Amide proton transfer-weighted (APTw) imaging is a kind of new magnetic resonance molecular imaging that rapidly developed in recent years. APTw imaging reflects the protein concentration and acid-base changes in tissues by detecting amide protons in free proteins and peptides in tissues. APTw imaging is a complementary technique to the existing magnetic resonance techniques, which can provide new molecular biological information for central nervous system diseases. In this article, the basic principle of APTw imaging and its application in common central nervous system diseases such as brain tumor, ischemic stroke, and neurodegenerative diseases are reviewed to provide new methods for promoting the transformation of APTw imaging from the research stage to routine clinical application, and facilitating the precise diagnosis and treatment of central nervous system diseases.

Amide proton transfer-weighted (APTw) imaging is a kind of new magnetic resonance molecular imaging that rapidly developed in recent years. APTw imaging reflects the protein concentration and acid-base changes in tissues by detecting amide protons in free proteins and peptides in tissues. APTw imaging is a complementary technique to the existing magnetic resonance techniques, which can provide new molecular biological information for central nervous system diseases. In this article, the basic principle of APTw imaging and its application in common central nervous system diseases such as brain tumor, ischemic stroke, and neurodegenerative diseases are reviewed to provide new methods for promoting the transformation of APTw imaging from the research stage to routine clinical application, and facilitating the precise diagnosis and treatment of central nervous system diseases.

ObjectiveTo explore the intervention mechanism of Xiangsha Liujunzi Tang in rats with functional dyspepsia （FD） based on the Ras homolog gene family member A （RhoA）/Rho-associated coiled-coil containing protein kinase 2 （ROCK2）/Myosin phosphatase target Subunit 1 （MYPT1） pathway. MethodSixty male SD suckling rats in SPF grades were randomly divided into blank group （n=10） and model group （n=50）. The comprehensive modeling method （gavage administration of iodoacetamide+exhaustion of swimming+disturbance of hunger and satiety） was used to replicate the rat model of FD. After successful replication of the model， the rats in the model group were randomly divided into model group， mosapride group， and high， middle， and low-dose Xiangsha Liujunzi Tang groups， with 10 rats in each group. Rats in the blank group and model group were given 10 mL kg^-1·d^-1 normal saline， those in the mosapride group were given 1.35 mg·kg^-1·d^-1 mosapride， and those in the high， middle， and low-dose Xiangsha Liujunzi Tang groups were given 12， 6， and 3 g·kg^-1·d^-1 Xiangsha Liujunzi Tang， respectively. The intervention lasted 14 days. The general living conditions of rats were observed before and after modeling and administration， and the 3-hour food intake and body mass of rats were measured. After intervention， the intestinal propulsion rate of rats was measured， and the pathological changes in the gastric tissue were observed by hematoxylin-eosin （HE） staining. The content of choline acetyl transferase （ChAT） and vasoactive intestinal peptide （VIP） in the medulla oblongata and gastric tissue homogenate was determined by enzyme-linked immunosorbent assay （ELISA）， the distribution of adenosine triphosphate （ATP） enzyme in gastric antrum smooth muscle was observed by frozen section staining， and the protein expression levels of RhoA， ROCK2， and phosphorylated-myosin phosphatase target subunit 1 （p-MYPT1） in the gastric tissue were detected by Western blot. ResultCompared with the blank group， the model group had withered hair， lazy movement， slow action， poor general living condition， lower 3-hour food intake， body mass， and lower intestinal propulsion rate （P<0.05）， whereas no obvious abnormality in gastric histopathology. In the model group， the content of ChAT in the medulla oblongata and gastric tissue decreased， the content of VIP in gastric tissue increased， the distribution of ATP enzyme in gastric antrum smooth muscle decreased significantly， and the protein expression levels of RhoA， ROCK2， and p-MYPT1 in the gastric tissue decreased significantly （P<0.05）. As compared with the model group， the general living condition of rats in each intervention group was significantly improved， and the 3-hour food intake， body mass， and intestinal propulsion rate were significantly increased （P<0.05）. There was no significant difference in gastric pathology in the intervention groups. The content of ChAT in the medulla oblongata and gastric tissue increased significantly， the content of VIP in the gastric tissue decreased， the distribution of ATP enzyme in gastric antrum smooth muscle increased significantly， and the protein expression levels of RhoA， ROCK2， and p-MYPT1 in the gastric tissue increased significantly （P<0.05）. The intervention effect of Xiangsha Liujunzi Tang group on the above indexes was dose-dependent. ConclusionXiangsha Liujunzi Tang can effectively improve the general living condition and gastric motility of rats with FD， and its specific mechanism may be related to the activation of the RhoA/ROCK2/MYPT1 pathway in the gastric tissue to regulate smooth muscle relaxation and contraction and promote gastric motility.

