Objective:To explore the effects of estrogen receptor α (ERα) encoded by protein encoding gene ESR1 on the radiation resistance of breast cancer cells and their molecular mechanisms.Methods:The ESR1 overexpression plasmid was transfected into estrogen receptor (ER)-negative breast cancer cells. Then, the shRNA-ESR1 vector was introduced into ER-positive cell to establish models with different phenotype. The ATG5 mRNA level and protein expression levels of LC3B-I, LC3B-II, P62, FIP200, ATG5, ATG7, ATG12, Beclin1, ULK1 were detected using qPCR and Western blot techniques. Cell death was measured using flow cytometry. The radiation sensitivity was determined through the colony formation assay. The mortality of breast cancer cells under the autophagy gene knockdown and overexpression or treated with estrogen receptor inhibitor (TAM) combined with ionizing radiation were detected by trypan blue staining.Results:Under the condition of 8 Gy X-ray irradiation, the knockdown of ESR1 in ER-positive ZR75 breast cancer cells promoted cell death ( t = 3.49, 3.13, P < 0.05), while the overexpression of ESR1 in ER-negative MDA-MB-231 breast cancer cells inhibited cell death ( t = 4.16, 7.48, P < 0.05). Compared to the control group, the treatment with chloroquine increased the number of formed colonies of ESR1 knockdown ZR75 cells ( t = 8.49, P < 0.05), and inhibiting autophagy could reduce the death of ZR75 cells caused by ESR1 silencing. Under the treatment with ionizing radiation, the overexpression of ESR1 in MDA-MB-231 cells promoted protective autophagy, which, however, was reduced after ESR1 knockdown in ZR75 cells. Furthermore, it was observed that the knockdown of ATG5 in ZR75 cells was associated with reduced autophagy and an increase in cell death ( t = 4.19, 6.39, P < 0.05). In contrast, the overexpression of ATG5 in ZR75 cells reversed the increase in cell death caused by ESR1 knockdown ( t = 1.70, 4.65, P < 0.05). After the treatment of ER-positive ZR75 breast cancer cells with TAM, the expressions of ATG5 and ATG12 decreased, suggesting inhibited autophagy and an increase in cell death ( t = 18.70, P < 0.05). Furthermore, these processes were promoted by ionizing radiation ( t = 16.82, P < 0.05). Conclusions:The estrogen receptor encoded by ESR1 promotes protective autophagy of ER-positive breast cancer cells by increasing ATG5, further leading to radiation resistance in ER-positive breast cancer cells. Treatment with tamoxifen combined with ionizing radiation can increase the radiation sensitivity of ER-positive breast cancer cells.

Objective:To understand the etiology of a confirmed case of Coronavirus Disease 2019 (COVID-19).Methods:The pharyngeal swabs, serum and nasal swabs of a case of COVID-19 were inoculated into Vero-E6 cell tubes for virus isolation. The cytopathic effect (CPE) were observed daily. Collecting cell’s isolation when CPE was over 75%, after repeated freezing and thawing for 3 times, the supernatant was centrifugally taken, and the images of the virus were obtained by transmission electron microscopic observation, and the nucleic acid of the virus was extracted, second generation sequencing and sequence evolution analysis were used to identify and type the virus strains.Results:One strain of 2019 novel coronavirus (2019-nCoV) was successfully isolated from the nasal swab of this case of COVID-19, and one strain of herpes simplex virus type 1 (HSV-1) was also successfully isolated from the throat swab of the same case.Conclusions:COVID-19 cases have the possibility of co-infection with 2019-nCoV and HSV-1.

