-001 group took TCIC-001 orally, drinking water in stages, with a total liquid intake of 1 500 mL; the PEG group took PEG orally, taking it in 4 doses, with a total liquid intake of 3 000 mL. The primary endpoint indicator is the quality of intestinal hygiene evaluated by the Boston Bowel Preparation Scale (BBPS), the secondary endpoint indicators were medication adherence, medication duration, frequency of bowel movements, duration of bowel movements, and incidence of adverse events between two groups. Results No significant differences were observed in sex, age, or defecation frequency between the two groups. For efficacy, both groups achieved equivalent bowel cleanliness, with a “good preparation” rate of 93.55% and comparable BBPS score of each intestinal segment and total scores. For tolerability, the TCIC-001 group had a shorter medication duration compared to the PEG group ([48.8±25.9] min vs [82.8±28.4] min, P<0.001), a longer defecation duration ([288.6±74.0] min vs [236.5±74.3] min, P<0.001), and a lower incidence of first defecation before medication completion (9.68% vs 41.94%, P=0.004). Regarding safety, no significant differences were observed between the TCIC-001 group and the PEG group in incidences of chloride disturbances (0% vs 9.68%) and calcium disturbances (3.23% vs 6.45%), and no other adverse events. Conclusions TCIC-001 demonstrated comparable bowel-cleansing efficacy to PEG while significantly improving tolerability (reduced medication time and lower risk of premature defecation) and maintaining favorable safety.

Ureteral stenosis is a comparatively rare complication following hematopoietic stem cell transplantation (HSCT). The etiology is still unclear and most believe that this may be due to the reactivation of BK virus in a state of immunodeficiency. In the later stages of ureteral stenosis with scarring, invasive interventions must be taken to relieve the hydronephrosis. Common treatments, such as D-J stent placement and permanent nephrostomy may not only entail the risk of infection, but also seriously affect the quality of life. Few cases of surgical intervention have been reported. In this article, a 25-year-old female was admitted to Peking University First Hospital suffering from recurrent flank pain. Seven years before, she developed hemorrhagic cystitis and bilateral urethritis 40 days after allogeneic HSCT. After continuous bladder irrigation and antiviral therapy, the left-sided hydronephrosis gradually alleviated while the right-sided one did not improve. D-J stents were used for urine drainage for 7 years before percuta-neous nephrostomy. Preoperative antegrade pyelography revealed significant hydronephrosis in the right kidney with long stricture of proximal-middle ureter. After comprehensive decision, she underwent ileal ureter replacement. The operation was successful. The segmental lesion was dissected and the scar tissue was removed. A 25 cm intestinal tube was isolated to connect the pelvis and bladder. An anti-reflux nipple was created at the distal end of ileal ureter to prevent the potential infection. The blood loss was minimal. After surgery, the drainage tube was removed in 2 weeks, the nephrostomy tube and the D-J stent was removed in 3 months. Follow-up mainly included clinical assessment, serologic testing, renal ultrasonography, blood gas analysis and radiological examination. During the follow-up of 6 years, she was symptom-free and no postoperative complications occurred. The serum creatinine level was stable. No hydronephrosis was observed under ultrasonography. Obvious peristaltic waves and ureteral jets of the ileal ureter was confirmed on cine magnetic resonance urography. To sum up, ureteral stenosis after HSCT is relatively rare. Obstruction caused by scarring is usually irreversible and surgical intervention should be designed according to the location and length of the lesion. Ileal ureter replacement can be a safe, feasible and effective method to solve this kind of complex stricture.
Adult ; Cicatrix ; Constriction, Pathologic/etiology* ; Female ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Humans ; Hydronephrosis/surgery* ; Quality of Life ; Ureter/surgery* ; Ureteral Obstruction/surgery*

Objective To investigate the inhibitory effect of agonistic CD40 monoclonal antibody on the colon cancer cells (HCT116) proliferation in vitro.Methods The DCs (dendritic cells) loaded with tumor cells (HCT116) antigens were activated by different methods.According to the activation method,the cells were divided into three groups:agonistic CD40 monoclonal antibody group,blank control group and TNF-α positive control group.The cells were cultured for 7 days,and the expression rates of CD80,CD83,CD86 and HLA-DR on DC surface in each group were detected by flow cytometry.The concentration of cytokine IL-12(p70) in DCs culture supernatant was determined by ELISA kit.The proliferation activity of the T lymphocytes was evaluated by MTT (methyl thiazolyl tetrazolium).Then the inhibition rate of colon cancer HCT116 cells proliferation,which induced by the tumor-specific effector T lymphocytes,was assayed.Results Compared with the blank control group,the agonistic CD40 monoclonal antibody group had a significantly higher expression rates of CD80,CD83,CD86 and HLA-DR on DC surface (P＜0.05).The concentration of IL-12 in the supernatant of DC was also much higher in the agonistic CD40 monoclonal antibody group (P＜0.05,(716.80±53.43) pg/ml vs.(405.51 ±12.17) pg/ml).The DCs activated by CD40 monoclonal antibody had stronger ability to stimulate proliferation of T lymphocytes (P＜0.05,the stimulation index was (2.006 2±0.438 3) to (1.365 0±0.209 8)).The tumor-specific CTLs induced by DCs in the agonistic CD40 monoclonal antibody group had stronger ability to inhibit colon cancer HCT116 cells (P＜0.05,the inhibition rate was (66.08±0.41)％ vs.(46.60± 1.10)％).However,there was no statistical significance between the agonistic CD40 monoclonal antibody group and the TNF-α positive control group (P＞0.05).Conclusion Agonistic CD40 monoclonal antibody in vitro can promote activation and mature of DCs,then the activated DCs can induce the production of tumor-specific CTL,which can significantly inhibit the proliferation of colon cancer HCT116 cells.