Background::Hepatopancreatoduodenectomy (HPD) has been considered the only curative treatment for metastatic cholangiocarcinoma and some locally advanced gallbladder cancers (GBCs). However, HPD has not yet been included in treatment guidelines as a standard surgical procedure in consideration of its morbidity and mortality rates. The aim of this study was to evaluate the safety and effectiveness of HPD in treating biliary malignancies.Methods::The medical records of 57 patients with advanced biliary cancer undergoing HPD from January 2009 to December 2019 were retrospectively retrieved. A case-control analysis was conducted at our department. Patients with advanced GBC who underwent HPD (HPD-GBC group) were compared with a control group (None-HPD-GBC group). Baseline characteristics, preoperative treatments, tumor pathologic features, operative results, and prognosis were assessed.Results::Thirteen patients with cholangiocarcinoma and 44 patients with GBC underwent HPD at our department. Significant postoperative complications (grade III or greater) and postoperative pancreatic fistula were observed in 24 (42.1%) and 15 (26.3%) patients, respectively. One postoperative death occurred in the present study. Overall survival (OS) was longer in patients with advanced cholangiocarcinoma than in those with GBC (median survival time [MST], 31 months vs. 11 months; P < 0.001). In the subgroup analysis of patients with advanced GBC, multivariate analysis demonstrated that T4 stage tumors ( P = 0.012), N2 tumors ( P = 0.001), and positive margin status ( P = 0.004) were independently associated with poorer OS. Patients with either one or more prognostic factors exhibited a shorter MST than patients without those prognostic factors ( P < 0.001). Conclusion::HPD could be performed with a relatively low mortality rate and an acceptable morbidity rate in an experienced high-volume center. For patients with advanced GBC without an N2 or T4 tumor, HPD can be a preferable treatment option.

Objective:To study the difference of facilitative glucose transporter 8 (GLUT8) expression in sperms among asthenozoospermia (AS) patients, teratozoospermia (TM) patients and normal reproductive men, thus to investigate the correlation between the expression of GLUT8 and sperm motility.Methods:The sperm motility parameters of each group were detected by computer-assisted semen analysis system (CASA). A case-control study method was used to collect semen from patients with AS, TM and normal reproductive men who underwent routine semen examination in the Andrology Laboratory, Department of Reproductive Medicine, the Affiliated Taizhou People's Hospital of Nanjing Medical University from December 2019 to December 2020. The semen of AS patients (41 samples), normal viable spermatozoa (NV) patients (41 samples), TM patients (40 samples) and normal morphology spermatozoa (NM) patients (40 samples) were collected and selected into AS group, NV group, TM group and NM group according to the criteria of enrollment. Western blotting was used to assess the expression of GLUT8 protein in NV group, AS group, NM group and TM group, with 7 cases in each group. The differences of sperm parameters and GLUT8 protein between NV group and AS group, NM group and TM group were compared.Results:Sperm parameters of NV group and AS group were significantly different in progressive rate (62.64%±37.14%, 14.41%±11.89%, P<0.001), motility rate (55.62%±12.31%, 24.40%±12.75%, P<0.001), curvilinear velocity [(87.22±12.35) μm/s, (71.75±18.35) μm/s, P<0.001], the straight line velocity [(40.22±6.71) μm/s, (33.31±10.11) μm/s, P<0.001], average path velocity [(47.66±6.49) μm/s, (39.42±10.25) μm/s, P<0.001], and amplitude of lateral head displacement [(2.88±0.49) μm, (2.35±0.66) μm, P<0.001], and there were no significant differences in sperm parameters between NM group and TM group (all P>0.05). The relative expression of GLUT8 protein in AS group (0.26±0.17) was significantly lower than that in NV group (2.00±0.38, P=0.002), but there was no significant difference in GLUT8 protein expression in NM group and TM group ( P>0.05). Conclusion:GLUT8 protein expression in sperm decreased in AS, but there was no significant correlation between GLUT8 protein expression and sperm morphology.

