Objective To explore the predictive value of the preoperative C-reactive protein-albumin-lymphocyte ratio(CALLY index)for short-term prognosis in patients undergoing radical gastrectomy.Methods The clinical data of 228 gastric cancer patients who underwent radical gastrectomy were retrospectively analyzed.Based on follow-up results,patients were divided into the good prognosis group(n=205)and the poor prognosis group(n=23).The differences in clinical characteristics and laboratory test results between the two groups were compared.Cox proportional hazards regression model was used to analyze the impact of CALLY index on poor prognosis in patients.The receiver operating characteristic(ROC)curve was used to determine the clinical value and optimal cutoff value of CALLY index in predicting poor prognosis of patients.Kaplan-Meier method was used to analyze the difference in disease-free survival(DFS)between patients with different CALLY index levels.Results After a follow-up of 3 to 53 months(median follow-up of 36 months),23 patients developed poor prognosis(including 3 deaths and 20 recurrences or metastases).Compared with the good prognosis group,tumors in the poor prognosis group were larger,the proportion of poorly differentiated tumors was higher and white blood cell count(WBC),neutrophil count(NEU),C-reactive protein(CRP)were higher,and lymphocyte(LYM),albumin(ALB),prealbumin,total cholesterol(TC)and CALLY indexl were lower.Multivariate Cox regression analysis showed that the elevated CALLY index(HR=0.306,95%CI:0.102-0.921,P=0.035)was an independent protective factor for poor prognosis,while larger tumors and poorly differentiated tumors were independent risk factors for poor prognosis.ROC curve analysis showed that the area under the curve for predicting poor prognosis in gastric cancer patients undergoing radical gastrectomy was 0.862(95%CI:0.810-0.904),with a sensitivity of 95.65%,specificity of 69.76%,and an optimal cutoff value of 2.21.Kaplan-Meier analysis showed that patients with a CALLY index>2.21 had a longer disease-free survival than those with a CALLY index≤2.21(mean DFS:48 months vs.42 months,Log-rank χ2=4.123,P=0.042).Conclusion The preoperative CALLY index is a simple,effective and easily accessible predictor for predicting short-term prognosis in patients undergoing radical gastrectomy.A high CALLY index indicates a better prognosis of patient.

Elucidate the influence of RFRP-3 on follicular development and steroid hormone synthe-sis in mice.Forty 6-week-old female KM mice were randomly allocated into four groups,namely the 0(control),100,500 and 2 000 ng/d treatment groups.Each group received daily intraperitoneal injections of RFRP-3 for a duration of 7 days.The ovarian coefficients were calculated and recorded by measuring the wet weight of the ovaries.The effects of RFRP-3 at different concentrations on follicular maturation in mice were investigated through HE staining.Western blot analysis was em-ployed to assess the expression of apoptosis-related proteins,steroidogenic enzymes,and oocyte se-cretion factors within the mouse ovaries.The concentrations of progesterone(P4)and estradiol(E2)in the serum of the mice were determined using radioimmunoassay techniques.The results re-vealed no significant differences in body weight between the experimental groups and the control.However,the ovarian coefficients in the 500 and 2 000 ng/d treatment groups were significantly re-duced when compared to the control(P＜0.01).A marked decrease in the numbers of secondary and antral follicles was observed in the 500 ng/d and 2 000 ng/d groups(P＜0.01),concomitant with a substantial increase in atretic follicles(P＜0.01).A significant decline in follicle count was also noted in these groups(P＜0.01).Compared to the control,the protein expression of Bax and Caspase3 was substantially upregulated in the 500 and 2 000 ng/d treatment groups(P＜0.05),while the expression of Bcl-2 protein was significantly downregulated(P＜0.01).Similarly,the protein expression of 3βHSD,StAR,CYP11a1,and CYP17a1 was significantly decreased at the 500 and 2 000 ng/d groups(P＜0.01).E2 concentrations were moderately reduced in the 500 ng/d group(P＜0.05)and significantly decreased in the 2000 ng/d group(P＜0.01),whereas P4 levels remained unchanged across all experimental groups.Notably,the expression of BMP15 and GDF9 at both the gene and protein levels was markedly attenuated in the 500 and 2 000 ng/d treatment groups compared to the control(P＜0.05).In conclusion,RFRP-3 appears to inhibit follicular de-velopment and steroid hormone secretion in mice by modulating the expression of apoptotic fac-tors,oocyte secretion factors,and steroidogenic enzymes within the ovaries.This study provides a theoretical foundation for understanding the regulatory mechanisms of RFRP-3 on mammalian follicular development and steroid hormone synthesis.

