Objective:To investigate the clinicopathological characteristics of early gastric cancer with mixed histological staging, and to analyze the prognostic effect of endoscopic submucosal dissection (ESD) for early gastric cancer.Methods:Clinical data of early gastric cancer patients treated with ESD in Gansu Wuwei Cancer Hospital from January 2011 to March 2020 were collected, and clinicopathological characteristics of patients with mixed-type early gastric cancer were analyzed by descriptive statistical methods. The clinical effects and influencing factors of ESD on early gastric cancer were analyzed by logistic regression. Kaplan-Meier was used to estimate the survival rate, and log-rank test was used to compare the survival rate.Results:A total of 269 patients (280 lesions) were included in this study, including 216 males (80.30%) and 53 females (19.70%), with age of 60.43±8.01 years. There were 25 lesions (8.93%) of mixed early gastric cancer, 248 lesions (88.57%) of differentiated early gastric cancer, and 7 lesions (2.50%) of undifferentiated early gastric cancer. Compared with differentiated and undifferentiated early gastric cancer, the lesion site of mixed early gastric cancer was mainly located in the upper 1/3 of the stomach [64.00% (16/25), 40.73% (101/248) VS 0.00% (0/7), χ2=10.211, P=0.006], the proportion of the lesion size ≤2 cm was relatively small [52.00% (13/25), 80.65% (200/248) VS 85.71% (6/7), χ2=11.173, P=0.004], and the proportion of infiltration depth in the mucosa was lower [52.00% (13/25), 85.48% (212/248) VS 57.14% (4/7), χ2=20.019, P<0.001], the proportion of positive vertical resection margin was relatively high [20.00% (5/25), 2.82% (7/248) VS 0.00% (0/7), χ2=16.657, P<0.001], the proportion of vascular invasion was higher than that of differentiated carcinoma but lower than that of undifferentiated carcinoma [36.00% (9/25), 2.42% (6/248) VS 42.86% (3/7), χ2=58.413, P<0.001], the complete resection rate was lower [76.00% (19/25), 93.15% (231/248) VS 100.00% (7/7), χ2=9.497, P=0.009], the curative resection rate was lower than that of differentiated early gastric cancer, but higher than that of undifferentiated early gastric cancer [48.00% (12/25), 89.52% (222/248) VS 42.86% (3/7), χ2=39.757, P<0.001], and the proportion of eCura grade C2 was higher than that of differentiated cancer, but lower than that of undifferentiated cancer [48.00% (12/25), 5.65% (14/248) VS 57.14% (4/7), χ2=58.766, P<0.001]. The results of multivariate analysis showed that the larger lesions ( P=0.004, OR=0.539, 95% CI: 0.354-0.822) was the risk factor for curative resection. In terms of infiltration depth, mucosal ( P=0.001, OR=51.799, 95% CI: 5.535-84.768) and submucosal 1 ( P<0.001, OR=29.301, 95% CI: 24.694-73.972) were protective factors for curative resection compared with submucosal 2. In terms of differentiation degree, compared with mixed type, differentiated type ( P=0.024, OR=3.947, 95% CI: 1.195-13.032) was the protective factor for curative resection, while undifferentiated type ( P=0.443, OR=0.424, 95% CI: 0.048-3.788) showed no difference between curative resection and mixed type. During the follow-up, 7 patients died. The overall survival time was 114.42±0.97 months, and the 5-year survival rate was 97.10%. There was no significant difference in the survival rate of early gastric cancer patients with different degrees of differentiation ( χ2=0.434, P=0.805). The survival rate of early gastric cancer patients with or without curative resection was significantly different ( χ2=4.081, P=0.043). Conclusion:Mixed early gastric cancer patients show high margin positive rate, vascular infiltration, and less curative resection than differentiated early gastric cancer. Therefore, the process of treating mixed early gastric cancer should be more rigorous. The long-term survival prognosis of early gastric cancer after ESD treatment is promising.