Objective    To investigate the predictive value of volatile organic compounds (VOCs) on pulmonary nodules in people aged less than 50 years. Methods    The 147 patients with pulmonary nodules and aged less than 50 years who were treated in the Department of Thoracic Surgery of Sichuan Cancer Hospital from August 1, 2019 to January 15, 2020 were divided into a lung cancer group and a lung benign disease group. The lung cancer group included 36 males and 68 females, with the age of 27-49 (43.54±5.73) years. The benign lung disease group included 23 males and 20 females, with the age of 22-49 (42.49±6.83) years. Clinical data and exhaled breath samples were collected prospectively from the two groups. Exhaled breath VOCs were analyzed by gas chromatography mass spectrometry. Binary logistic regression analysis was used to select variables and establish a prediction model. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve of the prediction model were calculated. Results    There were statistically significant differences in sex (P=0.034), smoking history (P=0.047), cyclopentane (P=0.002), 3-methyl pentane (P=0.043) and ethylbenzene (P=0.009) between the two groups. The sensitivity, specificity and area under the ROC curve of the prediction model with gender, cyclopentane, 3-methyl pentane, ethylbenzene and N,N-dimethylformamide as variables were 80.8%, 60.5% and 0.781, respectively. Conclusion    The combination of VOCs and clinical characteristics has a certain predictive value for the benign and malignant pulmonary nodules in people aged less than 50 years.

Objective: To improve the awareness of emergency biliary obstruction (BO) disease, and to further improve the diagnosis and treatment ability of BO patients. Methods: Data of the etiology, clinical manifestations, imaging data, laboratory tests, and emergency treatment outcomes in 63 BO patients were retrospectively analyzed. Results: Common bile duct stones were the most common cause of BO patients (63.49%), followed by cholangiocarcinoma (19.05%); the most common clinical manifestations of BO patients were jaundice (90.48%), abdominal pain (87.30%), and fever (53.97%); the diagnostic ability of computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) in patients with BO was significantly higher than that of ultrasound (P<0.05), but there was no significant difference between CT and MRCP (P=1.000); compared with benign group, hemoglobin and albumin in malignant group were significantly lower, while total bilirubin and direct bilirubin were higher, with statistically significant difference (P<0.05). Most patients in BO patients improved after treatment, and the mortality rate of BO patients was 3.17%(2/63) at the end of emergency visit. Conclusions Common bile duct stones and cholangiocarcinoma are still the most common causes of emergency BO patients. The most common clinical manifestations of patients with emergency BO are jaundice, abdominal pain, and fever. Better than abdominal ultrasound, CT and MRCP have comparable diagnostic capabilities in the diagnosis of emergency BO patients. Anemia, hyperbilirubinemia and hypoproteinemia are alarm indicators for malignant tumors in emergency BO patients. Most patients can temporarily get better at the end of emergency visit.

Since the outbreak of corona virus disease 2019(COVID 19), the epidemic has spread rapidly, which brings great challenge to the surgical diagnosis, treatment and management of lung neoplasm Sichuan International Medical Exchange &Promotion Association organized thoracic surgery experts to sum up experiences from experts in major hospital, and formulated the Guidance suggestion on surgical diagnosis, treatment and management of lung neoplasm during the outbreak of COVID-19 to provide references for thoracic surgeons.

Objective To evaluate if the flexible ureteroscopy could treat stones located in lower calyx with the infundibulopelvic angle (IPA) less than 30°.Methods Thirty-six patients with inferior caliceal calculi on whom flexible ureteroscopic procedures were performed between November 2009 and June 2015 were reviewed.The mean age of the patients was 52.1 years (34-71),with the mean stone diameter of (1.5 ± 0.8) cm (1.2-2.6 cm).IPA was smaller than 30° in all 36 cases,which confirmed by CTU examination.IPA was less than 10° in 15 patients,between 11 ° and 20° in 13 patients and between 21 ° and 30° in 8 patients.Results The success rate was 63.9％ (23/36 patients) in patients with IPA smaller than 30° after first session of procedure,and the stone free rate reached 100％ after the second session of procedure.The mean operation duration was (95.5 ± 31.4) min(51-127 min).The mean hospital stay after operation was(4.1 ± 1.2)days (3-5 days).No major complications were recorded and no patients needed to convert to open surgery.Double J tube was removed after 4 weeks postoperatively.Patients were followed up for 4-12 months,during which ultrasound and CT scan were used for stone detection.Conclusions The small IPA (＜30°) negatively affected the SFR in the first session operation.However,its negative effect was solvable by using modern endoscopes.A complete stone clearance was achievable even in case of unfavorable anatomic conditions in experienced hand.

