Gastric cancer has high incidence and mortality rate. Chemotherapy is the first-line treatment for gastric cancer and has achieved considerable success. However, due to genetic variations and tumor heterogeneity, the effectiveness of chemothrapy drugs varies among different patients. Therefore, accurate assessment of patient’s sensitivity to chemotherapy drugs is crucial for personalized treatment. Gastric cancer organoids serve as effective tools for predicting patient’s sensitivity to chemotherapy drugs. This review summarizes the applications and related research progress of gastric cancer organoids in determining chemotherapy drug sensitivity, discusses the strengths and limitations of organoid models, and proposes outlooks for future research directions, hoping that organoids can provide more effective personalized treatment options and a greater range of drug choices for gastric cancer treatment.

Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

BACKGROUND:Mesenchymal stem cells have been widely used in the treatment of various diseases due to their wide range of sources,their ease of proliferation in vitro and their ability to secrete a range of immunomodulatory factors to suppress inflammation and promote tissue repair and regeneration.However,in the treatment of many diseases,the therapeutic effect is limited.The effort to engineer and modify mesenchymal stem cells for specific disease pathogenesis or intervention targets is an important development for cell therapy in the future.OBJECTIVE:Interleukin-10 is a typical anti-inflammatory cytokine that helps to modulate the immune response and induces macrophage polarization towards an anti-inflammatory phenotype.This study investigated the therapeutic effect of interleukin-10 engineered human umbilical cord mesenchymal stem cells on inflammatory bowel disease.METHODS:Human umbilical cord mesenchymal stem cells stably overexpressing interleukin-10 were established by electro-transfection,and screened for clinical-grade cells based on the cell therapy product criteria.C57BL/6J mice were given 5%aqueous dextran sulfate sodium ad libitum to establish a model of acute colitis.Empty plasmid-transfected human umbilical cord mesenchymal stem cells or interleukin-10-human umbilical cord mesenchymal stem cells(1×106 cells/each mouse)were injected on day 1 before modeling(tail vein injection)and day 4(intraperitoneal injection)after modeling,respectively.On day 6 after modeling,colon tissue sections were taken for hematoxylin-eosin staining to assess histological changes.Immunofluorescence staining was performed to detect the expression of proliferating cell nuclear antigen and CD31.RESULTS AND CONCLUSION:The engineered human umbilical cord mesenchymal stem cells stably overexpressing interleukin-10 were constructed,and met the quality standard of clinical-grade human umbilical cord mesenchymal stem cells.Human umbilical cord mesenchymal stem cells could repair acute colitis in mice.The therapeutic effect of interleukin-10-human umbilical cord mesenchymal stem cells was more efficacious,which more significantly suppressed body weight loss(P<0.05),colon shortening(P<0.05),and damage of colonic tissues(P<0.05)in acute colitis mice.In interleukin-10-human umbilical cord mesenchymal stem cell treatment group,there were significantly more proliferating cell nuclear antigen-positive cells and CD31-positive cells in the colon sections than in the human umbilical cord mesenchymal stem cell treatment group,suggesting that interleukin-10-overexpressing human umbilical cord mesenchymal stem cells contributed to the repair of colon tissue by significantly promoting the proliferation of intestinal tissues and angiogenesis.

BACKGROUND:Mesenchymal stem cells have been widely used in the treatment of various diseases due to their wide range of sources,their ease of proliferation in vitro and their ability to secrete a range of immunomodulatory factors to suppress inflammation and promote tissue repair and regeneration.However,in the treatment of many diseases,the therapeutic effect is limited.The effort to engineer and modify mesenchymal stem cells for specific disease pathogenesis or intervention targets is an important development for cell therapy in the future.OBJECTIVE:Interleukin-10 is a typical anti-inflammatory cytokine that helps to modulate the immune response and induces macrophage polarization towards an anti-inflammatory phenotype.This study investigated the therapeutic effect of interleukin-10 engineered human umbilical cord mesenchymal stem cells on inflammatory bowel disease.METHODS:Human umbilical cord mesenchymal stem cells stably overexpressing interleukin-10 were established by electro-transfection,and screened for clinical-grade cells based on the cell therapy product criteria.C57BL/6J mice were given 5%aqueous dextran sulfate sodium ad libitum to establish a model of acute colitis.Empty plasmid-transfected human umbilical cord mesenchymal stem cells or interleukin-10-human umbilical cord mesenchymal stem cells(1×106 cells/each mouse)were injected on day 1 before modeling(tail vein injection)and day 4(intraperitoneal injection)after modeling,respectively.On day 6 after modeling,colon tissue sections were taken for hematoxylin-eosin staining to assess histological changes.Immunofluorescence staining was performed to detect the expression of proliferating cell nuclear antigen and CD31.RESULTS AND CONCLUSION:The engineered human umbilical cord mesenchymal stem cells stably overexpressing interleukin-10 were constructed,and met the quality standard of clinical-grade human umbilical cord mesenchymal stem cells.Human umbilical cord mesenchymal stem cells could repair acute colitis in mice.The therapeutic effect of interleukin-10-human umbilical cord mesenchymal stem cells was more efficacious,which more significantly suppressed body weight loss(P<0.05),colon shortening(P<0.05),and damage of colonic tissues(P<0.05)in acute colitis mice.In interleukin-10-human umbilical cord mesenchymal stem cell treatment group,there were significantly more proliferating cell nuclear antigen-positive cells and CD31-positive cells in the colon sections than in the human umbilical cord mesenchymal stem cell treatment group,suggesting that interleukin-10-overexpressing human umbilical cord mesenchymal stem cells contributed to the repair of colon tissue by significantly promoting the proliferation of intestinal tissues and angiogenesis.

Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

In order to improve the teaching quality of stomatology standardized residency training, the method of PDCA cycle quality management was tried, and 8 stomatology teachers were evaluated by 4 rounds of improvements. The evaluation included theoretical knowledge teaching satisfaction, operational skills teaching satisfaction, teaching level, teacher quality assessment, teaching quality supervision group evaluation and other indicators. The comprehensive teaching ability of all the teachers recruited in this study was significantly improved after 12 months of PDCA cycle training. The results suggest that the application of PDCA cycle helps stomatology teachers to provide high quality training to residents and provide the reference for the management of clinical teaching.

Objective To compare different drainage methods after right hepatectomy. Methods From April 2017 to February 2018, 90 patients who underwent right hepatectomy at Zhongshan Hospital of Fudan University were prospectively randomized to the latex tube group (right subphrenic drain with a latex tube connecting to a collection bag, n=30), the silicone tube group (right subphrenic drain with a silicone tube connecting to a closed-suction, n=30) or the combination group ( right subphrenic drain with a latex tub, combined with a silicone tube, n=30). The amount of fluid collection after the operation, complications after surgery, recovery of liver function, and length of hospital stay after operation were compared. Results There were no significant differences in the clinicopathological features among the 3 groups, including gender, age, cirrhosis status, extent of hepatectomy, and blood loss (P＞0. 05). There were no significant differences among the three groups on the incidences of postoperative complications [ the latex tube group, 20. 0% (6/30); the silicone tube group, 23. 3% (7/30); the combination group, 16. 7% (5/30); P＞0. 05]. Ultrasonography showed significantly lower rates of subphrenic collection in the combination group compared with the latex tube group and the silicone tube group [16. 7% (5/30) vs. 63. 3% (19/30) vs. 53. 3% (16/30); P＜0. 05]. The rates of postoperative fever, serum total bilirubin, ALT and postoperative hospital stay were similar among the three groups (P＞0. 05). Conclusions Drainage using the combina-tion of a latex tube connecting to a collection bag and a silicone tube connecting to closed-suction after right hepatectomy significantly reduced postoperatively subphrenic collection and prevented infection of the collec-tion. However, the treatment strategy did not delay liver function recovery, prolong hospital stay nor increase post-operative infection rate.

Objective To investigate the clinical value of immediate fluid resuscitation and delayed resuscitation in patients with traumatic shock. Methods The patients with traumatic shock treated in the Critical Care Medicine Department of People's Hospital of Wenjiang District from March 2014 to March 2017 were selected. According to the number of admission cases,one hundred and twenty patients with traumatic shock were randomly divided into two groups,60 cases in each group. The control group was given early immediate fluid resuscitation,the observation group was given delayed resuscitation,and the blood coagulation and blood routine indexes of the two groups were compared before and after the fluid resuscitation in the two groups,and the amount of fluid rehydration and the fatality rate in the two groups of patients with 1 h shock were observed,and the incidence rate of acute respiratory distress syndrome ( ARDS) and multiple organ dysfunction syndrome (MODS) were compared. Results After treatment,the blood clotting and blood routine indexes of the two groups were improved (P<0. 05),of which the thromboplastin time (PT) ((11. 04±1. 17) s),activated partial thromboplastin time (APTT) ((28. 12±5. 93) s) in the observation group in the observation group were lower than those of the control group( (15. 12±1. 26) s,(36. 17±9. 05) s) (t = -15. 37,-9. 81,P<0. 05),platelet countPLT) ((146. 92±16. 85)×109 / L) was higher than that of the control group ((114. 18±10. 69)×109 / L ) (t= -9. 77,P<0. 05),and the blood routine hemoglobin (Hb) ((112. 21±9. 46) g/ L),and the base surplus (BE)((-5. 30 ± 2. 45) mmol/ L ) were all higher than those of the control group ((92. 95 ± 11. 20) g/ L, (-8. 27±3. 53) mmol/ L ) (t= -11. 46,-8. 99,P<0. 05),blood lactic acid (BL) ((2. 79±1. 12) mmol/ L ) was lower than that of the control group ((3. 54±1. 37) mmol/ L) (t = -8. 99,P<0. 05). The volume of 1 h infusion of shock in the observation group ((569. 96±187. 34) ml ) was lower than that of the control group((1957. 35±204. 14) ml) (t = 8. 725,P<0. 05). The incidence of ARDS (3. 33% (2/ 60)),MOD(3. 33%(2/ 60)) and fatality(1. 67%(1/ 60)) were lower than those of the control group(8. 33%(5/ 60),6. 67%(4/60),6. 67%(4/ 60) ( χ2 = 2. 725,3. 214,2. 985,P< 0. 05) . Conclusion The early stage of traumatic shock delayed fluid resuscitation is conducive to the protection of the blood coagulation function of patients,to improve blood indicators,to reduce the amount of 1 h infusion and to reduce the incidence of ARDS and MODS.