Measuring eye movement is a fundamental approach in cognitive science as it provides a variety of insightful parameters that reflect brain states such as visual attention and emotions. Combining eye-tracking with multimodal neural recordings or manipulation techniques is beneficial for understanding the neural substrates of cognitive function. Many commercially-available and custom-built systems have been widely applied to awake, head-fixed small animals. However, the existing eye-tracking systems used in freely-moving animals are still limited in terms of their compatibility with other devices and of the algorithm used to detect eye movements. Here, we report a novel system that integrates a general-purpose, easily compatible eye-tracking hardware with a robust eye feature-detection algorithm. With ultra-light hardware and a detachable design, the system allows for more implants to be added to the animal's exposed head and has a precise synchronization module to coordinate with other neural implants. Moreover, we systematically compared the performance of existing commonly-used pupil-detection approaches, and demonstrated that the proposed adaptive pupil feature-detection algorithm allows the analysis of more complex and dynamic eye-tracking data in free-moving animals. Synchronized eye-tracking and electroencephalogram recordings, as well as algorithm validation under five noise conditions, suggested that our system is flexibly adaptable and can be combined with a wide range of neural manipulation and recording technologies.

OBJECTIVETo explore the feasibility, safety and efficacy of intraoperative regional infusion chemotherapy by celiac trunk in advanced gastric cancer patients.

METHODSOne hundred and twenty-six patients with advanced gastric cancer(stageII(-III() were screened from database of Gastrointestinal Surgery Department of Taizhou People's Hospital between January 2008 and December 2010 who underwent R0 resection and D2 lymphadenectomy, received postoperative chemotherapy(XELOX or FOLFOX), and had complete follow-up data. They were divided into infusion chemotherapy group (65 cases) and control group (61 cases) according to regional infusion chemotherapy or not (fluorine 1 000 mg and cisplatin 60 mg). The side effects of chemotherapy, parameters related to the operation, long-term survival and relapse rate were compared between the two groups.

RESULTSThe baseline data between the two groups were comparable(all P>0.05). Postoperative III( and IIII( adverse reaction of chemotherapy was not significantly different between the two groups (P>0.05). The time of postoperative intestinal function recovery [(67.9±14.8) hours vs. (68.9±15.0) hours, t=-0.380, P=0.705), volume of postoperative 1-week drainage [(66.1±17.1) ml vs.(61.9±18.2) ml, t=1.478, P=0.142], recent morbidity of complications[55.4%(36/65) vs. 49.2%(30/61), χ=0.256, P=0.613], and the long-term morbidity of complications [16.9% (11/65) vs. 14.8% (9/61), χ=0.111, P=0.739] were all not significantly different between the two groups. The 3-year survival rate and 3-year relapse-free survival rate in infusion chemotherapy group were significantly higher than those in control group(58.4% vs. 37.7%, χ=5.382, P=0.020; 58.4% vs. 34.4%, χ=6.636, P=0.010).

CONCLUSIONRegional infusion chemotherapy by celiac trunk during operation for advanced gastric cancer patients is safe and feasible, and can reduce the risk of local recurrence and improve survival rate.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Celiac Artery ; Chemotherapy, Cancer, Regional Perfusion ; adverse effects ; methods ; mortality ; Cisplatin ; administration & dosage ; adverse effects ; therapeutic use ; Deoxycytidine ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Fluorine ; administration & dosage ; adverse effects ; therapeutic use ; Fluorouracil ; analogs & derivatives ; therapeutic use ; Gastrectomy ; Humans ; Leucovorin ; therapeutic use ; Lymph Node Excision ; Neoplasm Recurrence, Local ; prevention & control ; Organoplatinum Compounds ; therapeutic use ; Postoperative Complications ; Recovery of Function ; Stomach Neoplasms ; drug therapy ; mortality ; surgery ; Survival Rate