Objective To evaluate the safety and efficacy of transcatheter arterial embolization (TAE) combined with argon-helium cryoablation in treating small renal cancers. Methods During the period from February 2008 to July 2013, a total of 44 patients with small renal cancer were treated with TAE and argon-helium cryoablation at The Medical Imaging Department of Nanjing General Hospital of Nanjing Military Area Command. The renal function was reexamined one month after the treatment. Contrast-enhanced CT or MRI was performed in all patients within 1-3 months after the treatment. By using mRECIST, the therapeutic efficacy was evaluated. All patients were followed up for 12-46 months (mean 28 months). Results A total of 48 lesions in the 44 patients were treated with sequential therapy of TAE and argon-helium cryoablation. Of the 48 lesions, complete remission (CR) was achieved in 38, partial remission (PR) in 6 and stable disease (SD) in 4, the remission rate (CR+PR) was 91.7%. No severe complications occurred in all patients, except one who developed localized hemorrhage during the performance of argon-helium cryoablation, which was improved after symptomatic medication. The mean postoperative hospitalization time was 4 days. Three patients were lost to follow-up, one patient died of esophageal cancer-related complication. The remaining patients were survival during the follow-up period, among them recurrence occurred in five within 13-22 months after the treatment, and the sequential therapy of TAE and argon-helium cryoablation had to be carried out once more. Conclusion For the treatment of small renal cancers, the sequential therapy of TAE combined with argon-helium cryoablation is minimally-invasive, safe and effective, and TAE that is performed before argon-helium cryoablation can reduce the incidence of bleeding occurring in the freezing process. Therefore, this technique should be recommended in clinical practice.

OBJECTIVETo evaluate the association of signal transducer and activators of transcription 3 (STAT3) -1096G/C polymorphism in promoter region with the susceptibility to HBsAg positive hepatocellular carcinoma (HCC).

METHODSA total of 632 patients with HCC and 723 HBV-infected subjects without HCC treated at Changhai Hospital of Shanghai from 2009 to 2012 were included in this case-control study. The polymorphism of STAT3 -1096 G/C was genotyped by Fluorescent probe-Real time quantitative PCR. Univariate analysis was used to calculate the odds ratio (OR) and its 95% confidence interval (CI).

RESULTSThe frequency of genetic allele STAT3 -1096G/C (GC+CC) of control group and case group were 61.83% (447/723) and 60.60% (383/632), while difference of HCC risk was not found among different genotypes (OR = 0.95, 95%CI: 0.76-1.18). When stratified by sex, the frequency of genetic allele STAT3 -1096C (GC+CC) of control group and case group were 62.18% (314/505) and 61.75% (331/536) in men, 61.01% (133/218) and 54.17% (52/96) in women, respectively, while difference of HCC risk was not found among different genotypes (OR = 0.98, 95%CI: 0.77-1.26; OR = 0.76, 95%CI: 0.47-1.26, respectively). When stratified by HBV genotypes, the frequency of genetic allele STAT3 -1096C (GC+CC) of control group and case group were 61.45% (110/179) and 53.13% (34/64) in HBV genotype B, 62.87% (276/439) and 60.27% (226/375) in HBV genotype C, respectively, while difference of HCC risk was not found among different genotypes (OR = 0.71, 95%CI: 0.40-1.26; OR = 0.90, 95%CI: 0.68-1.19, respectively).

CONCLUSIONSTAT3 -1096G/C polymorphism was not associated with the susceptibility to HCC for the HBV-infected subjects without HCC.