Objective To investigate that butyrate-producing probiotic clostridium butyricum improves the intestinal epithelial barrier function in food allergic mice by regulating TWIK-related potassium channel-1 (Trek1) expression in intestinal epithelial cells.Methods An intestinal allergy mouse model was created,then the model construction effect was verified by detecting the related indicators by ELISA,flow cytometer.The change of small intestinal tissue permeability was detected by the Ussing chambers.The Trek1 expressions in mouse jejunum tissue in control group and allergy group were detected by Western blot and immunofluorescent method;in the Transwell system,T84 cells were used to establish epithelial cellular monolayer for exposing to the allergic mediators,the Trek1 mRNA and protein expression were detected by qRT-PCR and Western blot.Then the allergic mice were grouped and treated by different methods including normal saline,SIT,SIT/SB,SB,SIT/CB,CB,SIT/CB/Spadin,the expression of mice intestinal Trek1,intestinal barrier function and allergic reaction indicators were detected.Results Compared with the control group,the small intestinal Trek1 protein and tissue expression level in the food allergic mice were significantly decreased,the intestinal mucosal permeability was significantly increased,the differences were statistically significant(P＜0.05);after T84 cells exposing to the allergic mediators,Trek1 mRNA and protein expression were significantly decreased(P＜0.05),but adding p38 inhibitor in advance could antagonize this change;the single use of SIT,clostridium butyricum and sodium butyrate could increase the intestinal Trek1 expression in food allergic mice,and alleviated the allergic reaction(P＜0.05),whereas the combined use of SIT and clostridium butyricum or sodium butyrate had more significant effect(compared with the SIT group,P＜0.05),moreover could significantly decrease small intestinal mucosal permeability and improved the intestinal barrier function(P＜0.05).Conclusion Sodium butyrate or butyrate-producing probiotic clostridium butyricum can restore the intestinal barrier function,alleviates the allergic reaction and strengthens the SIT curative effect in allergic mice by increasing Trek1 expression.

Objective To investigate the effectiveness of Lactobacillus paracasei N1115 combined with fructooligosaccharides (FOS) in the treatment of nonalcoholic fatty liver disease(NAFLD) in a mouse model and to analyze the possible mechanism.Methods Fifty male C57BL/6 mice were randomly divided into five groups and respectively given normal diet (ND group), high-fat diet (HFD group), HFD containing Lactobacillus paracasei N1115 (HFD+L) (2.2×109 CFU/ml), HFD containing FOS (HFD+FOS) (4 g/kg per day) and HFD containing Lactobacillus paracasei N1115 and FOS for 16 consecutive weeks.Levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), lipopolysaccharide (LPS) and diamine oxidase (DAO) in serum samples from each group were measured.Expression of tight-junction proteins (Claudin-1 and Occludin), p38 and phosphorylated p38 (p-p38) in intestinal tissues were analyzed.Results Compared with the HFD group, the HFD+FOS+L group showed decreased levels of TC, TG, LDL, LPS and DAO in serum samples, but increased serum HDL level (P<0.05).Moreover, combined treatment with Lactobacillus paracasei N1115 and FOS alleviated liver lipid deposition, significantly increased the expression of Claudin-1 and Occludin in intestine and inhibited the phosphorylation of p38 (P<0.05).Conclusion Lactobacillus paracasei N1115 combined with FOS may increase the expression of Claudin-1 and Occludin through inhibiting the phosphorylation of intestinal p38, which is conducive to maintaining the intestinal mucosal barrier integrity and alleviating NAFLD.