Objective:To study the difference of facilitative glucose transporter 8 (GLUT8) expression in sperms among asthenozoospermia (AS) patients, teratozoospermia (TM) patients and normal reproductive men, thus to investigate the correlation between the expression of GLUT8 and sperm motility.Methods:The sperm motility parameters of each group were detected by computer-assisted semen analysis system (CASA). A case-control study method was used to collect semen from patients with AS, TM and normal reproductive men who underwent routine semen examination in the Andrology Laboratory, Department of Reproductive Medicine, the Affiliated Taizhou People's Hospital of Nanjing Medical University from December 2019 to December 2020. The semen of AS patients (41 samples), normal viable spermatozoa (NV) patients (41 samples), TM patients (40 samples) and normal morphology spermatozoa (NM) patients (40 samples) were collected and selected into AS group, NV group, TM group and NM group according to the criteria of enrollment. Western blotting was used to assess the expression of GLUT8 protein in NV group, AS group, NM group and TM group, with 7 cases in each group. The differences of sperm parameters and GLUT8 protein between NV group and AS group, NM group and TM group were compared.Results:Sperm parameters of NV group and AS group were significantly different in progressive rate (62.64%±37.14%, 14.41%±11.89%, P<0.001), motility rate (55.62%±12.31%, 24.40%±12.75%, P<0.001), curvilinear velocity [(87.22±12.35) μm/s, (71.75±18.35) μm/s, P<0.001], the straight line velocity [(40.22±6.71) μm/s, (33.31±10.11) μm/s, P<0.001], average path velocity [(47.66±6.49) μm/s, (39.42±10.25) μm/s, P<0.001], and amplitude of lateral head displacement [(2.88±0.49) μm, (2.35±0.66) μm, P<0.001], and there were no significant differences in sperm parameters between NM group and TM group (all P>0.05). The relative expression of GLUT8 protein in AS group (0.26±0.17) was significantly lower than that in NV group (2.00±0.38, P=0.002), but there was no significant difference in GLUT8 protein expression in NM group and TM group ( P>0.05). Conclusion:GLUT8 protein expression in sperm decreased in AS, but there was no significant correlation between GLUT8 protein expression and sperm morphology.

Objective:To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China.Methods:This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed.Results:Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn′t be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%.Conclusions:More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.

Objective:To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China.Methods:This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed.Results:Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn′t be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%.Conclusions:More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.