Objective To investigate the relations between microRNA-451 (miR-451) expression and gastric cancer (GC).Methods Expression of miR-451 in tumor and paired non-cancerous tissues was measured by real-time quantitative polymerase chain reaction.The association of miR-451 expression with clinical pathological characteristics and prognosis was statistically analyzed;in addition,slow virus LV-mir-451 was applied to infect human gastric cancer cell line BGC-823 and MKN-45,and construct miR-451 over-expressed stable cell lines.Finally,to detect cell proliferation,migration and invasion.Results miR-451 expression decreased in GC tissues vs.pericarcinous tissues (0.010 ± 0.007 vs.0.014 ± 0.008,t =3.015,P ＜ 0.05),and its down-regulation positively correlated with lymphatic metastasis,clinical staging and shorter overall survival.miR-451 expression in BGC-823 and MKN-45 cells did not impact on cell proliferation,but did reduce migration rates (0.863 ±0.026 vs.1.107 ±0.032,t =9.820,P＜0.05;0.863 ±0.026 vs.1.060±0.054,t =4.369,P＜0.05) and invasion rates (1.040 ± 0.055 vs.1.522 ± 0.001,t =5.84,P ＜ 0.05;1.040 ± 0.055 vs.1.696 ± 0.078,t =10.16,P ＜ 0.05) in BGC-823 cells.Conclusions miR-451 may act as a prognostic marker in GC.

Background and objective hTe curative effect of radiotherapy may be limited by the radioresistance of tumor. Mimetic compounds of Second mitochondria-derived activator of caspase (Smac) were hopeful to become new drugs of radiosensitization for tumor because they can increase radiation induced apoptosis in tumor cells. hTe aim of present study is to observe the radiosensitization effect of a new Smac mimetic ANTP-SmacN7 fusion peptide in H460 cell line.Methods In order to observe if the fusion peptide can enter into tumor cell, ANTP-SmacN7 fusion peptide was synthesized and linked by FITC. H460 cell was divided into control, radiation only, ANTP-SmacN7 only and ANTP-SmacN7 combined with radia-tion group. hTe cells were exposed by 0, 2, 4 and 6 Gy and the concentration of ANTP-SmacN7 was 20 μmol/L. Proliferation of H460 tumor cell was detected by WST-1 assay. hTere are four groups in the present study: control group, radiation group, ANTP-SmacN7 group and ANTP-SmacN7 combined with radiation group. Apoptosis was detected by lfow cytometry at 24 and 48 hours atfer the treatment of all the groups. hTe level of caspase3 and cleaved caspase3 were detected by Western blot as-say.Results ANTP-SmacN7 can enter into cells and promote the radiosensitization of H460 cell obviously (F=25.1,P<0.01, sensitivity enhancement ratio was 1.86). The treatment of ANTP-SmacN7 combined with radiation decreased the cloning forming effciency (χ2=45.2,P<0.01; χ2=40.3,P<0.01), activated caspase3 by promoting the expression of cleaved caspase3 and increased the apoptosis of H460 cell line.ConclusionANTP-SmacN7 fusion peptide had remarkably radiosensitization effect on H460 cell line. ANTP-SmacN7 fusion peptide might be hopeful to be applied in radiosensitization therapy as a new Smac mimetic polypeptide in the future.

Objective CD8 +T cells increased in the airway of patients with chronic obstructive pulmonary disease and exis -ted constantly .The aim was to investigate the role of CD 8 +T-cells in rats with chronic bronchitis ( CB) which was induced by cigarette smoking and intratracheal injection with lipopolysaccharide ( LPS) . Methods 18 health Wistar rats were radomly divided into sham smoking group(group A), CB group(group B) and N-acetylcysteine prevention group (group C).The rats in group B and group C re-ceived intratracheal injection with LPS twice and exposed to cigarette smoking for 4 weeks to induce CB model .The rats in Group C re-ceiving intragastric administration with N-acetylcysteine (NAC)(200mg/kg) before received LPS and smoking.Group A was the sham smoking group.The lung tissue of all rats were stained by HE then evaluated about pathological scores .The expression of nuclear fac-tor-κB (NF-κB), major histocompatibility complex class I (MHCI), CD8 +T cell and Vascular endothelial growth factor (VEGF) in airway were detected by immunohistochemisty which was stained by labeled streptavidin biotin method . Results The pathological scores of airway ( 10 .83 ±3 .31 ) in group B were higher than (1.17 ±2.40) in group A(P <0.05).The pathological scores of airway(4.66 ±2.25) in group C were less than (10.83 ±3.31) in group B(P <0.05).The expression of NF-κB(4.84), MHC I (2.48),CD8 +T cell(5.35)and VEGF(5.02) in airway increased in group B when compared with (1.18, 1.25, 1.33) and (1.18) in group A respectively(P <0.05).The expression of NF-κB (2.18), MHC I(1.46),CD8 +(2.35)and VEGF(2.02) in airway decreased in group C when compared with (4.84), MHC I(2.48),CD8 +T cell(5.35)and VEGF(5.02) in group B respectively (P<0.05 ). There were positive correlations between the expression of NF-κB, MHC I and CD8 +T cells in airways(r=0.670, r=0.701, respec-tively, all P<0.01).There were positive correlations between the expression of CD 8 +T cells and VEGF the pathological scores of air-ways(r=0.689, r=0.782, respectively, all P<0.01). Conclusion NAC can inhibit airway inflammation which is regulated by CD8 +T-cells and VEGF through suppressing the expression of NF -κB and MHC I.