Adolescent ; Adult ; Artificial Organs ; Female ; Humans ; Male ; Middle Aged ; Trachea ; surgery ; Young Adult

Objective To investigate the clinical effect of operation of superficial temporal artery-middle cerebral artery(STA -MCA)bypass combined with temporal muscle sticking in the treatment of adult moyamoya disease.Methods A retrospective analysis was the data of operation,including preoperative evaluation,operation method,postoperative follow -up.Results Postoperative complications occurred in 5 cases,including 3 cases of intracranial hemorrhage,2 cases of cerebral infarction.During the follow -up of 6 -35 months,no recurrent hemor-rhage cases,1 cases of cerebral infarction,TIA remission rate was 93.5%.Postoperative cerebral blood flow of 38 cases significantly improved compared with preoperative by SPET,accounted for 86.3%.Cerebral blood flow of 41 cases was well compensated by vascular bridge,accounted for 91%.Conclusion Operation of STA -MCA bypass combined with temporal muscle sticking can significantly reduce the incidence of stroke,fewer complications,which is an ideal method in the treatment of adult moyamoya disease.

Objective To explore the correlation between imaging features and pathological findings of alveolar soft part sarcoma (ASPS).Methods The clinical data,radiographic images and pathological characteristics of seven patients with histopathologically proved ASPS from 2003 to 2009 were retrospectively reviewed.Digital radiography (DR),plain CT,pre and post-contrast MR and DSA were performed in all patients.HE staining and periodic acid-Schiff (PAS) staining were used in pathological examination and CD34 were marked in immunehistochemical study.Results All patients were females.Their age ranged from 16 to 37 years with median of 24 years.Two tumors were located in pelvics,three were located in thighs,and two were located in legs.DR and CT plain scan features of ASPS were non-specific.MR demonstrated the tumors with large diameter and well defined margin locating in the deep tissues.Tumors were hyperintense on T2-weighted and T1-weighted images with many flow void vessels and persistent remarkable enhancement.There were numerous vessels with arteriovenous fistula on DSA.Pathological examination revealed solid nests of several polygonal tumor cells arranged in an alveolar pattern and separated by thinwalled,sinusoidal vascular channels.Tumor cell were noted on periodic acid-Schiff (PAS) stains.And the endothelial cells of sinusoidal vascular channels were positive on CD34.Conclusions As a malignant tumor which predominantly developed in deep location of trunk or extremities in young females,numerous void signal and hyperintensity on T1-weighted were the features of ASPS on MR.Numerous vessels could also be confirmed on DSA.These image findings were correlated closely with the pathological manifestations.

Objective To establish an animal model with installation of gastrobiliary duct drainage (GBDD) in the primary suture after exploration of common bile duct, to assess the safety and feasibility of GBDD. Methods Thirty dogs were randomly divided into three groups: control group (n=5), primary suture group (n= 10) and GBDD group (n= 15). Serum TBil levels, bile leakage,and complications were observed and compared. Results No increase in serum TBil level was observed in the control group. However, serum TBil levels were significantly increased in the primary suture group compared to the GBDD group (P＜0. 01). GBDD were all successfully withdrawn at mean (7. 0±1.7) days after the operation. No bile leakage was found in the GBDD group, which was significantly different compared to 5/10 bile leakage cases in primary suture group (P＜0. 05). There were 3/10 cases of bile peritonitis, infection of incisional wound and splitted in the primary suture group, while there were no such complications in the GBDD group (all P＞0.05). Conclusions GBDD is safe and feasible. It can shorten biliary drainage time and prevent occurrence of bile leakage.Therefore, it has unique value in clinical application.

Object To isolate and identify the biflavonoids from the stem bark of Daphne giraldii Nitsche. Methods The flavonoids were isolated and purified by column chromatography on silica gel and Sephadex LH-20. Their structures were determined by spectroscopic methods, including IR, 1HNMR, 13 CNMR, HMBC and FAB-MS.Results Four biflavonoids daphnodorins A-D 1 (Ⅰ-Ⅳ) were isolated from the stem bark of D. giraldii. Conclusion The above four biflavonoids were isolated from the title plant only.