Aged ; Alleles ; Carcinoma, Hepatocellular ; Case-Control Studies ; China ; Disease Susceptibility ; Female ; Genetic Predisposition to Disease ; Genotype ; Hepatitis B ; Hepatitis B virus ; Humans ; Liver Neoplasms ; Male ; Odds Ratio ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide

Objective To monitor the renal pelvic pressure and to investigate its clinical significance during retrograde flexible ureteroscopic lithotripsy (RFUL).Methods The data of renal pelvic pressure measured in 60 cases of RFUL with the mean irrigation pump speed and pressure of 30 ml/min and 30 mmHg were analyzed retrospectively.The influence factors of renal pelvic pressure and its correlation with postoperative fever were analyzed.Renal pelvic pressure was measured by baroceptor,which was connected to PHILIP-MP4 monitor IBP channel and ureteric catheter positioned in renal pelvis through a dual channel ureteral access sheath (UAS).The renal pelvic pressure data was collected and analyzed in every 2 seconds by computer.The 60 cases were divided into 3 groups according to their intra-pelvic pressure situations:normal pressure group(NP,IPPmax ≤30 mmHg),high pressure group(HP,IPPmax＞30 mmHg,but high pressure duration≤ 10 min),and backflow pressure group(BP,IPPmax＞30 mmHg and high pressure duration＞ 10 min).Results The baseline intra-pelvic pressure (IPP0) and max imum intra-pelvic pressure (IPPmax) were (13.2±5.6) mmHg and (95.6±2.3) mmHg respectively.IPP levels during the RFUL were significantly higher than the IPP0(P＜0.001).There were 32,17 and 11 cases in NP,HP and BP groups,respectively.There were 6 cases with fever higher than 38.5 ℃ (10％),in which there were 1 case in NP,1 case in HP group and 4 cases in BP group.The postoperative fever rate in NP,HP and BP group were 3％,6％ and 36％ respectively,which were significantly different between groups(P＜0.01).There were 12 cases with procalcitonin ＞0.1 ng/ml and 8 cases with procalcitonin ＞0.5 ng/ml,in which 2 cases in HP group and 6 cases in BP group.Conclusions RFUL would result in a temporal elevated intrapelvic pressure greater than 30 mmHg.Postoperative fever is relevant with renal perfusion pressure and perfusion time.It's necessary for the surgeons to adjust the perfusion pressure during operation.

Objective To compare the therapeutic effect of retrograde ureteroscopic Ho:YAG laser lithotripsy (UHL) and percutaneous nephrolithotripsy (PCNL) in treating patients with renal calculi of ≤3 cm.Methods From Feb.2008 to Apr.2011,a total of 109 cases (117 renal calculi in total) treated by either PCNL (50) or UHL (67) were retrospectively analyzed.Operative time,stone free rate,postoperative hospital stay,hospitalization expenses and complications were compared in the 2 groups.Results The mean stone burden of the UHL group and PCNL group was 2.5 cm (1.5-3.0) cm and 2.4 cm (1.3-3.0) cm,respectively.There was no significant difference in two groups.In UHL group,operations were performed successfully in all 67 calculi,of whom,43 patients needed combination of flexible ureteroscopy to break the stone fragments falling into the renal calices.No serious complication was recorded except postoperative fever in 3 cases.In PCNL group,all patients had been successful operated.Postoperative fever occurred in 2 cases.Obvious intraoperative and postoperative haemorrhage appeared in 1 case,and cured by selective renal artery embolization.The operation time of the UHL group and PCNL group was (117.0±36.5) min and (90.0±18.3) min respectively,and had no significant difference in two groups (P＞0.05).The stone free rate of the UHL group and PCNL group was 94％ (63/67) and 92％ (46/50) respectively,and had no significant difference in two groups (P＞0.05).Hemoglobin decline of the UHL group and PCNL group was (0.3±0.1) g/L and (20.6±8.1) g/L,and had significant difference in two groups (P＜0.05).Postoperative hospital stay of the UHL group and PCNL group was (5.0±2.4) day and (7.0±3.7) day,and had statistical difference in two groups (P＜ 0.05).Hospitalization expenses of the UHL group and PCNL group was (15 477.0±754.3) RMB and (27 453.0± 1763.5) RMB,and had statistical difference in two groups (P＜0.05).Conclusions Although UHL and PCNL have similar curative effect in treating renal stones of less than 3 cm,UHL have the advantages of lcss trauma and complication,lower expenses and fewer hospital stay.In treating renal stones of smaller than 3 cm,especially in the contraindication of PCNL,UHL may be a better choice.