Objective To track and evaluate the implementation and application of the occupational health standard Radiation shielding requirements for radiotherapy room—Part 4: Radiotherapy room of ²⁵²Cf neutron afterloading (GBZ/T 201.4-2015) by radiation health technical service agencies, medical institutions, health supervision agencies, and radiotherapy facility design units, and to provide a scientific basis for the further revision and implementation of this standard. Methods Following the Guideline for health standards tracking evaluation (WS/T 536-2017) and the project implementation plan, relevant practitioners were randomly selected for a questionnaire survey. The survey primarily focused on their awareness, standard training, application, and revision suggestions of GBZ/T 201.4-2015. The results were summarized and analyzed. Results A total of 168 evaluation questionnaires were collected from relevant practitioners in 28 provinces. Only 31.6% of the respondents reported being “well familiar” or “ familiar” with the standard, 27.4% of the respondents believed that the standard was widely used, and 45.2% of the respondents believed that the standard could meet the needs of their work. Only 14.9% of the respondents had received relevant training on the standard, more than half of the respondents had not applied the standard within the past 10 years, and 45.2% of the respondents believed that the standard "needs to be revised". Conclusion Due to the small number of californium-252 neutron afterloading radiotherapy devices in operation on the market, the overall awareness of the standard is low, suggesting that relevant authorities need to strengthen training and publicity of the standard, and that certain sections of the standard need to be revised or merged.

Objective To explore the predictive value of the preoperative C-reactive protein-albumin-lymphocyte ratio(CALLY index)for short-term prognosis in patients undergoing radical gastrectomy.Methods The clinical data of 228 gastric cancer patients who underwent radical gastrectomy were retrospectively analyzed.Based on follow-up results,patients were divided into the good prognosis group(n=205)and the poor prognosis group(n=23).The differences in clinical characteristics and laboratory test results between the two groups were compared.Cox proportional hazards regression model was used to analyze the impact of CALLY index on poor prognosis in patients.The receiver operating characteristic(ROC)curve was used to determine the clinical value and optimal cutoff value of CALLY index in predicting poor prognosis of patients.Kaplan-Meier method was used to analyze the difference in disease-free survival(DFS)between patients with different CALLY index levels.Results After a follow-up of 3 to 53 months(median follow-up of 36 months),23 patients developed poor prognosis(including 3 deaths and 20 recurrences or metastases).Compared with the good prognosis group,tumors in the poor prognosis group were larger,the proportion of poorly differentiated tumors was higher and white blood cell count(WBC),neutrophil count(NEU),C-reactive protein(CRP)were higher,and lymphocyte(LYM),albumin(ALB),prealbumin,total cholesterol(TC)and CALLY indexl were lower.Multivariate Cox regression analysis showed that the elevated CALLY index(HR=0.306,95%CI:0.102-0.921,P=0.035)was an independent protective factor for poor prognosis,while larger tumors and poorly differentiated tumors were independent risk factors for poor prognosis.ROC curve analysis showed that the area under the curve for predicting poor prognosis in gastric cancer patients undergoing radical gastrectomy was 0.862(95%CI:0.810-0.904),with a sensitivity of 95.65%,specificity of 69.76%,and an optimal cutoff value of 2.21.Kaplan-Meier analysis showed that patients with a CALLY index>2.21 had a longer disease-free survival than those with a CALLY index≤2.21(mean DFS:48 months vs.42 months,Log-rank χ2=4.123,P=0.042).Conclusion The preoperative CALLY index is a simple,effective and easily accessible predictor for predicting short-term prognosis in patients undergoing radical gastrectomy.A high CALLY index indicates a better prognosis of patient.