A 36-year-old male underwent local resection of hemangioma of liver under general anesthesia. Physical examination showed the following results:body temperature was 36. 0 ℃,heart rate 71 beats/min,breathing rate 14 breathes/min,blood pressure 120/82 mmHg. The patient received induced anesthesia with 1. 5% halothane. And then received intravenous administration of midazolam,esmolol, propofol,remifentanil,suxamethonium chloride,and vecuronium bromide,successively. The patient's hepatic hemangioma was resected smoothly. He developed high fever(40℃),his heart rate was 140 beats/min,blood pressure 96/52 mmHg 90 minutes later. The anaesthetist considered as malignant hyperthermia due to halothane combined succinylcholine chloride. Halothane was withdrawn immediately. He underwent comprehensive treatments immediately,including physical cooling;correcting acidosis,hyperkalemia,and arrhythmia;elevating blood pressure;diuresis,protection of renal function,and synchronous direct current cardioversion. The patient developed ventricular tachycardia, arrhythmia, cardiac arrest, and high temperature( >42 ℃),successively during the treatment. Finally,the patient died despite resuscitation attempts about 3 hours after malignant hyperthermia occurred.

A 36-year-old male underwent local resection of hemangioma of liver under general anesthesia. Physical examination showed the following results:body temperature was 36. 0 ℃,heart rate 71 beats/min,breathing rate 14 breathes/min,blood pressure 120/82 mmHg. The patient received induced anesthesia with 1. 5% halothane. And then received intravenous administration of midazolam,esmolol, propofol,remifentanil,suxamethonium chloride,and vecuronium bromide,successively. The patient's hepatic hemangioma was resected smoothly. He developed high fever(40℃),his heart rate was 140 beats/min,blood pressure 96/52 mmHg 90 minutes later. The anaesthetist considered as malignant hyperthermia due to halothane combined succinylcholine chloride. Halothane was withdrawn immediately. He underwent comprehensive treatments immediately,including physical cooling;correcting acidosis,hyperkalemia,and arrhythmia;elevating blood pressure;diuresis,protection of renal function,and synchronous direct current cardioversion. The patient developed ventricular tachycardia, arrhythmia, cardiac arrest, and high temperature( >42 ℃),successively during the treatment. Finally,the patient died despite resuscitation attempts about 3 hours after malignant hyperthermia occurred.

Objective To investigate the relation between lesions of medullary infarction and clinical symptoms and signs.Methods Eleven patients with medullary infarction confirmed by MRI were identified.Their clinical presentations and the relation between clinical presentation and location of lesion in MRI were assessed and analyzed.Results Among the 11 patients,5 cases suffered from lateral medullary infarction,6 medial medullary infarction(including two cases of bilateral infarction).Regarding clinical symptoms,common symptoms in lateral medullary infarction are blurred speech,dizziness,choking water,swallowing difficulties and facial numbness;in medial medullary infarction are limb weakness and blurred speech.The common signs of lateral medullary infarction are dysarthria,sensory disturbance,Horner sign and facial paralysis;in medial medullary infarction are paralysis of limbs and peripheral paralysis of the tongue.Conclusion Clinical manifestations are vailed depending on the sites of medullary infarction.MRI is helpful in diagnosing of medullary infarction.