Objective To evaluate the clinical efficacy of gemcitabine-oxaliplatin (GEMOX) regimen combined with targeted therapy for advanced gallbladder cancer.Methods The retrospective descriptive study was conducted.The clinical data of 21 patients with advanced gallbladder cancer who were admitted to the Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine between January 2016 and December 2017 were collected,including 8 males and 13 females,aged from 28 to 80 years,with the age of (58± 12)years.Patients received GEMOX regimen combined with targeted therapy.According to the results of gene test,patients selected tageted therapy with Cetuximab,Herceptin or Apatinib.Observation indicators:(1) gene test situations;(2) situations of GEMOX regimen combined with targeted therapy;(3) adverse reactions of GEMOX regimen combined with targeted therapy.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were described as M (range).Count data were represented as absolute number or percentage.The survival curve and rate were respectively drawn and calculated using the Kaplan-Meier method.The survival analysis was done using the Log-rank test.Results (1) Gene test situations:of 21 patients,19 were confirmed as K-ras wild type,including 13 of single K-ras wild type,4 of K-ras wild type combined with human epidermal growth factor receptor 2 (HER2),2 of K-ras wild type combined with vascular endothelial growth factor receptor 2 (VEGFR2);5 were detected positive HER2,including 1 of single positive HER2,4 of positive HER2 combined with K-ras wild type;3 were detected positive VEGFR2,including 1 of single positive VEGFR2,2 of positive VEGFR2 combined with K-ras wild type.Two and 19 patients had 0 and l of Eastern Cooperative Oncology Group score.(2) Situations of GEMOX regimen combined with targeted therapy:all the 21 patients underwent ≥ 2 courses of GEMOX regimen combined with targeted therapy.Among the 21 patients,0,4,9 and 8 were respectively detected in the complete remission (CR),partial remission (PR),stable disease (SD) and disease progression (PD).Fourteen patients (13 of single K-ras wild type and 1 of K-ras wild type combined with positive VEGFR2) received GEMOX regimen combined with Cetuximab therapy,including 0 with CR,4 with PR,5 with SD and 5 with PD;5 patients (1 of single positive HER2 and 4 of positive HER2 combined with K-ras wild type) received GEMOX regimen combined with Herceptin therapy,including 0 with CR,0 with PR,2 with SD and 3 with PD;2 patients (1 of single positive VEGFR2 and 1 of positive VEGFR2 combined with K-ras wild type) received GEMOX regimen combined with Apatinib therapy,including 0 with CR,0 with PR,2 with SD and 0 with PD.The objective response rate was 19.0％ (4/21) and disease control rate was 61.9％(13/21) in the 21 patients.The median onset time was 1.8 months in the 21 patients.The 3-,6-and 9-month progression free survival (PFS) rates and median PFS time were respectively 90.5％,71.4％,58.5％ and 10.7 months.The 6-and 12-month overall survival rates were respectively 90.2％ and 58.6％,and median overall survival (OS) time was 15.5 months in the 21 patients.The PFS and OS time were 8.4 months and 10.4 months in the 7 patients combined with jaundice,10.5 months and 14.8 months in the 14 patients without jaundice,with no statistically significant difference (x2 =0.868,0.774,P＞0.05).(3) Adverse reactions of GEMOX regimen combined with targeted therapy:the most common adverse events were skin rash and digestive tract reactions.No serious adverse event occurred during the therapy.All the adverse events were improved after symptomatic treatments.Conclusion GEMOX regimen combined with targeted therapy for advanced gallbladder cancer has good outcomes,less adverse reactions and higher safety.

OBJECTIVETo prepare cisPLLAtin-loaded polylactic acid/cnts, and to study the anti-tumor effect of 5-FU-PLLA-CNTs on human gastric carcinoma cell lines(MGC803 and MNK45).

METHODS5-FU-PLLA-CNTs were prepared with ultrasound emulsification. The morphology of 5-FU-PLLA-CNTs was determined by scanning electron microscope(SEM), and its drug loading and drug release curve in vitro were detected by UV-Vis-NIR spectrophotometer. Cells were divided into experiment, positive control and negative control groups. CCK8 method was used to test the cytotoxic effect of 5-FU-PLLA-CNTs in different concentrations on MGC803 and MNK45 cell proliferation. Flow cytometry was employed to measure the apoptotic rate of MGC803 and MNK45 cells before and after the intervention of 5-FU-PLLA-CNTs.

RESULTSDeep layer film of 5-FU-PLLA-CNTs was successfully established, whose drug-load rate was(4.54±0.43)%, entrapment rate was(21.56±2.36)%. In vitro release test showed release rate within 24 h of 5-FU-PLLA-CNTs was 23.9% in a as lowly increasing manner, and accumulating release rate was 85.3% at day 31. CCk8 experiment revealed, as compared to control group, 5-FU-PLLA-CNTs significantly inhibited the proliferation of two cell lines in dose-dependent and time-dependent manner. The best 5-FU-PLLA-CNTs concentration of inhibition for human gastric cancer cell lines was 1 mg/well. Flow cytometry indicated the apoptotic rate of MGC803 and MNK45 cells in experiment group treated by 1 mg/well 5-FU-PLLA-CNTs significantly increased as compared to negative control group (P<0.05), while the difference was not significant as compared to positive control group (P>0.05).

CONCLUSIONThe 5-FU-PLLA-CNTs has good drug sustained-release capacity, and can significantly kill and inhibit the proliferation of MGC803 and MNK45 cell lines.

Cell Line, Tumor ; Cell Proliferation ; drug effects ; Delayed-Action Preparations ; Fluorouracil ; pharmacology ; Humans ; Lactic Acid ; pharmacology ; Nanotubes, Carbon ; Polyesters ; Polymers ; pharmacology ; Stomach Neoplasms ; pathology