Elucidate the influence of RFRP-3 on follicular development and steroid hormone synthe-sis in mice.Forty 6-week-old female KM mice were randomly allocated into four groups,namely the 0(control),100,500 and 2 000 ng/d treatment groups.Each group received daily intraperitoneal injections of RFRP-3 for a duration of 7 days.The ovarian coefficients were calculated and recorded by measuring the wet weight of the ovaries.The effects of RFRP-3 at different concentrations on follicular maturation in mice were investigated through HE staining.Western blot analysis was em-ployed to assess the expression of apoptosis-related proteins,steroidogenic enzymes,and oocyte se-cretion factors within the mouse ovaries.The concentrations of progesterone(P4)and estradiol(E2)in the serum of the mice were determined using radioimmunoassay techniques.The results re-vealed no significant differences in body weight between the experimental groups and the control.However,the ovarian coefficients in the 500 and 2 000 ng/d treatment groups were significantly re-duced when compared to the control(P＜0.01).A marked decrease in the numbers of secondary and antral follicles was observed in the 500 ng/d and 2 000 ng/d groups(P＜0.01),concomitant with a substantial increase in atretic follicles(P＜0.01).A significant decline in follicle count was also noted in these groups(P＜0.01).Compared to the control,the protein expression of Bax and Caspase3 was substantially upregulated in the 500 and 2 000 ng/d treatment groups(P＜0.05),while the expression of Bcl-2 protein was significantly downregulated(P＜0.01).Similarly,the protein expression of 3βHSD,StAR,CYP11a1,and CYP17a1 was significantly decreased at the 500 and 2 000 ng/d groups(P＜0.01).E2 concentrations were moderately reduced in the 500 ng/d group(P＜0.05)and significantly decreased in the 2000 ng/d group(P＜0.01),whereas P4 levels remained unchanged across all experimental groups.Notably,the expression of BMP15 and GDF9 at both the gene and protein levels was markedly attenuated in the 500 and 2 000 ng/d treatment groups compared to the control(P＜0.05).In conclusion,RFRP-3 appears to inhibit follicular de-velopment and steroid hormone secretion in mice by modulating the expression of apoptotic fac-tors,oocyte secretion factors,and steroidogenic enzymes within the ovaries.This study provides a theoretical foundation for understanding the regulatory mechanisms of RFRP-3 on mammalian follicular development and steroid hormone synthesis.

Objective: To investigate the effect of cinobufacin combined with As₂O₃ on the angiogenesis of subcutaneous transplantation tumor in colorectal carcinoma BALB/C nude mice. Methods: The colorectal carcinoma transplantation tumor model of BALB/C nude mice was established and divided into 4 groups, 5 mice in each group. The growth state of nude mice was observed by injecting the corresponding reagents into the tumor in As₂O₃ group, cinobufacin group, cinobufacin combined As₂O₃ group and the blank control group (replaced by phosphate buffer), respectively. The nude mice were killed two weeks later, and the tumor tissues, liver and kidney tissues and orbital vein blood were taken. The tumor volume inhibition rate and mass inhibition rate of nude mice were calculated. The histomorphology of tumor, liver and kidney and blood routine were detected. The expressions of vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), fibroblast growth factor-basic (b-FGF) and CD105 in transplanted tumor tissues were detected by using immunohistochemistry method, and the microvascular density (MVD) of transplanted tumor in nude mice was evaluated. Western blot method was used to detect the protein expression levels of VEGF, EGFR and b-FGF. Results: After 2 weeks of administration, the tumor volume and tumor mass in As₂O₃ group, cinobufacin group and cinobufacin combined As₂O₃ group were lower than those in the blank control group. The volume inhibition rate was 16%, 17%, 72%, and the mass inhibition rate was 31%, 33%, 78%, respectively, and the difference was statistically significant (all P < 0.01); there was no statistical difference between As₂O₃ group and cinobufacin group in the tumor volume and tumor mass (P > 0.05), and cinobufacin combined As₂O₃ group had the most obvious therapeutic effects (all P < 0.05). The immunohistochemistry method showed that the expressions of VEGF, EGFR, b-FGF and MVD were decreased in As₂O₃ group, cinobufacin group and cinobufacin combined As₂O₃ group compared with the blank control group, and there were statistical differences of the four groups (all P < 0.05). There was no statistical difference of the marker changes in As₂O₃ group and cinobufacin group (all P > 0.05), and cinobufacin combined As₂O₃ group had the most significant decrease in the marker changes, and there was a significant difference compared with the other groups (all P < 0.05). Western blot showed that compared with the blank control group, the other three groups could downregulate the protein expressions of VEGF, EGFR and b-FGF in the transplanted tumor of nude mice. And the decreasing expression of each protein in cinobufacin combined As₂O₃ group was the most significant. Pathomorphology examination showed that the histomorphology of liver and kidney of the four groups of nude mice was normal. Blood routine examination showed that compared with the blank control group, the white blood cell count of nude mice in other groups was decreased, and the difference was statistically significant (all P < 0.05). The white blood cell count of cinobufacin combined As₂O₃ group was decreased most significantly; there was no statistically significant difference in hemoglobin and platelet count among the four groups (all P > 0.05). Conclusions Cinobufacin and As₂O₃ show synergistic effects in the tumor angiogenesis and inhibition of transplantation tumor growth of colorectal cancer BALB/C nude mice. Moreover, cinobufacin and As₂O₃ have no obvious toxicity to the hepatic, kidney and hematopoietic tissues.

Objective Using Cerenkov radiation energy transfer (CRET) effect of rare earth nanoparticles (RENPs) to enhance and convert Cerenkov luminescence into Cerenkov luminescence excited fluorescence,and to compare the accuracy of Cerenkov luminescence tomography (CLT) and Cerenkov luminescence excited fluorescence tomography (CLFT).Methods 68Ga (0.74 MBq) was used to respectively excite Y2O3 ∶Eu3+,Er2O3 and Eu2O3(10 mg/ml).Various radioactivities of 68Ga (3.70,1.85,0.92,0.46,0.23 MBq) were used to respectively excite Y2O3 ∶Eu3+ with a fixed concentration (10 mg/ml).A fixed radioactivity of 68Ga (3.70 MBq) was used to excite Y2O3 ∶Eu3+ with different concentrations (10.0,5.0,2.5,1.2,0.6 mg/ml) in order to find the relationships between the optical intensity and the radioactivity of 68Ga or the concentration of Y2O3 ∶Eu3+.Polyethylene tubes containing 68Ga (0.74 MBq) and 68Ga (0.74 MBq) +Y2O3 ∶Eu3+(1 mg) were respectively implanted into two nude mice,then PET/CT and optical imaging were acquired.Three-dimensional reconstruction was proceeded.One-way analysis of variance,two-sample t test,linear correlation analysis were used for data analysis.Results Y2O3 ∶Eu3+ could significantly and stably enhance the Cerenkov optical signal (F=53.35,q =17.03,P＜0.001).The enhanced optical signal intensity had linear relationships with the radioactivity of 68Ga or the concentration of Y2O3 ∶Eu3+(r values:0.99and 0.93).Three-dimensional reconstruction result showed that CLFT had significantly higher similarity than CLT (0.43±0.14 vs 0.16±0.06,t =5.090,P＜0.05).Conclusion CLFT could reflect the distribution of radiopharmaceuticals more precisely than CLT,and therefore might have potential in biologic optical imaging.

BACKGROUND/AIMS: In recent years, endoscopic submucosal tunnel dissection (ESTD) has gained popularity worldwide. The aim of this study was to evaluate the safety and efficacy of ESTD in treating upper gastrointestinal submucosal tumors (SMTs) in a large-volume endoscopic center. METHODS: Patients with SMTs were enrolled in this study between January 2012 and January 2015. Demographic data, clinical data, and treatment outcome were collected and analyzed. RESULTS: Seventy SMTs originating from the muscularis propria (MP) layer were identified in 69 patients. All patients successfully underwent the ESTD procedure. The mean procedure time was 49.0±29.5 minutes, and the mean tumor size was 18.7±7.2 mm. Among all lesions, the majority (70.0%) were located in the esophagus, 12.9% in the cardia, and 17.1% in the stomach. Complete resection was achieved in 67 lesions (95.7%). Perforation occurred in three patients (4.3%), who were treated by endoclips. Pneumothorax occurred in two patients (2.9%) and was successfully managed by thoracic drainage. During a median follow-up of 18.1 months, patients were free of local recurrence or distant metastasis. CONCLUSIONS: Our results demonstrated the feasibility and safety of ESTD in treating upper gastrointestinal SMTs originating from the MP layer. Large-scale comparative studies with other treatment methods should be conducted in the future.
Cardia ; Drainage ; Esophagus ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Pneumothorax ; Recurrence ; Stomach ; Treatment Outcome

Objective To quantitatively compare the diagnostic capability of 68Ga-NGR and 18F-FDG in well-differentiated hepatocellular carcinoma (HCC) bearing mice by microPET/CT imaging.Methods The in vitro cellular uptake, in vivo microPET/CT imaging and biodistribution studies of 68Ga-NGR and 18F-FDG were quantitatively compared in SMMC-7721-based well-differentiated HCC.The human fibrosarcoma (HT-1080) and human colorectal adenocarcinoma (HT-29) cells/xenografts were respectively used as positive and negative reference groups for CD13.The expression of CD13 was qualitatively verified by immunohistostaining.The levels of CD13 and glucose-6-phosphatase (G6Pase) were semi-quantitatively analyzed by Western blot test for all 3 types of tumors.Two-sample t test was used for data analysis.Results The in vitro cellular uptake showed that the 68Ga-NGR uptake in SMMC-7721 and HT-1080 cells was higher than that in HT-29 cells, and the 68Ga-NGR uptake was higher than 18F-FDG uptake in SMMC-7721 cells.The in vivo microPET/CT imaging results revealed that the uptake of 68Ga-NGR in SMMC-7721 tumor was (2.17±0.21) %ID/g, remarkably higher compared to (0.73±0.26) %ID/g of 18F-FDG uptake (t=8.826, P<0.01).The tumor/liver ratio of 68Ga-NGR was 2.05±0.16, which was 2.03-fold higher than that of 18F-FDG.In the HT-1080 tumors, the uptakes of 68Ga-NGR and 18F-FDG were both high, and the values were (2.46±0.23) %ID/g, (3.47±0.31) %ID/g.The uptake of 68Ga-NGR was significantly lower than that of 18F-FDG in HT-29 tumors: (0.67±0.20) %ID/g vs (3.17±0.29) %ID/g;t=4.221, P<0.01.Western blot and immunohistostaining results were as follows: HT-1080(CD13+, G6Pase-), SMMC-7721(CD13+, G6Pase+), HT-29(CD13-, G6Pase-).Conclusions The uptake of 68Ga-NGR is higher than 18F-FDG uptake in SMMC-7721 tumor bearing mice, therefore it is worthwhile to consider the feasibility of clinical translation for PET/CT in diagnosis of HCC.Furthermore, because of the difference in 68Ga-NGR and 18F-FDG avidities in tumors with different molecular phenotypes of CD13 and G6Pase, there is an underlying potential for molecular imaging in the determination of molecular phenotypes.

Objective To quantitatively compare the diagnostic capability of 68Ga-NGR and 18F-FDG in well-differentiated hepatocellular carcinoma (HCC) bearing mice by microPET/CT imaging.Methods The in vitro cellular uptake,in vivo microPET/CT imaging and biodistribution studies of 68Ga-NGR and 18F-FDG were quantitatively compared in SMMC-7721-based well-differentiated HCC.The human fibrosarcoma (HT-1080) and human colorectal adenocarcinoma (HT-29) cells/xenografts were respectively used as positive and negative reference groups for CD13.The expression of CD13 was qualitatively verified by immunohistostaining.The levels of CD13 and glucose-6-phosphatase (G6Pase) were semi-quantitatively analyzed by Western blot test for all 3 types of tumors.Two-sample t test was used for data analysis.Results The in vitro cellular uptake showed that the 68Ga-NGR uptake in SMMC-7721 and HT-1080 cells was higher than that in HT-29 cells,and the 68Ga-NGR uptake was higher than 18F-FDG uptake in SMMC-7721 cells.The in vivo micro-PET/CT imaging results revealed that the uptake of 68Ga-NGR in SMMC-7721 tumor was (2.17±0.21) ％ID/g,remarkably higher compared to (0.73±0.26) ％ID/g of 18F-FDG uptake (t =8.826,P＜0.01).The tumor/liver ratio of 68Ga-NGR was 2.05±0.16,which was 2.03-fold higher than that of 18F-FDG.In the HT-1080 tumors,the uptakes of 68 Ga-NGR and 18F-FDG were both high,and the values were (2.46±0.23) ％ID/g,(3.47±0.31) ％ID/g.The uptake of 68Ga-NGR was significantly lower than that of 18F-FDG in HT-29 tumors:(0.67±0.20) ％ID/g vs (3.17±0.29) ％ID/g;t=4.221,P＜0.01.Western blot and immunohistostaining results were as follows:HT-1080(CD13+,G6Pase-),SMMC-7721(CD13+,G6Pase+),HT-29 (CD13-,G6Pase-).Conclusions The uptake of 68Ga-NGR is higher than 18F-FDG uptake in SMMC-7721 tumor bearing mice,therefore it is worthwhile to consider the feasibility of clinical translation for PET/CT in diagnosis of HCC.Furthermore,because of the difference in 68Ga-NGR and 18F-FDG avidities in tumors with different molecular phenotypes of CD13 and G6Pase,there is an underlying potential for molecular imaging in the determination of molecular phenotypes.